[Efficacy of intravenous thrombolysis for acute severe cerebral infarction and risk factors of poor prognosis: a randomized controlled trial in 152 cases]

OBJECTIVE

To investigate the clinical efficacy and safety of intravenous thrombolysis in patients with acute severe cerebral infarction and analyze the risk factors of poor prognosis after thrombolysis.

METHODS

This randomized controlled trial was conducted among 152 patients with acute severe cerebral infarction, with the onset time all within 4.5 h. The patients were randomized into control group (76 cases) and observation group (76 cases) and received treatment with routine therapy (antiplatelet aggregation, statins, neuroprotection and drugs that stimulate blood flow) and intravenous thrombolytic therapy with alteplase in addition to the routine therapy, respectively. The NIHSS scores were recorded at 24 h, 1 week and 1 month after the treatment. The mRS scores at 3 months and the incidence of symptomatic intracranial hemorrhage at one week after the treatment were compared between the two groups. According to mRS scores at 3 months, the patients in the observation group were divided into good prognosis group (30 patients) and poor prognosis group (46 patients), and the risk factors for poor prognosis were analyzed using univariate and multivariate Logistic regression analysis.

RESULTS

At 24 h, 1 week and 1 month after the treatment, the reduction of NIHSS scores was more significant in the observation group than in the control group (F=24.684, P < 0.001). At 3 months after the treatment, the mRS scores were significantly lower (t=4.396, P < 0.001) and the good prognosis rate was significantly higher (χ²=13.636, P < 0.001) in the observation group than those of the control group. Symptomatic intracranial hemorrhage occurred in 4 cases in the observation group and in 2 cases in the control group within 1 week after the treatment (χ²=0.694, P=0.405). The time from onset to thrombolysis (OR=0.173, P=0.035), prethrombolytic systolic pressure (OR=0.869, P=0.019) and baseline NIHSS score (OR=0.466, P=0.011) were identified as independent risk factors for poor prognosis after intravenous thrombolysis.

CONCLUSION

Intravenous thrombolysis is effective and safe for patients with acute severe cerebral infarction, and the time from onset to thrombolysis, prethrombolytic systolic pressure and baseline NIHSS score are independent risk factors for a poor prognosis after intravenous thrombolysis.

[The epidemic situation and intervention countermeasures of stroke in Japan]

From 1951 to 1980, stroke was the main cause of disability and death among middle-aged and elderly residents in Japan. Its mortality once stood in the first place among all the developed countries, with the mortality of hemorrhagic stroke significantly higher than that of the western countries. In 1965, the mortality of stroke in Japan reached a peak of 175.8 per 100 000. Since then, it began to decline rapidly with a range of 5%-7%, and dropped to 139.5 per 100 000 in 1980, and from the top cause of death to the third place. By 2010, the mortality had dropped to 97.7 per 100 000. The significant decline in stroke morbidity and mortality in Japan is mainly attributed to controlling important risk factors and the public health service system's improvement. Setting up related policies and regulations to ensure comprehensive interventions and using the existing monitoring systems and surveys to assess interventions' effectiveness also contributes. Given the similarities of epidemiological characteristics and risk factors on stroke in Japan and China, strategies and measures adopted in Japan will have certain positive significance for China.

Single-photon detection in the mid-infrared up to 10 μm wavelength using tungsten silicide superconducting nanowire detectors

We developed superconducting nanowire single-photon detectors based on tungsten silicide, which show saturated internal detection efficiency up to a wavelength of 10 μm. These detectors are promising for applications in the mid-infrared requiring sub-nanosecond timing, ultra-high gain stability, low dark counts, and high efficiency, such as chemical sensing, LIDAR, dark matter searches, and exoplanet spectroscopy.

