ObjectiveTo investigate the impact of melanoma-associated antigen D4 （MAGED4） on the malignant biological behavior of hepatocellular carcinoma （HCC）， providing experimental evidence for its evaluation as a potential therapeutic target in HCC. MethodsGenes positively correlated with MAGED4 expression in HCC were screened using the LinkedOmics database， followed by GO functional and KEGG pathway enrichment analyses. Endogenously low-expressing SMMC-7721 and Huh7 cells were selected， with normal hepatic LO2 cells serving as controls. Stable overexpression cell lines were established via lentiviral infection （MAGED4 overexpression group）， with RT-PCR and Western blot validating overexpression efficiency. The effects of MAGED4 overexpression on cell proliferation， cell cycle distribution， migration， and adhesion were systematically analyzed using CCK-8 assays， flow cytometry， scratch healing assays， Transwell migration assays， and cell adhesion assays. ResultsBioinformatics analysis indicated that MAGED4 co-expressed genes were significantly enriched in biological processes closely associated with tumor proliferation and metastasis， including cell-cell adhesion， extracellular matrix organization， and the PI3K-Akt signaling pathway. A stable MAGED4 overexpression cell model was successfully established. In vitro functional assays demonstrated that MAGED4-overexpressing SMMC-7721 and Huh7 cells exhibited a mesenchymal-like morphology， whereas LO2 cells maintained an epithelial-like morphology. Compared with the empty-virus control groups， the MAGED4-overexpressing groups showed significantly increased proliferative activity （48 h： t=3.887， 22.070， 8.866， all P<0.05； 72 h： t=3.231， 23.840， 9.848， all P<0.05； 96 h： t=5.123， 49.800， 5.909， P<0.05， P<0.01， P<0.05）， wound healing rates （12 h： F=40.90， 44.00， 200.50， all P<0.001； 24 h： F=112.00， 34.89， 249.20， all P<0.001）， and numbers of migrated cells （F=239.20， 59.79， 132.80， all P<0.001）， along with significantly decreased numbers of adherent cells （F=73.65， 85.91， 138.00， all P<0.001）， while no significant differences were observed in cell cycle phase distribution in all three cell lines. ConclusionMAGED4 enhances proliferation and migration while suppressing adhesion in both HCC and normal hepatocytes， however， induces mesenchymal-like morphological changes exclusively in HCC cells， suggesting that MAGED4 is capable of driving HCC progression and may serve as a potential therapeutic target for HCC.

