End-to-End Video Saliency Detection via a Deep Contextual Spatiotemporal Network

As an interesting and important problem in computer vision, learning-based video saliency detection aims to discover the visually interesting regions in a video sequence. Capturing the information within frame and between frame at different aspects (such as spatial contexts, motion information, temporal consistency across frames, and multiscale representation) is important for this task. A key issue is how to jointly model all these factors within a unified data-driven scheme in an end-to-end fashion. In this article, we propose an end-to-end spatiotemporal deep video saliency detection approach, which captures the information on spatial contexts and motion characteristics. Furthermore, it encodes the temporal consistency information across the consecutive frames by implementing a convolutional long short-term memory (Conv-LSTM) model. In addition, the multiscale saliency properties for each frame are adaptively integrated for final saliency prediction in a collaborative feature-pyramid way. Finally, the proposed deep learning approach unifies all the aforementioned parts into an end-to-end joint deep learning scheme. Experimental results demonstrate the effectiveness of our approach in comparison with the state-of-the-art approaches.

Disparities in Dental Use and Untreated Caries Prevalence by Income

INTRODUCTION

Untreated dental caries (UC), although preventable, is the most prevalent disease in the United States. UC diminishes quality of life and lowers productivity for millions of Americans and is notably higher among lower-income compared to higher-income persons.

OBJECTIVE

This study examines changes in disparities by income in past-year dental use (DU) and UC in 4 life stages (2-5, 6-19, 20-64, and ≥65 y) between 1999-2004 and 2011-2016. We also examined changes in dental safety net policies during this time.

METHODS

We obtained data on dependent variables, UC and DU, from cross-sectional, nationally representative surveys for 1999-2004 and 2011-2016. We used multivariable regression models with 3 main-effect explanatory variables: income (<200% or ≥200% federal poverty level), life stage, and survey period (1999-2004 or 2011-2016) and sociodemographic variables. We included 2-way interaction terms among main-effect variables to test whether disparities had changed over time in each life stage and a 3-way term to test changes in disparities differed across life stages.

RESULTS

Model-adjusted disparities in DU decreased for both preschool-age and school-age children, and disparities in UC decreased for school-age children. Changes in DU and UC disparities were not detectable for working-age adults and increased for retirement-age adults. Changes in DU and UC among preschool and school-age children were not significantly different from one another and were significantly different from changes among retirement-age adults. Compared to working-age adults, changes in disparities for DU and UC were significantly different for school-age children, and changes in DU were significantly different for preschool-age children. Between surveys, the dental safety net was expanded for youth but remained largely unchanged for adults.

CONCLUSIONS

Expanding the dental safety net for youth could have contributed to increased access to dental care among children relative to adults and contributed to the decrease in disparities in DU and UC among youth.

KNOWLEDGE TRANSFER STATEMENT

Between 1999-2004 and 2011-2016, the dental safety net was expanded for youth but remained largely unchanged for adults. Using national survey data to compare changes in disparities in past-year dental use and untreated dental caries by income between adults and youth sheds light on the potential impact of expanding the dental safety net.

[From treatable to curable to eliminated ---- a decade of research progress in the diagnosis and treatment of hepatitis C]

Hepatitis C is the first chronic viral infection that can be cured, and it has taken only 30 years from the discovery of the hepatitis C virus genome to the ability to eliminate the public health threat posed by hepatitis C virus. In the past ten years, the etiological detection of hepatitis C has experienced the development from sensitive and quantitative to rapid, convenient, automatic and point of care testing. With the continuous introduction of direct antiviral drugs, all types of hepatitis C patients, including special populations, can be safely and effectively cured by short courses of all-oral drugs. Progress in the diagnosis and treatment of hepatitis C is an important basis for eliminating the public health threat of hepatitis C. China has published the Planning of prevent and treatment for viral hepatitis in China (2017-2020). We look forward to achieving WHO's goal of eliminating viral hepatitis as a public health threat at an early date through effective screening, diagnosis and treatment.

Triplex qRT-PCR with specific probe for synchronously detecting Bovine parvovirus, bovine coronavirus, bovine parainfluenza virus and its applications

