简介：AbstractMalaria was once one of the most serious public health problems in China, with more than 30 million malaria cases annually before 1949. However, the disease burden has sharply declined and the epidemic areas has shrunken after the implementation of an integrated malaria control and elimination strategy, especially since 2000. Till now, China has successfully scaled up its efforts to become malaria-free and is currently being evaluated for malaria-free certification by the WHO. In the battle against malaria, China’s efforts have spanned generations, reducing from an incidence high of 122.9/10 000 (6.97 million cases) in 1954 to 0.06/10 000 (7855 cases) in 2010. In 2017, for the first time, China reached zero indigenous case of malaria, putting the country on track to record three consecutive years of zero transmission by 2020, accoding to the National Malaria Elimination Action Plan (2010-2020). China’s efforts to eliminate malaria is impressive, and the country is dedicated to sharing its lessons learned in malaria elimination-including, but not limited to, the application of novel genetics-based approaches—with other nations through new initiatives. China will promote international relationships and establish collaborative platforms on a wide range of topics in roughly 65 countries, including 20 African nations. China’s experience in applying innovative genetics-based approaches and tools to characterize malaria parasite populations, including surveillance of markers related to drug resistance, categorization of cases as indigenous or imported, and objective identification of the likely sources of infections to inform efforts towards malaria control and elimination in Africa could offer game-changing results when applied to settings with ongoing transmission.

简介：AbstractThere has been a long history since human beings began to realize the existence of post-traumatic symptoms. Posttraumatic stress disorder (PTSD), a diagnostic category adopted in 1980 in the Diagnostic and Statistical Manual of Mental Disorders-III, described typical clusters of psychiatric symptoms occurring after traumatic events. Abundant researches have helped deepen the understanding of PTSD in terms of epidemiological features, biological mechanisms, and treatment options. The prevalence of PTSD in general population ranged from 6.4% to 7.8% and was significantly higher among groups who underwent major public traumatic events. There has been a long way in the studies of animal models and genetic characteristics of PTSD. However, the high comorbidity with other stress-related psychiatric disorders and complexity in the pathogenesis of PTSD hindered the effort to find specific biological targets for PTSD. Neuroimage was widely used to elucidate the underlying neurophysiological mechanisms of PTSD. Functional MRI studies have showed that PTSD was linked to medial prefrontal cortex, anterior cingulate cortex and sub-cortical structures like amygdala and hippocampus, and to explore the functional connectivity among these brain areas which might reveal the possible neurobiological mechanism related to PTSD symptoms. For now, cognitive behavior therapy-based psychotherapy, including combination with adjunctive medication, showed evident treatment effects on PTSD. The emergence of more effective PTSD pharmacotherapies awaits novel biomarkers from further fundamental research. Several natural disasters and emergencies have inevitably increased the possibility of suffering from PTSD in the last two decades, making it critical to strengthen PTSD research in China. To boost PTSD study in China, the following suggestions might be helpful: (1) establishing a national psychological trauma recover project, and (2) exploring the mechanisms of PTSD with joint effort and strengthening the indigenized treatment of PTSD.

