Alcohol consumption and fatty liver disease

Hamaguchi et al recently reported some interesting observations on alcohol consumption and risk of fatty liver disease from a large population. However, we feel that it might be necessary to discuss some concerns in this study. As the alcohol consumption categorization was defined by the same criteria in both men and women, which might affect their results. As another factor is soft drinks consumption. It has been proved that soft drinks, especially fructose, contributes to the development of obesity, diabetes, metabolic syndrome, and nonalcoholic fatty liver disease. However, this confounding factor was not adjusted or discussed in this article. The third is the genetic background, for some genetic factors are related with the development of fatty liver disease, which was also not considered yet.

Pregnancy after liver transplantation:Four-year follow-up of the first case in China's Mainland

The safety and feasibility of pregnancy following liver transplantation(LT) have been accredited in a series of LT center.The first case in China's Mainland is reported.The follow-up data of a 22-year-old pregnant patient with end-stage liver disease undergone orthotopic liver transplantation were analyzed retrospectively.After surgery,the patient was uneventfully recovered and became pregnant 33 mo after LT.The patient was closely monitored and treated with a standard and individualized triple-drug immunosuppressive therapy throughout her pregnancy.Caesarean section was performed in March 18,2004,and a health live-born infant was delivered.After the delivery,a 4-year follow-up period indicated that the patient was satisfactory with her condition and her baby was healthy.Our case shows that a successful pregnancy following LT is possible and safe in women with end-stage liver diseases under close monitoring.Three factors including mother,baby,and transplanted liver function must be considered for the safety of high-risk pregnancies.

Comment on“Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis”

The present letter to the editor is in response to the research“Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis”by Elshaarawy et al in World J Gastroenterol 2021;13(5):424–439.The preoperative assessment of the liver reserve function in hepatocellular carcinoma(HCC)patients with cirrhosis is crucial,and there is no universal consensus on how to assess it.Based on a retrospective study,Elshaarawy et al investigated the impact of various classical clinical indicators on liver failure and the prognosis after hepatectomy in HCC patients with cirrhosis.We recommend that we should strive to explore new appraisal indicators,such as the indocyanine green retention rate at 15 min.

Difficulties and Countermeasures of Rural Human Settlement Environment Governance in Tianjin

The course of rural human settlement environment governance in Tianjin could be roughly divided into four stages:germination,initiation,promotion and deepening.After the development for nearly 20 years,rural human settlement environment governance of Tianjin is faced with many difficulties,such as imperfect village construction planning,poor use effect of sewage facilities,low participation of farmers,and insufficient financial investment.Therefore,some countermeasures and suggestions are put forward,such as scientific planning and overall consideration,innovating financing mechanism,encouraging diversified investment of funds,and strengthening the publicity of rural human settlement environment governance.

Microarray analysis to explore the effect of CXCL12 isoforms in a pancreatic pre-tumor cell model

CXCL12 expression was significantly lower in tumor samples than in corresponding normal samples.CXCL12 expression was significantly positively related to the infiltration levels of T cells,dendritic cells(DCs),immature DCs,cytotoxic cells,Tfh cells,mast cells,B cells,Th1 cells,natural killer(NK)cells,pDCs,neutrophils,and T helper cells(Spearman correlation coefficient>0.5,P<0.001)and negatively correlated with the infiltration level of NK CD56bright cells.In addition,pancreatic hTERT-HPNE cells treated with three diverse CXCL12 isoforms exhibited changes mainly in the regulation of the epithelialmesenchymal transition activation pathway.

Assessment on the component pattern of mountain vacation potential suitability in Hunan Province, China

In China,mountain destinations offer more opportunities for vacation than beaches and springs,with a larger national coverage,richer landscapes and various diverse folk cultures.Hunan Province,for example,serves as a typical mountain tourism destination.Our research aims to assess the potential suitability and component pattern of holidaymaking in Hunan Province to support for scientific endeavors and sustainable use of mountain resources in Hunan.An approach for mapping potential suitability was constructed based on Weighted Linear Combination(WLC)of six primary factors including terrain,climate suitability period,biology and environment,human activity culture,hydrological landscape,and road infrastructure,which is calculated on the base of eleven secondary factors used as suitability criteria.Analytic hierarchy process(AHP)and geographic information system(GIS)were also integrated into the evaluation models to prepare six single and complex factor suitability maps for mountain vacation.Multivariate clustering was used to clarify the component pattern of single factor combinations in each mountain vacation suitability index(MVSI)class.The results have shown that:1)Regions with high suitability are distributed with characteristics of significant dispersion and limited aggregation;2)15.89%of the sample mountains are highly suitable,30.78%are moderately suitable,42.61%are marginally suitable and 10.72%are poorly suitable;3)The complexity of index combination corresponding to each level is different;4)Different combinations emphasize different destination needs.The study reveals the suitability class,characteristics,and limiting factors of mountain vacation in different geographical locations on the provincial scale.These elements play an instructive role in scientific decision-making and orderly exploitation of resources among Hunan’s Mountain destinations.Furthermore,the study can also be used as a basis for the suitability evaluation of mountain vacation in other areas.