Bovine parvovirus (BPV), bovine coronavirus (BCoV) and bovine parainfluenza virus (BPIV) are common etiologies causing gastrointestinal and respiratory diseases in dairy herds. However, there are few reports on the synchronous detection of BPV, BCoV and BPIV. The present article aimed to develop a quick and accurate RT-PCR assay to synchronously detect BPV, BCoV and BPIV based on their specific probes. One pair universal primers, one pair specific primers and one specific probe was designed and synthesized. After the concentrations of primer and probe and annealing temperature were strictly optimized, the specificity, sensitivity and repeatability of the established triplex probe qRT-PCR were evaluated, respectively. The results showed the recombinant plasmids of pMD18-T-BPV, pMD18-T-BCoV and pMD18-T-BPIV were 554bp, 699bp and 704bp, respectively. The optimal annealing temperature was set at 45.0°C for triplex qRT-PCR. The triplex probe qRT-PCR can only synchronously detect BPV, BCoV and BPIV. Detection sensitivities were 2.0×102, 2.0×102 and 2.0×101 copies/μL for BPV, BCoV and BPIV, being 1000-fold greater than that in the conventional PCR. Detection of clinical samples demonstrated that triplex probe qRT-PCR had a higher sensitivity and specificity. The intra-assay and inter-assay coefficient of variation were lower than 2.0%. Clinical specimens verified that the triplex qRT-PCR had a higher sensitivity and specificity than universal PCR. In conclusion, this triplex probe qRT-PCR could detect only BPV, BCoV and BPIV. Minimum detection limits were 2.0×102 copies/μL for BPV and BCoV, and 2.0×101 copies/μL for BPIV. The sensitivity of this triplex probe qRT-PCR was 1000-fold greater than that in the conventional PCR. The newly qRT-PCR could be used to monitor or differentially diagnose virus infection.

Regulation of circadian behavioural output via clock-responsive miR-276b

Growing evidence indicates that microRNAs play numerous important roles. However, the roles of some microRNAs involved in regulation of circadian rhythm and sleep are still not well understood. In this study, we show that the miR-276b is essential for maintaining both sleep and circadian rhythm by targeting tim, npfr1 and DopR1 genes, with miR-276b deleted mutant flies sleeping more, and vice versa in miR-276b overexpressing flies. Through analysing its promoter, we found that mir-276b is responsive to CLOCK and regulates circadian rhythm through the negative feedback loop of the CLK/CYC-TIM/PER. Furthermore, miR-276b is broadly expressed in the clock neurons and the central complexes such as the mushroom body and the fan-shape body of Drosophila brain, in which up-regulation of miR-276b in tim, npfr1 and DopR1 expressing tissues significantly causes sleep decreases. This study clarifies that the mir-276b is very important for participating in regulation of circadian rhythm and sleep.

Inhibitory Effect of the Traditional Chinese Medicine Ephedra sinica granules on Streptococcus pneumoniae Pneumolysin

Streptococcus pneumoniae (S. pneumoniae) is an opportunistic pathogen that causes pneumonia, meningitis and bacteremia in humans and animals. Pneumolysin (PLY), a major pore-forming toxin that is important for S. pneumoniae pathogenicity, is a promising target for the development of anti-infective agents. Ephedra sinica granules (ESG) is one of the oldest medical preparation with multiple biological activities (such as a divergent wind and cold effect); however, the detailed mechanism remains unknown. In this study, we found that ESG treatment significantly inhibited the oligomerization of PLY and then reduced the activity of PLY without affecting S. pneumoniae growth and PLY production. In a PLY and A549 cell co-incubation system, the addition of ESG resulted in significant protection against PLY-mediated cell injury. Furthermore, S. pneumoniae-infected mice showed decreased mortality, and alleviated tissue damage and inflammatory reactions following treatment with ESG. Our results indicate that ESG is a potential candidate treatment for S. pneumoniae infection that targets PLY. This finding partially elucidates the mechanism of the Chinese herbal formula ESG in the treatment of pneumococcal disease.

Proteomic and mechanistic study of Qingxuan Tongluo formula and curcumin in the treatment of Mycoplasma pneumoniae pneumonia

OBJECTIVE

Mycoplasma pneumoniae (MP) is the only pathogen in the Mycoplasma family that can cause respiratory symptoms, including acute upper respiratory tract infection and bronchitis, which are often attributed to Mycoplasma pneumoniae pneumonia (MPP). MPP is one of the diseases that commonly affects the pediatric respiratory system, but its pathogenesis is unclear. This study investigated the therapeutic effects and mechanisms of Qingxuan Tongluo formula and its main component, curcumin, on MPP.

METHODS

A mouse model of MPP was obtained by nasal drip of the MP strain. The effects of Qingxuan Tongluo formula and curcumin on the treatment of MPP were studied. The proteomic profiles of the alveolar lavage fluid of mice in the model group, Qingxuan Tongluo formula group and curcumin group were evaluated by LC-MS/MS. ELISA and immunohistochemistry were used to verify the possible presence of MP infection biomarkers and drug target proteins.

RESULTS

Compared with the mice in the model group, the MPP mice in the Qingxuan Tongluo formula group had significantly reduced fever and cough and prolonged the cough incubation period. Moreover, the pulmonary pathology of the MPP mice was significantly improved, and the lung histopathological score was decreased. After treatment with Qingxuan Tongluo formula and curcumin, the functional and pathway abnormalities caused by MP were mainly inhibited. Levels of HSP90AA1, GRP94, ENO1 and PLG expression were verified by ELISA and immunohistochemistry.

