[A petition to American philanthropist for the donation of an American hospital in Tianjin]

At the dawn of the Republic of China, a group of doctors, educators, businessmen, officials, and the America returned Students in Tianjin jointly submitted a petition to American philanthropist for donation of a large-scale modern hospital. This petition, appended to a report to Carnegie Endowment for International Peace, has long been neglected by researchers. The memorandum may be informative to study local medical service at a transition period, and also helps understand the establishment and subsequent contribution of China Medical Board.

Microarray analysis of long non-coding RNAs related to microRNA-148b in gastric cancer

The miR-148/152 family (miR-148a, miR-148b, miR-152) is differentially expressed in gastric cancer tissues and non-tumor tissues. Our previous studies indicated that miR-148/152 family is important in the tumorigenesis and development of gastric cancer. We also found several target genes that were regulated by the miR-148/152 family and several factors that could influence members of this family. However, the molecular mechanisms and function of this family in gastric cancer remain unclear. Recently, long non-coding RNAs (lncRNAs) have been found to play an important role in the pathogenesis of many diseases. The aim of the present study was to perform expression profiling to identify lncRNAs that might be associated with miR-148b in gastric cancer and predict their potential functions. Total RNA was extracted from gastric cancer cell line SGC-7901 treated with miR-148b mimics and from untreated gastric cancer cells. Microarray analysis was performed using the Agilent LncRNA + mRNA Human Gene Expression Microarray V3.0 platform, which was designed for the profiling of human lncRNAs and protein-coding transcripts. A total of 37581 lncRNA and 34303 mRNA transcripts were detected in gastric cancer cell line SGC-7901 and cell line SGC-7901 treated with miR-148b mimics. Among the differentially expressed lncRNAs, 240 up-regulated and 64 down-regulated lncRNAs were identified. XLOC_000983 was the most up-regulated lncRNA, and M18204.1 was the most down-regulated lncRNA. Among the differentially expressed mRNAs in different cell lines, 196 were consistently up-regulated and 320 were consistently down-regulated. POSTN was the most up-regulated mRNA, and HBB was the most down-regulated mRNA. Gene Ontology (GO) and pathway analyses indicated that the lncRNAs influenced by miR-148b might play an important role in the immune system and were associated with the development of gastric cancer. The altered expression of lncRNAs influenced by miR-148b may play a partial role in pathways implicated in gastric cancer development and progression, such as the immune response pathway.

[Exposure status and health risk assessment of deoxynivalenol from cereals in Chinese population in different regions]

Objective: To evaluate the dietary exposure to deoxynivalenol (DON) from cereals and health risk in Chinese residents in different regions. Methods: The data of DON concentration in cereals was derived from the national food safety risk surveillance from 2010 to 2017, with 15 422 samples of cereals included. China was roughly divided into north part and south part, along with the Qinling Mountains-Huaihe River line. Sample size of each type of cereals, i.e. wheat flour, maize meal, oats and rice was 4 948, 696, 626, 1 006 in the north, while 5 648, 1 068, 266, 1 164 in the south. The data of cereals consumption was derived from China National Nutrition and Health Survey in 2002 and 68 335 respondents aged 3 and above, with 34 234 from the north and 34 101 from the south, were included. Simple distribution model was applied for calculation and comparison of the dietary exposure to DON from cereals in northern and southern residents based on individual consumption of cereals, body weight and average DON concentration in each type of cereals. Results: Average DON concentration in wheat flour, maize meal, oats, and rice sampled in northern China were 235.4, 121.6, 7.0 and 4.6 μg/kg, respectively, while 239.1, 124.3, 29.0 and 15.5 μg/kg in cereals sampled in southern China. The average DON exposure from cereals in surveyed Chinese inhabitants was 0.78 μg/(kg·d). Among them, the DON exposure of northern residents was higher than that of southern residents (P<0.001), and the average exposures were 1.15 and 0.41 μg/(kg·d), respectively. A total of 49.2% of northern residents exceeded provisional maximum tolerable daily intake for DON exposure from cereals, which was much higher than that of southern residents (8.6%) (P<0.001). Wheat-based food products were the main source of DON exposure, with a contribution rate of 96.5% in the north and 68.3% in the south. Average DON exposure was the highest in the 3-6 years [2.12 μg/(kg·d) for children in north and 0.73 μg/(kg·d) in south]. Conclusion: Exposure to DON from cereals in northern residents of China was considerably high, with a certain health risk. Northern children aged 3 to 6 exposed even more DON and needed significant attention.

Factors Influencing Rust (Melampsora apocyni) Intensity on Cultivated and Wild Apocynum venetum in Altay Prefecture, China

Rust (Melampsora apocyni) on Apocynum venetum is the major constraint to the commercial development of this medicinal herb. To determine the factors influencing rust intensity (maximum disease index [DI_max]), rust was investigated from 2011 to 2015 in both cultivated and wild A. venetum plants. Partial least squares path modeling (PLS-PM) was used to analyze the paths and extent of the factors related to pathogen, environment, and host that affect rust intensity. DI_max exhibited considerable variations across years and study sites, with variations linked to various factors fostering disease development. PLS-PM explained 80.0 and 70.1% of variations in DI_max in cultivated and wild plants, respectively. Precipitation was the key factor determining DI_max in both cultivated and wild plants (path coefficient [PC] = 0.313 and 0.544, respectively). In addition, the topsoil water content in cultivated plants and the total vegetation coverage in wild plants were also critical determinants of DI_max via their effects on the microclimatic factor (contribution coefficients [CC] = 0.681 and 0.989, respectively; PC = 0.831 and 0.231, respectively). In both cultivated and wild plants, host factors were mainly dominated by A. venetum density (CC = 0.989 and 0.894, respectively), and their effect on DI_max via the microclimatic factor (PC = 0.841 and 0.862, respectively) exceeded that via the inoculum factor (PC = 0.705 and 0.130, respectively). However, the indirect effects led to DI_max variation, while the dilution effect on host (CC = 0.154) from weed in wild plants led to the indirect effect size in wild plants of 0.200, which was lower than -0.699 in cultivated plants.

[Preliminary study on the evaluation of pneumoconiosis]

Objective: Select the appropriate disease assessment indicators, formulate the comprehensive evaluation group of pneumoconiosis patients, and explore the role of the comprehensive evaluation grouping in the clinical evaluation of pneumoconiosis, and provide the basis for the prognosis of pneumoconiosis. Methods: Combined with clinical symptoms, pulmonary function, pneumoconiosis stage, acute exacerbation and complications, a comprehensive assessment of pneumoconiosis patients was established.138 newly diagnosed pneumoconiosis patients were divided into low risk group, middle risk group and (very) high risk group. The patients were followed up by telephone to record their health status and quality of life within one year after discharge from hospital. Analysis of the relationship between the comprehensive assessment group of patients with pneumoconiosis and symptom score, pulmonary function, pneumoconiosis stage, acute exacerbation and complications. The relationship between the comprehensive assessment group of pneumoconiosis patients and the risk events (the number of visits, hospitalization, mechanical ventilation, death cases in one year) and CAT score were analyzed. Results: There were significant differences in clinical symptoms, pulmonary function injury, pneumoconiosis stage, acute exacerbation and complications among patients in low risk group, middle risk group and (very) high risk group (P<0.01) . With the increase of comprehensive assessment score, CAT score increased, the risk events increased, the difference was statistically significant (P<0.01) . Spearman correlation analysis showed that the comprehensive assessment group was significantly correlated with the number of visits, hospitalization, mechanical ventilation, deaths and CAT score in one year. Conclusion: Combined with clinical symptom assessment, pulmonary function assessment, chest imaging assessment, acute exacerbation assessment, and complication assessment, the pneumoconiosis patients' comprehensive assessment group formulated can evaluate the severity of pneumoconiosis patients, and make a more accurate and comprehensive judgement of the disease.

