Associations between changes in social contact pattern and the mental health status of Chinese adults: cross-sectional findings

The study aims to examine the associations between social contact pattern changes and mental health status, including depression, anxiety, and loneliness, among Chinese adults in the context of coronavirus disease 2019 (COVID-19). Data on social contact patterns before and after the outbreak of COVID-19 were obtained from 3511 participants. Mental health (ie, depression, anxiety, and loneliness) was assessed by the 9-item Patient Health Questionnaire, Dark Future Scale, and the 9-scale Three-Item Loneliness Scale, respectively. Poisson regression analyses revealed that the participants who had increased in-person communication were more likely to have mental disorders [depression: prevalence ratio (PR)=1.13, 95% confidence interval (CI): 1.02, 1.26; anxiety: PR=1.15, 95% CI: 1.01, 1.30]. The current study concluded that the in-person communication increase before and after the outbreak of COVID-19 was associated with mental disorders among Chinese adults.

Preoperative contrast-enhanced CT-based radiomics signature for predicting hypoxia-inducible factor 1α expression in retroperitoneal sarcoma

AIM

To develop and test a contrast-enhanced computed tomography (CECT)-based radiomics signature (RS) to preoperatively predict hypoxia-inducible factor 1α (HIF-1α) expression in retroperitoneal sarcoma (RPS).

MATERIALS AND METHODS

This study included 129 patients with RPS retrospectively who underwent CECT, including 64 male and 65 female patients (55 [2-84] years). Participants were divided into a training set comprising 85 patients and a test set comprising 44 patients. Clinical data and CECT findings of all patients were collected. RS construction was performed by the minimum redundancy maximum relevance method and least absolute shrinkage and selection operator algorithm. The clinical information was analysed by univariate and multivariate logistic regression analysis. The RS and risk factors were included to build a radiomics nomogram. The predictive efficacy of different models was evaluated by accuracy, area under the receiver operating characteristic curve (AUC), and decision curve analysis.

RESULTS

The RS combined signature was constructed on the basis of multi-phase CECT and had an accuracy of 0.795 and an AUC of 0.719 (95% confidence interval [CI], 0.552-0.886) in the test set, which were higher than that of the radiomics nomogram (accuracy: 0.636; AUC: 0.702 [95% CI, 0.547-0.857]) and the clinical model (accuracy: 0.682; AUC: 0.486 [95% CI, 0.324-0.647]). The decision curve analysis showed that the RS combined signature provided better clinical application than the clinical model and radiomics nomogram.

CONCLUSIONS

The multi-phase CECT-based RS constructed can be used as a powerful tool for predicting HIF-1α expression in patients with RPS.

Risk assessment and stratification of mild cognitive impairment among the Chinese elderly: attention to modifiable risk factors

BACKGROUND

The early identification of individuals at risk of mild cognitive impairment (MCI) has major public health implications for Alzheimer's disease prevention.

OBJECTIVE

This study aims to develop and validate a risk assessment tool for MCI with a focus on modifiable factors and a suggested risk stratification strategy.

METHODS

Modifiable risk factors were selected from recent reviews, and risk scores were obtained from the literature or calculated based on the Rothman-Keller model. Simulated data of 10 000 subjects with the exposure rates of the selected factors were generated, and the risk stratifications were determined by the theoretical incidences of MCI. The performance of the tool was verified using cross-sectional and longitudinal datasets from a population-based Chinese elderly cohort.

RESULTS

Nine modifiable risk factors (social isolation, less education, hypertension, hyperlipidaemia, diabetes, smoking, drinking, physical inactivity and depression) were selected for the predictive model. The area under the curve (AUC) was 0.71 in the training set and 0.72 in the validation set for the cross-sectional dataset. The AUCs were 0.70 and 0.64 in the training and validation sets, respectively, for the longitudinal dataset. A combined risk score of 0.95 and 1.86 was used as the threshold to categorise MCI risk as 'low', 'moderate' and 'high'.

CONCLUSION

A risk assessment tool for MCI with appropriate accuracy was developed in this study, and risk stratification thresholds were also suggested. The tool might have significant public health implications for the primary prevention of MCI in elderly individuals in China.

Development and validation of risk prediction models for stroke and mortality among patients with type 2 diabetes in northern China

BACKGROUND

Stroke is one of the leading causes of disability and mortality in patients with type 2 diabetes mellitus (T2DM). Risk models have been developed for predicting stroke and stroke-associated mortality among patients with T2DM. Here, we evaluated risk factors of stroke for individualized prevention measures in patients with T2DM in northern China.

METHODS

In the community-based Tianjin Chronic Disease Cohort study, 58,042 patients were enrolled between January 2014 and December 2019. We used multiple imputation (MI) to impute missing variables and univariate and multivariate Cox's proportional hazard regression to screen risk factors of stroke. Furthermore, we established and validated first-ever prediction models for stroke (Model 1 and Model 2) and death from stroke (Model 3) and evaluated their performance.

RESULTS

In the derivation and validation groups, the area under the curves (AUCs) of Models 1-3 was better at 5 years than at 8 years. The Harrell's C-index for all models was above 0.7. All models had good calibration, discrimination, and clinical net benefit. Sensitivity analysis using the MI dataset indicated that all models had good and stable prediction performance.

CONCLUSION

In this study, we developed and validated first-ever risk prediction models for stroke and death from stroke in patients with T2DM, with good discrimination and calibration observed in all models. Based on lifestyle, demographic characteristics, and laboratory examination, these models could provide multidimensional management and individualized risk assessment. However, the models developed here may only be applicable to Han Chinese.

The use of social media for a better world: roles of social experience, empathy and personal impulsiveness in charitable crowdfunding

Purpose

Charitable crowdfunding features are embedded in social media platforms to encourage pro-social behaviors. Although such new practice allows practitioners to leverage the power of a highly connected crowd, accomplishing the fundraising goal is still a challenge. This study seeks to understand what drives the donation intention in charitable crowdfunding features on social media platforms by examining the roles of social experience, empathy and personal impulsiveness.

