[Advances in circadian rhythms in oral maxillofacial tissues and oral-related diseases]

Circadian rhythm is an internal autonomous timing mechanism formed by the body in response to changes of external environment. It participates in the regulations of various physiological activities, affecting the formation and outcome of various diseases in the human body. This paper summarizes the changes of local tissue rhythms in common disease states, such as oral and maxillofacial malformations, inflammation and malignant tumors. The importance of circadian clock system to the activities of oral and maxillofacial tissues are dialectically analyzed, mainly on the mechanisms of action in maintaining oral health and in affecting the processes of common oral diseases and oral-related systemic diseases. At the same time, chronological therapy and new strategies of prevention and treatment for oral-related diseases based on the changes in tissue rhythm are summarized and prospected to provide new ideas for maintaining oral and systemic health.

[Consensus of experts on the oral health management and medical risk prevention for the patients with chronic airway diseases (2022 edition)]

Today, there is greater awareness on the association between oral diseases and respiration diseases after the outbreak of COVID-19. However, confusion regarding the oral health management and medical risk prevention for patients with chronic airway diseases has been remained among dental clinicians. Therefore, the dental experts of the Fifth General Dentistry Special Committee, Chinese Stomatological Association, combined with the experts of respiratory and critical care medicine, undertook the formation of consensus on the oral health management of patients with chronic airway diseases in order to help dental clinicians to evaluate medical risks and make better treatment decision in clinical practice. In the present consensus report, the relationship of oral diseases and chronic airway diseases, the oral health management and the treatment recommendations of patients with chronic airway diseases are provided.

[Consensus of experts on the medical risk prevention for the patients with cardiovascular diseases during dental treatment (2022 edition)]

With the aging process of population in the society, the prevalence of cardiovascular diseases (CVD) in China is increasing continuously and the number of dental patients with CVD is increasing gradually too. Due to the lack of guidelines for dental patients with CVD in our country, how to implement standardized preoperative evaluation and perioperative risk prevention remains a problem to be solved for dentists at present. The present expert consensus was reached by combining the clinical experiences of the expert group of the Fifth General Dentistry Special Committee, Chinese Stomatological Association and respiratory and cardiology experts in diagnosis and treatment for CVD patients, and by systematically summarizing the relevant international guidelines and literature regarding the relationship between CVD and oral diseases and the diagnosis and treatment of dental patients with heart failure, hypertension and antithrombotic therapy. The consensus aims to provide, for the dental clinicians, the criteria on diagnosis and treatment of CVD in dental patients in China so as to reduce the risk and complications, and finally to improve the treatment levels of dental patients with CVD in China.

The Effect of Endolymphatic Hydrops and Mannitol Dehydration Treatment on Guinea Pigs

Background

Endolymphatic hydrops (EH) is considered as the pathological correlate of Menière’s disease (MD) and cause of hearing loss. The mechanism of EH, remaining unrevealed, poses challenges for formalized clinical trials.

Objective

This study aims to investigate the development of hearing loss, as well as the effect of dehydration treatment on EH animal models.

Methods

In this study, different severity EH animal models were created. The laser Doppler vibrometer (LDV) and auditory brainstem responses (ABR) were used to study the effects of EH and the dehydration effects of mannitol. The LDV was used to measure the vibration of the round window membrane (RWM) reflecting the changes in inner ear impedance. ABR was used to evaluate the hearing changes. Furthermore, tissue section and scanning electron microscopy (SEM) observations were used to analyze the anatomical change to the cochlea and outer hair cells.

Results

The RWM vibrations decreased with the severity of EH, indicating an increase in the cochlear impedance. The dehydration therapy lowered the impedance to restore acoustic transduction in EH 10- and 20-day animal models. Simultaneously, the ABR thresholds increased in EH models and were restored after dehydration. Moreover, a difference in the hearing was found between ABR and LDV results in severe EH animal models, and the dehydration therapy was less effective, indicating a sensorineural hearing loss (SNHL).