A potential biomarker for colorectal cancer: long non-coding RNA RP1-13P20.6

Long non-coding RNAs (lncRNAs) occupy the majority of the human genome. Their dysregulation is usually related with the procession of diseases, including tumors. Abnormally expressed lncRNAs have been found in colorectal cancer (CRC), but are not fully understood. In the current study, we determined the expression level of a novel lncRNA-RP1-13P20.6 in 99 pairs of CRC tissues compared to their matched normal adjacent tissues, using real time polymerase chain reaction. We further assessed the correlation between their expression levels and their clinicopathological parameters, and determined the potential of RP1-13P20.6 as a biomarker for CRC. The expression of lncRNA-RP1-13P20.6 in CRC tissues and cell lines decreased significantly with an area under the curve (AUC) of 0.755 (p < 0.001). However, there was no significant difference between the expression levels of lncRNA-RP1-13P20.6 and the clinicopathological characteristics. The abnormal expression level and AUC values suggest that lncRNA-RP1-13P20.6 is a potential biomarker for CRC.

[Relationship between epicardial adipose tissue and clinical prognosis of patients with coronary heart disease after percutaneous coronary intervention]

Objective: To further evaluate the clinical value of epicardial adipose tissue volume (EATV) in predicting the prognosis of coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods: From July 2013 to July 2016 in TEDA International Cardiovascular Disease Hospital, a total of 474 patients diagnosed with CHD were included in this study.According to the result of EATV, patients were divided into three groups, group A (EATV≤75 ml), group B (75 ml<EATV<150 ml), and group C (EATV≥150 ml). Then the level of body mass index (BMI), hypersensitive c-reactive protein (hs-CRP), interleukin (IL)-6 and tumor necrosis factor (TNF)-α were tested for all the three groups.All the patients were followed up for 1 year for major adverse cardiovascular events (MACE). The clinical value of EATV in predicting the occurrence of MACE events was evaluated. Results: The BMI, level of hs-CRP, TNF-α in group B were higher than group A, group C were significantly higher than group B, with statistically significant difference across all the comparisons (P<0.05). Spearman correlation analysis showed EATV was positively correlated with hs-CRP, IL-6, TNF-α (r=0.675-0.700, P<0.01). The incidence of MACE in the three groups were 8.50% in group C, 5.26% in group B, 3.13% in group A, and the differences were all significant (P<0.01). ROC curve showed the cut-off value of EATV level was 120.39 ml to predict MACE (area under cure: 0.751, 95%CI: 0.634-0.868, P<0.01), and the sensitivity was 72.7%, the specificity was 61%.EATV>120.39 ml can be used as an independent risk factor for predicting the occurrence of MACE. Conclusion: The level of EATV is closely related to the occurrence of MACE events, and EATV>120.39 ml is an independent risk factor for MACE in patients with CHD after PCI.

Specific computed tomography imaging characteristics of congenital mesoblastic nephroma and correlation with ultrasound and pathology

INTRODUCTION

Congenital mesoblastic nephroma (CMN) is a common solid renal tumor in the neonate. Congenital mesoblastic nephroma can be divided into classic, cellular, and mixed types. The prognosis of CMN is very optimistic. But CMN can easily be misdiagnosed as the other malignant renal tumors by radiology. However, no studies have described the computed tomography (CT) imaging appearance of CNM in detail. The objective of this study is retrospective analyses of the multislice CT characteristics of CMN and their corresponding ultrasound findings and pathology.

METHODS

This retrospective study reviewed the enhanced CT images of the CMNs and other renal tumors in children younger than 1 year in the past 10 years from the First Affiliated Hospital of Sun Yat-sen University. Two radiologists had noted the CT imaging characteristics of these images. t-test and Fisher's exact test were used in the comparison of imaging characteristics between the CMNs and other renal tumors.

RESULTS AND DISCUSSION

Compared with other malignant renal tumors, the CMNs tend to appear as smaller round masses without clear coverage or clear boundary with the kidney in CT images (P < 0.01). The intratumor pelvis and the double-layer sign are the specific characteristics of CMNs (P < 0.01). The gender, quality of tumor (solid or solid-cystic), character of enhancement (homogeneous or heterogeneous enhancement), peri-renal hemorrhage, or peripheral lymph node enlargement showed no statistical significance (P > 0.05) between CMNs and other renal tumors. The appearances of CMN with classic components in the CT images are relevant to the pathological findings. The intratumor pelvis is caused by the classic components of CMN growing to encapsulate the pelvis. The double-layer sign in CT image correlates with the specific hypoechoic ring in ultrasound, which is caused by the slow blood flow and delay contrast agent filling in the blood sinus located in the peripheral part of the tumor. The differential diagnosis of CMN should include the other solitary renal tumors such as Wilms' tumor, clear-cell sarcoma of the kidney, and rhabdoid tumor of the kidney.

CONCLUSION

The unclear coverage and unclear boundary with the kidney, the intratumor pelvis, and double-layer sign after contrast were specific CT imaging characteristics of CMN.

[HER2 status in gastric adenocarcinoma of Chinese: a multicenter study of 40 842 patients]

Objective: To investigation HER2 status in gastric adenocarcinoma of Chinese and contributing factors to the HER2 expression. Methods: HER2 status of 40 842 gastric adenocarcinomas and clinical data were retrospectively collected from 23 hospitals dated from 2013 to 2016. The association between HER2 positivity and clinicopathologic features was analyzed. Results: Of the 40 842 patients the median age was 62 years, the male female ratio was 2.6∶1.0. The rate of HER2 positivity was 8.8% (3 577/40 842). HER2 expression was related to the tissue type, tumor location, Lauren classification and tumor differentiation (P values: 0.009, 0.001, <0.01 and <0.01, respectively). Different HER2 expression status was observed between primary and recurrent tumors in 7.6% (48/635) cases. The rates of HER2 positivity ranged from 2% to 10% among different institutions. The rates of HER2 FISH amplification were dramatically different among the 23 hospitals (0-100%) with an average rate of 10% (810/8 156) in patients with HER2 IHC 2+ . Conclusions: HER2 expression is associated with clinicopathologic characteristics. HER2 re-assessment of tumor tissue and use of in situ hybridization techniques increase HER2 positivity. The current retrospective study should reflect the HER2 status in gastric adenocarcinoma of Chinese patients.

Primary Angioplasty without Stenting for Symptomatic, High-Grade Intracranial Stenosis with Poor Circulation

BACKGROUND AND PURPOSE

Although the Stenting versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study demonstrated a high incidence of perioperative complications for Intracranial Atherosclerotic disease (ICAD) treatments with stent placement, some studies have shown that submaximal angioplasty with an undersized balloon limits the risks of perioperative complications, suggesting that intervention may remain an alternative option for ICAD if perioperative complications are minimized. We sought to evaluate clinical and angiographic outcomes after primary angioplasty without stent placement in patients with symptomatic, high-grade intracranial stenosis and poor antegrade flow who were refractory to medical therapy.