CONCLUSION

Qingxuan Tongluo formula significantly reduced fevers and cough and prolonged the cough incubation period of MPP mice. Qingxuan Tongluo formula and curcumin significantly improved the pathological changes in lung tissue caused by MP infection. Proteomics analyses indicated that Qingxuan Tongluo formula and curcumin may have therapeutic effects on MPP by regulating energy metabolism, relieving oxidative stress and activating the fibrinolytic system. ENO1 and PLG were found to be potential drug targets.

[Risk factors associated with the progression of chronic HBV infection in patients with normal ALT]

Hepatitis B virus (HBV) infection is one of the common causes of chronic hepatitis in China. Active antiviral therapy can effectively reduce the occurrence risk of end-stage liver diseases, such as decompensated cirrhosis, liver failure and hepatocellular carcinoma. The existing international and domestic guidelines for the prevention and treatment of chronic hepatitis B recommends regular follow-up for patients with normal alanine aminotransferase (ALT). Studies have shown that a high percentage (25.4%-88.9%) of patients with chronic HBV infection have normal ALT levels; however, hepatic histopathology revels obvious inflammation, fibrosis (G≥2 and/or S≥2), cirrhosis and liver cancer. In this paper, we reviewed the relatively insidious risk factors associated with the progression of chronic HBV infection in patients with normal ALT.

A randomized, double-blind, placebo-controlled, multicenter clinical trial for efficacy and safety of traditional Chinese medicine combined with antibiotics in the treatment of bacterial pneumonia in children

BACKGROUND

Pneumonia is the second leading cause of death in children worldwide after preterm birth and certification. Bacteria, viruses, mycoplasma, and other microorganisms are known to be the main causes of pneumonia, of which bacterial pathogenic factors account for 12.5% of cases. The invention and application of antibiotics have improved the prognosis of children with community-acquired bacterial pneumonia (CABP) to a certain extent, but with the emergence of antibiotic resistance worldwide, the mortality of children with CABP is still high. "Maxing Shigan Decoction" and "Qingfei Decoction" have significant efficacy in the treatment of CABP in children, but there is no standardized randomized controlled trial to systematically evaluate the outcomes.

METHODS

This study is a randomized, double-blind, placebo-controlled, multicenter clinical trial that will randomize 240 patients with CABP to group of Oral Maxing Shigan Decoction, group of Qingfei Decoction or group of placebos administered 3 times a day for 7 days. This study will observe a wide range of clinically relevant endpoints that have been used in clinical trials of pneumonia, including but not limited to clinical cure rate, antibiotic application days, complete antipyretic rate, complete antipyretic days, disease efficacy, traditional Chinese medicine syndrome effect, and antibiotic upgrade treatment rates. Safety will be assessed by monitoring for the incidence of adverse events during the study.

DISCUSSION

This clinical trial is the first to evaluate the efficacy and safety of "Maxing Shigan Decoction" and "Qingfei Decoction" in the treatment of children with CABP. The research results will provide a reference for future research design.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR1900025354. Registered on 14th October 2019-Retrospectively registered, http://www.chictr.org.cn/.

[Clinical cure of hepatitis B: consensus and controversy]

Hepatitis B virus (HBV) infection is a serious global public health issue. At present, clinical cure is the ideal endpoint for hepatitis B treatment. That is to say, after the completion of treatment, the serum hepatitis B virus surface antigen (HBsAg) is negative, with or without the presence of antibody against hepatitis B virus surface antigen (anti-HBs), undetectable HBV DNA, liver biochemical indicators within normal range, and improved liver tissue lesions. However, it is difficult to achieve a satisfactory clinical cure effect based on the existing therapeutic drugs. To this end, scientists have conducted many explorations, whether it is a combination of nucleos(t)ide analogues and pegylated interferon therapy strategies, or timely termination of antiviral drug treatment, or accelerate the research and development of innovative drugs. The road to clinical cure of hepatitis B is obstructive and long, with full of opportunities and controversies, but the lead is about to come. We always believe that through unremitting efforts, the dream of helping chronic hepatitis B patients to obtain clinical cure or even complete cure will eventually come true.

On-Site Fluorination for Enhancing Utilization of Lithium in a Lithium-Sulfur Full Battery

The rechargeability of the lithium anode in lithium-sulfur (Li-S) batteries is an issue for this type of battery. In this work, we demonstrate a Li-S full battery comprising a protected anode scaffold and a Li₂S cathode. The stabilized performance is attained by an on-site fluorination strategy, using BiF₃ for the interfacial coating of the anode. Unlike previously reported LiF protective coating derived from the vapor/solution depositions, BiF₃ nanocrystals would be lithiated on-site to the anode surface and server as the protective layer. The chemically inertial Li₃Bi alloy can provide additional ion-conductive paths and stitch the LiF to form a seamless protective layer, thereby suppressing the dendrite propagation and parasitic reactions effectively. With the designed anode structures and compositions, the high-loading full battery (8.05 mg cm^-2) can achieve an exceptional utilization of both sulfur (898 mAh g_S^-1) and lithium (1533 mAh g_Li^-1) over 200 cycles, marking a step toward cyclable Li metal batteries at a high capacity.

