A Panel Containing PD-1, IL-2Rα, IL-10, and CA15-3 as a Biomarker to Discriminate Breast Cancer from Benign Breast Disease

Background: Programmed cell death protein 1 (PD-1), an immune checkpoint molecule, has recently been recognized as a predictive and prognostic biomarker in several malignant tumors, but its diagnostic value remains largely unknown. Aim: We aimed to investigate the differential diagnostic efficiency of PD-1 and other immune molecules, and propose a panel of immune molecules combined with cancer antigen 15-3 (CA15-3) to distinguish breast cancer (BC) from benign breast disease (BBD). Methods: Ninety-one eligible BC patients and 31 BBD patients were enrolled. Pretreatment peripheral blood was collected and tested for mRNA expression of PD-1, cytotoxic T lymphocyte antigen 4 (CTLA-4), forkhead box P3 (FOXP3), transforming growth factor beta (TGF-β), interleukin-10 (IL-10), IL-2 receptor alpha (IL-2Rα), and cluster of differentiation 28 (CD28) by quantitative real-time PCR. Results: The diagnostic areas under curve (AUCs) of PD-1, IL-2Rα, and IL-10 for BC-BBD discrimination were 0.764, 0.758, and 0.743, respectively. The diagnostic efficiencies of these 2 parameters in distinguishing early-stage or advanced BC from BBD were consistent with a role in BC-BBD discrimination. A panel of PD-1 + IL-10 + IL-2Rα + CA15-3 showed the highest AUC (0.862), with sensitivity of 0.933 and specificity of 0.724, for BC-BBD discrimination. In addition, for early-stage BC discrimination, this panel also had the highest AUC (0.811), with a sensitivity of 0.933 and specificity of 0.614, while for advanced BC discrimination, a panel of PD-1 + IL-10 + CA15-3 exhibited the highest AUC (0.896), with a sensitivity of 0.933 and specificity of 0.783. Conclusion: These data indicate that the panel containing PD-1, IL-2Rα, IL-10, and CA15-3 can effectively discriminate BC from BBD with a high efficiency. After further confirmation, it could be used to complement conventional imaging modalities, especially in discriminating early-stage BC from BBD.

[The association of lipid profile and bleeding in patients with minor stroke or transient ischemic attack on antiplatelet therapy: subgroup analysis of CHANCE]

Objective: Abnormalities of lipid profile were considered as risk factors of hemorrhage after ischemic stroke. We aimed to determine the relationship between lipid levels and bleeding in minor stroke or transient ischemic attack (TIA) patients receiving antiplatelet therapy. Methods: Serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglyceride were tested in a subgroup of 3 044 consecutive patients from Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. Patients were randomized to clopidogrel plus aspirin group or single aspirin group. The primary endpoint was any bleeding within 90 days. The secondary endpoint was severe bleeding according to the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) definition. Cox proportional hazards models were used to assess the associations of lipid levels and outcomes. Results: A total of 59 (1.9%) bleeding events occurred at 90 days. High-density lipoprotein cholesterol (adjusted HR=2.16; 95%CI 1.17-4.00, P=0.014) and age (adjusted HR=1.04; 95%CI 1.01-1.06, P=0.006) were significantly associated with any bleeding. High-density lipoprotein cholesterol was also associated with severe bleeding (adjusted HR=3.05; 95%CI 1.39-6.68, per 1 mmol/L increase). No correlations between outcomes and levels of total cholesterol, low-density lipoprotein cholesterol and triglyceride were found. There was no interaction of any lipid component level with randomized antiplatelet therapy. Conclusions: Elevated high-density lipoprotein cholesterol is independently associated with any bleeding and severe bleeding in the patients with acute minor stroke or high-risk TIA on antiplatelet therapy.

