[Prevention and control of pediatric tinea capitis]

Tinea capitis is a superficial fungal infection of the scalp and hair caused by Dermatophytes. It represents the most prevalent superficial fungal infection among preadolescent children worldwide, including in developing countries such as China. The highly contagious nature of tinea capitis can result in outbreaks within communal settings for children. Furthermore, pustular lesions associated with this condition can lead to permanent scarring and hair loss, imposing a significant psychological burden on affected children and their parents. This article aims to provide a comprehensive literature review encompassing the susceptible person, epidemiological characteristics, trends, etiology, modes of transmission, clinical manifestations, treatment, and prevention strategies of tinea capitis. The ultimate objective is to raise awareness, implement effective prevention and control measures, interrupt the transmission cycle, and ultimately reduce the incidence of tinea capitis in the pediatric population.

[Patient-reported outcomes of locally advanced gastric cancer undergoing robotic versus laparoscopic gastrectomy: a randomized controlled study]

Objective: To compare the patient-reported outcomes and short-term clinical outcomes between robotic-assisted and laparoscopic-assisted radical gastrectomy for locally advanced gastric cancer. Methods: This single-center prospective randomized controlled trial was conducted in the Department of Gastrointestinal Surgery,Affiliated Hospital of Qingdao University from October 2020 to August 2022. Patients with locally advanced gastric cancer who were to undergo radical gastrectomy were selected and randomly divided into two groups according to 1∶1, and received robotic surgery and laparoscopic surgery, respectively. Patient-reported outcomes and short-term clinical outcomes (including postoperative complications, surgical quality and postoperative short-term recovery) were compared between the two groups by t test, Mann-Whitney U test, repeated ANOVA, generalized estimating equation, χ2 test and Fisher's exact test. Results: A total of 237 patients were enrolled for modified intention-to-treat analysis (120 patients in the robotic group, 117 patients in the laparoscopic group). There were 180 males and 59 females, aged (63.0±10.2) years (range: 30 to 85 years). The incidence of postoperative complications was similar between the robotic group and laparoscopic group (16.7% (20/120) vs. 15.4% (18/117), χ2=0.072, P=0.788). The robotic group had higher patient-reported outcomes scores in general health status, emotional, and social domains compared to the laparoscopic group, differences in time effect, intervention effect, and interaction effect were statistically significant (general health status: χ2 value were 275.68, 3.91, 6.38, P value were <0.01, 0.048, 0.041; emotional: χ2 value were 77.79, 6.04, 6.15, P value were <0.01, 0.014, 0.046; social: χ2 value were 148.00, 7.57, 5.98, P value were <0.01, 0.006, 0.048). However, the financial burden of the robotic group was higher, the differences in time effect, intervention effect and interaction effect were statistically significant (χ2 value were 156.24, 4.08, 36.56, P value were<0.01, 0.043,<0.01). Conclusion: Compared to the laparoscopic group, the robotic group could more effectively relieve postoperative negative emotions and improve recovery of social function in patients.

Comparison of first-line immunotherapy efficacy between advanced lung squamous cell carcinoma and pulmonary lymphoepithelioma-like carcinoma: A propensity score matching multicenter study

Background

Compared with other lung squamous cell carcinomas (LUSC), pulmonary lymphoepithelioma-like carcinoma (pLELC) is closely associated with Epstein-Barr virus (EBV) infections with a unique molecular profile and immune microenvironment. This study was thus established to compare the treatment response and effectiveness of immunotherapy between pLELC and LUSC.

Material and Methods

We enrolled 31 patients with pLELC and 116 with LUSC receiving first-line immunotherapy at three centers in China and compared the treatment response and effectiveness of immunotherapy. Propensity score matching (PSM) was used to balance the differences in baseline data between the two groups.

Results

Before PSM, progression-free survival and overall survival were longer in the pLELC group than in the LUSC group (progression-free survival: hazard ratio (HR), 1.67, 95% CI: 1.05-2.63, P = 0.028; overall survival: HR, 1.90, 95% CI: 1.06-3.40, P = 0.028). This remained unchanged after PSM (progression-free survival: HR, 1.79, 95% CI: 1.02-3.15, P = 0.044; overall survival: HR, 2.20; 95% CI: 1.10-4.37, P = 0.022).

Conclusion

pLELC showed a clinically meaningful survival benefit compared with traditional LUSC following immunotherapy. Subsequent studies should consider the role of the EBV in the tumor immune microenvironment of pLELC.

[Secular trends of age at menarche and age at menopause in women born since 1951 from a county of Shandong Province, China]

OBJECTIVE

To describe the secular trends of age at menarche and age at natural menopause of women from a county of Shandong Province.

METHODS

Based on the data of the Premarital Medical Examination and the Cervical Cancer and Breast Cancer Screening of the county, the secular trends of age at menarche in women born in 1951 to 1998 and age at menopause in women born in 1951 to 1975 were studied. Joinpoint regression was used to identify potential inflection points regarding the trend of age at menarche. Average hazard ratios (AHR) of early menopause among women born in different generations were estimated by performing multivariate weighted Cox regression.

RESULTS

The average age at menarche was (16.43±1.89) years for women born in 1951 and (13.99±1.22) years for women born in 1998. The average age at menarche was lower for urban women than that for rural women, and the higher the education level, the lower the average age at menarche. Joinpoint regression analysis identified three inflection points: 1959, 1973 and 1993. The average age at menarche decreased annually by 0.03 (P < 0.001), 0.08 (P < 0.001), and 0.03 (P < 0.001) years respectively for women born during 1951-1959, 1960-1973, and 1974-1993, while it remained stable for those born during 1994-1998 (P=0.968). As for age at menopause, compared with women born during 1951-1960, those born during 1961-1965, 1966-1970 and 1971-1975 showed a gradual decrease in the risk of early menopause and a tendency to delay the age at menopause. The stratified analysis presented that the risk of early menopause gradually decreased and the age of menopause showed a significant delay among those with education level of junior high school and below, but this trend was not obvious among those with education level of senior high school and above, where the risk of early menopause decreased and then increased among those with education level of college and above, and the corresponding AHRs were 0.90 (0.66-1.22), 1.07 (0.79-1.44) and 1.14 (0.79-1.66).

CONCLUSION

The age at menarche for women born since 1951 gradually declined until 1994 and leveled off, with a decrease of nearly 2.5 years in these years. The age at menopause for women born between 1951 and 1975 was generally delayed over time, but the trend of first increase and then decrease was observed among those with relatively higher education levels. In the context of the increasing delay in age at marriage and childbearing and the decline of fertility, this study highlights the necessity of the assessment and monitoring of women' s basic reproductive health status, especially the risk of early menopause.

[Taxonomic rank of human parasites]

Biological category is effective to indicate the evolution of organism populations between past and present. Conventional taxonomy of human parasites mainly depends on important morphological features, which suffers from a problem of categorizing related-genera species with similar morphological characteristics. With recent advances in molecular biological technologies, the effective applications of mitochondrial and ribosomal biomarkers and sequencing greatly improve the development of the taxonomic rank of human parasites. Worldwide, the classification of human parasites have been continuously revised and improved. Hereby, we re-categorize parasitic Protozoa, Trematoda, Cestoda and Nematoda, so as to provide insights into the researches on molecular systematics and genetic evolution of human parasites.

[Thinking and suggestions on pathway management of perioperative enhanced recovery after surgery in gastrointestinal tumors in China]

Enhanced recovery after surgery (ERAS) is a multimodal perioperative care program to decrease the risk of delayed hospitalization, medical complications, readmission and to improve patient short- and long-term outcomes with minimized level of surgical stress responses through multidisciplinary cooperation. Despite its huge success, the program has challenges for further optimization with a primary focus on modification according to the specific pathophysiology and perioperative management characteristics of patients with gastrointestinal tumors to improve the compliance and implementation rate of items. Patient education, prehabilitation, multimodal analgesia, precision surgery, early mobilization, early oral feeding and oral nutrition supplement (ONS) should be regarded as core terms suitable for all the patients. During the application of ERAS pathway management, it is necessary to fully understand the perioperative changes of organ function and pathophysiology, and to strictly implement the ERAS program and items based on evidence-based medicine. Moreover, the close collaboration of multidisciplinary teams is needed to improve the compliance and increase the adherence rate of ERAS protocol for patients, which emphasizes the dynamic, gap-free and whole course management that covers pre-hospital, pre-operative, intra-operative, post-operative and post-hospital periods. Concurrently, we encourage our patients and their families to participate in the whole healthcare activities. Even more concerning, it is indispensable to adjust ERAS program for special time and special patients. At present, several consensus and guidelines on the ERAS management of gastrointestinal tumor surgery have come out for clinical practice in China, which, however, still lacks a high-level evidence from more high-quality clinical trials conducted by Chinese researchers. It is urgent to carry out a series of large-scale randomized controlled studies in accordance with international standards to obtain high-level evidence-based medical evidence for clinical practice, which is problem-oriented and integrated with features of metabolism and perioperative management of gastrointestinal tumor surgery.

