ObjectiveTo investigate the modifiable areal unit problem （MAUP） in the spatial pattern of Pseudostellaria heterophylla production regions and reveal the impact of statistical scales on the spatial distribution characteristics of this medicinal plant species. MethodsUsing multi-source data （literature records， field surveys， and statistical data）， we systematically analyzed the spatial patterns across three administrative levels （provincial， prefectural， and county scales）. Spatial autocorrelation （Moran's I） analysis， high-low clustering （Getis-Ord General G）， and hot/cold spot analysis （Getis-Ord Gi*） were employed. ResultsThe literature-based analysis showed that the production regions of P. heterophylla presented random distribution on the provincial scale and significant aggregation on the prefectural scale. The field survey data showed that the production regions displayed random distribution on the provincial scale but significant aggregation on both prefectural and county scales. The statistical data revealed that the production regions lacked spatial autocorrelation on the provincial scale but demonstrated significant aggregation on prefectural and county scales. ConclusionMAUP effects have substantive implications for understanding and decision-making in the arrangement of medicinal plant production regions. The county scale proves to be the most sensitive and explanatory level for analyzing the spatial pattern of P. heterophylla production regions， providing a critical foundation for habitat modeling， suitability evaluation， and ecological cultivation planning of medicinal plants.

Objective: To investigate the objective characteristics of tongue manifestation in different stages of damp-heat syndrome in diabetic kidney disease (DKD). Methods: A cross-sectional study enrolled 134 patients with DKD G3-5 stages who met the diagnostic criteria for damp-heat syndrome in DKD. The patients were treated at Dongzhimen Hospital, Beijing University of Chinese Medicine, from May 2023 to January 2024. The patients were divided into three groups: DKD G3, DKD G4, and DKD G5 stage, with 53, 33, and 48 patients in each group, respectively. Clinical general data (gender, age, and body mass index) and damp-heat syndrome scores were collected from the patients. The YZAI-02 traditional Chinese medicine (TCM) AI Tongue Image Acquisition Device was used to capture tongue images from these patients. The accompanying AI Open Platform for TCM Tongue Diagnosis of the device was used to analyze and extract tongue manifestation features, including objective data on tongue color, tongue quality, coating color, and coating texture. Clinical data and objective tongue manifestation characteristics were compared among patients with DKD G3-5 based on their DKD damp-heat syndrome status. Results: No statistically significant difference in gender or body mass index was observed among the three patient groups. The DKD G3 stage group had the highest age (P<0.05). The DKD G3 stage group had a lower score for symptoms of poor appetite and anorexia(P<0.05) than the DKD G5 group. No statistically significant difference was observed in damp-heat syndrome scores among the three groups. Compared with the DKD G5 stage group, the DKD G3 stage group showed a decreased proportion of pale color at the tip and edges of the tongue (P<0.05). The DKD G4 stage group exhibited an increased proportion of crimson at the root of the tongue, a decreased proportion of thick white tongue coating at the root, a decreased proportion of pale color at the tip and edges of the tongue, an increased hue value (indicating color tone) of the tongue color in the middle, an increased brightness value (indicating color lightness) of the tongue coating color in the middle, and an increased thickness of the tongue coating (P<0.05). No statistically significant difference was observed in other tongue color proportions, color chroma values, body characteristics, coating color proportions, coating color chroma values, and coating texture characteristics among the three groups. Conclusion Tongue features differ in different stages of DKD damp-heat syndrome in multiple dimensions, enabling the inference that during the DKD G5 stage, the degree of qi and blood deficiency in the kidneys, heart, lungs, liver, gallbladder, spleen, and stomach is prominent. Dampness is more likely to accumulate in the lower jiao, particularly in the kidneys, whereas heat evil in the spleen and stomach is the most severe. These insights provide novel ideas for the clinical treatment of DKD.

