Objective: To analyze the issuance of Chinese adolescents mental health promotion policies and policy objects, and to explore the use of different object policy tools and the effectiveness of the policy, so as to provide reference for the improvement of the subsequent policy. Methods: Adolescents mental health promotion policies published and policy documents that included adolescents in mental health promotion policies and regulations in China from 2014 to the present were obtained, with the search period of July to August 2024. Policy content and effectiveness were analyzed by using content cross tabulation analysis and Policy Modeling Consistency Index Model (PMC index model). It coded with Nvivo 20 software to understand the types of tools that policy depends on. Results: A total of 41 documents were included. The number of adolescent mental health promotion policy texts rose by year, most of which were issued independently, accounting for 70% of the total number of texts issued; 30% were jointly issued, with the Ministry of Education and the National Health Commission as the core subjects. Supply type policy tools accounted for 47.45 % of the total, while environment type and demand type policy tools accounted for 29.68% and 22.87% respectively; the use of policy tools by different policy targets varies, with families and social organizations using more supply type and demand type policy tools, while the education system and healthcare institutions were more inclined to supply type policy tools, and the government departments were more inclined to supply type policy tools and environment type policy tools. In terms of policy effectiveness, there was a common problem of a lack of incentives and constraints, and the PMC values of two long term planning mental health policies were high (7.76, 7.56), and both reached the excellent level. Conclusions China has paid more attention to adolescents mental health, and the basic guarantees have been established and overall policy effectiveness is good, but the use of policy tools is uneven. There is a need to improve the operational content of medium and long term policies and to strengthen synergies between implementing departments.

INTRODUCTION: Lecanemab has shown promise in treating early Alzheimer's disease (AD), but its safety and efficacy in Chinese populations remain unexplored. This study aimed to evaluate the safety and 6-month clinical outcomes of lecanemab in Chinese patients with mild cognitive impairment (MCI) or mild AD. METHODS: In this single-arm, real-world study, participants with MCI due to AD or mild AD received biweekly intravenous lecanemab (10 mg/kg). The study was conducted at Hainan Branch, Ruijin Hospital Shanghai Jiao Tong University School of Medicine. Patient enrollment and baseline assessments commenced in November 2023. Safety assessments included monitoring for amyloid-related imaging abnormalities (ARIA) and other adverse events. Clinical and biomarker changes from baseline to 6 months were evaluated using cognitive scales (mini-mental state examination [MMSE], montreal cognitive assessment [MoCA], clinical dementia rating-sum of boxes [CDR-SB]), plasma biomarker analysis, and advanced neuroimaging. RESULTS: A total of 64 patients were enrolled in this ongoing real-world study. Safety analysis revealed predominantly mild adverse events, with infusion-related reactions (20.3%, 13/64) being the most common. Of these, 69.2% (9/13) occurred during the initial infusion and 84.6% (11/13) did not recur. ARIA-H (microhemorrhages/superficial siderosis) and ARIA-E (edema/effusion) were observed in 9.4% (6/64) and 3.1% (2/64) of participants, respectively, with only two symptomatic cases (one ARIA-E presenting with headache and one ARIA-H with visual disturbances). After 6 months of treatment, cognitive scores remained stable compared to baseline (MMSE: 22.33 ± 5.58 vs . 21.27 ± 4.30, P = 0.733; MoCA: 16.38 ± 6.67 vs . 15.90 ± 4.78, P = 0.785; CDR-SB: 2.30 ± 1.65 vs . 3.16 ± 1.72, P = 0.357), while significantly increasing plasma amyloid-β 42 (Aβ42) (+21.42%) and Aβ40 (+23.53%) levels compared to baseline. CONCLUSIONS: Lecanemab demonstrated a favorable safety profile in Chinese patients with early AD. Cognitive stability and biomarker changes over 6 months suggest potential efficacy, though high dropout rates and absence of a control group warrant cautious interpretation. These findings provide preliminary real-world evidence for lecanemab's use in China, supporting further investigation in larger controlled studies. REGISTRATION ClinicalTrials.gov , NCT07034222.
Humans ; Alzheimer Disease/drug therapy* ; Male ; Female ; Aged ; Middle Aged ; Cognitive Dysfunction/drug therapy* ; Aged, 80 and over ; Amyloid beta-Peptides/metabolism* ; Biomarkers ; East Asian People

