Objective To integrate and analyze the disease burden of esophageal cancer caused by alcohol consumption in China from 1990 to 2019, along with the differences between genders, and predict the trends in disease burden changes from 2020 to 2029 to improve prevention and treatment strategies. Methods The disease burden of esophageal cancer caused by alcohol consumption in China from 1990 to 2019 was extracted and integrated from the 2019 Global Burden of Disease (GBD) database, and the corresponding trend was analyzed using the Joinpoint regression model with Joinpoint 4.9.1.0 software. The gray prediction model [GM (1, 1) ] was used to forecast the disease burden of alcohol-related esophageal cancer in China from 2020 to 2029. Results In 2019, the leading causes of esophageal cancer in China were tobacco, alcohol, high body mass index, and insufficient fruit and vegetable intake, accounting for the first to fifth positions in esophageal cancer deaths. From a gender perspective, in 2019, the death number and standardized mortality rate for males were 18.97 times and 20.00 times higher than for females, respectively. The disability-adjusted life years (DALYs) and standardized DALYs rate for males were 33.08 times and 24.78 times higher than those for females, respectively, indicating a heavier disease burden of alcohol-related esophageal cancer among Chinese males. From 1990 to 2019, the average annual percentage change (AAPC) in deaths and DALYs due to alcohol-related esophageal cancer in China was 2.08% and 1.63%, respectively, showing a continuous upward trend with statistical significance (P<0.05). The AAPC values for standardized mortality rate and standardized DALYs rate from 1990 to 2019 were –0.92% and –1.23%, respectively, showing a continuous downward trend with statistical significance (P<0.05). The population aged ≥55 years was the main group bearing the disease burden among all age groups from 1990 to 2019. The gray prediction model predicted that by 2029, the overall standardized mortality rate and standardized DALYs rate would decrease to 2.94/100 000and 67.94/100 000, with a greater decline in females than in males. Conclusion Over the past 30 years, the disease burden of alcohol-related esophageal cancer in China has slightly decreased. However, the reduction in disease burden is still lower compared to the overall decline in esophageal cancer burden, and the disease burden for males is significantly higher than for females. Focusing on prevention and treatment for males and the elderly population remains a major issue in addressing alcohol-related esophageal cancer in China.

Objective To observe the value of clinical and CT radiomics features for predicting microsatellite instability-high(MSI-H)status of gastric cancer.Methods Totally 150 gastric cancer patients including 30 cases of MSI-H positive and 120 cases of MSI-H negative were enrolled and divided into training set(n=105)or validation set(n=45)at the ratio of 7∶3.Based on abdominal vein phase enhanced CT images,lesions radiomics features were extracted and screened,and radiomics scores(Radscore)was calculated.Clinical data and Radscores were compared between MSI-H positive and negative patients in training set and validation set.Based on clinical factors and Radscores being significant different between MSI-H positive and negative ones,clinical model,CT radiomics model and clinical-CT radiomics combination model were constructed,and their predictive value for MSI-H status of gastric cancer were observed.Results Significant differences of tumor location and Radscore were found between MSI-H positive and negative patients in both training and validation sets(all P＜0.05).The area under the curve(AUC)of clinical model,CT radiomics model and combination model for evaluating MSI-H status of gastric cancer in training set was 0.760,0.799 and 0.864,respectively,of that in validation set was 0.735,0.812 and 0.849,respectively.AUC of clinical-CT radiomics combination model was greater than that of the other 2 single models(all P＜0.05).Conclusion Clinical-CT radiomics combination model based on tumor location and Radscore could effectively predict MSI-H status of gastric cancer.

