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Purpose: Although the Americas and Europe have historically dominated the global research landscape, emerging economies - Brazil, Russia, India, China, and South Africa (BRICS) have significantly increased their contributions in recent years. This article studies clinical trial trends in the BRICS nations between 2018 and 2022 and compares it with trends in the G7 nations (comprising Canada, France, Germany, Italy, Japan, the UK, the USA, and the European Union). This will help stakeholders in planning drug development strategies. Materials and Methods: Data were collected from the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and the World Bank database. An electronic search was done for the total number of trials registered between January 1, 2018, and March 15, 2023. Information was analyzed based on the year of registration, therapeutic area, type of intervention, sponsorship, and type of special population. The trial density indices (TDIs) were calculated based on population (Xi) and gross domestic product (GDP) (Yi) using author-derived formulae. Results: Altogether 2, 77, 536 trials from the BRICS and G7 were registered. China and the US had the most trials among the BRICS and G7, respectively. Between 2018 and 2022, the gap between the BRICS and G7 steadily reduced. The most common indication for clinical trials among the BRICS was cancer. Based on population, the TDI was the highest in China and the lowest in Russia. In proportion to the GDP, the TDI was maximum in Russia and minimum in India. Conclusion: There is a remarkable reduction in the gap in clinical trial trends between the BRICS and G7 nations. Among the BRICS, India and China are at the forefront in drug development. There is scope for improvement in trial density based on India's population and GDP. Stakeholders are likely to utilize the strengths of the BRICS as an attractive destination for investment in this area.

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Abstract Objective: To investigate the incidence, clinical and genetic characteristics of pediatric lymphoma patients of China with inborn errors of immunity (IEI)-related gene mutations, which have not been fully studied. Method: From Jan. 2020 to Mar. 2023, IEI-related genetic mutations were retrospectively explored in 108 children with lymphomas admitted to Beijing Children's Hospital by NGS. Genetic rule and clinical characteristics as well as treatment outcomes were compared between patients with or without IEI-related gene mutations. Results: A total of 17 patients (15.7 %) harbored IEI-associated mutations, including 4 cases with X-linked lymphoproliferative syndrome (XLP), 3 cases had mutations in tumor necrosis factor receptor superfamily 13B (TNFRSF13B), 2 cases with Activated p110 syndrome (APDS). Patients with IEI all had alteration of immunocompetence with decreased levels of immunoglobulin and lymphocyte subsets. Recurrent infection existed in 41.2 % of patients. The 18-month event-free survival (EFS) and the overall response rate (ORR) of patients with IEI are significantly lower than those without IEI (33.86% vs. 73.26 %, p = 0.011; 52.94% vs. 87.91 %, p = 0.002, respectively). In addition, patients with IEI had a higher progression disease (PD) rate of 23.5 % than those without IEI of 4.4% (p = 0.006). Conclusion: The present study demonstrated that IEI-associated lymphomas were much more common than originally appreciated in pediatric lymphomas, and those were insensitive to treatment and more likely to progress or relapse. The genomic analysis and a thorough review of the medical history of IEI can be used to distinguish them from pediatric lymphomas without IEI, which are beneficial for the early diagnosis and direct intervention.

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Severe typical deep-pitted lesions of Potato Common Scab (PCS) disease were observed in two locations in China, Dingxi, Gansu Province, and Shuozhou, Shaanxi Province, in 2021. Potato farms in Dingxi growing cultivar Huangxin 226 (26 hectares) exhibited a scab disease incidence of 10%, while cultivar Jinshu 15# (4 hectares) in Shuozhou showed a disease incidence of 30% (Fig. 1). During harvest, tubers displaying PCS symptoms were collected for pathogen isolation. To obtain pathogen isolates, surface-sterilized tuber tissue with scab lesions was ground in sterile water, serially diluted, and plated onto ISP5 agar medium plates (Handique et al. 2022). Five pure colonies of Streptomyces isolate were obtained, designated as ZRIMU1503, ZRIMU1502, ZRIMU1320, ZRIMU1321and ZRIMU791. Genomic DNA was extracted and sequenced using Illumina technology. Sequencing data of the 5 isolates were uploaded to NCBI GenBank and annotated (Accession numbers: JBBAYL010000000, JBBAYM010000000, JBBAYN010000000, JBBAYO010000000 and JBBAYP010000000, respectively) using the PGAP pipeline (Tatusova et al. 2016). Average Nucleotide Identity (ANI) values (97.52 %, 97.53 %,97.54 %,97.57 % and 97.52 %, respectively) indicated the identity of the five isolates to the type strain S. brasiliscabiei IBSBF 2867T. Additionally, pairwise comparisons of Digital DNA Hybridization (DDH) value (76.2%, 76.3%, 76.4%, 76.4% and 76.2% respectively) of all the Streptomyces type strains show the highest identity to S. brasiliscabiei IBSBF 2867T. Twelve housekeeping genes (acnA, atpD, dnaN, gap, gyrA, gyrB , infB, mdh, recA, rplB, rpoB, and trpB) were extracted from the genome sequence of the five isolates to construct a multi-locus sequence analysis (MLSA) tree. The evolutionary distance of the five isolates was constructed using MEGAX software (Kumar et al., 1994), along with other Streptomyces strains that are known to cause PCS. The resulting cladogram demonstrated the isolated strains clustered together with S. brasiliscabiei IBSBF 2867T (Fig.2). Koch's postulates were fulfilled by inoculating a perlite potting mix with spore suspensions of each isolate (104 CFU/ml), planting tubers (cv. Favorita), and reproducing PCS symptoms at harvest after three months. Negative control received water treatment. The plants were kept in greenhouse with 12 h of light per day and irrigated regularly. The experiment was repeated twice, once in April 2022 and again in April 2023. On harvest, all five isolates exhibited development of severe symptoms of PCS (Fig.1), while the negative controls had no lesions. The pathogen was reisolated from the lesions and confirmed to be identical to the original isolate by 16S rRNA gene sequences. To our knowledge, this is the first report of S. brasiliscabiei causing PCS in China. S. brasiliscabiei was identified as a new species to cause PCS in Brazil and was identified based on morphology, pathogenicity, and genetic features (Corrêa et al. 2021). Multiple pathogen-causing PCS has been recognized in China and a surge of disease incidence in potato fields has been reported (Handique et al. 2022; Wu et al. 2023). S. brasiliscabiei causes severe symptoms which makes potatoes unmarketable. The disease epidemiology of this pathogen needs to be investigated.