MATERIALS AND METHODS

All cases with high-grade, symptomatic intracranial stenosis and poor antegrade flow treated with intracranial angioplasty without stent placement at Xuanwu Hospital, Capital Medical University, from January 2010 to December 2016, were retrospectively reviewed. The main outcomes included the changes in antegrade flow and residual stenosis and any stroke or death within 1 month. We also evaluated functional outcomes, stroke, and restenosis in patients on follow-up.

RESULTS

Thirty-five patients (mean age, 64.3 years) were included, and the mean follow-up time was 9.7 months. The average preprocedural stenosis was 88.4%. The immediate, average postprocedure stenosis rate was 25.3%, and the average postprocedural stenosis rate at last angiographic follow-up was 34.7%. The primary end point of major stroke or death at 30 days was observed in 1 patient (1/35, 2.9%), and no patient had intraprocedural complications. The incidence of stroke or death at the last follow-up was 2.9%, which was superior to the results of the medical and stent-placement arms of the SAMMPRIS study. Severe restenosis was observed in 3 (3/25, 12%) patients but without any symptoms.

CONCLUSIONS

In this retrospective series, primary balloon angioplasty was an effective treatment option for symptomatic intracranial stenosis with a high risk of stroke.

[Diagnostic value of contrast-enhanced CT scans in identifying lung adenocarcinomas manifesting as ground glass nodules]

Objective: To investigate the value of contrast-enhanced CT scans in differential diagnosis of atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), minimal invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) in patients who manifested as ground glass nodules (GGNs) or mixed GGNs (mGGNs) in unenhanced CT imaging. Methods: The unenhanced and enhanced CT images of 194 patients with GGNs in the lung were retrospectively analyzed, including 64 cases with pre-invasive lesions, 80 cases with MIA, and 50 cases with IAC. The prediction of pathological types was based on maximal diameters and the solid portions of the lesions displayed on unenhanced and enhanced CT images, and then compared with pathological diagnosis. Results: In 64 patients with pre-invasive lesions, the CT value increased in 59 cases after contrast-enhanced administration, whereas the solid portions increased in 5 cases. In the 80 patients with MIA, solid portions increased in 50 cases and the CT value increased in 30 cases after contrast administration. In 50 cases with IAC, almost all of them showed increased solid portions, whereas only 2 cases showed an increase of CT values. In the pre-invasive group and the MIA group, the increase of CT values after contrast administration was (45.88±15.97) HU and (66.47±44.54) HU, respectively, showing statistically significant difference (P=0.001). The increase of solid portions in the MIA group and IAC group was (1.55±0.73) mm and (1.88±0.75) mm, respectively, also showing significant difference (P=0.032). Conclusion: Contrast-enhanced CT scans were more useful than unenhanced CT scans for the diagnosis of lung adenocarcinomas manifesting as GGNs .

[Effects of epicardial adipose tissue and inflammatory factors on left ventricular diastolic function in patients with coronary heart disease]

Objective: To investigate the effects ofepicardial adipose tissue volume (EATV) and inflammatory factors on left ventricular diastolic function in patients with coronary heart disease(CHD). Methods: The clinical data of patients with coronary heart disease receiving coronary artery intervention therapy from January 2014 to October 2015 in TEDA international cardiovascular hospital were preoperatively collected.We measured the indexes of EATV and left ventricular diastolic function. Results: The difference of age (F=7.76, P=0.01), IL-6 (F=14.34, P<0.01), Hs-CRP (F=4.08, P=0.04), adiponect-in (F=4.50, P=0.04) and EATV (F=71.29, P<0.01) between the diastolicdysfunction group (n=156) and the normal group (n=76) was statistically significant.Multivariate logistic regression analysis showed that EATV was a risk factor for left ventricular diastolic dysfunction in patients with coronary artery disease (P<0.05), OR=1.05, 95%CI (1.03-1.06). The AUC value of EATV in the diagnosis of left ventriculardiastolic function in patients with coronary heart disease was 0.79, 95%CI (0.73-0.85) P<0.01. Conclusions: EATV can be used as an independent risk factor for left ventricular diastolic dysfunction.It has some non-invasive diagnosis and predictive value, and it can be used as a new therapeutic target.

[Incidence and risk factors of chronic kidney disease in community-based patients with diabetes]

OBJECTIVE

To estimate the incidence rate and effects of risk factors on chronic kidney disease (CKD) in Chinese patients with diabetes, based on Electronic Health Records (EHRs) from the Chinese Electronic health Records Research in Yinzhou (CHERRY) Study.

METHODS

Using the CHERRY cohort study with the individual-level information on chronic disease management; and health administrative, clinical and laboratory databases, patients with diabetes without kidney disease at baseline were enrolled and followed up from January 2009 through December 2016. CKD was defined as the estimated glomerular filtration rate(eGFR) <60 mL/(min×1.73 m²) or urine albumin/creatinine ratio (ACR)≥3 mg/mmol. Standardized incidence rates of CKD in diabetic population were calculated according to the 2010 China census data. Cox proportional hazards models were used to explore the association of risk factors on CKD in patients with diabetes.

RESULTS

Over a median 3.2 years of follow-up, 13 829 patients with diabetes were included in this analysis and 1 087 developed CKD. The crude and standardized incidence rate was 23.7(95%CI: 22.3-25.2) and 14.8(95%CI:12.1-17.6) per 1 000 person-years respectively. The incidence rate for developing CKD in patients with diabetes aged over 60 years was higher than those aged 60 and below (26.6 vs. 11.5 per 1 000 person-years, P<0.05). Cox proportional hazards models showed that age over 60 years(HR=1.88, 95%CI: 1.51-2.35), hypertension (HR=1.81, 95%CI: 1.56-2.10), total cholesterol (HR=1.07, 95%CI: 1.00-1.14) and duration of diabetes (HR per year increment=1.02, 95%CI: 1.00-1.03) and the level of high density lipoprotein cholesterol (HDLC, HR=0.49, 95%CI: 0.40-0.61) were significantly associated with CKD. No statistical significance was found for sex, smoking status, alcohol use and average level of fasting glucose (All P>0.05). Subgroup analysis indicated that even when the lipid levels were well-controlled, comorbidity of hypertension was still associated with CKD in the patients with diabetes.

CONCLUSION

Incidence rate of chronic kidney disease in this Chinese population with diabetes was high. Age and comorbidity of hypertension were the most important risk factors for CKD, suggesting the priority for CKD screening in patients with diabetes in China. Control of blood pressure and lipid were especially crucial to prevent CKD in patients with diabetes.

[Effectiveness of different screening strategies for primary prevention of cardiovascular diseases in a rural northern Chinese population]

OBJECTIVE

To estimate the potential health benefit of screening strategies for cardiovascular diseases primary prevention in a rural northern Chinese population.

METHODS

A total of 6 221 adults aged 40-74 years old, from rural Beijing, China and free from cardiovascular diseases at baseline were included. The following screening strategies were compared: Strategy 1, the strategy based on numbers of risk factors recommended by the Chinese Guideline for Prevention of Cardiovascular Diseases in people aged 40-74; Strategy 2, screening people aged 40-74 based on the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) risk prediction model; Strategy 3, screening people aged 50-74 using the China-PAR risk prediction model. Participates who were classified into medium- or high-risk by the corresponding strategies would be introduced to lifestyle intervention, while high risk population would take medication in addition. Markov model was used to compare the potential health benefits within 10 years in each scenario, which applied the parameters from this rural northern Chinese cohort, published literatures, meta-analyses and systematic reviews, clinical trials and other cohort studies of Chinese population. Quality-adjusted life year (QALY) gained, cardiovascular diseases (CVD) events/deaths could be prevented and number needed to be screened (NNS) per QALY gained/per CVD event prevented/per CVD death prevented were calculated to compare the effectiveness. One-way sensitivity analysis concerning uncertainty of cardiovascular disease incidence rate and probabilistic sensitivity analysis about the uncertainty of hazard ratios were conducted.

