Objective: To investigate the awareness of knowledge about hepatitis C prevention and control among outpatients in Ningbo City, Zhejiang Province, and its influencing factors, so as to provide the evidence for strengthening health education on hepatitis C prevention and control. Methods: Based on sentinel surveillance of hepatitis C, the outpatients aged 15 to 65 years at seven hospitals in Yinzhou District, Cixi City and Xiangshan County of Ningbo City were selected using the convenient sampling method from April to June during 2020 and 2022. Demographic information, knowledge and behaviors related to hepatitis C prevention and control were collected through questionnaire surveys. The influencing factors for knowledge about hepatitis C prevention and control were analyzed using a multivariable logistic regression model. Results: A total of 2 792 participants were surveyed, including 1 157 males (41.44%) and 1 635 females (58.56%). The awareness rate of knowledge about hepatitis C prevention and control was 56.23%, and was lower in knowledge about hepatitis C vaccine and treatment. The awareness rates of knowledge about hepatitis C prevention and control among outpatients from 2020 to 2022 were 47.11%, 53.22% and 70.65%, respectively, showing an upward trend (P<0.05). Multivariable logistic regression analysis showed that participants aged 25 to <50 years (OR=1.358, 95%CI: 1.073-1.719), with an educational level of high school or junior college (OR=1.431, 95%CI: 1.134-1.806) or above junior college (OR=3.728, 95%CI: 2.958-4.699), with household monthly income per capita of 3 000 to <5 000 yuan (OR=1.828, 95%CI: 1.344-2.486) or ≥5 000 yuan (OR=1.858, 95%CI: 1.366-2.526), without a history of invasive treatments such as pedicure in public places (OR=1.287, 95%CI: 1.024-1.618), without a history of contact with family members' blood-contaminated items (OR=2.050, 95%CI: 1.552-2.707), and always using condoms during sexual contacts (OR=1.740, 95%CI: 1.273-2.378) had higher awareness of knowledge about hepatitis C prevention and control. Conclusions The awareness of knowledge about hepatitis C vaccine and treatment among outpatients in Ningbo City needs to be improved. Age, educational level, household monthly income per capita, history of invasive treatments such as pedicure in public places, history of contact with family members' blood-contaminated items and frequency of condom use during sexual contacts are associated with outpatients' awareness of knowledge about hepatitis C prevention and control.

