Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases

BACKGROUND: Bendamustine was approved in China on May 26th, 2019 by the National Medical Product Administration for the treatment of indolent B-cell non-Hodgkin lymphoma (NHL). The current study was the registration trial and the first reported evaluation of the efficacy, safety, and pharmacokinetics of bendamustine in Chinese adult patients with indolent B-cell NHL following relapse after chemotherapy and rituximab treatment. METHODS: This was a prospective, multicenter, open-label, single-arm, phase 3 study (NCT01596621; C18083/3076) with a 2-year follow-up period. Eligible patients received bendamustine hydrochloride 120 mg/m2 infused intravenously on days 1 and 2 of each 21-day treatment cycle for at least six planned cycles (and up to eight cycles). The primary endpoint was the overall response rate (ORR); and secondary endpoints were duration of response (DoR), progression-free survival (PFS), safety, and pharmacokinetics. Patients were classified according to their best overall response after initiation of therapy. Proportions of patients in each response category (complete response [CR], partial response [PR], stable disease, or progressive disease) were summarized along with a two-sided binomial exact 95% confidence intervals (CIs) for the ORR. RESULTS: A total of 102 patients were enrolled from 20 centers between August 6th, 2012, and June 18th, 2015. At the time of the primary analysis, the ORR was 73% (95% CI: 63%-81%) per Independent Review Committee (IRC) including 19% CR and 54% PR. With the follow-up period, the median DoR was 16.2 months by IRC and 13.4 months by investigator assessment; the median PFS was 18.6 months and 15.3 months, respectively. The most common non-hematologic adverse events (AEs) were gastrointestinal toxicity, pyrexia, and rash. Grade 3/4 neutropenia was reported in 76% of patients. Serious AEs were reported in 29 patients and five patients died during the study. Pharmacokinetic analysis indicated that the characteristics of bendamustine and its metabolites M3 and M4 were generally consistent with those reported for other ethnicities. CONCLUSION: Bendamustine is an active and effective therapy in Chinese patients with relapsed, indolent B-cell NHL, with a comparable risk/benefit relationship to that reported in North American patients. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, No. NCT01596621; https://clinicaltrials.gov/ct2/show/NCT01596621.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; Bendamustine Hydrochloride/therapeutic use* ; China ; Humans ; Lymphoma, Non-Hodgkin/drug therapy* ; Neoplasm Recurrence, Local/drug therapy* ; Prospective Studies ; Rituximab/therapeutic use*

Ecological agriculture is a crucial way for agriculture of Chinese materia medica, which emphasizes the application of ecological principles in the cultivation of traditional Chinese medicine. While long-term intensive farming and modern chemical agriculture have threatened soil health, the sustainable development of ecological agriculture of Chinese materia medica is constrained. No-til-lage can reduce both frequency and intensity of tillage. Compared with conventional agriculture, no-tillage can reduce soil disturbance, maintain no-tillage for a long or permanent period and keep mulching. The application of no-tillage has a long history. More and more studies have shown that no-tillage has many advantages over conventional tillage, and the ecological and economic benefits of no-tillage are particularly outstandingin long-term. The cultivation of Chinese medicinal materials adheres to the principle of not grabbing land from farmland, making full use of the soil resources under forests, mountains and wasteland. Reducing the risk of soil loss and sustai-nable utilization are the core issues in the process of new land cultivation. No-tillage application, which not only inherits the traditional Chinese concept of natural farming, but also integrates the laws of ecological agriculture, will become the core strategies of sustainable development of Chinese materia medica ecological agriculture. This study will introduce the basic concepts and development process of no-tillage, analyze their ecological benefits in ecological agriculture of Chinese materia medica, and put forward their application strategies.
Agriculture ; China ; Drugs, Chinese Herbal ; Materia Medica ; Medicine, Chinese Traditional ; Sustainable Development