[Sharing the WHO guideline on control and elimination of human schistosomiasis to achieve the goal of schistosomiasis elimination in China]

Currently, the national schistosomiasis control program of China is moving from transmission interruption to elimination, and there are multiple challenges during the stage moving towards the progression of schistosomiasis elimination, including a high difficulty in shrinking snail-infested areas, unstable achievements for infectious source control, imperfect surveillance system and a reduction in schistosomiasis control and administration. Based on the core suggestions proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, recommendations on schistosomiasis surveillance system building, development of novel diagnostics, adjustment of the schistosomiasis control strategy and maintaining and improvements of the schistosomiasis control capability are proposed for the national schistosomiasis control program of China in the new era according to the actual status of schistosomiasis control in China. Formulation of the national schistosomiasis control strategy and goal from One Health perspective, verification of transmission interruption and elimination of schistosomiasis, precision implementation of schistosomiasis control interventions with adaptations to local circumstances, development and application of highly sensitive and specific diagnostics are recommended for elimination of schistosomiasis in China. In addition, the implementation of the 2022 WHO guideline on control and elimination of human schistosomiasis may guide the elimination of schistosomiasis in China.

[Analysis of the new WHO guideline to accelerate the progress towards elimination of schistosomiasis in China]

On February 2022, WHO released the evidence-based guideline on control and elimination of human schistosomiasis, with aims to guide the elimination of schistosomiasis as a public health problem in disease-endemic countries by 2030 and promote the interruption of schistosomiasis transmission across the world. Based on the One Health concept, six evidence-based recommendations were proposed in this guideline. This article aims to analyze the feasibility of key aspects of this guideline in Chinese national schistosomiasis control program and illustrate the significance to guide the future actions for Chinese national schistosomiasis control program. Currently, the One Health concept has been embodied in the Chinese national schistosomiasis control program. Based on this new WHO guideline, the following recommendations are proposed for the national schistosomiasis control program of China: (1) improving the systematic framework building, facilitating the agreement of the cross-sectoral consensus, and building a high-level leadership group; (2) optimizing the current human and livestock treatments in the national schistosomiasis control program of China; (3) developing highly sensitive and specific diagnostics and the framework for verifying elimination of schistosomiasis; (4) accelerating the progress towards elimination of schistosomiasis and other parasitic diseases through integrating the national control programs for other parasitic diseases.

[Contribution to global implementation of WHO guideline on control and elimination of human schistosomiasis by learning successful experiences from the national schistosomiasis control program in China]

Schistosomiasis is a parasitic disease that seriously hinders socioeconomic developments and threatens public health security. To achieve the global elimination of schistosomiasis as a public health problem by 2030, WHO released the guideline on control and elimination of human schistosomiasis on February, 2022, with aims to provide evidence-based recommendations for schistosomiasis morbidity control, elimination of schistosomiasis as a public health problem, and ultimate interruption of schistosomiasis transmission in disease-endemic countries. Following concerted efforts for decades, great achievements have been obtained for schistosomiasis control in China where the disease was historically highly prevalent, and the country is moving towards schistosomiasis elimination. This article reviews the successful experiences from the national schistosmiasis control program in China, and summarizes their contributions to the formulation and implementation of the WHO guideline on control and elimination of human schistosomiasis. With the progress of the "Belt and Road" initiative, the world is looking forward to more China's solutions on schistosomiasis control.

[Levels and trends of significant injury-caused deaths in the Chinese population, 2010-2019]

Objective: To analyze the level and changing trend of significant injury-caused deaths in the Chinese population from 2010 to 2019 and provide evidence for related intervention. Methods: Data on notable injury-caused deaths in areas under National Disease Surveillance Programs were collected from 2010 to 2019. Crude and standardized mortality rates of four significant injuries were calculated to describe the status of injury-caused deaths. The trend of changes in standardized mortality rates was analyzed using the Joinpoint regression model. Results: The overall trend of standardized mortality rate on an injury during 2010-2019 was consistently decreasing (AAPC=-3.5%, P<0.001) while the general direction of accidental fall standardized mortality rate was increasing (AAPC=1.0%, P=0.104). The standardized mortality rate for significant injuries fluctuated with age, increasing for those aged 50-79 years (AAPC=3.9% for the 50- group, AAPC=5.6% for the 60- group, and AAPC=4.6% for the 70- group, all P<0.001). The standardized mortality rates for all major injuries were higher in males than those in females, with road traffic accidents and drowning declining faster in males than that in females (AAPC=-5.3% in the male road traffic accident group, AAPC=-3.8% in the female road traffic accident group, AAPC=-4.0% in the male drowning group, AAPC=-3.5% in the female drowning group, all P<0.001), and suicide and sequelae declining faster in females than that in males (AAPC=-6.4% in female, AAPC=-4.7% in male, all P<0.001). The standardized mortality rate for significant injuries was higher in rural than that in urban areas and decreased faster than that in urban areas. The central region had the highest standardized mortality rate for suicide and sequelae. The western part had the highest standardized mortality rates for road traffic accidents, accidental falls, and drowning, with the fastest decline in road traffic accidents and drowning (AAPC=-5.3% in the road traffic accident group and AAPC=-5.3% in the drowning group, both P<0.001). Conclusions: The mortality rate from significant injuries in the Chinese population showed a continuous downward trend from 2010 to 2019, with a rebound in the standardized mortality rate from accidental falls in recent years among the elderly, males, rural residents, and central and western regions being the focus of future prevention and control.

[The effects of robotic-assisted versus laparoscopic-assisted radical right hemicolectomy on short-term outcome and long-term prognosis based on propensity score matching]

Objective: To compare the short-term and long-term outcomes between robotic-assisted and laparoscopic-assisted radical right hemicolectomy in patients with adenocarcinoma of the right colon. Methods: Retrospective review of a prospectively collected database identified 288 right colon cancer patients who underwent either robotic-assisted (n=57) or laparoscopic-assisted right hemicolectomy (n=231) between October 2014 and October 2020 at Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University. There were 161 males and 127 females, aging (60.3±12.8) years (range: 17 to 86 years). After propensity score matching as 1∶4 between robotic-assisted and laparoscopic-assisted right hemicolectomy, there were 56 cases in robotic group and 176 cases in laparoscipic group. Perioperative outcomes and overall survival were compared between the two groups using t test, Wilcoxon rank sum test, χ² test, Fisher exact test, Kaplan-Meier method and Log-rank test, respectively. Results: The total operative time was similar between the robotic and laparoscopic group ((206.9±60.7) minutes vs. (219.9±56.3) minutes, t=-1.477, P=0.141). Intraoperative bleeding was less in the robotic group (50 (20) ml vs. 50 (50) ml, Z=-4.591, P<0.01), while the number of lymph nodes retrieved was significantly higher (36.0±10.0 vs. 29.0±10.1, t=4.491, P<0.01). Patients in robotic group experienced significantly shorter hospital stay, shorter time to first flatus, and defecation (t: -2.888, -2.946, -2.328, all P<0.05). Moreover, the overall peri-operative complication rate was similar between robotic and laparoscopic group (17.9% vs. 22.7%, χ²=0.596,P=0.465). The 3-year overall survival were 92.9% and 87.9% respectively and the 3-year disease-free survival rates were 83.1% and 82.6% with no statistical significance between the robotic and laparoscopic group (P>0.05). Conclusions: Compared to laparoscopic-assisted right hemicolectomy, robot-assisted right hemicolectomy could improve some short-term clinical outcomes. The two procedures are both achieving comparable survival.

[Questionnaire investigation of radiation rectal injury with anxiety, depression and somatic disorder]

