Objective:To explore the genotypes and frequency distribution of thalassemia in Lingui District,Guilin City,and provide reference for the prevention and control of thalassemia in this area. Methods:The results of genetic testing for thalassemia in 1501 suspected cases at the Second Affiliated Hospital of Guilin Medical University were analyzed retrospectively. The deletional mutations of α-thalassemia were detected by gap-PCR,the non-deletional mutations of α-thalassemia and β-thalassemia mutations were detected by PCR-reverse dot blot (PCR-RDB). Results:In 1501 samples,a total of 678 cases of thalassemia carriers were detected,with a detection rate of 45.17％. Among them,379 cases were α-thalassemia (including deletional α-thalassemia and non-deletional α-thalassemia),with a detection rate of 25.25％,the most common genotype was--SEA/αα (227 cases,15.12％),followed by-α3.7/αα (53 cases,3.53％). 270 cases of β-thalassemia were detected,with a detction rate of 17.99％,and βCD41-42/βN (144 cases,9.59％) was the main genotypes,followed by βCD17/βN (66 cases,4.40％) . In addition,there were 29 cases of αβ compound thalassemia,accounting for 1.93％,and the most common genotype was--SEA/αα complex βCD41-42/βN (5 cases,0.33％). Conclusion:Lingui District in Guilin City is a high-incidence area of thalassemia,and the genotypes of carriers are complex and diverse,with genetic heterogeneity. The results of this study provide a scientific basis for genetic counseling and prenatal diagnosis in this area.

OBJECTIVE: To investigate the factors related to renal impairment in patients with diabetic kidney disease (DKD) from the perspective of integrated Chinese and Western medicine. METHODS: Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included. According to Kidney Disease Improving Global Outcomes (KDIGO) staging guidelines, patients were divided into a chronic kidney disease (CKD) 1-3 group and a CKD 4-5 group. Clinical data were collected, and logistic regression was used to analyze the factors related to different CKD stages in DKD patients. RESULTS: Demographically, male was a factor related to increased CKD staging in patients with DKD (OR=3.100, P=0.002). In clinical characteristics, course of diabetes >60 months (OR=3.562, P=0.010), anemia (OR=4.176, P<0.001), hyperuricemia (OR=3.352, P<0.001), massive albuminuria (OR=4.058, P=0.002), atherosclerosis (OR=2.153, P=0.007) and blood deficiency syndrome (OR=1.945, P=0.020) were factors related to increased CKD staging in patients with DKD. CONCLUSIONS Male, course of diabetes >60 months, anemia, hyperuricemia, massive proteinuria, atherosclerosis, and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD. (Registration No. NCT03865914).
Humans ; Male ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Hyperuricemia ; Kidney ; Proteinuria ; Renal Insufficiency, Chronic/complications*

OBJECTIVE: To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients. METHODS: By extracting the CM clinical electronic medical records (EMRs) of 7,170 hospitalized patients with ischemic stroke from 2016 to 2018 at Weifang Hospital of Traditional Chinese Medicine, Shandong Province, China, a patient similarity network (PSN) was constructed based on the symptomatic phenotype of the patients. Thereafter the efficient community detection method BGLL was used to identify subgroups of patients. Finally, subgroups with a large number of cases were selected to analyze the specific manifestations of clinical symptoms and CM syndromes in each subgroup. RESULTS: Seven main subgroups of patients with specific symptom characteristics were identified, including M3, M2, M1, M5, M0, M29 and M4. M3 and M0 subgroups had prominent posterior circulatory symptoms, while M3 was associated with autonomic disorders, and M4 manifested as anxiety; M2 and M4 had motor and motor coordination disorders; M1 had sensory disorders; M5 had more obvious lung infections; M29 had a disorder of consciousness. The specificity of CM syndromes of each subgroup was as follows. M3, M2, M1, M0, M29 and M4 all had the same syndrome as wind phlegm pattern; M3 and M0 both showed hyperactivity of Gan (Liver) yang pattern; M2 and M29 had similar syndromes, which corresponded to intertwined phlegm and blood stasis pattern and phlegm-stasis obstructing meridians pattern, respectively. The manifestations of CM syndromes often appeared in a combination of 2 or more syndrome elements. The most common combination of these 7 subgroups was wind-phlegm. The 7 subgroups of CM syndrome elements were specifically manifested as pathogenic wind, pathogenic phlegm, and deficiency pathogens. CONCLUSIONS There were 7 main symptom similarity-based subgroups in ischemic stroke patients, and their specific characteristics were obvious. The main syndromes were wind phlegm pattern and hyperactivity of Gan yang pattern.
Humans ; Syndrome ; Ischemic Stroke ; Medicine, Chinese Traditional ; Liver ; Phenotype