[Influence of two kinds of probiotics combined with bismuth quadruple therapy for Helicobacter pylori eradication]

Objective: To investigate the efficacy and safety of Compound Lactobacillus Tablets or Saccharomyces boulardii Sachets combining with bismuth quadruple therapy for Helicobacter pylori(H.pylori) eradication. Methods: A total of 360 H. pylori- infected patients were enrolled and randomly assigned into three groups. Group A received esomeprazole 20 mg bid+ bismuth potassium citrate 220 mg bid+ amoxicillin 1 000 mg bid+ furazolidone 100 mg bid for 10 days. Group B or group C received the same quadruple therapy for 10 days as group A, as well as Compound Lactobacillus Tablets 1 000 mg tid or Saccharomyces boulardii Sachets 500 mg bid for 14 days. Drug-related side effects and adverse reactions were collected during the therapy, and H. pylori eradication results were confirmed by (13)C/(14)C-UBT at least 4 weeks after cessation of therapy. Results: The H. pylori eradication rates in group A, B and C were 81.7%, 84.2% and 85.0% by ITT analysis (P=0.768) and 92.5%, 90.1% and 93.6% by PP analysis (P=0.770), respectively. The overall side effects and adverse reactions rates (P=0.008) and occurrence of diarrhea (P<0.001) were significantly lower in group B than group A. The overall side effect rates (P=0.003) and occurrence of diarrhea (P<0.001), abdominal distension (P=0.004) and constipation(P=0.002) were significantly lower in group C than group A. There was no significant difference in side effects and adverse reactions rates between the two probiotics groups. Conclusions: Both Compound Lactobacillus Tablets and Saccharomyces boulardii Sachets, combining with bismuth quadruple therapy, reduced the overall side effects and adverse reactions rates for H. pylori eradication. Moreover, the former can reduce the incidence of diarrhea, and the latter can reduce the incidence of diarrhea, abdominal distension and constipation.

The relationship of plasma miR-503 and coronary collateral circulation in patients with coronary artery disease

OBJECTIVE

Although angiogenesis plays an important role in coronary collateral circulation (CCC) formation and there are many determinants of coronary angiogenesis, they cannot fully explain the mechanism of CCC formation or as potent biomarker for CCC status. Therefore, there is of great clinical significance to identify the novel molecules associated with CCC. Previously, miR-503 exerts anti-angiogenesis effect via inhibition of VEGF-A and its expression is associated with many angiogenesis-related factors. Thus, we aimed to investigate the relationship of plasma miR-503 with CCC formation as well as its predictive power for CCC status in patients with coronary artery disease.

METHODS

Among patients who underwent coronary angiography with coronary artery disease and a stenosis of ≥90% were included in our study. Collateral degree was graded according to Rentrop Cohen classification. The patients were divided to good CCC group (grade 2 or 3) and poor CCC group (grade 0 or 1) according to Rentrop grade. We investigated the plasma levels of miR-503 and VEGF-A by ELISA or q RT-PCR, respectively. In addition, we assayed the correlations of plasma miR-503 with VEGF-A or Rentrop grade using the spearman correlation test and its predictive power by receiver operating characteristic (ROC) and binary logistical regression analysis.

RESULTS

Our data showed that plasma VEGF-A was significantly higher in good CCC group than that in poor group. Plasma miR-503 was lower in CAD patients with good CCC or poor CCC compared with control subjects and lowest in good CCC group. In addition, miR-503 negatively correlated with VEGF-A and Rentrop grade, respectively. Moreover, miR-503 displayed more potent predictive power for CCC status than VEGF-A, but its sensitivity and specificity for CCC status were only 72.4 or 60.9%, respectively.

CONCLUSIONS

Lower plasma miR-503 level was related to better CCC formation, accompanied by up-regulation of VEGF-A. In addition, miR-503 displayed potent predictive power for CCC status, but its sensitivity and specificity were not high enough, indicating that miR-503 might be as an additional prognosis biomarker for CCC.

The relationship of plasma decoy receptor 3 and coronary collateral circulation in patients with coronary artery disease

OBJECTIVE

Previously, decoy receptor 3 (DcR3) was found to be a potential angiogenetic factor, while the relationship of DcR3 with coronary collateral circulation formation has not been investigated. In this study, we aimed to investigate whether plasma decoy receptor 3 levels was associated with CCC formation and evaluate its predictive power for CCC status in patients with coronary artery disease.

METHODS

Among patients who underwent coronary angiography with coronary artery disease and had a stenosis of ≥90% were included in our study. Collateral degree was graded according to Rentrope Cohen classification. Patients with grade 2 or 3 collateral degree were enrolled in good CCC group and patients with grade 0 or 1 collateral degree were enrolled in poor CCC group.