RESULTS

Compared with non-screening strategy, the potential health benefits of each strategy were: Strategy 1 would gain QALY of 498 (95%CI: 103-894) and prevent 298 (95%CI: 155-441) CVD events; Strategy 2 would gain QALY of 691 (95%CI: 233-1 149) and prevent CVD events of 374 (95%CI: 181-567); Strategy 3 would gain QALY of 654 (95%CI: 199-1 108) and prevent CVD events of 346 (95%CI: 154-538). Screening strategy based on ChinaPAR risk prediction model (strategy 2 or 3) would be generally better in terms of QALY gained, CVD events/deaths prevented and NNS than the strategy based on numbers of CVD risk factors (all P<0.05 except NNS per QALY gained and NNS per CVD event prevented in 40-74 years). Similar benefits were obtained for the strategy 2 and 3. The results were consistent in the sensitivity analyses on the parameters of incidence rates and hazard ratios.

CONCLUSION

Screening people to target increased risks of cardiovascular diseases in this rural northern Chinese population is necessary. Screening strategy based on China-PAR risk prediction model could gain more health benefits than that based on numbers of CVD risk factors.

[Association between the ratio of early diastolic transmitral velocity to early diastolic mitral annular velocity and invasive measured left atrial pressure in patients with atrial fibrillation and preserved left ventricular ejection fraction]

Objective: To evaluate the association between the ratio of early diastolic transmitral velocity to early diastolic mitral annular velocity (E/E') and left atrial pressure (LAP) estimated from invasive catheter measurements in patients with atrial fibrillation (AF). Methods: A total of 46 consecutive patients with non-valvular AF and preserved left ventricular ejection fraction (LVEF) admitted in our department to receive the first radiofrequency ablation from May to July 2017 were included. All patients underwent echocardiography at 24-48 hours before radiofrequency ablation, and LAP was invasively measured during the ablation procedure. According to mean LAP, patients were divided into 2 groups of normal LAP (LAP≤12 mmHg(1 mmHg=0.133 kPa, n=31) and elevated LAP (LAP>12 mmHg, n=15). Linear correlation analysis was used to evaluate the relationship between E/E' and LAP. Results: E/E' correlated well with LAP (septal E/E' (E/E'(sep)), r= 0.397, P=0.006; lateral E/E' (E/E'(lat)), r=0.433, P=0.003; mean E/E' (E/E'(mean)), r=0.431, P=0.003). Using receiver operating characteristic analysis, the optimal cut-off for E/E'(sep) was 12.5 (sensitivity 73.3%, specificity 67.7%), E/E'(lat) was 10.8 (sensitivity 80.0%, specificity 77.4%), E/E'(mean) was 11.0 (sensitivity 86.7%, specificity 64.5%) to predict mean LAP>12 mmHg. Conclusion: E/E', especially the E/E'(lat), is positively correlated with LAP in patients with AF and preserved LVEF, and may be used to estimate the diastolic function in AF patients with preserved LVEF.

[Progress in research of family-based cohort study on common chronic non-communicable diseases in rural population in northern China]

Family-based cohort study is a special type of study design, in which biological samples and environmental exposure information of the member in a family are collected and related follow up is conducted. Family-based cohort study can be applied to explore the effect of genetic factors, environmental factors, gene-gene interaction, and gene-environment interaction in the etiology of complex diseases. This paper summarizes the objectives, methods and results, as well as the opportunities and challenges of the family-based cohort study on common chronic non-communicable diseases in rural population in northern China.

[Influence of intravenous thrombolysis on prognosis of acute ischemic stroke in patients with moderate to severe leukoaraiosis]

Objective: To investigate the influence of intravenous thrombolysis on prognosis of acute ischemic stroke in patients with moderate to severe leukoaraiosis and to analyze influencing factors of the clinical prognosis. Methods: We consecutively included acute ischemic stroke patients with middle cerebral artery occlusion (n=101) from Department of Neurology or Emergency, and patients were divided into two groups according to whether on intravenous thrombolysis therapy (IVT) or not. The Fugl-Meyer scale score (FMS) was used to assess motor function outcome and the National Institutes of Health Stroke Scale (NIHSS) score was used to assess neurologic function. Clinical data were obtained and compared between the two groups. Patients were followed up for 90 days, the primary clinical endpoint events included stroke recurrence and death, and the key secondary endpoint events included other vascular events after IVT. Multivariate linear regression analysis was used to analyze the relevant factors influencing the motor function 90 days later. Results: Among the 101 enrolled patients, 37 (36.6%) were classified as IVT group and 64 (63.4%) as no IVT group. In IVT group, hemorrhagic transformation and symptomatic intracranial hemorrhage were observed in 32.4% (12/37) and 13.5% (5/37) of the patients, which were higher than those in the no IVT group (9.4% (6/64) and 1.6% (1/64) , respectively) (χ(2)=8.511, P=0.004; χ(2)=5.993, P=0.014). And there was no significant difference between the two groups in NIHSS score and FMS score at any time point. In addition, there was no significant increase in 90-day FMS score in the two groups compared with the FMS score on admission (83±9 vs 80±12; 86±8 vs 80±10). After followed up for 90 days, the primary clinical endpoints were obtained in 32 patients (32/101; 31.9%), including 18 cases of stroke recurrence (18/101; 17.8%) and 14 cases of death (14/101; 13.9%). No significant difference was found in primary clinical endpoints between the two groups. Multivariate linear regression analysis revealed that symptomatic intracranial hemorrhage (t=-2.318; P=0.023), baseline NIHSS score (t=-4.263; P=0.000), recurrent stroke (t=-9.114; P=0.000) and hemorrhage transformation (t=-2.121; P=0.037) were risk factors of poor 90-day motor function recovery, but not application of intravenous thrombolysis therapy (t=0.328; P=0.744). Conclusions: Acute ischemic stroke patients with moderate to severe LA have higher risk of hemorrhagic transformation and symptomatic intracranial hemorrhage after intravenous thrombolysis. However, there is no association of intravenous thrombolysis therapy with motor function recovery.

Synovial sarcoma of the tongue: report of a case and review of the literature

This report outlines the work-up and management of a 35-year-old man with a synovial sarcoma of the lateral border of the tongue. Synovial sarcoma of the tongue is an extremely rare tumour with variable morphological microscopic types and characters of immunohistochemical profile. There have only been 15 cases previously reported. This report aims to update the literature on this subject and explore the best treatment options.