Conclusion

Endolymphatic hydrops causes hearing loss by increasing the cochlear impedance in all tested groups, and mannitol dehydration is an effective therapy to restore hearing. However, SNHL occurs for the EH 30-day animal models, limiting the effectiveness of dehydration. Our results suggest the use of dehydrating agents in the early stage of EH.

[Optical Composition and Potential Driving Factors of Chromophoric Dissolved Organic Matter in Large Lakes and Reservoirs in the Eastern Region of China]

Intensified urbanization has been occurring in the eastern region of China in recent decades, and excessive industrial and household sewage has been discharged into lakes and reservoirs, which has directly lowered water quality and destructed the functions of aquatic ecosystems. Lakes and reservoirs are typically drinking water sources supplying water for metropolitan areas as well as large- and medium-sized cities. Chromophoric dissolved organic matter (CDOM) is the colored fraction of DOM, and its source and optical composition strongly affect water supply safety and the health of surrounding citizens. In April 2021, we collected 68 samples from Reservoir Changtan (n=11), Lake Taihu (n=25), Lake Hongze (n=18), and Lake Gaoyou (n=14), and we further carried out 28 days of laboratory bio-incubation, together with optical measurements and parallel factor analysis (EEMs-PARAFAC) to analyze the bio-degradability ω(BDOC), sources, and optical composition of CDOM in these waters. The results showed that after 28 days of laboratory bio-incubation, the bioavailability of dissolved organic carbon (BDOC) of the four lakes and reservoirs were all higher than 50%. PARAFAC results showed that CDOM collected from the four lakes was composed of four fluorescent components, including a terrestrial humic-like C1, a tryptophan-like C2, and tyrosine-like C3 and C4. Protein-like components (C2, C3, and C4) contributed importantly to the CDOM pool in the four waterbodies, and in Lake Hongze the contribution of C2-C4 was as high as (90.0±2.2)%. In Lake Hongze, total phosphorus (TP) correlated closely with C1-C3, indicating that those components can be used to trace the variability of TP. Among the four waterbodies, a₂₅₄ was positively correlated with DOC (R²=0.96, P<0.01), indicating that a₂₅₄ can be used to estimate the dynamics of DOC in these waters. In Lake Taihu, we found a low level of humification index (HIX) and a high level of biological index (BIX), indicating that autochthonous substances contributed importantly to the CDOM pool in this lake. In comparison, allochthonous sources contributed importantly to the CDOM pool in the remaining three waters. The enhanced monitoring of the discharge of industrial and agricultural effluents in the upstream watersheds of the four waters can help to protect the water quality and maintain healthy aquatic ecosystems.

Clinical Characteristics of COVID-19 Patients' Postvaccination

To investigate the clinical characteristic of domestic coronavirus disease 2019 (COVID-19) patients after vaccination campaign conducted in China. According to vaccination status and months from first vaccine dose to infection detection, patients were divided into unvaccinated, <3 months, 3–6 months, and >6 months groups. The information of demographic and clinical characteristics, laboratory and thoracic computed tomography (CT) findings, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid and IgM, IgG antibodies was retrospectively collected. Therapeutic approaches, temperature-normalizing and viral shedding times, outcomes were also summarized. SARS-CoV-2 antibody levels were further analyzed based on the other following variables: time from second vaccine dose to infection, vaccine dose, the interval from the first to the second dose, and vaccine brand. Among 208 COVID-19 patients, 13 (6.28%) were unvaccinated. No significant differences in demographic and clinical characteristics, laboratory and CT findings, and SARS-CoV-2 nucleic acid loads were detected between groups (all p > 0.05). In comparison with the unvaccinated group, the median SARS-CoV-2 IgG levels were noticeably increased in those vaccinated groups (0.603 in unvaccinated, 15.925 in <3 months, 14.04 in 3–6 months, and 4.94 in >6 months, respectively, p < 0.05). However, SARS-CoV-2 IgG levels were not altered between groups divided based on the other variables. Vaccination does not affect the clinical characteristics in COVID-19 patients. COVID-19 patients with vaccination have high SARS-CoV-2 IgG levels. Underscore the necessity of rapid implementation of vaccination campaigns can be speculated.