Objective To investigate the prevalence of Schistosoma japonicum infections in wild rodents in schistosomiasis-endemic areas of China, so as to provide insights into formulation of technical guidelines for monitoring of and the precise control strategy for S. japonicum infections in wild rodents during the elimination phase. Methods Two administrative villages where schistosomiasis was historically highly prevalent were selected each from Dongzhi County, Anhui Province, and Duchang County, Jiangxi Province as study villages. Wild rodents were captured from study villages with baited traps or cages at night in June and September, 2021. The number of rodents captured was recorded, and the rodent species was characterized based on morphologi-cal characteristics. Liver tissues were sampled from captured rodents for macroscopical observation of the presence of egg granu- lomas, and S. japonicum infection was detected simultaneously using liver tissue homogenate microscopy, examinations of mesenteric tissues for parasites, and modified Kato-Katz thick smear technique (Kato-Katz technique). A positive S. japonicum infection was defined as detection of S. japonicum eggs or adult worms by any of these methods. The rate of wild rodent capture and prevalence of S. japonicum infections in wild rodents were compared in different study villages and at different time periods, and the detection of S. japonicum infections in wild rodents was compared by different assays. Results The overall rate of wild ro- dent capture was 8.28% (237/2 861) in Dongzhi County, and the wild rodent capture rates were 9.24% (133/1 439) and 7.31% (104/1 422) in two study villages (χ² = 3.503, P = 0.061), and were 8.59% (121/1 409) and 7.99% (116/1 452) in June and September, 2021, respectively (χ² = 0.337, P = 0.561). The overall rate of wild rodent capture was 3.72% (77/2 072) in Duchang County, and the wild rodent capture rates were 6.91% (67/970) and 0.91% (10/1 102) in two study villages (χ² = 51.901, P < 0.001), and were 4.13% (39/945) and 3.37% (38/1 127) in June and September, 2021, respectively (χ² = 0.815, P = 0.365). Rattus norvegicus was the predominant rodent species captured in both counties, accounting for 70.04% (166/237) of all captured wild rodents in Dongzhi County and 88.31% (68/77) in Duchang County. No S. japonicum infection was detected in wild rodents captured in Duchang County. Nevertheless, the overall prevalence of S. japonicum infections was 51.05% (121/237) in wild rodents captured in Dongzhi County, with prevalence rates of 50.38% (67/133) and 51.92% (54/104) in two study villages (χ² = 0.098, P = 0.755), and 54.31% (63/116) and 47.93% (58/121) in September and June, 2021, respectively (χ² = 0.964, P = 0.326). Of 237 wild rodents captured in Dongzhi County, there were 140 (59.07%) rodents with visible hepatic egg granulomas, 117 (49.47%) tested positive for S. japonicum eggs by liver tissue homogenate microscopy, 34 (14.35%) tested positive for S. japonicum eggs with Kato-Katz technique; however, no adult S. japonicum worms were detected in mesenteric tissues. In addition, hepatic egg granulomas were found in all wild rodents tested positive for S. japonicum eggs with liver tissue homogenate microscopy. Conclusions The rate of wild rodent capture and prevalence of S. japonicum infection in wild rodents vary greatly in schistosomiasis-endemic areas of China, and the prevalence of S. japonicum infection is slightly higher in wild rodents captured in autumn than in summer. Liver tissue is recommended as the preferred sample for surveillance of S. japonicum infection in wild rodents, and a combination of macroscopical observation of hepatic egg granulomas and liver tissue homogenate microscopy may be a standard method for surveillance of S. japonicum infection in wild rodents.

Objective To identify the current research hotspots of global health training, and construct a global health talent training evaluation index system. Methods Publications pertaining to global health talent training evaluation were retrieved in China National Knowledge Infrastructure, Wanfang Database, and Web of Science Core Collection from 2003 to 2022, and keywords were extracted from eligible publications for co-occurrence and cluster analyses using the CiteSpace software. Based on keywords clustering results, a global health talent training evaluation index system was constructed using a context, input, process, and product (CIPP) evaluation model as a theoretical framework. Results A total of 692 Chinese publications and 1 264 English publications were included. Keyword co-occurrence and cluster analyses yielded 10 Chinese and 10 English keyword clusters, and the 10 Chinese keyword clusters included analytic hierarchy process, health diplomacy, personnel structure, crossdiscipline, educational assessment, global health discipline development, training needs, curriculum program, quality evaluation and logistics support, while the English keyword clusters included evidence-based practice, capacity building, global health, quality of life, machine learning, leadership, sub-Saharan Africa, health equity, global health security and global health diplomacy. Based on keyword clustering, a global health talent training evaluation index system was constructed with CIPP as the theoretical framework, which contained 4 primary indicators, 15 secondary indicators and 59 tertiary indicators, and the primary indicators included 4 dimensions of context evaluation, input evaluation, process evaluation and product evaluation. Conclusions A global health talent training evaluation index system has been constructed, which provides an effective evaluation tool and quantitative evidence for future global health talent training.

