Objective: To explore the causal association between dietary components (carbohydrate, fat, protein, and sugar) and 119 genera of known gut microbiota using Mendelian randomization (MR) methods. Methods: Genome-wide association study (GWAS) data for dietary components were collected from the DietGen, while GWAS data for gut microbiota were collected from the MiBioGen. Single nucleotide polymorphism (SNP) loci associated with the four dietary components were used as instrumental variables, and 119 known gut microbiota genera were used as the outcomes. MR analysis was performed using inverse variance weighted (IVW) method. Heterogeneity was evaluated using Cochran's Q test, horizontal pleiotropy and exclude outliers were tested using MR-Egger regression and MR-PRESSO test. Common genetic pleiotropic genes between dietary components and gut microbiota were identified by MAGMA and PLACO analyses. Results: The MR analysis revealed causal associations between carbohydrates and 4 gut microbiota genera, fats and 14 genera, proteins and 14 genera, and sugars and 11 genera (all P<0.05). The MR-Egger regression analysis showed no horizontal pleiotropy among the selected SNPs, and the MR-PRESSO test did not identify any outliers (all P>0.05). The MAGMA and PLACO analyses revealed that 74.42% (32/43) of the causal associations had pleiotropic genes, with 1 to 10 pleiotropic genes identified. Multiple causal association groups shared the same pleiotropic genes. Conclusion There are potential genetic and causal associations between dietary components and gut microbiota.

Objective: To investigate the association between childhood obesity and type 2 diabetes mellitus (T2DM) as well as coronary artery heart disease (CHD). Methods: Genome-wide association study (GWAS) data for childhood obesity were collected from the ECG consortium, encompassing information on children aged 2 to 18 years, including 18 613 cases and 12 696 controls. GWAS data for T2DM were collected from the DIAGRAM consortium, including 242 283 cases and 1 569 734 controls. GWAS data for CHD were collected from the CARDIoGRAMplusC4D consortium, including 10 801 cases and 137 371 controls. Pleiotropic genes associated with both T2DM and CHD were analyzed using the MAGMA, PLACO and conditional false discovery rate (cFDR) methods. Mendelian randomization (MR) analysis was performed using inverse variance weighted (IVW) method, exploring the causal relationships among childhood obesity, T2DM and CHD. Heterogeneity was evaluated using Cochran's Q test, horizontal pleiotropy and exclude outliers were tested using MR-Egger regression and MR-PRESSO test. The mediating variables among the three diseases were investigated by using a mediation analysis. Results: The results of MAGMA, PLACO and cFDR analyses identified 80 pleiotropic genes associated with both T2DM and CHD, primarily distributed on chromosomes 3, 17 and 19. The MR analysis revealed that childhood obesity increased the risk of T2DM (OR=1.151, 95%CI: 1.033-1.283) and CHD (OR=1.158, 95%CI: 1.068-1.255), T2DM increased the risk of CHD (OR=1.182, 95%CI: 1.139-1.227), and CHD increased the risk of T2DM (OR=1.124, 95%CI: 1.055-1.198). The MR-Egger regression analysis showed no horizontal pleiotropy, and the MR-PRESSO test did not identify any outliers (all P>0.05). Mediation analysis indicated that childhood obesity directly increased the risk of CHD (effect value=0.096, 95%CI: 0.012-0.180) and indirectly increased the risk of CHD through T2DM (effect value=0.023, 95%CI: 0.005-0.041), with the mediation effect accounting for 15.65% of the total effect. Conclusions There are potential causal associations between childhood obesity and T2DM as well as CHD, with a bidirectional causal relationship between T2DM and CHD. T2DM also plays a mediating role in the association between childhood obesity and CHD.