[Magnetic resonance imaging analysis on the effect of marathon on the dynamic changes of morphological characteristics of patellar tendon in amateur marathon runners after half marathon]

Objective: To explore the dynamic changes of morphological characteristics of patellar tendon (PT) in amateur athletes after a half-marathon using magnetic resonance imaging. Methods: A total of 19 male amateur marathon runners with 38 knee joints,aged from 26 to 53(41.5±7.9) years, running for 3 to 18 years, with a weekly running volume of 30-90 km and a monthly running volume of 100-300 km were enrolled and underwent 1.5T MRI scan before the half-marathon, within 3 hours after running and 3 days after running. Ten healthy male volunteers with 20 knee joints, who had never participated in marathon and exercised (including but not limited to running) per week for less than 150 minutes were recruited as the control group, aged from 26 to 54 (39.4±9.1) years. Firstly, the PT signal was qualitatively assessed on fat-suppressed proton density-weighted imaging (fs-PDWI) sequence to observe the presence of patellar tendinitis. Then, the length, proximal, middle and distal cross-sectional area (CSA), and volume of PT were measured using the post-processing tool ITK-SNAP, and the data were standardized. The independent sample t-test was used for comparing. One-way repeated measures analysis of variance was used to analyze the morphological changes of PT before and after half-marathon running. Results: The incidence of asymptomatic patellar tendinitis in amateur marathon runners was 26.3% (5/19). No significant MR signal changes of PT were observed in all runners after running. The proximal CSA in runners group was larger than that in controls [(4.20±0.62) mm²/kg^3/4 vs (3.63±0.57) mm²/kg^3/4, P<0.05], and there was no significant difference in length, medium and distal CSA and volume(all P>0.05). The length, proximal and distal CSA and volume of PT in runners group increased at 3 h after running [(47.35±3.22) mm vs (46.83±3.35) mm; (102.52±13.03) mm² vs (98.98±13.14) mm²; (108.67±15.72) mm² vs (100.27±14.37) mm²; (4 020.36±514.38) mm³ vs (3 826.57±499.23) mm³, all P<0.05]. There was no significant difference between before running and 3 days after running(all P>0.05). The middle CSA were not significantly different among different periods(all P>0.05). Conclusion: Marathon has effect on the normal PT morphology in male amateur marathon runners, showing an increase in proximal CSA. A half-marathon will cause reversible changes in PT length, regional CSA and volume.

[Diffusion tensor imaging in quantitative evaluation on thigh muscle of male amateur marathon runners after running a half marathon]

Objective: To investigate the effect of half marathon on thigh muscle in male amateur marathon runners by diffusion tensor imaging (DTI). Methods: A total of 17 male amateur marathon runners aged from 27 to 57 (43.7±2.8) years were recruited from May to August 2020 in Hangzhou, Zhejiang Province. MRI examination of bilateral thigh muscles were performed before and 3 h, 3 d and 7 d after a half marathon. The fractional anisotropy (FA) values was obtained by DTI sequence. The FA values of rectus femoris, intermedius femoris, medial femoris, lateral femoris, biceps femoris longus, semitendinosus, semimembranosus, adductor magnus and adductor longus were measured on the horizontal axis of bilateral thigh muscles. Friedman M test was used to compare the changes of FA values of each muscle at each time point before and after running, and pairwise comparison of FA values of statistically significant muscles at 3 h, 3 d and 7 d after running was performed. Results: The overall FA value of thigh muscle group [M (Q₁, Q₃)] at 3 h after running was decreased compared to before running [0.24 (0.20, 0.28) to 0.25 (0.21, 0.29), P<0.001], and there was no significant difference between baseline values at 3 d and 7 d after running (all P>0.05). FA values of vastus intermedius, vastus medialis, semimembranosus and adductor magnus at 3 h after running were lower than those before running [(0.19 (0.18, 0.22) vs 0.21 (0.19, 0.24), 0.19 (0.17, 0.20) vs 0.21 (0.18, 0.23), 0.26 (0.24), 0.29) vs 0.27 (0.15, 0.30) and 0.20 (0.19, 0.22) vs 0.21 (0.20, 0.23), both P<0.05], and there was no statistical significance between 3 d and 7 d after running and those before running (all P>0.05). FA value of vastus lateralis muscle at 3 h after running decreased compared with that before running, but the difference was not statistically significant (P>0.05). FA value began to increase at 7 d after running, and the difference was statistically significant [0.24 (0.21, 0.27) vs 0.23 (0.19, 0.25), P = 0.002]. FA value of rectus femoris muscle at 3 h after running decreased compared with that before running, but the difference was not statistically significant (P>0.05), and began to increase at 3 d after running and the difference was statistically significant [0.29 (0.26, 0.34) vs 0.26 (0.23, 0.29), P=0.006]. FA value of adductor longus muscle increased at 3 h after running, but the difference was not statistically significant (P>0.05). FA value continued to increase at 3 d and 7 d after running, and the difference was statistically significant [0.23 (0.21, 0.25) vs 0.22 (0.19, 0.24), 0.23 (0.21, 0.26) vs 0.22 (0.19, 0.24), all P<0.05]. Conclusions: The change of FA value of thigh muscle after half marathon is reversible. At 3 h after half marathon, FA values of femoris intermedius, femoris medialis, semimembranosus muscle and adductor magnus muscle of amateur marathon runners decreased most obviously, which may be the dominant muscle group during running.

