Objective To establish a method for determination of pyriclobenzuron (PBU) residues in rice and paddy environments, and to determine the residual amounts and observe the degradation dynamics of PBU. Methods In July 2022, the paddies of Zhejiang Academy of Agricultural Sciences were selected as experimental fields, and were divided into the blank control group (no pesticide application), the 1-fold-concentration pesticide group (1 kg/667 m²), and the 5-fold-concentration pesticide group (5 kg/667 m²), with a 100 m² area in each group. At the early tillering stage of rice, 20% suspension of PBU sulfate was sprayed once in the 1-fold-concentration and 5-fold-concentration pesticide groups, and rice plants, paddy water and soil samples were collected 2 h, and 1, 2, 3, 5, 7, 11, 14, 21, 28, 35, 49 d and 63 d following spraying PBU, while rice straw, field soil, brown rice and rice husk samples were collected 98 d following spraying. PBU was extracted and purified in samples using a quick, easy, cheap, effective, rugged, and safe (QuEChERS) pretreatment technique, and the PBU contents were determined in samples using ultrahigh performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The solvent standard working solution and matrix standard working solution were prepared. A linear regression equation was fitted between PBU concentration (x-axis) and peak area (y-axis), and the ratio of the slope (k) of the matrix standard curve to the slope (K) of the solvent standard curve was calculated to evaluate the matrix effect of PBU in samples. According to the Guidelines for Pesticide Residue Testing in Crops (NY/T 788—2018), the addition levels of PBU were set at 0.005, 0.050, 5.000, 1 000.000 mg/kg in rice plants, 0.005, 0.050, 2.000, 10.000 mg/kg in paddy water, 0.005, 0.050, 2.000 mg/kg in soil, and 0.005, 0.050, 5.000 mg/kg in brown rice and rice husks. The recovery and relative standard deviation (RSD) of PBU addition were calculated to evaluate the effectiveness of UPLC-MS/MS for determination of PBU contents. The first-order kinetic equation of PBU concentration was fitted in samples at different sampling time points to analyze the trends in PBU degradation in rice plants, paddy water, and soil, and the half-life of PBU was calculated in different samples. Results There was a good linear relationship between the mass concentration and peak area of PBU at concentrations of 0.000 1 to 0.020 0 mg/kg under solvent and matrix conditions (R² = 0.985 8 to 0.999 7, t = -0.47 to 1.62, all P values < 0.01). The matrix effects of PBU were 70.26%, 65.42% and 65.12% in rice plants, brown rice and rice husks, indicating a matrix-inhibitory effect, and the matrix effect was 87.06% in soils, indicating a weak matrix effect. The recovery of PBU addition was 77.61% to 100.12% in different samples, with RSD of 1.43% to 6.74%, and a limit of quantification (LOQ) of 0.005 mg/kg, and the addition recovery and RSD met the requirements of the Guidelines for Pesticide Residue Testing in Crops (NY/T 788—2018), validating the effectiveness of UPLC-MS/MS assay. Following spraying PBU at a dose of 1 kg/667 m², the half-life of PBU was 6.24 d in rice plants and 3.43 d in paddy water samples, respectively. The final residues of PBU were lower than the LOQ of 0.005 mg/kg in brown rice and rice husk samples 98 d following spraying PBU. Following spraying PBU at a dose of 5 kg/667 m², the half-life of PBU was 15.75 d in rice plants and 7.62 d in paddy water samples, respectively. The final residue of PBU was lower than the LOQ of 0.005 mg/kg in brown rice 98 d following spraying PBU, and the final residue of PBU was 0.049 mg/kg in rice husks. Conclusions A simple, and highly accurate and precise UPLC-MS/MS assay has been developed for determination of PBU residues in rice plants and paddy environments through extraction and purification of PBU from matrix samples using QuEChERS pretreatment. After spraying PBU in paddies, the concentration of PBU gradually decreases in rice plants and paddy water over time, and the final residual concentration is low.

