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OBJECTIVES: This study aimed to assess the healthcare-seeking behaviour and related factors of people with acute respiratory symptoms in the rural areas of central and western China to estimate the disease burden of influenza more accurately. DESIGN: Cross-sectional survey. SETTINGS: Fifty-two communities/villages in the Wanzhou District, Chongqing, China, a rural area in southwest China, from May 2022 to July 2022. PARTICIPANTS: The participants were those who had been living in Wanzhou District continuously for more than 6 months and consented to participate. OUTCOME MEASURES: A semistructured questionnaire was used to determine the healthcare-seeking behaviour of participants, and the dichotomous response of 'yes' or 'no' was used to assess whether participants had acute respiratory symptoms and their healthcare-seeking behaviour. RESULTS: Only 50.92% (360 of 707) of the patients with acute respiratory infection visited medical and health institutions for treatment, whereas 49.08% (347 of 707) avoided treatment or opted for self-medication. The primary reason for not seeing a doctor was that patients felt their condition was not serious and visiting a medical facility for treatment was unnecessary. Short distance (87.54%) and reasonable charges (49.48%) were ranked as the most important reasons for choosing treatment at primary medical and health facilities (80.27%). The primary reasons for which patients visited secondary and tertiary hospitals (7.78% and 8.61%, respectively) were that doctors in such facilities were better at diagnosis (57.14%) and at treatment (87.10%). CONCLUSION: The findings provided in this study indicated that regular healthcare-seeking behaviour investigations should be conducted. The disease burden of influenza can be calculated more accurately when healthcare-seeking behaviour investigations are combined with surveillance in the hospitals.

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Much research has examined the incorporation of academic and scientific writing in science learning. However, less research has applied a narrative approach that represents events in a time sequence. Furthermore, modern technology has greatly extended students' modes of science expression beyond the printed texts. Yet, connecting students' rich experience in digital storytelling with their academic learning in science is still an area of needed research. This study focused on analyzing the products students generated as a way to examine how they integrated science in their multimodal sci-fi narratives. These narratives were created in a program designed to engage adolescents in integrated STEM and digital literacy learning. More specifically, this study developed a two-dimensional framework (science and integration) to evaluate the 35 products produced by 136 participants in 5 iterations of the program. Content and thematic analyses revealed that a wide variety of sophisticated mechanisms was applied for science integration, including: (1) building connections among diverse science topics; (2) leveraging innovative narrative techniques; (3) responding critically to socio-scientific problems; and (4) designing and redesigning multimodal elements. Supplementary Information: The online version contains supplementary material available at 10.1186/s43031-023-00072-7.

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Objective:To observe the clinical efficacy of mouse nerve growth factor (mNGF) combined with rehabilitation on children with global developmental delay(GDD).Methods:It was a prospective multicenter clinical randomized controlled trial (RCT) involving 120 children with GDD admitted to 5 hospitals in China from May 2020 to January 2022.They were randomly divided into mNGF group and conventional rehabilitation group using block randomization method.All children were managed by standardized rehabilitation after recruitment, and those in the mNGF group were additionally given mNGF injections.All subjects were surveyed using the Gesell Development Diagnosis Schedules(GDDS) at baseline, 90 days and 120 days after treatment, and their developmental quotient (DQ) was recorded.Clinical efficacy was analyzed by the paired t-test, rank sum test and Chi- squared test. Results:After 90 days of treatment and the continuous follow-up to 120 days, the increases in the DQ of gross motor (7.520±13.900 vs.0.450±11.459), fine motor (7.800±15.346 vs.1.250±11.581), adaptive behavior (7.730±13.428 vs.2.100±12.022) and personal-social behavior (6.780±11.651 vs.1.780±10.120) than baseline were significantly higher in mNGF group than those of conventional rehabilitation group (all P<0.05). Serious adverse events and important drug-related medical events were not reported. Conclusions:mNGF combined with rehabilitation effectively enhances the development levels of gross motor, fine motor, adaptive behavior and personal-social behavior, and continuously improves the condition of GDD in children with a high safety.

