OBJECTIVES: To investigate the clinical application of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in the etiological diagnosis and treatment of refractory pneumonia (RTP) in children. METHODS: A retrospective analysis was performed on 160 children with RTP who were admitted to the Department of Pediatric Internal Medicine, Maternal and Child Health Hospital of Inner Mongolia Autonomous Region, from January 2020 to March 2023. According to whether mNGS was performed, they were divided into two groups: mNGS (n=80) and traditional testing (n=80). All children received the tests of inflammatory markers and pathogen tests after admission. Traditional pathogenicity tests included microbial culture (sputum specimen collected by suction tube), nucleic acid detection of respiratory pathogens, and serological test (mycoplasma, tuberculosis, and fungi). For the mNGS group, BALF specimens were collected after bronchoscopy and were sent to the laboratory for mNGS and microbial culture. The two groups were analyzed and compared in terms of the detection of pathogens and treatment. RESULTS: Compared with the traditional testing group, the mNGS group had a significantly higher detection rate of pathogens (92% vs 58%, P<0.05), with more types of pathogens and a higher diagnostic rate of mixed infections. Compared with the traditional testing group, the mNGS group had a significantly higher treatment response rate and a significantly lower incidence rate of complications during hospitalization (P<0.05). Treatment was adjusted for 68 children in the mNGS group according to the results of mNGS, with a treatment response rate of 96% (65/68) after adjustment. CONCLUSIONS Compared with traditional pathogen tests, BALF mNGS can significantly improve the detection rate of pathogens and find some rare pathogens. In clinical practice, when encountering bottlenecks during the diagnosis and treatment of children with RTP, it is advisable to promptly perform the mNGS to identify the pathogens.
Humans ; Child ; Bronchoalveolar Lavage Fluid ; Retrospective Studies ; Pneumonia/therapy* ; High-Throughput Nucleotide Sequencing ; Bronchoscopy ; Sensitivity and Specificity

Humans ; Carcinoma, Hepatocellular/surgery* ; Liver Neoplasms/pathology* ; Cholangiocarcinoma/pathology* ; Bile Ducts, Intrahepatic/pathology* ; Bile Duct Neoplasms/pathology*

Blastocystis is a common unicellular intestinal protozoa in humans and animals, and the most common clinical manifestations of infections include abdominal pain and diarrhea. Based on the sequence of the small-subunit ribosomal RNA (SSU rRNA) gene, 28 subtypes of B. hominis (ST1 to ST17, ST21 and ST23 to ST32) have been characterized. Previous studies have demonstrated that B. hominis infection is strongly associated with inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and other intestinal diseases, which threatens the health and quality of life among patients with B. hominis infection and is considered as an important public health problem. This review summarizes the progress of researches on B. hominis infection among IBD and IBS patients during the past 20 years, so as to provide insights into management of blastocystosis in China.
Animals ; Humans ; Irritable Bowel Syndrome/parasitology* ; Blastocystis Infections/complications* ; Quality of Life ; Blastocystis hominis/genetics* ; Feces/parasitology* ; Inflammatory Bowel Diseases/parasitology*