OBJECTIVE To explore the effect and mechanism of the alcoholic extract from Scabiosa comosa against hepatic fibrosis （HF）. METHODS Intragastrical administration of carbon tetrachloride was given to induce HF model. By observing the pathological changes in liver tissue， mRNA and protein expressions of HF indexes [α-smooth muscle actin （α-SMA）， collagen type Ⅰ] and phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） pathway-related factors were detected， and the improvement effects and possible mechanism of low-dose， medium-dose and high-dose （50， 100， 200 mg/kg） of alcoholic extract from S. comosa on HF model rats were investigated. Drug-containing serum was prepared by intragastrical administration of alcoholic extract from S. comosa at a concentration of 1 800 mg/（kg·d） （calculated by the amount of raw material）. The effects of drug- containing serum of alcoholic extract from S. comosa on the expression of miRNA-21 were observed through the intervention of HSC-T6 cells with low， medium and high concentrations of drug-containing serum of alcoholic extract from S. comosa （diluted to 10%， 15%， 20%）. miRNA-21 mimics or inhibitors were used to transfect HSC-T6 cells， and the mRNA and protein expressions of factors related to the PI3K/Akt signaling pathway were detected. RESULTS The results of in vivo experiments showed that low， medium and high doses of alcoholic extract from S. comosa significantly ameliorated the histopathological changes in liver tissue of HF rats， and the percentage of collagen was significantly reduced （P＜0.01）； mRNA and protein expressions of the indicators related to HF as well as PI3K and Akt were significantly reduced （P＜0.01）， and mRNA and protein expressions of phosphatase and tensin homolog deleted on chromosome ten （PTEN） were increased in liver tissue of rats （P＜0.01）. The results of in vitro experiments showed that drug-containing serum of alcoholic extract from S. comosa significantly inhibited the expression of miRNA-21 at low， medium and high concentrations （P＜0.01）； whereas after transfection with miRNA-21 mimics， it was found that miRNA-21 mimics significantly increased mRNA and protein expressions of PI3K and Akt （P＜0.01）， while significantly decreased mRNA and protein expressions of PTEN （P＜0.01）； after transfection with miRNA-21 inhibitor， the changes of above indexes were opposite to the above results （P＜0.01）. CONCLUSIONS Alcoholic extracts of S. comosa may inhibit the PI3K/Akt signaling pathway by affecting the expression of miRNA-21， so as to achieve the effect of anti-hepatic fibrosis.

Objective: To investigate the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Shaoxing City from 2006 to 2022, so as provide insights into improvements of the HFRS control strategy. Methods: Data pertaining to HFRS cases in Shaoxing City from 2006 to 2022 were captured from the Surveillance System of China Information System for Disease Control and Prevention. The temporal, population and regional distributions of HFRS were analyzed using the descriptive epidemiological method, and the trends in incidence of HFRS were evaluated using annual percent change (APC). Results: Totally 1 022 HFRS cases were reported in Shaoxing City from 2006 to 2022, with annual average incidence of 1.22/105 and three deaths. The incidence of HFRS appeared a tendency towards a decline in Shaoxing City from 2006 to 2022 (APC=-11.101%, t=-9.930, P<0.001), and the incidence of HFRS peaked from May to June and from November to January of the next year. A higher incidence of HFRS was seen in men than in women (1.76/105 vs. 0.68/105; χ2=201.361, P<0.001). There were 714 HFRS cases at ages of 30 to 59 years (69.86%), and farmers were the predominant occupation (78.18%). The three counties with the largest number of HFRS cases included Zhuji (366 cases), Xinchang (263 cases) and Shengzhou (134 cases). The incidence of HFRS was lower in urban districts (Yuecheng, Keqiao and Shangyu) than in counties (Zhuji, Shengzhou and Xinchang) (0.58/105 vs. 1.96/105; χ2=326.880, P<0.001). Conclusion The incidence of HFRS appeared a tendency towards a decline in Shaoxing City from 2006 to 2022, and the incidence was high in late spring, early summer and winter. The HFRS cases were mainly males, young and middle-aged people, and farmers, and predominantly distributed in counties. Targeted control measures are needed.

Objective: To investigate the epidemiological and etiological characteristics of viral diarrhea among children under 5 years of age in Shaoxing City, Zhejiang Province, so as to provide insights into management of viral diarrhea. Methods: The surveillance data on viral diarrhea among children under 5 years of age in Shaoxing City from 2019 to 2022 were collected, including demographics and stool testing results. The epidemiological and etiological characteristics of viral diarrhea were analyzed using a descriptive epidemiological method. Results: A total of 763 diarrheal children under 5 years of age were reported in Shaoxing City from 2019 to 2022, and 236 children were tested positive for virus (30.93%). The detection of virus was 49.01%, 31.61%, 20.43% and 21.89% from 2019 to 2022, which appeared an overall tendency towards a decline (P<0.05). The incidence of viral diarrhea peaked from November to March of the next year and from May to July, and the detection of virus was lower among children with diarrhea living in urban areas (Yuecheng District, Keqiao District and Shangyu District) than among those in suburb areas (Zhuji City, Shengzhou City and Xinchang County) (30.22% vs. 52.00%, P<0.05). There were 206 children tested positive for a single virus, and the detection rates of rotavirus (RV), enteric adenovirus (EAdV), norovirus (NoV), and sapovirus (SaV) were 9.57%, 8.91%, 8.39%, and 0.13%, respectively. There were 25 children with virus co-infections, and the positive rates of EAdV and NoV, RV and EAdV and RV and NoV co-infections were 1.31%, 1.18% and 0.79%, respectively. There were 5 children with triple infections of RV, EAdV and NoV (0.66%). The highest detection of EAdV was seen in April, the highest detection of RV and NoV was seen in January, while SaV was only detected in April. Conclusion The incidence of viral diarrhea among children under 5 years of age peaked in winter and spring in Shaoxing City from 2019 to 2022, and the cases predominantly occurred in urban areas. The detection of virus appeared an overall tendency towards a decline, with high detection of RV, EAdV and NoV.