Design/methodology/approach

A survey questionnaire was distributed to social media users in China to collect data. A total of 206 valid responses were analyzed using structural equation modeling to test the proposed hypotheses.

Findings

The results showed that empathy mediates interaction with the fundraiser and perceived proximity with the donatee on a user's donation intention. We also found that social influence on social media platforms positively influences empathy and donation intention. In addition, personal impulsiveness was found to moderate the relationship between empathy and donation intention.

Originality/value

This study contributes to existing literature and practices. It identifies three dimensions of social experience and examines their effects on donation intention, providing insights into the charitable crowdfunding features on social media. Moreover, this study extends the understanding to empathy by delineating its mediating role in the relationship between social experience and donation intention and examining how personal impulsiveness moderates the effect of empathy on donation intention. Furthermore, this study provides valuable insights for practitioners to craft strategies to stimulate pro-social behaviors and increase donations.

Depressive Symptoms and Cognitive Decline Among Chinese Rural Elderly Individuals: A Longitudinal Study With 2-Year Follow-Up

Background

Depressive symptoms and mild cognitive impairment (MCI) are highly prevalent in rural China. The study aimed to investigate the longitudinal associations between changes in depressive symptoms and cognitive decline and MCI incidence among Chinese rural elderly individuals.

Methods

A 2-year follow-up study was conducted among 1,477 participants from the Anhui Healthy Longevity Survey (AHLS). Depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9), and cognitive status was evaluated by the Mini Mental State Examination (MMSE). Multivariable linear regression and logistic regression were employed.

Results

Every 1-unit PHQ-9 score increase was significantly associated with more cognitive decline (β = 0.157, 95% CI: 0.092, 0.221, p < 0.001) and a higher risk of MCI incidence (OR = 1.063, 95% CI: 1.025, 1.103, p = 0.001). The participants who experienced worsening of depression symptoms had a larger decline in the 2-year MMSE score (β = 0.650, 95% CI: 0.039, 1.261, p = 0.037) and elevated risks of incident MCI (OR = 1.573, 95% CI: 1.113, 2.223, p = 0.010).

Limitations

Screening tools rather than standard diagnostic procedures were used in the study. Moreover, the long-term associations still need further exploration since the follow-up time was short.

Conclusions

Increased depressive symptoms were associated with more cognitive decline and higher risks of incident MCI among Chinese rural residents.

The association between leftover food consumption and depression among older adults: Findings from a cross-sectional study

BACKGROUND

Leftover food consumption is very prevalent among the Chinese older adults, however, the potential effects of leftover eating consumption on depression have not yet been investigated.

OBJECTIVES

The study aims to determine the association between leftover consumption on depression among older adults.

METHODS

Data of leftover consumption frequency was collected in a cross-sectional study with a provincial representative sample of 5992 older adults (aged 60 or older) in 2019. Depression symptoms were assessed by the 9-item screener Patient Health Questionnaire (PHQ-9). Multiple logistic regression models were applied to analyze the association of the frequency of leftover eating consumption and the presence and the severity of depression.

RESULTS

After controlling for all the covariates, the participants who consume leftover food everyday had higher risk of having depression symptom comparing to those who had the lowest frequency of leftover eating (OR: 1.675, 95% CI: 1.435-1.956, p < 0.001). The participants who consume leftover food every day was also associated with more severe depression symptoms (OR: 1.621, 95% CI: 1.397-1.881, p < 0.001), when comparing to the reference group. The associations seemed stronger in men than women.

LIMITATIONS

The causal relationship between leftover consumption behavior and depression could not be determined due to the cross-sectional design. Moreover, the variety or handling method of the leftover food was not specified.

CONCLUSION

Leftovers eating frequency was associated with the presence and severity of depression symptoms among older adults.

Cross-Sectional Associations between Living and Built Environments and Depression Symptoms among Chinese Older Adults

In this study, we explored the cross-sectional associations between living and built environments and depression among older Chinese adults. Data from 5822 participants were obtained. Depression symptoms were evaluated through the use of the Patient Health Questionnaire (PHQ-9), with a score higher than 4 categorized as having depression symptoms. The living environment was assessed by asking about dust in the environment and barrier-free facilities. We considered the presence of amenities within a 10 min walking distance and the proportion of green space within an 800 m distance from participants’ dwellings to reflect the built environment. Data were analyzed by multilevel logistic regression. Participants living in a non-dusty environment with proximity to green space had a lower risk of depression (non-dusty environment: OR = 0.784, 95% CI = 0.642, 0.956; green space: OR = 0.834, 95% CI = 0.697, 0.998). However, having no access to barrier-free facilities and hospital proximity increased the depression risk (barrier-free facilities: OR = 1.253, 95% CI = 1.078, 1.457; hospital: OR = 1.318, 95% CI = 1.104, 1.574). Dusty environments, access to barrier-free facilities and proximity to hospitals and green spaces were associated with depression symptoms among older Chinese adults.

Serum sodium on admission affects postoperative in-hospital mortality in acute aortic dissection patients

Background

Acute aortic dissection (AAD) is very fatal without surgical treatment. Higher serum sodium can increase in-hospital mortality of many diseases; however, the effect of serum sodium on postoperative in-hospital mortality in AAD patients remains unknown.

Methods

We collected a total of 415 AAD patients from January 2015 to December 2019. Patients were classified into four categories (Q1-Q4) according to the admission serum sodium quartile. The cox proportional hazards model evaluated the association between serum sodium and in-hospital mortality. All-cause in-hospital mortality was set as the endpoint.