Effect of Rare Earth Elements on Thermal Fatigue Property of Low Chromium Semi-Steel

The effect of rare earth elements on eutectic carbide′s morphology of low chromium semi steel in as cast state and after heat treatment was investigated, and accordingly, the thermal fatigue property of this material was studied. The results show that RE can improve the eutectic carbide′s morphology, inhibit the formation and propagation of thermal fatigue cracks, therefore, promote the thermal fatigue property, which is more noticeable in case of the RE modification in combination with heat treatment. The optimal thermal fatigue property can be obtained when treated with 0.2% RE modification as well as normalization at 950 ℃ for 3 h.

Prevention of late complications of endoscopic resection of colorectal lesions with a coverage agent:Current status of gastrointestinal endoscopy

Endoscopic ectomy of large nonpedunculated colorectal lesions(≥20 mm)might cause significant adverse incidents,such as delayed perforation and delayed bleeding,despite the closure of mucosal lesions with clips.The conventional utilization of prophylactic clipping has not decreased the risk of postprocedural delayed adverse events,and additional outcomes and cost-effectiveness research is needed for patients with proximal lesions≥20 mm,in whom prophylactic clipping might be useful.Coverage of the wound after endoscopic excision offers shield protection against delayed concomitant diseases.

Research on Cooperation Mechanism of China's Financial Regulation and Supervision System

Financial regulation and supervision is an important subject in finance research. After the U. S. subprime mortgage crisis,the weakness in this field becomes the research focus. Every country attaches importance to strengthen the financial supervision and management. But the financial regulatory system is a large system,and the process of model building and index selection is very complicated. A model for China's financial regulation and supervision system was proposed and a system evaluation method was improved. A more exact result was drawn by choosing 2003- 2009 index data.

Emotion of Physiological Signals Classification Based on TS Feature Selection

This paper propose a method of TS-MLP about emotion recognition of physiological signal.It can recognize emotion successfully by Tabu search which selects features of emotion’s physiological signals and multilayer perceptron that is used to classify emotion.Simulation shows that it has achieved good emotion classification performance.

Design of The Principle of Remote Sensing Network Course Based on Blackboard Academic Suite

Blackboard academic suite is an excellent teaching software,Design of the principle of remote sensing network course based on it includes five kernel parts:course content construction,experimental process recurrence,interactive cooperation creation,exercises evaluation,course data evaluation and feedback.Teacher also should use some tactics to motivate students use blackboard academic suite,so as to improve students' learning interest and initiative,and teaching quality of the principle of remote sensing course.

"Co-construction"to"Symbiosis":Research on the Integrated Governance Mechanism of Industrial Colleges in Higher Vocational Colleges

Industrial colleges are the connection point between higher vocational colleges and enterprises to carry out in-depth collaborative education.At present,there are three forms of industrial colleges:surface cooperative industrial college focusing on order cooperation,middle-level industrial college relying on industry development,and deep cooperative industrial college with integrated development.There are several common problems among the three forms of industrial colleges,such as vague positioning,unclear division of responsibilities and rights between both parties,and "free riding"at all levels.In order to establish symbiotic industrial colleges,there is a need to change the concept first,then establish and improve the system,and finally,establish a cross-border teacher pool.

Traditional Chinese Medicine Pattern Classification and Herbal Medicine for COVID-19: A Comparative Study of Data from Different Sources

Background: Traditional Chinese medicine(TCM) plays a crucial role in the prevention and control of coronavirus disease 2019(COVID-19). Objective: The study aimed to reveal the distribution characteristics of COVID-19 TCM syndrome types and syndrome elements and the law of TCM treatment and medication. Methods: The TCM diagnosis and treatment protocol for COVID-19 and clinical research data were obtained through network retrieval, and Revman 5.3 and SPSS 23.0 were employed to analyze the composition of TCM syndromes and the situation of TCMs in meta and frequency. Results: The top three TCM syndromes of COVID-19 included damp-heat accumulation in the lung pattern, damp abundance due to spleen deficiency, and epidemic toxin invading the lung pattern, while the syndrome elements were dampness, heat, and toxin. Gypsum fibrosum, Pogostemonis herba, and Armeniacae semen were identified as the commonly used drugs. Different syndrome elements were identified at lung disease location: Forsythiae fructus, Glycyrrhizae radix, and Armeniacae semen can be used for “wind;” Glycyrrhizae radix, Armeniacae semen, and Scutellariae radix can be used for “Heat;” Armeniacae semen, Sheng Gypsum fibrosum, and Ephedrae herba can be used for “Toxin;” Ephedrae herba, Armeniacae semen, and Atractylodis rhizome can be used for “Damp;” Magnoliae officinalis Cortex, Ephedrae herba, and Zingiberis Rhizoma recens can be used for “cold;” and Armeniacae semen, Gypsum fibrosum, Ephedrae herba, and Lepidii/Descurainiae semen can be used for “epidemic.” Conclusion: The establishment of a treatment scheme based on the classification of disease syndrome elements should be considered for sudden infectious diseases, such as COVID-19. Pogostemonis herba, Armeniacae semen, Gypsum fibrosum, and Glycyrrhizae radix should be considered as effective drugs from TCM for the treatment of COVID-19.

