Integrated neutrophil-to-lymphocyte ratio and handgrip strength better predict survival in patients with cancer cachexia

OBJECTIVES

Systemic inflammation and skeletal muscle strength play crucial roles in the development and progression of cancer cachexia. In this study we aimed to evaluate the combined prognostic value of neutrophil-to-lymphocyte ratio (NLR) and handgrip strength (HGS) for survival in patients with cancer cachexia.

METHODS

This multicenter cohort study involved 1826 patients with cancer cachexia. The NLR-HGS (NH) index was defined as the ratio of neutrophil-to-lymphocyte ratio to handgrip strength. Harrell's C index and receiver operating characteristic (ROC) curve analysis were used to assess the prognosis of NH. Kaplan-Meier analysis and Cox regression models were used to evaluate the association of NH with all-cause mortality.

RESULTS

Based on the optimal stratification, 380 women (NH > 0.14) and 249 men (NH > 0.19) were classified as having high NH. NH has shown greater predictive value compared to other indicators in predicting the survival of patients with cancer cachexia according to the 1-, 3-, and 5-y ROC analysis and Harrell's C index calculation. Multivariate survival analysis showed that higher NH was independently associated with an increased risk of death (hazard ratio = 1.654, 95% confidence interval = 1.389-1.969).

CONCLUSION

This study demonstrates that the NH index, in combination with NLR and HGS, is an effective predictor of the prognosis of patients with cancer cachexia. It can offer effective prognosis stratification and guidance for their treatment.

[Establishment of acute graft-versus-host disease model after non-myeloablative haploidentical peripheral blood stem cell transplantation in aged mice]

Objective: To establish an acute graft-versus-host disease (aGVHD) model in aged mice after non-myeloablative haploidentical peripheral blood stem cell transplantation (haplo-PSCT). Methods: C57BL/6 (H-2b) male mice aged 6-8 weeks were used as donor mice, and CB6F1 (H-2b×d) female mice aged 14-16 months were used as recipient mice. The donor mice were injected subcutaneously with rehuman granulocyte-colony stimulating factor (rhG-CSF) 5 days before transplantation for hematopoietic stem cell mobilization.The recipient mice were divided into control group (CG), spleen cell low-dose group (SL), spleen cell medium-dose group (SM) and spleen cell high-dose group (SH) according to random number table method, with 16 rats in each group, all of which received total linear accelerator X-ray irradiation (TBI) with a total dose of 6 Gy. Peripheral blood mononuclear cells (PBMC) and spleen cells of different doses (0.5×107/each, 1.0×107/each and 2.0×107/each in SL group, SM group and SH group, respectively) were transfused through the tail vein within 4 hours after TBI, and only the same amount of normal saline was transfused in CG group. After transplantation, the survival and weight changes of mice in each group were observed for 30 days, and the changes of blood routine were monitored regularly. Mice peripheral blood was collected 21 days after transplantation to detect the chimerism rate of the donor. Hematoxylin-eosin staining was performed on the skin, liver and colon of mice 21 days after transplantation to analyze the histopathological changes of aGVHD target organs. Results: All the mice in each group were successfully transplanted. After TBI, the weight and activity of mice in all groups decreased, and the phenomenon of bone marrow suppression appeared. During the observation period, all mice in CG group and SL group survived, 3 mice in SM group died with survival time of (26.0±5.8) days, and 6 mice in SH group died with survival time of (20.9±7.3) days. The body weight of mice in SH group was lower than that in CG group, SL group and SM group 21days after transplantation [(25.0±0.7), (25.5±0.4), (25.0±1.4) vs (20.8±0.8) g, all P<0.05]. Compared with CG group, SL group and SM group, the levels of leukocyte, erythrocyte, hemoglobin and platelet in SH group decreased 21 days after transplantation (all P<0.05). There was no significant difference in donor chimerism rate among SL group, SM group and SH group [(95.8%±0.8%), (95.5%±1.4%) and (95.1%±1.3%), respectively, all P>0.05]. Compared with CG group, SL group and SM group, the tissue structure of aGVHD target organs in SH group was severely damaged, with a large number of inflammatory cells infiltratedand higher histopathological scores than SL group and SM group (all P<0.05). Conclusion: For aging CB6F1 mice, after 6 Gy TBI pretreatment with linear accelerator X-ray, PBMC (1×107/each) and spleen cells (2.0×107/each) were injected to successfully induce aGVHD model after non-myelablative haplo-PSCT.