This study examines the progress and application of Artificial Intelligence (AI) in the prevention and control of infectious diseases within Chinese healthcare institutions. It analyzes the difficulties and challenges encountered during implementation to promote the intelligent transformation and upgrading of infectious disease prevention and control. The results indicate that AI technology has made progress in areas such as infectious disease surveillance and early warning, risk assessment and emergency response, screening and detection, image-based diagnosis and analysis, and health management. Nevertheless, significant challenges remain, including limited application depth and breadth, issues with data quality and privacy protection, insufficient technological maturity and interpretability, potential legal risks, and a shortage of interdisciplinary professionals. To advance the application of AI technology in infectious disease prevention and control and support the modernization of China′s relevant systems, recommendations include strengthening policy support, establishing data standards and robust privacy protection mechanisms, increasing R&D investment, refining laws and regulations, and enhancing the training of interdisciplinary talent.

This study examines the progress and application of Artificial Intelligence (AI) in the prevention and control of infectious diseases within Chinese healthcare institutions. It analyzes the difficulties and challenges encountered during implementation to promote the intelligent transformation and upgrading of infectious disease prevention and control. The results indicate that AI technology has made progress in areas such as infectious disease surveillance and early warning, risk assessment and emergency response, screening and detection, image-based diagnosis and analysis, and health management. Nevertheless, significant challenges remain, including limited application depth and breadth, issues with data quality and privacy protection, insufficient technological maturity and interpretability, potential legal risks, and a shortage of interdisciplinary professionals. To advance the application of AI technology in infectious disease prevention and control and support the modernization of China′s relevant systems, recommendations include strengthening policy support, establishing data standards and robust privacy protection mechanisms, increasing R&D investment, refining laws and regulations, and enhancing the training of interdisciplinary talent.

To explore the epidemiological characteristics of public health emergency events (PHEE) of varicella in the Beijing-Tianjin-Hebei region and analyze its related influencing factors. Excel was used to organize the varicella data in the Beijing-Tianjin-Hebei region from 2006 to 2021, reported by the management information system of PHEE, to describe the epidemiological characteristics of varicella events. Spatial autocorrelation and spatial scanning methods were used to test and determine its spatial clusters. Geographic detectors were used to analyze the impact of socio-economic factors. From 2006 to 2021, there were 644 reported varicella events in the Beijing-Tianjin-Hebei region, with a total of 18 052 cases and an incidence rate of 2.78%. The number, duration and response time M ( Q1, Q3) of each reported event were 22 (15, 35) cases, 19 (7, 34) days and 7 (4, 17) days, respectively. Hebei Province had a shorter response time and duration of events compared to Beijing and Tianjin. The most reported varicella events were in 2006 and 2007, with 112 and 106 events, respectively. By 2014, the number of events had decreased yearly, and there was a small peak from 2017 to 2019 between 2014 and 2021. From 2006 to 2021, the PHEE of varicella showed a seasonal bimodal distribution from March to June and from October to January of the following year, with peaks in May and December. There was a total of 500 reported varicella events in primary schools, including 218 events in rural primary schools (34%), 142 events in county and town primary schools (22%) and 140 events in urban primary schools (22%). The distribution of varicella events showed a positive spatial autocorrelation and strong spatial clustering, with Moran′s I of 0.31. The Class 1 clustering area was centered in Kuancheng Manchu Autonomous County, Chengde City, with a radius of 207 km and included 58 districts ( LLR=3 550.23, RR=3.78). The most explanatory factor among socio-economic factors was the proportion of the population aged 0-24 years old ( q=0.22), and the interaction effect between each factor was stronger than the independent effect. Overall, there are differences in the level of handling varicella events across Beijing, Tianjin and Hebei. The main occurrence of varicella events is in primary schools, especially in rural areas. Varicella events exhibit spatial clustering. Population structure-related factors have a strong impact on the risk of the incidence of varicella events.

