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.

Objective:Glioblastoma(GBM)and brain metastases(BMs)are the two most common malignant brain tumors in adults.Magnetic resonance imaging(MRI)is a commonly used method for screening and evaluating the prognosis of brain tumors,but the specificity and sensitivity of conventional MRI sequences in differential diagnosis of GBM and BMs are limited.In recent years,deep neural network has shown great potential in the realization of diagnostic classification and the establishment of clinical decision support system.This study aims to apply the radiomics features extracted by deep learning techniques to explore the feasibility of accurate preoperative classification for newly diagnosed GBM and solitary brain metastases(SBMs),and to further explore the impact of multimodality data fusion on classification tasks. Methods:Standard protocol cranial MRI sequence data from 135 newly diagnosed GBM patients and 73 patients with SBMs confirmed by histopathologic or clinical diagnosis were retrospectively analyzed.First,structural T1-weight,T1C-weight,and T2-weight were selected as 3 inputs to the entire model,regions of interest(ROIs)were manually delineated on the registered three modal MR images,and multimodality radiomics features were obtained,dimensions were reduced using a random forest(RF)-based feature selection method,and the importance of each feature was further analyzed.Secondly,we used the method of contrast disentangled to find the shared features and complementary features between different modal features.Finally,the response of each sample to GBM and SBMs was predicted by fusing 2 features from different modalities. Results:The radiomics features using machine learning and the multi-modal fusion method had a good discriminatory ability for GBM and SBMs.Furthermore,compared with single-modal data,the multimodal fusion models using machine learning algorithms such as support vector machine(SVM),Logistic regression,RF,adaptive boosting(AdaBoost),and gradient boosting decision tree(GBDT)achieved significant improvements,with area under the curve(AUC)values of 0.974,0.978,0.943,0.938,and 0.947,respectively;our comparative disentangled multi-modal MR fusion method performs well,and the results of AUC,accuracy(ACC),sensitivity(SEN)and specificity(SPE)in the test set were 0.985,0.984,0.900,and 0.990,respectively.Compared with other multi-modal fusion methods,AUC,ACC,and SEN in this study all achieved the best performance.In the ablation experiment to verify the effects of each module component in this study,AUC,ACC,and SEN increased by 1.6%,10.9%and 15.0%,respectively after 3 loss functions were used simultaneously. Conclusion:A deep learning-based contrast disentangled multi-modal MR radiomics feature fusion technique helps to improve GBM and SBMs classification accuracy.

Objective:To evaluate the efficiency and safety of endoscopic anti-reflux mucosectomy (ARMS) for refractory gastroesophageal reflux disease (rGERD) in the absence of hiatus hernia (HH).Methods:Among 28 rGERD patients adimitted to Gastrointestinal Medical Center, Subei People's Hospital from Jan 2018 to Jun 2020 16 underwent endoscopic mucosal resection (EMR) and 12 did endoscopic submucosal dissection (ESD), The GERD symptoms, endoscopy, 24-h pH monitoring results, manometry, were compared before and after the procedure.Results:ARMS was successfully performed in all 28 patients. Three months after ARMS, 19 patients discontinued the use of pump inhibitors (PPIs), while 9 patients reduced their PPI dose. The GERD questionnaire scores, the median gastroesophageal flap valve grade, the median DeMeester score and acid exposure time based on 24 h esophageal pH monitoring were significantly lower than those before treatment [6.5±2.5 vs.13.4±3.1, 1(1-2) vs.3(1-3), 14.8(8.2-30) vs.34.6(16.2-60.7), 4.4%(1.3%-7.9%) vs. 8.7%(6.2%-13.9%),all P<0.01]. Esophageal sphincter pressure increased after ARMS, from (9.0±3.2) mmHg to (15.5±5.5) mmHg ( t=0.159, P<0.01). The operation time used in ESD was (66.9±4.5) minutes compared to EMR [(29.1±2.0) minutes]( t=13.911, P<0.001). The treatment cost of ESD was (19.9±1.6) thousand yuan vs. for EMR [(9.0±1.6) thousand yuan]( t=58.411, P<0.001). There were no major complications in both groups. Conclusions:ARMS is safe and effective for treatment of rGERD in the absence of HH, and EMR is less time-consuming and more acceptable technique.

Objective:To evaluate the efficacy and safety of a China-made disposable peroral cholangioscope in animal cholangioscopy.Methods:Six healthy Bama minipigs underwent the domestic disposable peroral cholangioscopy after anesthesia. The operation performance and image quality of the products were evaluated, and intraoperative and postoperative complications were recorded.Results:All 6 animals received the domestic disposable peroral cholangioscopy. The cholangioscope showed good operating performance and could smoothly enter the biliary tract through the duodenoscope. The water injection, suction and instrument channels were unobstructed. The cholangioscopic image was clear, the color resolution was good, and there was no image distortion. The lumen and the mucosal surface could be accurately assessed. During the examination, there was no operative injuries such as bleeding, perforation, or adverse events such as respiratory depression or cardiac arrest. All pigs survived the operation with no adverse reaction.Conclusion:The China-made disposable peroral cholangioscope is safe, with good operability and high-quality image.