Addressing the enduring challenge of evaluating traditional Chinese medicines (TCMs), the integrated evidence chain-based effectiveness evaluation of TCMs (Eff-iEC) has emerged. This paper explored its capacity through a demonstration study that evaluated the effectiveness evidence of six commonly used anti-hepatic fibrosis Chinese patent medicines (CPMs), including Biejiajian Pill (BP), Dahuang Zhechong Pill (DZP), Biejia Ruangan Compound (BRC), Fuzheng Huayu Capsule (FHC), Anluo Huaxian Pill (AHP), and Heluo Shugan Capsule (HSC), using both Eff-iEC and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. The recognition of these CPMs within the TCM academic community was also assessed through their inclusion in relevant medical documents. Results showed that the evidence of BRC and FHC received higher assessments in both Eff-iEC and GRADE system, while the assessments for others varied. Analysis of community recognition revealed that Eff-iEC more accurately reflects the clinical value of these CPMs, exhibiting superior evaluative capabilities. By breaking through the conventional pattern of TCMs effectiveness evaluation, Eff-iEC offers a novel epistemology that better aligns with the clinical realities and reasoning of TCMs, providing a coherent methodology for clinical decision-making, new drug evaluations, and health policy formulation.

Objective:To learn about the single nucleotide polymorphism (SNP) population structure and regional distribution characteristics of Yersinia pestis in the natural focus of plague in Qinghai-Tibet Plateau. Methods:A total of 319 representative strains of Yersinia pestis isolated from natural focus of plague in Qinghai-Tibet Plateau from 1954 to 2020 were selected, and 2 298 SNP loci included in the global Yersinia pestis phylogenetic tree were compared by whole genome sequencing technology. MEGA 6.0 software was used to construct phylogenetic trees of 319 strains of Yersinia pestis from Qinghai-Tibet Plateau, determine the SNP population structure of Yersinia pestis in the focus, and describe its regional distribution characteristics. Results:The 319 strains of Yersinia pestis isolated from Qinghai-Tibet Plateau natural plague foci were distributed in 5 clades, namely 1.IN, 2.ANT, 3.ANT, 0.PE and 2.MED. The 1.IN clade contained 209 strains (65.52%, 209/319), which was the dominant population of strains in Qinghai Province, accounting for 90.51% (143/158). The 2.ANT clade contained 83 strains (26.02%, 83/319), which was the dominant population in Tibet Autonomous Region, accounting for 67.24% (78/116). The 3.ANT, 0.PE, and 2.MED clades contained 12 (3.76%, 12/319), 9 (2.82%, 9/319) and 6 strains (1.88%, 6/319), respectively, which were scattered in Qinghai Province, Gansu Province, Sichuan Province, Tibet Autonomous Region, and Xinjiang Uygur Autonomous Region under the jurisdiction of Qinghai-Tibet Plateau. Conclusion:The SNP population structure of Yersinia pestis in natural focus of plague in Qinghai-Tibet Plateau is relatively rich, and the strains are distributed in 5 clades: 1.IN, 2.ANT, 3.ANT, 0.PE and 2.MED, showing the distribution characteristics of specific regions.

Objective:To learn about the operation of fluoride reduction and water improvement projects, the current situation of water fluoride level and the changing trend of fluorosis in drinking water-borne endemic fluorosis areas in Shaanxi Province, and to evaluate the effect of prevention and control measures.Methods:From March 2014 to December 2021, 15 endemic villages in drinking water-borne endemic fluorosis areas of Dali, Dingbian, Jingbian, Jingyang and Liquan counties in Shaanxi Province were selected as monitoring villages to investigate the operation of water improvement projects. Water samples were collected, and the water fluoride level was detected according to the "Standard Examination Methods for Drinking Water - Nonmetal Parameters" (GB/T 5750.5-2006). "Diagnosis of Dental Fluorosis" (WS/T 208-2011) was done to detect dental fluorosis in all children aged 8 - 12 who were born and lived in the monitoring village. Using "Diagnostic Standard for Endemic Skeletal Fluorosis" (WS/T 192-2008) and "Determination of Fluoride in Urine - Ion Selective Electrode Method" (WS/T 89-2015), X-ray examination and urine fluoride level test were performed on adults over 25 years old who had lived in the monitoring village for more than 5 years, respectively.Results:From 2014 to 2021, a total of 122 water improvement projects were investigated, all of which were in normal operation. The qualified rate of water fluoride increased from 81.25% (13/16) in 2014 to 100.00% (11/11) in 2021. A total of 5 595 children aged 8 - 12 were examined, 1 790 children with dental fluorosis were detected, with a detection rate of 31.99%. The detection rate of dental fluorosis in children decreased from 52.05% (304/584) in 2014 to 9.68% (93/961) in 2021, showing an overall downward trend (χ 2trend = 533.76, P < 0.001). In 2014, 791 adults were examined, and 256 patients with skeletal fluorosis were detected, the detection rate was 32.36%. In 2019, 770 adults were examined, and 88 patients with skeletal fluorosis were detected, with a detection rate of 11.43%. The detection rate of skeletal fluorosis in adults in 2019 was lower than that in 2014, and the difference was statistically significant (χ 2 = 99.54, P < 0.001). In 2014, 754 adult urine samples were collected, and the geometric mean of urine fluoride was 2.571 mg/L. In 2019, 770 adult urine samples were collected, and the geometric mean of urine fluoride was 1.292 mg/L. The geometric mean of urine fluoride in adults in 2019 was lower than that in 2014, and the difference was statistically significant ( Z = - 12.74, P < 0.001). Conclusions:From 2014 to 2021, the water improvement projects in drinking water-borne endemic fluorosis areas in Shaanxi Province are running normally, and the qualified rate of water fluoride has increased. The incidence of dental fluorosis in children and skeletal fluorosis in adults has decreased. In the later stage, it is necessary to continuously strengthen the monitoring and management of water improvement projects to prevent the rebound of water fluoride from causing residents' illness.

