[An overview of validation methods based on the medical claims database]

Medical claims database is an important source of data for studying the characteristics, and burden of diseases, to provide a basis for the development of policy on management. The database is usually used to identify patients through International Classification of Diseases and free text-building algorithms, thus it is crucial to validate whether the algorithm is correctly identifing the targeted population. This paper introduces both traditional and emerging validation methods including machine learning, natural language processing and database linkage etc.. We also have tried to present a suitable validation method for the current situation in China, so as to promote the application of big data in medical areas and to provide reference for epidemiology studies, based on medical claims database in this country.

[Clinical characteristics of 84 children with invasive Haemophilus influenzae infection from 2014 to 2018]

Objective: To investigate the clinical characteristics of invasive Haemophilus influenzae (HI) infection in children. Methods: The clinical manifestations, laboratory examinations and treatment outcomes of 84 children with HI infection confirmed by bacterial culture in 7 tertiary children's hospitals from 2014 to 2018 were analyzed retrospectively. Results: Among the 84 cases, 50 were males. The age was 1.54 years (ranged from 5 days to 13 years).Twenty cases (24%) had underlying diseases and 48 cases (57%) had not received antibiotics before collecting specimens. Eighty-two cases (98%) had fever and 75 cases (89%) had clear infection foci, among which 31 cases (37%) had meningitis and 27 cases (32%) had pneumonia. Blood culture was positive in 62 cases (74%), cerebrospinal fluid culture was positive in 10 cases (12%), blood culture and cerebrospinal fluid culture were both positive in 11 cases (13%). Antibiotics susceptibility test showed that 27% (22/82) of all HI strains produced β-lactamases and 48% (37/77) strains were resistant to ampicillin. The drug resistance rates to cefuroxime, ampicillin-sulbactam, trimethoprim-sulfamethoxazole and azithromycin were 25% (20/80) , 20% (9/45) , 71% (44/62) and 19%(11/58), respectively. All strains were sensitive to meropenem, levofloxacin and ceftriaxone. After sensitive antibiotic therapy, 83% (70/84) of all patients were cured and improved, the mortality rate and loss of follow-up rate were 13% (11/84) and 4% (3/84) respectively. Conclusions: Meningitis and pneumonia are common presentation of invasive HI infections in children. Mortality in HI meningitis children is high and the third generation of cephalosporins, such as ceftriaxone can be used as the first choice for the treatment of invasive HI infection.

[Detection and analysis of FAM19A4 promoter methylation in cervical exfoliated cells]

Objective: To investigate the cinical value of FAM19A4promoter methylation in cervicalexfoliated cells for triage of cervical cancer. Methods: A total of 162 high-risk HPV-infected patients who were pathologically confirmed as different cervical lesions from August 2017 to December 2017 were collected in Guangdong Women and Children Hospital. Taqman probe-based quantitative PCR (qPCR) was used to detect the methylation of FAM19A4 promoterin different grades of cervical lesions, and the value of FAM19A4 methylation in predicting cervical HSIL and the above lesions was calculated by diagnostic test. Results: (1)The positive rates of FAM19A4 methylation in cervical exfoliated cells increased with the severity of cervical lesions, which were 7.69% (4/52) , 34.62% (9/26) , 55.56% (20/36) , 95.83% (46/48) in normal cervix/cervicitis, cervical LSIL, HSIL, and cervical cancer, respectively(P<0.05).(2)There was no significant difference in the detection rates of FAM19A4 methylation between different age groups, pathological types, clinical stage, tumor size and lymph node metastasis status (P>0.05). (3) The specificity and positive predictive value of FAM19A4 methylation in detecting cervical HSIL alone and ≥HSIL lesions were the optimal, with the AUC of 0.69 and 0.84, respectively. When combined with HPV16/18 genotyping, the sensitivity was significantly improved. Conclusions: The detection of FAM19A4 promoter methylation in cervical exfoliated cells has a high clinical value of discriminating ≥HSIL lesions; and the cotest of methylated FAM19A4 and HPV16/18 genotyping can identify ≥HSIL lesions more sensitively.

