Objective To analyze the trends in the disease burden of schistosomiasis in China from 1992 to 2021, and to project the disease burden of schistosomiasis in China from 2022 to 2030, so as to provide insights into the elimination of schistosomiasis in China. Methods The prevalence, age-standardized prevalence, disability-adjusted life year (DALYs) rate and age-standardized DALYs rate of schistosomiasis, as well as the years lost due to disability (YLDs) rate and age-standardized YLDs rate of anemia attributable to Schistosoma infections in China, the world and different socio-demographic index (SDI) regions were captured from the Global Burden of Disease Study 2021 (GBD 2021) data resources, and the trends in the disease burden due to schistosomiasis were evaluated with estimated annual percentage change (EAPC) and its 95% confidence interval (CI). In addition, the age, period and cohort effects on the prevalence of schistosomiasis were examined in China using an age-period-cohort (APC) model, and the disease burden of schistosomiasis was predicted in China from 2022 to 2030 using a Bayesian age-period-cohort (BAPC) model. Results The age-standardized prevalence and DALYs rate of schistosomiasis, and the age-standardized YLDs rate of anemia attributable to Schistosoma infections were 761.32/10⁵, 5.55/10⁵ and 0.38/10⁵ in China in 2021. These rates were all lower than the global levels (1 914.30/10⁵, 21.90/10⁵ and 3.36/10⁵, respectively), as well as those in the medium SDI regions (1 413.61/10⁵, 12.10/10⁵ and 1.93/10⁵, respectively), low-medium SDI regions (2 461.03/10⁵, 26.81/10⁵ and 4.48/10⁵, respectively), and low SDI regions (5 832.77/10⁵, 94.48/10⁵ and 10.65/10⁵, respectively), but higher than those in the high SDI regions (59.47/10⁵, 0.49/10⁵ and 0.05/10⁵, respectively) and high-medium SDI regions (123.11/10⁵, 1.20/10⁵ and 0.12/10⁵, respectively). The prevalence and DALYs rate of schistosomiasis were higher among men (820.79/10⁵ and 5.86/10⁵, respectively) than among women (697.96/10⁵ and 5.23/10⁵, respectively) in China in 2021, while the YLDs rate of anemia attributable to Schistosoma infections was higher among women (0.66/10⁵) than among men (0.12/10⁵). The prevalence of schistosomiasis peaked at ages of 30 to 34 years among both men and women, while the DALYs rate of schistosomiasis peaked among men at ages of 15 to 19 years and among women at ages of 20 to 24 years. The age-standardized prevalence of schistosomiasis showed a moderate decline in China from 1992 to 2021 relative to different SDI regions [EAPC = -1.51%, 95% CI: (-1.65%, -1.38%)], while the age-standardized DALYs rate [EAPC = -3.61%, 95% CI: (-3.90%, -3.33%)] and age-standardized YLDs rate of anemia attributable to Schistosoma infections [EAPC = -4.16%, 95% CI: (-4.38%, -3.94%)] appeared the fastest decline in China from1992 to 2021 relative to different SDI regions. APC modeling showed age, period, and cohort effects on the trends in the prevalence of schistosomiasis in China from 1992 to 2021, and the prevalence of schistosomiasis appeared a rise followed by decline with age, and reduced with period and cohort. BAPC modeling revealed that the age-standardized prevalence and age-standardized DALYs rate of schistosomiasis, and age-standardized YLDs rate of anemia attributable to Schistosoma infections all appeared a tendency towards a decline in China from 2022 to 2030, which reduced to 722.72/10⁵ [95% CI: (538.74/10⁵, 906.68/10⁵)], 5.19/10⁵ [95% CI: (3.54/10⁵, 6.84/10⁵)] and 0.30/10⁵ [95% CI: (0.21/10⁵, 0.39/10⁵)] in 2030, respectively. Conclusions The disease burden of schistosomiasis appeared a tendency towards a decline in China from 1992 to 2021, and is projected to appear a tendency towards a decline from 2022 to 2030. There are age, period and cohort effects on the prevalence of schistosomiasis in China. Precision schistosomiasis control is required with adaptations to current prevalence and elimination needs.