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OBJECTIVE: This work compares the marketing authorization, labels and dosage forms of medicines in the WHO Model List of Essential Medicines for Children (EMLc) in China, the Russian Federation and Brazil to urge policymakers to pay more attention to paediatric medication. METHODS: Medicines were selected from the 8th EMLc. By searching relevant databases, which include different types of medical information in China, the Russian Federation and Brazil, the marketing authorization, labels and dosage forms of paediatric medicines in the three countries were evaluated. RESULTS: A total of 485 drug products containing 312 active pharmaceutical ingredients listed in the WHO EMLc were evaluated. Among them, 344 products were approved for use in China, 286 in the Russian Federation and 264 in Brazil. Out of the 344 approved medicines, 317 (92.15%) were authorized for paediatric use in China, 224 (78.32%) in the Russian Federation and 218 (82.58%) in Brazil. In terms of guidance information labelling on drug labels, 75.08%, 83.04% and 88.07% of paediatric drugs approved in China, the Russian Federation and Brazil, respectively, clearly indicated the usage and dosage for paediatric use. Additionally, injections and tablets were the most prevalent dosage forms in these three countries. CONCLUSION: There is still scope for enhancing the marketing authorization and development of dosage forms for paediatric medicines in the three countries. Furthermore, additional measures are being implemented to enhance the information provided on drug labels for children, particularly in China.

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OBJECTIVE: To investigate the incidence, clinical and genetic characteristics of pediatric lymphoma patients of China with inborn errors of immunity (IEI)-related gene mutations, which have not been fully studied. METHOD: From Jan. 2020 to Mar. 2023, IEI-related genetic mutations were retrospectively explored in 108 children with lymphomas admitted to Beijing Children's Hospital by NGS. Genetic rule and clinical characteristics as well as treatment outcomes were compared between patients with or without IEI-related gene mutations. RESULTS: A total of 17 patients (15.7 %) harbored IEI-associated mutations, including 4 cases with X-linked lymphoproliferative syndrome (XLP), 3 cases had mutations in tumor necrosis factor receptor superfamily 13B (TNFRSF13B), 2 cases with Activated p110 syndrome (APDS). Patients with IEI all had alteration of immunocompetence with decreased levels of immunoglobulin and lymphocyte subsets. Recurrent infection existed in 41.2 % of patients. The 18-month event-free survival (EFS) and the overall response rate (ORR) of patients with IEI are significantly lower than those without IEI (33.86% vs. 73.26 %, p = 0.011; 52.94% vs. 87.91 %, p = 0.002, respectively). In addition, patients with IEI had a higher progression disease (PD) rate of 23.5 % than those without IEI of 4.4 % (p = 0.006). CONCLUSION: The present study demonstrated that IEI-associated lymphomas were much more common than originally appreciated in pediatric lymphomas, and those were insensitive to treatment and more likely to progress or relapse. The genomic analysis and a thorough review of the medical history of IEI can be used to distinguish them from pediatric lymphomas without IEI, which are beneficial for the early diagnosis and direct intervention.

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Older adults have a high prevalence of falls due to a decline in physiological functions and various chronic diseases. This study aimed to investigate the prevalence of and risk factors for falls among older individuals in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We collected information from 9737 older individuals (average age=84.26 years) from the CLHLS and used binary logistic regression analysis to explore the independent risk factors and protective factors for falls. The logistic regression analysis results are reported as adjusted odds ratios (aORs) and 95% confidence intervals (95%CIs). The prevalence of falls among older adults in China was 21.6%, with women (24.6%) having a higher prevalence than men (18.1%). Logistic regression analysis revealed that never (or rarely) eating fresh fruit, difficulty with hearing, cataracts, and arthritis were the common independent risk factors for falls in older Chinese men and women. Among men, age ≥80 years (aOR=1.86), never doing housework (aOR=1.36), and dyslipidemia (aOR=1.47) were risk factors, while eating milk products once a week was a protective factor. Alcohol consumption (aOR=1.40), physical labor (aOR=1.28), and heart disease (aOR=1.21) were risk factors for falls in women, while a daily sleep duration of 6-12 h and garlic consumption once a week were protective factors. The prevalence of falls among older adults in China is 21.6% and is greater in women than in men. These risk and protective factors can be used to formulate reasonable recommendations for living habits, diet, and chronic disease control strategies.