[Progress in antiviral treatment of hepatitis C after liver transplantation]

Recipients who detect hepatitis C virus (HCV) ribonucleic acid during the liver transplantation will promptly infect the transplanted liver, so it is called recurrent HCV after liver transplantation. HCV recurrence can lead to the progression of fibrosis and cirrhosis to the transplanted liver, and thereby significantly reduce the transplanted liver survival rate. Therefore, the effective elimination of HCV is the key to improve the patients' prognosis. Patients should receive antiviral therapy as long as HCV RNA can be detected after liver transplantation, and treatment should be stopped as soon as the disease condition stabilizes. Currently, highly safe pan-genotypic direct-acting antiviral drugs (DAA) have been recommended to patients after liver transplantation, as their interaction with immunosuppressive drugs (DDI) is minimal. Clinically, different treatment scheme should be selected according to the hepatorenal function, and DDIs of the patient. This article reviews the current situation and progress of antiviral treatment for HCV infection after liver transplantation.

The single nucleotide polymorphism rs11643718 in SLC12A3 is associated with the development of diabetic kidney disease in Chinese people with type 2 diabetes

AIMS

To examine the association between 24 literature-based single nucleotide polymorphisms and diabetic kidney disease in Chinese people with type 2 diabetes.

METHODS AND RESULTS

Twenty-four candidate diabetic kidney disease-susceptible single nucleotide polymorphisms were genotyped in 208 participants with type 2 diabetes and diabetic kidney disease and 200 participants with type 2 diabetes without diabetic kidney disease (case and control groups, respectively), together with 206 healthy participants using MassARRAY. Rs11643718 in the SLC12A3 gene was associated with diabetic kidney disease in the recessive model after adjusting for confounding factors, such as age and gender (adjusted odds ratio 2.056, 95% CI 1.120-3.776; P = 0.020). Meta-analyses further confirmed the association (P = 0.002). In addition, participants with the GG genotype had worse renal function and more albuminuria than those with the AA+AG genotype (P < 0.05). Renal section immunohistochemistry was conducted in participants with type 2 diabetes, diabetic kidney disease and AA+AG or GG genotypes and in participants with glomerular minor lesions. Together with data from the Nephroseq database, it was shown that the abundance of SLC12A3 was reduced in patients with the GG genotype, while elevated expression of SLC12A3 was associated with better renal function. In addition, rs10951509 and rs1345365 in ELMO1, which were determined to be in high linkage disequilibrium by SHEsis software, were also associated with diabetic kidney disease (adjusted P = 0.010 and 0.015, respectively).

CONCLUSIONS

The G allele and GG genotype of SLC12A3 rs11643718 are associated with the development of diabetic kidney disease in a Chinese population with type 2 diabetes.

[Elimination of hepatitis C, our progress, challenges and hopes]

Hepatitis C infection is a serious public health threat, and the World Health Organization has recommended the elimination of public health threats from viral hepatitis, including hepatitis C, by 2030. Many countries and regions are actively exploring strategies and models to eliminate the public health threat of hepatitis C. It is estimated that there are at least 7.6 million cases of chronic hepatitis C in China, with both diagnosis and treatment rates far away to 2030 target. China's government, social organizations and doctors at different levels are also actively exploring the mode of eliminating the public health threat of hepatitis C in China, including the main mode supported by national standards, government-led mode, social institution undertaking and government-supported mode, medical alliance mode, screening in high-prevalence areas and services contracted with family doctors. China can have a lessons learning from international and ourselves experience, particularly as "Test and treat all based on needs and demand" strategy in Covid-19 control, finally achieve eliminate the public health threat of hepatitis C as soon as possible.

[Current status, treatment and prospect of patients with chronic hepatitis C genotype 3 in China]

Chronic hepatitis C (CHC) is one of the most important causes of chronic liver disease in the world. Among them, chronic hepatitis C with genotype 3 is closely related to the progression of liver disease, and its treatment is still challenging. With the passage of time, the proportion of patients with chronic hepatitis C genotype 3 has been on the rise in China, which raises the difficulty of treatment. Therefore, we need to combine domestic and foreign research to explore a more suitable plan for Chinese patients with chronic hepatitis C genotype 3.

Overweight and high serum total cholesterol were risk factors for the outcome of IVF/ICSI cycles in PCOS patients and a PCOS-specific predictive model of live birth rate was established

PURPOSE

The clinical outcome after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is diverse in infertility patients with polycystic ovary syndrome (PCOS). The aim of this study was to develop a nomogram based on an association of patients' characteristics to predict the live birth rate in PCOS patients.

