[Multicenter evaluation of the diagnostic efficacy of jaundice color card for neonatal hyperbilirubinemia]

Objective: To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice. Methods: Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate's parents used the JCard to measure jaundice at the neonate's cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson's correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis. Results: Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation (r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0 μmol/L. The TcB value of 205.2 μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusion: JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

[Comparison of Vocational Exhaustion Positive Rate among Different Occupational Stress Groups]

Objective: To explore the statistical differences of the vocational exhaustion positive rate among various occupational stress factors, occupational stress reaction, personality characteristics and relieving factors, to lay a foundation for reducing occupational stress of the medical staffs. Methods: 656 medical staffs in Yangzhong and Chifeng hospitals were included to conduct the evaluation of the occupational stress and job burnout, analyze the differences among the various factors by comparing them. Results: Various levels of vocational exhaustion positive rate among different occupational stress factors, occupational stress reaction, personality characteristics and relieving factors show statistical difference (P<0.05) . Among occupational stress factors, the vocational exhaustion positive rate of high level groups of conflict in groups was the highest (73.4%) , among occupational stress reaction, the vocational exhaustion positive rate of high level groups of body complain was the highest (80.4%) , among personality characteristics, the vocational exhaustion positive rate of low level groups of self-esteem was the highest (74.4%) , among relieving factors, the vocational exhaustion positive rate of high level groups of family support was the highest (76.4%) . Conclusion: The vocational exhaustion rate of medical staffs show very high in the profession, comprehensive factors should be considered to create harmonious working atmosphere and to reduce vocational exhaustion positive rate of the medical staffs, to reduce the positive rate of vocational exhanstion in medical staffs.

[Comparison of Occupational Stress and Its Factors of Workers in An Oil Refinery]

Objective: To explore the differences of occupational stress and its factors between petroleum refining workers and support staffs, and to propose more targeted measures to promote the health of petroleum refining and petrochemical workers. Methods: A questionnaire survey was conducted among 353 petroleum refining workers and 189 employees in the logistics department using the occupational stress inventory revised edition (OSI-R) scale between June 13, 2017 and July 27, 2017. Results: Among the occupational factors, there were significant differences in the job requirements, work risk, job monotony, participation in the decision-making scores among the male workers between labor group and logistics group (P<0.01) . And for female workers in the chemical group and logistics group there were also differences in the value of work control, job requirements, work monotonous, work prospects, improvement of opportunity (P<0.05) . In the aspect of personality traits, the score of work psychological control in chemical group was higher than that of the logistics group, while the organization loyalty score was lower than that of the logistics group. Be-sides, there were significant differences between chemical group and logistics group in the score of A behavior, self-esteem and anxiety traits among female group (P<0.05) . In terms of mitigating factors, there was a significant difference in social support score between chemical group and logistics group among female workers (P<0.01) . Comparison of the two groups of psychological stress showed that the mental health and anxiety status of the chemical group and the logistics group showed a difference (P<0.05) , and female workers in the chemical group job satisfaction score lower than the logistics group, but the body Complaints score higher than the logistics group. Conclusion: The psychological stress response of petroleum refining workers is obviously more serious than the staff of logistics department, and there were significant differences between the two groups on occupational stress factors.

[Analysis on the relationship between Occupational Stress Factors and Psychological Stress Reaction among Petrochemical Workers]

Objective: To explore the relationship between occupational stress factors and psychological stress reaction among petrochemical workers, detecting the effects caused by the occupational stress and putting forward solutions to reduce the occupational stress degree. Methods: 392 petrochemical workers in Oil refining enterprise were included to conduct the evaluation of the occupational stress, correlation analysis and ridge regression were used to analyze the relationship between occupational stress and five aspects of psychological stress reaction and to detect the influencing factors. Results: Mission control, decision control, environmental control, resources control, promotion, and participation in decision making were positively correlated with job satisfaction (P<0.01) , technology utilization degree, work order tonality, job prospects were negatively correlated with job satisfaction (P<0.05) ; mission control, resource control, promotion, participation in decision-making were positively correlated with mental health (P<0.01) , work order tonality, job prospects were negatively correlated with mental health (P<0.05) ; load change risk, work, work order tonality, job prospects were positively correlated with depression (P<0.05) resource control, promotion opportunities were negatively correlated with depression (P<0.05) ; quantitative risk load, work, work order tonality, job prospects were positively correlated with anxiety (P<0.05) , the task control, promotion, and participation in decision-making were negatively correlated with anxiety (P<0.05) ; work, load change, work order tonality, risk scoring for job prospects were positively correlated with body complaint (P<0.01) , mission control, decision control, resource control were negatively correlated with body complaint (P<0.05) . Conclusion: Different stress factors make different effects in different psychological stress reaction, the main predictors and predictive power of each psychological stress reaction were not the same.