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The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism has been inconsistently reported to be a risk factor for Childhood immunoglobulin A vasculitis (IgAV) nephritis. We comprehensively searched electronic databases as of Jan 2020. Nineteen studies with 1104 cases and 1589 controls were included. Sensitivity analyses based on different subgroups were performed. Further analyses were conducted for association of ACE polymorphism with disease severity and prognosis. Significant associations were found between ACE I/D polymorphism and childhood IgAV nephritis, with the strongest association in DD vs. II comparison (OR 1.72, 95% CI 1.21-2.46). Subgroup analyses generally showed significant results. Besides, ACE polymorphism was significantly associated with proteinuria (DD + DI vs. II: OR 2.22, 95% CI 1.14-4.33; DI + II vs. DD: OR 0.49, 95% CI 0.30-0.81) and worse prognosis (the strongest effect in DD + DI vs. II: OR 4.43, 95% CI 1.84-10.71) among children with IgAV nephritis. The ACE polymorphism seemed not to be associated with hematuria, hypertension, and renal pathology. This study suggested significant association of ACE gene polymorphism with the risk of IgAV nephritis in children. D allele in the ACE genotype could be a useful genetic marker to predict proteinuria and worse prognosis for childhood IgAV nephritis.

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OBJECTIVE@#To analyze the clinical features and genetic basis of three children with mental retardation, language impairment and autistic features due to de novo variants of FOXP1 gene.@*METHODS@#Clinical data of the children were collected.Trio-whole exome sequencing was carried out for the children and their parents. Pathogenicity of the variants was analyzed through bioinformatics prediction.@*RESULTS@#All of the children had various degrees of mental retardation in conjunct with language deficit, global developmental delay, abnormal behavior and peculiar facial features, among whom two also developed autism spectrum disorders. The results of genetic testing showed that all three children harbored de novo variants of the FOXP1 gene, namely c.613_c.614delCTinsTA, c.1248delC and c.1393A>G. Two of these were frameshift variants and one was missense variant, which were all rated as pathogenic based on the guidelines of the American College of Medical Genetics (ACMG). Database search suggested that c.613_c.614delCTinsTA and c.1248delC were unreported previously.@*CONCLUSION@#For the three children from unrelated families with mental retardation in conjunct with language deficit, global growth delay, abnormal behavior and peculiar facial features, the c.613_ c. 614delCTinsTA, c.1248delC and c.1393A>G variants of the FOXP1 gene may be the pathogenic factors. Above cases have further expanded the genotype-phenotype profile of FOXP1 deficiency syndrome.

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BACKGROUND Acid-sensing ion channels (ASICs) are ligand-gated cation channels activated by extracellular protons. However, the role of ASICs in kidney diseases remains uncertain. This study investigated ASICs expression in kidney tissues and their role in the development of Henoch-Schönlein purpura nephritis (HSPN). MATERIAL AND METHODS The expression of ASIC subunits was examined by immunochemical techniques in the kidney tissue from HSPN patients. Acid-induced ASICs expression in cultured renal tubular epithelial cells was determined by quantitative RT-PCR analysis. The expression of K7 and K18 protein in renal tubular epithelial cells was used to evaluate acid-induced cell injury. In addition, we observed the effect of blocking ASICs on acid-induced cell injury to assess the role of ASICs in renal tubular epithelial cell injury. RESULTS The results showed that ASIC1, ASIC2, and ASIC3 proteins were obviously expressed in renal tubular cells from HSPN patients. ASIC1 expression and 24-h urine protein level were higher in the pathological grade ISKD III group than in the ISKD II group. ASIC1, ASIC2, and ASIC3 mRNA, and K7 and K18 protein expression in cultured renal tubular epithelial cells were increased when exposed to pH 6.5. K7 and K18 protein expression was closely related to ASIC1 expression, and ASICs blockers reduced K7 and K18 protein expression in tubular epithelial cells. CONCLUSIONS These findings suggest ASICs are most highly expressed in renal tubular cells of HSPN patients, which is closely related to renal tubular injury. ASICs might be involved in the development of HSPN.

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Scholars have focused on the relationship between Henoch-Sch?nlein purpura nephritis and IgA nephropathy in children, when they gradually recognizes the similarities and differences between Henoch-Sch?nlein purpura nephritis and IgA nephropathy in their incentives, genetic factors, renal immunopathology, therapy and so on,with aberrantly glycosylated IgA1 involved in the pathogenesis of Henoch-Sch?nlein purpura nephritis and IgA nephropathy. This paper will review their differences and similarities,along with their relation, according to the research progress.