METHODS

All women in a public university hospital who attempted to conceive by IVF/ICSI for PCOS infertility from January 2014 to October 2018 were included. The nomogram was built from a training cohort of 178 consecutive patients and tested on an independent validation cohort of 81 patients. PCOS was confirmed in all participants.

RESULTS

Three variates significantly associated with live birth rate of PCOS patients were BMI, total serum cholesterol (TC) and basal FSH. This predictive model built on the basis of BMI, TC, basal FSH, type of embryo transferred and age showed good calibration and discriminatory abilities, with an area under the curve (AUC) of 0.708 (95% CI 0.632-0.785) for the training cohort. The nomogram showed satisfactory goodness-of-fit and discrimination abilities in the independent validation cohort, with an AUC of 0.686 (95% CI 0.556-0.815).

CONCLUSION

Our simple evidence-based nomogram presents graphically risk factors and prognostic models for IVF/ICSI outcomes in patients with PCOS, which can offer useful guidance to clinicians and patients for individual adjuvant therapy.

Professionalism Among Chinese Engineers: An Empirical Study

In 2016, Davis and Zhang surveyed 71 Chinese engineers to investigate the claim that the concept of "profession" may have a far wider range than the term. They concluded that China seems to have a profession of engineering (as Davis has long defined "profession") even though the Chinese still lacked an exact translation of the English term. In part, the survey reported here simply continues the work of Davis and Zhang. It confirms their result using a much larger, better educated, demographically different pool of 229 Chinese engineers. But, in part too, it does something else. It investigates the concept professional competence-the perceived knowledge, skill, and judgment that those surveyed attribute to themselves and other engineers. The article has four parts. The first part describes the basics of the survey (who was interviewed, how, when, and so on). The second part describes some important features of the survey's questions, explaining how the questions closely track both the concept of profession and the concept of professional competence. The third part reports and interprets the results relevant to the presence or absence of the concepts of profession and professional competence. The fourth part reports the conclusions.

[Clinical analysis of kidney injury in patients with COVID-19]

Objective: To investigate the relationship between novel coronavirus pneumonia (COVID-19) and kidney injury. Methods: A retrospective analysis was performed on confirmed COVID-19 patients in the Central Theater Command General Hospital of Chinese PLA on March 12, 2020. A total of 87 hospitalized confirmed COVID-19 patients were enrolled in the study, and they were hospitalized for at least one week. The recorded information included clinical data and indicators of kidney-related laboratory tests. Results: The average age of patients was (65.2±17.1) years, and 34.5% (30/87) patients were ≥ 75 years old and 31.0% (27/87) patients were 60-74 years old. Male and female patients accounted for 59.8% (52/87) and 40.2% (35/87), respectively. There were 29.9% (26/87) and 12.6% (11/87) patients who had already showed mild elevation of blood urea nitrogen (BUN) and serum creatinine (SCr) at admission. Moreover, 25.3% (22/87) and 4.6% (4/87) patients still exhibited mild elevation of BUN and SCr one week after admission. However, 28.7% (25/87) patients showed an elevation of BUN one week later after admission, though their BUN levels were normal at admission. Likewise, 16.1% (14/87) patients showed an elevation of SCr one week later after admission, while their SCr levels were normal at admission. Only two patients had an increase of SCr ≥26.5 μmol/L, and both of them were over 75 years old. Conclusions: COVID-19 patients with severe acute kidney injury are uncommon. However, attention should be paid to acute kidney injury of the elderly patients in the diagnosis and treatment of COVID-19.

Context-aware Graph Label Propagation Network for Saliency Detection

Recently, a large number of existing methods for saliency detection have mainly focused on designing complex network architectures to aggregate powerful features from backbone networks. However, contextual information is not well utilized, which often causes false background regions and blurred object boundaries. Motivated by these issues, we propose an easyto-implement module that utilizes the edge-preserving ability of superpixels and the graph neural network to interact the context of superpixel nodes. In more detail, we first extract the features from the backbone network and obtain the superpixel information of images. This step is followed by superpixel pooling in which we transfer the irregular superpixel information to a structured feature representation. To propagate the information among the foreground and background regions, we use a graph neural network and self-attention layer to better evaluate the degree of saliency degree. Additionally, an affinity loss is proposed to regularize the affinity matrix to constrain the propagation path. Moreover, we extend our module to a multiscale structure with different numbers of superpixels. Experiments on five challenging datasets show that our approach can improve the performance of three baseline methods in terms of some popular evaluation metrics.