[Enhanced Remediation of Cd Contaminated Soil by Cotton with DOM]

To reveal the effects of dissolved organic matter (DOM) on the remediation of cadmium (Cd)-contaminated soils by cotton, the effects of cotton straw dissolved organic matter (CM) and farmyard manure dissolved organic matter (FM) on soil available Cd (DTPA-Cd) content, cotton biomass, photosynthetic characteristics, and Cd accumulation were investigated in a pot-based experiment under three exogenous soil Cd levels (mg·kg^-1) of 0 (C0), 5 (C5), and 10 (C10). The results showed that the application of CM and FM increased the content of available Cd in soil, with the maximum increase of 30.89% and 8.51%, respectively, and that of CM was higher than that of FM. The effects of CM and FM application on total biomass and photosynthetic characteristics in cotton showed that biomass accumulation and net photosynthetic rate were promoted at the C0 level, there was no significant difference compared to that in the control (CK) at the C5 level, and total biomass accumulation and net photosynthetic rate were inhibited at the C10 level; however, transpiration rate both showed higher than the CK treatment at the same Cd level. The application of DOM altered the Cd content of all parts of the cotton compared to that in the CK treatment, where the application of CM resulted in significantly higher Cd content in all parts of the cotton (except for lint) than that in the CK treatment at the same Cd level; however, the application of FM mainly increased the Cd content in the root. The root was the main organ for the increase in total Cd accumulation, the application of CM and FM significantly increased the total Cd accumulation in cotton, and the total Cd accumulation increased by 27.76%-113.05% and 17.77%-93.79%, respectively. Therefore, DOM can be used as an additive to repair Cd-contaminated soil, which has certain application potential. It is recommended to apply cotton straw DOM to repair Cd-contaminated soil.

Multifunctional Fluorescent Probe for Simultaneously Detecting Microviscosity, Micropolarity, and Carboxylesterases and Its Application in Bioimaging

Based on OR logic gate, we proposed a smart near-infrared (NIR) fluorescent probe, named VPCPP, for simultaneously monitoring local microviscosity, micropolarity, and carboxylesterases (CEs) in living cells through blue and red channels. This proposed probe was capable of distinguishing cancer cells from normal cells and had good potential for identifying living liver cell lines. Furthermore, the fluctuations of the three analytes of interest in different cell status was successfully explored. Particularly, facilitated with high-content analysis (HCA) and VPCPP, a simple and efficient high-throughput screening (HTS) platform was first constructed for screening antitumor drugs and studying their effect on the analytes. For the first time, we found that sorafenib-induced ferroptosis led to an increase in the microviscosity and up-regulation of CEs at the same time. Additionally, the procedure that aristolochic acid (AA) induced the overexpression of CEs was verified. Besides, VPCPP was utilized for imaging the variations of the two microenvironment parameters and CEs in the inflammation model. Finally, VPCPP was able to image the tumor ex vivo and in vivo through two channels and one channel separately, as well as to visualize the kidneys and liver ex vivo with dual emissions, which indicated that the probe had great potential for imaging applications such as medical diagnosis, preclinical research, and imaging-guided surgery.