Role of Functional IFNL4, IFNLR1, IFNA, IFNAR2 Polymorphisms in Hepatitis B virus-related liver disease in Han Chinese population

Recent studies show that variants in some interferon genes together with interferon receptor genes are associated with the outcome of infectious diseases. We examined the association between the risk of hepatitis B virus (HBV)-related liver disease and the functional polymorphisms within IFNL4, IFNLR1, IFNA1, IFNA2, IFNA5 and IFNAR2 genes (14 loci in all) in a Han Chinese population. A total of 3128 people participated and were divided into 5 groups: healthy controls, natural clearance, chronic hepatitis B(CHB), liver cirrhosis and hepatocellular carcinoma (HCC). Significant associations were observed for 4 variants in IFNAR2, IFNLR1 with HBV infection, and IFNLR1-rs4649203 was associated with HBV recovery. Moreover, we demonstrated the clear relevance of 5 polymorphisms in IFNA1, IFNA2, IFNL4 with HCC. Three SNPs in IFNL4 gene may be important susceptible factors for the progression of HBV-related liver disease by trend chi-square test. The IFNL4 haplotype conformed by rs12971396_G, rs8113007_T and rs7248668A was more frequent in HCC than CHB and LC group. Three polymorphisms in the 5' region of the IFNL4 gene are associated with the progression of HBV-related liver disease. IFNA1- rs1831583 and IFNA2- rs649053 are associated with the development of HCC. IFNLR1- rs4649203, rs7525481 are predictors for HBV infection, and rs4649203 is a predictor of spontaneous clearance. IFNAR2 -rs1051393, rs12233338 may be predictive markers of HBV infection in the Chinese population.

A light-mediated metal-free atom transfer radical chain transfer reaction for the controlled hydrogenation of poly(vinylidene fluoride-chlorotrifluoroethylene)

A light-mediated atom transfer radical chain transfer process is proposed for the controlled hydrogenation of P(VDF-CTFE) using metal-free photocatalyst.

Dynamics of amino acid redistribution in the carnivorous Venus flytrap (Dionaea muscipula) after digestion of 13 C/15 N-labelled prey

Amino acids represent an important component in the diet of the Venus flytrap (Dionaea muscipula), and supply plants with much needed nitrogen resources upon capture of insect prey. Little is known about the significance of prey-derived carbon backbones of amino acids for the success of Dionaea's carnivorous life-style. The present study aimed at characterizing the metabolic fate of ¹⁵ N and ¹³ C in amino acids acquired from double-labeled insect powder. We tracked changes in plant amino acid pools and their δ¹³ C- and δ¹⁵ N-signatures over a period of five weeks after feeding, as affected by contrasting feeding intensity and tissue type (i.e., fed and non-fed traps and attached petioles of Dionaea). Isotope signatures (i.e., δ¹³ C and δ¹⁵ N) of plant amino acid pools were strongly correlated, explaining 60% of observed variation. Residual variation was related to contrasting effects of tissue type, feeding intensity and elapsed time since feeding. Synthesis of nitrogen-rich transport compounds (i.e., amides) during peak time of prey digestion increased ¹⁵ N- relative to ¹³ C- abundances in amino acid pools. After completion of prey digestion, ¹³ C in amino acid pools was progressively exchanged for newly fixed ¹² C. The latter process was most evident for non-fed traps and attached petioles of plants that had received ample insect powder. We argue that prey-derived amino acids contribute to respiratory energy gain and loss of ¹³ CO₂ during conversion into transport compounds (i.e., 2 days after feeding), and that amino-nitrogen helps boost photosynthetic carbon gain later on (i.e., 5 weeks after feeding).

TGF-β1 attenuated branching morphogenesis of embryonic murine submandibular gland through Smad3 activation

Transforming growth factor-β1 (TGF-β1) plays several crucial regulatory roles in multiple physiological and pathological processes. The aim of this work was to investigate the role of TGF-β1 in branching morphogenesis of salivary gland. We harvested and cultured submandibular salivary glands (SMGs) from murine embryos, which were then treated with exogenous TGF-β1, or its neutralized antibody, Smad3 inhibitor, or Smad3 small interfering RNA (siRNA). Our results suggested that TGF-β1 attenuated branching morphogenesis of embryonic murine SMG via Smad3 activation, thus playing a negative regulatory role in salivary gland development.

Oncogenic K-Ras upregulates ITGA6 expression via FOSL1 to induce anoikis resistance and synergizes with αV-Class integrins to promote EMT

In many cancer types, integrin-mediated signaling regulates proliferation, survival and invasion of tumorigenic cells. However, it is still unclear how integrins crosstalk with oncogenes to regulate tumorigenesis and metastasis. Here we show that oncogenic K-Ras^V12 upregulates α6-integrin expression in Madin–Darby canine kidney (MDCK) cells via activation of the mitogen-activated protein kinase/extracellular signal-regulated kinase (ERK)/Fos-related antigen 1-signaling cascade. Activated α6-integrins promoted metastatic capacity and anoikis resistance, and led to perturbed growth of MDCK cysts. Transcriptomic analysis of K-Ras^V12-transformed MDCK cells also revealed robust downregulation of αV-class integrins. Re-expression of αV-integrin in K-Ras^V12-transformed MDCK cells synergistically upregulated the expression of Zinc finger E-box-binding homeobox 1 and Twist-related protein 1 and triggered epithelial-mesenchymal transition leading to induced cell motility and invasion. These results delineate the signaling cascades connecting oncogenic K-Ras^V12 with α6- and αV-integrin functions to modulate cancer cell survival and tumorigenesis, and reveal new possible strategies to target highly oncogenic K-Ras^V12 mutants.

KIF26B, a novel oncogene, promotes proliferation and metastasis by activating the VEGF pathway in gastric cancer

Tumor metastasis is the main reason of cancer-related death for gastric cancer (GC) patients and gene expression microarray data indicate that kinesin family member 26B (KIF26B) is one of the most upregulated genes in metastatic GC samples. Specifically, KIF26B expression was upregulated in a stepwise manner from non-tumorous gastric mucosa, primary GC tissues without metastasis, via primary GC tissues with metastasis, to secondary lymph node metastatic (LNM) foci. Increased expression of KIF26B was correlated with tumor size, positive LNM or distant metastases and poor prognosis. KIF26B, negatively regulated by miR-372, promoted GC cell proliferation and metastasis in vitro and in vivo. Mechanistic investigations confirmed that the main target of KIF26B was the vascular endothelial growth factor (VEGF) signaling pathway, particularly by inhibition or overexpression of VEGFA, PXN, FAK, PIK3CA, BCL2 and CREB1. Thus, KIF26B, a novel oncogene regulated by miR-372, promotes proliferation and metastasis through the VEGF pathway in GC.

[A sero-epidemiological study of hepatitis B among general population in Beijing]

OBJECTIVE

To understand the sero-prevalence of hepatitis B in general population in Beijing and provide evidence for the prevention and control of hepatitis B.

METHODS

A serological survey was conducted in general population aged >1 year selected through multistage randomized cluster sampling in Beijing from August 2013 to February 2014. The estimated sample size was 5 200. Venous blood samples were collected from them to detect five hepatitis B serological indicators. The information about the hepatitis B immunization history and risk factors of the study subjects were collected through a questionnaire survey.

RESULTS

A total of 6 705 people were surveyed. The sero-positive rates of HBsAg, anti-HBs, anti-HBc and total HBV infection rate were 2.74%, 44.72%, 26.91% and 26.95% respectively. The age standardized rates were 2.73%, 44.83%, 26.84% and 26.87% respectively. As for the general population, in Beijing since the prevalence rate of hepatitis B surface antigen has decreased to 2.73%, <1% in children aged less than 5 years old, <1% in people aged less than 25 years old.

CONCLUSION

The integrated prevention and control strategy of hepatitis B had a significant effect in Beijing. We should continue to strengthen the work of adult hepatitis B vaccination.