Objective:To investigate the clinicopathological characteristics, immunophenotypes, molecular features, and differential diagnosis of BAP1 mutated clear cell renal cell carcinoma (CCRCC) for better understanding this entity.Methods:Clinical data, histological morphology, immunophenotypes and molecular characteristics of 18 BAP1 mutated CCRCC cases diagnosed at the Department of Pathology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China from January 2020 to December 2022 were analyzed. The patients were followed up.Results:There were 17 males and 1 female patients, aged from 39 to 72 years, with an average age of 56.3 years. Sixteen patients with primary CCRCC were followed up for an average of 24 months, 7 patients had metastases occurred from 4 to 22 months postoperatively. Thirteen of the 16 patients were alive at the time of the last follow-up while 3 patients died 12, 15, and 20 months after the surgery, respectively. One patient underwent retroperitoneal mass resection, but had lung metastasis 32 months after surgery. One case received cervical tumor resection and died at 22 months after the surgery. Characteristic CCRCC regions were identified in 11 of the 18 cases. The tumor cells were arranged in papillary, alveolar, and large nest patterns. Abundant lymphoid tissue, necrosis, and psammoma bodies were seen. Tumor cells showed abundant eosinophilic cytoplasm, and sometimes exhibited rhabdoid differentiation. Round eosinophilic globules were located in the cytoplasm and extracellular matrix. There were 9 cases with WHO/International Society of Urological Pathology grade 3, and 9 cases with grade 4. PAX8 (18/18), carbonic anhydrase 9 (CA9, 16/18), CD10 (18/18), and vimentin (18/18) were positive in the vast majority of tumors.TFE3 was expressed in 5 cases, with strong expression in only 1 case. Eighteen cases were all positive for P504s. Twelve cases harbored a BAP1 mutation combined with von Hippel-Lindau (VHL) mutation, and 2 cases had mutations in BAP1, VHL and PBRM1 simultaneously. SETD2 mutation was not found in any of the cases.Conclusions:BAP1 mutated CCRCC contained papillary, alveolar, and large nest patterns, eosinophilic cytoplasm, high-grade nucleoli, and collagen globules, with P504s positivity. In practical work, when encountering CCRCC containing these features, pathologists should consider the possibility of BAP1 mutations and conduct related molecular tests.

Objective The occurrence of chickenpox in rapidly developing areas poses substantial seasonal risk to children.However,certain factors influencing local chickenpox outbreaks have not been studied.Here,we examined the relationship between spatial clustering,heterogeneity of chickenpox outbreaks,and socioeconomic factors in Southern China. Methods We assessed chickenpox outbreak data from Southern China between 2006 and 2021,comprising both relatively fast-growing parts and slower sub-regions,and provides a representative sample of many developing regions.We analyzed the spatial clustering attributes associated with chickenpox outbreaks using Moran's I and local indicators of spatial association and quantified their socioeconomic determinants using Geodetector q statistics. Results There were significant spatial heterogeneity in the risk of chickenpox outbreaks,with strong correlations between chickenpox risk and various factors,particularly demographics and living environment.Furthermore,interactive effects among specific are factors,such as population density and per capita residential building area,percentage of households with toilets,percentage of rental housing,exhibited q statistics of 0.28,0.25,and 0.24,respectively. Conclusion This study provides valuable insights into the spatial dynamics of chickenpox outbreaks in rapidly developing regions,revealing the socioeconomic factors affecting disease transmission.These implications extend the formulation of effective public health strategies and interventions to prevent and control chickenpox outbreaks in similar global contexts.

To explore the epidemiological characteristics of public health emergency events (PHEE) of varicella in the Beijing-Tianjin-Hebei region and analyze its related influencing factors. Excel was used to organize the varicella data in the Beijing-Tianjin-Hebei region from 2006 to 2021, reported by the management information system of PHEE, to describe the epidemiological characteristics of varicella events. Spatial autocorrelation and spatial scanning methods were used to test and determine its spatial clusters. Geographic detectors were used to analyze the impact of socio-economic factors. From 2006 to 2021, there were 644 reported varicella events in the Beijing-Tianjin-Hebei region, with a total of 18 052 cases and an incidence rate of 2.78%. The number, duration and response time M ( Q1, Q3) of each reported event were 22 (15, 35) cases, 19 (7, 34) days and 7 (4, 17) days, respectively. Hebei Province had a shorter response time and duration of events compared to Beijing and Tianjin. The most reported varicella events were in 2006 and 2007, with 112 and 106 events, respectively. By 2014, the number of events had decreased yearly, and there was a small peak from 2017 to 2019 between 2014 and 2021. From 2006 to 2021, the PHEE of varicella showed a seasonal bimodal distribution from March to June and from October to January of the following year, with peaks in May and December. There was a total of 500 reported varicella events in primary schools, including 218 events in rural primary schools (34%), 142 events in county and town primary schools (22%) and 140 events in urban primary schools (22%). The distribution of varicella events showed a positive spatial autocorrelation and strong spatial clustering, with Moran′s I of 0.31. The Class 1 clustering area was centered in Kuancheng Manchu Autonomous County, Chengde City, with a radius of 207 km and included 58 districts ( LLR=3 550.23, RR=3.78). The most explanatory factor among socio-economic factors was the proportion of the population aged 0-24 years old ( q=0.22), and the interaction effect between each factor was stronger than the independent effect. Overall, there are differences in the level of handling varicella events across Beijing, Tianjin and Hebei. The main occurrence of varicella events is in primary schools, especially in rural areas. Varicella events exhibit spatial clustering. Population structure-related factors have a strong impact on the risk of the incidence of varicella events.