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This study explored the association between loneliness and mental health among nurses in China during the COVID-19 pandemic. This cross-sectional study was conducted from March to April 2022. We enrolled 2,811 nurses from a tertiary hospital in China. Demographic characteristics, lifestyle factors, work-related factors, and psychological characteristics were collected from participants via a self-reported questionnaire. Loneliness was measured with the three-item short form of the Revised UCLA Loneliness Scale, and the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale were used to measure mental health. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were determined using binary logistic regression. Among participants in this study, 12.0% (337) experienced loneliness, and 7.8% (219) and 6.7% (189) reported depression and anxiety, respectively. The loneliness scores were categorized into three levels (3, 4-6, and 7-9). For depression, compared with the lowest reference, the ORs and 95% CI across the tertile were 1.31 (0.69-1.84) and 2.53 (1.11-5.76) after adjustment, respectively, and the P-value for trend was 0.045. For anxiety, compared with the lowest reference, the ORs and 95%CI across the tertile were 1.84 (1.28-2.63) and 2.52 (1.57-4.10) after adjustment, respectively; the P-value for trend was 0.004. This study showed that loneliness was significantly associated with poor mental health among nurses during the COVID-19 pandemic. These findings suggested that medical establishments should offer interventions for nurses to prevent mental health problems by targeting this modifiable risk factor.

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Löfgren syndrome (LS) is a unique acute manifestation of sarcoidosis and characterized by erythema nodosum, bilateral hilar lymphadenectasis, and/or bilateral ankle arthritis or periarthritis. A 37 - year - old female patient with LS presented with fever accompanied by multiple joint swelling and pain, nodular skin erythema, and bilateral hilar lymphadenectasis. The patient had received treatment involving non - steroidal anti - inflammatory drugs and glucocorticoids in other hospitals, but the effects were poor, and the conditions reemerged. The LS duration has lasted for more than 3 months. Following traditional Chinese medicine (TCM) treatment, syndrome differentiation as well as giving patients oral Chinese medicine decoction, the symptoms of the patient were rapidly relieved within one week and did not recur during a six - month follow - up period. This case is the first clinical report of acute sarcoidosis LS treated using T CM and reflects the significant advantages of this form of therapy in emergency treatment

El síndrome de Löfgren (LS) es una manifest ación única y aguda de sarcoidosis, caracterizada por eritrema nodoso, linfadenectasis hilar bilateral, y/o a r tritis de tobillo bilateral o periartritis. Una paciente de 37 años de sexo femenino con LS se presentó con fiebre, acompañada de inflamación y do lor múltiple de articulaciones, eritrema nodular cutáneo, y linfadenectasis hilar bilateral. La paciente recibió un tratamiento que consistió en antiinflamatorios no esteroidales y glucocorticoides en otros hospitales, pero los efectos fueron leves y las c ondiciones reemergieron. El LS ha durado más de tres meses. Siguiendo el tratamiento de medicina tradicional china (MTC), la diferenciación de síndrome, así como darles a los pacientes una decocción de medicina china por vía oral, los síntomas de la pacien te rápidamente fueron aliviados en el curso de una semana y no recidivaron durante los seis meses de un seguimiento. El caso es el primer reporte clínico de tratamiento de sarcoidosis aguda asociada a LS usando TCM y refleja las significativas ventajas de esta forma de terapia en el tratamiento de emergencia.

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SUMMARY OBJECTIVE: The aim of this study was to explore the correlation between skeletal muscle content and the presence and severity of metabolic dysfunction-associated fatty liver disease in patients with metabolic dysregulation in China. METHODS: A cross-sectional study was conducted among patients from the endocrinology outpatient department at Ningbo First Hospital, in Ningbo, China, in April 2021. Adult patients with metabolic dysregulation who accepted FibroScan ultrasound were included in the study. However, those without clinical data on skeletal muscle mass were excluded. FibroScan ultrasound was used to noninvasively evaluate metabolic dysfunction-associated fatty liver disease. The controlled attenuation parameter was used as an evaluation index for the severity of liver steatosis. Bioelectrical impedance analysis was used to measure the skeletal muscle index. RESULTS: A total of 153 eligible patients with complete data were included in the final analysis. As the grading of liver steatosis intensifies, skeletal muscle index decreases (men: Ptrend<0.001, women: Ptrend=0.001), while body mass index, blood pressure, blood lipid, uric acid, aminotransferase, and homeostatic model assessment of insulin resistance increase (Ptrend<0.01). After adjusting for confounding factors, a negative association between skeletal muscle index and the presence of metabolic dysfunction-associated fatty liver disease was observed in men (OR=0.691, p=0.027) and women (OR=0.614, p=0.022). According to the receiver operating characteristic curve, the best cutoff values of skeletal muscle index for predicting the metabolic dysfunction-associated fatty liver disease presence were 40.37% for men (sensitivity, 87.5%; specificity, 61.5%) and 33.95% for women (sensitivity, 78.6%; specificity, 63.8%). CONCLUSION: Skeletal muscle mass loss among patients with metabolic dysregulation was positively associated with metabolic dysfunction-associated fatty liver disease severity in both sexes. The skeletal muscle index cutoff value could be used to predict metabolic dysfunction-associated fatty liver disease.