[Validity and reliability of physical activity questionnaires in children and adolescents: a Meta-analysis]

Objective: This review is to systematically summarize the studies examining physical activity questionnaires in children and adolescents and assess the overall validity and reliability, providing evidence on epidemiology research of physical activity in youth. Methods: A meta-analysis was performed using Stata 14.0 software. PubMed/Medline and EMBASE databases using the following terms:'Physical Activity'AND (' Questionnaire'OR'Self-report'OR'Recall') AND'Valid*'AND (' Reliab*'OR'Reproducib*'OR'Sensitiv*'OR'Responsiv*') AND (' Child*' OR'Adolescen*'OR'Youth') were searched from January 2008 to December 2018. Articles meeting the inclusion criteria were screened and adopting 'COnsensusbased Standards for the selection of health status Measurement Instruments' to evaluate the quality of the included studies. Results: This review yielded 17 articles on 20 different physical activity questionnaires, the total number of 2 778 participants for validity study and 2 137 participants for reliability study. The combined values of correlation coefficients in validity study were 0.27 (95%CI: 0.23-0.31) for moderate-to-vigorous intensity physical activity, 0.24 (95%CI: 0.18-0.30) for moderate intensity physical activity, 0.33 (95%CI: 0.24-0.42) for vigorous intensity physical activity. The combined values of intraclass correlation coefficients in reliability study were 0.75 (95%CI: 0.68-0.83) for moderate-to-vigorous intensity physical activity, 0.56 (95%CI: 0.46-0.65) for moderate intensity physical activity, 0.68 (95%CI: 0.61-0.75) for vigorous intensity physical activity. Conclusion: Until now, no questionnaires were identified for good validity and reliability to assess the physical activity level in young population.

MRI Signal Intensity and Electron Ultrastructure Classification Predict the Long-Term Outcome of Skull Base Chordomas

BACKGROUND AND PURPOSE

MR imaging is a useful and widely used evaluation for chordomas. Prior studies have classified chordomas into cell-dense type and matrix-rich type according to the ultrastructural features. However, the relationship between the MR imaging signal intensity and ultrastructural classification is unknown. We hypothesized that MR imaging signal intensity may predict both tumor ultrastructural classification and prognosis.

MATERIALS AND METHODS

Seventy-nine patients with skull base chordomas who underwent 95 operations were included in this retrospective single-center series. Preoperative tumor-to-pons MR imaging signal intensity ratios were calculated and designated as ratio on T1 FLAIR sequence (R_T1), ratio on T2 sequence (R_T2), and ratio on enhanced T1 FLAIR sequence (R_EN), respectively. We assessed the relationships among signal intensity ratios, ultrastructural classification, and survival.

RESULTS

Compared with the matrix-rich type group, the cell-dense type chordomas showed lower R_T2 (cell-dense type: 1.90 ± 0.38; matrix-rich type: 2.61 ± 0.60 P < .001). The model of predicting cell-dense type based on R_T2 had an area under the curve of 0.83 (95% CI, 0.75-0.92). In patients without radiation therapy, both progression-free survival (P = .003) and overall survival (P = .002) were longer in the matrix-rich type group than in the cell-dense type group. R_EN was a risk factor for progression-free survival (hazard ratio = 10.24; 95% CI, 1.73-60.79); R_T2 was a protective factor for overall survival (hazard ratio  = 0.33; 95% CI, 0.12-0.87); and R_EN was a risk factor for overall survival (hazard ratio = 4.76; 95% CI, 1.51-15.01).

CONCLUSIONS

The difference in MR imaging signal intensity in chordomas can be explained by electron microscopic features. Both signal intensity ratios and electron microscopic features may be prognostic factors.

A new method to reliably determine elastic strain of various crystal structures from atomic-resolution images

Elastic strain engineering is an important strategy to design material properties in semiconductor and emerging advanced manufacturing industries. Recently, peak-pair method has drawn great attention compared to geometric phase analysis, owing to its precise determination of atom position at real space. Most current strain characterization methods estimate the local strain by comparing it with the related information from unstrained areas as reference. However, peak-pair method generated large errors in some cases because of the complexity of lower symmetric crystal structures, such as hexagonal structure. In this study, we introduce a new algorithm to overcome this limitation by directly comparing the atom positions with multiple references with different lattice symmetries. Furthermore, this new method is validated through several complicated crystal systems such as hexagonal, orthorhombic, monoclinic, and tetragonal structure, and returns expected values. This finding is essential to reliably determine the localized elastic strain with various crystal structures.

MicroRNA-194 participates in endotoxemia induced myocardial injury via promoting apoptosis

OBJECTIVE

To investigate the expression level of microRNA-194 in myocardial injury induced by lipopolysaccharide (LPS) and its underlying mechanism.