BackgroundSibling relationships play a critical role in shaping anxiety symptoms in firstborn children. Anxiety symptoms often originate in early childhood and can persist into adolescence and adulthood. However， there is insufficient research on anxiety symptoms in preschool children， especially firstborn preschool children. ObjectiveTo explore the influencing factors of anxiety symptoms among firstborn preschool children， so as to provide references for the intervention of anxiety symptom for children in families with multiple children. MethodsFrom October to December 2021， a total of 8 449 children from 234 kindergartens in Longhua District of Shenzhen were included using a cluster sampling method. Sibling Inventory of Behavior （SIB） and Spence Preschool Anxiety Scale （SPAS） were used to investigate. Logistic regression analysis was used to identify influencing factors of anxiety symptoms in firstborn preschool children. ResultsA total of 8 419 （99.64%） valid questionnaires were collected. Anxiety symptoms were detected in 344（4.09%） firstborn preschool children. Statistically significant differences were observed between anxiety group and non-anxiety group in terms of household registration， monthly family income， maternal age， maternal education level， paternal education level， family living conditions and whether they are left-behind children （χ²/t=9.906， 33.490， 5.136， 13.485， 9.690， 17.332， 21.975， P<0.05 or 0.01）. Compared with non-anxiety group， children in the anxiety group scored higher on the SIB dimensions of rivalry， aggression and avoidance （t=165.322， 74.471， 286.419， P<0.01）， and lower on companionship， empathy and teaching （t=59.133， 42.417， 39.112， P<0.01）. Risk factors for anxiety symptoms in firstborn preschool children included left-behind children， as well as negative sibling relationships characterized by rivalry and avoidance （OR=1.195， 1.143， 1.260， P<0.05 or 0.01）. ConclusionFirstborn preschool children who are left-behind are more susceptible to anxiety symptoms. Negative sibling relationships， characterized by competition and avoidance， may also contribute to the emergence of anxiety symptoms in firstborn preschool children.

Aim To investigate the effect of CDR132L(miR-132 antisense oligonucleotide)on vascular remode-ling and function in mice with hypertension and hyperlipidemia,and explore its possible mechanism.Methods A total of 30 8-week-old male C57BL/6 mice were randomly divided into three groups:control group,model group and CDR132L group,with 10 mice in each group.The control group received with a standard diet while the model group and CDR132L group received N-nitro-L-arginine methyl ester(L-NAME)and high-fat diet to induce hypertension and hyperlip-idemia.The CDR132L group was administered with intraperitoneal injection of CDR132L at a dose of 20 mg/kg once weekly for six consecutive weeks,whereas the control group and the model group were given intraperitoneal injection of an equivalent volume of normal saline.The tail-cuff method was utilized for blood pressure measurement,blood lipid and glucose levels were assayed by an automatic biochemical analyzer,the thoracic aorta structure was observed by HE staining,endothelium-dependent relaxation of the thoracic aorta was evaluated by the vascular ring test,the expression level of miR-132 in the thoracic aorta was measured by qPCR,the protein expression levels of Gab1 and endothelial nitric oxide synthase(eNOS)in the thoracic aorta were determined by Western blot.Results Compared with the control group,the model group demonstrated notable rises in systolic and diastolic blood pressure,serum triglyceride,total cholesterol lev-els,and body weight.Moreover,the intima of thoracic aorta and the thickness of vascular wall was uneven,the smooth muscle cells of the tunica media were arranged irregularly,with a large amount of fat deposition in the vascular wall,and the endothelium-dependent relaxation response of thoracic aorta was decreased(P＜0.05).The expression level of miR-132 in the thoracic aorta was significantly increased(P＜0.05),while the expression level of Gabl and eNOS protein was markedly decreased(P＜0.05).Compared with the model group,the CDR132L group showed no significant differences in systolic and diastolic blood pressure,serum triglyceride and total cholesterol levels,as well as body weight(P＞0.05).However,the CDR132L group exhibited a complete and smooth intima of the thoracic aorta with minimal intravascular lipid deposition,the thickness of the vascular wall was uniform,the smooth muscle cells of the tunica media were arranged order-ly,accompanied by enhanced endothelium-dependent relaxation response of the thoracic aorta(P＜0.05).The expression level of miR-132 in the thoracic aorta was significantly decreased(P＜0.05),while the expression levels of Gab1 and eNOS protein were significantly increased(P＜0.05).Conclusion CDR132L can improve vascular remodeling and endothelium-dependent relaxation in hypertensive and hyperlipidemia mice,which may be related to the decrease of miR-132 expression level and the up-regulation of Gab1 and eNOS protein expression levels in the thoracic aorta.