Objective:To investigate the birth weight (BW) of infants born to pregnant women living with human immunodeficiency virus (HIV) and its associated factors, and to provide more evidence for the prevention of mother-to-child transmission (PMTCT) in China.Methods:This study was a retrospective cohort study. Between January 2004 and December 2021, pregnant women living with HIV and their infants in Hubei Province were recruited and followed up, and clinical data were collected through hospital medical records and HIV/acquired immunodeficiency syndrome comprehensive response information management system. The multivariable linear regression was performed on the collected data to investigate associated influencing factors of BW.Results:In total, 531 pregnant women living with HIV (581 pregnancies) and 581 infants were enrolled. Of the 581 infants, 36 were HIV-positive, with a PMTCT rate of 6.2%. The mean BW of the infants was (3 075.0±470.2) gram. Protease inhibitor (PI) based-anti-retroviral therapy (ART) ( β=-0.1, 95% confidence interval ( CI)-188.2 to -37.1, P=0.004), ART in the first trimester( β=-0.1, 95% CI -201.9 to -65.5, P<0.001), infant HIV infection ( β=-0.1, 95% CI -310.4 to -68.2, P=0.002), hepatitis C virus infection ( β=0.1, 95% CI 71.2 to 410.4, P=0.005) and gestational age ( β=0.6, 95% CI 155.9 to 191.5, P<0.001) were associated with decreased BW. Conclusions:While improving the effectiveness of PMTCT for HIV, more attention should be paid to pregnant women who received ART in the first trimester and PI-based ART for preventing lower BW and improving maternal and infantile health.

Objective:To investigate the common diseases and the Constitution of Traditional Chinese Medicine of plateau-related soldiers, and explore the correlation between them.Methods:A total of 271 plateau-related soldiers in our sanatorium from January 1, 2020 to December 31, 2020 were selected as the subjects. All of them were assessed by the TCM constitution scale and the self-designed disease questionnaire and Sociodemographic information.Results:Eighty two percent of 271 plateau-related soldiers were regarded as paranoid constitution and 17.7% were gentleness type. There 73.1% of plateau-related soldiers had one or more diseases, and 90.9% of them were paranoid constitution. There were 47 cases of respiratory diseases, including 2 cases of gentleness type (4.3%) and 45 cases of paranoid constitution (95.7%); 53 cases of digestive system diseases, including 1 case of gentleness type (1.9%) and 52 cases of paranoid constitution (98.1%); 27 cases of skin diseases, including 1 case of gentleness type (3.7%) and 26 cases of paranoid constitution (96.3%); 148 cases of musculoskeletal diseases, including 15 cases of gentleness type (10.1%) and 133 cases of paranoid constitution (89.9%). The digestive system diseases with the highest proportion of paranoid constitution were selected for TCM Constitution correlation analysis, suggesting that there was a correlation between them( χ2=11.32, P<0.01). People including Qi deficiency and phlegm-dampness were more prone to digestive system diseases ( P<0.01). There was a significant negative correlation between gentleness type and digestive system diseases [ OR=0.17, 95% CI(0.040-0.726); P=0.017], as well as Qi deficiency [ OR=4.98, 95% CI(2.717-9.120)] and phlegm-dampness [ OR=12.00, 95% CI(5.269-27.332)]were risk factors for them ( P<0.01). Conclusions:The overall health level of plateau-related soldiers was not optimistic. The digestive system diseases of them were positively correlated with Qi deficiency and phlegm-dampness.