Objective: To observe the incidence and treatment of radiation rectal injury complicated with anxiety, depression and somatic symptom disorder. Methods: A cross-sectional survey research method was carried out. Patients with radiation rectal injury managed by members of the editorial board of Chinese Journal of Gastrointestinal Surgery were the subjects of investigation. The inclusion criteria of the survey subjects: (1) patients suffered from pelvic tumors and received pelvic radiotherapy; (2) colonoscopy showed inflammatory reaction or ulcer in the rectum. Exclusion criteria: (1) patient had a history of psycho-somatic disease before radiotherapy; (2) patient was unable to use a smart phone, unable to read and understand the questions in the questionnaire displayed on the phone; (3) patient refused to sign an informed consent form. According to the SOMA self-rating scale, PHQ-15 self-rating scale, GAD-7 and PHQ-9 self-rating scale, the electronic questionnaire of "Psychological Survey of Radiation Proctitis" was designed. The questionnaire was sent to patients with radiation rectal injury managed by the committee through the WeChat group. Observational indicators: (1) radiation rectal injury symptom assessment: using SOMA self-rating scale, radiation rectal injury symptom classification: mild group (≤3 points), moderate group (4-6 points) and severe group (> 6 points); (2) incidence of anxiety, depression and physical disorder: using GAD-7, PHQ-9 and PHQ-15 self-rating scales respectively for assessment; (3) correlation of radiation rectal injury symptom grading with anxiety, depression, and somatic symptom disorder. Results: Seventy-one qualified questionnaires were collected, of which 41 (56.9%) were from Guangzhou. Among the 71 patients, 6 were males and 65 were females; the mean age was (55.7±9.3) years old and 48 patients (67.6%) were less than 60 years old; the median confirmed duration of radiation rectal injury was 2.0 (1.0, 5.0) years. (1) Evaluation of symptoms of radiation rectal injury: 18 cases of mild (25.4%), 27 cases of moderate (38.0%), and 26 cases of severe (36.6%). (2) Incidence of anxiety, depression and somatic disorder: 12 patients (16.9%) without comorbidities; 59 patients (83.1%) with anxiety, depression, or somatic disorder, of whom 2 patients only had anxiety, 1 patient only had depression, 9 only had somatic disorder, 2 had anxiety plus depression, 4 had anxiety plus somatic disorder, 2 had depression plus somatic disorder, and 40 had all three symptoms. (3) correlation of radiation rectal injury grading with anxiety, depression, and somatic symptom disorder: as compared to patients in mild group and moderate group, those in severe group had higher severity of anxiety and somatic symptom disorder (Z=-2.143, P=0.032; Z=-2.045, P=0.041), while there was no statistically significant difference of depression between mild group and moderate group (Z=-1.176, P=0.240). Pearson correlation analysis revealed that radiation rectal injury symptom score was positively correlated with anxiety (r=0.300, P=0.013), depression (r=0.287, P=0.015) and somatic symptom disorder (r=0.344, P=0.003). Conclusions: The incidence of anxiety, depression, and somatic symptom disorder in patients with radiation rectal injury is extremely high. It is necessary to strengthen the diagnosis and treatment of somatic symptom disorder, so as to alleviate the symptoms of patients with pelvic perineum pain and improve the quality of life.

[Identification of factors affecting Oncomelania hupensis density in Eastern Dongting Lake regions]

OBJECTIVE

To evaluate the impact of water pollutants, water levels and meteorological factors on the Oncomelania hupensis density in Eastern Dongting Lake regions, so as to provide insights into schistosomiasis control.

METHODS

O. hupensis snails were surveyed using a systematic sampling method in snail-infested marshlands in Eastern Dongting Lake regions from 2007 to 2014, and data pertaining to water pollutants, water levels and meteorological factors were collected. The duration of submergence and the date of the start of submergence were calculated. The snail density and its influencing factors were descriptively analyzed, and a linear mixed model was generated to examine the impacts of variables on the snail density. In addition, smooth curves were fitted to investigate the relationship between snail density and variables.

RESULTS

The snail density appeared a fluctuation in Eastern Dongting Lake regions during the period from 2007 to 2014, with the highest density on October, 2010 (52.79 snails/0.1 m²) and the lowest density on January 2009 (2.15 snails/0.1 m²). Linear mixed-model analysis showed that permanganate index, total phosphorus and the date of the start of submergence affected the snail density (t = 6.386, -2.920 and -3.892, all P values < 0.01). Smooth curve analysis revealed that the associations of the snail density with the permanganate index and total phosphorus appeared an approximately quadratic curve. After the end of April, the earlier date of the start of submergence resulted in a higher snail density.

CONCLUSIONS

Permenganate index, total phosphorus and the date of the start of submergence affect the O. hupensis snail density in Eastern Dongting Lake regions.

[Adherence to adjuvant with therapy imatinib in patients with gastrointestinal stromal tumor: a national multi-center cross-sectional study]

Objective: To analyze the current adherence to imatinib in patients with gastrointestinal stromal tumors (GIST) in China and its influencing factors. Methods: A cross-sectional survey was conducted. Study period: from October 1, 2020 to November 31, 2020. Study subjects: GIST patients taking imatinib who were diagnosed and treated in public tertiary level A general hospitals or oncology hospitals; those who had not been pathologically diagnosed, those who never received imatinib, or those who had taken imatinib in the past but stopped afterwards were excluded. The Questionnaire Star online surgery platform was used to design a questionnaire about the adherence to adjuvant imatinib therapy of Chinese GIST patients. The link of questionnaire was sent through WeChat. The questionnaire contained basic information of patients, medication status and Morisky Medication Adherence Scale. Results: A total of 2162 questionnaires from 31 provinces, autonomous regions, and municipalities were collected, of which 2005 were valid questionnaires, with an effective rate of 92.7%. The survey subjects included 1104 males and 901 females, with a median age of 56 (22-91) years old. Working status: 609 cases (30.4%) in the work unit, 729 cases (36.4%) of retirement, 667 cases of flexible employment or unemployment (33.3%). Education level: 477 cases (23.8%) with bachelor degree or above, 658 cases (32.8%) of high school, 782 cases (39.0%) of elementary or junior high school, 88 cases (4.4%) without education. Marital status: 1789 cases (89.2%) were married, 179 cases (8.9%) divorced or widowed, 37 cases (1.8%) unmarried. Two hundred and ninety-four patients (14.7%) had metastasis when they were first diagnosed, including 203 liver metastases, 52 peritoneal metastases, and 39 other metastases. One thousand eight hundred and sixty-nine patients underwent surgical treatment, of whom 1642 (81.9%) achieved complete resection. The median time of taking imatinib was 25 (1-200) months. Common adverse reactions of imatinib included 1701 cases (84.8%) of periorbital edema, 1031 cases (51.4%) of leukopenia, 948 cases (47.3%) of fatigue, 781 cases (39.0%) of nausea and vomiting, 709 cases (35.4%) of rash, and 670 cases (33.4%) of lower extremity edema. The score of the Morisky Medication Adherence Scale showed that 392 cases (19.6%) had poor adherence, 1023 cases (51.0%) had moderate adherence, and 590 cases (29.4%) had good adherence. Univariate analysis showed that gender, age, work status, economic income, residence, education level, marriage, the duration of taking medication and adverse reactions were associated with adherence to adjuvant imatinib therapy (all P<0.05). Multivariate analysis showed that female (OR=1.264, P=0.009), non-retirement (OR=1.454, P=0.001), monthly income ≤4000 yuan (OR=1.280, P=0.036), township residents (OR=1.332, P=0.005), unmarried or divorced or widowed (OR=1.362, P=0.026), the duration of imatinib medication >36 months (OR=1.478, P<0.001) and adverse reactions (OR=1.719, P=0.048) were independent risk factors for poor adherence to adjuvant imatinib. Among patients undergoing complete resection, 324 (19.7%) had poor adherence, 836 (50.9%) had moderate adherence, and 482 (29.4%) had good adherence. Meanwhile, 55 patients with good adherence (11.4%) developed recurrence after surgery, 121 patients with moderate adherence (14.5%) developed recurrence, 61 patients with poor adherence (18.8%) developed recurrence, and the difference was statistically significant (P=0.017). Conclusions: The adherence to adjuvant therapy with imatinib in Chinese GIST patients is relatively poor. Females, non-retirement, monthly income ≤4000 yuan, township residents, unmarried or divorced or widowed, the duration of imatinib medication >36 months, and adverse reactions are independently associated with poor adherence of GIST patients. Those with poor adherence have a higher risk of recurrence after surgery. Positive interventions based on the above risk factors are advocated to improve the prognosis of patients with GIST.

[Definition of tumor rupture in gastrointestinal stromal tumor]

Tumor rupture is a common clinical event in the process of tumorigenesis, progression, diagnosis and treatment of gastrointestinal stromal tumor, which is closely associated with tumor recurrence, metastasis and poor prognosis. Tumor rupture may be associated with some intrinsic biological aggressiveness qualities, such as large tumor size, high mitotic count, and KIT exon 11 deletion mutations involving codons 557 and 558, and may be relatively more frequent with small intestine GIST and excellent response to imatinib neoadjuvant therapy resulting in tumor tissue rapid liquefacient and necrosis. The triggering factors involve sudden increase in abdominal pressure, external pressure, collision and improper surgical operation, etc. Tumor rupture is considered as an important risk factor of recurrence after macroscopically complete resection of tumor, and an indication for determining interval or even lifelong adjuvant therapy with imatinib according to guidelines. However, there is no consensus or universally accepted definition of tumor rupture, and, consequently, its incidence varies greatly across reported series and lacks detailed epidemiological data. Without pre-defined criteria, it is difficult to assess the clinical significance of rupture. We reviewed the relevant literature and international guidelines, and generally divided tumor rupture into spontaneous rupture and iatrogenic rupture. Based on the Oslo criteria, we proposed the following six definitions for tumor rupture: (1) tumor fracture or spillage; (2) blood-stained ascites; (3) gastrointestinal perforation at the tumor site; (4) microscopic infiltration of an adjacent organ; (5) intralesional dissection or piecemeal resection; (6) incisional biopsy. The following types of minor defects of tumor integrity should not be defined as rupture: (1) mucosal defects or spillage contained within the gastrointestinal lumen; (2) microscopic tumor penetration of the peritoneum or iatrogenic damage only to the serosa; (3) uncomplicated transperitoneal needle biopsy; (4) R1 resection. In addition, we further emphasize the importance of identifying risk factors of tumor rupture, prevention and positive intervention.