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Objetivos: analisar a aplicação da auriculoterapia no contexto de saúde de crianças (zero a 12 anos incompletos) e as evidências científicas da sua efetividade em relação às finalidades terapêuticas propostas. Métodos:revisão integrativa da literatura, realizada em novembro de 2023, nas bases de dados e biblioteca virtual MEDLINE/PubMed, Scopus, Biblioteca Virtual em Saúde/BIREME, COCHRANE Library e Scientific Electronic Library Online, utilizando o descritor controlado "Auriculotherapy" e o descritor não controlado "Children", sem restrição temporal de publicação. Para análise utilizou-se o referencial de acurácia de evidências. Resultados:foram selecionados dez artigos oriundos de Cuba (n=4), Taiwan (n=3), China (n=2) e Iran (n=1). Eles foram publicados nos últimos 15 anos e abordavam predominantemente crianças em idade escolar. Aqueles com evidência forte relacionam-se às temáticas: tratamento de onicofagia, miopia e transtorno de déficit de atenção e hiperatividade (TDAH). Os pontos auriculares de maior recorrência de uso foram: Shenmen, coração e olho. Conclusão: essa terapia mostra-se efetiva como coadjuvante para tratamento de onicofagia, TDAH e miopia na população pediátrica em idade escolar, e para as demais finalidades terapêuticas identificadas na revisão, apesar dos resultados promissores, é preciso desenvolver mais pesquisas para que se possa afirmar sua efetividade.

Objectives: to analyze the application of auriculotherapy in the health context of children (zero to 12 incomplete years) and the scientific evidence of its effectiveness in relation to the proposed therapeutic purposes. Methods:integrative literature review, carried out in November 2023, in the databases and virtual library MEDLINE/PubMed, Scopus, Biblioteca Virtual em Saúde/BIREME, COCHRANE Library, and Scientific Electronic Library Online, using the controlled descriptor "Auriculotherapy" and the uncontrolled descriptor "Children", with no time restriction on publication. For analysis, we used the reference of evidence accuracy. Results: ten articles were selected from Cuba (n=4), Taiwan (n=3), China (n=2), and Iran (n=1), which were published in the last 15 years and predominantly dealt with school-age children. Those with strong evidence are related to the themes: treatment of onychophagia, myopia, and attention deficit hyperactivity disorder (ADHD). The auricular points with the highest recurrence of use were: Shenmen, heart, and eye. Conclusion:this therapy has been shown to be effective as an adjunct for the treatment of onychophagia, ADHD, and myopia in the school-age pediatric population, and or the other therapeutic purposes identified in the review, despite the promising results, further research is needed to affirm its effectiveness.

Objetivos: analizar la aplicación de la auriculoterapia en el contexto de la salud de los niños (cero a 12 años incompletos) y la evidencia científica de su eficacia en relación con los fines terapéuticos propuestos. Métodos: revisión integrativa de la literatura, realizada en noviembre de 2023, en las bases de datos MEDLINE/PubMed, Scopus, Biblioteca Virtual em Saúde/BIREME, Biblioteca COCHRANE y Scientific Electronic Library Online y biblioteca virtual, utilizando el descriptor controlado "Auriculoterapia" y el descriptor no controlado "Niños", sin restricción de tiempo de publicación. Para analizarlo, utilizamos el parámetro de precisión de las pruebas. Resultados: se seleccionaron diez artículos de Cuba (n=4), Taiwán (n=3), China (n=2) e Irán (n=1), que se publicaron en los últimos 15 años y trataban predominantemente de niños en edad escolar. Los que presentan pruebas sólidas están relacionados con los temas: tratamiento de la onicofagia, la miopía y el trastorno por déficit de atención con hiperactividad (TDAH). Los puntos auriculares más utilizados fueron: Shenmen, corazón y ojo. Conclusión: esta terapia está demostrando ser eficaz como complemento para el tratamiento de la onicofagia, el TDAH y la miopía en la población pediátrica en edad escolar, y para los otros fines terapéuticos identificados en la revisión, a pesar de los resultados prometedores, se necesitan más investigaciones para afirmar su eficacia.