OBJECTIV E To study composition an d content changes of volatile components during the bleaching process of Atractylodis macrocephala with the water of washing rice. METHODS The raw products of A. macrocephala and bleached products of 5 different bleaching stages were prepared （in the first and second stages ，raw products were bleached with 9-fold volumn of the water of washing rice for 12 h and 24 h，respectively；in the third ，fourth and fifth stages ，the raw products were firstly bleached with 9-fold volumn of the water of washing rice for 24 h，and then bleached with 9-fold volumn of clean water for 12，24 and 48 h，respectively）；the bleaching temperature was set at 26 ℃. The volatile components of raw products of A. macrocephala and its bleached products of 5 different bleaching stages were qualitatively analyzed by using headspace gas chromatography-mass spectrometry. The relative percentage of each component was calculated by peak area normalization method. RESULTS A total of 49 volatile components were identified from raw products of A. macrocephala and its bleached products of 5 different bleaching stages，including 20 common volatile components such as terpinolene ，cyperene and atractylon ，etc. Among them ，33，31，28， 30，28 and 29 volatile components were identified from the raw products of A. macrocephala and the bleached products of the first to fifth stages ，the relative percentages of which were 66.218％ ，64.711％ ，79.410％ ，65.419％ ，67.101％ ，66.818％ ， respectively；among them ，the relative percentage of atractylon in bleached products was the highest in the fourth stage （41.206％），but was the lowest in the third stage （35.926％）. Compared with the raw product ，16 volatile components such as pethylbrene and β-vetivenen were added in the bleaching process ，while 8 volatile components such as ethyl palmitate and β-maaliene were not detected. However ，5 volatile components including 11-rotundene and （－）-valeranone in the bleaching process showed a trend of disappearance-emergence and disappearance-emergence-disappearance. CONCLUSIONS In the third stage，the total relative percentage of each volatile component and the relative percentage of representative dry component as ， atractylone are the lowest in bleached products of A. ； macrocephala，i.e. the bleaching technology of relieving the dry property of A. macrocephala e with the water of washing rice is bleaching with 9-fold volumn of the water of washing rice for 24 h，and then bleaching with 9-fold volumn of clean water for 12 h.

Allyl Compounds ; Animals ; Lung ; Male ; Paraquat/pharmacology* ; Poisons ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Sulfides

Objectives: To determine the association of different levels of sunlight exposure, measured using the Filipino sunlight exposure questionnaire (SEQ) with 25-hydroxyvitamin D (25-OHD) levels among working urban adult Filipinos. Methods: Seventy-five adult participants, living and working in Metro Manila, for at least 1 year, were grouped according to their perceived sunlight exposure pattern: low sunlight exposure (mostly indoor work); moderate sunlight exposure (both indoor and outdoor work); and high sunlight exposure (mostly outdoor work). After completion of the self-administered Filipino SEQ, they underwent serum 25-OHD level determination. Strength of correlation between the SEQ scores and 25-OHD levels was computed. Results: Serum 25-OHD levels generally increased with increasing sunlight exposure levels. The overall Pearson’s correlation between the SEQ scores and 25-OHD levels of the participants was 0.396 (P ¼ 0.001). The correlation for the individual domains was 0.342 for intensity of sunlight exposure (P ¼ 0.003), 0.321 for factors affecting sunlight exposure (P ¼ 0.005), and 0.256 for sun protection practices (P ¼ 0.027). Conclusions The sunlight exposure of working urban adult Filipinos, as measured by the Filipino SEQ, has an overall significant, direct and moderate association with serum 25-OHD levels. This Filipino SEQ can serve as a valuable clinical tool for sunlight exposure assessment to identify individuals at risk for vitamin D deficiency.

During the Coronavirus Disease 2019 (COVID-19) pandemic, practices of gastrointestinal procedures within the digestive tract require special precautions due to the risk of contraction of severe acute respiratoy syndrome coronavirus-2 (SARS-CoV-2) infection. Many procedures in the gastrointestinal motility laboratory may be considered moderate to high-risk for viral transmission. Healthcare staff working in gastrointestinal motility laboratories are frequently exposed to splashes, air droplets, mucus, or saliva during the procedures. Moreover, some are aerosol-generating and thus have a high risk of viral transmission. There are multiple guidelines on the practices of gastrointestinal endoscopy during this pandemic. However, such guidelines are still lacking and urgently needed for the practice of gastrointestinal motility laboratories. Hence, the Asian Neurogastroenterology and Motility Association had organized a group of gastrointestinal motility experts and infectious disease specialists to produce a position statement paper based-on current available evidence and consensus opinion with aims to provide a clear guidance on the practices of gastrointestinal motility laboratories during the COVID-19 pandemic. This guideline covers a wide range of topics on gastrointestinal motility activities from scheduling a motility test, the precautions at different steps of the procedure to disinfection for the safety and well-being of the patients and the healthcare workers. These practices may vary in different countries depending on the stages of the pandemic, local or institutional policy, and the availability of healthcare resources. This guideline is useful when the transmission rate of SARS-CoV-2 is high. It may change rapidly depending on the situation of the epidemic and when new evidence becomes available.