Association between health behaviours and the COVID-19 vaccination: risk compensation among healthcare workers in Taizhou, China

This study is conducted to explore the association between health behaviors and the COVID-19 vaccination based on the risk compensation concept among health-care workers in Taizhou, China. We conducted a self-administered online survey to estimate the health behaviors among the staff in a tertiary hospital in Taizhou, China, from May 18 to 21 May 2021. A total of 592 out of 660 subjects (89.7%) responded to the questionnaire after receiving an e-poster on WeChat. Subjects who had been inoculated with the COVID-19 vaccine were asked to mention the differences in their health behaviors before and after the vaccination. The results showed that there were no statistical differences in health behaviors between vaccinated and unvaccinated groups, except in terms of the type of gloves they used (62.8% in the vaccinated group and 49.2% in the unvaccinated group, p = .048). Subjects who received earlier COVID-19 vaccinations exhibited better health behaviors (22.40% increased for duration of wearing masks (P = .007), 25.40% increased for times of washing hands (P = .01), and 20.90% increased for times of wearing gloves (P = .01)). Subjects also revealed better health behaviors (washing hands, wearing gloves, and wearing masks) after vaccination compared to that before. In conclusion, concept of risk compensation was not applied in our findings. The health behaviors did not reduce after the COVID-19 vaccination, which even may improve health behaviors among health-care workers in the hospital setting.

[Epidemiological characteristics and influencing factors for high risk cardiovascular disease population in Jiangsu province]

Objective: To investigate the detection types and aggregation of high-risk population of cardiovascular disease (CVD) in Jiangsu province and the related influencing factors to provide reference for the prevention and control of cardiovascular disease. Methods: A total of 120 211 participants were included in the investigation. Information was collected by questionnaire based survey, physical examination and biochemical tests. χ² test and multivariate logistic regression were used for statistical analysis. Results: The detection rate of CVD high risk was 25.03%. The detection rates were 19.01%, 4.85%, 3.18% and 5.31% for hypertension, dyslipidemia, cardiovascular history and WHO assessed risk ≥20% types, respectively. Male, rural, old age, low education level, low family income, drinking, waist circumference exceeding standard, overweight and obesity were risk factors of CVD (all P<0.01). The composition ratios of aggregation of 1, 2 and ≥3 high risk types of CVD were 74.01%, 22.91% and 3.08%, respectively. With the increase of aggregation types, the correlation strength increased with age, rural residents, education level and annual family income. Conclusion: Targeted measures should be carried out according to different influencing factors for the prevention and control of CVD in Jiangsu province in order to achieve the maximum prevention and control effect with the minimum cost.

Morning Versus Evening Dosing of Sublingual Immunotherapy in Allergic Asthma: A Prospective Study

BACKGROUND

Sublingual immunotherapy (SLIT) has been proved to be an effective and safe treatment for allergic asthma (AS) in children. Nonetheless, several issues regarding SLIT remain to be resolved, including the information about optimal administration timing.

METHODS

A total of 163 AS children aged 4-13 years were enrolled and randomized into the morning dosing (MD) group and the evening dosing (ED) group. Participants received SLIT with Dermatophagoides farinae drops between 7:00 a. m. and 9:00 a.m. (for the MD group) or between 8:00 p. m. and 10:00 p.m. (for the ED group). The total asthma symptom score (TASS), total asthma medicine score (TAMS), Asthma Control Questionnaire (ACQ), forced expiratory volume in one second (FEV₁), FEV₁/forced volume vital capacity (FVC), fractional exhaled nitric oxide (FeNO) and adverse events (AEs) were assessed at baseline, 0.5 and 1 year during the 1-year SLIT.