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Objetivo: examinar la relación entre éxito en la carrera y ambiente de trabajo con enfermeras actuantes en tecnología de reproducción asistida (TRA), e identificar factores que afectan su éxito en la carrera. Método: estudio transversal realizado en 53 centros de fertilidad de 26 provincias en la China Continental. Datos recolectados utilizando cuestionario de datos demográficos, un Cuestionario de Competencias de TRA para Enfermeras Especializadas, la Career-Success Scale (Escala de éxito profesional) y la Nursing Work Environment Scale (Escala del entorno de trabajo de enfermería). Se aplicó estadística inferencial y descriptiva. Resultados: 597 enfermeras actuantes en TRA participaron en nuestra encuesta, entregando 555 cuestionarios válidos. Los puntajes generales promedio de éxito en la carrera y ambiente de trabajo fueron 3,75 (desviación estándar, [DE]=1,01) y 3,42 (DE=0,77) respectivamente. Se observó fuerte correlación positiva entre éxito en la carrera y ambiente de trabajo (r=0,742; p<0,01). La regresión múltiple mostró que la concurrencia a conferencias académicas, atención psicológica, desarrollo profesional, apoyo y cuidado, salario y bienestar constituyeron factores significantes con influencia en el éxito en la carrera. Conclusión: la concurrencia a conferencias académicas, atención psicológica y ambiente de trabajo guardan relación positiva con el éxito en la carrera. Los gestores deberían considerar formas de abordar tales factores.

Objective: to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. Method: a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. Results: 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. Conclusion: attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors.

Objetivo: examinar a relação entre o sucesso profissional e o ambiente de trabalho de enfermeiros da área de tecnologia de reprodução assistida e identificar os fatores que afetaram tal sucesso. Método: estudo transversal conduzido em 53 centros de fertilidade em 26 províncias da China Continental. Os dados foram coletados por meio de um questionário demográfico, um questionário sobre competências de enfermagem especializada em tecnologias de reprodução assistida, da Career-Success Scale (Escala de Sucesso Profissional) e da Nursing Work Environment Scale (Escala do Ambiente de Trabalho na Enfermagem). Aplicaram-se análises de estatística descritiva e inferencial. Resultados: participaram do estudo 597 enfermeiros da área de tecnologia de reprodução assistida, e 555 questionários válidos foram coletados. As pontuações globais médias para o sucesso profissional e o ambiente de trabalho foram 3,75 [desvio padrão (DP) = 1,01] e 3,42 (DP = 0,77), respectivamente. Verificou-se forte correlação positiva entre o sucesso profissional e o ambiente de trabalho (r = 0,742; p < 0,01). A análise de regressão múltipla mostrou que a participação em eventos acadêmicos, a assistência psicológica, o desenvolvimento profissional, o apoio e os cuidados, e o salário e o bem-estar foram fatores que influenciaram significativamente o sucesso profissional. Conclusão: a participação em eventos acadêmicos, a assistência psicológica e o ambiente de trabalho mostraram correlação positiva com o sucesso profissional. Os gestores deveriam considerar formas de abordar esses fatores.

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Fundamento en la medicina china, los accidentes cerebrovasculares se relacionan con el síndrome de golpe de viento (Zhong Feng), lo cual se corresponde en la medicina occidental con los accidentes cerebrovasculares hemorrágicos e isquémicos. Objetivo caracterizar a los pacientes con accidentes cerebrovasculares en fase aguda según diagnóstico de la medicina china. Métodos estudio descriptivo, de serie de casos (n=40), que incluyó a pacientes atendidos en el periodo marzo-diciembre de 2018 en el Hospital Dr. Gustavo Aldereguía Lima, de Cienfuegos. Se analizaron las variables: edad, sexo, tipo de enfermedad cerebrovascular en fase aguda, gravedad del ataque del golpe de viento, síndrome según órganos y vísceras, y factor patógeno presente. Resultados predominaron los accidentes cerebrovasculares trombóticos, de los cuales 75,0 % se comportaron como golpe de viento graves tipo flácido; y el 81,3 % estuvo asociado al síndrome de insuficiencia de sangre de hígado. Los embólicos: ataques leves en el 33,3 %; y 18,8 % síndrome de insuficiencia de sangre de hígado. Las hemorragias cerebrales intraparenquimatosas: 62,5 % ataque grave tipo tenso; y 71,4 % fuego de hígado. Hemorragia subaracnoidea: 15 % como ataque grave tipo flácido; y 17,6 % síndrome de insuficiencia de Yin de hígado. El factor patógeno más frecuente resultó el viento interno, presente en 90,0 % de los casos. Conclusiones el análisis de los pacientes con accidente cerebrovascular en fase aguda según diagnóstico tradicional chino, mostró que existe relación clínica con el síndrome golpe de viento y de los Zhang fu de la medicina china.

Foundation In Chinese medicine, strokes are related to wind stroke syndrome (Zhong Feng), which corresponds in Western medicine to hemorrhagic and ischemic strokes. Objective to characterize patients with strokes in the acute stage according to Chinese medicine diagnosis. Methods descriptive case series study (n=40), which included patients treated from March to December 2018 at the Dr. Gustavo Aldereguía Lima Hospital, Cienfuegos. The analyzed variables were: age, sex, type of cerebrovascular disease in the acute stage, severity of the wind stroke attack, syndrome according to organs and viscera, and pathogenic factor present. Results thrombotic strokes predominated, of which 75.0% behaved as severe flaccid type wind stroke; and 81.3% were associated with liver blood failure syndrome. Embolics: mild attacks in 33.3%; and 18.8% liver blood failure syndrome. Intraparenchymal cerebral hemorrhages: 62.5% severe tense attack; and 71.4% liver fire. Subarachnoid hemorrhage: 15% as severe flaccid type attack; and 17.6% liver Yin deficiency syndrome. The most frequent pathogenic factor was internal wind, present in 90.0% of cases. Conclusions the analysis of patients with stroke in the acute phase according to traditional Chinese diagnosis showed that there is a clinical relationship with wind stroke syndrome and the Zhang fu of Chinese medicine.