RESULTS

Plasma DcR3 level was significantly higher in good CCC group (328.00±230.82 vs 194.84±130.63ng/l, p<0.01) and positively correlated with Rentrope grade (p<0.01). In addition, plasma DcR3 was also positively correlated with VEGF-A. Both ROC (receiver operating characteristic curve) and multinomial logistical regression analysis showed that plasma DcR3 displayed potent predictive power for CCC status.

CONCLUSIONS

Higher plasma DcR3 level was related to better CCC formation and displayed potent predictive power for CCC status.

[Study on spatial - temporal characteristics of Schistosoma japonicum infections among human in Hunan Province, 2004-2011]

Objective To explore the spatial-temporal characteristics and changing regularities of Schistosoma japonicum infections among human from 2004 to 2011. Methods The township level spatial databases of schistosomiasis in Hunan Province from 2004 to 2011 were established, and the related spatial analysis was performed by SPSS 17.0, ArcGIS 10.1 and SaTScan 7.03. Results The schistosome infection rate among human in Hunan Province sharply decreased from 3.0% in 2004 to 0.8% in 2011. However, the rate among residents in parts of some townships in 2011 was still hovering at a higher level (P₉₀ = 2.12%), and the higher rate was distributed along the Oncomelania hupensis snail ridden areas outside embankment. The autocorrelation analysis showed that the global Moran's I for schistosome infection rate among human was 0.34 to 0.53 from 2004 to 2011, and was higher than the expected value (Z > 8.71, P < 0.05). The local G statistics indicated that the positive hotspot high-high clustering areas were mainly near the coast of Dongting Lake from 2004 to 2011, and the number of townships with schistosomiasis endemic in the clustering areas reached 30 to 70. The spatial scan analysis showed that the number of townships in the clustering areas ran up to 145 to 183 from 2004 to 2011. Conclusions The schistosome infection rate among human decreased significantly in Hunan Province from 2004 to 2011. However, the rate in parts of some townships still remains at a comparatively high level, and there are positive spatial correlation and spatial agglomerations in the schistosome infection rate among human, suggesting that the prevention and control work on schistosomiasis in these areas should be strengthened in the future.

Protective role of surface Toll-like receptor 9 expressing neutrophils in local inflammation during systemic inflammatory response syndrome in mice

Clinically, systemic inflammatory response syndrome (SIRS) occurs after serious trauma or sepsis. In sepsis, neutrophils are the major effector cells responsible for eliminating pathogens. However, the role of neutrophils in development of SIRS, especially in local inflammatory area, is controversial. In this study, we established a SIRS mouse model characterized with cytokine-mediated lethal shock by intraperitoneal injection of oligodexynucleotides containing CpG motifs (CpG ODN) in D-galactosamine (D-GalN) sensitized mice based on our previous work and found that abundant neutrophils were rapidly recruited into the peritoneal cavity, where some neutrophils expressed surface TLR9 (sTLR9), defined as sTLR9⁺ neutrophils. Along with the progression of SIRS, the expression of sTLR9 in sTLR9⁺ neutrophils isolated from peritoneal lavage cells (PLCs) was declined in accompany with an increase in the level of the inflammatory cytokine TNFα and a decrease in the level of the anti-inflammatory cytokine IL-10 in Ly6G⁺ PLCs. When using CCT ODN, an oligodeoxynucleotide with CCT repeats, which we have previously shown to be capable of rescuing mice from lethal shock, the expression of sTLR9 on neutrophils was significantly elevated. Adoptive therapy using early recruited neutrophil-rich PLCs containing sTLR9⁺ neutrophils that express high levels of sTLR9, could rescue mice from SIRS. Overall, the data reveal that the early recruited sTLR9⁺ neutrophils may, at least in the area of local inflammation, play a protective role during SIRS development and provide a method to rescue the patients with severe SIRS via the up-regulation of sTLR9 levels on the surface of neutrophils or via adoptive therapy with protective sub-populations of neutrophils.

Detection of drug-responsive B lymphocytes and antidrug IgG in patients with β-lactam hypersensitivity

BACKGROUND

Delayed-type β-lactam hypersensitivity develops in subset of patients. The cellular immunological processes that underlie the drug-specific response have been described; however, little is known about involvement of the humoral immune system. Thus, the aim of this study was to utilize piperacillin hypersensitivity as an exemplar to (i) develop cell culture methods for the detection of drug-specific B-cell responses, (ii) characterize drug-specific IgG subtypes and (iii) assess reactivity of IgG antibodies against proteins modified to different levels with piperacillin haptens.