[Clinical value of anti-liver/kidney microsomal-1 antibody in patients with liver disease]

Objective: To investigate the clinical and laboratory features of patients with liver disease and positive anti-liver/kidney microsomal-1 (anti-LKM-1) antibody, and to provide a reference for clinical diagnosis and differential diagnosis. Methods: The clinical data of patients with positive anti-LKM-1 antibody who were treated in our hospital from 2006 to 2016 were collected, and clinical and laboratory features were analyzed and compared. An analysis was also performed for special cases. Results: The measurement of related autoantibodies was performed for about 100 thousand case-times, and 15 patients were found to have positive anti-LKM-1 antibody. Among the 15 patients, 7 were diagnosed with type 2 autoimmune hepatitis (AIH) with an age of 11.0 ± 9.0 years and were all adolescents with acute onset; 8 were diagnosed with hepatitis C with an age of 51.5 ± 9.0 years, among whom 7 were middle-aged patients and 1 was a child aged 12 years, and all of them had an insidious onset. Compared with the patients with hepatitis C, the AIH patients had significantly higher levels of alanine aminotransferase (1 003.9 ± 904.3 U/L vs 57.0 ± 84.1 U/L, P < 0.05), aspartate aminotransferase (410.7 ± 660.3 U/L vs 34.9 ± 42.9 U/L, P < 0.05), and total bilirubin (98.0 ± 191.0 μmol/L vs 15.4 ± 6.0 μmol/L, P < 0.05). There was a reduction in immunoglobulin G after the treatment with immunosuppressant, compared with the baseline. Of all 8 patients with hepatitis C, 6 received antiviral therapy with interferon and ribavirin, and 5 out of them achieved complete response, among whom 4 had a reduction in the level of anti-LKM-1 antibody after treatment; however, a 12-year-old child developed liver failure after interferon treatment and died eventually. Conclusion: Positive anti-LKM-1 antibody is commonly seen in patients with type 2 AIH or hepatitis C, but there are differences between these two groups of patients in terms of age, disease onset, liver function, and the level of anti-LKM-1 antibody. The hepatitis C patients with a confirmed diagnosis and exclusion of autoimmune hepatitis can achieve good response to interferon under close monitoring, even if anti-LKM-1 antibody is positive. As for adolescent patients with hepatitis C and positive anti-LKM-1 antibody, the possibility of AIH should be excluded.

Patrones de distribución de individuos longevos de plantas relictas en los alrededores de la montana Fanjingshan en China: implicaciones para su conservación <em>in situ</em>

Las áreas montañosas de la región centro-sur de China están ampliamente reconocidas por su papel como refugio de plantas relictas durante la última etapa del Neógeno y el Cuaternario. En el presente trabajo se intentan explorar los patrones de distribución de los hábitats naturales y la localización exacta de los refugios para especies vegetales relictas en los alrededores de la montaña Fanjinshan, mediante el empleo de datos dendrológicos de individuos longevos (≥ 100 años). En el área de estudio se encontraron seis especies vegetales típicamente relictas: Cyclocarya paliurus, Ginkgo biloba, Liriodendron chinense, Pinus massoniana, Podocarpus macrophyllus y Taxus chinensis. Los individuos longevos se dividieron en tres categorías de acuerdo con su edad estimada: individuos de Clase I (≥ 500 años), de Clase II (300–499 años) y de Clase III (100–299 años). Nuestros resultados muestran que la región situada al suroeste de la montaña se corresponde con la principal área de distribución de los árboles de Clase I de G. biloba y T. chinensis, localizándose la mayor parte de éstos en los alrededores de una pequeña aldea (Yangliu, en el condado de Yinjiang). La región situada al noreste de Fanjinshan alberga, por su parte, las seis especies relictas, y los análisis florísticos muestran una elevada similaridad entre ambas regiones por lo que respecta al crecimiento arbóreo medido como DBH [diámetro a la altura del pecho (1,3 m)]. Por consiguiente, estas dos regiones habrían proporcionado hábitats adecuados para la supervivencia de especies relictas. La región suroeste, y en especial la aldea de Yangliu, deben recibir la máxima prioridad para la conservación in situ de especies relictas (y otras especies raras y amenazadas). La región noreste también debe priorizarse dada su elevada diversidad de especies relictas.