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Recent studies using bottles as tracers have shown that illegal dumping from ships is responsible for the rapid increase in drink bottles washing up on oceanic islands and at remote continental beaches away from local litter inputs. However, these studies have been in areas with moderate to high levels of shipping activity. I examined bottles stranded on the Pitcairn Islands in the central South Pacific, which are far from major shipping routes. Drink bottles from Asia dominated, with most coming from China. The top four brands (three Chinese and one multinational) were the same as at Tristan da Cunha in the central South Atlantic Ocean, which lies on the shipping route between South America and Asia. Bottle ages also were similar at Pitcairn and Tristan, indicating that vessels are the main source of bottles at both islands. Stricter controls are needed to reduce illegal dumping of plastics at sea.

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The present study was conducted to ascertain the estrogenic effect of Zhuang Medicated Thread Moxibustion (ZMTM) and explore its time - sensitive impact on estradiol (E2) in female perimenopausal rats. 40 female rats were randomized into four gr oups: the control, model, ZMTM, and acupuncture groups. The perimenopausal syndrome was induced in the last three groups with a daily subcutaneous dose of 80 mg/kg of 4 - vinylcyclohexene diepoxide for 15 days. Afterward, rats in the model and control group s were fed routinely, while rats in the ZMTM and acupuncture groups were treated with six ZMTM and acupuncture courses, respectively. Results of the study suggested that following the six courses of treatment, the E2 level in the model group was significan tly the lowest, while the regular group was the highest (P < 0.05). There was also a gradual increase in the E2 level of the ZMTM group compared to the model and acupuncture groups, e.g. after the 5th and 6th courses of treatment, their E2 level was signif icantly higher than the model and acupuncture groups. The ZMTM group was better than the model and acupuncture groups. In summary, ZMTM can improve perimenopausal induced rats' estrogen level.

El presen te estudio se llevó a cabo para determinar el efecto estrogénico de la moxibustión con hilo medicado Zhuang (ZMTM) y explorar su impacto sensible al tiempo en el estradiol (E2) en ratas hembras perimenopáusicas. Se dividió al azar una muestra de 40 ratas h embras en cuatro grupos: control, modelo, ZMTM y acupuntura. El síndrome perimenopáusico se indujo en los últimos tres grupos con una dosis subcutánea diaria de 80 mg/kg de diepóxido de 4 - vinilciclohexeno durante 15 días. Después, las ratas en los grupos m odelo y control fueron alimentadas rutinariamente, mientras que las ratas en los grupos ZMTM y acupuntura recibieron seis cursos de ZMTM y acupuntura, respectivamente. Los resultados del estudio sugieren que después de los seis cursos de tratamiento, el ni vel de E2 en el grupo modelo fue significativamente más bajo, mientras que el grupo regular fue más alto ( p < 0,05). También hubo un aumento gradual en el nivel de E2 del grupo ZMTM en comparación con los grupos modelo y acupuntura, por ejemplo, desp ués del quinto y sexto cursos de tratamiento, su nivel de E2 fue significativamente más alto que los grupos modelo y acupuntura. El grupo ZMTM fue mejor que los grupos modelo y acupuntura. En resumen, el ZMTM puede mejorar el nivel de estrógeno de las rata s inducidas por la perimenopausia.

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Abstract Objective: The comparative network analysis of national health macrosystems is an area whose academic development has not reached due relevance if its influence on decision-making related to the design of public health policies is considered; the establishment of comparative elements between two socially, economically and culturally distant countries, such as Mexico and China, is a complex process given the difficulty of locating equivalent evaluation indicators among some of its elements. Materials and methods: The present work reflects on the similarities and dissimilarities between the national health systems, with an impact on the care provided to the most vulnerable population segments, applying a comparative nodes and networks analysis considering social and economic factors. Results: The network analysis shows that, for practical purposes, the nodes considered in the Mexican health system is superior to those nodes identified in the Chinese health system in terms of quality, mainly in nodes such as convenience of the location, using cutting-edge technology in health institutions and the skill and competence of medical personnel; conversely, the Chinese system is superior to the Mexican in terms of efficiency, mainly involuntary co-payment insurance systems to reduce the catastrophic health expenditure of the vulnerable rural population. Conclusions: The conclusions drawn may serve for subsequent studies to identify opportunities for improvement, correlations and/or trends that could be implemented in the Mexican health system, once the pertinent feasibility studies have been carried out.