With the emergence of DNA nanotechnology in the 1980s, self-assembled DNA nanostructures have attracted considerable attention worldwide due to their inherent biocompatibility, unsurpassed programmability, and versatile functions. Especially promising nanostructures are tetrahedral framework nucleic acids (tFNAs), first proposed by Turberfield with the use of a one-step annealing approach. Benefiting from their various merits, such as simple synthesis, high reproducibility, structural stability, cellular internalization, tissue permeability, and editable functionality, tFNAs have been widely applied in the biomedical field as three-dimensional DNA nanomaterials. Surprisingly, tFNAs exhibit positive effects on cellular biological behaviors and tissue regeneration, which may be used to treat inflammatory and degenerative diseases. According to their intended application and carrying capacity, tFNAs could carry functional nucleic acids or therapeutic molecules through extended sequences, sticky-end hybridization, intercalation, and encapsulation based on the Watson and Crick principle. Additionally, dynamic tFNAs also have potential applications in controlled and targeted therapies. This review summarized the latest progress in pure/modified/dynamic tFNAs and demonstrated their regenerative medicine applications. These applications include promoting the regeneration of the bone, cartilage, nerve, skin, vasculature, or muscle and treating diseases such as bone defects, neurological disorders, joint-related inflammatory diseases, periodontitis, and immune diseases.
Nucleic Acids/chemistry* ; Regenerative Medicine ; Consensus ; Reproducibility of Results ; DNA/chemistry*

Objective:To investigate the expression of miR-203a in bladder cancer (BC) cell lines (RT-112, T24, 5637, UM-UC-3) and evaluate the effects on BC cell proliferation and radiosensitivity.Methods:Mir-203a mimics, mir-203a inhibitor, CDK6 siRNA, CDK6 expression plasmid and corresponding negative controls were transfected into BC cells. Quantitative real-time PCR was used to detect the expression of miR-203a in BC cell lines and human bladder epithelial immortalized cell line (SV-HUC-1). CCK8 assay was used to investigate the regulation of miR-203a and cyclin-dependent kinases 6(CDK6) on the proliferation of BC cells. Colony formation assay was performed to assess the effect of miR-203a and CDK6 on the radiosensitivity of BC cells. The target gene of miR-203a was confirmed by luciferase reporter assay. The effect of miR-203a on CDK6 protein expression was detected by Western blot. Multi-group comparison was performed by one-way ANOVA and two-group comparison was conducted by t-test. Results:Compared with the SV-HUC-1 cells, the expression levels of miR-203a in RT-112, T24, 5637 and UM-UC-3 cells were significantly down-regulated (all P<0.05). Compared with NC group, overexpression of miR-203a significantly inhibited the proliferation of BC cells, whereas knockdown of miR-203a significantly promoted the proliferation of BC cells (both P<0.05). Compared with NC group, overexpression of miR-203a significantly increased the sensitivity of BC cells to radiotherapy, whereas knockdown of miR-203a significantly weakened the sensitivity of BC cells to radiotherapy (both P<0.05). CDK6 was the target of miR-203a. Compared with NC group, overexpression of miR-203a significantly down-regulated the expression level of CDK6 protein, whereas knockdown of miR-203a significantly up-regulated the expression level of CDK6 protein (both P<0.05). After overexpression of CDK6 in T24 and UM-UC-3 cells transfected with miR-203a mimics, the cell proliferation ability was significantly increased, whereas the sensitivity to radiotherapy was significantly decreased compared with mir-203a mimics (both P<0.05). After CDK6 was silenced in RT-112 and 5637 cells transfected with miR-203a inhibitor, the proliferation ability of cells was significantly decreased, whereas the sensitivity to radiotherapy was remarkably increased compared with miR-203a inhibitor group (both P<0.05). Conclusion:miR-203a can serves as a tumor suppressor gene to inhibit the proliferation of BC cells and enhance the radiosensitivity of BC cells.

For the wounds caused by burns and other various reasons, the key of therapy is to close the open wounds in time by surgical operation. One of the most important methods is autologous skin grafting. However, for large area and long-term chronic trauma, the lack of autologous skin makes the treatment a huge challenge. For this reason, clinical medical workers have gradually developed miniature free skin grafting through continuous research. This paper reviews the relevant skin grafting techniques, including pinch free skin grafting, stamp free skin grafting, meek grafting, microne free skin grafting, etc.

