Background: Preterm birth is a common cause of death in newborns and may result from many determinants, but evidence for the socioeconomic and environmental determinants of preterm birth in Tibetan women of childbearing age is limited. The aim of this study was to understand the current status of preterm birth in native Tibetan women and investigate the socioeconomic and environmental determinants. Methods: Data were drawn from a cohort study which was conducted from August 2006 to August 2012 in rural Lhasa, Tibet, China. A total of 1419 Tibetan pregnant women were followed from 20 weeks' gestation until delivery; the loss to follow?up rate was 4.69%. The incidence of preterm birth was estimated to show the status of preterm births in Tibet. Logistic regression models for longitudinal data were established, and odds ratios (ORs) together with 95% confidence intervals (CIs) were used to evaluate the association between the occurrence of preterm birth and 16 selected potential determinants based on the hierarchical conceptual frame. Results: The incidence of preterm birth was 4.58% (95% CI = 3.55–5.80%). After adjusting for health?related variables of the mothers and newborns, socioeconomic and environmental determinants associated with preterm birth included season (spring: OR = 0.28, 95%CI = 0.09–0.84; autumn: OR = 0.21, 95% CI = 0.06–0.69; and winter: OR = 0.31, 95% CI = 0.12–0.82) and calendar year of delivery (2010: OR = 5.03, 95% CI = 1.24–20.35; 2009: OR = 6.62, 95% CI = 1.75–25.10; and 2007–2008: OR = 5.93, 95% CI = 1.47–23.90). Conclusions: The incidence of preterm birth among native Tibetan women was low and there was a decreasing trend in recent years;however, it is still essential to strengthen seasonal maternal care, extend the spacing between pregnancies, and reinforce adequate maternal nutrition.

Objective To investigate the effects of elemene combined with chemotherapy on S100A4 and MMP-9 protein expression in Lewis lung carcinoma mice and to explore the possible mechanism. Methods Twenty-four mice inoculated with Lewis cells were randomly divided into 4 groups,including lung carcinoma model group,chemotherapy group,elemene group,and combination group,6 mice in each group. On day 11 after inoculation, the mice in chemotherapy group were given intraperitoneal injection of etoposide (3 mg·kg-1·d-1)and cisplatin (3 mg·kg-1·d-1),the mice in elemene group were given intraperitoneal injection of elemene (100 mg·kg-1·d-1), the mice in the combination group were given intraperitoneal injection of elemene (100 mg·kg-1·d-1),etoposide (3 mg·kg-1·d-1),and cisplatin (3 mg·kg-1·d-1). After 7-day continuous treatment,the tumor body mass, spleen index, thoracic gland index, growth-inhibition rate, and metastasis-inhibition rate in various groups were measured,the contents of protein S100A4 and matrix metalloproteinase 9 (MMP-9)in tumor tissues were determined by enzyme-linked immunosorbent assay (ELISA),and the protein expression levels of S100A4 and MMP-9 were detected by immunohistochemical staining. Results In the combination group, the growth-inhibition rate and the inhibitory rate of metastases were increased obviously, the spleen index and thoracic gland index were also increased, the contents of S100A4 and MMP-9 were decreased, and the protein expression rates of S100A4 and MMP-9 were reduced(P < 0.05 or P < 0.01 compared with the chemotherapy group). Conclusion Elemene combined with chemotherapy could inhibit the Lewis lung carcinoma growth and metastasis in mice, and the possible mechanism might be associated with the decrease of S100A4 and MMP-9 protein expression in the tumor tissues.

