Objective To explore the mediating role of activities of daily living (ADL) in pain and depressive symptoms in the elderly in China. Methods Utilizing the data from 2020 China Health and Retirement Longitudinal Study, 4403 Chinese elderly individuals aged ≥ 60 years old were selected as the research subjects. Depression Scale (CES-D 10) of the Center for Epidemiological Survey and ADL scale were used in the study. The PROCESS4.1 macro was used to test the mediating effect of daily living activities between pain and depressive symptoms, and the Bootstrap method was applied for verification of the mediating variables. Results A total of 2368 cases of depressive symptoms were detected in the elderly in China, with a detection rate of 53.78%. Pain was positively correlated with depressive symptoms (r=0.27, P<0.01), and activities of daily living were negatively correlated with pain and depressive symptoms (r=-0.27, -0.337, P<0.01). The results showed that the total effect value of pain on depressive symptoms was 0.33, the direct effect value was 0.24, and the mediating effect value of daily living activities was 0.09, accounting for 27.27%. Conclusion Pain and activities of daily living are important factors influencing depressive symptoms in the elderly, and activities of daily living play a partial mediating role in the relationship between pain and depressive symptoms in the elderly.

Objective　To explore the mediating role of cognitive function in the association between literacy level and depressive symptoms in middle-aged and elderly people in China. Methods　 Using the fourth national follow-up data of the China Health and Elderly Care Tracking Survey 2018, 8 124 middle-aged and elderly people aged 45 years and above were included as the study subjects. The PROCESS 4.0 program was used to test the mediating effect of cognitive function between literacy level and depressive symptoms, and the Bootstrap method was used for the mediator variable validation. Results The detection rate of depressive symptoms among middle-aged and elderly people in China was 38.10%. After controlling for gender, place of residence, marital status, smoking, alcohol consumption, and exercise, literacy level was a negative predictor of depressive symptoms in middle-aged and elderly people (β =－0.480, t =－11.248, P<0.001). Cognitive function accounted for 58.75% of the amount of mediating effect between literacy level and depressive symptoms. Conclusion 　Literacy level and cognitive function are associated with depressive symptoms in middle-aged and elderly people. Literacy level can influence depressive symptoms directly or indirectly through the mediation of cognitive dysfunction.

Objective To investigate the changing trend and epidemiological characteristics of the incidence and mortality of chronic kidney disease (CKD) with age, period and birth cohort in Chinese population. Methods Based on the data of incidence and mortality of CKD in Chinese population aged 20-80 years from 1990 to 2019 in GHDx database, joinpoint regression model was used to analyze the incidence and mortality trend of CKD. An age-period-cohort model was constructed to analyze the effects of age, period, and birth cohort on the trend of CKD incidence and mortality. Results Joinpoint regression analysis showed that the standardized incidence rate of chronic kidney disease in Chinese population increased from 146.37/100 000 in 1990 to 161.52/100 000 in 2019, while the standardized mortality rate decreased from 12.98/100 000 in 1990 to 11.23/100 000 in 2019. The APC model analysis showed that the risk of CKD incidence and death in the Chinese population increased with age, while the risk of CKD incidence increased with the increase of period. The risk of death did not change significantly with the increase of period. The cohort born later had a lower risk of CKD incidence and death compared to the cohort born earlier. Conclusion At present, the age effect and period effect of the incidence and death risk of chronic kidney disease in China are dominant. It is important to take effective measures and intervene in a timely manner, especially to strengthen the protection of older high-risk groups born earlier.

This article reported a case of neurodevelopmental disorder accompanied by spastic diplegia and visual impairment with the manifestation of small fetal head circumference. Prenatal ultrasonography performed at 33 +5 weeks of pregnancy revealed small fetal head circumference (-2.61SD) and oligohydramnios. Whole-exome sequencing identified a heterozygous frameshift variation of c.1623_1624insA (p.R542Tfs*30) in the CTNNB1 gene (NM_001904.4) of the fetus. No phenotypic abnormalities or corresponding gene variations were detected in the parents, suggesting it was a de novo variation. Based on the clinical manifestations, the fetus was diagnosed with a neurodevelopmental disorder accompanied by spastic diplegia and visual defects. Following genetic counseling, the pregnant woman chose to terminate the pregnancy.