Rationale and design of a randomised double-blind 2×2 factorial trial comparing the effect of a 3-month intensive statin and antiplatelet therapy for patients with acute mild ischaemic stroke or high-risk TIA with intracranial or extracranial atherosclerosis(INSPIRES)

Background It remains unclear if intensive antiplatelet and statin treatments begun within 24-72 hours of cerebral ischaemic events from intracranial or extracranial atherosclerosis is effective or safe.Methods The Intensive Statin and Antiplatelet Therapy for High-risk Intracranial or Extracranial Atherosclerosis(INSPIRES)trial is a randomised,double-blind,placebo-controlled,multicentre and 2×2 factorial trial.6100 individuals between the ages of 35 and 80 who have experienced a mild ischaemic stroke or high-risk transient ischaemic attack(TIA)within the previous 72 hours that is attributed to≥50%atherosclerotic stenosis of a major intracranial or extracranial artery or multiple infarctions of atherosclerotic origin will be enrolled in the trial.Eligible subjects will be randomised 1:1:1:1 to one of four groups:(1)intensive antiplatelet therapy(combined clopidogrel and aspirin for days 1-21,then aspirin placebo and clopidogrel for days 22-90)plus immediate intensive statin therapy(atorvastatin at a dose of 80 mg daily for the first 21 days,then 40 mg daily for days 22-90);(2)intensive antiplatelet therapy plus delayed intensive statin therapy(atorvastatin placebo for days 1-3,followed by 40 mg per day of atorvastatin for days 4-90);(3)standard antiplatelet therapy(combination of clopidogrel placebo with aspirin for 90 days)plus immediate intensive statin therapy and(4)standard antiplatelet therapy plus delayed intensive statin therapy.The primary efficacy endpoint is any new stroke(ischaemic or haemorrhagic)within 90 days after randomisation.The primary safety endpoint is moderate to severe bleeding at 90 days.Conclusion The INSPIRES trial will assess the efficacy and safety of intensive antiplatelet therapy and immediate intensive statin therapy begun within 72 hours of onset in decreasing the recurrent stroke at 90 days in patients with acute mild ischaemic stroke or high-risk TIA of intracranial or extracranial atherosclerosis origin.

轻型缺血性卒中或短暂性脑缺血发作的早期双联抗血小板治疗

王拥军及同事探讨了应用双联抗血小板治疗预防卒中复发或短暂性脑缺血发作的最新证据。轻型缺血性卒中和短暂性脑缺血发作(TIA)患者在头几周内有较高的卒中及其他血管事件的复发风险(5%~11.7%严。双联抗血小板治疗,包括氯吡格雷和阿司匹林,是减少卒中复发的有效治疗策略Magic Group的专家小组(http://magicproject.org/)最近在The BMJ中发表了一个强烈的快速推荐建议,即对于轻型缺血性卒中和TIA患者应在症状出现24小时内开始双联抗血小板治疗,并持续10~21天3。

Efficiency and Productivity of County-level Public Hospitals Based on the Data Envelopment Analysis Model and Malmquist Index in Anhui, China

Background： China began to implement the national medical and health system and public hospital reforms in 2009 and 2012, respectively. Anhui Province is one of the four pilot provinces, and the medical reform measures received wide attention nationwide. The effectiveness of the above reform needs to get attention. This study aimed to master the efficiency and productivity of county-level public hospitals based on the data envelopment analysis （DEA） model and Malmquist index in Anhui, China, and then provide improvement measures for the future hospital development. Methods： We chose 12 country-level hospitals based on geographical distribution and the economic development level inAnhui Province. Relevant data that were collected in the field and then sorted were provided by the administrative departments of the hospitals. DEA models were used to calculate the dynamic efficiency and Malmquist index factors for the 12 institutions. Results： During 2010-2015, the overall average relative service efficiency of 12 county-level public hospitals was 0.926, and the number of hospitals achieved an effective DEA for each year from 2010 to 2015 was 4, 6, 7, 7, 6, and 8, respectively, as measured using DEA. During this same period, the average overall production efficiency was 0.983, and the total productivity factor had declined. The overall production efficiency of five hospitals was 〉1, and the rest are 〈1 between 2010 and 2015. Conclusions： In 2010-2015, the relative service efficiency of 12 county-level public hospitals in Anhui Province showed a decreasing trend, and the service efficiency of each hospital changed. In the past 6 years, although some hospitals have been effective, the efficiency of the county-level public hospitals in Anhui Province has not improved significantly, and the total factor productivity has not been effectively improved. County-level public hospitals need to combine their own reality to find their own deficiencies.