Results

By adjusting many covariates, cox proportional hazards model revealed the in-hospital mortality risk of both Q3 and Q4 groups was 3.086 (1.242–7.671, P = 0.015) and 3.370 (1.384–8.204, P = 0.007) respectively, whereas the risk of Q2 group was not significantly increased. Univariate and multiple Cox analysis revealed that Stanford type A, serum glucose, α-hydroxybutyrate dehydrogenase and serum sodium were risk factors correlated with in-hospital death in AAD patients.

Conclusion

The study indicates that the admission serum sodium of AAD patients has a vital impact on postoperative hospital mortality.

A Case of Lung Adenocarcinoma Response to Alectinib Harboring a Rare EML4-ALK Variant, Exon 6 of EML4 Fused to Exon 18 of ALK

More than 20 types of ALK fusion variant subtypes have been identified, including different fusion partner genes or EML4-ALK fusions with different breakpoints. However, different ALK fusions show different sensitivities to ALK-tyrosine kinase inhibitors (ALK-TKIs) and the emergence of rare fusions brings great challenges to the target therapy in clinic. We report a rare EML4-ALK (E6;A18) fusion in a patient with lung adenocarcinoma that responded well to alectinib. This is the second case of this rare variant reported but the first report of response to an ALK-TKI. This evidence is the first to show that alectinib may be effective for this rare fusion type of non-small cell lung cancer, and these findings have important implications for drug selection in patients with this subtype. Further studies are needed to understand the function of this variant.

Photoluminescence and magnetism integrated multifunctional black phosphorus probes through controllable PO bond orbital hybridization

Biological probes with integrated photoluminescence and magnetism characteristics play a critical role in modern clinical diagnosis and surgical protocols combining fluorescence optical imaging (FOI) with magnetic resonance imaging (MRI) technology. However, traditional magnetic semiconductors can easily generate a spin splitting at the Fermi level and half-metallic electronic occupation, which will sharply reduce the radiation recombination efficiency of photogenerated carriers. To overcome this intrinsic contradiction, we propose a controllable oxidation strategy to introduce some particular PO bonds into black phosphorus nanosheets, in which the p orbital hybridization between P and O atoms not only provides some carrier recombination centers but also leads to a room-temperature spin polarization. As a result, the coexistence of photoluminescence and magnetism is realized in multifunctional black phosphorus probes with excellent biocompatibility. This work provides a new insight into integrating photoluminescence and magnetism together by intriguing atomic orbital hybridization.

A phaseⅠ/Ⅱa clinical study of cetuximab combined with fruquintinib in the third-line treatment of RAS/BRAF wild-type colorectal cancer

TPS151

Background: The standard third-line treatment of mCRC is regofenib, fruquintinib or TAS-102. However, the efficacy was not satisfied. Because VEGF and EGFR share the downstream signal pathway, targeting these two pathways may have synergistic efficacy. Preclinical studies have confirmed the effect of the combination of regorafenib and cetuximab. The subsequent phase Ⅰb study in advanced cancer showed the combination is effective. Fruquintinib is the same anti-VEGF drugs and was approved in China. Our department has treated one patient of advanced colorectal cancer, no standard regimen after third-line treatment. The efficacy is SD and PFS time exceeded 6 months. Therefore this study explores the safety and efficacy of fruquintinib combined with cetuximab. Methods: This is a single-center, non-random, prospective, open exploratory study. Eligible pts were diagnosed as advanced RAS/BRAF wild-type colorectal cancer and had received at least two prior regimens of standard therapies. The purpose of phase Ⅰ is to confirm the safety and the appropriate dose of fruquintinib combined with cetuximab. The phase Ⅱa investigate the safety and the efficacy of fruquintinib combined with cetuximab. Phase I: The dose of cetuximab is 500mg/m2 every two weeks which is clinically tolerable, so the dose need not be adjusted. fruquintinib is taken once daily for the first 21 days of each 28-day cycle and the dose adjustment is required due to the side effects. The standard dose of fruquintinib is 5mg/d, but the side effects are serious. The dose of 3mg/d is the minimum effective dose, therefore the initial dose of fruquintinib starts from 4mg, and three patients are enrolled. If DLT appeared in less than three patients, the dose elevated to 5mg/d. Three patients were enrolled in the 5mg/d dose group. If DLT appeared in less than three patients, the right dose of fruquintinib was 5mg/d. If DLT appeared in all three patients of the 5mg/d, fruquintinib was declined to 4mg/d combined with cetuximab to carry out a phase Ⅱa study. Fruquintinib initial dose is 4mg/d. If DLT was present in all three patients, the dose was reduced to 3mg/d. The standard dose of fruquintinib (3mg/d) was determined to be MDT, and the subsequent phase Ⅱa study was conducted by giving fruquintinib 3mg/d. The phase Ⅱa study is cetuximab 500mg/m2 biweekly combined with fruquintinib according to the confirmed dose in phase Ⅰ, taking it once daily for the first 21 days of each 28-day cycle. The number of cases is 20.Response assessment via CT/MRI is to be done q8 wks (RECIST 1.1). Continue until disease progression or unacceptable toxicity. The primary objective is to estimate safety, grade 3/4 adverse, and DLT. Secondary objectives include ORR, PFS, and OS. Final analysis to be done 6 mo after enrollment of the final pt. Clinical trial information: ChiCTR2000038227 . Research Sponsor: None

Er:YAG MOPA system based on a polarization-multiplexing 4-pass structure

A 4-pass structure Er:YAG MOPA system at 1645 nm is theoretically and experimentally investigated. In accordance with the theoretical analysis, the 4-pass structure significantly improved the amplification performance. The highest gain is about 4 with 1 mJ incident seed energy. The power fluctuation and beam quality are improved after the amplification.