Objective:To understand the epidemiological characteristics of public health emergency events (PHEE) of varicella in China from 2006 to 2021 and related response performances.Methods:The data of varicella PHEE in 31 provinces of China from 2006 to 2021 were collected through the Public Health Emergency Management Information System, Microsoft Excel 2019 software and SPSS 26.0 statistical software were used to conduct descriptive epidemiological, statistical analysis on the time, area, location distribution, scale and epidemic management.Results:A total of 11 443 PHEE involving 341 048 related cases were reported from 2006 to 2021, with an annual attack rate of 1.78%-3.80% and a total attack rate of 2.33% (341 048/14 624 042). The number of PHEE and related cases of varicella decreased from 1 107 (35 349) in 2007 to 262 (6 884) in 2012 ( Z=-2.40, P<0.001), then increased year by year to 1 318 (42 649) in 2019 ( Z=2.58, P<0.001), with a significant decline since 2020. The varicella PHEE in China presents the seasonal characteristics,the peak is from April to June and from October to December, respectively. The sub-peak of varicella PHEE in eastern China generally appears 1-2 months earlier than in central and western China. Varicella PHEE reports are mainly distributed in eastern China, the attack rate is relatively high in western China, school-reported varicella PHEE was 88.26% of the total reports (10 099/11 443). The epidemic scale of varrcella PHEE typically range from 10 to 29 cases per year among the given outbreaks. The M ( Q1, Q3) of average number of cases, average duration, and average reporting interval of PHEE were 23 (16,35), 20 (14, 26) days, and 9 (5,19) days, respectively, and the reporting interval was positively correlated with the duration ( r=0.854, P<0.001). Conclusions:The varicella PHEE in China from 2006 to 2021 has not been effectively controlled. Schools are the key places to prevent and control varicella PHEE. Improving the sensitivity of varicella PHEE monitoring, strengthening the timely disposal of varicella epidemic, and promoting varicella vaccination are effective measures to prevent and control varicella PHEE.

Baylisascaris schroederi,a roundworm(ascaridoid)parasite specific to the bamboo-feeding giant panda(Ailuropoda melanoleuca),represents a leading cause of mortality in wild giant panda populations.Here,we present a 293-megabase chromosome-level genome assembly of B.schroederi to infer its biology,including host adaptations.Comparative genomics revealed an evolutionary trajectory accompanied by host-shift events in ascaridoid parasite lineages after host separations,suggesting their potential for transmission and rapid adaptation to new hosts.Genomic and anatomical lines of evidence,including expansion and positive selection of genes related to the cuticle and basal metabolisms,indicate that B.schroederi undergoes specific adaptations to survive in the sharp-edged bamboo-enriched gut of giant pandas by structurally increasing its cuticle thickness and efficiently utilizing host nutrients through gut parasitism.Additionally,we characterized the secretome of B.schroederi and predicted potential drug and vaccine targets for new control strategies.Overall,this genome resource provides new insights into the host adaptation of B.schroederi to the giant panda as well as the host-shift events in ascaridoid parasite lineages.Our findings on the unique biology of B.schroederi will also aid in the development of prevention and treatment measures to protect giant panda populations from roundworm parasitism.