The study aims to investigate spatial distribution pattern and age structure of wild Angelica sinensis in Gansu province.Ten plots each with an area of 100 m2 were set and the spatial coordinates of all wild A. sinensis individuals were measured within each plot. Based on plant individual mapping data,we explored the spatial distribution pattern and its differences between different life history stages of wild A. sinensis in Gansu province by using nearest neighbor distance statistics. Correlation analysis were carried out to explore the relationship between spatial aggregation degree and topographic factors. We also distinguished individuals to three life history stages( i.e. seedlings,adults and boltings) and then test the differences among/between them using nonparametric test.(1)We found that the dominant spatial distribution pattern of wild A. sinensis population in Gansu was aggregated distribution. There was no significant correlation between spatial aggregation degree of wild A. sinensis and altitude,slope and aspect. There was no significant difference between the average distance from seedlings to their nearest bolting individuals; the average distance from adult individuals to their nearest seedlings was significantly larger than the average distance from adult individuals to their nearest adult individuals; and the average distance from bolting individuals to their nearest adult individuals was significantly smaller than the average distance from bolting individuals to their nearest bolting individuals.(2)The age structure was showed as a declining population,characterized by less seedlings and bolting individuals,while more adult individuals within population. The population characteristics of wild A. sinensis,characterized by aggregated distribution pattern and senescent type of age structure,are disadvantage to its population development. The factors,such as habitat specialization,human activities and intraspecific competition,which shapes the current population characteristics,may increase the threatened status of wild A. sinensis. We suggest to strengthen the protection of wild A. sinensis.
Altitude ; Angelica sinensis ; growth & development ; China ; Conservation of Natural Resources ; Ecosystem ; Seedlings ; Spatial Analysis

Rhizosphere bacteria play a vital role in plant nutrition absorption,growth and disease resistance. In this study,high-throughput sequencing technology was used to analyze the rhizosphere bacterial communities of Salvia miltiorrhiza and S. miltiorrhiza f. alba. Moreover,the function of dominant rhizosphere bacterial communities was analyzed. We found that Sphingobacteriales,Sphingomonadales and Nitrosomonadaceae were both dominant and specific bacteria in the rhizosphere of S. miltiorrhiza. The main functions of dominant rhizosphere bacteria communities in both species include promoting transformation of soil nutrients,improving plant immunity and ability of stress tolerance. This study was the first to compare rhizobacterial communities structure and function of S. miltiorrhiza and S. miltiorrhiza f. alba,which provided a new theoretical reference for studing the rhizosphere mechanism of healthy S. miltiorrhiza planting in the future.
Bacteria ; classification ; High-Throughput Nucleotide Sequencing ; Rhizosphere ; Salvia miltiorrhiza ; microbiology ; Soil Microbiology

Objective To evaluate the clinical value of neonatal peripheral blood smear spherical erythrocyte count in the diagnosis of ABO-HDN.Methods 165 cases clinically diagnosed with ABO-HDN in Zhongshan Boai Hospital from 2009 to 2015 were listed as the experimental group by retrospective analysis,68 cases of non-ABO-HDN were listed as control group.Besides,relevant clinical data and experimental examination were investigated,and the results of their hemolysis test were analysed.Results Peripheral blood smear spherical erythrocyte count were positive in 110 cases of 165 patients with ABO-HDN,the positive rate of spherical erythrocytes was 66.7 ％ (x2 =58.069,P＜ 0.05).The spherical erythrocyte positive rates were 68.8 ％,60.5 ％ and 66.7 ％ in patients aged ≤2d,3 ～4d,≥5d respectively.The diagnostic sensitivity of spherical erythrocytes to ABO-HDN was 66.7 ％,the specificity was 88.2 ％,the positive predictive value was 93.2 ％,and negative predictive value was 52.2 ％.When spherical erythrocyte count positive point was set as ≥5 ％ spherical erythrocytes,the diagnostic sensitivity of spherical erythrocytes to ABO-HDN was 66.7％ and the specificity was 88.2％.If the positive point was set as ≥10％ spherical erythrocytes,the sensitivity of ABO-HDN decreases to 9.3％,and the specificity reaches 98.5 ％.In ABO-HDN group,the levels of nucleated red blood cell,RDW and Ret were higher,along with the lower level of hemoglobin compared with non-ABO-HDN group (all P＜0.05).Conclusion The peripheral blood smear spherical erythrocyte count had a high sensitivity and specificity for the diagnosis of ABOHDN.Combined with jaundice,anemia and RDW,peripheral blood smear spherical erythrocyte count can provide guidance for the early diagnosis,prevention and treatment of ABO-HDN.

Objective To evaluate the actual effect of the schistosomiasis control program in Jiangsu Province from 2010 to 2015. Methods A total of 67 schistosomiasis-endemic counties in 10 cities were selected, and a combination of retrospective investigation and on-site investigation was adopted to collect and record the epidemic data of the counties from 2010 to 2015, and a retrospective survey database of epidemic situation was established. The effects of integrated control strategies with both Oncomelania hupensis snail control and infection source control were evaluated. Results From 2010 to 2015, 2 465 911 persons who lived in endemic areas were detected for schistosomiasis, with 16 974 positive cases of blood examinations, and 8 positive cases of fecal examinations. Totally 5 145 people with advanced schistosomiasis were treated and 40 460 people with the history of schistosome cercarial-infested water contact received the expanded chemotherapy. A total of 127 636 cattle raised in the endemic areas were detected, and 51 619 cattle (head-times) with the history of cercarial-infested water contact also received the expanded chemotherapy. The area with snails control by molluscicides was 18 604.84 hm². By the end of 2015, schistosomeinfected snails had not been found and there was no zoological schistosome infection for 5 consecutive years, and in addition, there had been no acute schistosome-infected persons for 6 consecutive years in the whole province. The area with snails dropped to 1 977.18 hm², with a decreasing rate of 55.24% compared with that in 2010. Conclusion After the implementation of the plan for the prevention and control of schistosomiasis in Jiangsu Province (2010–2015), the prevention and control of schistosomiasis has achieved remarkable effects and realized the goal of the plan.