[Randomized controlled trial based on big data]

A large amount of data has been accumulated in Chinese medical area. Problems as how to use big data to carry out randomized controlled trials have also been increasingly noteworthy. Through learning the successful experiences in conducting randomized controlled trials on big data from abroad, this article introduces the knowledge regarding sources of data, identification of research subjects and outcomes, interventions, methods of randomization and the implementation of informed consent, etc., all related to big data, hoping to shed light on studies of this kind, for the years to come in China.

[Analysis on the heritability of diabetes, based on data from the Chinese adult twins]

Objective: To analyze the heritability of diabetes among the Chinese twin adults. Methods: A total of 10 253 same-sex twin pairs aged 25 years and older, were selected from the Chinese National Twin Registry (CNTR) program. Heritability of diabetes was calculated by using the structural equation model. Results: After adjusted for age and gender, the overall heritability rates of diabetes were 0.41 (0.15-0.75), 0.83 (0.72-0.91) and 0.34 (0.04-0.73) in the <45 and ≥45 years twin pairs, respectively. After adjusted for age, rates of heritability appeared as 0.37 (0.05-0.78) and 0.88 (0.79-0.94) in men and women, respectively. Conclusions: Diabetes is affected by both genetic and environmental factors. The genetic effect of diabetes seemed stronger on female than that on male twins but was dying down along with ageing.

Significant enhancement of energy storage density and polarization in self-assembled PbZrO3 : NiO nano-columnar composite films

Self-assembled nanostructures are important for determining the physical properties of epitaxial oxide films. We successfully fabricated perfectly ordered NiO nano-columns embedded in an antiferroelectric (AFE) PbZrO3 (PZO) matrix over large areas. In this system, a giant recoverable energy storage density of Wr = 24.6 J cm-3 and polarization of PS = 91 μC cm-2 were achieved in the structure of PZO : NiO nano-composites. These values are 333% and 253% larger than those of a pure PZO film, respectively. Additionally, the properties could be tuned by gradually changing the volume ratio of the constituents. Hence, we demonstrate a new approach for enhancing the energy storage of AFE materials and exercising control over nano-column-embedded nanocomposites.

[One case report of nasal kaposiform hemangioendothelioma in adult]

A female patients，25-year-old，with the rigth nasal cavity bleeding 3 months as the main complaint to the hospital，physical examination indicated a soya bean size red mass at the surface of rigth inferior turbinate，and completely removaled of the mass under nasal endoscope，the pathologic results of the kaposiform hemangioendothelioma．.

[Clinical characteristics and antimicrobial resistance of pneumococcal infections from 9 children's hospitals in 2016]

Objective: To describe the clinical characteristics of pneumococcal infections and drug resistance of Streptococcus pneumoniae isolates from children's hospitals, which would provide reference for preventing and treating pneumococcal diseases. Methods: This was a prevalence survey. In this study, the age, specimen type, monthly distribution characteristics, and antimicrobial resistance of Streptococcus pneumoniae isolates from 9 children's hospitals in China were investigated between January 1, 2016 and December 31, 2016. The WHONET 5.6 software was used to analyze the antibiotic susceptibility of Streptococcus pneumoniae. The comparison of rates was performed by Chi-square test. Results: A total of 6 200 isolates of streptococcus pneumoniae were obtained, namely, 95.1% (5 876/6 177) from the respiratory tract specimens, 2.2% (136/6 177) from blood specimens and 0.4% (24/6 177) from cerebrospinal fluid specimens. The isolates were mainly from children older than 1 and younger than 5 years (54.7%, 3 381/6 185) . Most of strains (33.2%, 1 184/3 563) were isolated in November, December and January. Streptococcus pneumoniae isolates were completely sensitive to vancomycin (100.0%, 6 189/6 189) , linezolid (100.0%, 6 030/6 030) , moxifloxacin (100.0%, 3 064/3 064) , highly sensitive to levofloxacin (99.8%, 5 528/5 540), ertapenem (98.8%, 3 024/3 061) and lowly sensitive to erythromycin (1.7%, 102/6 016), clindamycin (3.7%, 116/3 136), and tetracycline (5%, 244/4 877), respectively. According to the parenteral susceptibility breakpoints for non-meningitis isolates, the sensitivity of Streptocococus pneumoniae to penicillin from children's hospital of Chongqing Medical University (49.3%, 892/1 809) was significantly lower than those of other hospitals (χ(2)=1 268.161, P<0.05) . Conclusions:Streptococcus pneumoniae is mainly isolated from respiratory tract, from children older than 1 and younger than 5 years and during November to January in tertiary children's hospital of China. The Streptococcus pneumoniae from children is highly sensitive to vancomycin, linezolid, moxifloxacin, levofloxacin. There are also significant differences in the sensitivity of penicillin for Streptococcus pneumoniae from different hospitals.