RESULTS

After 1 year, 62 patients in the MD group and 63 patients in the ED group completed the entire study. The clinical efficacy, pulmonary function and FeNO in both groups improved significantly at 0.5 and 1 year (p < 0.001). Compared to the MD group, the ED group showed significant lower ACQ score at 0.5 year (p < 0.001) and lower FeNO at 1 year (p < 0.05). No significant difference between two groups was observed in AE rate (p > 0.05). All AEs occurred in the first month, with no systemic AEs reported.

CONCLUSION

1-year house dust mite (HDM) SLIT is effective and well-tolerated in AS children regardless of administration time. SLIT dosing in the evening might enhance the asthma control level and reduce FeNO level compared with SLIT dosing in the morning.

Cohort study of THRIVE predicting adverse outcomes in acute ischemic stroke of the anterior circulation and posterior circulation after 3 months and 1 year of follow-up

PURPOSE

To evaluate the difference of Totaled Health Risks In Vascular Events (THRIVE) in predicting adverse outcomes in acute ischemic stroke (AIS) of the anterior circulation and posterior circulation at 3-month and 1-year follow-up.

METHODS

A total of 858 patients with AIS were followed up for 3 months and 1 year, and their data prospectively collected. The occurrence of death or moderate to severe disability (modified Rankin Scale ≥ 3 points) was regarded as the endpoint. MedCalc software was used to create the THRIVE receiver operating characteristic curve. The area under the curve (AUC) was calculated to compare the THRIVE scale in predicting adverse outcomes in AIS of the anterior and posterior circulation and compare the differences.

RESULTS

At 3-month follow-up, the AUC of THRIVE was 0.685 (95% CI 0.644-0.724) for AIS of the anterior circulation and 0.709 (95% CI 0.647-0.765) for AIS of the posterior circulation. The area difference between them was 0.0235 (95% CI -0.0728-0.120, P = 0.6330[>0.05]). The AUC of THRIVE for AIS in the anterior circulation at 1 year was 0.701 (95% CI 0.660-0.740), and that for AIS in the posterior circulation at 1 year was 0.747 (95% CI 0.687-0.800). The area difference between them was 0.0458 (95% CI -0.0489-0.140, P = 0.3436 [>0.05]). The difference was not statistically significant.

CONCLUSION

THRIVE can well predict the short-term and long-term adverse prognosis of AIS in the anterior and posterior circulation and has the same predictive effect.

Multifunctional carbonized nanogels to treat lethal acute hepatopancreatic necrosis disease

Background

Shrimp aquaculture has suffered huge economic losses over the past decade due to the outbreak of acute hepatopancreatic necrosis disease (AHPND), which is mainly caused by the bacteria Vibrio parahaemolyticus (V. parahaemolyticus) with the virulence pVA1 plasmid, which encodes a secretory photorhabdus insect-related (Pir) toxin composed of PirA and PirB proteins. The Pir toxin mainly attacks the hepatopancreas, a major metabolic organ in shrimp, thereby causing necrosis and loss of function. The pandemic of antibiotic-resistant strains makes the impact worse.

Methods

Mild pyrolysis of a mixture of polysaccharide dextran 70 and the crosslinker 1,8-diaminooctane at 180 ℃ for 3 h to form carbonized nanogels (DAO/DEX-CNGs) through controlled cross-linking and carbonization. The multifunctional therapeutic CNGs inherit nanogel-like structures and functional groups from their precursor molecules.

Results

DAO/DEX-CNGs manifest broad-spectrum antibacterial activity against Vibrio parahaemolyticus responsible for AHPND and even multiple drug-resistant strains. The polymer-like structures and functional groups on graphitic-carbon within the CNGs exhibit multiple treatment effects, including disruption of bacterial membranes, elevating bacterial oxidative stress, and neutralization of PirAB toxins. The inhibition of Vibrio in the midgut of infected shrimp, protection of hepatopancreas tissue from Pir toxin, and suppressing overstimulation of the immune system in severe V. parahaemolyticus infection, revealing that CNGs can effectively guard shrimp from Vibrio invasion. Moreover, shrimps fed with DAO/DEX-CNGs were carefully examined, such as the expression of the immune-related genes, hepatopancreas biopsy, and intestinal microbiota. Few adverse effects on shrimps were observed.