ObjectiveTo investigate the possible mechanism of Wenfei Huaxian Decoction （温肺化纤汤） in treatment of pulmonary fibrosis in systemic sclerosis-associated interstitial lung disease （SSc-ILD）. MethodsSixty C3H/He female rats were randomly divided into a control group， a model group， a pirfenidone group， and low-， medium-， and high-dose Wenfei Huaxian Decoction groups. The SSc-ILD model mice was established by subcutaneous injection of bleomycin solution 0.04 mg/d into the back of mice for 28 days in all groups but the control group. After successful modelling， the pirfenidone group was given pirfenidone capsule 300 mg/（kg·d） by gavage， the low-， medium- and high-dose Wenfei Huaxian Decoction groups were given Wenfei Huaxian Decoction 7.81， 15.62， and 31.24 g/（kg·d） by gavage， respectively， and the control group as well as the model group were given normal saline 0.1 ml/10 g by gavage， for a total of 21 days. At the end of the intervention， HE staining and Masson staining were used to observe the pathological changes in the skin and lung tissues； the hydroxyproline content of the skin and lung tissues was detected； the protein expression levels of endoplasmic reticulum stress-related proteins glucose-regulated protein 78 （BIP） and C/EBP homologous protein （CHOP） as well as those of nuclear factor kappa B （NF-κB） pathway p65 were measured by western blot； ELISA was performed to determine the expression levels of interferon gamma （IFN-γ）， interleukin 6 （IL-6） and tumour necrosis factor alpha （TNF-α） in serum of rats. ResultsThe results of HE and Masson staining indicated that compared with the control group， the dermis significantly thickened， the number of collagen fibers significantly enlarged， and the number of inflammatory cells significantly increased in the model group； the lung tissue showed a marked inflammatory cellular response with massive collagen fibre proliferation with inflammatory cell infiltration. Compared with the model group， the skin tissue and lung tissue collagen fibre proliferation significantly reduced and inflammatory cell infiltration reduced in the pirfenidone group and all dose groups of Wenfei Huaxian Decoction， and the effects of pirfenidone group and Wenfei Huaxian Decoction medium- and high-dose groups were basically comparable. Compared with the model group， the content of hydroxyproline in skin and lung tissue， the serum level of IFN-γ， IL-6 and TNF-α， and the expression levels of BIP and CHOP protein in lung tissue increased in model group （P＜0.05）. Compared with model group， the content of hydroxyproline in skin tissue of pirfenidone group， low-and medium-dose Wenfei Huaxian Decoction groups decreased， and the content of hydroxyproline in lung tissue of medium-dose Wenfei Huaxian Decoction group decreased. The serum level of IFN-γ， IL-6， TNF-α and the expression levels of BIP， CHOP and p65 protein in lung tissue of rats in pirfenidone group and high-dose Wenfei Huaxian Decoction group decreased （P＜0.05）. The content of hydroxyproline in lung tissue of medium-dose Wenfei Huaxian Decoction group was significantly lower than that of low-dose and high-dose Wenfei Huaxian Decoction group， and the serum level of IFN-γ， IL-6， TNF-α in low- and medium-dose Wenfei Huaxian Decoction group were higher than those in high-dose Wenfei Huaxian Decoction group. The expression level of BIP protein in high-dose group was significantly lower than that in low- and medium-dose Wenfei Huaxian Decoction groups （P＜0.05）. ConclusionWenfei Huaxian Decoction can improve the skin and lung fibrosis of SSc-ILD rats， which may act through anti-inflammation， inhibition of NF-κB pathway， and then inhibition of endoplasmic reticulum stress， which ultimately blocked the fibrotic process.

Objectives:Aimed to establish a rapid, high-throughput, automated method for determining the creatine kinase (CK-MM) isoform levels.Methods:Magnetic beads labeled with anti-CK-MM antibodies were combined with alkaline phosphatase-based chemiluminescence detection. Clinical and diagnostic performance validation of the assay was determined by analysis of 998 and 75 dried blood spot samples from healthy newborns and Duchenne muscular dystrophy (DMD) patients, respectively, and the CK activity was also determined. The blank and detection limits, cross-reactivity, recovery rate of the method, intra-and inter-assay coefficient, and the hook effect were evaluated.Results:Blank and detection limits were 17.4 and 39.3 ng/ml, respectively. Cross-reactivity toward CK-MB and CK-BB isoforms was 0.2% and 0.02%, respectively. Intra-and inter-assay coefficients of variation were<1%. Mean recovery was 100.32%, with no hook effect in CK-MM levels<50 000 ng/ml. Overall, the mean CK-MM concentrations in newborns and DMD patients were (27.05±0.97) and (3 720±300.5) ng/ml, respectively. A significant positive correlation between the dried blood spot detected CK-MM levels and total CK enzyme activity, evaluated in corresponding serum samples from the 75 DMD patients, was observed ( r=0.91, P<0.001), ?which is in good agreement with the clinical. Conclusions:An assay for rapid quantitative determination of CK-MM that meets clinical newborn screening requirements was established. It had a good value for application.

OBJECTIVES: This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults. METHODS: We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag non-linear model. RESULTS: Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a non-linear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period. CONCLUSIONS The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.

OBJECTIVES: This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults. METHODS: We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag non-linear model. RESULTS: Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a non-linear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period. CONCLUSIONS The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.

OBJECTIVES: This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults. METHODS: We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag non-linear model. RESULTS: Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a non-linear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period. CONCLUSIONS The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.