[Consistency of ALK Ventana-D5F3 immunohistochemistry interpretation in lung adenocarcinoma among Chinese histopathologists]

Objective: To understand the consistency of ALK Ventana-D5F3 immunohistochemistry (IHC) interpretation in Chinese lung adenocarcinoma among histopathologists from different hospitals, and to recommend solution for the problems found during the interpretation of ALK IHC in real world, with the aim of the precise selection of patients who can benefit from ALK targeted therapy. Methods: This was a multicenter and retrospective study. A total of 109 lung adenocarcinoma cases with ALK Ventana-D5F3 IHC staining were collected from 31 lung cancer centers in RATICAL research group from January to June in 2018. All cases were scanned into digital imaging with Ventana iSCANcoreo Digital Slide Scanning System and scored by 31 histopathologists from different centers according to ALK binary (positive or negative) interpretation based on its manufacturer's protocol. The cases with high inconsistency rate were further analyzed using FISH/RT-PCR/NGS. Results: There were 49 ALK positive cases and 60 ALK negative cases, confirmed by re-evaluation by the specialist panel. Two cases (No. 2302 and No.2701) scored as positive by local hospitals were rescored as negative, and were confirmed to be negative by RT-PCR/FISH/NGS. The false interpretation rate of these two cases was 58.1% (18/31) and 48.4% (15/31), respectively. Six out of 31 (19.4%) pathologists got 100% accuracy. The minimum consistency between every two pathologists was 75.8%.At least one pathologist gave negative judgement (false negative) or positive judgement (false positive) in the 49 positive or 60 negative cases, accounted for 26.5% (13/49), 41.7% (25/60), respectively, with at least one uncertainty interpretation accounted for 31.2% (34/109). Conclusion: There are certain heterogeneities and misclassifications in the real world interpretation of ALK-D5F3 IHC test, which need to be guided by the oncoming expert consensus based on the real world data.

Study of SU-8 photoresist cross-linking process by atomic force acoustic microscopy

In this paper, a method is presented to detect the different phases of epoxy cross-linking process and the subsurface structures of SU-8 thin films by atomic force acoustic microscopy (AFAM). The AFAM imaging of SU-8 thin films was investigated under different exposure and bake conditions. Optimized conditions were obtained for the cross-linking of SU-8 thin film at the exposure does of eight laser pulses with the laser fluence 10 mJ cm^-2 per pulse and the post exposure bake (PEB) time at 90 s. The subsurface structures of undeveloped SU-8 thin films were visible in the AFAM images. This method provides an effective and low-cost way for the determination of different phases of epoxy cross-linking process in nanostructured compounds, for the non-destructive testing of subsurface defects, and for the evaluation of the quality of patterned structures.

The association between weight fluctuation and all-cause mortality: A systematic review and meta-analysis

BACKGROUND

Many observational studies have reported an association between weight fluctuation and all-cause mortality. However, the conclusions obtained from these studies have been unclear.

OBJECTIVE

The current meta-analysis aimed to clarify the association between weight fluctuation and all-cause mortality.

DATA SOURCE

We electronically searched PubMed, Embase, and Web of Science for articles reporting an association between weight fluctuation and all-cause mortality that were published before April 30, 2018.

STUDY APPRAISAL AND SYNTHESIS METHODS

The methodological quality of each study was appraised using the modified Newcastle Ottawa Quality Assessment Scale. The hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were extracted from the included studies and pooled using random-effect models. Meta-regression approaches were also performed to explore sources of between-study heterogeneity.

RESULTS

A total of 15 studies were eligible for the current meta-analysis. The pooled overall HR for all-cause mortality in the group with the greatest weight fluctuations compared with the most stable weight category was 1.45 (95% CI: 1.29-1.63). Considerable between-study heterogeneity was observed, some of which was partially explained by the different follow-up durations used by the included studies. Moreover, publication bias that inflated the risk of all-cause mortality was detected using Egger's test (P = .001).

CONCLUSION

Weight fluctuation might be associated with an increased risk of all-cause mortality.

Comprehensive Gene Expression Analysis in NMIBC Using RNA-seq Reveals New Therapy Strategies

Non-muscle invasive bladder cancer (NMIBC) patients often have fewer treatment options, and suffer the progression of disease due to mechanisms that are not clear, as well as due to its diversity. This study was designed to explore the molecular mechanism of bladder cancer through an RNA-seq. In addition to conventional analyses, we also simplified the network through modularization using the WGCNA algorithm, with the help of the topological overlapping matrix and hierarchical cluster tree, which are based on the PPI network of STRING. Furthermore, the hub genes were confirmed through survival analyses in the independent cohorts (n = 431). Among them, 15 genes were significantly associated with poor prognosis. Finally, we validated the results at mRNA and protein level using qRT-PCR, IHC and western blotting. Taken together, our research is important for the prediction, as well as the prospective clinical development of drug targets and biomarkers.

Contrast-enhanced CT findings of intravenous leiomyomatosis

AIM

To characterise the contrast-enhanced computed tomography (CT) imaging findings of nine patients with intravenous leiomyomatosis (IVL).

MATERIALS AND METHODS

The contrast-enhanced CT imaging findings of nine patients with histopathologically proven IVL were examined. The location, morphology, extension pathway, adhesion, and degree and pattern of enhancement of the tumour were assessed.

RESULTS

Four patients had tumours located within the inferior vena cava, and five had tumours that involved the right heart. Seven patients with residual uterus myoma showed enhanced heterogeneous contrast of the uterus. Eight tumours extended into the inferior vena cava through the iliac veins and one through the bilateral iliac veins. All the IVLs demonstrated heterogeneous enhancement on contrast-enhanced CT and appeared to have lower density than the contrast-enhanced venous blood. On the coronal and sagittal images, tumours were continuous and, when the right heart was involved, the lesions displayed a characteristic "walking stick head" or "snake head" appearance. The lesion looked similar to a "sieve" on axial contrast-enhanced CT images, and a "luffa sponge" on post-processing coronal or sagittal images.