METHODS

IgG secretion and CD19⁺ CD27⁺ expression on B cells were measured using ELISPOT and flow cytometry, respectively. A piperacillin-BSA adduct was used as an antigen in ELISA antibody binding studies. Adducts generated using different ratios of drug to protein were used to determine the degree of conjugation required to detect IgG binding.

RESULTS

B cells from hypersensitive patients, but not controls, were stimulated to secrete IgG and increase CD27 expression when cultured with soluble piperacillin. A piperacillin-BSA adduct with cyclized and hydrolysed forms of the hapten bound to eight lysine residues was used to detect hapten-specific IgG 1-4 subclasses in patient plasma. Hapten inhibition and the use of structurally unrelated hapten-BSA adducts confirmed antigen specificity. Antibody binding was detected with antigens generated at piperacillin/BSA ratios of 10:1 and above, which corresponded to a minimum epitope density of 1 for antibody binding.

CONCLUSION

These data show that antigen-specific B lymphocytes and T lymphocytes are activated in piperacillin-hypersensitive patients. Further work is needed to define the role different IgG subtypes play in regulating the iatrogenic disease.

NONCLASSICAL 21-HYDROXYLASE DEFICIENCY PRESENTED AS ADDISON'S DISEASE AND BILATERAL ADRENAL INCIDENTALOMAS

Background

21-hydroxylase deficiency (21 OHD) is the most common form of congenital adrenal hyperplasia (CAH) and it has been widely described in the literature. Adrenocortical incidentalomas are unfrequently the presenting manifestations of CAH, especially in nonclassical form of 21 OHD (NC 21 OHD). Myelolipoma has previously been reported more frequently than other adrenal adenomas associated with CAH.

Case

We report a 40-year old male case of NC 21 OHD with hypoadrenocorticism after unilateral adrenalectomy of the right side because of a large solid incidentaloma (5×4×4cm³) at the age of 31. This patient began to suffer from obvious symptoms of adrenal insufficiency after 9 years from the surgery. He was reviewed and a very low-density adrenal mass (4.1×3.9cm) was found on computed tomography of the abdomen. After he was admitted to our hospital, this patient was confirmed with NC 21 OHD and presented low level cortisol, striking elevated ACTH, aldosterone insufficiency, increased 17-hydroxyprogesterone, progesterone, decreasing androgens and azoospermatism.

Conclusion

Patients with 21 OHD could be on risk not only for adrenal hyperplasia, but also to develop adrenal adenomas, particularly if the disease was poorly controlled.

Rapid in-focus corrections on quantitative amplitude and phase imaging using transport of intensity equation method

Transport of intensity equation (TIE) method can acquire sample phase distributions with high speed and accuracy, offering another perspective for cellular observations and measurements. However, caused by incorrect focal plane determination, blurs and halos are induced, decreasing resolution and accuracy in both retrieved amplitude and phase information. In order to obtain high-accurate sample details, we propose TIE based in-focus correction technique for quantitative amplitude and phase imaging, which can locate focal plane and then retrieve both in-focus intensity and phase distributions combining with numerical wavefront extraction and propagation as well as physical image recorder translation. Certified by both numerical simulations and practical measurements, it is believed the proposed method not only captures high-accurate in-focus sample information, but also provides a potential way for fast autofocusing in microscopic system.

Hydroxyapatite/N-doped carbon dots/Ag3PO4 composite for improved visible-light photocatalytic performance

A new ternary hydroxyapatite/N-doped carbon dots/Ag₃PO₄ (HA/N-CDs/Ag₃PO₄) composite with remarkable photocatalytic performance and stability was developed via a cost-effective route.

Polarization loss in the organic ferroelectric trialkylbenzene-1,3,5-tricarboxamide (BTA)

The depolarization mechanism for the archetypical molecular ferroelectric BTA is quantitatively understood as an activated collective reversal of molecular dipoles.