BACKGROUND: The mechanisms distinguishing metabolically healthy from unhealthy phenotypes within the same BMI categories remain unclear. This study aimed to investigate the associations between regional fat distribution and metabolically unhealthy phenotypes in Chinese adults across different BMI categories. METHODS: This cross-sectional study involving 11833 Chinese adults aged 20 years and older. Covariance analysis, adjusted for age, compared the percentage of regional fat (trunk, leg, or arm fat divided by whole-body fat) between metabolically healthy and unhealthy participants. Trends in regional fat percentage with the number of metabolic abnormalities were assessed by the Jonckheere-Terpstra test. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated by logistic regression models. All analyses were performed separately by sex. RESULTS: In non-obese individuals, metabolically unhealthy participants exhibited higher percent trunk fat and lower percent leg fat compared to healthy participants. Additionally, percent trunk fat increased and percent leg fat decreased with the number of metabolic abnormalities. After adjustment for demographic and lifestyle factors, as well as BMI, higher percent trunk fat was associated with increased odds of being metabolically unhealthy [highest vs. lowest quartile: ORs (95%CI) of 1.64 (1.35, 2.00) for men and 2.00 (1.63, 2.46) for women]. Conversely, compared with the lowest quartile, the ORs (95%CI) of metabolically unhealthy phenotype in the highest quartile for percent arm and leg fat were 0.64 (0.53, 0.78) and 0.60 (0.49, 0.74) for men, and 0.72 (0.56, 0.93) and 0.46 (0.36, 0.59) for women, respectively. Significant interactions between BMI and percentage of trunk and leg fat were observed in both sexes, with stronger associations found in individuals with normal weight and overweight. CONCLUSIONS Trunk fat is associated with a higher risk of metabolically unhealthy phenotype, while leg and arm fat are protective factors. Regional fat distribution assessments are crucial for identifying metabolically unhealthy phenotypes, particularly in non-obese individuals.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Adipose Tissue ; Body Fat Distribution ; Body Mass Index ; China/epidemiology* ; Cross-Sectional Studies ; Health Surveys ; Phenotype

Traditional development of small protein scaffolds has relied on display technologies and mutation-based engineering, which limit sequence and functional diversity, thereby constraining their therapeutic and application potential. Protein design tools have significantly advanced the creation of novel protein sequences, structures, and functions. However, further improvements in design strategies are still needed to more efficiently optimize the functional performance of protein-based drugs and enhance their druggability. Here, we extended an evolution-based design protocol to create a novel minibinder, BindHer, against the human epidermal growth factor receptor 2 (HER2). It not only exhibits super stability and binding selectivity but also demonstrates remarkable properties in tissue specificity. Radiolabeling experiments with ^99mTc, ⁶⁸Ga, and ¹⁸F revealed that BindHer efficiently targets tumors in HER2-positive breast cancer mouse models, with minimal nonspecific liver absorption, outperforming scaffolds designed through traditional engineering. These findings highlight a new rational approach to automated protein design, offering significant potential for large-scale applications in therapeutic mini-protein development.

Diabetes, a metabolic disease stemming from impaired or defective insulin secretion, ranks among the most severe chronic illnesses globally. While several approved drugs exist for its treatment, they often come with multiple side effects. Therefore, there is a pressing need for safe and effective anti-diabetic medications. Traditional Chinese medicine has recognized Lycium barbarum (LB; goji berry) plant, commonly known as "wolfberry fruit" in China, for over 2,000 years. Natural compounds derived from LB show promise in reducing diabetes levels. Although research on the impact of LB on diabetes is still limited, our review aims to explore the potential of LB in reducing the risk of diabetes and examine the underlying mechanisms involved. LB can modulate diabetes through various pathways, such as inhibiting α-amylase and α-glucosidase activities, promoting β-cell proliferation, stimulating insulin secretion, inhibiting glucagon secretion, improving insulin resistance and glucose tolerance, and enhancing antioxidant and anti-inflammatory activities. Additionally, LB improves gut flora and immunomodulation, further aiding diabetes management. These findings highlight the potential clinical utility of LB in managing diabetes and its complications within the framework of evidence-based modern medicine.