MATERIALS AND METHODS

LPS-induced H9c2 cardiomyocytes injury model was established. The expression level of microRNA-194 at different treatment time points was detected. Survival and apoptosis of cardiomyocytes were detected after overexpression or knockdown of microRNA-194. The target genes of microRNA-194 were predicted by bioinformatics analysis. The relationship between microRNA-194 and target genes was verified by the dual luciferase reporter analysis and Western blot. The effects of microRNA-194 mimics and overexpression plasmid pcDNA3/Slc7a5 on the cardiomyocyte apoptosis were investigated by MTT assay. Expressions of relative genes involved in Wnt/β-catenin pathway during the process of LPS-induced cardiomyocytes injury were detected by qRT-PCR and Western blot.

RESULTS

The expression level of microRNA-194 was increased in LPS-induced H9c2 cardiomyocytes injury model in a time-dependent manner. Overexpressed microRNA-194 directly bound to the target gene Slc7a5 and inhibited its expression. Transfection of microRNA-194 mimics increased apoptosis of H9c2 cells, which was rescued by overexpression of pcDNA3/Slc7a5. MicroRNA-194 was capable of promoting cardiomyocyte apoptosis by activating Wnt/β-catenin pathway.

CONCLUSIONS

MicroRNA-194 promotes cardiomyocyte apoptosis and participates in myocardial injury induced by endotoxemia via activating Wnt/β-catenin pathway.

Nuclear Dependence of the Transverse Single-Spin Asymmetry in the Production of Charged Hadrons at Forward Rapidity in Polarized p+p, p+Al, and p+Au Collisions at sqrt[s_{NN}]=200 GeV

We report on the nuclear dependence of transverse single-spin asymmetries (TSSAs) in the production of positively charged hadrons in polarized p^{↑}+p, p^{↑}+Al, and p^{↑}+Au collisions at sqrt[s_{NN}]=200  GeV. The measurements have been performed at forward rapidity (1.4<η<2.4) over the range of transverse momentum (1.8<p_{T}<7.0  GeV/c) and Feynman x (0.1<x_{F}<0.2). We observed positive asymmetries for positively charged hadrons in p^{↑}+p collisions, and significantly reduced asymmetries in p^{↑}+A collisions. These results reveal a nuclear dependence of TSSAs for charged-hadron production in a regime where perturbative techniques are applicable. These results provide new opportunities to use p^{↑}+A collisions as a tool to investigate the rich phenomena behind TSSAs in hadronic collisions and to use TSSAs as a new handle in studying small-system collisions.

[Analysis of pregnancy outcome of embryos derived from abnormal prokaryotes]

Objective: To summarize the clinical outcome of abnormal prokaryotic embryos [0PN (non-pronuclear), 1PN (one-pronuclear)] transfer for reference in clinical work. Methods: To collect the clinical data of infertility patients who received in vitro fertilization/intracytoplasmic sperm microinjection-embryo transfer from January 1, 2013 to December 31, 2018 at the reproductive center of Beijing Chaoyang Hospital Affiliated to Capital Medical University, and to retrospectively analyze the pregnancy outcome of the cases of embryo transfer from 0PN and 1PN sources. Results: Forty-seven patients were transplanted non-2PN-derived embryos during 50 cycles. There were 18 cycles which only 0PN embryos were transplanted, and the clinical pregnancy rate was 50.0%. There were 17 cycles which only 1PN embryos were transplanted, and the clinical pregnancy rate was 29.4% (compared with 0PN, the difference was not statistically significant, P>0.05). No abnormalities were found in the delivered newborns. Conclusions: In the absence of 2PN-derived embryos, patients can be transplanted blastocysts from 0PN and 1PN sources. Acceptable clinical pregnancy outcomes can be achieved, and the clinical outcomes of 0PN may be better than 1PN.