[Association between obesity and DNA methylation among the 7-16 year-old twins]

Objective: On whole-genome scale, we tried to explore the correlation between obesity-related traits and DNA methylation sites, based on discordant monozygotic twin pairs. Methods: A total of 90 pairs of 6-17 year-old twins were recruited in Chaoyang district, Yanqing district and Fangshan district in Beijing in 2016. Information on twins was gathered through a self-designed questionnaire and results: from physical examination, including height, weight and waist circumference of the subjects under study. DNA methylation detection was chosen on the Illumina Human Methylation EPIC BeadChip. R 3.3.1 language was used to read the DNA methylation signal under quality control on samples and probes. Ebayes function of empirical Bayes paired moderated t-test was used to identify the differential methylated CpG sites (DMCs). VarFit function of empirical Bayes paired moderated Levene test was used to identify the differentially variables CpG sits (DVCs) in obese and normal groups. Results According to the obesity discordance criteria, we collected 23 pairs of twins (age range 7 to 16 years), including 12 male pairs. A total of 817 471 qualified CpG loci were included in the genome-wide correlation analysis. According to the significance level of FDR set as <0.05, no positive sites would meet this standard. When DMC CpG site cg05684382, with the smallest P value (1.26E-06) as on chromosome 12, the DVC CpG site cg26188191 with the smallest P value (6.44E-06) appeared in CMIP gene on chromosome 16. Conclusions: In this study, we analyzed the genome-wide DNA methylation and its correlation with obesity traits. After multiple testing corrections, no positive sites were found to have associated with obesity. However, results from the correlation analysis demonstrated sites cg05684382 (chr: 12) and cg26188191 (chr: 16) might have played a role in the development of obesity. This study provides a methodologic reference for the studies on discordance twins related problems.

Comparative study of ultra-lightweight pulp foams obtained from various fibers and reinforced by MFC

A range of cellulose-based, ultra-lightweight pulp foams with different morphologies were prepared and reinforced with microfibrillated cellulose (MFC). By careful design of the pulp foam forming process, free-standing ultra-lightweight pulp foams were obtained through high velocity mixing and air/oven drying from cellulose fiber in the presence of surfactant, MFC, and retention aid. The effects of different types of fibers and surfactants on the air uptake volumes and mechanical properties of the foam were systematically investigated. The structures characterized using an optical microscope and scanning electron microscope (SEM) showed that the foam was composed of wood fibers into two- or three-dimensional microstructures within random orientations surrounding gas bubbles. The results indicated that in spite of the strength of the foam could be manipulated by varying the surfactants and processing parameters, the addition of MFC indeed improved strength of pulp foams further. The process developed in this work provides a cost effective approach to fabricate the strong and ultra-lightweight pulp foam, with a density lower than 0.02g/cm³, using a standard handsheet former.

Oral Chinese herbal medicine as maintenance treatment after chemotherapy for advanced non-small-cell lung cancer: a systematic review and meta-analysis

BACKGROUND

The concept of maintenance therapy in cancer treatment is currently under debate because of modest survival benefits, added toxicity, economic considerations, and quality-of-life concerns. Traditional Chinese Medicine (tcm) is widely used in China for cancer patients, offering the advantages of low toxicity and enhancement of quality of life. However, no systematic reviews or meta-analyses have assessed the role of tcm as maintenance treatment for non-small-cell lung carcinoma.

