Electrochemical metrics for corrosion resistant alloys

Corrosion is an electrochemical phenomenon. It can occur via different modes of attack, each having its own mechanisms, and therefore there are multiple metrics for evaluating corrosion resistance. In corrosion resistant alloys (CRAs), the rate of localized corrosion can exceed that of uniform corrosion by orders of magnitude. Therefore, instead of uniform corrosion rate, more complex electrochemical parameters are required to capture the salient features of corrosion phenomena. Here, we collect a database with an emphasis on metrics related to localized corrosion. The six sections of the database include data on various metal alloys with measurements of (1) pitting potential, Epit, (2) repassivation potential, Erp, (3) crevice corrosion potential, Ecrev, (4) pitting temperature, Tpit, (5) crevice corrosion temperature, Tcrev, and (6) corrosion potential, Ecorr, corrosion current density, icorr, passivation current density, ipass, and corrosion rate. The experimental data were collected from 85 publications and include Al- and Fe-based alloys, high entropy alloys (HEAs), and a Ni-Cr-Mo ternary system. This dataset could be used in the design of highly corrosion resistant alloys.

lncRNA SNHG3 accelerates the proliferation and invasion of non-small cell lung cancer by downregulating miR-340-5p

Small nucleolar RNA host genes (SNHGs) as a subset of long non-coding RNAs (lncRNAs) act critical roles in tumor progression. The present study aimed to elucidate the role and mechanisms of SNHG3 in non-small cell lung cancer (NSCLC). The correlation of SNHG3/miR-340-5p/HOXA10 with the clinicopathological features and outcomes in NSCLC was analyzed by TCGA cohort. In vitro and in vivo functional experiments were conducted to assess the role of SNHG3 in NSCLC cells. Bioinformatic analysis and luciferase gene reporter were used to estimate the interaction between miR-340-5p and SNHG3/HOXA10 3'UTR. The effects of SNHG3 and (or) miR-340-5p on HOXA10 expression were detected by qRT-PCR and Western blot analysis. As a consequence, the elevated expression of SNHG3 and HOXA10 or lowered expression of miR-340-5p was related to the lymph node infiltration, distant metastases and unfavorable prognosis in NSCLC. Ectopic expression of SNHG3 boosted the proliferation and invasion of NSCLC cells in vitro and in vivo, whereas downregulation of SNHG3 reversed these effects. Moreover, SNHG3 could bind with miR-340-5p and reduce its expression levels, and miR-340-5p attenuated SNHG3-induced tumor proliferation and HOXA10 expression in NSCLC cells. Our findings unveiled that SNHG3 might be an oncogenic factor in NSCLC by downregulating miR-340-5p.

[Application of expert consensus to guide the vaccination of children with special health status]

Vaccination of children with special health status has become one of the urgent difficulties to be solved in provinces or regions with high immunization planning vaccination rate. The relevant consensus opinions on vaccination compiled by different expert teams have been issued in China, which provides an important basis for vaccinators to scientifically understand the necessity of vaccination and to study and judge the safety and effectiveness of vaccination. Based on the author's experience of participating in the compilation of a series of consensus on vaccination for children in special health status, this paper discusses how to objectively understand the role of expert consensus and puts forward some suggestions on the wider application of consensus in the future.

Endovascular Recanalization of Symptomatic Nonacute Intracranial Internal Carotid Artery Occlusion: Proposal of a New Angiographic Classification

BACKGROUND AND PURPOSE

The optimal treatment for symptomatic nonacute intracranial ICA occlusion is uncertain, and endovascular recanalization remains a technical challenge. Our purpose was to report multicenter clinical results of endovascular recanalization for medically refractory, nonacute, intracranial ICA occlusion and to propose a new angiographic classification to explore which subgroups of patients are most amenable to this treatment.

MATERIALS AND METHODS

From January 2015 to December 2019, thirty-six consecutive patients who underwent endovascular recanalization for refractory, nonacute, atherosclerotic intracranial ICA occlusion at 3 stroke centers were analyzed retrospectively. The patients were divided into 3 types according to an angiographic classification. Rates of technical success, periprocedural complications, and any stroke or death within 30 days along with follow-up results were evaluated.

RESULTS

The overall technical success rate was 80.6% (29/36), and the rate of any stroke or death within 30 days was 16.7% (6/36). The recanalization success rate gradually decreased from type I to type III in the 3 classification groups (92.9%, 81.3%, and 50%, P = .038), and the opposite was true of the perioperative complication rates (7.1%, 18.8%, and 50%, P = .038). Type I lesions showed favorable recanalization effects, 92.9% technical success rates, and 7.1% perioperative complications.

CONCLUSIONS

Endovascular recanalization for nonacute atherosclerotic intracranial ICA occlusion is technically feasible, especially in patients with type I lesions, and could offer an alternative option for patients with recurrent ischemic symptoms despite aggressive medical therapy. The angiographic classification proposed is conducive to the selection of suitable patients and difficulty in grading.