Objective:To study the biological traits and mutations of the influenza A (H3N2) virus in order to produce a vaccine and offer references for controlling and preventing influenza epidemics.Methods:Four strains of the influenza A(H3N2) virus were chosen from the Huai′an surveillance network laboratory. Nucleic acid extraction, library building, and sequencing (CridION x5 MKI Nanopore) were used to produce the whole-genome sequences. Using homologous alignments of whole-genome sequences, phylogenetic tree construction, and amino acid variant screening, bioinformatics analysis was carried out.Results:The nucleotide identity between 8 gene segments ranged from 97.1% to 100.0%. The gene that differed the most from the reference sequences was HA (97.1%-99.9%), and the gene that differed the least was MP (98.6%-99.9%). The HA gene (3.06%) and MP gene (1.43%) were the regions with the greatest and lowest frequencies of nucleotide site change, respectively. The rates of nucleotide change varied significantly between the genes ( χ2=14.293, P=0.046). Four influenza A(H3N2) virus strains′ whole-genome phylogenies from each of the eight gene segments maintained a roughly consistent topological structure. One strain was linked to the 3C.2a1b.1b clade, which was lost at the 142NWT, 149NGT(HA1), and 436NLS(NA). Three strains were linked to the 3C.2a1b.2a.1a clade lineage. Amantadine and NA inhibitors were effective against all Huai′an strains. Conclusions:The antigenicity of one strain of Huai'an strain changed and its matching with the vaccine strain of that year was low. It is suggested that the genetic surveillance of H3N2 influenza virus should be continuously strengthened to provide scientific basis for influenza prevention and control and influenza vaccine screening.

Objectives:To analyze the disease burden and changing trends of non-rheumatic valvular heart disease(NRVHD)from 1990 to 2019 in China. Methods:Based on the Global Burden of Disease 2019 database,we collected data related to NRVHD in China from 1990 to 2019,analyzed the crude incidence rate,crude prevalence rate,crude disability-adjusted life year(DALY),and age-scaled rate of NRVHD during this period,and analyzed the corresponding trends.The grey prediction model GM(1,1)was used to predict the disease burden of NRVHD in China from 2020 to 2029. Results:The crude incidence,crude prevalence,and crude DALY rates of NRVHD increased in China from 7.87/100 000,123.21/100 000,and 9.83/100 000 in 1990 to 22.85/100 000,374.16/100 000,and 11.95/100 000 in 2019;the age-standardized incidence rate and the age-standardized prevalence rate increased from 9.22/100 000 and 169.04/100 000 in 1990 to 15.30/100000 and 262.85/100 000 in 2019 respectively,with females being higher than males;the age-standardized DALY rate declined from 13.43/100 000 in 1990 to 9.07/100 000 in 2019,with females being higher than males.Joinpoint regression model analysis showed an increasing trend in the age-standardized incidence rate and age-standardized prevalence rate,and a decreasing trend in the age-standardized DALY rate(annual average percentage change[AAPC]values of 1.86%,1.72%and-1.66%,respectively),trend of change was statistically significant(all P<0.05).The burden of disease for all age groups from 1990 to 2019 showed an overall increasing trend,and the crude incidence rate,crude prevalence rate and crude DALY rate all increased with age,and the elderly group over 60 years old was the main group of disease burden.The results of the grey prediction model showed that by 2029,the age-standardized incidence rate and age-standardized prevalence rate would increase to 18.51/100 000 and 303.26/100 000,respectively,and the age-standardized DALY rate would decrease to 7.42/100 000. Conclusions:From 1990 to 2019,the age-standardized incidence rate and age-standardized prevalence rate of NRVHD in China showed an increasing trend,and the age-standardized DALY rate all showed a decreasing trend.The disease burden of NRVHD in China remains high.Women and the senior population are the main target groups needing special attention in China,and more targeted prevention and treatment strategies are needed for high-risk population.

ObjectiveAntibiotic resistance genes （ARGs） have received wide attention all over the world. The purpose of this study was to explore the bacterial community structure， the types and levels of antibiotic resistance genes in a water body in east China， and to compare and analyze the characteristics of microbial species distribution and antibiotic resistance gene distribution in various water environments. MethodsA total of 10 households in Haimen City， Jiangsu Province were selected and their surrounding water environment samples were collected. 21 water samples including river water （4）， Mingou water （9） and well water （8） were collected for metagenomics sequencing， assembled with MetaWRAP， annotated with CARD database， and analyzed with R software. ResultsIn various water bodies， the dominant bacteria phyla was Proteobacteria， the dominant bacteria genera were Deuterostomia， Pseudomonas， Flavobacteriales and Streptomycetaceae. The ARGs annotated were mainly composed of quinolones， aminoglycosides， macrolides and beta-lactams antibiotic resistance genes. The top four relative abundance of resistance genes were macB， RanA， evgS and TxR， The average absolute abundance and expression of resistance genes in well water and Mingou water were higher than those in river water. ConclusionMultiple ARGs are detected to varying degrees in well water， river water， and Mingou water bodies， and the expression of resistance genes in well water and Mingou water bodies is higher than that in river water bodies， possibly due to human production and living activities.

