To analyze the disease burden, temporal trends, and attributable risk factors of early-onset female breast cancer (EOBC) in China and globally from 1990 to 2021.

Objective To analyze the structural and phylogenetic characteristics of the mitochondrial genome from Bulinus globosus, so as to provide a theoretical basis for classification and identification of species within the Bulinus genus, and to provide insights into understanding of Bulinus-schistosomes interactions and the mechanisms of parasite transmission. Methods B. globosus samples were collected from the Ruya River basin in Zimbabwe. Mitochondrial DNA was extracted from B. globosus samples and the corresponding libraries were constructed for high-throughput sequencing on the Illumina NovaSeq 6000 platform. After raw sequencing data were subjected to quality control using the fastp software, genome assembly was performed using the A5-miseq and SPAdes tools, and genome annotation was conducted using the MITOS online server. Circular maps and sequence plots of the mitochondrial genome were generated using the CGView and OGDRAW software, and the protein conservation motifs and structures were analyzed using the TBtools software. Base composition and codon usage bias were analyzed and visualized using the software MEGA X and the ggplot2 package in the R software. In addition, a phylogenetic tree was created in the software MEGA X after sequence alignment with the software MAFFT 7, and visualized using the software iTOL. Results The mitochondrial genome of B. globosus was a 13 730 bp double-stranded circular molecule, containing 2 ribosomal RNA (rRNA) genes, 22 transfer RNA (tRNA) genes, and 13 protein-coding genes, with a marked AT preference. The mitochondrial genome composition of B. globosus was similar to that of other species within the Bulinus genus. Phylogenetic analysis revealed that the complete mitochondrial genome sequence of B. globosus was clustered with B. truncatus, B. nasutus, and B. ugandae into the same evolutionary clade, and gene superfamily analysis showed that the metabolism-related proteins of B. globosus were highly conserved, notably the cytochrome c oxidase family, which showed a significant consistency. Conclusions This is the first whole mitochondrial genome sequencing to decode the compositional features of the mitochondrial genome of B. globosus from Zimbabwe and its evolutionary relationship within the Bulinus genus, which provides important insights for further understanding of the phylogeny and mitochondrial genome characteristics of the Bulinus genus.

Anti-CD20 monoclonal antibodies for the treatment of refractory nephrotic syndrome （RNS） in children. The first- generation rituximab is the most widely used in clinical practice； it shows definite efficacy in children with RNS， is recommended by guidelines， particularly for achieving a high remission rate in minimal change nephrosis， and can significantly reduce the cumulative use of glucocorticoids and immunosuppressants. The second-generation ofatumumab has potential as an alternative treatment for patients who are intolerant or resistant to rituximab， while the third-generation obinutuzumab has shown efficacy in complex cases such as rituximab resistance or post-transplant recurrence. However， there is still controversy regarding the optimization of rituximab treatment dosage and whether ofatumumab and obinutuzumab offer greater advantages than rituximab for the treatment of RNS in children. The most common adverse reaction induced by anti-CD20 monoclonal antibodies is infusion reactions， and long-term adverse events mainly include increased risks of sustained immunosuppression and infections. Rituximab has significant economic advantages for the treatment of RNS， but additional pharmacoeconomic research based on China’s healthcare environment is needed to evaluate the cost-effectiveness of ofatumumab and obinutuzumab in this population. Given that the current use of ofatumumab and obinutuzumab in this field is considered off-label use， clinical application should only proceed after a rigorous evaluation of the patient’s benefits and risks.

OBJECTIVE To provide direction and reference for the adjustment of the discount rate （DR） in China’s pharmacoeconomic guidelines. METHODS Search was conducted on the official websites of the International Society for Pharmacoeconomics and Outcomes Research， health technology assessment agencies in various countries/regions， as well as relevant websites of other upper-middle-income or high-income countries/regions. The recommended DR， adjustment trends， and setting rationales in pharmacoeconomic evaluation guidelines across different countries/regions were then summarized and compared. Based on theoretical derivation and literature analysis， the effects of different DR on the incremental cost-effectiveness ratio （ICER） were examined. RESULTS & CONCLUSIONS Among the 40 included guidelines， the base-case DR ranged from 1.5% to 5%， with 5% being the most common value； the range for sensitivity analysis was 0 to 12%. Thirty-six countries/regions applied the same DR to both costs and health outcomes， while in the Netherlands， Belgium， Poland and Czech Republic， DR for costs was higher than for health outcomes. In recent years， Korea， France and Ireland had lowered their DR in response to economic changes， whereas the Netherlands and Czech Republic had raised their DR for cost. The setting of the DR was primarily based on the public project investment interest rate or referred to recommendations from internationally authoritative institutions and other relevant guidelines. The direction and magnitude of the impact of different DR on the ICER largely depended on the distribution of costs and health outcomes between the intervention and reference measure. The setting and adjustment of DR were closely associated with the economic environment. Based on international experience, the DR in China can be lowered by 0.5% to 1.5%， and localized empirical research can be conducted using internationally common estimation methods.