Objective:To study the effect of high flow humidification oxygen inhalation on hypoxemia in patients undergoing cardiac surgery and the effect of postoperative weaning time.Methods:A total of 80 patients with hypoxemia after cardiac surgery from January 2018 to January 2020 were selected for the study, according to the random number table, they were divided into the observation group and the control group, 40 cases each.The control group was treated with noninvasive positive pressure ventilation, while the observation group was treated with high flow humidification and oxygen absorption. The weaning time, the changes of the arterial oxygen partial pressure (PaO 2), partial pressure of carbon dioxide (PaCO 2), oxygenation index (PaO 2/FiO 2), pH value, spontaneous breathing frequency (RR), heart rate before and after treatment 2 h, 6 h, 24 h, and the incidence of complications were compared between the two groups. Results:The weaning time in the observation group was (35.51±4.61) h, and that in the control group was (44.04±3.85) h, the difference was statistically significant( t value was 8.982, P<0.01). The PaO 2 in the observation group at 2, 6, 24 h after treatment were (73.96±4.32), (79.82±3.61), (94.82±2.71) mmHg(1 mmHg=0.133 kPa), and those in the control group were (70.72±3.10), (75.63±3.88), (90.27±3.55) mmHg, the differences were statistically significant( t values were 3.854, 5.000, 6.443, P<0.01). The PaO 2/FiO 2 in the observation group at 2, 6, 24 h after treatment were (239.45±18.74), (269.85±20.09), (291.83±17.30) mmHg, and those in the control group were (226.74±20.72), (251.12±16.74), (279.65±19.40) mmHg, the differences were statistically significant( t values were 2.877, 4.530, 2.964, P<0.01). The RR in the observation group at 2, 6, 24 h after treatment were (24.74±2.03), (22.61±1.86), (18.63±2.05) times/min, and those in the control group were (26.07±1.89), (24.24±1.73), (20.11±1.87) times/min, the differences were statistically significant( t values were 3.033, 4.058, 3.373, P<0.01). The heart rate in the observation group at 2, 6, 24 h after treatment were (83.32±4.88), (76.06±4.71), (70.34±3.82) times/min, and those in the control group were (86.06±3.29), (80.91±4.31), (75.71±6.22) times/min, the differences were statistically significant( t values were 2.944, 4.805, 4.653, P<0.01). The total incidence of complications in the observation group was 7.50%(3/40), and that in the control group was 25.00%(10/40), the difference was statistically significant( χ 2 value was 4.501, P<0.05). Conclusions:High flow humidification and oxygen absorption is well for patients with hypoxemia after cardiac surgery, which effectively improve the blood gas index, shorten the weaning time, reduce the incidence of complications, and have good safety, which is worth popularizing.

Objective: To analyze the epidemiological characteristics of coronavirus disease 2019 ( COVID-19 ) in Shaoxing from January 23 to March 31, 2020, so as to provide basis for the prevention and control of COVID-19. Methods: The information of the COVID-19 cases in Shaoxing were collected from the National Diseases Prevention and Control Information System and the field investigation by CDCs. A descriptive analysis was used for the epidemiological characteristics, including time, spatial and population distribution, clinical features and exposure history. Results: Totally 42 confirmed cases of COVID-19 were reported by March 31, without deaths. The first case was reported on January 23 and the last one was on February 13. The onset of cases peaked in mid-to-late January. All the counties ( cities or districts ) had confirmed cases, 14 cases were reported in Yuecheng District. Twenty-five ( 59.52% ) cases were 45 years old or over. Thirteen ( 30.95% ) cases were engaged in business and eight ( 19.05% ) cases were unemployed. No cases were found among medical staff. The main clinical symptoms were fever, dry cough, fatigue and imaging features of pneumonia, with nine ( 21.43% ) severe cases and three ( 7.14% ) critical cases. There were 34 ( 80.95% ) imported cases, who mainly came from Hubei Province. Totally 1 955 close contacts were tracked down, among whom 4 cases were confirmed, with the infection rate of 0.20%. Conclusions The COVID-19 cases reported in Shaoxing were mainly aged 45 years or over, severe and imported from Hubei Province. There was no continuous transmission in the community, and no infection in medical staff or deaths.

Objective To investigate the value of bedside lung ultrasound B-line score in the diagnosis of acute heart failure (AHF). Methods A retrospectively analysis was conducted. The adult patients presenting with acute dyspnea in intensive care unit (ICU) of Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2016 to June 2017 were enrolled. An 8-zone lung ultrasound was performed and plasma B-type natriuretic peptide (BNP) level was tested in all patients. AHF was determined as the final diagnosis by two experienced ICU doctors according to the diagnostic criteria of AHF. Patients were divided into two groups: AHF group and non-AHF group. The levels of BNP and B-line score were compared between the two groups, and the diagnostic value of BNP and B-line score in AHF was evaluated. Results Fifty-six patients were included in this study, with 32 of men and 24 of women,and with an average age of 77.3±8.8. Thirty-six patients were diagnosed as AHF. The level of BNP and lung ultrasound B-line score in AHF group were higher than those in non-AHF group [BNP (ng/L): 1 640.4±1 078.4 vs. 236.9±124.9,B line score: 12.8±5.3 vs. 5.4±1.8, both 1 < 0.01]. There was a strong correlation between elevated BNP levels and an increased B-lines score (R2 = 0.712, 1 = 0.000). The receiver operating characteristic curve (ROC) showed that when the cut-off of lung ultrasound B-line score was 8.5, AHF could be discriminated from dyspnea caused by other diseases (sensitivity was 77.8%, specificity was 95%, positive likelihood ratio was 15.56, negative likelihood ratio was 0.23).The area under the ROC curve (AUC) of lung ultrasound B-line score was 0.917 [95% confidence interval (95%CI) =0.847-0.987, 1 = 0.000], slightly lower than that of plasma BNP [0.979 (95%CI = 0.951-1.008)]. Conclusion Lung ultrasound B-line score was highly specific, but moderately sensitive for identifying patients with AHF.