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AbstractObjectiveTo assess the prevalence of diabetes and its risk factors.DesignPopulation based, cross sectional study.Setting31 provinces in mainland China with nationally representative cross sectional data from 2015 to 2017.Participants75 880 participants aged 18 and older—a nationally representative sample of the mainland Chinese population.Main outcome measuresPrevalence of diabetes among adults living in China, and the prevalence by sex, regions, and ethnic groups, estimated by the 2018 American Diabetes Association (ADA) and the World Health Organization diagnostic criteria. Demographic characteristics, lifestyle, and history of disease were recorded by participants on a questionnaire. Anthropometric and clinical assessments were made of serum concentrations of fasting plasma glucose (one measurement), two hour plasma glucose, and glycated haemoglobin (HbA1c).ResultsThe weighted prevalence of total diabetes (n=9772), self-reported diabetes (n=4464), newly diagnosed diabetes (n=5308), and prediabetes (n=27 230) diagnosed by the ADA criteria were 12.8% (95% confidence interval 12.0% to 13.6%), 6.0% (5.4% to 6.7%), 6.8% (6.1% to 7.4%), and 35.2% (33.5% to 37.0%), respectively, among adults living in China. The weighted prevalence of total diabetes was higher among adults aged 50 and older and among men. The prevalence of total diabetes in 31 provinces ranged from 6.2% in Guizhou to 19.9% in Inner Mongolia. Han ethnicity had the highest prevalence of diabetes (12.8%) and Hui ethnicity had the lowest (6.3%) among five investigated ethnicities. The weighted prevalence of total diabetes (n=8385) using the WHO criteria was 11.2% (95% confidence interval 10.5% to 11.9%).ConclusionThe prevalence of diabetes has increased slightly from 2007 to 2017 among adults living in China. The findings indicate that diabetes is an important public health problem in China.

Spodoptera frugiperda is one of the most destructive crop pests in the world. Metarhizium rileyi is an entomopathogenic fungus specific for noctuid pests and is a very promising prospect in biological control against S. frugiperda. Two M. rileyi strains (XSBN200920 and HNQLZ200714) isolated from infected S. frugiperda were used to evaluate the virulence and biocontrol potential to different stages and instars of S. frugiperda. The results showed that XSBN200920 was significantly more virulent than HNQLZ200714 to eggs, larvae, pupae, and adults of S. frugiperda. In the larvae infected with the two M. rileyi strains, the activity of three protective enzymes (including peroxidase (POD), superoxide dismutase (SOD), catalase (CAT)) and two detoxifying enzymes (including glutathione-S transferase (GST) and carboxylesterase (CarE)) increased firstly and then decreased. The expression levels of protective enzymes and detoxification enzymes in larvae treated with XSBN200920 were greater than with HNQLZ200714. Furthermore, antioxidant stress-related gene (MrSOD and MrCAT family genes) expression in the two strains was measured by RT-qPCR (real-time quantitative PCR). The expression of these genes was significantly higher in the XSBN200920 strain compared to HNQLZ200714. There were also significant differences in the sensitivity of the two strains to the growth of different carbon and nitrogen sources and oxidative stress agents. In addition, the activity expression of antioxidant enzymes on the third day of culturing in XSBN200920 was significantly higher than with HNQLZ200714. In summary, the high virulence of M. rileyi XSBN200920 was not only determined by the expression levels of protective and detoxifying enzymes of the host but also regulated by the growth of entomogenic fungi and the resistance to the oxidative stress against S. frugiperda at different stages and instars. This study provides a theoretical fundament for the systematic control of Spodoptera frugiperda using Metarhizium rileyi.