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简介：AbstractBackground:The past decade has witnessed an ever-increasing momentum of transcatheter aortic valve replacement (TAVR) and a subsequent paradigm shift in the contemporary management of severe aortic stenosis (AS). We conducted a multi-centric TAVR registry based on Chinese patients (the China Aortic valve tRanscatheter Replacement registrY [CARRY]) to delineate the clinical characteristics and outcomes of Chinese patients who underwent TAVR and compare the results between different valve types in different Chinese regions.Methods:CARRY is an all-comer registry of aortic valve disease patients undergoing TAVR across China and was designed as an observational study that retrospectively included all TAVR patients at each participating site. Seven hospitals in China participated in the CARRY, and 1204 patients from April 2012 to November 2020 were included. Categorical variables were compared using the chi-squared test, and continuous variables were analyzed using a t test or analysis of variance (ANOVA) test. The Kaplan-Meier curve was used to estimate the risk of adverse events during follow-up.Results:The mean age of the patients was 73.8 ± 6.5 years and 57.2% were male. The median Society of Thoracic Surgeon-Predicted Risk of Mortality score was 6.0 (3.7-8.9). Regarding the aortic valve, the proportion of bicuspid aortic valve (BAV) was 48.5%. During the hospital stay, the stroke rate was 0.7%, and the incidence of high-degree atrioventricular block indicating permanent pacemaker implantation was 11.0%. The in-hospital all-cause mortality rate was 2.2%. After 1 year, the overall mortality rate was 4.5%. Compared to patients with tricuspid aortic valve (TAV), those with BAV had similar in-hospital complication rates, but a lower incidence of in-hospital mortality (1.4% vs. 3.3%) and 1 year mortality (2.3% vs. 5.8%).Conclusions:TAVR candidates in China were younger, higher proportion of BAV, and had lower rates of post-procedural complications and mortality than other international all-comer registries. Given the use of early generation valves in the majority of the population, patients with BAV had similar rates of complications, but lower mortality than those with TAV. These findings further propel the extension of TAVR in low-risk patients.Trial Registration:https://www.chictr.org.cn/(No. ChiCTR2000038526).

简介：AbstractAcute pancreatitis (AP) is a common acute abdominal condition of the digestive system. In recent years, treatment concepts, methods, and strategies for the diagnosis of AP have advanced, and this has played an important role in promoting the standardization of AP diagnosis and treatment and improving the treatment quality of AP patients. On the basis of previous guidelines and expert consensus, this guideline adopts an evidence-based, problem-based expression; synthesizes important clinical research data at home and abroad in the most recent 5 years; and forms 29 recommendations through multidisciplinary expert discussion, including diagnosis, treatment, and follow-up. It is expected to provide evidence support for the treatment of AP in the clinical setting in China.

简介：AbstractThe incidence of pancreatic cancer has been rising worldwide, and its clinical diagnosis and treatment remain a great challenge. To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years, Chinese Pancreatic Association, the Chinese Society of Surgery, Chinese Medical Association revised the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer in China (2014) after reviewing evidence-based and problem-oriented literature published during 2015-2021, mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer, conversion strategies for locally advanced pancreatic cancer, treatment of pancreatic cancer with oligo metastasis, adjuvant and neoadjuvant therapy, standardized processing of surgical specimens and evaluation of surgical margin status, systemic treatment for unresectable pancreatic cancer, genetic testing, as well as postoperative follow up of patients with pancreatic cancer. Forty recommendation items were finally proposed based on the above issues, and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation, Assessment, Development, and Evaluation system. This guideline aims to standardize the clinical diagnosis and therapy, especially surgical treatment of pancreatic cancer in China, and further improve the prognosis of patients with pancreatic cancer.

简介：AbstractThe pathogenesis of melasma is believed to be related to heredity, sun exposure, sex hormones, and other factors. The mechanisms underlying the development of melasma include increased melanin synthesis, vascular proliferation within the skin lesions, inflammation, and skin barrier dysfunction. The diagnosis of melasma is mainly based on clinical manifestations and noninvasive techniques. Coupling with recent research progress in melasma, the present consensus comprehensively elaborates the etiology, pathogenesis, clinical manifestations, staging, classification, diagnosis, and treatment of melasma to improve the diagnostic and therapeutic skills of Chinese dermatologists.

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简介：AbstractIn January 2019, the fourth rabies case caused by organ transplantation was noticed in China, with the conditions of one per year for the recent four years. Different from the previous cases, there were no definite epidemiological histories of exposure or rabies-related symptoms from this patient. This case strongly supports the call for the legislation of establishing a national-level management that will incorporate the screening programs on donors prior to the practice of organ transplantation to reduce the risks on rabies caused by organ transplantation.