Resumen Objetivo: El análisis de redes comparativo de macrosistemas nacionales de salud es un ámbito cuyo desarrollo académico no ha alcanzado la relevancia debida si se considera su influencia en la toma de decisiones relativas al diseño de políticas de salud pública. Así, el establecimiento de elementos comparativos entre dos países social, económica y culturalmente distantes, como México y China, es un proceso complejo dada la dificultad de ubicar indicadores equivalentes de evaluación entre algunos de sus elementos. Materiales y método: El presente trabajo reflexiona sobre las similitudes y diferencias entre los mencionados sistemas nacionales de salud, con incidencia en la atención que se brinda a los segmentos poblacionales más vulnerables, aplicando un análisis comparativo de nodos y redes considerando factores sociales y económicos. Resultados: El análisis de red muestra que, para efectos prácticos, los nodos considerados en el sistema de salud mexicano son superiores a los nodos identificados en el sistema de salud chino en términos de calidad, principalmente en nodos como conveniencia de la ubicación, utilizando tecnología de punta en instituciones de salud y la habilidad y competencia del personal médico; Por el contrario, el sistema chino es superior al mexicano en términos de eficiencia, principalmente sistemas de seguro de copago involuntario para reducir el gasto catastrófico en salud de la población rural vulnerable. Conclusiones: Las conclusiones extraídas podrán servir a estudios posteriores para identificar oportunidades de mejora, correlaciones y/o tendencias que pudieran implementarse en el sistema mexicano de salud, una vez efectuados los estudios de viabilidad pertinentes.

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Lymphoma is a hematologic malignancy which mainly consists of Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Although systemic chemotherapy, radiotherapy, and other advanced therapeutics, including rituximab or immune checkpoint inhibitors, have improved the prognosis in recent decades, there are still a number of patients with relapsed or refractory (R/R) lymphoma with a poor prognosis. Chimeric antigen receptor (CAR) T-cell therapy has provided a curative option for patients with relapsed or refractory lymphoma. Numerous clinical trials have been conducted worldwide and presented inspiring results that give insight into this breakthrough therapy. The development of cancer cell therapy in China has been rapid in the past years and dominates the field with the USA. This review aims to summarize the published results of CAR T-cell therapy alone or in combination with other therapies in mainland China, both in R/R NHL and R/R HL.

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OBJECTIVE: To examine the association between urbanization and psychological well-being (PWB) in China. METHODS: Data were obtained from the 2015 China Health and Nutrition Survey (CHNS) and included 3,071 men and 3,385 women aged 50 years or older who lived in 288 communities across 12 provinces and municipalities. The urbanization index, which summarizes 12 urbanization dimensions at community level, was categorized into tertiles representing low, medium, and high levels of urbanization. PWB was assessed by scoring three self-reported questions. Gender-stratified multilevel analyses were used to estimate the association between urbanization and PWB. RESULTS: After controlling for individual-level factors, the urbanization index was associated positively with PWB. More specifically, an increase of one SD in the score of community population density, economic activity, housing, education, sanitation, or diversity was associated significantly with PWB in both genders. In addition, increases in the score of community communications, social services, transportation, or modern markets were associated significantly with PWB in women, but not in men. CONCLUSION: Urbanization has, on average, had an independent and positive effect on PWB in middle-aged and older Chinese populations, with many components of urbanization being separately and positively associated with PWB, especially in women.

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ABSTRACT: Agriculture trade remains the economic fulcrum of most African countries as the continent continues to host the largest percent of arable land. This research analyzed the Economic Community of West African States (ECOWAS) and China's agricultural products trade determinants based on 19 years (2000-2018) panel dataset of West African countries aggregate agricultural products exports ($) and macroeconomic variables; GDP, population, arable land, language investment, and trade association(WTO)) as predictors. The PPML estimation method was employed due to its prediction accuracy, the size of the data, and potential hetroskadacity issues. With a 78.5% prediction power, the model explained the variation in ECOWAS-China agricultural trade (Exports). GDPj, lnPOPj, lnPOPi, and lnARLj, LndLj, ConfInsj, and WTOij were positive and statistically significant determinants of trade as hypothesized by existing trade literature. In addition, the China's population (lnPOPj) had a value of 0.5877, which is significant at the 5% level, indicating that a 1% increase in the Chinese population significantly increases trade in agricultural products with ECOWAS states. The coefficient of distance (Dij) is -4.4573 statistically significant at the 1% level, indicating that distance between partners impedes trade flow. There are unidentified barriers that delay the progress of trade in agricultural products between ECOWAS and China. Based on the above findings, Investments in ECOWAS arable lands demand urgent attention if significant progress in exports is expected, additionally, governments of both partners should assist Agricultural research and development to identify and rectify stifling trade barriers. Furthermore, as trade between ECOWAS and China has not yet reached its full peak, studies on export determinants of individual Agro-commodities and potentials are needed to enrich literature.