Objective: To assess the anti-inflammatory efficacy of ferruginol on dextran sulfate sodium (DSS) stimulated ulcerative colitis mice. Methods: Ulcerative colitis was induced in C57BL/6J mice by administering 2% of DSS through drinking water for 7 d. The mice in the treatment group were treated with DAA+50 mg/kg/day ferruginol orally. In the positive control group, sulfasalazine (50 mg/kg/day) was used alongside with DSS. After induction, the bodyweight, character of stool and feces occult blood were recorded daily, the disease activity index was calculated, and the colon length, colon weight, and spleen weight were recorded. The myeloperoxidase activity was assayed by spectrophotometry. Interleukin (IL)-6, IL-1β, and tumor necrosis factor-a were determined by ELISA method, and nuclear factor-κB, cyclooxygenase-2, matrix metalloproteinases-9, and inducible nitric oxide synthase by Western blotting assays. Results: Ferruginol significantly increased the bodyweight, colon weight, colon length, and decreased disease activity index and spleen weight. It exhibited anti-inflammatory activity against DSS induced ulcerative colitis in mice by reducing the activities of myeloperoxidase, tumor necrosis factor-α, nuclear factor-κβ, IL-1β, cyclooxygenase-2, matrix metalloproteinases-9, IL-6, and inducible nitric oxide synthase. Conclusions: Ferruginol could be used to treat ulcerative colitis by attenuating the inflammation in colon cells and maintaining colonic mucosal barrier integrity.

Objective To observe the clinical effects and safety of dapagliflozin combined with metformin in the treatment of elderly patients with type 2 diabetes mellitus(T2DM)complicated with nonalcoholic fatty liver disease(NAFLD).Methods The clinical data of enrolled elderly patients with T2DM and NAFLD were analyzed.They were divided into the treatment group and the control group according to cohort method.The treatment group was treated with oral dapagliflozin tablets(10 mg,qd)combined with metformin(500 mg,tid).The control group was treated with oral sitagliptin tablets(100 mg,qd)combined with metformin(500 mg,tid).All patients underwent 12 weeks of treatment.The two groups were compared on clinical efficacy,body mass index(BMI),waist hip ratio(WHR),visceral fat area,liver spleen density ratio,liver stiffness measurement(LSM),glucose and lipid metabolism,liver function indicators,and the occurrence of adverse drug reactions.Results There were 42 cases in control group,58 case in treatment group.After treatment,the total effective rates in the treatment group and the control group were 84.48％(49 cases/58 cases)and 66.67％(28 cases/42 cases);BMI were(24.28±2.52)and(25.73±2.06)kg·m-2;WHR were 0.71±0.13 and 0.80±0.16;visceral fat areas were(120.57±25.65)and(131.71±21.84)cm2;liver spleen density ratios were 0.88±0.20 and 0.79±0.18;2-hour postprandial blood glucose(2 h PG)levels were(8.77±1.65)and(11.08±2.19)mmol·L glycosylated hemoglobin(HbAlc)levels were(7.09±1.32)％and(7.68±1.26)％.The above indexes were significantly different between the treatment group and the control group(all P＜0.05).The total incidence rates of adverse reactions in the treatment group and the control group were 31.03％(18 cases/58 cases)and 11.90％(5 cases/42 cases),with statistically significant difference between the two groups(P＜0.05).Conclusion The treatment of dapagliflozin combined with metformin in elderly patients with T2DM and NAFLD has a significant clinical effect,which can improve lipid metabolism and liver function.