Conclusion

Our work proposes brand-new applications of multifunctional carbon-based nanomaterials as efficient anti-Vibrio agents in the aquatic industry that hold great potential as feed additives to reduce antibiotic overuse in aquaculture.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s12951-021-01194-8.

Early Death and Survival of Patients With Acute Promyelocytic Leukemia in ATRA Plus Arsenic Era: A Population-Based Study

Most randomized trials for acute promyelocytic leukemia (APL) have investigated highly selected patients under idealized conditions, and the findings need to be validated in the real world. We conducted a population-based study of all APL patients in Zhejiang Province, China, with a total population of 82 million people, to assess the generalization of all-trans retinoic acid (ATRA) and arsenic as front-line treatment. The outcomes of APL patients were also analyzed. Between January 2015 and December 2019, 1,233 eligible patients were included in the final analysis. The rate of ATRA and arsenic as front-line treatment increased steadily from 66.2% in 2015 to 83.3% in 2019, with no difference among the size of the center (≥5 or <5 patients per year, p = 0.12) or age (≥60 or <60 years, p = 0.35). The early death (ED) rate, defined as death within 30 days after diagnosis, was 8.2%, and the 3-year overall survival (OS) was 87.9% in the whole patient population. Age (≥60 years) and white blood cell count (>10 × 10⁹/L) were independent risk factors for ED and OS in the multivariate analysis. This population-based study showed that ATRA and arsenic as front-line treatment are widely used under real-world conditions and yield a low ED rate and a high survival rate, which mimic the results from clinical trials, thereby supporting the wider application of APL guidelines in the future.

[Analysis on the expression profile of circRNAs in hypertrophic myocardium mice]

Objective: To explore the differential expression of circRNAs and their potential impact on the pathophysiological process in cardiac hypertrophy. Methods: Six SPF C57BL/6J male mice, aged 8 to 10 weeks, were randomly divided into transverse aortic constriction (TAC) group (n=3) or sham operation(sham) group (n=3) according to random number table method. TAC mouse model was used to induce cardiac hypertrophy. Four weeks after surgery, high-throughput sequencing analysis was performed to detect differentially expressed circRNA in left myocardial tissues of mice between TAC group and sham group, and principal component analysis of circRNA was performed by R language software. Enrichment analysis was performed by GO and KEGG databases to predict the basic functions of differentially expressed circRNA-derived genes and their biological pathways. The differentially expressed circRNAs in the sequencing results were verified by real-time fluorescence quantitative polymerase chain reaction. Cytoscape software was used to construct circRNA-microRNA (miRNA) network maps to predict their interactions by combining differentially expressed circRNA and TargetScan predicted miRNA sites. Results: Principal component analysis was performed on 4 580 circRNAs detected from 6 samples of mice in TAC group and sham group. The results of R language software indicated that the variance contribution rate of the first 3 principal components, namely the first, second and third principal components, was 91.01%, 3.19% and 2.01%, respectively, and the cumulative variance contribution rate of the 3 components was 96.21%. Among the differentially expressed circRNAs, 6 (19%) were up-regulated and 25 (81%) were down-regulated in the TAC group. GO analysis showed that differentially expressed circRNA was closely related to the occurrence and development of cardiac hypertrophy, and KEGG pathway analysis suggested that downregulated circRNA expression was involved in the regulation of actin cytoskeleton. Fifteen out of the 31 differentially expressed circRNAs were selected for real-time fluorescence quantitative polymerase chain reaction verification, and the results showed that 8 circRNAs were consistent with sequencing results. circRNA-miRNA co-expression network analysis results showed that chr11:65218529-65233184-interacts with mmu-miRNA-30e-3p and mmu-miRNA-30a-3p. Conclusions The differential expression of circRNA in hypertrophic myocardium mice is evidenced in TAC mouse model. circRNA may interact with the corresponding miRNA to influence the occurrence and development of cardiac hypertrophy through autophagy-related cellular hypertrophy pathway or apoptosis-related pathological phenotypes.