Objective:To investigate the efficacy and safety of immune checkpoint inhibitors (ICI), programmed death receptor 1 (PD-1) inhibitors and programmed death receptor-ligand 1 (PD-L1) inhibitors in the treatment of extensive-stage small cell lung cancer (ES-SCLC).Methods:The databases of CNKI, Wanfang, VIP, China Biology Medicine disc, PubMed, Embase, and Cochrane Clinical Controlled Trial Center Registry (CENTRAL) were retrieved, and the randomized controlled trial literature on the treatment of ES-SCLC with immune checkpoint inhibitors published from the establishment of the database until October 4, 2023 were reviewed. After screening literature and extracting data according to inclusion and exclusion criteria, the risk of bias in the study was evaluated using Review Manager 5.4 software. The disease remission, prognosis and adverse events (AE) of patients treated with ICI combined with chemotherapy (experimental group) and placebo± chemotherapy (control group) in the whole group and liver metastases and brain metastases subgroups were compared.Results:A total of 11 randomized controlled trials were included, with 2 243 cases in the experimental group and 2 059 cases in the control group. The included research data were complete and showed no selective bias. Compared with the control group, the objective response rate (ORR) of patients in the experimental group was higher [control group vs. experimental group, 64% (864/1 358) vs. 70% (1 088/1 532), RR = 1.08 (95% CI: 1.03-1.14), P = 0.003], and the difference was statistically significant; progression free survival (PFS) [experimental group vs. control group, the median PFS time, 5.14 months (95% CI: 4.88-5.40 months) vs. 4.76 months (95% CI: 4.70-4.82 months), HR = 0.72 (95% CI: 0.67-0.78), P < 0.001] and overall survival (OS) [experimental group vs. control group, the median OS time, 12.89 months (95% CI: 12.18-13.60 months) vs. 10.41 months (95% CI: 10.03-10.79 months), HR = 0.72 (95% CI: 0.67-0.78), P < 0.001] were all improved, and the differences were statistically significant. The OS of patients with baseline liver metastasis in the experimental group was better than that in the control group (experimental group vs. control group, HR = 0.82 (95% CI: 0.71-0.95), P = 0.009], and the difference was statistically significant, while the difference in OS of patients with baseline brain metastases was not statistically significant between the experimental group and the control group [experimental group vs. control group, HR = 0.84 (95% CI: 0.66-1.08), P = 0.170]. The incidence of AE [experimental group vs. control group, 31% (597/1 952) (95% CI: 24%-37%) vs. 14% (255/1 762) (95% CI: 9%-22%), RR = 2.25 (95% CI: 1.67-3.02), P < 0.001] and the incidence of drug discontinuation or dose change caused by AE [experimental group vs. control group, 21% (379/1 774) (95% CI: 12%-41%) vs. 19% (307/1 588) (95% CI: 6%-25%), RR = 1.20 (95% CI: 1.07-1.33), P = 0.001] in the experimental group were higher than those in the control group, and the differences were statistically significant. However, the incidence of severe (≥grade 3) AE in both the experimental group and the control group was 34% (620/1 814, 557/1 632) (both 95% CI: 32%-36%), and the difference was not statistically significant [experimental group vs. control group, RR = 1.00 (95% CI: 0.91-1.10), P = 0.960]. The incidence of hypothyroidism [experimental group vs. control group, 11% (118/1 083) (95% CI: 9%-13%) vs. 1% (11/886) (95% CI: 0-2%), RR = 8.56 (95% CI: 4.63-15.80), P < 0.001] and the incidence of hyperthyroidism [experimental group vs. control group, 7% (75/1 083) (95% CI: 5%-8%) vs. 2% (17/886) (95% CI: 1%-4%), RR = 3.27 (95% CI: 1.95-5.46), P < 0.001] in the experimental group were both higher than those in the control group, and the differences were statistically significant. Conclusions:ICI combined with chemotherapy can effectively improve the OS, PFS and disease remission of patients with ES-SCLC, as well as improve the survival of patients with liver metastases. However, there is no benefit in the survival of patients with brain metastases. The incidence of immune-mediated AE to ICI combined with chemotherapy has increased, but the overall safety is good.