Attribution of NKG2DL to the inhibition of early stage allogeneic tumors in mice

Allogeneic tumors are eventually rejected by adaptive immune responses, however, little is known about how allogeneic tumors are eradicated at the early stage of tumor development. In present study, we found that NKG2DL low expressing cancer cells were developed into palpable allogeneic tumors in mice within a week after the inoculation, while NKG2DL high expressing cancer cells failed to. The NKG2DL high expressing cancer cells could increase NKG2D⁺ NK cells in the allogeneic mice after being inoculated for 3 days. Artificially up-regulating NKG2DL on cancer cells with low level expressed NKG2DL by a CpG ODN resulted in the retardation and rejection of the allogeneic tumors at the early stage. The contribution of up-regulated NKG2DL to the early rejection was further confirmed by the results that the development of allogeneic tumors from cancer cells transfected with NKG2DL genes was significantly inhibited in mice at the early stage. Overall, hopefully, the data may provide insights for combining the allogeneic NK cell adoptive transfer with the approaches of up-regulating NKG2DL to treat cancer patients.

[The effect of occupational exposure to coal tar pitch workers' health]

Objective: To investigate the effect of occupational exposure to coal tar pitch on workers' health and metabolism. Methods: 805 workers exposed to coal tar pitch were selected as exposure group from the produce and em-ploy factory. Other people handle administrative and logistical affairs who not exposed to coal tar pitch were selected as control group. Fix-point sample of air were collected to detect the concentration of coal tar pitch. Do physical examination and questionnaire to collect workers' basic and healthy information. To detect the metabolic product of urine samples in laboratory. Results: Anomaly detection rate of the skin in exposure group is 10.61. The lung function indices (FEV_1.0%) in exposure group were significantly lower than control group (P<0.05) . The monocyte count and monocyte rate in expo-sure group were significantly higher than control group (P<0.05) . The metabolic product content of PAHS in urine sam-ples is significantly higher in exposed group than control group (P<0.05) . Conclusion: The metabolic product content of polycyclic aromatic hydrocarbon is higher in exposed workers. Coal tar pitch damage workers' skin and lung function. It can cause pruritus chromatodermatosis and so on.

ZNF750 is a lineage-specific tumour suppressor in squamous cell carcinoma

ZNF750 controls epithelial homeostasis by regulating epidermal-differentiation genes, a role underscored by its pathogenic mutations in esophageal squamous cell cancers (SCCs). However, the precise role of ZNF750 in SCC cell biology remains unclear. In this study, we report that ZNF750 is exclusively deleted, mutated and underexpressed in human SCCs, and low ZNF750 expression is associated with poor survival. Restoration of wildtype, but not mutant ZNF750 protein uniquely inhibited the malignant phenotypes of SCC cells both in vitro and in vivo. Notably, ZNF750 promoted the expression of a long non-coding RNA (TINCR), which mediated both cancer-inhibition and differentiation-induction effects of ZNF750. In addition, ZNF750 potently suppressed cell migration by directly inhibiting the transactivation of LAMC2. Together, our findings characterize ZNF750 as a crucial SCC-specific suppressor and uncover its novel anticancer-associated functions.

Coping strategies and distress reduction in psychological well-being? A structural equation modelling analysis using a national population sample

BACKGROUND

Little is understood about of the role of coping strategies in psychological well-being (PWB) and distress for the general population and different physical and psychiatric disease groups. A thorough examination of these relationships may provide evidence for the implementation of public mental health promotion and psychiatric disease prevention strategies aimed at improving the use of positive coping approaches or addressing the causes and maintainers of distress. The present study using a structural equation modelling (SEM) approach and nationally representative data on the Canadian population investigates the relationships among PWB, distress and coping strategies and identifies major factors related to PWB for both the general population and diverse-specific disease groups.

METHODS

Data examined were from the Canadian Community Health Survey of Mental Health and Well-being (CCHS 1.2), a large national survey (n = 36 984). We applied exploratory factor analysis (EFA), confirmatory factor analysis and SEM to build structural relationships among PWB, distress and coping strategies in the general population.

RESULTS

Both SEM measurement and structure models provided a good fit. Distress was positively related to negative coping and negatively related to positive coping. Positive coping indicated a higher level of PWB, whereas negative coping was associated with a lower level of PWB. PWB was negatively related to distress. These same relationships were also found in the population subgroups. For the population with diseases (both physical and psychiatric diseases, except agoraphobia), distress was the more important factor determining subjective PWB than the person's coping strategies, whereas, negative coping had a major impact on distress in the general population. Strengths and limitations were also discussed.