Intense single-band red upconversion emission in BiOCl:Er3+ layered semiconductor via co-doping Ho3+

Exploring a new tuning way to facilely realize single-band red emission in trivalent rare-earth ions(RE3+) doped upconversion(UC) materials is still desirable.In this work,the intense single-band red emission is achieved by co-doping only Ho3+in the BiOCl:Er3+ under 1550 nm excitation.In the BiOCl layered host,co-doping Ho3+can further enhance the red emission and simultaneously suppress the green emission of Er3+,and thus obviously improve the red-to-green(R/G) ratio.It is found that Ho3+does not se rve as ene rgy trapping through the 5 I6 state as in traditional UC materials but acts as ET bridge(4 S3/2,2 H11/2(Er3+)→5 F4,5 S2(Ho3+)→4 F9/2(Er3+)).The tuning mechanism of Ho3+is discussed in detail and further confirms through a comparative experiment.Our research gives an unusual perspective to tune the UC behavior of Er3+through co-doping Ho3+,which might be inspiring for achievement of single-band red UC emission.

Soluble salt deposit in the Nihewan beds and its environmental significance

Observation and experimental analysis of soluble salt deposit along four profiles across the strata deposited in Nihewan paleolake basin enabled us to recognize the nature and evolution stages of the Nihewan paleolake and its significance in stratigraphical division and pa-leo-environmental reconstruction. The Nihewan paleolake was at least a weak-saline to semi-saline lake and represents an intracontinental lake in the semi-arid region. The lower member of sedimentary strata in the paleolake contains gypsum layer and gypsum lamellae. Soluble salt is mainly composed of SO42- and Ca2+ ions, representing a trend of the paleolake evolvinginto a stage of sulfate lake. The upper member of the strata has predominantly Cl-, K+, and Na+ ions in soluble salt, indicating a starting development of the paleolake to chlorite lake, but no salt rock was deposited, indicating a drying trend of the area.

A Cross-sectional Study Assessing Predictors of Essential Medicines Prescribing Behavior Based on Information-motivation-behavioral Skills Model among County Hospitals in Anhui, China

Background： The self-consciousness and practicality of preferentially prescribed essential medicines （EMs） are not high enough in county hospitals. The purposes of this study were to use the information-motivation-behavioral skills （IM B） model to identify the predictors of essential medicines prescribing behavior （EMPB） among doctors and to examine the association between demographic variables, IMB, and EMPB. Methods： A cross-sectional study was carried out to assess predictive relationships among demographic variables and IM B model variables using an anonymous questionnaire administered in nine county hospitals of Anhui province. A structural equation model was constructed for the I MB model to test the instruments using analysis of moment structures 17.0. Results： A total of 732 participants completed the survey. The average age of the participants was 37.7 ± 8.9 years old （range： 22-67 years old）. The correct rate of information was 90.64%. The average scores of the motivation and behavioral skills were 45.46 a： 7.34 （hundred mark system： 75.77） and 19.92 ± 3.44 （hundred mark system： 79.68）, respectively. Approximately half（50.8%） of respondents reported that the proportion of EM prescription was below 60%. The final revised model indicated a good fit to the data （x^2/df= 4.146, goodness of fit index = 0.948, comparative fit index = 0.938, root mean square error of approximation = 0.066）. More work experience （β = 0.153, P 〈 0.001 ） and behavioral skills （β = 0.449, P 〈 0.001 ） predicted more EMPB. Higher income predicted less information （β = -0.197, P 〈 0.001） and motivation （β =0.204, P 〈 0.001 ）. Behavioral skills were positively predicted by information （β = 0.135, P 〈 0.001 ） and motivation （β = 0.742, P 〈 0.001 ）. Conclusion： The present study predicted some factors of EMPB, and specified the relationships among the model variables. The utilization rate of EM was not high enough. Motivation and behavior skills were crucial factors affecting EMPB. The influence of demographic variables, such as income and work experience, on EMPB should be fully appreciated. Comprehensive intervention measures should be implemented from multiple perspectives.