Objective To explore whether the medalists in 1 500-m freestyle swimming choose different pacing strategies from their competitors,so as to determine the most effective pacing strategy characteristics to obtain victory in swimming race.Methods The 1 500-m freestyle finalists in World Swimming Championships from 2003 to 2023 were selected as candidates of this study.According to the final ranking of the 175 elite athletes in the race,the split time,cumulative time were calculated,respectively.The differences of the main indicators in pacing strategies between medalists and their competitors were compared,and the above variables were selected for one-way ANOVA statistical analysis.Results The medalists had a significant speed advantage regardless of split time in the race,as well as the velocity of the starting stage,intermediate swim and end spurt(P<0.01).After the normalization of the cumulative time,the differences between the medalists and 4th-8th athletes in the percentage of split time and normalized velocity were mainly reflected in the last 400 m or so of the first and second half of the race(P<0.05).Regardless of whether they won medals or not,the pacing strategies of male freestyle swimmers were mostly reverse J-and U-shaped,while those of the female were mainly reverse J-shaped(90.9%).The diving start indicator(DSI)and end-spurt indicator(ESI)of medalists were higher,but the ESI of medalists was significantly different from that of 4th-8th athletes(P<0.05).Meanwhile,the coefficient of variation(CV)and the median and quartile of the density distribution of CV were significantly lower in intermediate stage.Conclusions All 1 500-m freestyle finalists follow a similar parabolic pacing strategies regardless of gender and final race ranking.Compared with their competitors,the medalists choose a relatively conservative starting strategy,a more even pace through the middle section of the race and a strong end-spurt.In summary,the reverse J-shape is an effective pacing strategy for the success of elite freestyle athletes in 1 500-m swimming competitions.

Objective To explore whether the medalists in 1 500-m freestyle swimming choose different pacing strategies from their competitors,so as to determine the most effective pacing strategy characteristics to obtain victory in swimming race.Methods The 1 500-m freestyle finalists in World Swimming Championships from 2003 to 2023 were selected as candidates of this study.According to the final ranking of the 175 elite athletes in the race,the split time,cumulative time were calculated,respectively.The differences of the main indicators in pacing strategies between medalists and their competitors were compared,and the above variables were selected for one-way ANOVA statistical analysis.Results The medalists had a significant speed advantage regardless of split time in the race,as well as the velocity of the starting stage,intermediate swim and end spurt(P<0.01).After the normalization of the cumulative time,the differences between the medalists and 4th-8th athletes in the percentage of split time and normalized velocity were mainly reflected in the last 400 m or so of the first and second half of the race(P<0.05).Regardless of whether they won medals or not,the pacing strategies of male freestyle swimmers were mostly reverse J-and U-shaped,while those of the female were mainly reverse J-shaped(90.9%).The diving start indicator(DSI)and end-spurt indicator(ESI)of medalists were higher,but the ESI of medalists was significantly different from that of 4th-8th athletes(P<0.05).Meanwhile,the coefficient of variation(CV)and the median and quartile of the density distribution of CV were significantly lower in intermediate stage.Conclusions All 1 500-m freestyle finalists follow a similar parabolic pacing strategies regardless of gender and final race ranking.Compared with their competitors,the medalists choose a relatively conservative starting strategy,a more even pace through the middle section of the race and a strong end-spurt.In summary,the reverse J-shape is an effective pacing strategy for the success of elite freestyle athletes in 1 500-m swimming competitions.

The medical records of all 12 patients diagnosed as chronic active Epstein-Barr virus (CAEBV) infection at our hospital were analyzed retrospectively.There were 7 males and 5 females with a median onset age of 28 years.CAEBV was characterized by fever,splenomegaly,hepatomegaly and lymphadenopathy,etc.The abnormalities of laboratory examination included liver dysfunction,thrombocytopenia,anemia and leucopenia.EBV-DNA detected by real-time polymerase chain reaction was (1.7 × 103-3.5 × 107) copies/μg DNA in peripheral blood mononuclear cell.Among them,the outcomes were death (n =5),lost to follow-up (n =2) and T cell lymphoma (n =1).It is necessary to improve our awareness of CAEBV infection because of its poor prognosis and high mortality.