INTRODUCTION: Medical students are susceptible to depression due to the constant exposure to stressful situations and almost 30% of medical students suffer from depression. This study aimed to determine the prevalence of depression among first- to third-year medical students in a private medical institution. METHODS: A descriptive, cross-sectional study design was employed on first- to third-year medical students selected through simple random sampling. They were asked to answer the Patient Health Questionnaire-9 for the assessment of depression. RESULTS: The prevalence of moderate to severe depression was 19.1%. Almost 15% of the first-year medical students, 23.7% of the second-year medical students and 18.3% of the third-year students were found to have a risk of having depression. Twenty-one percent of the male students and 18.4% of the females were classified to have depression. CONCLUSION Almost one-fifth of the first- to third-year medical students in the private medical institution have depression. The highest prevalence of having depression was among second-year medical students, males, 20 to 22 years old.
Depression

Precision medicine became the key strategy in development priority of science and technology in China. The large population-based cohorts become valuable resources in preventing and treating major diseases in the population, which can contribute scientific evidence for personalized treatment and precise prevention. The fundamental question of the achievements above, therefore, is how to construct a large population-based cohort in a standardized way. The Chinese Preventive Medicine Association co-ordinated experienced researchers from Peking University and other well-known institutes to write up two group standards Technical specification of data processing for large population-based cohort study (T/CPMA 001-2018) and Technical specification of data security for large population-based cohort study (T/CPMA 002-2018), on data management. The standards are drafted with principles of emphasizing their scientific, normative, feasible, and generalizable nature. In these two standards, the key principles are proposed, and technical specifications are recommended in data standardization, cleansing, quality control, data integration, data privacy protection, and database security and stability management in large cohort studies. The standards aim to guide the large population-based cohorts that have been or intended to be established in China, including national cohorts, regional population cohorts, and special population cohorts, hence, to improve domestic scientific research level and the international influence, and to support decision-making and practice of disease prevention and control.
China ; Cohort Studies ; Delivery of Health Care ; Humans ; Population Surveillance ; Quality Control ; Reference Standards

Objective: To describe the genetic structure of populations in different areas of China, and explore the effects of different strategies to control the confounding factors of the genetic structure in cohort studies. Methods: By using the genome-wide association study (GWAS) on data of 4 500 samples from 10 areas of the China Kadoorie Biobank (CKB), we performed principal components analysis to extract the first and second principal components of the samples for the component two-dimensional diagram generation, and then compared them with the source of sample area to analyze the characteristics of genetic structure of the samples from different areas of China. Based on the CKB cohort data, a simulation data set with cluster sample characteristics such as genetic structure differences and extensive kinship was generated; and the effects of different analysis strategies including traditional analysis scheme and mixed linear model on the inflation factor (λ) were evaluated. Results: There were significant genetic structure differences in different areas of China. Distribution of the principal components of the population genetic structure was basically consistent with the geographical distribution of the project area. The first principal component corresponds to the latitude of different areas, and the second principal component corresponds to the longitude of different areas. The generated simulation data showed high false positive rate (λ=1.16), even if the principal components of the genetic structure was adjusted or the area specific subgroup analysis was performed, λ could not be effectively controlled (λ>1.05); while, by using a mixed linear model adjusting for the kinship matrix, λ was effectively controlled regardless of whether the genetic structure principal component was further adjusted (λ=0.99). Conclusions: There were large differences in genetic structure among populations in different areas of China. In molecular epidemiology studies, bias caused by population genetic structure needs to be carefully treated. For large cohort data with complex genetic structure and extensive kinship, it is necessary to use a mixed linear model for association analysis.
China ; Genetic Structures ; Genome-Wide Association Study ; Humans ; Linear Models ; Principal Component Analysis