Cucurbitadienol has anti-inflammation, anti-cancer activities, and acts as a precursor of traditional Chinese medicine active ingredients mogroside and cucurbitacine. For construction of a Sacchromyces cerevisiae cell factory for production of cucurbitadienol, we firstly cloned a cucurbitadienol synthase (CBS) gene from Siraitia grosvenorii. Then, through heterologous expression of CBS in the triterpenoid chassis strain WD-2091, the engineered strain could produced 27.44 mg•L ⁻¹ cucurbitadienol, which was determined by GC-MS. Further regulation of CBS expression led to cucurbitadienol's titer increasing by 202.07% and reaching 82.89 mg•L ⁻¹ in the shake flask fermentation and 1 724.10 mg•L ⁻¹ in the high cell density fermentation. Our research promotes the cucurbitane-type tetracyclic triterpenoids synthesis pathway analysis progress and provides the basis for further obtaining cell factories for production of cucurbitadienol tetracyclic triterpenoids.

The rich diversity in medicinal plants provides an important material basic for the development of Traditional Chinese medicine in China. It is important to explore the present situation of medicinal plants within special regions in order to provide scientific instructions for their sustainable protection and exploitation and utilization. In this study, we carried out the field survey according to the guideline of national survey of Chinese material medica resources and the guideline of plant species diversity survey and estimation at county level with the line transect method. With the field surveyed data, we explored the diversity and distribution of the threatened medicinal vascular plants in Lancang. We found that there were 33 species of the threatened medicinal vascular plants in this county. These species were from 23 genera and 17 families, and were composed of one critical endangered, 10 endangered and 22 vulnerable species. They were widely distributed across the whole county and were most concentrated in the town of Nuozhadu, Fazhanhe, Nuofu and Zhutang, which were located in the southeastern, southwestern and western of Lancang, respectively. We also found that the plant species richness followed a unimodal pattern along elevation. In addition, we found that the areas of Nuozhadu Nature Reserve in Lancang only covered six threatened medicinal vascular plants, while most of the regions with high species richness were not well protected. Therefore, we proposed to make more efforts to improve the protection measurements in order to better protect and utilize the medicinal plants in Lancang.

Objective To understand the schistosomiasis control knowledge,attitude,and practice(KAP),and influenc-ing factors of behaviors among residents in Jiangsu Province,so as to provide the evidence for making effective health education and health promotion models. Methods The probability proportionate to size sampling(PPS)and multi-stage sampling meth-ods were adopted to sample the research objects. A questionnaire survey of schistosomiasis control KAP was conducted in the res-idents of 16 to 69 years old in schistosomiasis endemic areas of Jiangsu Province,and the results were statistically analyzed. Re-sults The total awareness rate of the participants was 95.98%for schistosomiasis control knowledge. The correct rates of atti-tude and practice were 89.06%and 77.43%,respectively. The awareness/correct rates of knowledge,attitude and practice re-duced in turns significantly(χ2=1282.96,P<0.01). The knowledge awareness rate of fishermen and boatmen was 90.98%, but their attitude correct rate was only 53.81%(χ2=120.52,P<0.01). The unconditional logistic regression analysis showed that with the education level increasing,their practice correct rate rose,and the participants with the college degree or above had a higher correct rate compared to illeterate ones(OR=6.411,95%CI:4.896-8.395). The practice correct rate of the fisher-men and boatmen was only 5.1%of the rate of the farmers(OR=0.051,95%CI:0.029-0.091). Conclusions The total aware-ness rate of basic knowledge of schistosomiasis prevention and control in the residents of Jiangsu Province has reached the re-quirements in the"National Schistosomiasis Control Long-term Planning Outline(2004-2015)",but the correct rate of behav-iors is low. The education level,occupation and residential areas affect the health behaviors of schistosomiasis prevention and control. Therefore,it is necessary to carry out targeted health promotion activities to promote the formation of healthy lifestyle and behaviors.