BACKGROUND: As a stressor, severe acute respiratory syndrome (SARS)caused great psychological pressure during its outbreak in 2003 and SARSpatients suffered a sustained psychological stress. Investigation of the correlation of SARS onset with its psychology and etiology is now ongoing and the roles that the psychological factors might play in the disease course of SARS remain undefined.OBJECTIVE: To study the psychological status of SARS patients in the recovery stage so as to provide evidence to assist the resolution of their psychological problems.DESIGN: A sampling survey based on SARS patients.SETTING: Department of Rehabilitation with Breathing Exercise, Guang'anmen Hospital, China Academy of Traditional Chinese Medicine.PARTICIPANTS: SARS patients in the recovery stage, whose conditions were controlled and showed signs of improvement, were selected from the Third Disease Department and other departments, Beijing Geriatrics Hospital between April and June in 2003.INTERVENTIONS: Psychological status of SARS patients in the recovery stage was assessed with Symptom Check List (SCL-90) and Trait Coping Style Questionnaire (TCSQ).MAIN OUTCOME MEASURES:①Psychological statrs of SARS patients in the recovery stage;②differences of SCL-90 scores of SARS patients in the recovery stage in relation to sexes ,ages and education.RESULTS:①The somatization symptom scores of SARS patients in recovery stage in relation to sexes, ages and education.ery stage were significantly higher than norm( P ＜ 0.05), but those for compulsion, personal relationship, hostility and paranoia were significantly( P ＜ 0.05)②The somatization and anxiety scores of female patients were significantly higher than the female norm. Except somatization and psychoticism, the other factors of male patients had lower scores than norm. Moreover, the scores of SCL-90, somatization, anxiety and phobia in male SARS patients were significantly lower than those in female patients.③All factors in the aged group(50-60) scored less than those in other age groups, but scores for anxiety and somatization in patients between 30 -40years of age were obviously higher than those in other age groups, suggesting greater inpact of these two factors in these age group.④Patients receiving higher education had significantly lower scores for all factors except for somatization and anxiety than those with lower education.⑤Patients who used negative coping style had higher scores for all factors in SCL-90 than those who used positive coping style.CONCLUSION: The psychological status of SARS patients in the recovery stage are basically normal, but the anxiety of the female patients can be increased obviously, and the patients with lower education and those who use negative coping style have significant different psychology from other patients.

Objective To study the injury factors, pathogenic process and clinical features of delay two-phase multiple organ dysfunction syndrome (MODS) in severe burned patients and to replicate a standardized animal model that would accurately imitate the clinical features of MODS.Methods Forty-five human patients with burn size larger than 30% total body surface area (TBSA) were analyzed. All of them underwent severe burn shock in early stage and sepsis in late stage. Thirty-two goats were randomly divided into three groups: 1) hemorrhagic shock (group H, n=6); 2) endotoxemia (group E, n=6); and 3) hemorrhagic shock plus endotoxemia (group M, n=20). Hemorrhagic shock was produced according to the method of Wigger (6.7 kPa for an hour, 1 kPa=7.5 mmHg). Endotoxin (E. coli O111 B4) was given via the portal vein 24 hours after the resuscitation of hemorrhagic shock, in a dose of 30 ng/kg/min for 5 consecutive days. During the observation period of 10 days, all animals were hemodynamically monitored, given standard metabolic support and due cardiac and pulmonary support according to human intensive care.Results All the patients showed burn shock at 1-3 days and hyperdynamic circulation, hypermetabolism and systemic inflammatory responses over two weeks post-injury. Thirteen cases were found to develop MODS according to the prevailing diagnostic criteria, and 10 of them died with a mortality of 77%. Eighteen animals died in group M with a mortality of 90%, 12 of the 18 developed MODS, with overall incidence of 60%. Most animals in group M showed changes similar to that observed in human cases. The experimentation proved that in the pathogenic process of MODS, there was a two-hit phenomenon in the dvelopment of the syndrome. To prevent the development of MODS, it therefore was imperative to blunt the first hit or the second hit, so that an excessive inflammatory response was alleviated. This postulation has been verified in the treatment of extensive burns. Two patients with burn extent reaching 100% TBSA survived with only mild acute respiratory distress syndrome (ARDS) and renal dysfunction after comprehensive treatment of burn shock, including adequate fluid resuscitation, drugs to remove oxygen free radicals, rapid restoration of pHi, and early extensive excision of burn eschars.Conclusion Both in human patients or animal experimentation, the typical delay two-phase MODS is shown to be produced by two successive insults in the forms of hypovolemic shock and sepsis. This postulation is helpful in formulating the prevention and treatment modality of MODS.