Objective: To identify the main metals involved in cognitive impairment in the Chinese oldest old, and explore the association between these metal exposures and cognitive impairment. Methods: A cross-sectional study was conducted on 1 568 participants aged 80 years and older from Healthy Aging and Biomarkers Cohort Study (2017 to 2018). Fasting venous blood was collected to measure the levels of nine metals (selenium, lead, cadmium, arsenic, antimony, chromium, manganese, mercury, and nickel). The cognitive function of these participants was evaluated by using the Chinese version of the Mini-Mental State Examination (CMMSE). The random forest (RF) was applied to independently identify the main metals that affected cognitive impairment. The multivariate logistic regression model and restricted cubic splines (RCS) model were used to further verify the association of the main metals with cognitive impairment. Results: The age of 1 568 study subjects was (91.8±7.6) years old, including 912 females (58.2%) and 465 individuals (29.7%) with cognitive function impairment. Based on the RF model (the out-of-bag error rate was 22.9%), the importance ranking of variables was conducted and the feature screening of five times ten-fold cross-validation was carried out. It was found that selenium was the metal that affected cognitive function impairment, and the other eight metals were not included in the model. After adjusting for covariates, the multivariate logistic regression model showed that with every increase of 10 μg/L of blood selenium levels, the risk of cognitive impairment decreased (OR=0.921, 95%CI: 0.889-0.954). Compared with the lowest quartile(Q₁) of blood selenium, the ORs (95%CI) of Q₃ and Q₄ blood selenium were 0.452 (0.304-0.669) and 0.419 (0.281-0.622) respectively. The RCS showed a linear dose-response relationship between blood selenium and cognitive impairment (P_nonlinear>0.05). Conclusion: Blood selenium is negatively associated with cognitive impairment in the Chinese oldest old.
Aged, 80 and over ; Female ; Humans ; Selenium ; Cohort Studies ; Cross-Sectional Studies ; Metals/analysis* ; Cognitive Dysfunction/epidemiology* ; China/epidemiology*

OBJECTIVE: Metabolic syndrome is a complex medical condition that has become an alarming epidemic, but an effective therapy for this disease is still lacking. The use of the herbal formula Huangqisan (HQS) to treat diabetes is documented in the Chinese medical literature as early as 1117 A.D.; however, its therapeutic effects and underlying mechanisms remain elusive. METHODS: To investigate the beneficial effects of HQS on metabolic disorders, high-fat diet-induced obesity (DIO), leptin receptor dysfunction (db/db) and low-density lipoprotein receptor-knockout (LDLR RESULTS: HQS lowered body weight, fasting blood glucose and serum lipid levels and improved glucose tolerance and insulin sensitivity in DIO mice and db/db mice (P < 0.05). HQS also blocked atherosclerotic plaque formation in LDLR CONCLUSION HQS is effective for reversing metabolic disorder and has the potential to be used as therapy for metabolic syndrome.

Objective: We aimed to assess the features of notifiable infectious diseases found commonly in foreign nationals in China between 2004 and 2017 to improve public health policy and responses for infectious diseases. Methods: We performed a descriptive study of notifiable infectious diseases among foreigners reported from 2004 to 2017 in China using data from the Chinese National Notifiable Infectious Disease Reporting System (NNIDRIS). Demographic, temporal-spatial distribution were described and analyzed. Results: A total of 67,939 cases of 33 different infectious diseases were reported among foreigners. These diseases were seen in 31 provinces of China and originated from 146 countries of the world. The infectious diseases with the highest incidence number were human immunodeficiency virus (HIV) of 18,713 cases, hepatitis B (6,461 cases), hand, foot, and mouth disease (6,327 cases). Yunnan province had the highest number of notifiable infectious diseases in foreigners. There were different trends of the major infectious diseases among foreign cases seen in China and varied among provinces. Conclusions This is the first description of the epidemiological characteristic of notifiable infectious diseases among foreigners in China from 2004 to 2017. These data can be used to better inform policymakers about national health priorities for future research and control strategies.
Adolescent ; Adult ; Child ; Child, Preschool ; China ; epidemiology ; Communicable Diseases ; epidemiology ; Female ; HIV Infections ; epidemiology ; Hand, Foot and Mouth Disease ; epidemiology ; Hepatitis B ; epidemiology ; Humans ; Incidence ; Infant ; Male ; Middle Aged ; Prevalence ; Young Adult

Liuwei Dihuang Pills is a typical traditional Chinese medicine with "the same product made by many manufacturers". The quality and price of products made in various factories was different obviously. In this study, the quality differences of Liuwei Dihuang Pills were evaluated over multi-dimensions and throughout the whole production cycle involving raw materials, production process, quality control and post-marketing re-studies based on the "Chinese patent medicine evaluation standard with quality at the core" established earlier by our research group. The research results showed that the product quality of various manufacturers was significantly different, and the product quality was positively correlated with the market shares of enterprises, indicating that enterprises with more market shares paid more attention to product quality; and the sales determined the concern degree of enterprises on products, which was in line with general cognition. During the single-item evaluation of Liuwei Dihuang Pills, the score of raw material selection was relatively low, and the enterprises paid less attention to the initial raw materials. The whole production process was better, and the national compulsory implementation of "Production Quality Management Standard"(GMP) had a positive effect in improving product quality. Quality control could basically guarantee product quality. Intelligent manufacturing promoted by the government was beneficial to ensure product uniformity. The score rate of "quality evaluation" item was basically qualified, which indicated that the quality control level of Liuwei Dihuang Pills was acceptable as a whole, but there was still room for improvement. "Re-evaluation and Brand Construction" had the lowest scores, reflecting that enterprises did not pay enough attention to in-depth study and re-evaluation of "the same product made by many manufacturers". The evaluation results were in line with expectations, provided a reference example for the evaluation of high-quality Chinese patent medicine, a basis for the high-quality and good price of Chinese patent medicine, scientific data for improving medical insurance bidding, and thus facilitated promoting the healthy development of the traditional Chinese medicine industry.
Drugs, Chinese Herbal/analysis* ; Medicine, Chinese Traditional ; Nonprescription Drugs ; Quality Control