El curso superior del río más grande del sur de china como un «frente evolutivo» de plantas tropicales: evidencia del género endémico de Asia

El hotspot de biodiversidad en las fronteras de las provincias Guizhou-Yunnan- Guangxi es un centro de distribución de plantas tropicales en China. Se extiende por toda la cuenca alta del río Zhujiang, el mayor río del sur de China. En este artículo, se explora el papel del río en la propagación y la diversificación de las plantas tropicales en este área, usando el género endémico de Asia Hiptage Gaertn. (Malpighiaceae) como ejemplo. Se reconocen dos centros de diversidad y endemismo de Hiptage: la Península Indochina y el curso superior del río Zhujiang (UZJ). El índice de endemismo ajustado al área indica UZJ como la región más importante de distribución de especies endémicas, ya que, aunque UZJ tiene un área muy pequeña (~210.000 km2), seis de un total de siete especies son estrictamente endémicas. UZJ está situado en el extremo norte del área de distribución de Hiptage, lo que resultó principalmente de la disposición noroeste-sureste de los sistemas fluviales de UZJ, que facilitaron la expansión y diferenciación hacia el norte de este género tropical. Los paisajes de piedra caliza altamente fragmentados en esta región han contribuido al aislamiento de hábitat y pueden ser el principal factor para el origen de estas especies endémicas. Hiptage también se distingue por su sistema de polinización altamente especializado, con flores de imagen especular, lo que probablemente facilita la diversificación de las especies a través del aislamiento de la polinización. Otros estudios también encontraron que UZJ es un importante centro de diversificación de las familias de plantas tropicales Begoniaceae y Gesneriaceae. Por consiguiente, se concluye que UZJ es un «frente evolutivo» de plantas tropicales en China, lo que contribuye de manera significativa al origen y mantenimiento de la biodiversidad única en la zona.

Número especial sobre <em>Ecología, evolución y conservación en las plantas de China</em>: introducción y algunas consideraciones

China tiene una de las floras más ricas del mundo con alrededor 33.000 plantas vasculares, de las cuales hasta 17.000 son endémicas. Además de estas cifras asombrosas, la flora china es muy interesante desde el punto de vista de la evolución, ya que muestra un fuerte carácter relictual con algunos auténticos «fósiles vivientes» como Ginkgo biloba o Metasequoia glyptostroboides. Al mismo tiempo, China probablemente alberga el «frente evolutivo» más importante de las floras templadas del mundo, las montañas Hengduan. Por desgracia, la flora de China también destaca por el elevado número de especies amenazadas (casi 4000), sobre todo debido a la destrucción de los hábitats y la sobreexplotación de los recursos naturales. Este número especial, que corresponde al volumen 34 de Collectanea Botanica, tiene como objetivo contribuir al conocimiento de la flora de China a través de una serie de contribuciones (siete artículos y una nota breve) que abarcan varios temas como la biogeografía, la conservación, la demografía, la ecología, la evolución y las interacciones planta-animal.

Especies y comunidades vegetales del lago Poyang, el lago de agua dulce más grande de China

El estudio de la riqueza y la composición de especies vegetales de un humedal es esencial a la hora de estimar su importancia ecológica y sus servicios ecosistémicos, especialmente cuando éste está sujeto a perturbaciones humanas. El lago Poyang, situado en el curso medio del río Yangtsé (China central) constituye la mayor superfície de agua dulce del país. Alberga una elevada biodiversidad y proporciona hábitats importantes para la flora y fauna locales. En la actualidad existen planes de construir una presa que mantendrá el volumen de agua del lago estable. Sin embargo, y hasta la fecha, apenas existen estudios que hayan abordado la biodiversidad del lago y los posibles efectos negativos de la presa sobre ésta (y en especial sobre las especies endémicas y raras). Así pues, se ha llevado a cabo una intensa campaña de campo combinada con una búsqueda bibliográfica con el objetivo de evaluar la riqueza de especies y comunidades vegetales del lago Poyang y sus humedales asociados. Se han identificado un total de 124 familias, 339 géneros y 512 especies (incluyendo subespecies, variedades y formas) así como ocho comunidades vegetales dominantes, confirmándose así el papel de los humedales del lago Poyang como hotspot regional de biodiversidad. Resulta imperativo estudiar los efectos del represado sobre la vegetación, y, de manera especial, todo aquello concerniente a la protección de la biodiversidad local, el mantenimiento de los servicios ecosistémicos, el control de las especies invasoras y la restauración de los ecosistemas degradados.