[A multi-center retrospective study of perioperative chemotherapy for gastric cancer based on real-world data]

Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.

Intrinsic Spin Susceptibility and Pseudogaplike Behavior in Infinite-Layer LaNiO_{2}

The recent discovery of superconductivity in doped infinite-layer nickelates has stimulated intensive interest, especially for similarities and differences compared to that in cuprate superconductors. In contrast to cuprates, although earlier magnetization measurement reveals a Curie-Weiss-like behavior in undoped infinite-layer nickelates, there is no magnetic ordering observed by elastic neutron scattering down to liquid helium temperature. Until now, the nature of the magnetic ground state in undoped infinite-layer nickelates was still elusive. Here, we perform a nuclear magnetic resonance (NMR) experiment through ^{139}La nuclei to study the intrinsic spin susceptibility of infinite-layer LaNiO_{2}. First, the signature for magnetic ordering or freezing is absent in the ^{139}La NMR spectrum down to 0.24 K, which unambiguously confirms a paramagnetic ground state in LaNiO_{2}. Second, a pseudogaplike behavior instead of Curie-Weiss-like behavior is observed in both the temperature-dependent Knight shift and nuclear spin-lattice relaxation rate (1/T_{1}), which is widely observed in both underdoped cuprates and iron-based superconductors. Furthermore, the scaling behavior between the Knight shift and 1/T_{1}T has also been discussed. Finally, the present results imply a considerable exchange interaction in infinite-layer nickelates, which sets a strong constraint for the proposed theoretical models.

[Expert consensus on the strategy and measures to interrupt the transmission of schistosomiasis in China]

Since 2015 when the transmission of schistosomiasis was controlled in China, the country has been moving towards elimination of schistosomiasis, with the surveillance-response as the main interventions for schistosomiasis control. During the period of the 13th Five-Year Plan, the transmission of schistosomiasis had been interrupted in four provinces of Sichuan, Jiangsu, Yunnan and Hubei and the prevalence of schistosomiasis has been at the historically lowest level in China. As a consequence, the goal set in The 13th Five-Year National Schistosomiasis Control Program in China is almost achieved. However, there are multiple challenges during the stage moving towards elimination of schistosomiasis in China, including the widespread distribution of intermediate host snails and complicated snail habitats, many types of sources of Schistosoma japonicum infections and difficulty in management of bovines and sheep, unmet requirements for the current schistosomiasis control program with the currently available tools, and vulnerable control achievements. During the 14th Five-Year period, it is crucial to consolidate the schistosomiasis control achievements and gradually solve the above difficulties, and critical to provide the basis for achieving the ultimate goal of elimination of schistosomiasis in China. Based on the past experiences from the national schistosomiasis control program and the challenges for schistosomiasis elimination in China, an expert consensus has been reached pertaining to the objectives, control strategy and measures for The 14th Five-Year National Schistosomiasis Control Program in China, so as to provide insights in to the development of The 14th Five-Year National Schistosomiasis Control Program in China.

[Relationship of plasma vitamin A levels between neonates and pregnant women in third trimester]

OBJECTIVE

To study the correlation of plasma vitamin A (VitA) levels between neonates and pregnant women in third trimester.

METHODS

A total of 688 pregnant women were recruited in Yuanshi and Laoting counties of Hebei Province, from May to June 2009. Venous blood samples of women before delivery and cord blood samples of newborns were collected and measured for retinol (retinol concentration was used to reflect VitA level) using high performance liquid chromatography assay. According to venous blood plasma retinol concentration, maternal VitA nutritional status was divided into deficiency (<0.70 μmol/L), marginal deficiency (0.70-<1.05 μmol/L), and sufficiency (≥1.05 μmol/L). According to cord blood plasma retinol concentration, neonatal VitA nutritional status was divided into deficiency (<0.35 μmol/L), marginal deficiency (0.35-<0.70 μmol/L), and sufficiency (≥0.70 μmol/L); neonatal VitA relative deficiency was further defined as cord blood plasma retinol concentration lower than the 10th percentile. VitA placental transport ratio was defined as retinol concentration in the neonates divided by that in pregnant women. Multivariable fractional polynomials (MFP) model and Pearson correlation were used to study the dose-response relationship between maternal and neonatal plasma VitA levels, Logistic regression model to estimate the effect of maternal VitA nutritional status on neonatal VitA deficiency, and MFP model and Spearman correlation to describe the relationship between maternal VitA level and VitA placental transport ratio.

RESULTS

The average retinol concentration of the pregnant women was (1.15±0.30) μmol/L, and the prevalence of VitA deficiency and marginal deficiency were 4.5% and 37.8%, respectively. Average retinol concentration of the neonates was (0.78±0.13) μmol/L, and no neonates were VitA deficiency, 28.2% of the neonates were marginal deficiency. After multivariable adjustment, the VitA level of the neonates was positively and linearly related to maternal VitA level (p^m=1, P<0.05), with the corresponding Pearson correlation coefficient of 0.13 (P<0.01). As compared with the women with sufficient VitA, those with VitA deficiency (crude OR=2.20, 95%CI:1.04-4.66) and marginal deficiency (crude OR=1.43, 95%CI:1.01-2.02) had higher risks to deliver neonates with VitA marginal deficiency; while the risks turned to be non-significant after multivariable adjustment. The pregnant women with VitA deficiency had higher risk to deliver neonates with relative VitA deficiency before and after multivariable adjustment (crude OR=3.02, 95%CI:1.21-7.50; adjusted OR=2.76, 95%CI:1.05-7.22). The maternal VitA level was negatively and non-linearly correlated with placental transport ratio (p^m= -0.5, P<0.05), with corresponding adjusted Spearman correlation coefficient of -0.82 (P<0.001).

CONCLUSION

There was a positive linear dose-response relationship between VitA levels of newborns and pregnant women in third trimester, indicating that neonatal VitA storing levels at birth was affected by maternal VitA nutritional status.

[Progress of schistosomiasis control in Dongting Lake regions]

As an ancient parasitic disease, schistosomiasis has been endemic in Dongting Lake areas for more than 2 100 years. In the early 20th century, the first human case of schistosomiasis in China was reported in Dongting Lake areas, which was paid extensive attention. After the founding of the People's Republic of China, large-scale schistosomiasis control activities were launched promptly in Dongting Lake areas, and great successes have been achieved following the three stages of control efforts, including the snail control-based stage, synchronous chemotherapy for humans and livestock-based control stage and infectious source control-based control stage. In 2015, transmission control of schistosomiasis was achieved in Hunan Province. This paper comprehensively describes the discovery and control of schistosomiasis, analyzes the challenges for the current schistosomiasis control programs and proposes the emphasis for future control activities in Dongting Lake areas, so as to provide insights into the schistosomiasis control program in this area.

[Challenges and countermeasures of schistosomiasis control in Hunan Province in the new era]

This paper describes the current epidemic characteristics and endemic status of schistosomiasis, analyzes the main challenges of schistosomiasis control and proposes the emphasis and interventions for future schistosomiasis control activities in Hunan Province, so as to provide insights into the elimination of schistosomiasis in Hunan Province.

[Implications, spiritual characteristics and practical significance of Chinese schistosomiasis control culture]

The culture of schistosomiasis control is specific in the history of Chinese culture. Broadly speaking, the culture of schistosomiasis control is a summary of specific social mood, social consciousness and material culture created by Chinese populations during the progress of schistosomiasis control since the founding of the People's Republic of China. Narrowly speaking, the culture of schistosomiasis control is the spiritual culture that is jointly created and nurtured by schistosomiasis control workers since the founding of the People's Republic of China. The spiritual features of Chinese schistosomiasis control culture are characterized by the patriotism and care about the people, the matter-to-fact attitude, the pioneering and enterprising spirit, and the spirit of sacrifice and dedication. The ultimate goal of the research on the culture of schistosomiasis control is to facilitate the achievement of the strategic goal of Healthy China 2030 as scheduled, accelerate the progress towards elimination of schistosomiasis, and to promote the sustainable development of schistosomiasis control in China.