Template-free 3D titanium carbide (Ti3C2Tx) MXene particles crumpled by capillary forces

The shape of Ti₃C₂T_xMXenes can be altered using spray drying, providing a new route for controlling MXene nanosheet morphology.

An efficient perovskite solar cell with symmetrical Zn(ii) phthalocyanine infiltrated buffering porous Al2O3 as the hybrid interfacial hole-transporting layer

A new Zn(ii) phthalocyanine (Pc) based low bandgap HTM is introduced for perovskite solar cells. Steady state and time-resolved photoluminescence (PL) measurements indicated an evenly matched hole extraction efficiency between sym-HTPcH and spiro-OMeTAD. On account of the low film quality and resulting high recombination, Zn(ii) Pc normally cannot work as an effective HTM. We adopted insulating Al₂O₃ for the infiltration of sym-HTPcH to form a hybrid interfacial buffer layer, affording perovskite solar cells (PSCs) with an average PCE value of up to 12.3%, which is a significant improvement with respect to the control cell without the meso-Al₂O₃ layer (4.21%) and is the highest value ever reported for Zn(ii) phthalocyanine based devices under AM1.5G standard conditions. A hysteresis test revealed that our device structure with the new HTM exhibited a balanced charge extraction behaviour.

Effects of Astragalus Polysaccharides and Astragalosides on the Phagocytosis of Mycobacterium tuberculosis by Macrophages

The herb Astragalus membranaceus is used in traditional Chinese medicine to boost immunity. This study investigated the effects of Astragalus polysaccharides (APS) and astragalosides (AS) on the phagocytosis of Mycobacterium tuberculosis by macrophages. Peritoneal macrophages were obtained by peritoneal lavage from mice stimulated by starch gravy culture medium and cultured with M. tuberculosis and varying concentrations of APS and AS. Phagocytotic activity was measured using a real-time polymerase chain reaction assay to detect M. tuberculosis DNA. Levels of interleukin-1β, interleukin-6 and tumour necrosis factor-α secreted by activated macrophages in the culture supernatant were determined using an enzyme-linked immunosorbent assay. Macrophage phagocytotic activity and secreted cytokine levels were significantly increased after treatment with APS and AS. This study provides evidence that APS and AS have strong promoting effects on the phagocytosis of M. tuberculosis by macrophages and the secretion of interleukin-1β, interleukin-6 and tumour necrosis factor-α by activated macrophages.

[Retrospective cohort study for the impact on readmission of patients with ischemic stroke after treatment of aspirin plus clopidogrel or aspirin mono-therapy]

OBJECTIVE

To see the influence of different antiplatelet therapies on stroke patients' readmission by performing a deep data-mining into Beijing Healthcare Insuring Database, based on a large sample size.

METHODS

Aretrospective cohort study, was adopted to extract patients primarily diagnosed as ischemic stroke from healthcare database. The first hospital records were considered as the patient's baseline in this study, who were divided into MAPT (aspirin) and DAPT (aspirin and clopidogrel) according to the patient's baseline medications. A follow-up was conducted to see whether the patients would have rehospitalization record because of major result events after medication. The major result events, included: (1) recurrence of ischemic stroke; (2) hemorrhagic transformation of ischemic stroke; (3) myocardial infarction; (4) the digestive hemorrhage. The Kaplan-Meier figure was used to compare the survival situations between these two groups, the log-rank test was used to test the difference of the survival curve, and 1:1 propensity score matching was calculated from the patients' baseline data. Cox proportional hazards model was used to calculate the hazard ratio (HR).

RESULTS

A total of 27 695 patients From January 2010 to September 2013 were included, 4 047 with DAPT, and 23 648 with MAPT. Because the baseline characteristics of the patients was disequilibrium, so we used 1:1 propensity score matching, after which, the number of the two groups was 4 046 each. Adjusted for the general demographic characteristics such as age, sex, nationality, complication and drug combination, no statistical significance was observed between the survival curves of the two groups (P=0.06). HR value of major result events between the groups was 0.91 (0.82-1.01, P=0.07), which was not statistically significant. The covariate gender HR=1.36 (1.20-1.55, P<0.05), accompanied by diabetes HR= 1.36 (1.20-1.54, P<0.05), dyslipidemia HR=1.13 (1.00-1.27, P=1.13), heart disease HR=1.39 (1.22-1.58, P<0.05) was statistically significant. Drug combination with other antiplatelet agents HR=1.05 (0.95-1.17, P>1.05) did not increase the risk of readmission.

CONCLUSION

There was no difference in prevention of readmission between patients with DAPT and MAPT. Patients with complications should actively treat the complications at the same time as they prevent recurrence after first attack.

The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis

BACKGROUND

The clinical value of the prognostic nutritional index (PNI) in gastric cancer (GC) remains controversial. Therefore, we performed the meta-analysis to determine the prognostic and clinicopathological values of PNI in patients with GC.

METHODS

A literature search was performed in the PubMed, Embase, and Web of Science databases. Hazard ratios (HRs) and odds ratios (ORs) were extracted to estimate the association of PNI with survival and clinicopathological characteristics, respectively.

RESULTS

Ten studies involving 3396 patients with GC were analyzed. The pooled results indicated that a low PNI was a significant predictor of poor overall survival (OS) (HR = 1.89, 95% confidence interval [CI] = 1.67-2.13, P < 0.01) and postoperative complications (OR = 1.74, 95% CI = 1.41-2.16, P < 0.01). In the subgroup analysis, a low PNI was significantly associated with poor OS in patients with GC at stage I, II and III, but not at stage IV (HR = 1.14, 95% CI = 0.84-1.55, P = 0.40). Moreover, a low PNI was significantly associated with more advanced tumor features, such as older age, deeper depth of tumor, positive lymph node metastasis, more advanced TNM stages, and positive vessel and lymphatic invasion.

CONCLUSION

PNI was a predictive indicator of survival and postoperative complications, and was associated with clinicopathological features in GC patients. However, a low PNI was not significantly associated with poor OS in patients with GC at stage IV.

Donor-π-donor type hole transporting materials: marked π-bridge effects on optoelectronic properties, solid-state structure, and perovskite solar cell efficiency

Donor–π-bridge–donor type oligomers (D–π–D) have been studied intensively as active materials for organic optoelectronic devices.

Donor–π-bridge–donor type oligomers (D–π–D) have been studied intensively as active materials for organic optoelectronic devices. In this study, we introduce three new D–π–D type organic semiconductors incorporating thiophene or thienothiophene with two electron-rich TPA units, which can be easily synthesized from commercially available materials. A thorough comparison of their optoelectronic and structural properties was conducted, revealing the strong influence of the extent of longitudinal π-bridge conjugation on both the solid structure of the organic semiconductive materials and their photovoltaic performance when applied as hole transporting materials (HTM) in perovskite solar cells. Single-crystal measurements and time-resolved photoluminescence (TRPL) studies indicate that these coplanar donor–π–donor type HTMs could be promising alternatives to state-of-the-art spiro-OMeTAD, due to the multiple intermolecular short contacts as charge transporting channels and efficient charge extraction properties from the perovskite layer. The optimized devices with PEH-9 exhibited an impressive PCE of 16.9% under standard global AM 1.5 illumination with minimized hysteretic behaviour, which is comparable to that of devices using spiro-OMeTAD under similar conditions. Ambient stability after 400 h revealed that 93% of the energy conversion efficiency was retained for PEH-9, indicating that the devices had good long-term stability.