Objective:Through the analysis of the characteristics and main chemical components of Ginseng Radix et Rhizoma,the correlation between the characteristics and components of Ginseng Radix et Rhizoma was explored,and a new evaluation standard of Ginseng Radix et Rhizoma grade was established to provide a more comprehensive and scientific basis for the quality evaluation of Ginseng Radix et Rhizoma. Method:The appearance characteristics of 48 batches of Ginseng Radix et Rhizoma samples were quantitatively measured. The contents of 9 kinds of Ginseng Radix et Rhizoma were determined. The results of correlation analysis,principal component analysis and cluster analysis were used to classify ginseng medicinal materials according to the analysis results,and the grade evaluation criteria were constructed. Result:First-class ginseng medicinal materials:diameter of main root>1.72 cm,length of reed head>2.61 cm,weight of single branch>14.15 g,content of ginsenoside Rb₁>0.612 1%,content of ginsenoside Re>0.385 8%,content of ginsenoside Rg₁>0.320 8%,no scar,impurities,moth,mildew. Second-class ginseng medicinal materials:the diameter of main root is 1.55-1.72 cm,the length of reed head is 1.74-2.61 cm,the weight of single branch is 10.24-14.15 g,the content of ginsenoside Rb₁ is 0.496 8%-0.612 1%,the content of ginsenoside Re is 0.323 3%-0.385 8%,the content of ginsenoside Rg₁ is 0.263 6%-0.320 8%,and there are no scars,impurities,worms and mildew. Third-class ginseng medicinal materials:main root diameter 1.29-1.55 cm,reed head length 1.34-1.74 cm,single branch weight 6.90-10.24 g,ginsenoside Rb₁ content 0.389 5%-0.496 8%,ginsenoside Re content 0.235 2%-0.323 3%,ginsenoside Rg₁ content 0.217 1%-0.263 6%,no impurities,worms,mildew. Fourth-class ginseng medicinal materials:diameter of main root<1.29 cm,length of reed head<1.34 cm,weight of single branch<6.90 g,content of ginsenoside Rb₁<0.389 5%,the content of ginsenoside Re<0.235 2%,content of ginsenoside Rg₁<0.217 1%,without impurities,worms and mildew. Conclusion:The appearance indexes of ginseng medicinal materials were divided according to the standards of taproot diameter,reed head length and single ginseng weight,and the content of ginsenoside Rg₁,Re,Rb₁ was used as the internal quality evaluation index. Ginseng commercial specifications were divided into four grades,which integrated the appearance and internal indicators,and had more scientific and comprehensive characteristics,which could be used as the basis for the classification of Ginseng Radix et Rhizoma medicinal materials.

Objective To mastered the distribution characteristics of Haemaphysalis longicornis in the Tumen River basin along the border between Russia, Korea and Northeast China, and understand the status of Haemaphysalis longicornis carrying the virus of fever with thrombocytopenia syndrome (SFTS), then, isolate the virus and analyze its genetic characteristics. Method Ticks were collected from Hunchun, Tumen, Helong and Longjing cities in the Tumen River basin of Jilin Province from April to September, 2017. Haemaphysalis longicornis was selected and grouped. SFTS virus was detected by real-time quantitative polymerase chain reaction (RT-qPCR). Virus isolation was carried out in Vero cells, besides, S,M,L gene segments were amplified . The homology of S, M and L gene segments was compared, phylogenetic tree was established, and their gene characteristics were analyzed. Result Haemaphysalis longicornis mainly distributed in Hunchun and Tumen City in the lower reaches of Tumen River. It was the dominant species in the two counties, reaching 71.85% and 87.62% respectively. A virus named YBHC-TICK2-2017/CHINA was isolated from Haemaphysalis longicornis collected in Hunchun. The sequences of S segment (1 746 bp), M segment (3 336 bp) and L segment (6 376 bp) of the virus were 98.00%-99.00%, homologous to those of SFTS virus isolates from China and Korea recorded in National Center for Biotechnology Information (NCBI) Gen Bank. Phylogenetic tree analysis showed that the S segment gene sequence of the virus strain was divided into a cluster with Jilin strain (KT890282) in China, and M segment and L segment gene sequence with Jiangsu strain (KR230781) in China. Conclusions Haemaphysalis longicornis are widely distributed in the lower reaches of the Tumen river. It was the first time that SFTS virus was isolated from Haemaphysalis longicornis in this area, suggesting that this area is important for SFTS prevention.