[Effects of long non-coding RNA FLJ37505 on the proliferation and migration of bladder cancer cells]

Objective: To examine the expression of long-chain non-coding RNA (lncRNA) FLJ37505 in bladder cancer tissues and cell lines, and to analyze the molecular mechanism of FLJ37505 to inhibit the proliferation and migration of bladder cancer cells. Methods: Quantitative Real-time PCR(qPCR) was used to analyze the relative expression of FLJ37505 in 63 cases of bladder cancer tissues and bladder cancer cell lines (T24, J82, 5637, BIU-87 and UM-UC-3). The bladder cancer cell lines with the least expression of FLJ37505 were divided into control group (transfected with blank plasmid) and FLJ37505 group (transfected with a plasmid carrying the FLJ37505 sequence) according to random number method. MTS assay and scratch assay were used to detect the effect of up-regulation of FLJ37505 expression on cell proliferation and migration. Bioinformatics predicts the target gene of FLJ37505. The dual luciferase reporter system detects the binding of FLJ37505 to the target gene. qPCR and Western blot were used to detect the effect of FLJ37505 on the expression of target gene. Results: Compared with adjacent tissues, FLJ37505 expression was lower in bladder cancer tissue [(4.90±0.79) vs (0.89±0.28), P<0.05]. Compared with human normal bladder tubular epithelial cells, the expression of FLJ37505 was lower in bladder cancer cell lines (P<0.05), and FLJ37505 has the lowest expression in UM-UC-3 cells (P<0.01). Compared with the control group, the expression of FLJ37505 in UM-UC-3 cells of FLJ37505 group was higher [(0.79±0.04) vs (9.92±1.17), P<0.01]. Compared with the control group, the proliferation ability of UM-UC-3 cells in FLJ37505 group was inhibited (P<0.05), and the cell migration ability was also inhibited (P<0.01). Bioinformatics showed that the target gene of FLJ37505 is miR-203a-3p, and the target gene of miR-203a-3p is inositol polyphosphate 4-phosphatase typeⅡ (INPP4B). The dual luciferase reporter gene system showed that FLJ37505 could complement the miR-203a-3p (P<0.01), and miR-203a-3p could complement the INPP4B mRNA (P<0.01). Compared with the control group, the expression of miR-203a-3p was lower [(1.00±0.05) vs (0.20±0.02), P<0.01], the expression of INPP4B in mRNA and protein levels of UM-UC-3 cells in FLJ37505 group was significantly increased (all P<0.01). Conclusions: The expression of FLJ37505 was significantly decreased in bladder cell carcinoma and bladder cancer cells. Up-regulation of FLJ37505 significantly inhibits the proliferation and migration of bladder cell carcinoma UM-UC-3 cells, and the mechanism might be up-regulating the expression of the INPP4B gene by adsorbing miR-203a-3p.

Adjuvant chemotherapy for patients with gastric neuroendocrine carcinomas or mixed adenoneuroendocrine carcinomas

BACKGROUND

The aim of this study was to evaluate whether adjuvant chemotherapy is associated with improved survival in patients with resectable gastric neuroendocrine carcinomas (G-NECs) or mixed adenoneuroendocrine carcinomas (G-MANECs).

METHODS

The study included patients with G-NECs or G-MANECs who underwent surgery in one of 21 centres in China between 2004 and 2016. Propensity score matching analysis was used to reduce selection bias, and overall survival (OS) in different treatment groups was estimated by the Kaplan-Meier method.

RESULTS

In total, 804 patients with resectable G-NECs or G-MANECs were included, of whom 490 (60·9 per cent) received adjuvant chemotherapy. After propensity score matching, OS in the chemotherapy group was similar to that in the no-chemotherapy group. Among patients with G-NECs, survival in the fluorouracil (5-FU)-based chemotherapy group and the non-5-FU-based chemotherapy group was similar to that in the no-chemotherapy group. Similarly, etoposide plus cisplatin or irinotecan plus cisplatin was not associated with better OS in patients with G-NECs. Among patients with G-MANECs, OS in the non-5-FU-based chemotherapy group was worse than that in the no-chemotherapy group. Patients with G-MANECs did not have better OS when platinum-based chemotherapy was used.

CONCLUSION

There was no survival benefit in patients who received adjuvant chemotherapy for G-NECs or G-MANECs.

[Impact of water body environments on the microbial community of Oncomelania hupensis snails in marshlands around the eastern Dongting Lake]

OBJECTIVE

To evaluate the effects of water body environments on the microbial community of Oncomelania hupensis snails in marshlands of the eastern Dongting Lake where natural extinction of O. hupensis snails are found, so as to explore the correlation between the natural extinction of O. hupensis snails and the microbial community in snails.

METHODS

Snails were caged water bodies in the Qianliang Lake marshland (Qianliang Lake regions) where natural extinction of snails was found and in the Junshan Park marshland (Junshan Park regions) in the eastern Dongting Lake for 30 days, and then all snails were collected and identified for survival or death. DNA sequencing of the fungi and bacteria was performed in snails before and after immersion in waters, and the biodiversity and abundance were analyzed.

RESULTS

The survival rates of O. hupensis snails were 28.0% (70/250) and 64.8% (162/250) in Qianliang Lake regions and Junshan Park regions 30 days after immersion in waters, respectively (χ² = 81.365, P < 0.01). The number of the fungal community and the biodiversity of the bacterial community were both greater in snails caged in Qianliang Lake regions post-immersion than pre-immersion, and there was a significant difference in the structure of the fungal and bacterial communities. The microbial community with a significant difference included Flavobacteriaceae,which was harmful to O. hupensis snails.

CONCLUSIONS

The water body environment affects the composition of the microbial community in O. hupensis snails in marshlands with natural snail distinction around the eastern Dongting Lake; however, further studies are required to investigate whether the natural distinction of snails is caused by water body environments-induced changes of the microbial spectrum in O. hupensis snails.

[Institutional delivery rate in minority inhabited areas of China from 1996 to 2017]

Objective: To describe the secular trends of institutional delivery (ID) rate in minority inhabited areas of China from 1996 to 2017 according to national health policies. Methods: The number of live births and IDs for each county/district in 31 provinces of China were derived from the datasets collected by the Office for National Maternal & Child Health Statistics of China. Information on health policies and ethnical areas was derived from official governmental websites. The calendar years were divided into three periods: pre-program period (1996 to 1999), program implementation period (2000 to 2008) and post-program period (2009 to 2017). Minority autonomous regions, autonomous prefectures, and autonomous counties were defined as minority inhabited areas. The ethnic that a county was classified into was determined by a principle of close proximity to the name of the county or its next higher level administrative division. A total of 700 counties in minority inhabited areas were included in the analysis. Results: A total of 45 684 265 live births including 35 098 855 delivered in institutions were analyzed. The ID rate in minority inhabited areas was 37.5% (696 221/1 856 164) in 1996 and 99.2% (2 371 209/2 390 131) in 2017, with an annual growth rate of 4.7%. During the 22-years period, the ID rates in the eastern, central and western regions increased simultaneously, with the annual growth rates of 3.1%, 4.2% and 4.9% respectively. The difference between the eastern and western regions decreased steadily from 16% in 1996 to <1% in 2017 and the difference between the urban and rural areas decreased from 32.1% in 1996 to <1% in 2017. Besides, the ID rates in Tibetan and Yi inhabited areas with lower baseline levels increased 73 and 63 percentage points respectively. The number of counties with the ID rate of <96% were substantially reduced from 589 in 1996 to 72 in 2017; the 71 counties were all located in national deep poverty-stricken areas named Three Districts and Three States, predominantly involving Tibetan (58), Yi (6), Uygur (2) and Lisu (2) ethnics. Conclusion: During the past 22 years, the ID rate in minority inhabited areas in China has dramatically increased, achieving the goal of 2 020 ahead of schedule, but there remains a few western counties where ID rates are still<96%, indicating that minority inhabited western areas should be focused in developing national policies concerning institutional delivery.

[Effect analysis of 60 cases of modified septoplasty]

Objective:To investigate the clinical efficacy and operative skills of modified septum plasty in the treatment of deviated nasal septum. Method:Retrospectively analyzed the case characteristics, surgical methods, postoperative complications, VAS score and nasal resistance value of 60 patients who received nasal septum surgery. Result:The VAS score of 28 patients who underwent improved septoplasty was significantly lower than that before surgery, and the difference was statistically significant(P<0.01). The postoperative nasal resistance of the narrow side of the nasal cavity and total nasal resistance of the patients were significantly lower than those before the operation, and the difference was statistically significant(P<0.01 or P<0.05). Conclusion:Modified nasal septum plasty is a safe and effective method for the treatment of nasal septum deviation, which is worthy of clinical promotion.

[Expression of macrophage migration inhibitory factor gene in placenta tissue and its correlation with gestational diabetes mellitus]

Objective: To investigate the relationship between the expression of macrophage migration inhibitory factor (MIF) gene and the incidence of gestational diabetes mellitus (GDM) in Chinese Han population in northern China. Method: This study was consisted of 126 GDM women and 150 cases of healthy subjects who came from the obstetrics department of Maternity Hospital of Qingdao University and Maternity and Child Care Hospital of Donggang District of Rizhao. The protein expression of MIF in placenta tissue was detected by Western blot method. The blood glucose, insulin levels and other clinical physicochemical index were tested. The differences of MIF, fasting blood-glucose (FBG), fasting insulin (FIN) and the homeostasis model assessment of insulin resistance (HOMA-IR) were compared between the two groups of pregnant women. Result: The level of MIF protein in GDM group (0.85±0.10) was higher than that in healthy pregnant group (0.12±0.09), with significant difference (P<0.001). Insulin resistance index in GDM group were higher than that in healthy pregnant group, with significant difference (P<0.001). Conclusion: The expression of MIF in placental tissues of GDM women was increased and correlated with insulin resistance in GDM patients, suggesting that MIF may play an important role in the occurrence and development of GDM.