Objective To investigate the prognostic value of atherogenic index of plasma(AIP)for the occurrence of major adverse cardiovascular events(MACE)in elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 355 elderly patients with acute STEMI who received coronary interventional therapy in Department of Cardiology,Affilia-ted Hospital of Hebei University from January to May 2023 were recruited retrospectively,and fi-nally 343 of them with complete telephone follow-up data were included in this study.According to their AIP quartile level,they were divided into A1 group(＜0.212,84 cases),A2 group(0.212-0.339,87 cases),A3 group(0.339-0.434,86 cases)and A4 group(≥0.434,86 cases).The incidences of cardiac death,nonfatal myocardial infarction,ischemia-driven target vessel re-modeling and heart failure re-hospitalization were observed during 1-year follow-up.Kaplan-Meier survival curve was plotted to compare the incidence of MACE in the 4 groups.ROC curve analysis was employed to determine the predictive value of AIP.Results During 1-year follow-up,signifi-cant differences were observed in the proportions of ischemia-driven target vessel revasculariza-tion,heart failure re-hospitalization and non-fatal acute myocardial infarction among the 4 groups(P＜0.05,P＜0.01),and such difference was also seen in the cumulative survival rate among them(log rankx2=8.528,P=0.036).Multivariate Cox proportional hazards regression analysis showed that gender,hypertension,atrial fibrillation,multi-vessel disease,left main artery disease,number of stents,SYNTAX score,Killip grade,BNP,HbA1c,TC,LDL-C and HDL-C levels,and AIP were independent predictors of MACE.The AUC value of AIP in predicting MACE in elderly patients with acute STEMI was 0.855(95％CI:0.776-0.933),with a sensitivity of 66.7％and a specificity of 93.0％.When the above indicators combined together,the AUC value was 0.907(95％CI:0.954-0.987),and the sensitivity and specificity was 100.0％and 90.7％,respectively.The AUC value of combined prediction was significantly better than that of single indicator(P＜0.05).Conclusion AIP is a powerful biomarker,and can be used to predict the prognosis of elderly acute STEMI after coronary interventional therapy,and it combined with Killip grade,SYNTAX score,HbA1c,and number of stents shows better predictive efficacy.

BACKGROUND: This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability. METHODS: This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability. RESULTS: STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min. CONCLUSION The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
Reproducibility of Results ; Surveys and Questionnaires ; Practice Guidelines as Topic ; Humans

Backgrounds::GALLIUM is a global phase III study that demonstrated significant improvements in progression-free survival (PFS) for obinutuzumab plus chemotherapy (G-chemo) vs. rituximab plus chemotherapy (R-chemo) in previously untreated patients with follicular lymphoma (FL). This study aimed to report the results of a subgroup of patients in China. Methods::Patients were randomized to G-chemo or R-chemo. Responders received maintenance therapy for 2 years or until disease progression. The primary endpoint was investigator (INV)-assessed PFS. Secondary endpoints included the overall response rate (ORR) and complete response rate (CRR) at the end of induction chemotherapy, overall survival (OS), and safety.Results::Overall, 58 patients with FL were randomized to the G-chemo ( n = 25) and R-chemo arms ( n = 33). The INV-assessed PFS rate at 3 years was 81.8% in the G-chemo arm, vs. 70.2% in the R-chemo arm (hazard ratio 0.35; 95% confidence interval: 0.09-1.34; P = 0.1120). The INV-assessed CRRs (without positron emission tomography [PET]) in these arms were 24.0% and 21.2%, respectively, whereas the ORRs were 80.0% and 90.9%, respectively. INV-assessed CRR-PET was 52.6% in the G-chemo, vs. 60.9% in the R-chemo. Median OS was not reached in either arm. Grade 3 to 5 adverse events were more frequent in the R-chemo arm (97.0% vs. 88.0%). Conclusions::The results of this subgroup analysis were consistent with those of the global population, and they suggest that G-chemo has a positive benefit-risk profile in patients from China with FL.Trial registration::ClinicalTrials.gov, No. NCT01332968.