CONCLUSION

Contrast-enhanced CT imaging has unique advantages in the diagnosis of IVL, namely, luffa sponge and sieve appearance, which can be helpful for differential diagnosis. Contrast-enhanced CT can demonstrate tumour location and full-scale extension pathway, which are important for diagnosis, surgical planning, and follow-up of the tumour.

Describing the quality of life of boys with haemophilia in China: Results of a multicentre study using the CHO-KLAT

INTRODUCTION

The treatment of haemophilia varies across countries and across regions within some countries. Similar variation has been observed in health-related quality of life (HR-QoL). Relatively little is known about the HR-QoL of boys with haemophilia in China.

AIM

The aim of this study was to describe the HR-QoL of boys with haemophilia in China using the Canadian Haemophilia Outcomes-Kids Life Assessment Tool (CHO-KLAT).

METHODS

Boys (4-18 years of age) with haemophilia and their parents were enroled in a cross-sectional study. All parents/guardians of study subjects were requested to complete a CHO-KLAT questionnaire during a clinic visit, and report on several other clinical and socioeconomic factors in the past year. Boys who were > 7 years also completed the CHO-KLAT.

RESULTS

A total of 269 parents of boys with haemophilia, from 13 hospitals in 12 provinces, were enroled during 2014. The boys ranged from 4.0 to 17.9 years of age; 91% had haemophilia A, most had moderate (52%) or severe (36%) disease, and most were receiving sub-optimal on-demand therapy or low-dose prophylactic therapy. Child self-report CHO-KLAT scores were available for 171 boys ≥7 years of age and ranged from 24.2 to 85.3 with a mean of 57.6 (n = 171). Parent proxy-reported CHO-KLAT scores ranged from 25.0 to 88.7 with a mean of 55.1 (n = 269).

CONCLUSION

HR-QoL scores in boys with haemophilia in China were substantially lower than reported from Canadian and European boys with haemophilia. Longer term prospective studies are required to examine the factors impacting the HR-QoL for boys with haemophilia in China.

[Application of disparity discriminating accuracy test in evaluating the stereopsis of postoperative intermittent exotropia]

OBJECTIVE

To discuss the application of disparity discriminating accuracy test in evaluating the stereopsis of postoperative intermittent exotropia.

METHODS

Patients with intermittent exotropia who underwent surgery during July 2011 to June 2013 were followed up. The stereoacuity was examined by Titmus Stereotest, Randot Stereotest and Frisby Stereotest. Twenty adult cases whose stereoacuity reached normal were chosen as experimental group. Twenty healthy adults were selected as normal control group. Both groups were examined with disparity discriminating accuracy test. Discriminating accuracy of the two groups were analyzed with Two-Way ANOVA method. Test-retest reliability was analyzed with Intraclass Correlation Coefficient analysis.

RESULTS

The test-retest reliability of disparity discriminating accuracy test is excellent (ICC=0.99, P<0.01) . Discriminating accuracy under different disparities in experimental group were 0.56±0.09, 0.67±0.14, 0.77±0.15, 0.82±0.14, 0.85±0.11, 0.85±0.14, 0.87±0.10, 0.84±0.16, while those in control group were 0.77±0.09, 0.88±0.09, 0.93±0.08, 0.91±0.09, 0.95±0.08, 0.96±0.05, 0.97±0.06, 0.96±0.04. There were statistically significant differences between them (F=38.06, P<0.01) . The discriminating ability of group grating in both groups was affected by the size of disparity. Under situation of small disparity, a large difference was found between the experimental group (0.67±0.12)and control group(0.86±0.07) (F=4.84, P<0.05).

CONCLUSIONS

Stereoscopic function can be evaluated comprehensively with disparity discriminating accuracy test. Use this test, a certain degree of dysfunction in stereopsis can still be found in postoperative intermittent exotropic patients who reached normal stereoacuity examined with traditional stereotests. (Chin J Ophthalmol, 2016, 52: 584-588).

MRI findings in intraspinal mature teratoma

AIM

To characterise and evaluate magnetic resonance imaging (MRI) images for their clinical value in diagnosing and assessing intraspinal mature teratoma.

MATERIALS AND METHODS

MRI images obtained from eight patients with a histopathologically verified intraspinal mature teratoma were analysed retrospectively regarding tumour location, size, and margins. Additionally, the signal intensity and enhancement pattern on MRI and other associated malformations were also assessed.

RESULTS

Three cases that contained fatty tissue showed markedly heterogeneous hyperintense signalling on T1-weighted images, and mixed hyperintense and hypointense signalling on T2-weighted images and fat-suppression sequences. All three of those cases showed an irregular peripheral fatty tissue signal, and one case showed additional patches of an interspersed calcification signal. The remaining five cases without fatty tissue displayed heterogeneous hyperintense signalling on T1-weighted images and T2-weighted images, and also on fat-suppression sequences. Four of the five cases showed additional patches of interspersed nodular calcification signals. Contrast-enhanced MRI images showed only slight enhancement (n=3).

CONCLUSIONS

MRI is regarded as the reference standard diagnostic technique to reveal the location of teratomas and the degree of spinal cord involvement. In most cases, MRI provides accurate anatomical and histological information, which is necessary for patients with suspected intraspinal mature teratoma.

KRAS status and resistance to epidermal growth factor receptor tyrosine-kinase inhibitor treatment in patients with metastatic colorectal cancer: a meta-analysis

AIM

This study reviewed the association between KRAS mutation and resistance to treatment with epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitors (TKIs) in patients with metastatic colorectal cancer (mCRC).

METHOD

A search was carried out of PubMed, MEDLINE, EMBASE and the Cochrane Library databases (to November 2013) without language restrictions.