[Blood pressure changes in 18-59 years old adults in rural area of Shanxi province, China]

Objective: To analyze the blood pressure changes of adults aged 18-59 years in rural area of Shanxi province based on a cohort study, and provide reference for the study of the blood pressure level of rural residents and hypertension prevention and control in rural areas in China. Methods: Data were obtained from Shanxi Nutrition and Chronic Disease Family Cohort from 2002 to 2015. Subjects aged <18 years or ≥60 years and individuals with hypertension at baseline survey in 2002, and those who had taken antihypertensive drugs for nearly two weeks during the follow-up survey in 2015 were excluded from the study. A total of 1 629 subjects aged 18-59 years were included in the analyses of the blood pressure level and its change from the baseline survey in 2002 to follow-up survey in 2015. Results: The systolic blood pressure (SBP) of the subjects increased from (122.7±10.4) mmHg in 2002 to (132.8±17.6) mmHg in 2015 and the diastolic pressure (DBP) increased from (72.7±6.9) mmHg in 2002 to (78.8±10.3) mmHg in 2015. The SBP in men and women increased with growth rates of 6.7% and 9.5%. While DBP in men and women increased with growth rates of 9.3% and 7.8%. The SBP levels of those aged 18-, 30-, 40- and 50-59 years increased with growth rates of 5.0%, 6.7%, 9.4% and 11.8%. While the DBP of these age groups increased with growth rates of 12.2%, 8.2%, 8.2% and 6.5%. Conclusions: The blood pressure of adults aged 18-59 years old in rural area of Shanxi showed a substantially increasing trend. The mean increase level of SBP in women was higher than that in men, and increased with age. While the mean increase level of DBP in men is higher than that in women, and decreased with age.

[Follow-up analysis on change of serum total cholesterol concentration in rural residents in Shanxi province]

Objective: To analyze the longitudinal change of serum total cholesterol concentration in 733 rural residents in Shanxi province. Methods: Based on the residents of five rural areas in Shanxi province who participated in China nutrition and health survey in 2002, a follow-up survey was conducted in 2015. Fasting venous blood of the participants was collected and serum TC concentration was tested by cholesterol oxidase method. Results: Of 733 participants, 332 were male and 401 were female. In 2002 baseline survey, the age of the participants was (42.6±9.5) years old, 76.2% of male and 83.8% of female had junior middle school education or below. Proportion of smoking were 65.7% and 1.2%, drinking were 26.8% and 4.0%, obesity were 6.3% and 12.0%, and central obesity were 27.1% and 31.9%, respectively in male and female. The follow-up age of participants in 2015 was (55.8±9.5) years old, proportion of smoking changed to 48.2% and 1.5%, drinking were 49.7% and 3.0%, obesity increased to 11.8% and 18.2% and central obesity increased to 41.6% and 53.6%, respectively in male and female. The overall serum TC level increased from (3.82±0.89) mmol/L to (4.72±0.97) mmol/L with an average increase of 27.2%, which increased from (3.84±0.94) mmol/L to (4.54±0.93) mmol/L in male with an average increase of 22.7%, and increased from (3.81±0.84) mmol/L to (4.86±0.98) mmol/L in female with an average increase of 30.9%. The serum TC levels in 18-, 30-, 40-, and 50-59 years old group increased from (3.42±0.83), (3.72±0.77), (3.90±0.83) and (4.00±1.03) mmol/L to (4.38±1.01), (4.79±0.92), (4.73±0.99) and (4.76±0.96) mmol/L, with average increase range of 31.4%, 32.1%, 25.2% and 22.6%, respectively. The mean serum TC levels between two years all had statistically significant difference among groups of gender, age, education, marital status, family history of cardiovascular disease, smoking, drinking, BMI and waist circumference after paired t-test and ANOVA analysis (P<0.01). Conclusion: The longitudinal serum TC level of rural residents in Shanxi province increased rapidly.

[A cohort study on the association between dietary patterns which benefit for normal kidney function and the cognitive performance in the Chinese elderly]