[Small interference of transcription factor Snail contribute to enhanced cisplatin sensitivity on human laryngeal resistant cancer cells]

Objective:To study the relationship between transcription factor Snail and the sensitivity of cisplatin on human laryngeal resistant cancer cells.Method:siRNA interference of Snail was transfected by small RNA interference technology. The interference efficiency on mRNA level were detected by RT-qPCR assay; the expression of Snail protein level was assessed by immunofluorescence. The inhibition ratio of different cisplatin concentration (0, 1, 2, 4, 8, 16 μg/ml) was detected by CCK-8 assay; the protein level of Snail, E-cadherin, MDR1were detected by Western blot assay.Result:RT-qPCR assay show the expression of Snail on mRNA level was decreased to (67.85±9.50)% after transfection in Hep-2/CDDP cell(P<0.05). Immunofluorescence show fluorescence intensity of si-Hep-2/CDDP group was reduced both in nucleus and cytoplasm; CCK-8 assay show the inhibitory ratio of transfected group was increased compared to negative control and Hep-2/CDDP group in different cisplatin concentration (0, 1, 2, 4, 8, 16 μg/ml) (P<0.05). Western blot assay show the protein expression of Snail and MDR1 were down-regulated in transfected Hep-2/CDDP cells (allP<0.05), while epithelial marker E-cadherin was up-regulated in protein level (P<0.05).Conclusion:Small interference of transcription factor Snail could increase the expression of E-cadherin while decrease the expression of MDR1, and it was confirmed that interference Snail contribute to enhanced cisplatin sensitivity on human laryngeal resistant cancer cells.

[Investigation of epithelial-mesenchymal transition induced by cisplatin on human laryngeal resistant cancer cells]

Objective:To investigate the mechanism between epithelial-mesenchymal transition (EMT) and cisplatin induced resistant cell subline and the malignant biological characteristics, to explore EMT in human hep-2 laryngeal resistant cells. Method:Using cisplatin-resistant cells (hep-2/CDDP) and non-resistant cells (hep-2) established in our previous study; the invasion and migration biological behaviors were detected by transwell and scratch assay; the expressions of E-cadherin, Zo-1, Snail, Slug, Twist1, Vimentinon in the mRNA level were detected by RT-qPCR and the protein level by Western blot. Result:Transwell and scratch assay show the invasion and migration behaviors were increased in hep-2/CDDP cells (P<0.05), the epithelial marker E-cadherin and Zo-1 were downregulated in hep-2/CDDP cells (all P<0.05), transcription factor Snail, Slug were upregulated in mRNA and protein level (all P<0.01) while Twist1 had no significant changed in protein level (P>0.05), the expression of mesenchymal marker Vimentin was also increased in mRNA and protein levels in cisplatin resistant cells (P<0.01). It was confirmed that the hep-2/CDDP cells possessed EMT phenotypes. Conclusion:The cisplatin resistant laryngeal cancer cells perform higherinvasion and migration biological behaviors,and the mechanisms of increased ability of invasion and migration induced by cisplatin was associated to eEMT, study on signal path related to EMT may overcome cisplatin resistance and reduce invasion and migration behaviors.

[Impact of HIV/HBV infection and HIV/HBV co-infection on outcomes of pregnancy]

Both HIV and HBV infection have become major health problems, of global concern, due to the high prevalence in the past few decades. Data from cumulated epidemiological surveys have shown the links between maternal HIV or HBV infection and adverse outcomes on pregnancy. Maternal HIV or HBV infection may also increase the mother-to-child (MTCT) transmission of the two diseases. However, association between HIV-HBV co-infection and adverse pregnancy is still inconclusive. Does maternal HIV-HBV co-infection have an impact on mother-to-child transmission on either HIV or HBV? Study on effective precautionary measures to promote both maternal and child's health is deemed necessary.

[Effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand]

Objective: To observe the effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand. Methods: Forty-six patients with scar contracture after deep partial-thickness or full-thickness burn injury of dorsal hand hospitalized in our department from March 2013 to February 2015 were divided into routine training group (RT, n=18) and comprehensive training group (CT, n=28) according to their willingness. Two weeks after the wounds were healed, patients in group RT were treated with functional training of hands and self-made pressure gloves, while patients in group CT were treated with self-made hand flexing training band (consisting of nylon strap, flexing band, and velcro) on the basis of those in group RT. All patients were treated for 3 months. Before and after treatment, scar condition of affected hands was assessed with Vancouver Scar Scale (VSS). The range of motion of joints of affected hands was measured by Total Active Movement (TAM) Scale. The function of affected hands was evaluated by Carroll Upper Extremity Function Test. Data were processed with t test, chi-square test, and Mann-Whitney U test. Results: (1) The score of VSS in patients of group RT was (10.0±1.9) points before treatment and (4.4±1.4) points after treatment, with the improved score of (5.6±1.0) points. The score of VSS in patients of group CT was (10.5±1.8) points before treatment and (4.6±1.4) points after treatment, with the improved score of (5.9±1.2) points. There was no statistically significant difference in the improved score of patients between the two groups (t=0.834, P>0.05). The score of VSS in patients of groups RT and CT after treatment was significantly lower than that before treatment (with t values respectively 14.014 and 10.003, P values below 0.01). (2) Before treatment, the ratios of excellent and good results according to TAM were 2/9 in patients of group RT and 3/14 in group CT, with no statistical differences between them (χ(2)=2.140, P>0.05). After treatment, the ratio of excellent and good results according to TAM in patients of group CT (6/7) was higher than that in group RT (5/9, χ(2)=0.023, P=0.038). The ratios of excellent and good results according to TAM in patients of groups RT and CT after treatment were significantly higher than those before treatment (with Z values respectively -2.023 and -4.780, P values below 0.05). (3) The improved score of hand function in patients of group CT was (26±12) points, which was higher than (15±7) points in group RT (t=3.278, P=0.002). The score of hand function in patients of groups RT and CT after treatment was significantly higher than that before treatment (with t values respectively 2.628 and 6.125, P values below 0.05). There were no significant differences in grades of hand function of patients between the two groups before treatment (Z=-0.286, P>0.05). After treatment, the grade of hand function in patients of group CT was higher than that in group RT(Z=-1.993, P=0.046). The grades of hand function in patients of groups RT and CT after treatment were significantly higher than those before treatment (with Z values respectively -2.717 and -4.998, P values below 0.01). Conclusions: For patients with scar contracture after burn injury of dorsal hand, early functional training combined with hand flexing training band can improve the range of motion of hand joints and functional recovery of hand, and the result was better than functional training alone.

[Infestation status Aedes albopictus and related mosquito-borne infectious disease risk in central urban area in Shanghai]

OBJECTIVE

To evaluate Aedes albopictus infestation status in the central urban area of Shanghai, and analyze the related epidemic risk of mosquito-borne infectious disease.

METHODS

Consecutive mosquito surveillance was conducted in the green lands and residential areas in the central urban area of Shanghai during 2012-2014, the Aedes albopictus density and its seasonal fluctuation were observed; the sequence of Aedes albopictus in Shanghai was aligned with that in other epidemic area abroad, and the susceptibility of Aedes albopictus to mosquito-borne virus and endemic risk were analyzed.

RESULTS

No Aedes aegypti was found in the central urban area of Shanghai. As predominant species in both the residential area and the green lands, the proportion of Aedes albopictus in the residential area was significantly higher than that in the green lands(78.53% vs. 19.99%, χ(2) =15 525.168, P<0.001), and so was the density(11.91, 42.02 pcs/day · site in the residential area vs. 3.65, 2.18, 2.73 pcs/day · site in the green lands, all P value <0.001). In 2014, the density reached 42.02 pcs/day · site and the proportion reached 94.69% in the residential areas. Phylogenetic tree analysis showed that the genetic distance between Aedes albopictus in Shanghai and Aedes albopictus in Africa was quite far.

CONCLUSION

No Aedes aegypti was found in Shanghai and its surrounding areas, while Aedes albopictus infestation in the central urban area of Shanghai was serious. Strict measures should be taken to reduce the Aedes albopictus density for the effective control Zika virus spread.

Cardiopulmonary exercise testing screening and pre-operative pulmonary rehabilitation reduce postoperative complications and improve fast-track recovery after lung cancer surgery: A study for 342 cases

Background

An evaluation of cardiopulmonary exercise testing (CPET) screening and pre-operative pulmonary rehabilitation in reducing postoperative complications and improving fast-track recovery in high-risk patients who undergo resection for lung cancer.

Methods

Of 342 potential lung cancer cases, 142 high-risk patients were finally divided into two groups: group R (n = 71) underwent an intensive pre-operative pulmonary rehabilitation program (PRP), followed by lobectomy; group S (n = 71) underwent only lobectomy with conventional management. Postoperative complications, average days in hospital, postoperative days in hospital, and cost were analyzed.