RESULTS

Ten studies were included in the final meta-analysis, consisting of 1339 patients with mCRC, of whom 427 (32%) had a KRAS mutation. The objective response rate (ORR) of mCRC patients with KRAS mutation was 8% (33/427), whereas the ORR of mCRC patients with wild-type KRAS was 34% (306/912). The overall pooled response rate (RR) for the ORR was 1.297 (95% CI 1.244-1.353, P < 0.01). Subgroup analysis comparing cetuximab monotherapy treatment with cetuximab plus chemotherapy, showed a pooled RR of 1.26 (95% CI 1.12-0.63, P < 0.01) and 1.30 (95% CI 1.25-1.36, P < 0.01), respectively. For patients receiving anti-EGFR with monoclonal antibodies (mAb) given as first-line treatment or not, the pooled RRs were 1.34 (95% CI 1.23-1.46, P < 0.01) and 1.29 (95% CI 1.23-1.35, P < 0.01). The data on progression-free survival from five studies in the meta-analysis gave a hazard ratio (HR) of 1.99 with a 95% CI of 1.69-2.29. Finally, the data for overall survival in mCRC patients were pooled from the only three studies reporting the HR (1.80; 95% CI 1.50-2.10). None of the results had any evidence of heterogeneity.

CONCLUSION

All the results favoured a stronger link between mutant KRAS and anti-EGFR mAb, but due to a mutually exclusive relationship between KRAS and other gene mutations the clinical usefulness of KRAS mutation as a selection marker for sensitivity to EGFR TKIs in mCRC is limited.

Cholesterol induces pancreatic β cell apoptosis through oxidative stress pathway

Type 2 diabetes is often associated with high blood cholesterol. Here, we investigated the effect of cholesterol loading on MIN6 cells derived from pancreatic β cells. Exposure of MIN6 cells to cholesterol-induced apoptosis in time- and dose-dependent manner. Treatment with methyl-β-cyclodextrin that removes cholesterol from plasma membrane prevented the cells from cholesterol-induced apoptosis. Western blot analysis revealed that the levels of phosphorylated-p38 mitogen-activated protein kinase (P-p38 MAPK) and c-Jun N-terminal kinases (P-JNK) were significantly increased after the cholesterol loading, suggesting that the stress-activated protein kinase signaling was stimulated. A specific p38 inhibitor rescued MIN6 cells from cholesterol-induced apoptosis, while JNK inhibitor failed, suggesting the importance of activation of p38 MAPK signaling in response to cholesterol. The expression of Bip and CHOP, the endoplasmic reticulum (ER) stress markers, remained unaffected, indicating that the ER stress may not be involved in the cytotoxicity of cholesterol on the ΜΙΝ6 cells. The intracellular concentration of reactive oxygen species measured by use of 2',7'-dichlorofluorescin diacetate was significantly increased after cholesterol loading, demonstrating the induced apoptosis was mediated through oxidative stress. Addition of reduced form of glutathione in the medium rescued MIN6 cells from apoptosis induced by cholesterol loading. Taken together, these results demonstrate that the free cholesterol loading can induce apoptosis of MIN6 cells mediated by oxidative stress and the activation of p38 MAPK signaling.

Seasonal changes in antifreeze protein gene transcription and water content of beetle Microdera punctipennis (Coleoptera, Tenebrionidae) from Gurbantonggut desert in Central Asia

Desert beetle Microdera punctipennis (Coleoptera: Tenebriondae) is a special species in Gurbantonggut Desert in Central Asia. To investigate the possible strategy it employs for cold survival, seasonal changes in supercooling point (SCP), body water content, haemolymph osmolality and antifreeze protein gene (Mpafp) expression were measured over 13 months. Our results show SCPs in M. punctipennis adults changed from -8.0°C in summer to -18.7°C in winter. During winter, adults endured modest water loss; total water decreased from 65.4 percent in summer to 55.9% in winter. Mpafp mRNAs level increased by 13.1 fold from summer to early winter, and haemolymph osmolality increased accordingly from 550 mOsm to 1486 mOsm. Correlation coefficient of Mpafp mRNAs level and SCP indicates that Mpafp mRNA explained 65.3 percent of the variation in SCPs. The correlation between Mpafp mRNA level and total water reflected an indirect influence of antifreeze protein on water content via reducing SCP.

Application of monitored natural attenuation to remediate a petroleum-hydrocarbon spill site

Contamination of groundwater by petroleum-hydrocarbons is a serious environmental problem. The Monitored Natural Attenuation (MNA) approach is a passive remediation to degrade and dissipate groundwater contaminants in situ. In this study, a full-scale natural bioremediation investigation was conducted at a gasoline spill site. Results show that concentrations of major contaminants (benzene, toluene, ethylbenzene, and xylenes) dropped to below detection limit before they reached the downgradient monitor well located 280 m from the spill location. The results also reveal that natural biodegradation was the major cause of the observed contaminant reduction. The calculated natural first-order attenuation rates for BTEX and 1,2,4-trimethylbenzene (1,2,4-TMB) ranged from 0.051 (benzene) to 0.189 1/day (1,2,4-TMB). Evidence for the occurrence of natural attenuation includes the following: (1) depletion of dissolved oxygen, nitrate, and sulfate; (2) production of dissolved ferrous iron, sulfide, and CO2; (3) decreased BTEX concentrations and BTEX as carbon to TOC ratio along the transport path; (4) increased alkalinity and microbial populations; (5) limited spreading of the BTEX plume; and (6) preferential removal of certain BTEX components along the transport path. Additionally, the biodegradation capacity (44.73 mg/L) for BTEX and 1,2,4-TMB was much higher than other detected contaminants within the plume. Hence, natural attenuation can effectively contain the plume, and biodegradation processes played an important role in contaminant removal.