Objective: To explore the association between dietary pattern which benefit for normal kidney function and the risk of cognitive decline or impairment in the elderly. Methods: In 2015, subjects aged 60 and over from four counties in the Nutrition and Chronic Disease Family Cohort project, were followed up in 2017. Cognitive function was repeatedly assessed, using the Mini Mental State Evaluation (MMSE) scale. Dietary pattern that benefit for normal kidney function was extracted, using the reduced rank regression method and followed by logistic regression models to explore the associations between scores that showing the kidney function on dietary patterns and the risk of cognitive deterioration and impairment in two years among those who were with normal cognition in 2015. Results: Dietary pattern that benefit for normal kidney function, was characterized by high consumption of cereal, vegetables, legume and fruits but with less meat and soy products. Comparing with the group with lowest score quartile on this dietary pattern, the risk of cognitive deterioration in the highest quartile group was significantly low (P<0.01) in two years, with an odds ratio as 0.57 (95%CI: 0.37-0.85). Linear trend was also obviously visible (P=0.007) in this group. The ones at the highest quartile group among the normal cognition ones in 2015, the risk of cognitive impairment also significantly reduced (P<0.05) in two years time, with an odds ratio as 0.52 (95%CI: 0.29-0.93). Also, linear trend could obviously be seen (P=0.01). Conclusion: Dietary pattern that benefit for normal kidney function was both inversely associated with cognitive deterioration and impairment, in two years.

[Assessment on the capacity for prevention and control programs for chronic non-communicable diseases in China, in 2014]

Objective: To assess the capacity of prevention and control on chronic non- communicable diseases (NCDs) in China. Methods: On-line questionnaire survey was adopted by 3 395 CDCs at provincial, municipal and county (district) levels and 3 000 primary health care units, and assess on capacity of policy, infrastructure, capacity of training and guidance, cooperation, surveillance, intervention and management, assessment and scientific research from September 2014 to March 2015. Results: (1) Capacity of policy: 23 (71.9%) provincial, 139 (40.6%) municipal and 919 (31.2%) county (district) governments or health administrative departments had existing plans for prevention and control of NCDs. (2) Capacity of infrastructure: 25 (78.1%) provincial, 136 (39.8%) municipal and 529 (18.0%) county (district) CDCs had set up departments dedicated to the prevention and control of NCDs, with 9 787 staff members, accounting for 5.0% of the total CDC personnel, working on NCDs prevention and control programs. 68.1% of the CDCs had special funding set for NCDs prevention and control. (3) Capacity of training and guidance: 2 485 CDCs (74.9%) held all kinds of training on prevention and control of NCDs. 2 571 (87.3%) CDCs at the county (district) level provided technical guidance for primary health care units. (4) Capacity of cooperation: 42.0% of the CDCs had experiences collaborating with the mass media. (5) Capacity of surveillance: 73.8% of the CDCs had set up programs for death registration while less than 50.0% of the CDCs had implemented surveillance programs on major NCDs and related risk factors. In terms of primary health care units, 32.4% of them had set up reporting system for newly developed stroke case and 29.9% of them having programs on myocardial infarction case reporting. (6) Capacity of intervention and management: 69.1% and 68.2% of the CDCs conducted individualized intervention programs on hypertension and diabetes, while less than 40.0% CDCs conducting intervention programs on other NCDs and risk factors. More than 90.0% of the primary health care units carried out follow-up surveys on hypertension and diabetes. However, only 17.4% and 13.7% of the CDCs working on hypertension and diabetes patient management programs while 83.7% and 80.4%, of them following the standardized guidelines for management, with successful rates of control as 59.2% and 55.2%, respectively. (7) Capacity of assessment: 32.4% of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs. (8) Capacity of scientific research: the capacity on scientific research among provincial CDCs was apparently higher than that at the municipal or county (district) CDCs. Conclusions: Compared with the results of previous two surveys, the capacity on policies set for the prevention and control programs improved continuously, at all level NCDs, but remained relatively weak, especially at both county (district) and primary health care units.

[Effect of influenza and 23-valent pneumococcal polysaccharide vaccinations on elderly with chronic obstructive pulmonary diseases: a community-based intervention study]