The adverse health effects of air pollution remains a daunting public health problem globally. The research of the health effects of air pollution provides important evidence for ambient air quality standard establishments and air pollution interventions. In recent years, causal inference has been gradually introduced into the observational study of environmental epidemiology, which provides more statistical method options for the study of causal relationships between air pollution and population health effects. Controlling confounders in observational studies is a major challenge for causal inference. This study introduces the causal inference methods for the identification and control of confounding factors currently used in the study of air pollution and population health effects, in order to provide methodological reference and basis for the causal inference study of air pollution and population health effects in China.

Objective:To investigate the safety and efficacy of venetoclax with low-dose cytarabine (LDAC) in Chinese patients with acute myeloid leukemia (AML) who are unable to tolerate intensive induction chemotherapy.Methods:Adults ≥ 18 years with newly diagnosed AML who were ineligible for intensive chemotherapy were enrolled in this international, randomized, double-blind, placebo-controlled trial. Globally, patients ( n=211) were randomized 2∶1 to either venetoclax with LDAC or placebo with LDAC in 28-d cycles, with LDAC on days 1-10. The primary endpoint was OS; the secondary endpoints included response rates, event-free survival, and adverse events. Results:A total of 15 Chinese patients were enrolled (venetoclax arm, n=9; placebo arm, n=6) . The median age was 72 years (range, 61-86) . For the primary analysis, the venetoclax arm provided a 38% reduction in death risk compared with the placebo[hazard ratio ( HR) , 0.62 (95% CI 0.12-3.07) ]. An unplanned analysis with an additional 6 months of follow-up demonstrated a median OS of 9.0 months for venetoclax compared with 4.1 months for placebo. The complete remission (CR) rates with CR with incomplete blood count recovery (CRi) were 3/9 (33%) and 0/6 (0%) , respectively. The most common non-hematologic adverse effects (venetoclax vs placebo) were hypokalemia[5/9 (56%) vs 4/6 (67%) ], vomiting[4/9 (44%) vs 3/6 (50%) ], constipation[2/9 (22%) vs 4/6 (67%) ], and hypoalbuminemia[1/9 (11%) vs 4/6 (67%) ]. Conclusion:Venetoclax with LDAC demonstrated meaningful efficacy and a manageable safety profile in Chinese patients consistent with the observations from the global VIALE-C population, making it an important treatment option for patients with newly diagnosed AML who are otherwise ineligible for intensive chemotherapy.

The adverse health effects of air pollution remains a daunting public health problem globally. The research of the health effects of air pollution provides important evidence for ambient air quality standard establishments and air pollution interventions. In recent years, causal inference has been gradually introduced into the observational study of environmental epidemiology, which provides more statistical method options for the study of causal relationships between air pollution and population health effects. Controlling confounders in observational studies is a major challenge for causal inference. This study introduces the causal inference methods for the identification and control of confounding factors currently used in the study of air pollution and population health effects, in order to provide methodological reference and basis for the causal inference study of air pollution and population health effects in China.