METHODS

We searched the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, PubMed, embase, and the Cochrane Library databases for all eligible studies. The endpoints were overall survival (os), progression-free survival (pfs), the 1-year and 2-year survival rates, and performance status. Our meta-analysis used a fixed-effects model and a random-effects model for heterogeneity in the Stata software application (version 11.0: StataCorp LP, College Station, TX, U.S.A.), with the results expressed as hazard ratios (hrs) or risk ratios (rrs), with their corresponding 95% confidence intervals (95% cis).

RESULTS

Sixteen randomized studies representing 1150 patients met the inclusion criteria. Compared with best supportive care, observation, or placebo, tcm as maintenance treatment was associated with a significant increase in os (hr: 0.49; 95% ci: 0.35 to 0.68; p < 0.001), pfs (hr: 0.66; 95% ci: 0.51 to 0.84; p = 0.001), and 2-year survival rate (rr: 0.63; 95% ci: 0.44 to 0.92, p = 0.017), and a significant improvement in performance status (rr: 0.68; 95% ci: 0.61 to 0.75; p < 0.001).

CONCLUSIONS

For patients who show non-progression-including stable disease, partial response, or complete response-after first-line chemotherapy, including those with poor quality of life, oral Chinese herbal medicine can be considered an efficient and safe maintenance therapy strategy.

Mesangial proliferative lupus nephritis with podocytopathy: a special entity of lupus nephritis

Mesangial proliferative lupus nephritis may coexist with podocytopathy, but its clinical-morphological features, treatment response and outcomes have not been compared with mesangial proliferative lupus nephritis without podocytopathy. In this study, 125 biopsies of lupus nephritis patients showing mesangial proliferation with mesangial immune deposits were collected and divided into podocytopathy group (defined as podocyte foot process effacement (FPE) >50% with nephrotic syndrome (NS)) and mesangial group (FPE ≤50%, or FPE >50% without NS). Mesangial proliferation and tubular- interstitial lesions were semi-quantitatively analyzed. We found that the incidence of renal involvement as the onset symptoms ( P < .001), nephrotic syndrome ( P < .001), acute kidney injury ( P < .001), the degree of acute tubular- interstitial lesions ( P < .001), and renal relapse (51.6% vs. 23.7%, P = .005) were significantly higher in the podocytopathy group than in the mesangial group. In contrast, the incidence of arthritis ( P < .001), fever ( P = .042), low serum C4 ( P = .008) and hematuria ( P = .033) was significantly lower in the podocytopathy group than in the mesangial group. No patients developed end stage renal disease or death during a median follow-up of 64 (interquartile range (IQR) 37-103) months in the podocytopathy group and 53 (IQR 30-83) months in the mesangial group. In conclusion, mesangial proliferative lupus nephritis with and without podocytopathy should be subdivided into two separate classes of lupus nephritis.

Mesenchymal stromal cell injection promotes vocal fold scar repair without long-term engraftment

BACKGROUND

Regenerative medicine holds promise for restoring voice in patients with vocal fold scarring. As experimental treatments approach clinical translation, several considerations remain. Our objective was to evaluate efficacy and biocompatibility of four bone marrow mesenchymal stromal cell (BM-MSC) and tunable hyaluronic acid based hydrogel (HyStem-VF) treatments for vocal fold scar using clinically acceptable materials, a preclinical sample size and a dosing comparison.

METHODS

Vocal folds of 84 rabbits were injured and injected with four treatment variations (BM-MSC, HyStem-VF, and BM-MSC in HyStem-VF at two concentrations) 6 weeks later. Efficacy was assessed with rheometry, real-time polymerase chain reaction (RT-PCR) and histology at 2, 4 and 10 weeks following treatment. Lung, liver, kidney, spleen and vocal folds were screened for biocompatibility by a pathologist.