α

The xenogeneic decellularized corneal matrix (DCM) was expected to be used in lamellar keratoplasty in clinic as the substitute of allogeneic cornea. After decellularization treatment, the remaining risk of xenograft rejection needed to be assessed. The galactose-α1,3-galactose, as the most abundant and closely rejection-related xenogeneic antigen, should be one of the important factors concerned in immunological evaluation. In this study, residual αGal in the DCM was first determined by an enzyme-linked immunosorbent assay method with qualified accuracy and specificity. Then the DCM was implanted subcutaneously into the α1,3-galactosyltransferase gene-knockout (GTKO) mice, accompanied by the implantation in the wild-type C57BL/6 mice as a comparison. The total serum antibody levels, anti-Gal antibody levels, inflammatory cytokines and ratios of splenic lymphocyte subtypes were detected and the histopathological analysis of implants were performed to systematically evaluate the immune responses. The experimental result showed the fresh porcine corneal matrix samples had (9.90 ± 1.54) × 10¹² αGal epitope per mg while the content of residual αGal in the DCM was (7.90 ± 2.00) × 10¹² epitope per mg. The GTKO mice had similar potential of reaction to immune stimulation to that of wild-type C57BL/6 mice. At 4 weeks after implantation of DCM, in WT mice and GTKO mice there were both innate immunity response to the DCM characterized by macrophage infiltration. But the elevations of anti-Gal IgG level and the percentage of splenic natural killer cells were only detected in GTKO mice. These changes were thought to be pertinent to the residual αGal antigen, which could not be detected in WT mice. No further αGal antibody-mediated cellular immunity and significant changes of serum cytokine contents were found in GTKO mice, which perhaps suggested that the immune reactions to the DCM after 4 weeks of implantation were moderate and had minor effect on the survival of the corneal graft.

Obstructive jaundice caused by ulcerative duodenal stenosis: A case report

A peptic ulcer is a rare cause of distal common bile duct stricture, Obstructive jaundice as a complication of ulcerative duodenal stenosis is quite difficult to differentiate from malignant disease, especially in those in which esophagogastroduodenoscopy examination does not reveal an ulcer. In this case report, a 61-year-old male suffered from right upper quadrant pain, chills and fever caused by duodenal and distal common bile duct stenosis originating from ulcer and was treated surgically.

Long noncoding RNA TUG1 facilitates cell ovarian cancer progression through targeting MiR-29b-3p/MDM2 axis

Ovarian cancer (OC) is one of the most aggressive female cancers in the world. OC trends to be diagnosed at an advanced stage with abdominal metastasis. Our study explored the biological function and underlying mechanism of lncRNA on OC cell proliferation and migration. The expression of turine up-regulated gene 1 (TUG1) in human OC tissues and cell lines was measured by qRT-PCR. OC cell proliferation, viability, migration, and invasion were measured by MTT assays, colony formation assays, and transwell assays in vitro. Furthermore, the nude mice xenograft model was established to determine the effects of TUG1 in vivo. The relationship between TUG1 and miR-29b-3p, as well as miR-29b-3p and MDM2 were identified using the luciferase reporter assays. We showed that the expression of TUG1 and MDM2 were significantly increased, but the expression of miR-29b-3p was remarkably decreased in OC tissues and cell lines. Knockdown of TUG1 strongly inhibited the ability of cell proliferation, colony formation, migration, and invasion in vitro. The relationship between TUG1 and miR-29b-3p, or miR-29b-3p and MDM2 were predicted by StarBase and miRanda online software. Besides, miR-29b-3p reversed the positive effect of TUG1 on the OC cell proliferation, migration, and invasion through inhibiting MDM2 expression and increasing p53 phosphorylation level. Moreover, knockdown of TUG1 suppressed tumor growth in vivo. Taken all together, this study shows that TUG1 plays a crucial oncogenic role and facilitates cell proliferation, migration, and invasion in OC through regulating miR-29b-3p/MDM2 axis.

China’s Unwritten Code of Engineering Ethics

Since 2004, Nanyan Cao and some other scholars have implicitly or explicitly claimed that engineering ethics in China is importantly different from engineering ethics in the United States. The evidence for that claim relies on examination of official documents or certain large features of Chinese society (for example, millennia of Taoism, Confucianism, or Buddhism). Though neither is an uncommon approach to studying engineering ethics in China, neither actually studies engineering practice in China. This article does—or at least gets much closer. The authors have asked almost two hundred (Mainland) Chinese engineers about what they do and why they do it. The responses suggest that Chinese engineers, or at least those surveyed, think about engineering ethics much as American engineers do. The responses also suggest that much more empirical work needs to be done before we can claim to understand either the similarities or differences between engineering ethics in China and engineering ethics in “the West.”