Objective:To assess the current practice in perioperative nutritional managament of patients undergoing pancreatoduodenectomy from 64 level A tertiary hospitals in China, and investigate nutritional managament strategies.Methods:The cross-sectional survey was conducted. From March 31 st to April 13 th, electronic questionnaires of perioperative nutritional management of patients undergoing pancreatoduodenectomy were sent to the members of Youth Club of Chinese Pancreatic Surgery Association and some pancreatic surgeons from other level A tertiary hospitals in China. The questionnaires were issued by online Wechat platform. Observation indicators: (1) general data; (2) preoperative nutritional management; (3) intraoperative nutritional management; (4) postoperative nutritional management; (5) comparison of nutritional management among medical centers with different surgical amount. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Results:(1) General data: a total of 96 questionnaires from 64 level A tertiary hospitals in 35 cities of 22 provinces were retrieved. There were 94 males and 2 females, aged (42±7) years, with a range from 29 to 59 years. (2) Preoperative nutritional management. ① Preoperative nutritional evaluation and screening: 62.5%(60/96) of surgeons evaluated preoperative nutritional status for patients. For preoperative screening, 41.7%(40/96) of surgeons performed nutritional screening in every patient, and 54.2%(52/96) performed nutritional screening when considering nutritional support. For screening tools, Nutritional Risk Screening 2002 was used in 66.7%(64/96) of surgeons. For selection of non-tool evaluation parameters, 97.9%(94/96) chose two or more indicators for comprehensive evaluation, 92.7%(89/96) chose Albumin as the evaluation parameter. ② Preoperative nutritional support: there were 13.5%(13/96) of surgeons conducting nutritional support regularly. For preoperative nutritional support methods, nutritional support based on diet was conducted by 94.8%(91/96) of surgeons. For timing of perioperative nutritional support, 43.8%(42/96) of surgeons determined the time according to the surgical time. Based on the theory of enhanced recovery after surgery, 24.0%(23/96)of surgeons routinely gave liquid diet or carbohydrate load at the preoperative 2 hours. (3) Intraoperative nutritional management. ① Intraoperative jejunostomy management: 8.3%(8/96) of surgeons performed routine jejunostomy. ② Intraoperative nutrition line management: the nasojejunal tube was placed intraoperatively by 30.2%(29/96), and the nasogastric tube was placed intraoperatively by 78.1%(75/96). Of the above surgeons, 38.7%(29/75) determined the time to nasogastric tube removal based on gastric volume, and 32.0%(24/75) removed the nasogastric tube after flatus in patients. (4) Postoperative nutritional management. ① Postoperative nutritional support methods: 84.4%(81/96) of surgeons gave nutritional support, in which 56.8%(46/81) mainly gave the parenteral nutrition and transition to diet. Total parenteral nutrition at the postoperative first day or complementary parenteral nutrition was the first choice in 78.1%(75/96) of surgeons, oral feeding at postoperative 7 days was the first choice in 86.5%(83/96) of surgeons. ② Postoperative nutritional management for complications: 63.5%(61/96) of surgeons chose enteral nutritional support through percutaneous endoscopic gastrojejunostomy, nasogastric tube or nasojejunal tube for grade B or C pancreatic fistula, 72.9%(70/96) chose enteral nutritional support through percutaneous endoscopic gastrojejunostomy or nasojejunal tube for delayed gastric emptying. (5) Comparison of nutritional management among medical centers with different surgical amount: of the 96 surgeons, surgeons in medical centers with surgical amount >100 cases a year had the nasogastric tube placement rate of 66.7%(32/48), and surgeons in medical centers with surgical amount ≤100 cases a year had the nasogastric tube placement rate of 89.6%(43/48), showing a significant difference between the two groups ( χ2=7.375, P<0.05). Conclusions:There is no uniform standards for indications, routes, or timing of perioperative nutritional management of patients undergoing pancreatoduodenectomy among surgeons from level A tertiary hospitals in China. In patients undergoing pancreatoduodenectomy, the theories and practice of perioperative nutritional management and enhanced recovery after surgery are diverse, which urgently require prospective study with nutritional management strategy as intervention and expert consensus on perioperative nutritional managament in pancreatic surgery accorded with clinical practice in China.