CONCLUSIONS

Our findings have practical implications for public psychiatric disease intervention and mental health promotion. As previously noted positive/adaptive coping increased the level of PWB, whereas negative/maladaptive coping was positively related to distress and negatively related to PWB. Distress decreased the level of PWB. Our findings identified major correlates of PWB in both the general population and population subgroups. Our results provide evidence for the differential use of intervention tactics among different target audiences. In order to improve the mental health of the general population public mental health promotion should focus on strategies that reduce negative coping at a population level, whereas clinicians treating individual clients should make the reduction of distress their primary target to maintain or improve patients' PWB.

[Clinical treatment of infective endocarditis with vegetations in pregnant women and the outcomes of gestation]

OBJECTIVE

To investigate the clinical treatment of infective endocarditis with vegetations in pregnant women and the outcomes of the gestation.

METHODS

Nine cases of pregnant women diagnosed as infective endocarditis with vegetations in Beijing Anzhen Hospital, Capital Medical University from January 2001 to October 2015 were enrolled in retrospective analysis. Consultations were held by doctors from department of obstetrics, anesthesiology, cardiology, cardial surgery and extracorporeal circulation to decide the individualized treatment plan for the 9 cases of pregnant women after admissions. Clinical treatments including general treatment, anti-infection treatment, cardiac surgery, and termination of pregnancy surgery were completed through collaboration among related departments. The clinical characters, therapeutic regimens, maternal and neonatal outcomes of the 9 cases were analyzed.

RESULTS

(1) Clinical characters: the ages of the 9 cases of pregnant women were from 25 to 36 years old. The onset gestational ages were from 19 to 36 weeks.

CLINICAL SYMPTOMS

fever, cough, sputum and progressive anemia were the main symptoms. Patients had cyanosis of lips, could not lie on the back or even be orthopnea, when heart failure happened. Heart murmur was audible and splenomegaly was touched in physical examination. Blood cultures were positive. Basic heart disease types: 7 cases of congenital heart diseases included 2 cases of aortic insufficiency, 1 case of mitral insufficiency, 1 case of patent ductus arteriosus, 1 case of right ventricular outflow tract stenosis and 2 cases of ventricular septal defect.Two cases of rheumatic heart diseases included 1 case of mitral stenosis, 1 case of mitral stenosis after artificial disc changed and jammed. According to endocardial vegetations attached position there were 3 cases of mitral valve vegetations, 2 cases of pulmonary valve vegetations, 3 cases of aortic vegetations and 1 case of right ventricular outflow tract neoplasm. Preoperative heart function classification: 1 case of level Ⅱ, 3 cases of level Ⅲ, 5 cases of level Ⅳ. (2) TREATMENTS: general treatment included oxygen uptake, rest in bed, cardiac strengthen and diuretic therapy, etc. Combined and adequate antibiotics were applied in anti-infection treatment according to drug sensitive test. Nine cases of pregnant women were all performed surgical treatment of heart diseases and removal of the endocardial vegetations. Caesarean sections were performed for 2 cases in second trimester and for 7 cases in last trimester. Cardiac surgery and caesarean section were operated in 6 cases at the same time among 22-34 weeks of pregnancy. Cardiac surgery were respectively operated in 2 cases 11 days and 32 days after the caesarean section at 33, 37 weeks of pregnancy. While Cardiac surgery was operated (at 26 weeks of pregnancy) before the caesarean section (at 37 weeks of pregnancy) in another 1 case. (3) Maternal and neonatal outcomes: 7 cases of pregnant women were rescued successfully, while 2 cases of pregnant women were death. Postoperative heart function classification: 1 case of level Ⅰ, 2 cases of level Ⅱ, 4 cases of level Ⅲ and 2 cases of level Ⅵ. Neonatal survivals were 6 cases including 2case of full-term infants, 4 cases of preterm infants. Stillbirth or neonatal death were 3 cases, which included 2 cases performed caesarean section in second trimester and 1 case of very low weight infant who was given up treatment by family because of severe asphyxia. Followed up periods were from 1 to 7 years with an average time of (2.0±1.6) years. Infants and young children grew and developed well during the period of follow up.