RESULTS AND DISCUSSION

Persistent inflammation was identified in all hydrogel-injected groups. The BM-MSC alone treatment appeared to be the most efficacious and safe, providing an early resolution of viscoelasticity, gene expression consistent with desirable extracellular matrix remodeling (less fibronectin, collagen 1α2, collagen 3, procollagen, transforming growth factor [TGF]β1, alpha smooth muscle actin, interleukin-1β, interleukin-17β and tumor necrosis factor [TNF] than injured controls) and minimal inflammation. Human beta actin expression in BM-MSC-treated vocal folds was minimal after 2 weeks, suggesting that paracrine signaling from the BM-MSCs may have facilitated tissue repair.

Layer-dependent electronic properties of phosphorene-like materials and phosphorene-based van der Waals heterostructures

Black phosphorus is a layered semiconducting allotrope of phosphorus with high carrier mobility. Its monolayer form, phosphorene, is an extremely fashionable two-dimensional material which has promising potential in transistors, optoelectronics and electronics. However, phosphorene-like analogues, especially phosphorene-based heterostructures and their layer-controlled electronic properties, are rarely systematically investigated. In this paper, the layer-dependent structural and electronic properties of phosphorene-like materials, i.e., mono- and few-layer MXs (M = Sn, Ge; X = S, Se), are first studied via first-principles calculations, and then the band edge position of these MXs as well as mono- and few-layer phosphorene are aligned. It is revealed that van der Waals heterostructures with a Moiré superstructure formed by mutual coupling among MXs and among MXs and few-layer phosphorene are able to show type-I or type-II characteristics and a I-II or II-I transition can be induced by adjusting the number of layers. Our work is expected to yield a new family of phosphorene-based semiconductor heterostructures with tunable electronic properties through altering the number of layers of the composite.

Left Lobe Auxiliary Liver Transplantation for End-stage Hepatitis B Liver Cirrhosis

Auxiliary liver transplantation (ALT) for hepatitis B virus (HBV)-related liver cirrhosis previously showed poor results, because the native liver was a significant source of HBV recurrence and the graft could be rapidly destroyed by HBV infection in an immunosuppressive condition. Four patients with HBV-related liver cirrhosis were unable to undergo orthotopic liver transplantation because the only available grafts of left lobe were too small. Under entecavir-based anti-HBV treatment, they underwent ALT in which the recipient left liver was removed and the small left lobe graft was implanted in the corresponding space. The mean graft weight/recipient weight was 0.49% (range, 0.38%-0.55%). One year after transplantation, the graft sizes were increased to 273% and the remnant livers were decreased to 44%. Serum HBV DNA was persistently undetectable. Periodic graft biopsy showed no signs of tissue injury and negative immunostaining for hepatitis B surface antigen and hepatitis B core antigen. After a mean follow-up period of 21 months, all patients live well with normal graft function. Our study suggests that ALT for HBV-related liver cirrhosis is feasible under entecavir-based anti-HBV treatment. Successful application of small left livers in end-stage liver cirrhosis may significantly increase the pool of left liver grafts for adult patients.

Cardiotoxicity evaluation of nine alkaloids from Rhizoma Coptis

PURPOSE

Alkaloids derived from Rhizoma Coptis (RC) has been widely applied to clinical treatments in China. However, the toxicity of RC and the alkaloids from RC remained controversial. The research is designed to clarify the cardiotoxic compounds found in RC.

METHODS

In this study, the real-time cellular analysis cardio system and the high-content analysis were applied to monitor the function of cardiomyocytes (CMs) in the treatment of nine alkaloids in RC. Luciferase-coupled adenosine triphosphate (ATP) assay was used to detect cell viability.

RESULTS

The results showed that berberine, palmatine, berbamine, and oxyberberine were cardiotoxic, which resulted in arrhythmia and cardiac arrest on CMs in a time- and dose-dependent manner. Meanwhile, berbamine and oxyberberine caused shrinkage and detachment on CMs at 10 μM. Cytotoxicity was induced by these two compounds with decline in cell index and ATP depletion. Cardiotoxicity or cytotoxicity was not observed in the other five alkaloids within 10 μM.