ObjectivesTo investigate the prevalence and risk factors of hypothyroidism after universal salt iodisation for 20 years in mainland China.DesignNationwide, cross-sectional survey.Setting and participantsThe Thyroid Disorders, Iodine Status and Diabetes epidemiological study included adults from 31 provinces of China. Data included demographic, physical characteristics, urine, serum thyroid-stimulating hormone (TSH), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb) and thyroid ultrasonography. Subclinical hypothyroidism (SCH) was classified into severe SCH (TSH >10 mU/L) and mild SCH (TSH 4.2–9.9 mU/L). A total of 78 470 (38 182 men and 40 288 women) participants were included in the final analysis.ResultsThe prevalence of hypothyroidism was 13.95%. The prevalence rates of overt hypothyroidism (OH) and SCH were 1.02% and 13.93%, which mild SCH was significantly higher than severe SCH (12.18% vs 0.75%). Prevalence was higher in women than in men, and this gender difference was noted among all age groups. The prevalence of mild SCH, severe SCH and OH increases by 1.16%, 1.40% and 1.29% for every 10 years older. TPOAb or/and TgAb positive were significantly associated with OH and severe SCH (OR 15.9, p<0.001). However, SCH was positively correlated with increased urine iodine concentration, but this correlation was only in antibody-negative female patients. In non-autoimmune and male populations, there was a U-shaped relationship between severe SCH and OH and urine iodine concentration.ConclusionsMild SCH is the most common form of hypothyroidism, which is related to iodine intake. Severe SCH is more similar to OH which autoimmune is the main cause. The various effects of iodine on hypothyroidism depend on thyroid autoimmune and gender.

Abstract Background: Studies on the impact of blood glucose indicators on metabolism remain relatively scarce. The aim of this study was to investigate the associations between blood glucose indicators and metabolic disorders in China. Methods: Data were from the Thyroid disorders, Iodine status and Diabetes Epidemiological survey (TIDE survey), which randomly selected 31 cities from 31 provinces in the Chinese mainland. A total of 68,383 participants without preexisting diabetes and have complete data on blood glucose, lipids, and blood pressure were included in the analysis. The diabetic population was divided into seven groups based on different types of elevated blood glucose levels, including fasting plasma glucose (FPG), postprandial glucose (PPG), and hemoglobin A1c (HbA1c): FPG ≥7 mmol/L; PPG ≥11.1 mmol/L; HbA1c ≥6.5%; FPG ≥7 mmol/L and PPG ≥11.1 mmol/L; FPG ≥7 mmol/L and HbA1c ≥6.5%; PPG ≥11.1 mmol/L and HbA1c ≥6.5%; FPG ≥7 mmol/L, PPG ≥11.1 mmol/L, and HbA1c ≥6.5%. The effects of each blood glucose indicator on metabolism were investigated separately. Weighted calculation was applied during the analysis, with the weighting coefficient based on the number of people corresponding to the population characteristics of each sample in the 2010 Chinese Census. A logistic regression model with restricted cubic splines (RCS) was employed to characterize the nonlinear associations of age and body mass index (BMI) with the risk of diabetes subtypes defined by distinct blood glucose indicators elevations, as well as the relationships between different blood glucose indicators (FPG, PPG, HbA1c) and the risk of metabolic disorders such as hypertension, hypertriglyceridemia, hypercholesterolemia, high low-density lipoprotein cholesterol (high LDL-C) and low high-density lipoprotein cholesterol (low HDL-C). Results: Among individuals with diabetes, elevated PPG alone was the most common abnormality, affecting 26.96% (1382/5127) of the population. Among the seven groups with only one elevated blood glucose indicator, individuals with elevated PPG alone exhibited the highest mean levels of triglycerides (TG) at 2.11 mmol/L (95% confidence interval [CI]: 1.97–2.25 mmol/L, P = 0.004), total cholesterol (TC) at 5.26 mmol/L (95% CI: 5.18–5.33 mmol/L, P <0.001), and low-density lipoprotein cholesterol (LDL-C) at 3.12 mmol/L, (95% CI: 3.06–3.19 mmol/L, P = 0.001). Individuals with elevated PPG alone showed a high prevalence of hypertension (806/1382, 58.32%), hypertriglyceridemia (676/1382, 48.91%), hypercholesterolemia (694/1382, 50.22%), High LDL-C (525/1382, 37.94%), and Low HDL-C (364/1382, 26.34%). The association of age and BMI with the risk of diabetes revealed that the older the patient, the steeper the RCS curve for the odds ratio (OR) of diabetes with elevated PPG alone (age = 60, OR = 2.79, 95% CI [2.49–3.12], P <0.01). Similarly, as BMI increased, the RCS curve for the OR of diabetes with elevated HbA1c alone also steepened (BMI = 35, OR = 3.75, 95% CI [3.23–4.35], P <0.001). Additionally, the RCS yielded a positive association between blood glucose indicators and metabolic diseases risk. In individuals with diabetes, RCS for both the ORs of metabolic diseases (hypertension, hypertriglyceridemia, hypercholesterolemia, high LDL-C, low HDL-C) and the levels of metabolic indicators (TG, TC, LDL-C, HDL-C) revealed some inflection points within the ranges of FPG 5–6 mmol/L, PPG 6–8 mmol/L, and HbA1c 5.5–6.0%. Conclusions: PPG is more closely related to metabolic disorders than FPG and HbA1c in people with diabetes. For patients with diabetes and metabolic disorders, it may be necessary to monitor blood glucose fluctuations within specific ranges (FPG 5–6 mmol/L, PPG 6–8 mmol/L, and HbA1c 5.5–6.0%).