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PURPOSE: Data about the association between serum uric acid and metabolic syndrome in healthy adolescents are sparse. This study examined this association and determined the optimal cutoffs for serum uric acid to predict metabolic syndrome among healthy adolescents. METHODS: During 2010-2011, we conducted a cross-sectional study of 927 adolescents (53.0% boys) aged 11-16 years from junior and senior high schools in northeast China. All participants received a physical examination and gave venous blood samples. RESULTS: Serum uric acid was positively associated with abdominal obesity, dyslipidemia and hypertension in boys and with abdominal obesity and dyslipidemia in girls. For those with hyperurecemia, the odds ratios (95% CI) for metabolic syndrome were 7.67 (95% CI, 2.58~22.78) for boys and 4.77 (95% CI, 1.01~22.60) for girls. SUA was a better predictor of metabolic syndrome than fasting glucose, though not as good as waist circumference. CONCLUSIONS: Among adolescents in China, serum uric acid level may be a useful predictor of metabolic syndrome.

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Previous studies have demonstrated that individual anti-hypertension medications have different effects when administered in the morning vs. the evening. However, the impact of administration timing on fixed combinations of anti-hypertensive medications on blood pressure control is still unknown. In the present study, we examined the administration time-dependent effects of a fixed combination of amlodipine and diuretics (amlodipine complex) on blood pressure in hypertensive subjects. Eighty patients from Chongqing City were enrolled in this study. Subjects were randomly assigned to receive a single pill (amlodipine complex, each tablet containing amlodipine 5 mg and hydrochlorothiazide 25 mg), either in the morning (0800 hours, n=40) or at bedtime (2200 hours, n=40). Blood pressure was measured by ambulatory monitoring every 20 min during the day and every 30 min at night for 24 consecutive hours before and after the 12 weeks of treatment. Following treatment, the 24-h mean systolic and diastolic blood pressures were reduced significantly in both the morning and bedtime groups. However, the morning blood pressure surge was reduced to a greater degree in the bedtime group. In addition, the nocturnal blood pressure and the 24 h mean blood pressure were lower in the bedtime group. More patients converted from having a non-dipper to dipper blood pressure in the bedtime group. These findings confirm that amlodipine complexes have different efficiencies depending on treatment time. Administration of amlodipine complexes at bedtime could optimize the anti-hypertensive effect by augmenting blood pressure-lowering effects, increasing the diurnal/nocturnal ratio of blood pressure, normalizing the blood pressure pattern and minimizing the morning blood pressure surge.

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0-20 cm soil samples were collected from an 18-year wheat-maize rotation field on the North China Plain to study the effects of long-term fertilization on the contents and storages of soil particulate organic carbon (POC), particulate organic nitrogen (PON), incorporated organic carbon (IOC), and incorporated organic nitrogen (ION). The long-term fertilization experiment was designed to include 7 treatments, i.e., chemical NPK (NPK), organic manure (OM), 1/2 organic manure plus 1/2 chemical NPK (1/20 MN), chemical NP (NP), chemical PK (PK), chemical NK (NK), and control (CK). After 18 years experiment, all the fertilization treatments showed higher contents of soil POC, PON, IOC and ION, higher proportions of soil POC to soil total organic carbon (TOC) and of soil PON to soil total nitrogen (TON), and higher C/N ratio of soil particulate organic matter. The storages of soil POC and PON under fertilization treatments were increased by 11.7%-196.8% and 13.0%-152.2%, respectively, compared with the control. The contribution of soil POC to the increased storage of soil TOC ranged from 31.5% to 67.3%, and that of soil PON to the increased storage of soil TON ranged from 14.3% to 100.0%. The storages of soil IOC and ION under fertilization treatments increased by 2.0%-75.0% and 0.0%-69.8%, respectively, compared with the control. Among the fertilization treatments, treatment OM had the highest storages of soil POC, PON, IOC and ION, followed by treatment 1/20 MN, and the treatments of applying chemical fertilizers alone. Balanced application of chemical fertilizers (treatment NPK) showed higher storages of soil POC, PON, IOC and ION than imbalanced application (treatments NP, PK, and NK). It was suggested that applying organic manure or its combination with chemical NPK and the balanced application of chemical NPK could be the keys for the increase of soil POC, PON, IOC and ION contents and storages.

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