[Association between occupational hazard exposures and small airway function among middle-aged and elderly people]

Objective: To investigate the association between occupational hazard exposures and small airway function among middle-aged and elderly people. Methods: From July to December in 2015, a multistage cluster random sampling method was used to select 3 600 residents aged 40 years old and above from 6 chronic obstructive pulmonary disease surveillance points in Jiangsu province. A cross-sectional survey was conducted to collect relevant information. Multivariable linear regression model was performed to determine the relationship between occupational hazard exposures and small airway function. Results: A total of 3 347 participants were included in the final analysis, and 44.6% of participants had been exposed to occupational hazard exposures. Compared with participants without the exposure history of occupational hazards, the significantly lower post-bronchodilator FEF_50%, FEF_75% and MMEF levels were observed in those with the exposure history of occupational hazards (β=-82.74, -55.43 and -91.57, respectively). Post-bronchodilator FEF_75% and MMEF (β=-51.78 and -79.47, respectively) in the participants with the exposure history of occupational dust and post-bronchodilator FEF_50%, FEF_75% and MMEF (β=-96.84, -32.87 and -75.72, respectively) in the participants with the exposure history of occupational harmful gas all showed a lower level. Post-bronchodilator FEF_75% was negatively associated with occupational hazard exposures in males (β_male=-91.65 vs. β_female=-27.21, P for interaction=0.022). Conclusions: The small airway function is worse in the middle-aged and elderly population with the exposure history of occupational hazards, and it is more significant in the male population.

Cohort study on the prognosis of acute cerebral infarction in different circulatory systems at 1-year follow-up

Background

To evaluate the prognosis of acute cerebral infarction at 1-year follow-up in different circulation infarctions.

Methods

Clinical data of 858 consecutive patients with acute cerebral infarction were collected. Of the 858 cases, 21 (2.45%) were lost to follow-up and 837 completed follow-up and thus were enrolled in this study. At 1-year follow-up, death or moderate-to-severe dysfunction (modified Rankin Scale (mRS) ≥ 3 points) was regarded as the poor prognostic endpoint. Univariate analysis and multivariate logistic stepwise regression analysis were performed to assess the prognosis. The prediction probability of indicators was obtained for the multivariate model, and the receiver operating characteristic curve was delineated to calculate the area under the curve (AUC) to predict the fitness of the model.

Results

The older the age, the greater the probability of a poor prognosis. Patients with previous diabetes and cerebral infarction had a poor prognosis. The higher the National Institutes of Health Stroke Scale and mRS scores and the lower the Barthel index at admission, the worse the prognosis of the patients. The longer the hospital stay, the worse the prognosis of the patients. The prognosis of different circulation infarctions was different. The AUC of the multivariate model was AUC = 0.893, and the 95% confidence interval was 0.870–0.913, indicating a good fit. The prognosis of anterior circulation infarction (ACI) was worse than that of posterior circulation infarction (PCI) (P < 0.05). The prognosis of patients with ACI and PCI was not significantly different from that of patients with ACI or PCI alone (P > 0.05).

Conclusions

Diabetes, the Barthel index at admission and previous cerebral infarction are poor prognostic factors of acute cerebral infarction. The prognosis of ACI is worse than that of PCI. Different factors affect the prognosis of different circulatory system infarctions.

Extravasation of chemotherapeutic drug from an implantable intravenous infusion port in a child: A case report

BACKGROUND

Drug extravasation is a complication of totally implantable access port (TIAP) use and could cause tissue injury and sustained organ dysfunction. Therefore, the clinical management of children with TIAP is challenging.

CASE SUMMARY

This was a case of extravasation of a chemotherapeutic drug (paclitaxel) from an implantable infusion port in a 23-mo old child. After fully evaluating the skin at the site of extravasation, the nurse continued to use the infusion port to complete the follow-up chemotherapeutic course. The skin around the infusion port was red, and showed no ulceration, swelling, or induration at discharge.

CONCLUSION

Since children are more active and often noncompliant, it is necessary to appropriately train pediatric nurses caring for individuals with TIAPs, and any abnormal situation should be timely addressed.