Objective To evaluate the effect of body mass index (BMI) on early prognosis of the recipients after lung transplantation. Methods Clinical data of 307 lung transplant recipients were retrospectively analyzed. According to preoperative BMI, all recipients were divided into the low (BMI <18.5 kg/m², n=114), normal (18.5 kg/m²≤BMI <24 kg/m², n=145) and high (BMI≥24.0 kg/m², n=48) BMI groups, respectively. Baseline data including age, sex, blood type, BMI, preoperative complications, preoperative pulmonary hypertension, and intraoperative use of extracorporeal membrane oxygenation (ECMO) of all recipients were compared among three groups. The survival rate of all recipients was estimated by Kaplan-Meier curve and the survival curve was delineated. The differences of survival rate were analyzed by log-rank test. The 30-, 90- and 180-d mortality risk of all recipients after lung transplantation in different BMI groups was compared by multivariate Cox regression analysis. Results There were significant differences in age and sex of recipients among three groups (both P<0.05). There was a significant difference regarding the 180-d survival rate after lung transplantation among different BMI groups (P<0.05). Multivariate Cox regression analysis showed that the 90-d mortality risk after lung transplantation in the high BMI group was 2.295 times higher than that in the normal BMI group [hazard ratio (HR) 2.295, 95% confidence interval (CI) 1.064-4.947, P=0.034]. In the high BMI group, the 180-d mortality risk after lung transplantation was 2.783 times higher compared with that in the normal BMI group (HR 2.783, 95%CI 1.333-5.810, P=0.006), and the 180-d mortality risk in the low BMI group was 2.181 times higher than that in the normal BMI group (HR 2.181, 95%CI 1.124-4.232, P=0.021). Conclusions Compared with the recipients with normal BMI, their counterparts with high and low preoperative BMI have higher mortality risk early after lung transplantation. Adjusting preoperative BMI to normal range contributes to improving early prognosis of lung transplant recipients.

ObjectiveTo discover and analyze single or several correlative key amino acid sites that influence the host tropism during the influenza A virus （IAV） infection based on complete internal protein gene segments of IAV strains， and to provide evidence for the study of human host-adaptive mutations of IAV. MethodsThe full-length nucleotide sequences of 43 671 IAV strains containing 6 complete internal gene segments were downloaded from the GISAID EpiFlu^TM database， and 698 human-tropic （HU） and 1 266 avian-tropic （AV） representative strains were included. The consensus coding sequences of the representative strains from the amphitropic category were compared by R script， and the differential amino acid sites and their polymorphisms were then obtained. The multi-site combination analysis of differential sites was conducted with R script. ResultsA total of 49 and 57 conserved differential sites were obtained from the consensus sequence comparison between AV and H1N1 （subtype from HU）， and comparison between AV and H3N2 （another subtype from HU）， separately. 79 and 65 multi-site combinations were found between HU and AV strains through 3 and 4 sites combination analysis， respectively， and a total of 11 conserved sites were involved： site 271 and 684 in PB2； site 336， 486， 581 and 621 in PB1； site 204 and 356 in PA； site 33， 305 and 357 in NP. No eligible differential sites were found in M1 and NS1. ConclusionSeveral conserved amino acid differential sites， between HU and AV strains of IAV， are found in PB2， PB1， PA and NP proteins. Instead of working as single units， these sites may have interactions， forming specific amino acid combinations that determine the host tropism of IAV collectively.