Results

The 142 high-risk patients were screened by smoking history and CPET. Sixty-eight patients had bronchial hyperresponsiveness (BHR) and 47 patients had peak expiratory flow <250 L/minute by CPET. The rate of postoperative total complications in group R (16.90%) was significantly lower than in group S (83.31%) (P = 0.00), as was the rate of postoperative pulmonary complications PPC: group R (12.81%) versus S (13.55%) (P = 0.009); the PPC in the left lung (17.9%) was higher than in the right lung (2.3%) (P = 0.00). The average days in hospital in group S was significantly higher than in group R (P = 0.03). There was no difference between groups in average hospital cost (P = 0.304).

Conclusion

Pre-operative screening using CPET is conducive to identifying high-risk patients for lung resection. Pre-operative pulmonary rehabilitation is helpful to reduce postoperative complications and improve fast-track recovery.

Effects of epigallocatechin gallate on lipid metabolism and its underlying molecular mechanism in broiler chickens

The objective of this study was to investigate the effects of epigallocatechin gallate (EGCG) on fat metabolism and to establish the molecular mechanism of these effects in broilers. Seventy-two 28-day-old male Ross 308 broiler chickens were divided into three groups with different levels of EGCG supplementation for 4 weeks: normal control (NC) group, L-EGCG (a low-level supplement of EGCG, 40 mg/kg body weight daily) and H-EGCG (a high-level supplement of EGCG, 80 mg/kg body weight daily). After 4 weeks of oral administration, EGCG significantly reduced the level of abdominal fat deposition in broilers. The serum triglycerides and low-density lipoprotein cholesterol of chickens in H-EGCG group were also significantly decreased compared with the NC group, and the high-density lipoprotein cholesterol was notably increased at the same time. Moreover, the vital role of the liver and abdominal adipose tissue in lipid metabolism of poultry animals was examined through gene expression and enzyme activities related to fat anabolism and catabolism in these organs. Our data show that EGCG supplementation for 2 weeks significantly downregulated the expression of fatty acid synthesis and fat deposition-related genes, and upregulated the expression of genes involved in fatty acid β-oxidation and lipolysis genes. Simultaneously, the activities of hepatic fatty acid synthesis enzymes (fatty acid synthase and acetyl CoA carboxylase) were significantly decreased, and the activity of carnitine palmitoyl transferase-1 was notably elevated. The results suggest that EGCG could alleviate fat deposition in broilers through inhibiting fat anabolism and stimulating lipid catabolism in broilers.

Polymorphic microsatellite loci for the crimson snapper (Lutjanus erythropterus)

We isolated and characterized 22 polymorphic microsatellite loci in Lutjanus erythropterus using a (GT)13-enriched genomic library. We found between 2 and 8 alleles per locus, with a mean of 4.85. The observed and expected heterozygosities ranged from 0.065 to 0.867 and from 0.085 to 0.832, respectively, with means of 0.461 and 0.529, respectively. Allele frequencies in three loci were found to deviate from Hardy-Weinberg equilibrium. Evidence for null alleles was found for three loci. These markers will be useful for distinguishing released captive-bred L. erythropterus individuals from wild individuals.

Histone demethylase retinoblastoma binding protein 2 regulates the expression of α-smooth muscle actin and vimentin in cirrhotic livers

Liver cirrhosis is one of the most common diseases of Chinese patients. Herein, we report the high expression of a newly identified histone 3 lysine 4 demethylase, retinoblastoma binding protein 2 (RBP2), and its role in liver cirrhosis in humans. The siRNA knockdown of RBP2 expression in hepatic stellate cells (HSCs) reduced levels of α-smooth muscle actin (α-SMA) and vimentin and decreased the proliferation of HSCs; and overexpression of RBP2 increased α-SMA and vimentin levels. Treatment with transforming growth factor β (TGF-β) upregulated the expression of RBP2, α-SMA, and vimentin, and the siRNA knockdown of RBP2 expression attenuated TGF-β-mediated upregulation of α-SMA and vimentin expression and HSC proliferation. Furthermore, RBP2 was highly expressed in cirrhotic rat livers. Therefore, RBP2 may participate in the pathogenesis of liver cirrhosis by regulating the expression of α-SMA and vimentin. RBP2 may be a useful marker for the diagnosis and treatment of liver cirrhosis.

Helium ion microscopy of graphene: beam damage, image quality and edge contrast

A study to analyse beam damage, image quality and edge contrast in the helium ion microscope (HIM) has been undertaken. The sample investigated was graphene. Raman spectroscopy was used to quantify the disorder that can be introduced into the graphene as a function of helium ion dose. The effects of the dose on both freestanding and supported graphene were compared. These doses were then correlated directly to image quality by imaging graphene flakes at high magnification. It was found that a high magnification image with a good signal to noise ratio will introduce very significant sample damage. A safe imaging dose of the order of 10(13) He(+) cm(-2) was established, with both graphene samples becoming highly defective at doses over 5 × 10(14) He(+) cm(-2).The edge contrast of a freestanding graphene flake imaged in the HIM was then compared with the contrast of the same flake observed in a scanning electron microscope and a transmission electron microscope. Very strong edge sensitivity was observed in the HIM. This enhanced edge sensitivity over the other techniques investigated makes the HIM a powerful nanoscale dimensional metrology tool, with the capability of both fabricating and imaging features with sub-nanometre resolution.

[Cardio-pulmonary exercise capacity in patients with lung cancers: a comparison study between video-assisted thoracoscopic lobectomy and thoracotomy lobectomy]

OBJECTIVE

To determine the effect of video-assisted thoracoscopic lobectomy on the pulmonary rehabilitation of patients with lung cancers.

METHODS

Between September 2010 and December 2011, 138 patients. with lung cancers were treated with lobectomy: 68 using video-assisted thoracoscopic surgery (VATS) and 70 using thoracotomy. The preoperative and postoperative (7 d and 30 d) pulmonary functions and Cardio-pulmonary Exercise Capacities as well as postoperative (7 d and 30 d) DE Morton Index of the two groups of patients were assessed. The two groups of patients had similar in clinical characteristics.

RESULTS

(1) Patients in the VATS group had greater FEV1 (1.64 +/- 0.21) L and PEF [(310.58 +/- 30.13) L/min] on the 7 d after operations than those with thoracotomy [FEV1 (1.34 +/- 0.11) L and PEF (270.18 +/- 25.67) L/min], P < 0.05. (2) Patients in the VATS group had lower fatigue index (0.27 +/- 0.08) and dyspnea index (0.28 +/- 0.17) on the 7 d after operations than those with thoracotomy (0.44 +/- 0.10 fatigue index and 0.39 +/- 0.09 dyspnea index), P < 0.05. (3) Patients in the VATS group had longer 6-min walking distance on the 7 d [(490.57 +/- 118.33) m] and 30 d [(524.32 +/- 140.87) m] after operations than those with thoracotomy [(395.07 +/- 100.19) m at 7 d and (471.10 +/- 118.57) m at 30 d], P < 0.05. (4) Patients in the VATS group had higher DE Morton index (74.58 +/- 16.23) on the 7 d after operations than those with thoracotomy (55.87 +/- 14.79), P < 0.05.

CONCLUSION

VATS lobectomy for curative lung cancer resection appears to provide a superior functional health recovery compared with thoracotomy.

[Pulmonary hilum Castleman's disease: a report of 4 cases and review of literature]

OBJECTIVE

To investigate the clinical characteristics of pulmonary hilum Castleman's disease.

METHODS

The clinical characteristics of 4 patients diagnosed with pulmonary hilum Castleman's disease in our department were analysed and compared with findings in relevant literature.

RESULTS

Gender and age were not associated with Castleman's disease. The disease was often identified in physical examinations with atypical clinical symptoms. Chest CT was the most common and valuable diagnostic method revealing soft tissue mass near the pulmonary hilum. Gross-total resection of the tumor and (or) lobectomy through a combined posterior trans-thoracic approach were commonly performed, with good prognosis.

CONCLUSION

Hilum Castleman's disease can be effectively diagnosed and treated.

Adsorption of phenanthrene by quaternary ammonium surfactant modified peat and the mechanism involved

Removal of phenanthrene (PHE) from aqueous solution by adsorption onto quaternary ammonium surfactant modified peat was studied. The results show that surfactant modification enhanced the PHE adsorption capacity of peat. Low temperature and neutral pH favored PHE adsorption. Peat modified with long carbon chain surfactant performed better than peat modified with short carbon chain surfactant. The magnitude of PHE adsorption capacity followed the order of MP-HPB>MP-HTAB>MP-TBAB>RP, ranged from 924 to 1,228 μg g(-1). A negative trend between adsorption capacity (y) and (O+N)/C ratio of biosorbent (x) was observed (y = -1,369.6x + 2,176), which confirmed the negative effect of polarity on polycyclic aromatic hydrocarbon (PAH) removal. The study provides a guide to modify raw materials to enhance adsorption of hydrophobic organics.