CONCLUSION

For the first time, the cardiotoxicity of the nine alkaloids was evaluated to clarify the cardiotoxic components in RC. Furthermore, the experimental evidences were provided to support the safety of drug application.

[Mendelian randomization analysis of the relationship between obesity and DNA methylation]

Objective: To explore the association between DNA methylation and body mass index (BMI) using Mendelian randomization analysis. Methods: A total of 469 participants were selected from the Chinese National Twin Registry in 2013, who were living in Shandong, Jiangsu, Zhejiang, and Sichuan provinces, and at least 18 years of age. A questionnaire survey and physical examination were conducted to collect demographic, clinical, and behavioral information. Peripheral blood cells were collected to detect genotype and methylation status. Association analyses between DNA methylation and BMI and between CpGs and cis-SNP were conducted. With rs748212 as the instrumental variable, the association between cg15053022 and BMI was explored using the Mendelian randomization method. Results: A total of 469 participants were selected. The mean age of participants was (44.8±13.2) years and the BMI was (25.0±3.8) kg/m(2). Nine BMI-related DNA methylation sites were found and DNA methylation site cg15053022 in the ATP4A gene was negatively associated with cis-SNP rs748212 (β=-0.020); the mean methylation level of AA, AC, and CC were 0.212±0.025, 0.242±0.024, and 0.264±0.028, respectively. rs748212 was associated with BMI (β=0.04, P=0.007) and closely related to cg15053022 (F=237.66, P=0.143). Mendelian randomization analysis showed lower methylation levels at cg15053022 were associated with higher BMI (β=-1.97, P<0.001). Conclusion: This study supported the impact of cg15053022 methylation in the ATP4A gene on BMI using Mendelian randomization analysis and provided the basis for using Mendelian randomization analysis in methylation studies.

Tin Compensation for the SnS Based Optoelectronic Devices

In this paper we report the growth of high quality SnS thin films with good crystallinity deposited on two-dimensional (2D) mica substrates. It is believed that the 2D nature of SnS, with strong intra-layer covalent bonds and weak inter-layer van der Waals interactions, is responsible for its relative insensitivity to lattice mismatch. We also investigated the reduction of Sn vacancies in the material using Sn-compensation technique during the material growth process. The experimental results clearly demonstrated substantial enhancements in the electrical and structural properties for films deposited using Sn-compensation technique. A mobility of 51 cm²  V⁻¹ s⁻¹ and an XRD rocking curve full width at half maximum of 0.07° were obtained. Sn-compensated SnS/GaN:Si heterojunctions were fabricated and significant improvement in both the I-V characteristics and the spectral responsivities of the devices were characterized.

[The clinical analysis and surgical management of infant nasopharyngeal neoplasms]

Objective:To analysis the clinical features, diagnosis and treatment experience of nasopharyngeal neoplasm in infants.Method:Twenty infants cases of nasopharyngeal neoplasm, from June 2002 to March 2015, admitted in our department were retrospectively studied. Nasopharyngeal neoplasm in all cases were ablated with low temperature plasma radiofrequency ablation after anesthesia downlink preoperative 70 degrees endoscope, and new biological routine pathologic examination were done.Result:The low temperature plasma radiofrequency ablation has several advantages,such as simple and convenient operating, short operating time, intraoperative blood loss and clear vision.Five cases were diagnosed as postoperative pathological cyst,4 cases were teratoma, 4 cases were hairy polyps,3 cases were hamartoma, 2 cases were hyperplasia of lymphoid tissue, 1 case was glioma, and 1 case was rhabdomyosarcoma. Postoperative follow-up for 6 months to 12 years, recurrence were found in 2 cases, including 1 death case.Conclusion:Infants nasopharyngeal neoplasm are almost benign, clinical rare congenital nasopharyngeal tumor more than the early detection of an infant. CT and MRI examination has important significance to the diagnosis. Low temperature plasma radiofrequency ablation with Seventy degrees nasal endoscope is worth extending.