Objective: To explore the effect of influenza and 23 valent pneumococcal polysaccharide pneumococcal vaccinations on symptom-improvement among elderly with chronic obstructive pulmonary diseases (COPD). Methods: Data was gathered from 4 communities in 3 National Demonstration Areas set for comprehensive prevention and control of chronic non- communicable diseases in Chongqing city and Ningbo city respectively, from November 2013 to October 2014. The communities were selected by cluster sampling and divided into 4 groups: (1) injected influenza vaccines; (2) injected with pneumococcal vaccines; (3) received both of the two vaccines; (4) the control group that without any intervention measures. All the subjects aged from 60 to 75 were selected to fill in demographic information questionnaire and receive (COPD assessment test, CAT) scores twice, before intervention and 1 year after the vaccination. SAS 9.4 software was used to analyze the change of symptoms and CAT scores before and after the intervention program and comparing the improvement on symptoms among the elderly people under study. Results: A total of 1 244 subjects with nearly same baseline conditions after the propensity score matching, were involved in this study. CAT scores appeared as Median=21 (IQR: 17-26) at baseline. The CAT scores appeared as Median=18 (IQR: 14-24), decreasing in all the 3 vaccinated groups, one year after the intervention program (influenza vaccines, matching t test, t=-6.531, P=0.403; pneumococcal vaccines, Wilcoxon test, H=-9 623, P<0.001; combined vaccine vaccines, matching t test, t=-10.803, P<0.001). However, in the control group, no obvious change was observed (Wilcoxon H=1 167, P=0.403). Proportions of impacts at high or very high levels all decreased in the 3 intervention groups, while little change was observed in the control group. Outcomes from the Factorial analysis suggested that influenza vaccination could improve the general conditions and symptoms including cough, chest tightness, dyspnea, physical activities, and stamina. Pneumococcal vaccination appeared more effective on all of symptoms and indicators. Conclusion: Pneumococcal and influenza vaccination seemed helpful for elderly people suffering COPD to improve the general health condition.

[Epidemiological characteristics of waist circumference and abdominal obesity among Chinese children and adolescents aged 6-17 years]

Objective: To analyze the epidemiological characteristics of waist circumference and abdominal obesity among Chinese children and adolescents aged 6-17 years. Methods: Data was from the samples of aged 6-17 years in the China National Nutrition and Health Surveillance program in 2010-2012. P(90) (the same age, the same sex) was used as the diagnostic value for abdominal obesity. Results: The overall waist circumference of children and adolescents in all the age groups appeared higher in males than that in females (P<0.000 1), higher in cities than that in the rural areas (P<0.05), and higher in children with high family income than those with middle or low family incomes (P=0.000 3). The rate of abdominal obesity in children and adolescents aged 6-17 years appeared as 11.2% on average and 10.7% and 11.8% for boys and girls, respectively but with no significant difference (P>0.05). Rates on abdominal obesity appeared as 13.2% and 8.5% for boys while as 12.3% and 11.2% for girls respectively, in urban or rural areas. As for the levels of family income, the abdominal obesity rates appeared as 15.8%, 11.5% and 8.8% respectively for boys while 13.5%, 11.9% and 11.6% respectively for girls, under high, middle and low levels of family income. Conclusion: The rate of abdominal obesity in boys seemed more responsive to the impact of income in urban or rural areas.

[Epidemiological characteristics of overweight and obesity in Chinese children and adolescents aged 6-17 years]

Objective: To analyze the prevalence rates of overweight and obesity in Chinese children and adolescents aged 6-17 years, and to provide scientific basis for the development of prevention strategies on obesity. Methods: Data was from children and adolescents aged 6-17 years in the China National Nutrition and Health Surveillance 2010-2012 program. In children aged 6 years, criteria of overweight and obesity were followed the WHO growth reference for school-aged children and adolescents. In children and adolescents aged 7-17 years, overweight and obesity were defined by sex and age specific BMI, recommended by Guidelines for prevention and control of overweight and obesity among school-age children and adolescents according to the Chinese guidelines. Results: The overall rates on overweight and obesity were 9.6% and 6.4% among the Chinese children and adolescents aged 6-17 years, with 11.0% (12.8% for boys and 9.0% for girls) in urban and 7.7% (boys 9.7%, girls 5.5%) in rural areas. The rates of overweight and obesity among children and adolescents were 8.4% (boys 9.3%, girls 7.4%) and 5.2% (boys 6.2%, girls 4.1%) in the rural areas. According to the levels of household income, the overweight rates of children in high, middle and low incomes were 12.3%, 10.7% and 8.2%, with obesity as 8.6%, 7.2% and 5.7% respectively. Conclusions: In 2012, the prevalence rates of overweight and obese were 9.6% and 6.4% among children and adolescents aged 6-17 years, respectively, higher in urban than in rural areas and higher boys than in girls. The prevalence rates of overweight and obesity seemed to be related to the levels of household income.