Tunable electrical properties of silicon nanowires via surface-ambient chemistry

p-Type surface conductivity is a uniquely important property of hydrogen-terminated diamond surfaces. In this work, we report similar surface-dominated electrical properties in silicon nanowires (SiNWs). Significantly, we demonstrate tunable and reversible transition of p(+)-p-i-n-n(+) conductance in nominally intrinsic SiNWs via changing surface conditions, in sharp contrast to the only p-type conduction observed on diamond surfaces. On the basis of Si band energies and the electrochemical potentials of the ambient (pH value)-determined adsorbed aqueous layer, we propose an electron-transfer-dominated surface doping model, which can satisfactorily explain both diamond and silicon surface conductivity. The totality of our observations suggests that nanomaterials can be described as a core-shell structure due to their large surface-to-volume ratio. Consequently, controlling the surface or shell in the core-shell model represents a universal way to tune the properties of nanostructures, such as via surface-transfer doping, and is crucial for the development of nanostructure-based devices.

Prevalence and molecular diversity of Archaea in subgingival pockets of periodontitis patients

INTRODUCTION

The aim of this study was to investigate the prevalence and molecular diversity of Archaea in the subgingival crevices of patients with chronic periodontitis.

METHODS

Subgingival plaque was collected from 41 patients with chronic periodontitis and 15 healthy subjects. The prevalence of Archaea in those plaque samples was tested by polymerase chain reaction with two broad-range archaeal primer sets. Amplicons from eight Archaea-positive plaque samples were cloned and sequenced for molecular diversity analysis using one of these two primer sets and a novel third primer set.

RESULTS

Archaea were detected in the subgingival plaque of patients with chronic periodontitis at a prevalence of 70.7-73.2%, but were not detected in healthy subjects. Using one primer set, all sequences of the archaeal amplicons were identified as Methanobrevibacter oralis-like species. With another primer set, the amplicons were also found to be identical to the uncultured M. oralis-like species except one phylotype was found to belong to the class Thermoplasmata.

CONCLUSION

Archaea might be correlated with periodontal diseases. The diversity of Archaea associated with periodontitis was limited. Almost all sequenced amplicons fell into the genus Methanobrevibacter of the Euryarcheota phylum. M. oralis-like species was the predominant but non-exclusive archaeon in the subgingival dental plaque of patients with periodontitis.

Separation of oil from oily wastewater by modified resin

A new type of packing material, polystyrene resin modified by cetyltrimethyl-ammonium bromide (R-CTAB), was developed for separation of emulsified oil wastewater. The unique separation mechanism of the modified resin is due to the hydrogen bond formation between hydrocarbon molecules and the free hydrophilic part of the fixed surfactant. It changed the zeta potential of oil droplets and made them coalescing easier, which provide an optional choice without any chemicals added into the wastewater. A column of R-CTAB was investigated for its performance in separating emulsified oil droplets in oily wastewater. The effects of liquid space velocity and influent oil concentration were studied in particular. The results showed that R-CTAB column was more efficient than the un-modified resin column. Under the optimum experimental conditions, more than 85% of oil was removed by using R-CTAB column that at least 10% higher than the un-modified resin column.

Generalized negative binomial distribution: a promising statistical distribution for Oncomelania hupensis in the lake- and marsh-land regions of China

A new generalization of the negative binomial distribution (GNBD) is introduced and fitted to counts of Oncomelania hupensis, the intermediate host of Schistosoma japonicum, made, in areas of Chinese lakeland and marshland, early in the winter of 2005 and late in the spring of 2006. The GNBD was found to fit the snail data better than the standard negative binomial distribution (NBD) that has previously been widely used to model the distribution of O. hupensis. With two more parameters than the NBD, the GNBD can integrate many discrete distributions and is more flexible than the NBD in modelling O. hupensis. It also provides a better theoretical distribution for the quantitative study of O. hupensis, especially in building an accurate prediction model of snail density. The justification for adopting the GNBD is discussed. The GNBD allows researchers to broaden the field in the quantitative study not only of O. hupensis and schistosomiasis japonica but also of other environment-related helminthiases and family-clustered diseases that have, traditionally, been modelled using the NBD.

Characterization of the in vivo dynamics of medullary CD4+CD8- thymocyte development

Our previous studies have defined a differentiation program followed by the newly generated single-positive (SP) thymocytes before their emigration to the periphery. In the present study, we further characterize the development of CD4SP cells in the thymic medulla using mainly intrathymic adoptive transfer assays. By analyzing the differentiation kinetics of the donor cells, which were shown to home correctly to the medullary region following adoptive transfer, we established the precursor-progeny relationship among the four subsets of CD4SP thymocytes (SP1-SP4) and demonstrated that the progression from SP1 to SP4 was unidirectional and largely synchronized. Notably, while the phenotypic maturation from SP1 to SP4 was achieved in 2-3 days, a small fraction of donor cells could be retained in the thymus for a longer period, during which they further matured in function. BrdU incorporation indicated that cell expansion occurred at multiple stages except SP1. Nevertheless, CFSE labeling revealed that only a limited number of cells actually divided during their stay in the medulla. As to the thymic emigration, there was a clear bias toward cells with increasing maturity, but no distinction was found between dividing and nondividing thymocytes. Collectively, these data not only provide solid evidence for a highly ordered differentiation program for CD4SP thymocytes, but they also illustrate several important features associated with the developmental process.

White matter tractography by diffusion tensor imaging plays an important role in prognosis estimation of acute lacunar infarctions

The aim of this study was to evaluate the anatomical and clinical relationship between lacunar infarction and the corticospinal tract (CST) in patients with acute lacunar infarction and predict clinical outcome. We examined 28 pyramidal tract stroke patients in the acute phase or early subacute phase (<3 days) with a marked motor deficit. The anatomical location and the extent of CST involvement within the infarcts were visualized on three-dimensional colour-coded diffusion tensor tractography (DTT). With regard to the CST, all patients were divided into three clinical subgroups: Group 1 (intact type), Group 2 (partial involvement type) and Group 3 (whole involvement type). Subsequently, the severity of the motor deficit of each patient was determined according to the National Institutes of Health Stroke Scale (NIHSS) scores at the acute/early subacute phase (<3 days after onset of symptoms), early chronic phase (8-14 days) and outcome (30-60 days). NIHSS scores of Group 1 (12/28) were significantly lower than those of Group 2 (9/28) at the acute phase or early subacute phase (U = -2.816, p<0.01), and those of Group 2 were significantly lower than those of Group 3 (7/28) (U = -3.136, p<0.01). At outcome,NIHSS scores of Group 1 were significantly lower than those of Group 2 (U = -2.846, p<0.01), and scores of Group 2 were significantly lower than those of Group 3 (U = -3.130, p<0.01). At the same time, the NIHSS scores of each group gradually decreased from acute phase to outcome, Neurological improvement was statistically different among the three topographical types of infarction (H = 26.15, p<0.01; H = 11.03, p<0.01; H = 10.05, p<0.01). In conclusion, the three-dimensional colour-coded DTT allows in vivo differentiation of distinct CST stroke subtypes and may help in better establishing the prognosis for patients after CST stroke.

Mesenchymal hamartoma of liver: Magnetic resonance imaging and histopathologic correlation

AIM: To describe the imaging features of hepatic mesenchymal hamartoma with emphasis on magnetic resonance imaging (MRI) compared to histopathologic results.

METHODS: Spin-echo sequence(SE),fast spin-echo sequence(FSE) were detected in 12 children (7 males,5 females) with mesenchymal hamartoma of the liver (MHL), aged 1.2 months to 12 years,( mean age, 6.3 years) by axial, saggital, coronary plain imaging with an Elscint 2.0T MR equipment. Their main symptoms were abdominal mass (5 cases), enlarged liver (8 cases), abdominal pain (1 case) and anemia (2 cases), and negative alpha-fetoprotein. Dynamic enhancement examination was added in 2 cases.

RESULTS: Six cases had single mass type of MHL, in which 3 cases had solid masses showing slight low-signal-intensity in T1WI, and irregular high-signal-intensity in T2WI, 1 case had a cystic-solid mixed mass showing several border-clear cysts in a solid mass, 2 cases had cystic masses with multi-septa. Five cases had diffuse and multifocal lesions type of MHL with its signal intensity being similar to that of the solid mass. One case had a combined diffuse and single cystic mass. In the early dynamic enhancement examination, the lesions were slightly circum-enhanced , and the center was enhanced in the later scan images. Inner hepatic vessels were compressed in 5 cases, vena cava and abdominal aortae were compressed in 3 cases. Pathological findings included fiber hyperplasia, hyaline degeneration, biliary duct hyperplasia, lobule-like array.

CONCLUSION: MR imaging is a better way to differentiate and diagnose MHL. MHL may be recognized by its characteristic occurrence in infancy and MR imaging features.