Cockroach allergen exposure and risk of asthma

Cockroach sensitization is an important risk factor for the development of asthma. However, its underlying immune mechanisms and the genetic etiology for differences in allergic responses remain unclear. Cockroach allergens identification and their expression as biologically active recombinant proteins have provided a basis for studying the mechanisms regarding cockroach allergen-induced allergic sensitization and asthma. Glycans in allergens may play a crucial role in the immunogenicity of allergic diseases. Protease-activated receptor (PAR)-2, Toll-like receptor (TLR), and C-type lectin receptors have been suggested to be important for the penetration of cockroach allergens through epithelial cells to mediate allergen uptake, dendritic cell maturation, antigen-presenting cell (APC) function in T-cell polarization, and cytokine production. Environmental pollutants, which often coexist with the allergen, could synergistically elicit allergic inflammation, and aryl hydrocarbon receptor (AhR) activation and signaling may serve as a link between these two elements. Genetic factors may also play an important role in conferring the susceptibility to cockroach sensitization. Several genes have been associated with cockroach sensitization and asthma-related phenotypes. In this review, we will discuss the epidemiological evidence for cockroach allergen-induced asthma, cockroach allergens, the mechanisms regarding cockroach allergen-induced innate immune responses, and the genetic basis for cockroach sensitization.

Universality analysis of the existence of substantia nigra "swallow tail" appearance of non-Parkinson patients in 3T SWI

OBJECTIVE

To use the 3.0T susceptibility-weighted imaging (SWI) for universality analysis of the "swallow tail" appearance in the substantia nigra of non-Parkinson disease and discuss its lack of the value of imaging diagnosis of Parkinson disease (PD).

PATIENTS AND METHODS

Take 3.0TMR SWI in 60 PD patients (Group PD) and non-PD volunteers (Group N-PD), on the map of range analyze morphology and number of "swallow tail" appearance in substantia nigra of N-PD group volunteers, and compare the performance image of the corresponding region of the patients in the PD group.

RESULTS

After, 15 patients with lesions in the brain stem and significant motion artifacts were excluded. Forty-nine cases of group N-PD (96.08%) had typical "swallow tail" appearance in the bilateral or unilateral substantia nigra compacta posterolateral. All 54 patients with group PD (100%) lacked the "drop" rear elliptical high signal.

CONCLUSIONS

On the 3.0T SWI range map, the "swallow tail" appearance is ubiquitous in the substantia nigra of patients with non-PD. The deficiency of the signs has high sensitivity and specificity for PD diagnosis.

Targeted re-sequencing of linkage region on 2q21 identifies a novel functional variant for hip and knee osteoarthritis

OBJECTIVE

The aim of the study was to identify genetic variants predisposing to primary hip and knee osteoarthritis (OA) in a sample of Finnish families.

METHODS

Genome wide analysis was performed using 15 independent families (279 individuals) originating from Central Finland identified as having multiple individuals with primary hip and/or knee OA. Targeted re-sequencing was performed for three samples from one 33-member, four-generation family contributing most significantly to the LOD score. In addition, exome sequencing was performed in three family members from the same family.

RESULTS

Genome wide linkage analysis identified a susceptibility locus on chromosome 2q21 with a multipoint LOD score of 3.91. Targeted re-sequencing and subsequent linkage analysis revealed a susceptibility insertion variant rs11446594. It locates in a predicted strong enhancer element region with maximum LOD score 3.42 under dominant model of inheritance. Insertion creates a recognition sequence for ELF3 and HMGA1 transcription factors. Their DNA-binding affinity is highly increased in the presence of A-allele compared to wild type null allele.

CONCLUSION

A potentially novel functional OA susceptibility variant was identified by targeted re-sequencing. This variant locates in a predicted regulatory site and creates a recognition sequence for ELF3 and HMGA1 transcription factors that are predicted to play a significant role in articular cartilage homeostasis.

[Methodological bias and variation of systematic reviews on diagnostic test accuracy]

OBJECTIVE

To analyze methodological bias and variation of systematic reviews on diagnostic test accuracy (DTA).

METHODS

Meta-analyses on DTA were identified through an electronic search through databases as Medline, Embase and Cochrane between 1 January 2008 and 31 December 2012. Results from Meta-analyses on 10 primary studies were included. Pairs of reviewers worked independently to extract the related data of interest, together with those original data of the primary studies. Mixed linear model was used to investigate the direction and strength of the association among the 14 studies, featuring on estimates of the diagnostic accuracy.

RESULTS

A total of 23 papers on Meta-analyses with 550 primary studies were included. Results from mixed linear model showed that significant low estimates of diagnostic accuracy in studies unsatisfying " the reference standard would likely to correctly classify the target condition" [relative diagnostic odds ration (RDOR) =0.018 6, 95% CI: 0.001 0-0.358 5]. Studies whose reference standard were not independent of the index test produced significantly higher estimates of diagnostic accuracy (RDOR= 2.396 6, 95% CI:1.242 8-4.622 7).

CONCLUSION

Messages as " Is the reference standard likely to correctly classify the target condition?" and " Was the reference standard independent of the index test", were the origin of the methodological bias and variation of systematic reviews on diagnostic test accuracy.

Multicenter Prospective Trial of Stent Placement in Patients with Symptomatic High-Grade Intracranial Stenosis

BACKGROUND AND PURPOSE

On the basis of the high 1-month stroke and/or death (14.7%) rates associated with stent placement in the Stenting versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis trial, modifications in patient selection and procedural aspects for intracranial stent placement have been recommended. We performed a multicenter prospective single-arm trial to determine whether such modifications would result in lower rates of periprocedural stroke and/or death.

MATERIALS AND METHODS

The study enrolled patients with recent transient ischemic attack or ischemic stroke (excluding perforator ischemic events) related to high-grade (70%-99% in severity) stenosis of a major intracranial artery. Patients were treated by using angioplasty and self-expanding stents 3 weeks after the index ischemic event at 1 of the 10 high-volume centers in China. An independent neurologist ascertained the occurrence of any stroke and/or death within 1 month after the procedure.

RESULTS

A total of 100 consecutive patients were recruited. The target lesions were located in the middle cerebral artery (M1) (n = 38, 38%), intracranial internal carotid artery (n = 17, 17%), intradural vertebral artery (n = 18, 18%), and basilar artery (n = 27, 27%). The technical success rate of stent deployment with residual stenosis of <50% was 100%. The overall 1-month stroke and/or death rate was 2% (95% confidence interval, 0.2%-7.0%). Two ischemic strokes occurred in the pontine region (perforator distribution) in patients following angioplasty and stent placement for basilar artery stenosis.

CONCLUSIONS

The results of this prospective multicenter study demonstrated that modifications in patient selection and procedural aspects can substantially reduce the 1-month stroke and/or death rate following intracranial stent placement.