Exceptional spectrum and dynamic magnetization

A macroscopic effect can be induced by a local non-Hermitian term in a many-body system, when it manifests simultaneously level coalescence of a full real degeneracy spectrum, leading to exceptional spectrum. In this paper, we propose a family of systems that support such an intriguing property. It is generally consisted of two arbitrary identical Hermitian sub-lattices in association with unidirectional couplings between them. We show exactly that all single-particle eigenstates coalesce in pairs even only single unidirectional coupling appears. It means that all possible initial states obey the exceptional dynamics, resulting in some macroscopic phenomena, which never appears in a Hermitian system. As an application, we study the dynamic magnetization induced by complex fields in an itinerant electron system. It shows that an initial saturated ferromagnetic state at half-filling can be driven into its opposite state according to the dynamics of high-order exceptional point. Any Hermitian quench term cannot realize a steady opposite saturated ferromagnetic state. Numerical simulations for the dynamical processes of magnetization are performed for several representative situations, including lattice dimensions, global random and local impurity distributions. It shows that the dynamic magnetization processes exhibit universal behavior.

Clinical characteristic and surgical treatment of traumatic lumbar spondylolisthesis: A series of 28 patients

OBJECTIVE

To explore the clinical characteristics and the short-term efficacy of posterior operation for traumatic lumbar spondylolisthesis.

METHODS

All 28 patients (between January 2013 and June 2018) were treated with lumbar pedicle screw fixation combined with posterior intervertebral fusion. The clinical data and imaging materials of these patients were retrospectively analyzed.

RESULTS

The mean follow-up period was 24.3 months (12-36 months). The average VAS score and JOA score were significantly improved after surgery, and the difference was statistically significant (P<0.05).The last follow-up X-ray showed that 16 cases were degree 0 and 12 cases were degree I according to Meyerding grading, which were statistically improved compared with preoperative. Postoperative CT indicated lumbar internal fixation well, and the lumbar fusion rate was 100%. The Frankel grading of neurological function was significantly improved compared with preoperative.

CONCLUSION

Acute traumatic lumbar spondylolisthesis is caused by severe trauma and mostly occurred at L4/L5 and L5/S1 level. Early posterior reduction, decompression and intervertebral fusion can achieve satisfactory clinical and radiological outcome.

Quantum Phase Transition in a Quantum Ising Chain at Nonzero Temperatures

We study the response of a thermal state of an Ising chain to a nonlocal non-Hermitian perturbation, which coalesces the topological Kramer-like degeneracy in the ferromagnetic phase. The dynamic responses for initial thermal states in different quantum phases are distinct. The final state always approaches its half component with a fixed parity in the ferromagnetic phase but remains almost unchanged in the paramagnetic phase. This indicates that the phase diagram at zero temperature is completely preserved at finite temperatures. Numerical simulations for Loschmidt echoes demonstrate such dynamical behaviors in finite-size systems. In addition, it provides a clear manifestation of the bulk-boundary correspondence at nonzero temperatures. This work presents an alternative approach to understanding the quantum phase transitions of quantum spin systems at nonzero temperatures.

Weather-Manipulated Smart Broadband Electromagnetic Metamaterials

Smart materials and structures with tunable electromagnetic (EM) properties are highly demanded for active environmental sensitive systems. As polar molecules in the environment, in this work, water and ice are utilized as wetting and freezing conditions to manipulate the electromagnetic response behaviors in a graphene-based composite material, aiming to achieve a smart weather-manipulated EM metamaterial. Owing to the introduced polar water and ice phase in the self-assembled porous electromagnetic attenuating networks, energy consumption of EM waves is significantly altered via multiple scattering of polar induced interfaces. In frozen conditions, a wide absorption band (2-18 GHz) with efficient absorption (reflection loss < -10 dB) has been obtained. Additionally, the mechanical feature of the as-assembled metamaterials could also be manipulated via altering the weather conditions in terms of changing the phase of the introduced water. Interestingly, the mechanical properties could be massively changed while the broadband absorption capability has rarely been impacted. Implication of the results highlights an efficient method for fabricating smart EM metamaterials that are capable of being manipulated by the environment.