[Revised endoscopic sinus surgery combined middle turbinectomy in the treatment of refractory rhinosinusitis]

Objective:To investigate the comprehensive curativeeffect of refractory rhinosinusitis by endoscopic sinus surgery and middle turbinate resection.Method:A retrospective analysis with 178 cases of refractory rhinosinusitis.According to the operation methods, these patients were divided into two groups, observation group and control group, with 89 patients each. The observationgroup received revision endoscopic sinus surgery combined with middle turbinectomy and the control with traditional surgery. Followup to observe the curative effect and recurrence rate between the two groups. Result:Follow-up after 6 months, total effective rate of observation group was 88.76% and the effective rate of control group was 68.54%.The total effective rate of observation group is higher than the control group, and non efficiency rate is lower than that of the control group; besides that the incidence of complications and the recurrence rate of the observation group was lower than the control group. Conclusion:It can effectively prevent the recurrence of sinusitis by the revised operation of nasal endoscopic frontal sinus combined with middle turbinate partial or complete removal and fully treatment measures of peri operation period, that is to say it can improve the therapeutic effect of refractory sinusitis witch worthing the clinical popularization and application.

Clinical significance of CTHRC1 protein expression in human cancers: a meta-analysis

The aim of this meta-analysis was to investigate the overall diagnostic and prognostic values of CTHRC1 expression in human cancer development. Based on the inclusion and exclusion criteria, 8 cohort studies were included in the meta-analysis. The data were extracted, and analyses were performed using a random-effects model. Summary odds ratios (ORs) and effect sizes (ESs) with 95% confidence intervals (CIs) were calculated to assess the strength of the associations. A total of 1065 cancer patients from the 8 studies were included in the meta-analysis. The results revealed a positive correlation of CTHRC1 protein expression in tumors with tumor-node-metastasis (TNM) stage and with lymph node (LN) metastasis (TNM: OR = 2.98, 95%CI = 1.48-6.00, P = 0.002; LN: OR = 4.26, 95%CI = 1.88-9.67, P = 0.001). CTHRC1 expression was higher in tumors with sizes ≥5 cm than in tumors with sizes <5 cm (OR = 2.39, 95%CI = 1.12-5.09, P = 0.024). Patients with higher CTHRC1 expression had decreased overall survival (OS) (ES = 1.78, 95%CI = 1.23-2.33, P < 0.001) and poorer disease-free survival (DFS) (ES = 1.71, 95%CI = 1.11-2.31, P < 0.001). Disease-stratified analyses yielded significantly different estimates of CTHRC1 levels in the majority of the subgroups (all P < 0.05). In conclusion, increased CTHRC1 expression is associated with advanced TNM stage, increased LN metastasis and tumor size, and decreased OS and DFS, indicating that CTHRC1 may be a biomarker for prognosis of cancer patients.

[Influences of genetic and environmental factors on smoking related behaviors among male twin adults in China]

OBJECTIVE

To analyze the influences of genetic and environmental factors on smoking behavior, smoking cessation and onset age of smoking less than 20 years in male twin adults.

METHODS

A face-to-face questionnaire was conducted to collect data from 6 458 pair male twins aged ≥25 years registered in 9 provinces(municipality)in China. The heritability of three smoking related behaviors were calculated by using structural equation models.

RESULTS

The ACE models were the best models of the three dimensions of smoking, i.e. smoking behavior, smoking cessation and onset age of smoking less than 20 years for male twins, and the corresponding heritability of these behaviors were 0.26(0.19-0.34), 0.27(0.19-0.37)and 0.05(0.00-0.14), respectively. When adjusted for area and age, the heritability of these three behaviors were 0.26(0.19-0.34), 0.31(0.00-0.74)and 0.05(0.00-0.14), respectively.

CONCLUSIONS

All the three smoking related behaviors were affected by genetic factors, but environment factors had more effect on them. For smoking cessation, the heritability was highest, but the influence of environmental factors was lowest. Meanwhile, for onset age of smoking, the influence of environmental factors was highest.