Pressure dependent structural changes and predicted electrical polarization in perovskite RMnO₃

High pressure x-ray diffraction measurements on perovskite RMnO3 (R  =  Dy, Ho and Lu) reveal that varying structural changes occur for different R ions. Large lattice changes (orthorhombic strain) occur in DyMnO3 and HoMnO3 while the Jahn-Teller (JT) distortion remains stable. Conversely, in the small R-ion system LuMnO3, Mn-O bond distortions are observed between 4 and 8 GPa with a broad minimum in the JT distortion. High pressure infrared measurements indicate that a phonon near 390 cm(-1) corresponding to the complex motion of the Mn and O ions changes anomalously for LuMnO3. It softens in the 4-8 GPa region, which is consistent with the structural change in Mn-O bonds and then hardens at higher pressures. By contrast, the phonons continuously harden with increasing pressure for DyMnO3 and HoMnO3. Density functional theory methods show that E-phase LuMnO3 is the most stable phase up to the 10 GPa pressure examined. Simulations indicate that the distinct structural change under pressure in LuMnO3 can possibly be used to optimize the electric polarization by pressure/strain.

Demonstration of a near-IR line-referenced electro-optical laser frequency comb for precision radial velocity measurements in astronomy

An important technique for discovering and characterizing planets beyond our solar system relies upon measurement of weak Doppler shifts in the spectra of host stars induced by the influence of orbiting planets. A recent advance has been the introduction of optical frequency combs as frequency references. Frequency combs produce a series of equally spaced reference frequencies and they offer extreme accuracy and spectral grasp that can potentially revolutionize exoplanet detection. Here we demonstrate a laser frequency comb using an alternate comb generation method based on electro-optical modulation, with the comb centre wavelength stabilized to a molecular or atomic reference. In contrast to mode-locked combs, the line spacing is readily resolvable using typical astronomical grating spectrographs. Built using commercial off-the-shelf components, the instrument is relatively simple and reliable. Proof of concept experiments operated at near-infrared wavelengths were carried out at the NASA Infrared Telescope Facility and the Keck-II telescope.

Laser frequency combs emit a spectrum of equally spaced peaks that can provide precise frequency references useful for astronomy. Here, the authors demonstrate a frequency comb using electro-optical modulation, which has a line spacing that is resolvable using grating spectrographs unlike the mode-locking approach.

Marker-assisted selection of Fusarium wilt-resistant and gynoecious melon (Cucumis melo L.)

In this study, molecular markers were designed based on the sex determination genes ACS7 (A) and WIP1 (G) and the domain in the Fusarium oxysporum-resistant gene Fom-2 (F) in order to achieve selection of F. oxysporum-resistant gynoecious melon plants. Markers of A and F are cleaved amplified polymorphic sequences that distinguish alleles according to restriction analysis. Twenty F1 and 1863 F2 plants derived from the crosses between the gynoecious line WI998 and the Fusarium wilt-resistant line MR-1 were genotyped based on the markers. The results showed that the polymerase chain reaction and enzyme digestion results could be effectively used to identify plants with the AAggFF genotype in F2 populations. In the F2 population, 35 gynoecious wilt-resistant plants were selected by marker-assisted selection and were confirmed by disease infection assays, demonstrating that these markers can be used in breeding to select F. oxysporum-resistant gynoecious melon plants.

Visualization of nigrosomes-1 in 3T MR susceptibility weighted imaging and its absence in diagnosing Parkinson's disease

OBJECTIVE

To assess the imaging features of nigrosomes-1 in the substantia nigra through 3T MR susceptibility weighted imaging (SWI) and its disease-specific changes for the diagnosis of Parkinson's disease (PD).

PATIENTS AND METHODS

A total of 116 subjects were included in this study and allocated into 3 groups: 54 patients diagnosed with PD were assigned to the PD group, 51 age- and sex-matched volunteers without PD served as the control N-PD group, and 11 clinically suspected PD patients were allocated to the undiagnosed (UD) group. All patients received 3.0T superconducting MRI scanning on xxx. The images were analyzed and compared to assess the ability of nigrosomes-1 signals to depict PD pathology.

RESULTS

The signals of nigrosomes-1 were strong, droplet-like or oval in shape, and were found in 49 patients from the N-PD group (96.08%), on both sides of the SN (47 cases) and unilaterally (2 cases). In contrast, these signals were absent in all 54 cases from the PD group, and were undetected in 7 out of 11 cases in the UD group, 7 cases without the "drop" and 1 case with narrow strips of hyperintensity were clinically proven to PD, 2 cases with the typical hyperintensity were clinically proven to Parkinson's plus syndrome, 2 cases with slightly wider strip of hyperintensity were less sensitive to the drug levodopa.

CONCLUSIONS

The absence of typical droplet-like or oval-shaped nigrosomes-1 signals in 3.0T MR SWI may prove useful in identifying PD and Parkinson's syndrome with high sensitivity and specificity.

Pharmacovigilance in China: issues of concern identified through an analysis of the Chinese Adverse Drug Reaction Information Bulletin 2001 to 2014

WHAT IS KNOWN AND OBJECTIVE

The Adverse Drug Reaction Information Bulletin (ADRIB), issued by China Food and Drug Administration (CFDA), is a major source of information on drugs causing safety concerns in China. As the publication is only published in Chinese, we undertook an analysis of the reports in the ADRIB since its first publication in 2001 to give international readers a better appreciation of the pharmacovigilance issues addressed.

METHODS

Every issue of the ADRIB was scrutinized, and the issues addressed as well as the drugs involved are summarized and discussed.

RESULTS AND DISCUSSION

From 2001 to 2014, 109 items of ADR information have been reported. The antimicrobial agents were most often the subject of discussion. There were 28 traditional Chinese medicines (TCMs) discussed. Among the ADRs addressed, the adverse reactions of the skin and its appendages were most frequent. About two-fifths of the ADRs arose from the inherent properties of the active substance, and a majority of the ADRs were caused by off-label use, irrational drug combinations and misuse in special populations.

WHAT IS NEW AND CONCLUSION

Many of the pharmacovigilance issues addressed were similar to those considered by Western Drug Regulatory Agencies. The pharmacovigilance issues relating to Chinese traditional medicines are less well addressed internationally, and these would be of particular value as the use of such medicines increases in the West.

Reduction of Lactobacillus in the milks of cows with subclinical mastitis

Clinical and subclinical bovine mastitis are the most frequent diseases encountered on dairy farms worldwide, which cause significant economic loss and veterinary cost. The mastitic disease status is associated with increases in both milk bacterial pathogens and somatic cell count (SCC). Although it is well established that the mastitic pathogens generally correlate with the milk SCC, to our knowledge, the correlation between the probiotic genus, Lactobacillus, and the mastitic causative bacteria and SCC have not been determined previously. Thus, in this study, milk samples from 12 mild and 28 severe subclinical mastitic dairy cows were collected from the same farm. The overall milk bacterial load was quantified with the total plate count method. The Lactobacillus genus and 4 common clinical and subclinical mastitic pathogens (Escherichia coli, Staphylococcus aureus, Streptococcus agalactiae, and Trueperella pyogenes) in the sampled milk were enumerated by quantitative PCR. Mild and severe subclinical mastitic samples were distinctly separated on the principal component analysis score plot generated based on the quantities of these 5 target bacteria, suggesting that clear differences existed in the microbiological composition between the two sample groups. Based on comparison with the pairwise Mann-Whitney test, the mild subclinical mastitic dairy cows had a significantly higher amounts of lactobacilli (P=0.0175), but lower E. coli (P=0.0002), S. aureus (P<0.0001), S. agalactiae (P=0.0001) and T. pyogenes (P=0.0044) quantities, while an opposite trend occurred in the severe subclinical mastitic group. The negative correlation between Lactobacillus and the pathogenic bacteria, as well as the SCC, was confirmed with Spearman correlation analysis. Data generated from the current study may hint to a close relationship between Lactobacillus and the health of bovine udder.