[The multicenter study on the registration and follow-up of low anticoagulation therapy for the heart valve operation in China]

OBJECTIVE

To investigate the optimal anticoagulation methods and monitoring strategy for Chinese patients undergoing heart valve replacement, which is potentially quite different from western populations.

METHODS

In this multicenter prospective cohort study, the anticoagulation and monitoring strategy data was acquired from 25 773 in-hospital patients in 35 medical centers and 20 519 patients in outpatient clinic in 11 medical centers from January 1st, 2011 to December 31th, 2015.

RESULTS

As for in-hospital patients, mean age of study population was (48.6±11.2) years old; main etiology of valve pathology was rheumatic (87.5%) origin among study cohort; 94.8% of study population received mechanical valve implantation; international normalized ratio (INR) monitoring (in all the study centers) and low-intensity anticoagulation strategy (31 hospitals chose target INR range of 1.5-2.5, and actual values of INR among 89.2% of 100 069 in-hospital monitoring samples were 1.5-2.5), with mean actual INR values of 1.84±0.53, and warfarin dosage of (2.82±0.93) mg/d were widely adopted among the study centers; strategies of in-hospital warfarin administration were similar in all the study centers; complication rates of low-intensity anticoagulation strategy were low in severe hemorrhage (0.02%), thrombosis (0.05%), and thromboembolism (0.05%) events, without anticoagulation-related death.As for 18 974 outpatient clinic patients, the follow-up rate was 92.47%, with a total of 30 012 patient-years (Pty). Anticoagulation-related morbidity and mortality rates were 0.67% and 0.15% Pty; major hemorrhage morbidity and mortality rates were 0.25% and 0.13% Pty; thromboembolism morbidity and mortality rates were 0.45% and 0.03% Pty.The mean dosage of warfarin daily dosage was (2.85±1.23) mg/d and INR value was 1.82±0.57.No significant regional difference in the intensity of anticoagulation therapy was noted during the study.

CONCLUSIONS

INR can be used as a normalized indicator for intensity of anticoagulation therapy in China.The optimal anticoagulation intensity with INR range from 1.5 to 2.5 is safe and effective for Chinese patients with heart valve replacement, and there is no significant regional difference in the intensity of anticoagulation therapy.

Identification of a novel HLA-B*46 allele, HLA-B*46:28

HLA-B*46:28 has one nucleotide change from HLA-B*46:01:01 where 48R is changed to W.

[The establishment of Ting Hsien Experimental Project of Rural Health Service and its influence]

Founded by the Chinese Mass Education Movement (MEM) led by Dr.James Yen and Peking Union Medical College(PUMC), the Ting Hsien Experimental Project was a demonstration program for health service in a rural county. Through a 8-year endeavor (1929-1937) and using a bottom-up approach, Dr. Chen Chih-chien and Dr.YaoHsun-yuan took the leadership of a group of dedicated PUMC graduates and students, and created a three-level(village-district-county) system to deliver both curative as well as preventive medical service for rural population. This project, under the full support of MEM and Dr. John Black Grant, Director of the Department of Public Health of PUMC, offered an important example for rural community health care in contemporary China. Moreover, it demonstrated and inspired the concepts of the primary health care advocated by World Health Organization 40 years later.

Recapturing public health sciences for HIV/AIDS in China

In recent years, human immunodeficiency virus (HIV) has spread from high-risk groups to the general population in China. Scientific interpretation of HIV figures, prevalence and proportion vs. incidence is displayed to correctly guide politicians and lay people in understanding the situation. Although behaviour-focused studies have been conducted in China, many have focused on 'scientific' issues, with limited attention given to human dimensions or contexts. An evidence-based public health approach, with strict evaluation in terms of cost-effectiveness and behavioural outcomes, needs to be developed, together with activity to encourage decentralization and community engagement of programmes. Policies and strategies on HIV prevention and control need to be mindful of Chinese culture and reality, including the expansion of screening and surveillance.