Objective:To propose a monosegment thoracic and lumbar fracture dislocation (mTLFD) classification, and to evaluate its reliability and clinical application.Methods:All of 298 cases of thoracic and lumbar fracture dislocation who received surgical management in our hospital from January 2014 to December 2019 were retrospectively analyzed. 123 cases were included in the study according to inclusion and exclusion criteria. mTLFD classification was proposed based on the imaging characteristics: type I (intervertebral disc injury mainly) and type II (vertebral burst fracture mainly). The type II was classified based on distribution of injury segment: type IIa (T 11 and above) and Ttype IIb (below T 11). Six spinal surgeons (3 residents, 3 associate chief physicians) were selected to classify the 123 cases according to preoperative imaging data, and to perform reliability test of each type. The repeatability and reliability of the classification were evaluated by ICC index. Different management strategies were performedf or each type: type I was managed with posterior decompression interbody fusion and internal fixation; type IIa underwent posterior decompression and fixation, subtotal vertebral resection and fusion was performed if bony compromise was still present through intra-operative exploration. Type IIb underwent posterior decompression, posterolateral fusion and internal fixation on the first stage, while anterior subtotal vertebral resection and reconstruction was performed on the second stage if the bony compromise was still present based on post-operative CT examination. The American Spinal Injury Association (ASIA) grading of all patients was recorded, and the visual analogue scale (VAS), Oswetry disability Iindex (ODI) and local Cobb angle of each type was compared between pre-operation and final follow-up. Results:The average follow-up time of all patients was 10.4±1.8 months. The average repeatability and reliability ICC index of mTLFD of 3 residents and 3 deputy chief physicians were 0.926 and 0.964, respectively, and 0.746 and 0.907, respectively. The reliability ICC index of type I, type IIa and type IIb was 0.918, 0.947 and 0.962, respectively, and the repeatability ICC index was 0.930, 0.940 and 0.966, respectively. The neurological function recovery was obtained in 56 patients. The preoperative VAS of type I, type IIa and type IIb were 8.5±1.0, 8.4±1.0 and 8.3±0.9, and 2.0±1.1, 1.8±1.0 and 1.8±0.9 at the final follow-up (all P<0.001). The ODI of type I, type IIa and type IIb were 97.0%±2.1%, 97.1%±1.9% and 97.3%±2.1% before surgery, and 29.5%±6.8%, 27.0%±6.0% and 29.0%±6.7% at the final follow-up (all P<0.001). The local Cobb angles of type I, type IIa and type IIb were 20.9°±7.1°, 29.0°±9.1° and 26.4°±6.9° before surgery, and 12.5°±5.4°, 18.0°±9.1° and 13.1°±5.1° at the final follow-up (all P<0.001). Conclusion:The mTLFD classification proposed in this study has strong repeatability and reliability, and management strategy of each type have achieved satisfactory clinical efficacy, indicating that the classification has certain significance for management of thoracic and lumbar spine fracture dislocation.

In 2019, the rate of primary tooth caries rate among 1 598 preschool children in Shinan District and Shibei District of Qingdao was 59.4%. The multivariate logistic regression model showed that compared with children ≤ 2 years old with history of iron deficiency anemia (IDA), suffering IDA, breastfeeding to 2 years old and no tooth melanin, children ≤ 2 years old without history of IDA, not suffering IDA, breastfeeding to less than 2 years old and heavy tooth melanin had a lower risk of primary tooth caries, with OR ( 95%CI) values about 0.328 (0.197-0.549), 0.354 (0.208-0.603), 0.636 (0.437-0.926) and 0.301 (0.143-0.635), respectively.

In 2019, the rate of primary tooth caries rate among 1 598 preschool children in Shinan District and Shibei District of Qingdao was 59.4%. The multivariate logistic regression model showed that compared with children ≤ 2 years old with history of iron deficiency anemia (IDA), suffering IDA, breastfeeding to 2 years old and no tooth melanin, children ≤ 2 years old without history of IDA, not suffering IDA, breastfeeding to less than 2 years old and heavy tooth melanin had a lower risk of primary tooth caries, with OR ( 95%CI) values about 0.328 (0.197-0.549), 0.354 (0.208-0.603), 0.636 (0.437-0.926) and 0.301 (0.143-0.635), respectively.