In order to promote the high-quality development of higher education in China, this article starts from the new requirements for public health education in the construction of "New Medical Sciences" under the Healthy China Strategy, points out the bottleneck problem of "island-style" public health education, and elaborates on the historical necessity and far-reaching significance of developing integrated and innovative education for public health from the three aspects of setting up new concepts, constructing new structures, and establishing a new collaborative education system. From the logic and practice approach, this article proposes a series of specific strategies such as building a whole-chain public health education system, constructing an integrated and collaborative medicine-teaching-research education mechanism, establishing multi-channel and diversified course resources for public health, and developing a new form of digital public health education, in order to comprehensively promote the reform and innovation of public health education in terms of "the integration of medicine and prevention" and "interdisciplinary integration" and provide ideas and reference for cultivating interdisciplinary and innovative medical talents under the Healthy China Strategy.

Objective:To investigate the effects of brace masks on controlling facial hypertrophic scars. Method:Totally 63 patients with 286 post-bum facial hypertrophic scars samples were recruited for the study.And they were divided into the brace mask group with 28 cases(152 scars),cloth mask group with 26 cases(100 scars),and control group with 9 cases(34 scars).Patients in the brace mask group and cloth mask group received eight weeks of pressure therapy,while the control group did not receive pressure therapy interven-tion.Pre-and post-treatment,chromatography was used to evaluate the scar color(lightness,redness and yel-lowness).An ultrasonic measuring instrument was used to evaluate the scar thickness.The Vancouver scar scale(VSS)was used.Patient satisfaction with eight weeks of treatment was evaluated with satisfaction scale. Result:①Pre-and post-treatment comparison:The brightness decreased in control group and increased in mask group(P＜0.001).The redness increased in control group and decreased in mask group(P＜0.001).The thick-ness and VSS score increased in three groups bu more in control group(P=0.001).There was no change in yel-lowness for all the three groups(P=0.981).②compared the two mask groups,there was no significant differ-ence for all parameters(P＞0.05).③satisfaction:the overall satisfaction of the brace mask group and the cloth mask group are 75％and 69.2％respectively.The comfort and appearance satisfaction of the brace mask group is better than the cloth mask group.The price satisfaction of the mask group is lower. Conclusion:For the facial hypertrophic scars,this short-term efficacy study showed that the brace mask and cloth mask could improve the lightness and redness and inhibit the thickness of it.The overall satisfaction of patients is high after using brace masks and cloth masks.

African swine fever(ASF),caused by the African swine fever virus(ASFV),is a highly contagious infectious disease of pigs.This disease has been spread rapidly in China since 2018,po-sing a huge threat to China's pig farming industry.To rapid detect the ASFV,a loop-mediated iso-thermal amplification(LAMP)combined with the disposable nucleic acid visualization test strip was established for visual detection of the nucleic acid of ASFV B646L gene.The method was easy to operate without special instruments and equipment,while it effectively avoided the disadvantage of false positives caused by aerosol contamination.The method was able to detect 1.16 copies/μL of the recombinant plasmid in 50 min at 65 ℃.In addition,the method was specific with no cross-re-action with classical swine fever virus,porcine reproductive and respiratory syndrome virus,por-cine parvovirus,transmissible gastroenteritis virus.The results in this study provides a rapid,con-venient,sensitive and reliable method for early diagnosis and screening for ASFV suspected infec-tion cases.

Atherosclerosis(AS) is an important pathological feature of cardiovascular diseases such as myocardial infarction,stroke and other highly fatal diseases. Phlegm and dampness are considered to be an important pathogenesis of AS,which is difficult to heal and can cause complications. The establishment of an animal model with AS and phlegm-dampness syndrome,which could reflect the features of traditional Chinese medicine(TCM),and objective evaluation system are an important element of modern integrated TCM and western medicine research on cardiovascular diseases. It is of great significance for TCM to prevent and treat cardiovascular diseases. This article summarizes the scientific connotations of traditional Chinese and western medicine for AS and phlegm-dampness syndrome,comprehensively summarizes the current status of construction and evaluation in experimental animal model,analyzes the problems of current model,and discusses the factors of model construction and evaluation. Our aim is to establish normalized and standardized animal model with AS of phlegm-dampness syndrome.