RESUMO: O comércio agrícola continua sendo o sustentáculo econômico da maioria dos países africanos, visto que o continente continua a hospedar a maior porcentagem de terras aráveis. Este trabalho analisou os determinantes do comércio de produtos agrícolas de paises do oeste da África ECOWAS e da China com base em um conjunto de dados de painel de 19 anos (2000-2018) dos países da África Ocidental, agregando exportações de produtos agrícolas ($) e variáveis macroeconômicas (PIB, população, terras aráveis, investimento linguístico e associação comercial (OMC)) como preditores. O método de estimativa PPML foi empregado devido à sua precisão de previsão, o tamanho dos dados e possíveis problemas de heteroscedasticidade. Com um poder de previsão de 78,5%, o modelo explicou a variação do comércio agrícola Comunidade Económica dos Estados da África Ocidental (CEDEAO) -China (Exportações). GDPj, lnPOPj, lnPOPi e lnARLj, LndLj, ConfInsj e WTOij foram determinantes positivos e estatisticamente significativos do comércio, conforme hipotetizado pela literatura comercial existente. Além disso, a população chinesa (lnPOPj) teve um valor de 0,5877, o que é significativo ao nível de 5%, indicando que um aumento de 1% na população chinesa aumenta significativamente o comércio de produtos agrícolas com os estados da Comunidade Económica dos Estados da África Ocidental (CEDEAO).O coeficiente de distância (Dij) é -4,4573 estatisticamente significativo no nível de 1%, indicando que a distância entre os parceiros impede o fluxo comercial. Existem barreiras não identificadas que atrasam o progresso do comércio de produtos agrícolas entre a Comunidade Económica dos Estados da África Ocidental (CEDEAO) e a China. Com base nas conclusões acima, os investimentos em terras aráveis da Comunidade Económica dos Estados da África Ocidental (CEDEAO) exigem atenção urgente se houver progresso significativo nas exportações. Além disso, os governos de ambos os parceiros devem ajudar a pesquisa e o desenvolvimento agrícola a identificar e retificar as barreiras comerciais sufocantes. Além disso, como o comércio entre a Comunidade Económica dos Estados da África Ocidental (CEDEAO) e a China ainda não atingiu o seu pico, são necessários estudos sobre os determinantes das exportações de produtos agrícolas individuais e potenciais para enriquecer a literatura.

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Agriculture trade remains the economic fulcrum of most African countries as the continent continues to host the largest percent of arable land. This research analyzed the Economic Community of West African States (ECOWAS) and China's agricultural products trade determinants based on 19 years (2000-2018) panel dataset of West African countries aggregate agricultural products exports ($) and macroeconomic variables; GDP, population, arable land, language investment, and trade association(WTO)) as predictors. The PPML estimation method was employed due to its prediction accuracy, the size of the data, and potential hetroskadacity issues. With a 78.5% prediction power, the model explained the variation in ECOWAS-China agricultural trade (Exports). GDPj, lnPOPj, lnPOPi, and lnARLj, LndLj, ConfInsj, and WTOij were positive and statistically significant determinants of trade as hypothesized by existing trade literature. In addition, the China's population (lnPOPj) had a value of 0.5877, which is significant at the 5% level, indicating that a 1% increase in the Chinese population significantly increases trade in agricultural products with ECOWAS states. The coefficient of distance (Dij) is -4.4573 statistically significant at the 1% level, indicating that distance between partners impedes trade flow. There are unidentified barriers that delay the progress of trade in agricultural products between ECOWAS and China. Based on the above findings, Investments in ECOWAS arable lands demand urgent attention if significant progress in exports is expected, additionally, governments of both partners should assist Agricultural research and development to identify and rectify stifling trade barriers. Furthermore, as trade between ECOWAS and China has not yet reached its full peak, studies on export determinants of individual Agro-commodities and potentials are needed to enrich literature.

O comércio agrícola continua sendo o sustentáculo econômico da maioria dos países africanos, visto que o continente continua a hospedar a maior porcentagem de terras aráveis. Este trabalho analisou os determinantes do comércio de produtos agrícolas de paises do oeste da África ECOWAS e da China com base em um conjunto de dados de painel de 19 anos (2000-2018) dos países da África Ocidental, agregando exportações de produtos agrícolas ($) e variáveis macroeconômicas (PIB, população, terras aráveis, investimento linguístico e associação comercial (OMC)) como preditores. O método de estimativa PPML foi empregado devido à sua precisão de previsão, o tamanho dos dados e possíveis problemas de heteroscedasticidade. Com um poder de previsão de 78,5%, o modelo explicou a variação do comércio agrícola Comunidade Económica dos Estados da África Ocidental (CEDEAO) -China (Exportações). GDPj, lnPOPj, lnPOPi e lnARLj, LndLj, ConfInsj e WTOij foram determinantes positivos e estatisticamente significativos do comércio, conforme hipotetizado pela literatura comercial existente. Além disso, a população chinesa (lnPOPj) teve um valor de 0,5877, o que é significativo ao nível de 5%, indicando que um aumento de 1% na população chinesa aumenta significativamente o comércio de produtos agrícolas com os estados da Comunidade Económica dos Estados da África Ocidental (CEDEAO).O coeficiente de distância (Dij) é -4,4573 estatisticamente significativo no nível de 1%, indicando que a distância entre os parceiros impede o fluxo comercial. Existem barreiras não identificadas que atrasam o progresso do comércio de produtos agrícolas entre a Comunidade Económica dos Estados da África Ocidental (CEDEAO) e a China. Com base nas conclusões acima, os investimentos em terras aráveis da Comunidade Económica dos Estados da África Ocidental (CEDEAO) exigem atenção urgente se houver progresso significativo nas exportações. Além disso, os governos de ambos os parceiros devem ajudar a pesquisa e o desenvolvimento agrícola a identificar e retificar as barreiras comerciais sufocantes. Além disso, como o comércio entre a Comunidade Económica dos Estados da África Ocidental (CEDEAO) e a China ainda não atingiu o seu pico, são necessários estudos sobre os determinantes das exportações de produtos agrícolas individuais e potenciais para enriquecer a literatura.

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