CONCLUSIONS

The risk is extremely high of pregnancy with infective endocarditis with vegetations. But there is still a way to save the maternal and neonatal life by using a multidisciplinary collaboration formulation and implementation of individualized treatment plan and selecting the appropriate time for heart surgery and the termination of pregnancy.

Maltreatment in childhood substantially increases the risk of adult depression and anxiety in prospective cohort studies: systematic review, meta-analysis, and proportional attributable fractions

BACKGROUND

Literature supports a strong relationship between childhood maltreatment and mental illness but most studies reviewed are cross-sectional and/or use recall to assess maltreatment and are thus prone to temporality and recall bias. Research on the potential prospective impact of maltreatment reduction on the incidence of psychiatric disorders is scarce.

METHOD

Electronic databases and grey literature from 1990 to 2014 were searched for English-language cohort studies with criteria for depression and/or anxiety and non-recall measurement of childhood maltreatment. Systematic review with meta-analysis synthesized the results. Study quality, heterogeneity, and publication bias were examined. Initial screening of titles and abstracts resulted in 199 papers being reviewed. Eight high-quality articles met eligibility criteria. Population attributable fractions (PAFs) estimated potential preventive impact.

RESULTS

The pooled odds ratio (OR) between any type of maltreatment and depression was 2.03 [95% confidence interval (CI) 1.37-3.01] and 2.70 (95% CI 2.10-3.47) for anxiety. For specific types of maltreatment and depression or anxiety disorders, the ORs were: physical abuse (OR 2.00, 95% CI 1.25-3.19), sexual abuse (OR 2.66, 95% CI 1.88-3.75), and neglect (OR 1.74, 95% CI 1.35-2.23). PAFs suggest that over one-half of global depression and anxiety cases are potentially attributable to self-reported childhood maltreatment. A 10-25% reduction in maltreatment could potentially prevent 31.4-80.3 million depression and anxiety cases worldwide.

CONCLUSION

This review provides robust evidence of childhood maltreatment increasing the risk for depression and anxiety, and reinforces the need for effective programs and policies to reduce its occurrence.

Preparation and Characterization of Colon-Specific Microspheres of Diclofenac for Colorectal Cancer

Purpose: To prepare and evaluate colon specific drug delivery system of diclofenac sodium for highly localized delivery to the colon.Methods: The colon specific drug delivery system was prepared as matrix-type microspheres using Ethyl Cellulose (EC), Cellulose Acetate Phthalate (CAP), and Eudragit L 100-55 by the Solvent Evaporation Method. Microspheres were evaluated for physical properties like drug content, particle size, bulk density and angle of repose.Results: The size range of the microcapsules was 228 to 608 μm while drug content was between 74.49 and 91.50 % depending on the polymer used and the  polymer ratio. Mean bulk density was < 1.2 g/ml which indicates the good flow properties, while angle of repose was < 40 o, indicating free-flowing properties. The microspheres were spherical in shape with smooth and nonporous surface, except that the microspheres containing EC and CAP exhibited a rough and porous  surface. The microspheres containing Eudragit L 100-55 in combination with other polymers gave better sustained release (78.9 and 76.6 % at the end of 8 h for  formulation F4 and F5, respectively) than the others.Conclusion: Microspheres prepared with drug: EC: CAP ratio of 1:2:1 show the highest drug content, possess good flow properties and surface morphology, as well as promising drug release for colon specific drug delivery of diclofenac sodium for possible treatment of colorectal cancer.Keywords: Diclofenac, Colorectal cancer, Microspheres, Ethyl cellulose, Cellulose acetate phthalate, Eudragit L 100-55

A smoking cessation intervention among tuberculosis patients in rural China

OBJECTIVE

To assess the integration of a smoking cessation intervention into routine tuberculosis (TB) services.

METHOD

Consecutive TB patients registered from 1 March to 31 August 2010 were enrolled in an intervention for self-reported smoking to promote tobacco cessation during treatment for TB. Information on the harmful health effects of tobacco smoke and smoking and TB were provided to TB patients who self-reported as current smokers. Smoking status was reassessed at every follow-up visit during anti-tuberculosis treatment with reinforced health messages and advice to quit.