简介：AbstractBrucellosis is an important zoonotic infectious disease and is an important public health problem that causes serious economic consequences to the livestock industry. Brucella spp. comprise one of the most common pathogens causing laboratory-acquired infections (LAIs) and are becoming an increasingly important biosafety issue. To understand the significance of Brucella LAIs in China, related papers were search based on three Chinese databases (CNKI, Wanfang, and VIP), as well as PubMed. After assessment, 37 total cases were evaluated, including 27 students, seven laboratory technicians (one pregnant), two housekeeping staff, and one instructor. The age, sex, incubation period, pathogen detection results, and potential routes of infections were collected and analyzed. All LAIs occurred due to improper operations, inadequate biosafety training, and substandard laboratory safety conditions. Therefore, it is urgent to establish a comprehensive and systematic biosafety prevention/control system in laboratories to protect staff members from accidental exposures and LAIs; further, possible risks and control measures for the management of such infections were proposed.

简介：AbstractVitiligo is a common depigmented skin disease that negatively affects the physical and mental health of patients. The 2018 version of the Vitiligo Treatment Consensus has been updated based on the research progress on vitiligo in the past 3 years in combination with the clinical experiences of experts. The newly revised points include maintenance therapy, early glucocorticoid intervention, and oral mini-pulsed glucocorticoid administration protocols. The prospect of using JAK inhibitors in the treatment of vitiligo is also discussed.

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简介：AbstractImportance:The prevalence and characteristics of short stature (SS) among children in China should be assessed to provide guidance for planning and implementation of nationwide public health policies. Thus far, there have been no accurate estimates of the prevalence of SS in China.Objective:To analyze the prevalence of SS among children in China and to explore the influences of sex, area, age, study year, and study site on prevalence rates.Methods:Relevant literature was identified by searching the following databases: PubMed, Embase, The Cochrane Library, Chinese Biomedical Literature, China Knowledge Resource Integrated, WeiPu, and WanFang databases. Meta-analysis was carried out using STATA 11.2.Results:This meta-analysis included 39 studies with 348 326 Chinese participants; the studies covered 20 provinces, municipalities, and autonomous regions. The pooled prevalence of SS was 3.2% (95% confidence interval [CI], 2.6%-3.7%; I2 = 99.8%). The prevalence of SS in boys and girls were 3.1% (95% CI, 2.5%-3.7%) and 3.2% (95% CI, 2.6%-3.9%), respectively. The sex difference was not statistically significant (P > 0.05). The prevalence of SS was higher in rural areas than in urban areas (4.7% [95% CI, 3.6%-5.8%] vs. 2.8% [95% CI, 2.2%-3.4%]; P < 0.001). The prevalence of SS was higher in West China (5.2%; 95% CI, 4.4%-6.0%) than in Northeast China (0.6%; 95% CI, 0.3%-0.8%), East China (2.3%; 95% CI, 1.9%-2.8%), or Central China (2.9%; 95% CI, 1.9%-3.9%).Interpretation:The prevalence of SS among children was higher in western and rural areas of China. Close attention to children’s growth and development is needed to prevent the occurrence of SS.

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简介：AbstractGlobally, rabies remains a serious threat to public health. In particular, large number of cases continue to be detected in Africa and Asia. China has experienced three major outbreaks with the current epizootic starting in 1990s, peaking in 2007 with 3,300 cases, and consistently decreasing since this point. A key factor of the success in keeping the rabies outbreak under control is the National Public Health Reporting Program that was introduced to coordinate surveillance at provincial and regional levels. Through this program, it is possible to obtain an integrated overview of how rabies was spreading and how various factors were contributing to the outbreak. At the same time, samples have been collected from suspected rabies cases and a subset of positive samples selected for sequencing. In this way, it is possible to investigate the outbreak from a phylogenetic perspective, providing the comprehensive description of a rabies outbreak to date. In this work, we review rabies control efforts over the last 20 years, and show how this integrated approach has led to a deeper characterization of the outbreak and a better understanding of the factors driving the spread of the disease.