ObjectiveTo investigate the epidemic characteristics and influencing factors of acute conjunctivitis caused by human adenovirus（HAdv）in Yantian District of Shenzhen City， Guangdong Province from 2014 to 2022， and to provide evidence for formulating effective prevention and control measures. MethodsDescriptive epidemiology was used to analyze the epidemiological characteristics of acute hemorrhagic conjunctivitis （AHC） cases reported from the Chinese disease prevention and control information system. Etiological characteristics of laboratory-confirmed cases were analyzed， and a case-control study method of test-negative design （TND） was conducted as well. According to the result of HAdv detection， analysis was used to identify the influencing factors of morbidity. ResultsA total of 1 005 AHC cases were reported in Yantian District， Shenzhen City from 2014 to 2022， with an average annual incidence rate of 49.49/10⁵. The incidence rate ranged from 4.67/10⁵ to 117.28/10⁵. The peak incidence occurred from July to October each year， with a male-to-female ratio of 1.42∶1. The median （P₂₅，P₇₅） age of onset was 29（12，40） years. A total of 716 eye swabs were collected for etiological detection from 2014 to 2022. HAdv positive detection rate was 36.45% （263/716）， Cox 24v positive detection rate was 0.28% （2/716）， while EV70 was not detected. The longest viral shedding time in eye swabs was 10 days， with a median of 2 days. The highest HAdv positive detection rate （47.47%） was observed when the sampling-to-onset interval was 4‒5 days， and the difference was statistically significant （P<0.05）， with a trend of first increasing and then decreasing. Multivariate logistic regressing analysis showed that aged 18‒ years， and average temperature higher than 24.90 ℃ 3 days before onset （P<0.05） were the risk factors for acute HAdv conjunctivitis. ConclusionAHC in Yantian District， Shenzhen City showed a low level of prevalence from 2014 to 2022， with HAdv being the predominant pathogen. The peak period of viral shedding occurred on the 4th to 5th day after symptom onset， suggesting the importance of adherence to strict home isolation for infected persons. Aged18‒ years and average temperature increased 3 days before onset are associated with an increased risk of adenoviral conjunctivitis. It is recommended to strengthen personal protection and keep doing a good job of AHC surveillance and early warning， so as to timely prevent the outbreaks of AHC.

Objective: To investigate the incidence trend of sexually transmitted diseases (STDs) in Yantian District, Shenzhen City, Guangdong Province from 2008 to 2022, and the effects of age, period, and cohort on STDs incidence, so as to provide the basis for formulating control measures for STDs. Methods: Data of reported STDs cases (syphilis, gonorrhea, genital Chlamydia trachomatis infections, condyloma acuminatum and genital herpes) among population aged 15 to 64 years in Yantian District from 2008 to 2022 were collected through the Chinese Disease Control and Prevention Information System. The temporal and population distribution of STDs were descriptively analyzed. Trends in incidence of STDs were analyzed using average annual percent change (AAPC). Impacts of age, period and cohort on the incidence of STDs were analyzed by an age-period-cohort model. Results: A total of 6 156 cases of STDs aged 15 to 64 years were reported from 2008 to 2022, and the average annual incidence was 229.92/105. The overall incidence showed an upward trend (AAPC=2.409%, P<0.05), and an upward trend among females (AAPC=5.846%, P<0.05), but the trend was not statistically significant among males (AAPC=0.193%, P>0.05). The incidence of STDs showed an increasing trend followed by a decreasing trend with the increase of age. The incidence trend among males was consistent with the overall population, reaching its peak in the age group of 30 to 34 years (371.04/105), while the incidence among females showed an increasing trend with the increase of age, peaking in the age group of 60 to 64 years (442.15/105). Compared with 2013-2017, the incidence risk of STDs showed an increasing trend in 2018-2022 (RR=1.349, 95%CI: 1.217-1.495). Compared with the birth cohort of 1975-1979, the incidence risk of STDs in 1980-2005 birth cohort showed an increasing trend, with the highest incidence risk in 2000-2004 birth cohort (RR=4.178, 95%CI: 2.717-6.423). Conclusions The overall incidence of STDs among residents aged 15 to 64 years in Yantian District from 2008 to 2022 appeared a tendency towards a rise. Age, period and cohort all had impacts on the incidence, with a greater effect among females than males.

Objective:To understand the major cognition, major choice motivation and the relationship between the two of medical students, and provide references and suggestions for the selection of talents in various majors of medical schools and the effective development of enrollment work.Methods:This study selected undergraduates of Batch 2019 from Peking University Health Science Center as the survey objects, conducted a questionnaire survey on their major cognition, major choice motivation and influencing factors, and used principal component analysis and Spearman rank correlation analysis.Results:The study found that the major cognition scores of 640 undergraduates of Batch 2019 from Peking University Health Science Center were clinical medicine (3.24±0.89) > stomatology (2.89±1.00) > basic medicine (2.66±1.02) > pharmacy (2.54±0.97) > preventive medicine (2.29±0.93) > nursing medicine (2.21±0.99) > medical laboratory (1.98±0.95) > medical English (1.95±0.93). Six major motivation factors for professional choice were school and professional strength, professional learning and job prospects, own factors, Peking University sentiments and the influence of others, medical factors, school policies, and the contribution rates were 34.60%, 12.97%, 7.42%, 6.00%, 5.59% and 5.37%, respectively. Major cognition scores and major choice motivation factors were positively correlated with each other to some extent.Conclusions:At present, students' major cognition level of medical majors still has a large room for improvement, and the motivational factors of major choice are more complicated, among which "the school and professional strength" and "the prospects of study and work" are important factors. Medical schools should focus on strengthening major publicity, improving students' major cognition, attracting aspiring students to apply for medical majors from many aspects, and improving the training quality of medical professionals.