Objective : To detect the risk factors for bleeding in patients with cirrhosis and esophageal and gastric varices (EGV) and better understand the potentially life-threatening complications． Methods : Retrospectively， and a total of 309 patients with cirrhosis and EGV were enrolled in this study and were divided into the observation group and control based on EGV bleeding or not．Meanwhile，the patients＇epidemiological，clinical，laboratory， and radiological characteristics were collected and analyzed to construct a prediction model．The bootstrap method could be used to validate predictive models and the ROC curves to evaluate its forecasting ability. Results : High- density lipoprotein (HDL) (P＜0. 001，OR = 0. 131，95% CI = 0. 049－0. 350) ，C-reactive protein ( CRP) (P = 0. 010，OR = 2. 657，95% CI = 1. 269－5. 563) ，the width of portal vein (PVW) (P = 0. 050，OR = 1. 156，95% CI = 1. 000 －1. 336) ，the thickness of spleen (P = 0. 035，OR = 1. 492，95% CI = 1. 028 －2. 165) ，Child-Pugh grade B (P = 0. 003 ，OR = 11. 320，95% CI = 2. 232 －57. 407 ) and Child-Pugh grade C ( P = 0. 002 ，OR = 3. 888，95% CI = 1. 659－9. 114) were significantly associated with the occurrence of EGV bleeding．The AUC of the predictive risk model in the modeling group was 0. 802，and the validation group was 0. 836． Conclusion The lower HDL and higher CRP，PVW，the thickness of the spleen，Child-Pugh grade B and C are the risk factors for the occurrence of EGV bleeding.

BACKGROUND:In consideration of the food safety and ecological safety of transgenic plants,the retention of marker genes is the primary safety issue affecting transgenic plants. OBJECTIVE:Based on the principle of immune caries prevention,our research team successfully constructed the plant anti-caries vaccine fusion gene expression vector pCAMBIA-E8-APB-DOCK8 for these two caries causing virulence factors surface protein and glucosyltransferase,which provides a basis for the research and development of transgenic plant vaccine. METHODS:In this study,the selective marker genes Km and GUS in the plant caries vaccine fusion gene expression vector pCAMBIA-E8-APB-DOCK8 were removed by DNA recombination technology through a series of steps such as DNA fragment separation,connection,transformation,clone detection,and sequencing. RESULTS AND CONCLUSION:The efficiency of marker gene removal was 99%.This study has laid a good experimental foundation for the safe production of transgenic plant vaccine against dental caries,and also provided ideas for the construction of other plant vaccine vectors.