RESULTS

Of 800 TB patients enrolled, 572 (71.5%) were male and 244 (30.5%) were current smokers. Females were more likely to be non-smokers (100% vs. 35.8%, P < 0.001). Of the 244 current smokers, 144 (59.0%) started smoking at <20 years, 197 (80.7%) consumed ⩾20 cigarettes per day, 211 (86.5%) had perceived smoking dependence and 199 (81.6%) had made no attempt to quit before the diagnosis of TB. Of the 244 current smokers, 234 (95.9%) were willing to quit, and 156 (66.7%) reported abstinence at month 6. Challenges to implementing smoking cessation intervention were identified.

CONCLUSION

The majority of current smokers among TB patients were willing to quit and remained abstinent at the end of anti-tuberculosis treatment. This intervention should be scaled up nationwide.

Myeloid-specific TGF-β signaling in bone promotes basic-FGF and breast cancer bone metastasis

Breast cancer (BCa) bone metastases cause osteolytic bone lesions, which result from the interactions of metastatic BCa cells with osteoclasts and osteoblasts. Osteoclasts differentiate from myeloid lineage cells. To understand the cell-specific role of transforming growth factor beta (TGF-β) in the myeloid lineage, in BCa bone metastases, MDA-MB-231 BCa cells were intra-tibially or intra-cardially injected into LysM(Cre)/Tgfbr2(floxE2/floxE2) knockout (LysM(Cre)/Tgfbr2 KO) or Tgfbr2(floxE2/floxE2) mice. Metastatic bone lesion development was compared by analysis of both lesion number and area. We found that LysM(Cre)/Tgfbr2 knockout significantly decreased MDA-MB-231 bone lesion development in both the cardiac and tibial injection models. LysM(Cre)/Tgfbr2 knockout inhibited the tumor cell proliferation, angiogenesis and osteoclastogenesis of the metastatic bones. Cytokine array analysis showed that basic fibroblast growth factor (bFGF) was downregulated in MDA-MB-231-injected tibiae from the LysM(Cre)/Tgfbr2 KO group, and intravenous injection of the recombinant bFGF to LysM(Cre)/Tgfbr2 KO mice rescued the inhibited metastatic bone lesion development. The mechanism by which bFGF rescued the bone lesion development was by promotion of tumor cell proliferation through the downstream mitogen-activated protein kinase (MAPK)-extracellular signal-regulated kinase (ERK)-cFos pathway after binding to the FGF receptor 1 (FGFR1). Consistent with animal studies, we found that in human BCa bone metastatic tissues, TGF-β type II receptor (TβRII) and p-Smad2 were expressed in osteoclasts and tumor cells, and were correlated with the expression of FGFR1. Our studies suggest that myeloid-specific TGF-β signaling-mediated bFGF in the bone promotes BCa bone metastasis.

The efficacy of adjuvant imatinib therapy in improving the prognosis of patients with colorectal gastrointestinal stromal tumours

INTRODUCTION

Although it has now been accepted that imatinib is a valid treatment for gastrointestinal stromal tumour (GIST) patients in the adjuvant setting, information on its clinical efficacy in improving the prognosis for patients with colorectal GISTs is limited.

METHODS

The clinical and follow-up records of 42 colorectal GIST patients who underwent surgical resection at our institution between January 2004 and December 2013 were reviewed retrospectively. The effect of postoperative imatinib treatment on recurrence free survival and overall survival time was analysed with the Kaplan-Meier method and the multivariate Cox proportional hazards model.

RESULTS

Sixteen patients were assigned to imatinib treatment (imatinib group) after surgical tumour resection while twenty-six patients did not receive any adjuvant treatment (control group). The one, three and five-year recurrence free survival rates were 100%, 90% and 77% respectively. This was significantly higher than in the control group (92%, 53% and 36%) (logrank test, p=0.012). The one, three and five-year overall survival rates were 100%, 91% and 68% in the imatinib group compared with 96%, 77% and 39% in the control group (logrank test, p=0.021). Analysis with the multivariate Cox regression model yielded similar results on the efficacy of adjuvant imatinib in prolonging both recurrence free survival (hazard ratio [HR]: 0.23, 95% confidence interval [CI]: 0.07-0.80) and overall survival (HR: 0.20, 95% CI: 0.05-0.91).

CONCLUSIONS

Adjuvant imatinib therapy seems to be effective in decreasing the risk of tumour occurrence and prolonging the overall survival time in colorectal GIST patients.