ObjectiveTo observe the effect of Yangyin Xifeng Tongluo Formula （养阴熄风通络方） and its core herbs combination on prevention of ventricular precontraction （PVC）. MethodsExperiment 1： Forty SD rats were randomly divided into model group， formula group， core herb-pairs medium-dose group and amiodarone group， with 10 rats in each group. Rats in the model group were given 10 ml/（kg·d） of pure water by gavage， rats in the formula group were given 1.125 g/（kg·d） of Yangyin Xifeng Tongluo Granules （养阴熄风通络方颗粒） by gavage， rats in the core herb-pairs medium-dose group were given 0.585 g/（kg·d） of granules of core herb-pairs by gavage， and rats in the amiodarone group were given 18 mg/（kg·d） of amiodarone hydrochloride tablets by gavage. The rats in each group were gavaged once a day for 14 consecutive days， and then a PVC model was established using rat tail vein injection of aconitine 25 μg/kg to compare the mortality and incidence of PVC， ventricular tachycardia （VT） and ventricular fibrillation （VF）， the time of the appearance of PVC， and the duration of PVC in the rats in each group. Experiment 2： Sixty SD rats were randomly divided into model group， the amiodarone group， and the core herb-pairs of low， medium and high dose groups， 12 rats in each group. Rats in the model group were gavaged with 10 ml/（kg·d） of purified water， rats in the low， medium， and high dose groups were gavaged with 0.2925， 0.585， and 1.17 g/（kg·d） of the core herb-pairs granules respectively， and rats in the amiodarone group were gavaged with 18 mg/（kg·d） of amiodarone hydrochloride tablets. All of them were gavaged once a day. After 14 days， rats in each group were injected intravenously into the tail vein with aconitine 25 μg/kg， and then the rats in each group were observed to show the mortality and incidence of PVC， VT and VF， and the time of appearance and duration of PVC. ResultsExperiment 1： Compared with the model group， The difference in the incidence of PVC in rats of all groups was not statistically signi-ficant （P＞0.05）， and the mortality and incidence of VT and VF in rats in the formula group， the core herb-pairs medium-dose group， and the amiodarone group significantly reduced， with delayed time of the occurrence of PVC and shorter duration of the PVC （P＜0.05 or P＜0.01） as compared with the model group， whereas the difference between each group with medication intervention was not statistically significant （P＞0.05）. Experiment 2： There was no statistically significant difference in the incidence of PVC in all groups （P＞0.05）， and the mortality and incidence of VT and VF reduced in the core herb-pairs of low-， medium-， and high-dose groups and in the amiodarone group， and the appearance of PVC delayed and its duration shortened （P＜0.05 or P＜0.01） as compared with the control group， whereas the differences were not statistically significant in the comparison among groups with medication （P＞0.05）. ConclusionBoth Yangyin Xifeng Tongluo Formula and its core herb-pairs could delay the time of occurrence and shorten the duration of PVC.