Objective To observe the effect of sacubitril valsartan combined with dapagliflozin on cardiac function and blood glucose fluctuation in elderly patients with chronic heart failure(CHF)and type 2 diabetes mellitus(T2DM).Methods The elderly patients with CHF and T2DM were divided into treatment group and control group.Patients in the control group were given irbesartan tablets,150 mg each time,metoprolol sustained-release tablets,qd,with an initial dose of 23.75 mg,and the dose was increased to 47.5 mg after 2 weeks,and dapagliflozin tablets was taken in the morning,qd,5 mg each time.If the patient was well tolerated,the dose was increased to 10 mg each time.The treatment group was given dapagliflozin tablets,qd,5 mg each time,and the dose was increased to 10 mg each time if the patient was well tolerated.At the same time,sacubitril valsartan sodium tablets was given,bid,50 mg each time.If the patient was well tolerated,the dose should be doubled every 2-4 weeks,not exceeding 200 mg each time.The two groups were treated for 6 months.The cardiac function,blood glucose fluctuation,drug safety and prognosis were compared between the two groups.Results Forty-seven cases and forty-nine cases were included in the treatment and control group,respectively.After treatment,the total effective rates in the treatment and control group were 93.62％(44 cases/47 cases)and 79.59％(39 cases/49 cases),and there were significant differences(P＜0.05).After treatment,left ventricular ejection fraction(LVEF)in the treatment group group and the control group were(55.34±8.22)and(46.59±6.80)％;cardiac indexes(CI)were(2.54±0.41)and(2.37±0.39)L·min-1·m-2;postprandial glucose excursions(PGE)were(1.45±0.31)and(1.86±0.46)mmol·L-1;the largest amplitudes of glycemic excursions(LAGE)were(3.42±1.05)and(4.47±1.39)mmol·L-1;the incidence rates of major cardiovascular adverse events(MACE)were 4.26％(2 cases/47 cases)and 2.13％(1 cases/47 cases);readmission rates were 18.37％(9 cases/49 cases)and 14.29％(7 cases/49 cases).There were statistically significant differences in the above indexes between the treatment group and the control group.(all P＜0.05).The adverse drug reactions in the treatment group were urinary tract infection and hypotension,and the adverse drug reactions in the control group were urinary tract infection and angioedema,and the total adverse drug reaction rate of the two groups was 6.38％(3 cases/47 cases)and 4.08％(2 cases/49 cases),and there was no statistical significance(P＞0.05).Conclusion The combined treatment of sacubitril valsartan sodium tablets and dapagliflozin tablets can improve cardiac function,reduce blood glucose fluctuation,increase the total effective rate,and improve the prognosis of elderly patients with CHF and T2DM,with good drug safety.

Objective: To observe the effect of Shaoyaotang on mRNA and protein expressions of colon tissue activated protein-1 (AP-1) and tumor necrosis factor-α (TNF-α) of hot and humid-type intrinsic ulcerative colitis (UC) model in rats, in order to explore the mechanism of action of herbaceous peony decoction in the treatment of UC. Method: Totally 60 Wistar rats were randomly divided into blank group, model group, SASP group, and low, medium and high-dose Shaoyaotang groups. The damp-heat intrinsic UC rat model was replicated based on integrated disease and syndrome, namely, high-fat and high-sugar spicy food and immune complex method combined with 2,4,6-trinitrobenzene sulfolnic acid (TNBS) and ethanol complex method. After the successful modeling, low, medium and high-dose Shaoyaotang (6, 12, 24 g·kg^-1) was given by gavage, and 1 g·kg^-1 dose of salazol sulfadiazine was given to by gavage. The blank group was given constant volume normal saline for 21 d. Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR) was used to detect mRNA expressions of AP-1 and TNF-α in colon tissues, and Western blot was used to detect protein expressions of AP-1 and TNF-α in colon tissues. Result: Compared with the blank group, relative mRNA and protein expressions of AP-1, TNF-α in the model group were significantly increased (P<0.05). Compared with the model group, mRNA and protein expressions of AP-1, TNF-α in the treatment groups were significantly decreased (P<0.05). Conclusion: Shaoyaotang can inhibit the expression of TNF-α and stimulate AP-1 protein expression in rats with damp-heat UC.