[Short-term outcomes of minimally invasive reoperation for tricuspid regurgitation after left-sided valve surgery]

Objective: To examine the short-term outcomes of minimally invasive reoperation for severe tricuspid regurgitation after left-sided valve surgery. Methods: From January 2015 to December 2018, a total of 89 patients with severe tricuspid regurgitation after left-sided valve surgery received reoperation in Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University were included in this study. There were 21 males and 68 females, aging of (56.4±7.9) years (range: 41 to 74 years). The interval between previous left-sided valve surgery and tricuspid reoperation was (14.1±6.1) years (range: 4 to 33 years). A combination of multiple minimally invasive techniques were adopted, including endoscopy-assist right minithoracotomy approach, peripheral cannulation strategy with the vacuum-assist single venous drainage technique, heart beating technique, and temporary percutaneous pacemaker implantation, with a concomitant enhancement in preoperative right cardiac function optimization. Results: All patients received minimally invasive isolated tricuspid valve replacement (n=81) or tricuspid valve repair (n=8). After the application of multiple minimally invasive techniques, the operative mortality rate was only 3.4% (3/89). The causes of death were progressive right heart failure with multiorgan failure (n=1) and low cardiac output associated with postoperative bleeding (n=2). Regarding to the perioperative complications, renal replacement therapy rate was 5.6% (5/89), permanent pacemaker implantation rate was 1.1% (1/89), and the incidence of stroke was 0. Mechanical ventilation time was 24(24) hours, ICU stay time was 2.5 (3.0) days (M(Q(R))). During the short-term follow-up, there were no case of severe tricuspid regurgitation, 2 cases of moderate regurgitation, 4 cases of mild-to-moderate regurgitation. Conclusions: For severe tricuspid regurgitation after left-sided valve surgery, the advanced minimally invasive techniques can significantly reduce the operative mortality and morbidity. Minimally invasive bioprosthetic tricuspid valve replacement is a reliable alternative for severe tricuspid regurgitation after left-sided valve surgery.

[Surgical treatment for tricuspid regurgitation after left-sided valve surgery]

Late tricuspid regurgitation after left-sided valve surgery can negatively affect long-term prognosis. The surgical timing and strategy of tricuspid valve reoperation will have important impact on the surgical outcomes. However, there is no clear recommendations of the surgical timing for this condition in the current guidelines. Generally, tricuspid valve reoperation should be performed before irreversible right heart failure occurs. Although tricuspid valve repair is the first choice for tricuspid regurgitation, bioprosthetic tricuspid valve replacement might be a reliable alternative when tricuspid leaflets have severe rheumatic damage or right ventricle and tricuspid annulus significantly dilate. Combined minimally invasive surgical techniques, including right minithoracotomy approach, accessing the right atrium directly through the pericardium with limited dissection, peripheral cannulation strategy with the vacuum-assist single venous drainage technique and heart beating technique, can significantly decrease the operative mortality and postoperative bleeding. With development of interventional therapy, transcatheter tricuspid valve repair or replacement may become alternatives for tricuspid regurgitation after left-sided valve surgery in the future.

Smoke Sense Initiative Leverages Citizen Science to Address the Growing Wildfire-Related Public Health Problem

Smoke Sense is a citizen science project with investigative, educational, and action-oriented objectives at the intersection of wildland fire smoke and public health. Participants engage with a smartphone application to explore current and forecast visualizations of air quality, learn about how to protect health from wildfire smoke, and record their smoke experiences, health symptoms, and behaviors taken to reduce their exposures to smoke. Through participation in the project, individuals engage in observing changes in their environment and recording changes in their health, thus facilitating progression on awareness of health effects of air pollution and adoption of desired health-promoting behaviors. Participants can also view what others are reporting. Data from the pilot season (1 August 2017 to 7 January 2018; 5,598 downloads) suggest that there is a clear demand for personally relevant data during wildfire episodes motivated by recognition of environmental hazard and the personal concern for health. However, while participants shared clear perceptions of the environmental hazard and health risks in general, they did not consistently recognize their own personal health risk. The engagement in health protective behavior was driven in response to symptoms rather than as preventive courses of action. We also observed clear differences in the adoption likelihood of various health protective behaviors attributed to barriers and perceived benefits of these actions. As users experience a greater number and severity of symptoms, the perceived benefits of taking health protective actions exceeded the costs associated with the barriers and thus increased adoption of those actions. Based on pilot season data, we summarize key insights which may improve current health risk communications in nudging individuals toward health protective behavior; there is a need to increase personal awareness of risk and compelling evidence that health protective behaviors are beneficial.

[Analysis of outpatient utilization of pneumoconiosis patients in Jiangsu province]