Objective:To study the clustered regularly interspaced short palindromic repeats (CRISPR) genotype of Yersinia pestis and its regional distribution characteristics in natural plague focus of Tibet Autonomous Region. Methods:A total of 125 representative Yersinia pestis strains isolated from natural plague focus in Tibet Autonomous Region at different times, regions, hosts and vectors were selected as experimental strains, and the phenol chloroform mixed extraction method was used to extract Yersinia pestis DNA. Three pairs of CRISPR primers (for YPa, YPb, YPc locus) were used to amplify the DNA of the experimental strains, and the CRISPR genotype of Yersinia pestis was determined by sequencing. Results:All 125 strains of Yersinia pestis had three CRISPR locus: YPa, YPb, and YPc. A total of 18 spacer were found, including 8 in YPa loci, 6 in YPb loci, and 4 in YPc loci. Two new types of spacers had been discovered, namely b52 and c14. CRISPR typing revealed 10 genotypes, including G1, G7, G7-b4''', G7-b52, G7-c2 -, G8, G22, G22-a4 -, G22-b4''', and G22-c14, of which 6 were newly discovered genotypes. Among the 125 experimental strains, G7 was the main genotype, accounting for 65.6% (82/125), which was distributed in 6 prefecture level citys and 1 region of Tibet Autonomous Region. Next were G22 and G7-c2 - genetypes, accounting for 14.4% (18/125) and 11.2% (14/125), respectively. G22 gene type was distributed in Nagqu, Changdu, Lhasa citys, and Ngari Prefecture, while G7-c2 - genetype was distributed in Shigatse and Shannan cities. Conclusion:The CRISPR locus of Yersinia pestis in natural plague focus of Tibet Autonomous Region is highly polymorphic, and the Yersinia pestis strains with different genotypes have obvious regional distribution characteristics.

AIM:To observe the clinical efficacy of 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops in the treatment of dry eyes after pterygium surgery with lacrimal insufficiency.METHODS: A total of 64 cases(64 eyes)of pterygium patients with lacrimal insufficiency were treated with pterygium resection combined with limbal stem cell transplantation, and they were given routine anti-inflammatory and infection prevention treatment postoperatively. In terms of postoperative dry eye treatment, all patients were randomly divided into two groups. The observation group was treated with 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops, and the control group was treated with sodium hyaluronate eye drops. The break-up time of tear film(BUT), fluorescein(FL), Schirmer's Ⅰ test(SⅠt), ocular surface disease index(OSDI)score, central corneal thickness(CCT)changes, adverse reactions and complications were observed and compared between the two groups at different times postoperatively.RESULTS: Both groups of pterygium patients were accompanied with mild to moderate dry eyes with insufficient tear secretion preoperatively. At 2 wk after operation, both groups showed shorter BUT and higher FL score compared with those preoperatively(P<0.05). There was no significant difference between the two groups(P>0.05). At 4 wk after operation, BUT in the observation group was prolonged, OSDI score was decreased(both P<0.05), and FL score in both groups was decreased compared with those at with 2 wk after operation(P<0.05). The observation group was better than the control group(P<0.05). At the first day after operation, the CCT of the two groups was thicker than that preoperatively(P<0.05), and there was no significant difference in SⅠt between the two groups before and after operation(P>0.05).CONCLUSION: In the treatment of dry eye after pterygium surgery with lacrimal insufficiency, 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops can effectively reduce the postoperative dry eye symptoms, and its clinical effect is better than that of sodium hyaluronate eye drops alone.

Objective To analyze the effects of three sterilization methods,namely,pressure steam,low-temperature plasma and ethylene oxide,on the magnetic flux of magnetic surgical devices and their sterilization costs.Methods A total of 234 magnetic surgical devices of different specifications and models(magnetic rings)were randomly divided into Group A,Group B and Group C after the paired number was labelled,and each group consisted of 78 pieces(39 pairs).After packaging each pair of devices according to sterilization specifications,Group A was sterilized by pressure steam,Group B was sterilized by low-temperature plasma,and Group C was sterilized by ethylene oxide.We measured the magnetic flux of three sets of magnetic rings before and after sterilization,and comparatively analyzed the sterilization cost and sterilization time of the single package.Results There was no statistically significant difference in the impact of the three sterilization methods on the magnetic flux of the magnetic surgical devices(P＞0.05),but there was a significant difference in the magnetic flux before and after sterilization for each sterilization method(P＜0.001);the sterilization cost was(1.96±0.16)yuan for Group A,(23.17±0.32)yuan for Group B,and(8.16±0.18)yuan for Group C,showing statistically significant differences among the three groups(P＜0.01).The sterilization time was(65.21±3.36)min for Group A,(45.46±1.39)min for Group B,and(1020.38±12.21)min for Group C,with statistically significant differences among the three groups(P＜0.01).Conclusion None of the three sterilization methods affects the magnetic flux of the magnetic surgical devices.Pressure steam method shows the lowest cost of single package,low-temperature plasma method shows the highest cost of single package,while ethylene oxide method shows the highest sterilization time.Pressure steam should be the preferred sterilization method for magnetic surgical devices.