A member of the Y-box protein family interacts with an upstream element in the alpha1(I) collagen gene

Transforming growth factor beta (TGF-beta) stimulates protein complex formation on a TGF-beta response element (TAE) found in the distal portion (-1624) of the collagen alpha 1(I) promoter. To identify the fibroblast proteins in this complex, an expression library constructed from human embryonic lung fibroblasts mRNA was screened using a tetramer of TAE. Y-box binding protein (YB-1), was identified as a protein in the TAE-protein complex. The protein expressed by phage clones formed a specific complex with labeled TAE but not mutated TAE (mTAE) similar to the complex formed with nuclear protein. Nuclear protein-TAE complexes isolated from native gels contained YB-1 by Western analysis. TGF-beta treatment increased the amount of YB-1 protein in nuclear extracts, decreased its amount in cytoplasm, but did not alter the steady state levels of YB-1 mRNA. A full-length YB-1 protein expressed in human lung fibroblasts was primarily located in the nucleus with punctate staining in cytoplasmic regions. The expression of YB-1 decreased in the cytoplasm after 2 h of TGF-beta treatment. Therefore, the increased binding activity seen in TGF-beta-stimulated nuclear extracts was due primarily to relocalization of YB-1 from the cytoplasm to the nuclear compartment. Co-transfection of YB-1 cDNA with a collagen promoter-reporter construct caused a dose-dependent activation of collagen promoter activity in rat fibroblasts whereas the promoter with a mutation in the TAE element was not sensitive to YB-1 co-expression. In conclusion, we have identified YB-1 as a protein that interacts with a TGF-beta response element in the distal region of the collagen alpha 1(I) gene. YB-1 protein activates the collagen promoter and translocates into the nucleus during TGF-beta addition to fibroblasts, suggesting a role for this protein in TGF-beta signaling.

Language acquisition, unemployment and depressive disorder among Southeast Asian refugees: a 10-year study

The current study examines the risk-inducing effects of unemployment and the protective effects of language facility on the mental health of Southeast Asian refugees resettling in Canada. Rates of depression and of unemployment declined dramatically during the first decade after arrival. Although language fluency also improved during this period, approximately 8% of the sample spoke no English even after 10 years in the country. Initial depression was a strong predictor of subsequent depression. For males, job experience in Canada was the strongest predictor of subsequent employment whereas, for women, depression proved an important predictor of employability. For men in particular, unemployment was a potent risk factor for depression. During the initial period of resettlement, English-speaking ability had no effect on depression or on employment. However, by the end of the first decade in Canada. English language fluency was a significant predictor of depression and employment, particularly among refugee women and among people who did not become engaged in the labor market during the earliest years of resettlement. Study results demonstrate that the mental health salience of risk and protective factors changes according to the phase of resettlement.

[A randomized, controlled clinical trial of meropenem and imipenem/cilastatin in the treatment of acute bacterial infections]

OBJECTIVE

Meropenem is a new carbapenem antibiotic developed by Sumitomo Pharmaceuticals and shown to resist degradation by renal dehydropeptidase I (DPH-I), an enzyme which exists chiefly in the kidneys and decomposes carbapenem antibiotics. It has a powerful antibacterial activity with broad antibacterial spectrum. The objective of the study is to evaluate the efficacy and safety of meropenem.

METHODS

A randomized, open-label, controlled study was conducted for treating patients with bacterial infections. A total of 112 hospitalized patients were enrolled in the study. 55 patients received meropenem 500 mg every 12 hours (or 1g every 12 hours if necessary) and 57 patients received imipenem/cilastatin 500 mg/500 mg every 12 hours (or 1g/1g every 12 hours if necessary) intravenously. The duration of treatment was 7-14 days in both groups.

RESULTS

42 of the 55 cases receiving meropenem and 41 of the 57 cases receiving imipenem/cilastatin were assessable for clinical efficacy. The overall efficacy rate was 88.1%(37/42) for the meropenem group and 85.4%(35/41) for the imipenem/cilastatin group, whereas the bacterial eradication rate was 81.1%(30/37) and 84.2%(32/38), respectively. 47(69.1%) of 68 strains isolated from patients produced beta-lactamase. Adverse drug reaction was evaluated in 44 cases of the meropenem group and 41 cases of the imipenem/cilastatin group. The adverse drug reaction rate was 13.6%(6/44) and 12.2%(5/41), respectively. The results showed that there were no statistical differences between these two groups (P > 0.05).

CONCLUSION

Meropenem and imipenem/cilastatin were effective and safe for the treatment of lower respiratory tract infections and urinary tract infections and other infections caused by beta-lactamase-producing strains.

Non-specific deadenylation and deguanylation of naked RNA catalyzed by ricin under acidic condition

Ricin A-chain catalyzes the hydrolysis of the N-glycosidic bond of a conserved adenosine residue at position 4324 in the sarcin/ricin domain of 28S RNA of rat ribosome. The GAGA tetraloop closed by C-G pairs is required for recognition of the cleavage site on 28S ribosomal RNA by ricin A-chain. In this study, ricin A-chain (reduced ricin) exhibits specific depurination on a synthetic oligoribonucleotide (named SRD RNA) mimic of the sarcin/ricin domain of rat 28S ribosomal RNA under neutral and weak acidic conditions. Furthermore, the activity of intact ricin is also similar to that of ricin A-chain. However, under more acidic conditions, both enzymes lose their site specificity. The alteration in specificity of depurination is not dependent on the GAGA tetraloop of SRD RNA. A higher concentration of KCl inhibits the non-specific N-glycosidase activity much more than the specific activity of ricin A-chain. In addition, characterization of depurination sites by RNA sequencing reveals that under acidic conditions ricin A-chain can release not only adenines, but also guanines from SRD RNA or 5S ribosomal RNA. This is the first report of the non-specific deadenylation and deguanylation activity of ricin A-chain to the naked RNA under acidic conditions.

[Expression of Fas on monocytes and the level of plasma soluble FasL in patients with chronic renal failure]

OBJECTIVE

The dysfunction of monocytes in uremic patients has been demonstrated to be associated with monocyte accelerated apoptosis. The study was conducted toelucidate the mechanisms by which monocyte apoptosis was induced.