Objective: To understand the situation and characteristics of out-patient utilization of urban and rural pneumoconiosis patients in Jiangsu province, and to provide a reference for the formulation of relevant policies. Methods: Using a questionnaire on patients with pneumoconiosis and their influencing factors, 120 patients with pneumoconiosis were randomly selected in Nanjing, Wuxi, Suzhou, Yancheng Vocational Defense Institute or CDC. The rate of outpatients with pneumoconiosis in urban and rural areas and the choice of out-patient hospitals were analyzed. Results: Of the 75 patients with severe pneumoconi-related symptoms such as chest tightness and dyspnea in the first two weeks of the survey, 36 (48.0%) lived in cities and 39 (52.0%) lived in rural areas. Patients with pneumoconiosis who live in urban and rural areas have different aggravating conditions within two weeks. Two weeks of aggravated symptoms in outpatient consultations accounted for36 (48.0%) . Of the 36 patients who used outpatient treatment, rural residents mainly chose 8 people from a hospital and a township health hospital, accounting for 34.8%, while 10 people from urban residents chose a nursing home or nursing home, accounting for 40.0%. The main reason why urban and rural pneumoconiosis patients did not go to the doctor is "conscious symptoms are lighter" and "feel that the doctor is useless." Conclusion: The rate of outpatients with pneumoconiosis in Jiangsu province within two weeks is lower than that of ordinary elderly residents. There may be differences in treatment behavior patterns of urban and rural pneumoconiosis patients.Economic factors have a certain influence on the outpatient treatment behavior of pneumoconiosis patients. The recognition of outpatient service is the main factor affecting the outpatient treatment of pneumoconiosis patients. It is very important to popularize the knowledge of pneumoconiosis and do a good job in propaganda of occupational diseases and health education for pneumoconiosis patients. Focusing on the outpatient treatment of pneumoconiosis patients and making targeted medical policies is very important to standardize and improve the rehabilitation of pneumoconiosis patients.

[Analysis of annual hospitalization rate of pneumoconiosis patients and related influencing factors of social security]

Objective: To study the main factors that influencing Pneumoconiosis patients' healthcare seeking behaviors. Methods: Conducting a descriptive analysis to analyze the relationship between the annual hospitalization rate and social security status (medical insurance, location of medical insurance, proportion of insurance used for reimbursement of pneumoconiosis, whether there is employment injury insurance at work, whether to apply for compensation after diagnosing pneumoconiosis, whether they receive social assistance and a minimum allowance) , social relationship status of patients (whether there is pneumoconiosis in the family or relatives, whether there is a pneumoconiosis in a friend or a colleague, and whether or not he/she has received financial assistance) , life quality of patients (subjective feelings) and living standard of patients (dietary level) based on data acquired from 120 pneumoconiosis patients. Results: The results of single factor analysis reveal that the location of medical insurance, the proportion of insurance for reimbursement of pneumoconiosis, whether there is employment injury insurance at work, whether to apply for compensation after diagnosing pneumoconiosis are statistically significant in pneumoconiosis patients' hospital utilization ratio (P<0.05) . The place where medical insurance is located is the current place of residence, the reimbursement ratio of medical insurance for pneumoconiosis is listed as 50%-70%, the work unit has medical insurance, those who have not applied for compensation for pneumoconiosis have a higher utilization rate of hospitalization services. The annual hospitalization rate was 73.3%, 80.0%, 60.6%, 63.0%, respectively. Conclusion: The location of patient medical insurance, the proportion of insurance used for reimbursement of pneumoconiosis, whether there is employment injury insurance at work, and whether to apply for compensation after pneumoconiosis are the influencing factors of the patients' annual hospitalization rate.

Metabolic syndrome and renal cell cancer risk in Chinese males: a population-based prospective study

Background

Metabolic syndrome (MetS) is now a common public health problem. Few researches have reported the relationship between MetS and the risk of renal cell cancer (RCC). To investigate the association of metabolic syndrome and its components with the risk of RCC in Chinese males, the study was performed in the Kailuan male cohort, a large prospective cohort study.

Methods

A total of 104,333 eligible males enrolled in the every 2-year health checkup were involved in the Kailuan male cohort study (2006-2015). Information on demographic and socioeconomic characteristics, lifestyle, medical history and laboratory tests at baseline entry was obtained. Univariable and multivariable Cox proportional hazards regression models were used to estimate the association between MetS and the RCC risk.

Results

During a median follow-up of 8.9 years, 131 RCC cases were verified over a total of 824,211.96 person-years. Among the 5 single MetS components, hypertension (Systolic/diastolic blood pressure≥130/85 mm Hg or antihypertensive drug treatment of previously hypertension) (HR = 2.35, 95%CI:1.48-3.72) and elevated triglyceride (TG) (≥1.7mmol/L) (HR = 1.78, 95%CI:1.23-2.56) showed significant risk for RCC. Multivariate analysis showed that compared to those who did not meet MetS diagnostic criteria (number of abnormal MetS components&lt;3), HR of RCC risk for participants with MetS was 1.95 (95% CI 1.35-2.83). The number of abnormal MetS components was linearly associated with an increased risk of RCC (P trend&lt;0.001), and the HRs of RCC risk for males with 1, 2 and ≥3 MetS components were 1.27 (0.56-2.90), 2.42 (1.12-5.20) and 3.32 (1.56-7.07), respectively, compared with subjects without MetS components.

Conclusions

MetS was inversely associated with of RCC risk in males.

Key messages

MetS might be one of the scientific and important predictors of RCC. Controlling metabolic syndrome may potentially have key scientific and clinical significance for RCC prevention.