This report presents the endemic status of schistosomiasis in the People's Republic of China at national level in 2016,and analyzes the data collected from the national schistosomiasis prevention and control system and 454 national schisto-somiasis surveillance sites. Among the 12 provinces(municipality and autonomous region)of endemic of schistosomiasis japoni-ca in P. R. China,5 provinces (municipality and autonomous region),i. e.,Shanghai,Zhejiang,Fujian,Guangdong and Guangxi,had achieved elimination,and 7 provinces of Sichuan,Yunnan,Jiangsu,Hubei,Anhui,Jiangxi and Hunan had achieved transmission control by the end of 2016. There are 451 endemic counties(cities,districts)covering 257 million peo-ple,specifically including 29692 endemic villages of 69.39 million people at risk. Among the 451 endemic counties(cities,dis-tricts),35.25％(159/451),42.35％(191/451)and 22.39％(101/451)reached the criteria of elimination,transmission inter-ruption and transmission control,respectively in 2016. By the end of 2016,it was estimated of 54454 infections of schistosome, decreased by 29.46％compared with 77194 in 2015. No acute schistosomiasis case was reported in 2016. There were 30573 ad-vanced schistosomiasis cases documented in 2016. A total of 8500710 individuals received schistosomiasis examinations and 600 individuals were parasitologically diagnosed,decreased by 83.36％compared with 3606 in 2015. The Oncomelania hupen-sis snail survey was performed in 22140 endemic villages and O. hupensis snails were found in 7106 villages,accounting for 32.109％of the total villages,with 20 newly detected villages with snails. The snail survey covered area of 813963.91 hm2 and snails were found in an area of 235096.04 hm2,including a newly detected area of 1346.48 hm2. No schistosome-infected snails were found in 2016. A total of 881050 bovines were raised in the schistosomiasis endemic area. Of them,510468 bovines re-ceived examinations,resulting in 8 schistosome-infected bovines. There were 147642 schistosomiasis cases receiving drug treat-ment in 2016,with 2303555 individuals undergoing expanded chemotherapy;there were 9 bovines with schistosomiasis receiv-ing drug treatment,with 439857 bovines undergoing expanded chemotherapy;a total of 139483.84 hm2 area with snail control by using molluscicides,with actual molluscicide-treated area of 73941.75 hm2;and 3101.52 hm2 snail habitants were treated by environmental modification. Based on the data from the 454 national schistosomiasis surveillance sites,the mean Schistosoma japonicum infection rate was 0.02％ and 0.0078％ in humans and bovines,respectively. No schistosome-infected snails were found in all the surveillance sites. The results demonstrate a decline in the endemicity of schistosomiasis in P. R. China com-pared with the level of 2015. However,the distribution area of snails in China is still large and the infection source of schistoso-miasis still exists to some extent in some endemic areas;in some regions,the task to reach the standard of transmission interrup-tion is still arduous. There are still objective factors of epidemic and transmission and risk factors of endemic reversal and re-bound for schistosomiasis. So,further control and effective surveillance as well as accurate prevention and control should be im-plemented to promote the elimination process on schistosomiasis in P. R. China.

Objective:To explore the mechanism of Shaoyaotang in the treatment of ulcerative colitis (UC) based on toll-like receptor 4 (TLR4)/nuclear factor kappaB (NF-κB) signaling pathway. Method:A total of 50 Wistar rats were selected, including half male and half female. The damp-heat UC rat model was replicated by the methods of the combination of diseases and syndromes and the combination of 2, 4, 6-nitrobenzene sulfonic acid (TNBS) and ethanol. After the successful modeling, the model rats were randomly divided into model group, salazulesulfonate group, and low, medium and high-dose Shaoyaotang groups, and 10 rats (half male and half female) were selected as the blank control group. Low, medium and high-dose Shaoyaotang groups were given 6, 12, 24 g·kg^-1 by gavage, and salazonyl arsenic group was given 1 g·kg^-1 by gavage. Blank control group was given the equal volume of normal saline for 21 consecutive days. Colon samples were collected after the last administration, and the expressions of TLR4, NF-κB p65 and IL-6 mRNA in colon tissues were detected by fluorescent quantitative polymerase chain reaction (Real-time PCR）, and the expressions of TLR4, NF-κB p65 and IL-6 protein in colon tissues were detected by Western blot. Result:Compared with the blank control group, the relative expressions of TLR4, NF-κB p65, IL-6 mRNA and protein in the model group were significantly increased (P<0.05). Compared with the model group, the expression levels of TLR4, NF-κB p65 and IL-6 mRNA and protein in the salazopyridine group and Shaoyaotang groups were significantly decreased (P<0.05). Conclusion:Shaoyaotang can inhibit the development of UC by regulating the expressions of TLR4, NF-κB p65 and IL-6 mRNA and proteins in the TLR4/NF-κB pathway.