Low or high iodine intake may lead to thyroid dysfunction. In this study, the prevalences of overt and subclinical hypothyroidism and autoimmune thyroiditis were increased with increasing iodine intake in regions of China with iodine intake that was mildly deficient (median urinary iodine excretion, 84 μg per liter), more than adequate (median, 243 μg per liter), and excessive (median, 651 μg per liter). The prevalences of overt and subclinical hypothyroidism and autoimmune thyroiditis were increased with increasing iodine intake in regions of China with iodine intake that was mildly deficient, more than adequate, and excessive. Salt has been iodized throughout China since 1996, and as a result, iodine intake has increased countrywide. Data from the Ministry of Health of China indicate that the median urinary iodine excretion — a surrogate measure for iodine intake — increased from 165 μg per liter in 1995 to 330 μg per liter in 1997 and stabilized at a similar level (306 μg per liter) in 1999. 1 In fact, according to the guidelines of the World Health Organization (WHO), the United Nations Children's Fund, and the International Council for Control of Iodine Deficiency Disorders, 2 after iodization measures were instituted, the . . .

Metarhizium rileyi is an entomopathogenic fungus that naturally infects the larvae of Spodoptera frugiperda, and has biocontrol potential. To explore more natural entomopathogenic fungi resources, a total of 31 strains were isolated from 13 prefectures in Yunnan Province. All the strains were identified using morphology and molecular biology. The genetic diversity of the 31 isolates of M. rileyi was analyzed using inter-simple sequence repeat (ISSR) techniques. Seven primers with good polymorphism were selected, and fifty-four distinct amplification sites were obtained by polymerase chain reaction amplification. Among them, 50 were polymorphic sites, and the percentage of polymorphic sites was 94.44%. The thirty-one strains were divided into eight subpopulations according to the regions. The Nei’s gene diversity was 0.2945, and the Shannon information index was 0.4574, indicating that M. rileyi had rich genetic diversity. The average total genetic diversity of the subpopulations in the different regions was 0.2962, the gene diversity within the populations was 0.1931, the genetic differentiation coefficient was 0.3482 (>0.25), and the gene flow was 0.9360 (<1). The individual cluster analysis showed that there was no obvious correlation between the genetic diversity of the strains and their geographical origin, which also indicated that the virulence of the strains was not related to their phylogeny. Thus, the genetic distance of the different populations of M. rileyi in Yunnan Province was not related to the geographical distance. The virulence of those 32 strains against the 3rd-instar larvae of S. frugiperda were varied with the differences in geographical locations. On the 10th day of inoculation, seventeen strains had an insect mortality rate of 70.0%, and seven strains had an insect mortality rate of 100%. The half-lethal times of the M. rileyi SZCY201010, XSBN200920, and MDXZ200803 strains against the S. frugiperda larvae were less than 4 d. Thus, they have the potential to be developed into fungal insecticidal agents.