Objectives:To explore the clinical value of two-dimensional speckle tracking echocardiography(STE)on evaluating right ventricular function in patients with Fabry disease(FD). Methods:From August 2014 to June 2023,57 patients with FD and 57 age-(±2 year)and sex-matched healthy controls were included in this study.Clinical characteristics,echocardiographic parameters and right ventricular strain parameters were compared between the two groups.According to the left ventricular mass index(LVMI),FD patients were further divided into the left ventricular hypertrophy(LVH)group(n=22,men:LVMI≥115 g/m2,women:LVMI≥95 g/m2)and the non-LVH(n=35,men:LVMI<115 g/m2,women:LVMI<95 g/m2)group,the association between right ventricular strain and LVH in FD patients was analyzed. Results:(1)The brain natriuretic peptide(BNP)level was higher,heart rate and estimate glomerular filtration rate(eGFR)were lower in the FD group than in healthy control group(all P<0.05).Interventricular septum(IVS)and left ventricular posterior wall(LVPW)thickness as well as left ventricular mass index(LVMI)and right ventricular free wall(RVFW)thickness were significantly higher in FD group than in healthy control group(all P<0.05).(2)Subgroup analysis showed that the age,systolic blood pressure,BNP,LVMI and RVFW thickness were significantly higher,while eGFR was lower in the LVH group than in the non-LVH group(all P<0.05).(3)The left ventricular global longitudinal strain(LVGLS),right ventricular global longitudinal strain(RVGLS),right ventricular free wall strain(RVFWS),RVFWS at basal,middle and apical segment were lower in FD patients than in healthy controls(all P<0.05).There was no significant difference in right ventricular strain difference value(ΔRV)between the FD group and controls(P>0.05).(4)In the LVH group,LVGLS and RVGLS were significantly declined and ΔRV increased(all P<0.05),while RVFWS and all three segments preserved compared with the non-LVH group(all P>0.05). Conclusions:Myocardial strain analysis is valuable on the assessment of global and regional myocardial work in FD patients.RVGLS and RVFWS are reduced in FD patients.RVGLS is decreased in the LVH patients,while RVFWS is preserved in FD patients.

Objective:To examine the impact of varied surgical treatment strategies on the prognosis of patients with initial resectable gastric cancer liver metastases (IR-GCLM).Methods:This is a retrospective cohort study. Employing a retrospective cohort design, the study selected clinicopathological data from the national multi-center retrospective cohort study database, focusing on 282 patients with IR-GCLM who underwent surgical intervention between January 2010 and December 2019. There were 231 males and 51 males, aging ( M(IQR)) 61 (14) years (range: 27 to 80 years). These patients were stratified into radical and palliative treatment groups based on treatment decisions. Survival curves were generated using the Kaplan-Meier method and distinctions in survival rates were assessed using the Log-rank test. The Cox risk regression model evaluated HR for various factors, controlling for confounders through multivariate analysis to comprehensively evaluate the influence of surgery on the prognosis of IR-GCLM patients. A restricted cubic spline Cox proportional hazard model assessed and delineated intricate associations between measured variables and prognosis. At the same time, the X-tile served as an auxiliary tool to identify critical thresholds in the survival analysis for IR-GCLM patients. Subgroup analysis was then conducted to identify potential beneficiary populations in different surgical treatments. Results:(1) The radical group comprised 118 patients, all undergoing R0 resection or local physical therapy of primary and metastatic lesions. The palliative group comprised 164 patients, with 52 cases undergoing palliative resections for gastric primary tumors and liver metastases, 56 cases undergoing radical resections for gastric primary tumors only, 45 cases undergoing palliative resections for gastric primary tumors, and 11 cases receiving palliative treatments for liver metastases. A statistically significant distinction was observed between the groups regarding the site and the number of liver metastases (both P<0.05). (2) The median overall survival (OS) of the 282 patients was 22.7 months (95% CI: 17.8 to 27.6 months), with 1-year and 3-year OS rates were 65.4% and 35.6%, respectively. The 1-year OS rates for patients in the radical surgical group and palliative surgical group were 68.3% and 63.1%, while the corresponding 3-year OS rates were 42.2% and 29.9%, respectively. A comparison of OS between the two groups showed no statistically significant difference ( P=0.254). Further analysis indicated that patients undergoing palliative gastric cancer resection alone had a significantly worse prognosis compared to other surgical options ( HR=1.98, 95% CI: 1.21 to 3.24, P=0.006). (3) The size of the primary gastric tumor significantly influenced the patients′ prognosis ( HR=2.01, 95% CI: 1.45 to 2.79, P<0.01), with HR showing a progressively increasing trend as tumor size increased. (4) Subgroup analysis indicates that radical treatment may be more effective compared to palliative treatment in the following specific cases: well/moderately differentiated tumors ( HR=2.84, 95% CI 1.49 to 5.41, P=0.001), and patients with liver metastases located in the left lobe of the liver ( HR=2.06, 95% CI 1.19 to 3.57, P=0.010). Conclusions:In patients with IR-GCLM, radical surgery did not produce a significant improvement in the overall prognosis compared to palliative surgery. However, within specific patient subgroups (well/moderately differentiated tumors, and patients with liver metastases located in the left lobe of the liver), radical treatment can significantly improve prognosis compared to palliative approaches.