OBJECTIVES: This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults. METHODS: We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag non-linear model. RESULTS: Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a non-linear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period. CONCLUSIONS The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.

Objective: To investigate the use of new types of drugs among HIV/AIDS patients in Ningbo City, Zhejiang Province, so as to provide insights into surveillance and interventions for use of new types of drugs among HIV/AIDS patients. Methods: The HIV/AIDS patients in Ningbo City were randomly sampled from the HIV/AIDS Prevention and Control Information System of Chinese Disease Prevention and Control Information System. Patients' demographics, use of new types of drugs and sexual behaviors were collected using questionnaire surveys. Patients' hair samples were collected, and new types of drugs were determined in hair using liquid chromatography-mass spectrometry (LC-MS). In addition, factors affecting the use of new types of drugs were identified using a multivariable logistic regression model. Results: A total of 254 HIV/AIDS patients were enrolled, including 214 men (84.25%), 31 cases aged under 25 years (12.20%), 66 cases aged 25 to 30 years (25.98%), and 157 cases aged 31 to 75 years (61.81%). There were 30 cases reported previous use of new drugs (11.81%), including 27 cases reported previous use of methamphetamine (90.00%). There were 48 cases tested positive of new types of drugs, with a positive rate of 18.90%, including 44 cases tested positive for methamphetamine (91.67%). Multivariable logistic regression analysis identified age (25 to 30 years, OR=6.926, 95%CI: 1.412-33.969), occupation (students/teachers/cadres/employees/retirees, OR=6.971, 95%CI: 2.123-22.889; housekeeping and housework servants/unemployed, OR=3.356, 95%CI: 1.289-8.739; business/public place servants, OR=2.447, 95%CI: 1.033-4.448) and syphilis infection during recent six months (OR=3.491, 95%CI: 1.664-7.326) as factors affecting the use of new types drugs among HIV/AIDS patients. Conclusions The use of new types of drugs exists in HIV/AIDS patients in Ningbo City. Age, occupation and syphilis infection were associated with the use of new types of drugs among HIV/AIDS patients.