Strain variability is one of the most important factors to influence the accuracy of foodborne pathogens risk assessment, such as Listeria monocytogenes, Salmonella spp. Strain-to-strain variation is defined as the inherent differences among identically treated strains of the same microbial species. The differences cannot be eliminated by changing test methods or improving test protocols. This review addresses presently related studies of strain variability. Based on the effect of strain variability on the outcome of risk assessment, we summarize sources of variabilities in food chain, strain phenotypic variabilities and the methods to integrate strain variability in growth and inactivation into predictive modelling, and indicate the inadequacies in the study of strain variability. We suggest further study the mechanism of strain variability, expand the comparison of variability among different sources, and integrate the variability of gene expression, protein and cell metabolism into the predictive modelling.
Food Microbiology ; Listeria monocytogenes/genetics* ; Risk Assessment ; Salmonella/genetics*

Objective To observe the clinical effect of Yanshu compound radix sophore injection combined with radiotherapy in treatment of patients with bone metastases from lung cancer. Methods A total of 116 patients with bone metastases from lung cancer admitted to the Department of Radiation Oncology of Gansu Provincial Cancer Hospital from January 2014 to December 2018 were selected. The 58 patients were treated by using three-dimensional conformal radiotherapy (3D-CRT), zoledronic acid and oxycodone sustained-release tablets (control group); the others 58 patients were treated radix sphore injection on basis of control group (integrated Chinese and western medicine). The two groups were treated continuously for 10 days as 1 course of treatment, taking a rest for one week in the middle, then they took the second course of treatment; after the end of 2 courses, the therapeutic effects were evaluated in the two groups. The pain grading, Karnofsky functional status (KPS) score and myelosuppression were observed before and after treatment in two groups, respectively. Results The proportions of patients with painless and mild pain after treatment in the integrated Chinese and western medicine group were significantly lower than those in control group [painless: 22.41% (13/58) vs. 39.66% (23/58), mild pain: 10.35% (6/58) vs. 46.55% (27/58)], while the proportions of patients with moderate pain and severe pain in the integrated Chinese and western medicine group were significantly higher than those of the control group [moderate pain: 53.45(31/58) vs. 12.07% (7/58), severe pain: 13.79% (8/58) vs 1.72% (1/58), both P < 0.05]. After treatment, the proportion of patients with improved KPS score in integrated Chinese and western medicine group was significantly higher than that in control group [55.17% (32/58) vs. 36.21% (21/58), P < 0.05], and the proportion of patients with stable and decreased KPS score were less than that of control group [stable KPS score:18.97%(11/58) vs. 27.59%(16/58), decreased KPS score:25.86% (15/58) vs. 36.21% (21/58)]. The proportions of patients with blood cell count (WBC), hemoglobin (Hb) and platelet count (PLT) showing no myelosuppression (at the zero degree) after treatment in integrated Chinese and western medicine group were obviously higher than those in control group [WBC: 77.59% (45/58) vs. 36.21% (21/58), Hb: 77.59% (45/58) vs. 70.69% (41/58), PLT: 58.62% (34/58) vs. 32.76% (19/58), all P < 0.05]. Conclusion Yanshu compound radix sphore injection combined with radiotherapy can reudce bone metastasis pain, reduce bone marrow suppression and improve quality of life in patients with advanced lung cancer and bone metastasis.