Objective:To evaluate the efficiency and safety of endoscopic submucosal tunnel dissection (ESTD) on treatment of early esophageal cancer with submucosal fibrosis.Methods:In the Department of Gastroenterology of Northern Jiangsu People′s Hospital from June 2015 to Feburary 2018, data of 87 patients undergoing ESTD or endoscopic submucosal dissection (ESD) for early esophageal cancer or precancerous lesion were collected with inclusion criteria of cancer size less than 1/3 circumference with submucosal fibrosis, which was confirmed by pathology. According to the degree of submucosal fibrosis, 60 patients had mild fibrosis (31 underwent ESTD and 29 underwent ESD), and 27 patients had severe fibrosis (16 underwent ESTD and 11 underwent ESD). The dissection speed, en bloc resection rate, complete resection rate, and the complications (including bleeding, muscularis injury, perforation, neck subcutaneous emphysema and esophageal stenosis) were compared between the two methods of dissection in the groups with same degree of submucosal fibrosis.Results:For patients with mild submucosal fibrosis, ESTD had a higher en bloc resection rate (96.8%, 30/31) and complete resection rate (96.8%, 30/31), and lower muscularis injury rate (6.5%, 2/31) than those of ESD [82.8% (24/29), 75.9% (22/29), and 17.2% (5/29), respectively, all P<0.05]. There was no difference in the dissection speed, incidence of intraoperative bleeding, perforation and postoperative esophageal stenosis between the two methods (all P>0.05), and no postoperative delayed bleeding or neck subcutaneous emphysema occurred. For patients with severe submucosal fibrosis, ESTD had a higher dissection speed (12.3±2.8 mm 2/min), and lower incidence of intraoperative bleeding (12.5%, 2/16), muscularis injury (18.8%, 3/16), perforation (6.3%, 1/16) and neck subcutaneous emphysema (6.3%, 1/16) than those of ESD [7.1±3.2 mm 2/min, 54.5% (6/11), 54.5% (6/11), 27.3% (3/11), and 27.3% (3/11)]. There was no difference in en bloc resection rate, complete resection rate, and the incidence of postoperative esophageal stenosis between the two methods, and no postoperative delayed bleeding occurred. Cancer recurred locally in 2 patients undergoing ESD and 1 patient undergoing ESTD at 12 months after the operation, and 1 patient undergoing ESTD developed metachronous cancer at 24 months after the operation. Conclusion:ESTD is safe and effective for endoscopic management of early esophageal cancer or precancerous lesion with submucosal fibrosis. Compared with standard ESD, the advantage of ESTD is more efficient for patients with mild submucosal fibrosis, and is safer for patients with severe submucosal fibrosis.

The early accurate diagnosis of burn depth is of great significance in determining the corresponding clinical intervention methods and judging the prognosis quality of burn patients. However, the current diagnostic method of burn depth still relies mainly on the empirical subjective judgment of clinicians, with low diagnostic accuracy. Especially for deep partial-thickness burn wounds, the error of early diagnosis is pretty big. In recent years, with the rapid development of artificial intelligence technology, deep learning algorithm combined with image analysis technology can better identify and analyze the information of medical images. This article reviews the research progress of artificial intelligence technology in the diagnosis of burn depth.

Objective: To evaluate the efficacy of ultraviolet light in influenza B prevention and control in schools in Yantian District of Shenzhen in winter, and to provide a reference for preventing and controlling influenza B in schools. Methods: Multistage stratified cluster sampling was conducted. Ultraviolet irradiance was detected in 98 classes of 11 schools. The irradiance of different distances under each ultraviolet lamp were measured. Correlational analysis was conducted with influenza cases reported by Shenzhen Student Health Surveillance System. Results: A total of 473 ultraviolet lamps were detected, the qualified rate was 53.91%. The effective distance from the lamp corresponding power supply to efficient irradiance was (1.43±0.54)m. The total effective irradiance volume per unit time of each class was(13.65±32.66)m3. Totally 599 influenza cases in 74 classes were reported, with incidence rate of 13.76%. Fifty-eight classes reported influenza clustering, accounting for 59.18%. Average duration of the epidemic was(14.5±25.25)d. Spearman correlation analysis showed that the proportion of irradiance volume per unit time in classroom volume was negatively correlated with class influenza incidence(r=-0.32, P=0.00), but not significant with duration of influenza epidemic(P=0.78). Covariance analysis showed that the incidence of influenza and the duration of influenza epidemic in classes was not significantly correlated with the proportion of irradiance volume per class per unit time in classroom volume (P>0.05). Conclusion Ultraviolet light might not effectively reduce the incidence rate of influenza B and the duration of influenza epidemic in schools in Yantian District of Shenzhen over 2017-2018 winter.