Objective:To investigate the clinicopathological characteristics of early-onset colorectal cancer.Methods:The retrospective and descriptive study was conducted. The clincopatholo-gical data of 59 206 patients with colorectal cancer in the Surveillance, Epidemiology, and End Results Program of the United States of America From January 1,2010 to December 31,2019 were collected. There were 33 213 males, 25 993 males, aged (50±7)years. Observation indicators: (1) demographic and oncological characteristics of colorectal cancer patients; (2) comparison of clinico-pathological characteristics between early-onset and late-onset colorectal cancer. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison among groups was conducted using the Kruskal-Wallis H test. Count data were described as absolute numbers, and comparison among groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the non-parameter H test. Patients with early-onset colorectal cancer were segmented by age, and missing data for categorical variables is set as unknown. Results:(1) Demographic and oncological characteristics of colorectal cancer patients. Of 59 206 patients, there were 23 104 cases with early-onset colorectal cancer and 36 102 cases with late-onset colorectal cancer, and cases aged 13-29 years, cases aged 30-34 years, cases aged 35-39 years, cases aged 40-44 years, cases aged 45-49 years, cases aged 55-59 years were 1 041, 1 740, 3 288, 6 050, 10 985, 15 303,20 799, respectively. (2) Comparison of clinicopathological charac-teristics between early-onset and late-onset colorectal cancer. ① There were significant differences in gender, tumor location, degree of tumor differentiation, tumor histological type, tumor TNM staging, tumor T staging, tumor N staging, tumor M staging, preoperative carcinoembryonic antigen (CEA), perineural invasion, cancer nodule, tumor diameter between patients with early-onset and late-onset colorectal cancer ( P<0.01). Results of further analysis showed that cases with tumor located in ileocecal region, ascending colon, colon liver region, transverse colon were 2 329, 2 139, 579, 1 303 in the 6 350 patients with early-onset right colon cancer. The above indicators were 4 563, 3 945, 902, 1 951 in the 11 361 patients with late-onset right colon cancer. There was a significant difference in the above indicators between the two groups of patients ( χ2=114.27, P<0.01). Cases with tumor located in splenic region of the colon, descending colon, sigmoid colon, rectum sigmoid junction were 553, 1 354, 6 404, 2 431 in the 10 742 patients with early-onset left colon cancer. The above indicators were 865, 1 798, 9 668, 3 610 in the 15 941 patients with late-onset left colon cancer. There was a significant difference in the above indicators between the two groups of patients ( χ2=35.60, P<0.01). ②Of 23 104 patients with early-onset colorectal cancer, cases aged 13-29 years, cases aged 30-34 years, cases aged 35-39 years, cases aged 40-44 years, cases aged 45-49 years were 1 041, 1 740, 3 288, 6 050, 10 985, respectively. There were significant differences in gender, degree of tumor differentiation, tumor histological type, tumor TNM staging, tumor T staging, tumor N staging, pre-operative CEA, perineural invasion, cancer nodule, tumor diameter among patients of different age groups ( P<0.01). Results of further analysis showed that cases with tumor located in ileocecal region, ascending colon, colon liver region, and transverse colon were 91, 117, 45, 69 in the 6 350 early-onset right colorectal cancer patients aged 13-29 years. The above indicators were 165, 136, 47, 115, 304, 313, 93,201, 614, 535, 151, 330, 1 155, 1 038, 243, 588 in early-onset right colorectal cancer patients aged 30-34, 35-39, 40-44, 45-49 years, respectively. There was a significant difference in the above indicators among the five groups of patients ( H=36.63, P<0.01). Cases with tumor located in splenic region of the colon, descending colon, sigmoid colon, rectum sigmoid junction were 32, 83, 260, 95 in the 10 742 early-onset left colorectal cancer patients aged 13-29 years. The above indica-tors were 53, 112, 452, 171, 95, 230, 867, 342, 149, 337, 1 702, 665, 224, 592, 3 123, 1 158 in the 10 742 early-onset left colorectal cancer patients aged 30-34, 35-39, 40-44, 45-49 years, respectively. There was a significant difference in the above indicators among the five groups of patients ( H=47.84, P<0.01). Conclusions:Compared with late-onset colorectal cancer, early-onset colorectal cancer are more likely to occur in the left colon and rectum, with poorly differentiated and undifferentiated tumors, histological type of mucinous adenocarcinoma, TNM staging of stage Ⅲ and Ⅳ, higher proportion of nerve infiltration and cancer nodules, and larger tumor diameter. There are significant differences in clinicopathological characteristics of tumors among patients with early-onset colorectal cancer of different age groups.

ObjectiveTo systematically review the effects of bilingual training on cognition for older adults. MethodsResearches about bilingual training for cognition for the older adults were retrieved from PubMed, Web of Science, ScienceDirect, SpringerLink, Wanfang Data, and CNKI from 2011 to May, 2021, supplemented by references backtracking and manual retrieval. The data was extracted for analysis. ResultsA total of 21 researches were included from twelve countries, which published mainly on journals of medicine, neurology, psychology, biology, etc., in 2017 and 2019. Most of the researches were prospective researches and retrospective researches, and the targeted groups including healthy people, people with dementia and people with Alzheimer's disease (AD). The objects mainly involved the effects of bilingualism on cognition, the pathways and the limitations. ConclusionBilingual training may improve the cognition for older adults, through the brain connection related with memory, attention and execution, to delay the onset of AD or dementia; which may associate with the improvement of brain structure and function, including connectivity among regions, activation of cortical circuits, and structural integrity and plasticity. The effects are mainly on execution and perception, and delaying the cognitive decline, which appear in a short term. Bilingual training may finally promote language function, maintain the integrity of the brain structures, and compensate cognitive decline using more potential neural circuits. However, these researches need more uniform criteria for subjects, more reasonable control conditions, and more uniform paradigms.