Objective To investigate the expression of serum Golgi protein 73 in hepatocellular carcinoma(HCC) and analyze the clinical significance.Methods The expression of GP73 was measured by ELISA in 75 HCC ,30 chronic hepatitis and normal con -trols.Results The serum concentrations of GP73 were (128.3 ±33.6)μg/L,(80.3 ±19.2)μg/L and (78.3 ±18.5)μg/L in the HCC, chronic hepatitis patients and normal controls .The serum level of GP73 was significantly higher in HCC than those with chronic hepatitis and healthy controls .GP73 expression was positively correlated with clinical stage , humor size and metastasis.The positive rate of GP73 in stage was 60%,higher than the AFP positive rate(33%).Conclusions The serum level of GP73 is high in HCC and was helpful for distinguishing benign and malignant liver diseases .GP73 can be used as a diagnostic marker for HCC .

OBJECTIVETo investigate the distribution patterns of mosquito and mosquito-borne viruses in Dehong prefecture, Yunnan province, China.

METHODSMosquito samples were collected using the mosquito traps from five counties of Dehong prefecture on July, 2007 and 2010. Mosquito were cell cultured for viral isolation, and positive isolates were identified using RT-PCR and sequence analysis.

RESULTSA total of 43 634 mosquito comprised of 29 species representing six genera were collected. Culex tritaeniorhynchus and Anopheles sinensis comprised 78.69% and 14.77% of the total. Six strains of viruses were isolated from the mosquito pools. RT-PCR and phylogenetic analysis revealed three strains from Cx. tritaeniorhynchus, identified as genotype I Japanese encephalitis virus (JEV). One strain was identified from Cx. tritaeniorhynchus, as Getah virus (GETV). Two strains isolated from Cx. tritaeniorhynchus and Anopheles vagus were identified as Culex pipiens pallens Densovirus (CppDNV).

CONCLUSIONCx. tritaeniorhynchus had been the major species of mosquito and mainly transmitting vector of mosquito-borne viruses in Dehong prefecture. Genotype I JEV, GETV and CppDNV were the vectors causing transmission of mosquito-borne diseases in this area. Data from phylogenetic analysis showed that these newly discovered isolates seemed to have had close relationship with those viruses previously circulating in Yunnan and other provinces of China.

Alphavirus ; isolation & purification ; Animals ; Arboviruses ; classification ; isolation & purification ; China ; Culicidae ; virology ; Disease Vectors ; classification ; Encephalitis Virus, Japanese ; isolation & purification

Objective To investigate the distribution patterns of mosquitoes and mosquito-borne viruses in Dehong prefecture,Yunnan province,China. Methods Mosquito samples were collected using the mosquito traps from five counties of Dehong prefecture on July,2007 and 2010. Mosquitoes were cell cultured for viral isolation,and positive isolates were identified using RT-PCR and sequence analysis. Results A total of 43 634 mosquitoes comprised of 29 species representing six genera were collected. Culex tritaeriorhynchus and Anopheles sinensis comprised 78.69% and 14.77% of the total. Six strains of viruses were isolated from the mosquito pools. RT-PCR and phylogenetic analysis revealed three strains from Cx. tritaeriorhynchus,identified as genotypeⅠJapanese encephalitis virus(JEV). One strain was identified from Cx. tritaeriorhynchus,as Getah virus (GETV). Two strains isolated from Cx. tritaeriorhynchus and Anopheles vagus were identified as Culex pipiens pallens Densovirus(CppDNV). Conclusion Cx. tritaeriorhynchus had been the major species of mosquitoes and mainly transmitting vector of mosquito-borne viruses in Dehong prefecture. GenotypeⅠJEV,GETV and CppDNV were the vectors causing transmission of mosquitoe-borne diseases in this area. Data from phylogenetic analysis showed that these newly discovered isolates seemed to have had close relationship with those viruses previously circulating in Yunnan and other provinces of China.