METHODS

Seven non-dialyzed chronic uremic patients and 18 hemodialysis (HD) patients were enrolled in the study. Fifteen healthy volunteers were selected as controls. The expression of Fas and Fas ligand (FasL) was examined by immunofluorescent staining and flow cytometer analysis. The levels of soluble FasL (sFasL) in plasma were analyzed by enzyme-linked immunosorbent assay (ELISA). The percentage of apoptotic cells in monocytes cultured in vitro with recombinant human FasL (rHu-FasL) was quantitated by DNA content analysis after extraction of the degraded DNA. Monocyte survival rate was analyzed by 5-diphenyl tetrazolium bromide (MTT) staining.

RESULTS

Expression of Fas on monocytes was significantly higher in uremic and HD patients than that in healthy subjects. Higher levels of Fas expression were demonstrated on monocytes from HD as patients compared with those from non-dialyzed patients. There was no difference in monocyte Fas expression between pre- and post-dialysis session and between patients using polysulfone and cellulose dialyzer. There was no detectable FasL expression on monocytes from both uremic patients and healthy controls. Plasma sFasL could be detected in uremic and HD patients, but not in healthy controls. There was no significant difference in levels of plasma sFasL between non-dialyzed and HD patients, pre- and post-dialysis session, and patients treated with polysulfone and cellulose dialyzer. When monocytes were cultured in vitro with rHu-FasL for 2 hours, higher levels of apoptosis and lower survival rate were found in monocytes from HD patients as compared with those from healthy controls.

CONCLUSION

The up-regulated expression of functional Fas on monocytes and the presence of sFasL in plasma may contribute to the accelerated apoptosis of monocytes seen in uremic patients.

Enhanced oxidant stress in synovial vessels of patients on hemodialysis

OBJECTIVE

To test the hypothesis that the susceptibility of synovial vessels to redox uncoupling which could result in oxidative damage capable of promoting beta 2-microglobulin (beta 2 m) deposition.

METHODS

The expression of oxidative markers by microvascular endothelial cells in hemodialysis (HD) patients, non-uremic patients and normal subjects was determined using immunostaining and Northern blotting.

RESULTS

Synovial vascular endothelial cells of HD patients exhibited evidence of oxidant stress: induction of malondialdehyde (MDA) epitopes and heme oxygenase. These oxidative markers were not detectable in microvascular endothelial cells of other tissues from HD patients, as well as in the synovial vessels of non-uremic or normal controls. Higher levels of heme oxygenase mRNA in synovia were seen in patients with beta 2 m deposition compared with patients without beta 2 m deposition.

CONCLUSIONS

Oxidative damage of the synovial microvasculature in uremic patients may be one of the factors which can promote deposition of beta 2 m in osteoarticular tissue.

[Synthesis of the new reagent N-hexyl-N'-(sodium aminobenzenesulfonate) thiourea (HXPT) and its spectrophotometric study with Pd2+]

A new reagent N-Hexyl-N'-(sodium aminobenzenesulfonate) thiourea (HXPT) was synthesized. Its structure was also characterized. A new spectrophotometric method of determining Pd2+ was developed based on the new reagent. In the range of pH 5.4-5.8 Pd2+ forms a stable yellow complex with HXPT in the presence of CTMAB,and its apparent molar absorptivity is 2. 21 x 10(5) L x mol(-1) x cm(-1) at the maximum absorption wavelength 296.8 nm. Beer's law is obeyed in the range of 1-7 microg x 25 mL(-1) for Pd2+. This method has been used for the determination of trace Pd2+ in ores and catalyst with satisfactory results.

Perceived racial discrimination, depression, and coping: a study of Southeast Asian refugees in Canada

Using data obtained from personal interviews with 647 Southeast Asian refugees in Canada, this study tests hypotheses regarding both the association between perceived racial discrimination and depression, and the roles of coping and ethnic identity in conditioning the nature of the discrimination-depression relation. Refugees who reported that they had experienced racial discrimination had higher depression levels than their counterparts who reported no such experiences. Responding to discrimination through confrontation was not significantly associated with depression. Study findings support the effectiveness of forbearance in diminishing the strength of the association between discrimination and depression. The moderating effect of forbearance was conditioned by the level of ethnic identity: The beneficial effect of forbearance was significantly greater among those holding stronger ethnic identification. Cultural and situational interpretations of the findings are presented.

[The effects of nitric oxide and endothelia levels on plasma in patients with chronic heart failure]

OBJECTIVE

To study the effects of prostaglandin E1 on plasma nitric oxide (NO) and endothelin (ET) levels in patients with chronic heart failure.

METHODS

Pulmonary artery pressure (PAP), pulmonary arterial and venous plasma ET and angiotensin converting enzyme (ACE) levels were determined in patients with chronic heart failure (CHF) and the effects of prostaglandin E1 (PGE1) were evaluated.

RESULTS

(1) Pulmonary hypertension was present in patients with CHF. Plasma NO and ET levels in the pulmonary artery were higher than those in the pulmonary vein (P < 0.05), the levels in the latter was in turn higher than those in normal subjects (P < 0.05). (2) Plasma ACE levels showed a similar change, (3) The increase of plasma ET was more than the increase of NO in patients with CHF, thus, NO/ET ratio was decreased in CHF (P < 0.05). (4) PGE1 caused significant decrease in PAP but increase in cardial index. It decreased plasma NO, ET, ACE, and increased NO/ET ratio (P < 0.05). These effects became more apparent with the increase of PGE1 level.

CONCLUSION

NO and NO/ET ratio might be involved in CHF by causing pulmonary hypertension and local vascular endothelium perturbation. PGE1 could inhibit these effects and play an important role in the prevention and treatment of CHF.