Introduction To examine changes in the prevalence of diabetes and the control of risk factors for diabetes over 10 years among adults in China. Methods Two population‐based cross‐sectional surveys were used to obtain a nationally representative sample of adults aged 20 years and older in mainland China in 2007 (n = 46 239) and 2017 (n = 73 340). Changes in the prevalence of diabetes, impaired fasting glucose, impaired glucose tolerance, and prediabetes, as diagnosed by the World Health Organization criteria, were assessed over time. Results The weighted prevalence of diagnosed diabetes (3.8% vs 6.3%, p = .0001) and total diabetes (9.7% vs 11.7%, p = .005) increased among the overall population between 2007 and 2017. The weighted prevalence of undiagnosed diabetes (5.9% vs 5.4%, p = .7), impaired fasting glucose (2.7% vs 2.6%, p = .68), impaired glucose tolerance (12.7% vs 12.5%, p = .95), prediabetes (15.4% vs 15.1%, p = .79), the treatment of diabetes (34.1% vs 32.5%, p = .44), and the control of diabetes (31.1% vs 32.8%, p = .73) did not significantly change over this period. The awareness of diabetes (39.4% vs 53.6%, p = .0004) increased over 10 years among the overall population. The proportion of achieved high‐density lipoprotein cholesterol targets increased (p = .005), but the proportion of achieved body mass index (p = .01) and waist circumference (p = .0002) targets decreased significantly. Conclusions Between 2007 and 2017, the prevalence of total diabetes (diagnosed by the World Health Organization criteria), especially diagnosed diabetes, increased among adults in China. Although awareness of diabetes improved, effective interventions and clinical strategies are urgently required. Highlights The prevalence of total diabetes and diagnosed diabetes significantly increased among adults in China between 2007 and 2017 Waist circumference and the lipid accumulation product index were significantly increased among the overall and diabetic populations Only one fifth of patients diagnosed with diabetes had achieved all eight risk factor control goals in 2017

Spodoptera frugiperda (Lepidoptera: Noctuidae) is a migratory agricultural pest that is devastating on a global scale. Beauveria bassiana is a filamentous entomopathogenic fungus that has a strong pathogenic effect on Lepidoptera pests but little is known about the microbial community in the host gut and the dominant populations in fungus-infected insects. B. bassiana AJS91881 was isolated and identified from the infected larvae of Spodoptera litura. The virulence of AJS91881 to the eggs, larvae, pupae and adults of S. frugiperda was measured. Moreover, the gut microbial community diversity of healthy and fungus-infected insects was analyzed. Our results showed that after treatment with B. bassiana AJS91881, the egg hatching rate, larval survival rate and adult lifespan of the insects were significantly reduced, and the pupae rigor rate was significantly increased compared to that of the control group. Additionally, the gut microbial community was reconstructed after B. bassiana infection. At the phylum and genus level, the relative abundance of the Proteobacteria and Serratia increased significantly in the B. bassiana treatment group. The KEGG function prediction results showed that fungal infection affected insect gut metabolism, environmental information processing, genetic information processing, organism systems and cellular processes. Fungal infection was closely related to the metabolism of various substances in the insect gut. Serratia marcescens was the bacterium with the highest relative abundance after infection by B. bassiana; intestinal bacteria S. marcescens inhibited the infection of insect fungi B. bassiana against the S. frugiperda. The presence of gut bacteria also significantly reduced the virulence of the fungi against the insects when compared to the group with the larvae fed antibiotics that were infected with fungal suspension (Germfree, GF) and healthy larvae that were infected with fungal suspension prepared with an antibiotic solution (+antibiotic). In conclusion, the reconstruction of the insect intestinal bacterial community is an indispensable link for understanding the pathogenicity of B. bassiana against S. frugiperda. Most importantly, in the later stage of fungal infection, the increased abundance of S. marcescens in the insect intestine inhibited the virulence of B. bassiana to some extent. The findings aid in understanding changes in the gut microbiota during the early stages of entomopathogenic fungal infection of insects and the involvement of insect gut microbes in host defense mediated by pathogenic fungal infection. This study is also conducive to understanding the interaction between entomopathogenic fungi, hosts and gut microbes, and provides a new idea for the joint use of entomopathogenic fungi and gut bacteria to control pests.

Studying drug relationships can provide deeper information for the construction and maintenance of biomedical databases and provide more important references for disease treatment and drug development. The research model has expanded from the previous focus on a certain drug to the systematic analysis of the pharmaceutical network formed between drugs. Network model is suitable for the study of the nonlinear relationship of the pharmaceutical relationship by modeling the data learning. Association rule mining is used to find the potential correlations between the various sets of massive data. Therefore, based on the network model, this research proposed an algorithm for drug interaction under improved association rules, which achieved accurate analysis and decision-making of drug relationship. Meanwhile, this research applied the established association rule algorithm to discuss the relationship between Chinese medicine and mental illness medicine and conducted the algorithm research and simulation analysis of the association relationship. The results showed the association rule algorithm based on the network model constructed was better than other association algorithms. It had reliability and superiority in decision-making in improving the drug-drug relationship. It also promoted the rational use of medicines and played a guiding role in pharmaceutical research. This provides scientific research personnel with research basis and research ideas for disease-related diagnosis.