Objective To establish an animal model of dampness-syndrome in mice (single model) and evaluate its characteristics of dampness-syndrome. The above-mentioned mice with dampness syndrome were used to construct mice model of ischemic stroke (double model) and observe the effect of dampness-pathogenic on the outcome of stroke. Methods Healthy C57BL/6J male mice were randomly divided into dampness-syndrome (including sham-surgery group and ischemic stroke group,with 10 mice in each group) and non dampness-syndrome groups (including sham-surgery group and ischemic stroke group,with 10 mice in each group). The dampness-syndrome group was fed with high-fat diet and the non dampness-syndrome group was fed with normal diet for 12 weeks. After the mice model of dampness-syndrome was successfully established,transient middle cerebral artery occlusion/reperfusion (tMCAO/R) surgery was used to replicate an ischemic stroke mice model. Evaluation indicators for dampness-syndrome mice model:the general status including body weight,morphology,posture,activity status,and physical characteristics,the histopathological observation of the aorta (oil red O staining,Masson-trichrome staining) and liver (HE staining,oil red O staining),electron microscopic observation of the tongue tissue (scanning electron microscopy,electron microscopy),blood lipid levels[total cholesterol(TC),triglycerides(TG)]and liver coefficient. Evaluation indicators for ischemic stroke mice model:neurological function score and the cerebral infarction volume ratio. Results Compared with the non dampness-syndrome group,the mice in the dampness-syndrome group showed an increased in body weight,poor hair color,sparse hair,fatigue and laziness,mental atrophy,anorexia and lethargy. It was observed that the aortic lumen was narrowed,the intima was significantly thickened,lipid plaque deposition was increased,and foam cells were visible. A large amount of red lipid droplets appeared in liver cells. There were obvious lipid infiltration and diffuse steatosis. Increased keratosis of the mucosal layer of tongue tissue,the thicker stratum corneum,lipofuscin,and bacteria on the tongue surface were found. Serum TG and TC levels significantly increased(P<0.01),and the liver coefficient significantly decreased (P<0.001). Compared with non dampness-syndrome group (sham-surgery group),neurological function score and the cerebral infarction volume ratio in dampness-syndrome ischemic stroke group obviously increased (P<0.001). Conclusion High-fat feeding for 12 weeks combined with tMCAO/R modeling can successfully establish a mice model with dampness-syndrome ischemic stroke,and the neurological function score and cerebral infarction volume in the dampness-syndrome ischemic stroke group was more severe than that in the non dampness-syndrome ischemic stroke group.

Objective To elucidate the efficacy and possible mechanism of Qingchang mixture in ameliorating postoperative abdominal adhesions in rats.Methods Seventy-five Sprague-Dawley rats were randomly allocated into five experimental groups:the control group,the sham-operated group,the model group,the Qingchang mixture treatment group and the sodium hyaluronate treatment group.Except the control group and the sham-operated group,the other three groups were treated with cecal abrasion method to establish the rat model of abdominal adhesion.In the sodium hyaluronate group,2 mL sodium hyaluronate gel was meticulously applied to the injured abdominal wall and cecum prior to abdominal closure.Following successful establishment of adhesion model,the Qingchang mixture group received a daily oral gavage of 2 mL Qingchang mixture(14.58 g/kg),while the other four groups were given equal volume normal saline administration.In each group,five rats were euthanized on postoperative days 3,7 and 14 to assess abdominal adhesions using Nair's scoring system.Adhesive tissue or normal peritoneal tissue were harvested on postoperative day 7,and mRNA expression levels of interleukin-4(IL-4),signal transducer and activator of transcription 6(STAT-6)and interferon-γ(IFN-γ)were quantified via fluorescence-based real-time PCR.Concurrently,Western blot analysis was employed to evaluate protein expression levels of IL-4,interleukin-10(IL-10),STAT-6 and IFN-γ.Pathological alterations in adhesive tissue were visualized using hematoxylin-eosin(HE)staining under light microscopy,and inflammation and fibrotic changes were assessed accordingly.Results Compared with the blank and sham-operated groups,mRNA and protein expression levels of IL-4 and STAT-6 were significantly downregulated in the model group,protein expression level of IL-10 was also reduced.Conversely,the mRNA and protein expression levels of IFN-γ,as well as the inflammation and fibrosis scores were significantly elevated(P＜0.05).In comparison to the model group,IL-4 and STAT-6 mRNA and protein expression levels were increased in the Qingchang mixture group and the hyaluronic acid group,along with an increase in IL-10 protein expression.Conversely,these groups exhibited a significant reduction in Nair's scores,inflammation scores,fibrosis scores,and IFN-γ mRNA and protein expression levels were decreased(P＜0.05).Conclusion Qingchang mixture appears to suppress the development of postoperative peritoneal adhesions,likely through mechanism that involves modulating the expression of T-helper 1 and T-helper 2 cytokines,thereby attenuating inflammatory response.