Synthesis and performance of colloidal silica nano-abrasives with controllable size for chemical mechanical planarization

Under the analysis of particle growth mechanism, the monodisperse colloidal silica abrasives for chemical mechanical planarization (CMP) slurry were synthesized by the modified ion-exchanged and hydrothermal step-polymerization process. After the colloidal silica with controllable size was synthesized, its microstructure, stability and CMP performance was characterized and tested by SEM, HRTEM, Zeta potential Analyzer and CMP tester. Results show that the spherical, high stable (Zeta potential: -52.8 mV) colloidal silica with controllable size was achieved. About its CMP performance, the polishing rate for silicon double-side CMP is increased to be 317 nm/min and the polished surface roughness (RMS) was reduced to 0.32 nm.

Reproductive health risks and HIV infection vulnerability of hostesses in metropolitan areas, China: a qualitative study

In this paper, we describe sex-related health risks among hostesses in two metropolises in China based on data obtained from in-depth interviews. The data show that hostesses, many engaging in commercial sex, are vulnerable to HIV infection, unwanted pregnancies and reproductive tract infections. Nevertheless, many obstacles still are present that hinder them from engaging in safe sex. The findings from our study illustrate the need for targeted interventions in order to improve reproductive health and promote safe sex among this group.

Retroviral gene transfer of tissue-type plasminogen activator targets thrombolysis in vitro and in vivo

Patients usually have serious complications of thrombosis and bleeding by eating anticoagulation medicine for their residual lives after mechanical valve replacement operation. Tissue-type plasminogen activator (tPA) could target thrombolysis by activating plasminogen to fibrinolysin. In this study, we recombined a retroviral vector pLEGFP-N1-tPA and cultured purified packaging cells PT67/pLEGFP-N1-tPA to produce high-titer retrovirus. In vitro, two target cells, endothelial cell of umbilical vein (ECUV) 304 and heart muscle cell (HMC) that consist of endocardium and heart muscle, were infected by pLEGFP-N1-tPA. The results demonstrated that exogenous tPA was successfully transferred into ECUV304 and HMC. tPA in the two cells shows significant thrombolysis in plasma plate and the activity and content of tPA were high. Furthermore, in vivo, no thrombus was seen on the surface of Dacron patches (the same material making up a ring of mechanical valve) by tPA locally transferring around Dacron patches that were transplanted in the inferior caval veins of rabbits. tPA was successfully transferred into the local inferior caval vein. Activity and content of tPA were high in local tissue and blood and thrombolysis was effectively demonstrated by tPA rapidly, efficiently and long expressing. This laid the foundation for study and appliance of the tPA gene valve.

A study on female sex workers in southern China (Shenzhen): HIV-related knowledge, condom use and STD history

The present study aims to investigate the perspective relations between HIV/AIDS and condom-related knowledge, condom use, history of sexually transmitted diseases (STDs) and predictive factors of condom use by female sex workers (FSW) who were sent to the Women Re-education Center (WRC) in Shenzhen, People's Republic of China. Seven hundred and one FSW were interviewed. Whereas respondents had attained certain accurate knowledge about the HIV transmission routes, misconceptions were still commonly reported. Level of condom related knowledge was not high. The prevalence of using condoms with clients was relatively low-15%- 22% reported not using condoms consistently. One of the major obstacles was 'Refusal by clients'. Significant predictive factors associated with consistency of condom use with clients were age, educational background, average number of client intakes per day, capacity in determining the use of condoms and past STD history. The respondents may have developed a false sense of safety by subjectively assessing whether their clients had a STD but they were unaware that HIV carriers may show no obvious symptoms at all. The data has confirmed the worries regarding the potential 'bridging effect' of HIV transmission as resulted by cross-border commercial sex-networking activities.

[Frequency-specific responses of human brain to peripheral transcutaneous electric nerve stimulation: a functional magnetic resonance imaging study]

The purpose of the present investigation was to determine the responses of human brain to transcutaneous electric nerve stimulation (TENS) at different frequencies by functional magnetic resonance imaging (fMRI) examinations covering the whole brain of eleven healthy volunteers. Each subject received TENS at acupoints ST36 and SP6 of the left leg at the frequencies of 2 and 100 Hz. Frequency-specific responses were found in motor-related areas, thalamus, limbic system and associated cortex to stimulation of the two frequencies, while the primary somatosensory areas were activated by both. Therefore, it appears that 2 and 100 Hz TENS act through different neuro-pathways in the central nervous system.

Phylogenetic analysis of the S7 gene does not segregate Chinese strains of bluetongue virus into a single topotype

Bluetongue virus (BTV) infection of ruminants is endemic throughout tropical and subtropical regions of the world. The S7 gene segments of prototype Chinese strains of BTV serotypes 1, 2, 3, 4, 12, 15, and 16 were sequenced and compared to the same genes of prototype strains of BTV from the US, Australia, and South Africa. The S7 genes and predicted VP7 proteins of the Chinese viruses were relatively conserved, with the notable exception of serotype 15. Furthermore, phylogenetic analysis of the S7 genes did not predict geographic origin of the various strains of BTV.

Effects of infant birthweight and maternal body mass index in pregnancy on components of the insulin resistance syndrome in China

BACKGROUND

Reduced birthweight is associated with increased risk for the insulin resistance syndrome. Part of this risk is hypothesized to originate from undernutrition in utero. The prevalence of the insulin resistance syndrome increases in countries that undergo the transition from chronic malnutrition to adequate nutrition, when postnatal nutrition improves more rapidly than prenatal nutrition.

OBJECTIVE

To determine whether the components of the insulin resistance syndrome are associated with reduced fetal growth and maternal undernutrition.

DESIGN

A nonconcurrent, prospective study of men and women whose mothers' heights and weights were recorded during pregnancy.

SETTING

Beijing, China.

PARTICIPANTS

627 men and women (mean age, 45 years) whose mothers' obstetric records were preserved.

MEASUREMENTS

Adult offspring's blood pressure, plasma glucose levels, insulin levels, and lipid concentrations during an oral glucose tolerance test. The main explanatory measurements were mothers' body mass index during pregnancy and offspring's birthweight and adult size.

RESULTS

After adjustment for sex and current body mass index, low birthweight was associated with elevated plasma glucose levels, insulin levels, triglyceride concentrations, and blood pressure. For every 1-kg increase in birthweight, systolic blood pressure decreased by 2.9 mm Hg (95% CI, 0.3 to 5.4 mm Hg) and the 2-hour plasma glucose level decreased by 5.1% (CI, 0.7% to 9.3%). Low maternal body mass index in early and late pregnancy was associated with elevated levels of plasma glucose, insulin, and triglycerides in adult offspring but was not associated with elevated blood pressure.

CONCLUSIONS

Risk for the insulin resistance syndrome may be partially established through low maternal body mass before pregnancy and consequent fetal undernutrition. This risk is independent of that associated with adult obesity. In developing countries such as China, improved nutrition in girls and young women may offer long-term benefits to offspring.

Long-term efficacy of plasma-derived hepatitis B vaccine: a 15-year follow-up study among Chinese children

To determine necessity and timing of booster of hepatitis B vaccine, we need to observe the duration of its protection. We report the results of a 15-year follow-up of a cohort of 649 children who participated a randomized, double blind, placebo-controlled trial on a plasma-derived hepatitis B vaccine in 1982. During the 15 years after vaccination, more vaccinated children had anti-HBs of 10 S/N ratios or over, compared with the controls, at all nine observations. At 15 years 50.0% (26/52) of the participants studied in the vaccinated group and 33.3% of the tested controls (18/54) retained anti-HBs levels of S/N ratios> or =10 (P < 0.09). However, since 5 years after vaccination, median S/N ratios of anti-HBs among the vaccinated children with detectable anti-HBs were lower than those of the controls except that detected at 15 years. 16.7% (9/54) of the tested children in the control group were HBsAg positive at 15 years after vaccination, in comparison with 1.9% (1/52) of the tested children in the vaccinated (P < 0.02). 28 chronic HBsAg carriers were identified in the control cohort over the 15 years, whereas only 1 case was noted in the vaccinated group (8.2% vs. 0.3%, P < 0.00001), corresponding to an efficacy of 96%.

[Analysis and comparison of the chemical composition of two preparations of Chinemys reevesii Gray]

Amino-acids, nitrogen content, soaking extracts, ash contents, trace elements have been systematically determined for the traditional preparation and food-bacteria preparation of Chinemys reevesii. The results have shown that all the analytical targets in food-bacteria preparation are higher than or close to those in traditional preparation. So the food-bacteria preparation is better in quality.