[Epidemiological study of occupational diseases in Shenzhen City, China in 2006~2017]

Objective: To study the epidemiological characteristics of occupational diseases in Shenzhen City, China in 2006-2017, and to provide a scientific basis for prevention and control of occupational diseases. Methods: Cases of occupational diseases in 2006-2017 were collected from the Information System of Occupational Diseases and Occupational Health. A statistical analysis was performed to identify the characteristics of the disease distribution in terms of spectrum of disease, year, area, industry, type of economy and enterprise scale. Results: A total of 1673 cases of occupational disease (64 types, 8 classes) were diagnosed and reported in 2006-2017, chemical poisoning (31.50%) , ear, nose and throat diseases (28.21%) , and pneumoconiosis and other respiratory diseases (21.34%) were the most three commonest occupational diseases. The constituent of ratio of ear, nose and throat diseases and occupational diseases caused by physical factors increased in turn, the constituent of chemical poisoning, pneumoconiosis and other respiratory diseases, and skin disease reduced in turn, which all showed the difference was statistically significant (P<0.01) . Occupational diseases were often seen in districts of Baoan, Longgang, Longhua and Pingshan, as well as in private economy and small enterprise, mainly occurred in manufacturing industry. Conclusion: The incidence of occupational diseases increased steadily in 2006-2017, and we need to strengthen common occupational diseases, especially occupational noise-induced hearing loss, pay attention to districts of Baoan, Longgang, Longhua and Pingshan, as well as private economy and small enterprise.

Stimuli-Responsive Luminescent Properties of Tetraphenylethene-Based Strontium and Cobalt Metal-Organic Frameworks

Herein we report two new TPE-based 3D MOFs, that is, Sr-ETTB and Co-ETTB (TPE=Tetraphenylethylene, H₈ ETTB=4',4''',4''''',4'''''''-(ethene-1,1,2,2-tetrayl)tetrakis(([1,1'-biphenyl]-3,5-dicarboxylic acid))). Through tailoring outer shell electron configurations of Sr^II and Co^II cations, the fluorescence intensity of the MOFs is tuned from high emission to complete non-emission. Sr-ETTB with strong blue fluorescence shows reversible fluorescence variations in response to pressure and temperature, which is directly related to the reversible deformation of the crystal structure. In addition, non-emissive Co-ETTB counterpart exhibits a turn-on fluorescent enhancement under the stimulation of analyte histidine. In the process, TPE-cored linkers in the MOFs are released through competitive coordination substitution and subsequently reassembled to perform aggregation-induced luminescence behavior originated from the organic linkers.

Light Trapping in Single Elliptical Silicon Nanowires

Light trapping in single nanowires (NWs) is of vital importance for photovoltaic applications. However, circular NWs (CNWs) can limit their light-trapping ability due to high geometrical symmetry. In this work, we present a detailed study of light trapping in single silicon NWs with an elliptical cross-section (ENWs). We demonstrate that the ENWs exhibit significantly enhanced light trapping compared with the CNWs, which can be ascribed to the symmetry-broken structure that can orthogonalize the direction of light illumination and the leaky mode resonances (LMRs). That is, the elliptical cross-section can simultaneously increase the light path length by increasing the vertical axis and reshape the LMR modes by decreasing the horizontal axis. We found that the light absorption can be engineered via tuning the horizontal and vertical axes, the photocurrent is significantly enhanced by 374.0% (150.3%, 74.1%) or 146.1% (61.0%, 35.3%) in comparison with that of the CNWs with the same diameter as the horizontal axis of 100 (200, 400) nm or the vertical axis of 1000 nm, respectively. This work advances our understanding of how to improve light trapping based on the symmetry breaking from the CNWs to ENWs and provides a rational way for designing high-efficiency single NW photovoltaic devices.

[Evaluation of effects of salt reducing intervention among catering units in Shandong Province]

OBJECTIVE

To evaluate the effects of comprehensive intervention measures mainly consisting of salt reduction health education and labeling less salt foods among catering units.

METHODS

The total of 36 catering units were selected randomly and divided into intervention group A, B and control group in August of 2015. Health education was initiated in the intervention group A, including the training of knowledge on salt reduction for managers, cooks and service personnel of catering units every month; distribution of special salt control spoon for cooks; the arrangement of environment of salt reduction in catering units. And health education and labeling less salt foods was provided to the intervention group B, The control group C did not actively provide any intervention. The cook records the quantity of low-salt dishes sold, salt collection and the number of persons per meal in according to the requirements. Questionnaire survey and physical examination were performed to evaluate the effects of comprehensive intervention measures among catering units in the three groups of staffs in the catering units in a baseline study and an evaluation survey six months after the intervention.

RESULTS

Compared with group C, the knowledge, attitude and behavior of salt reduction was significantly improved in intervention group A and B(P&lt;0. 05). The behavior towards salt reduction improved much better in group B than in group A(P&lt;0. 05), and using salt spoon when cooking and recommending less salt food to customer improved 32. 1%(χ~2=51. 72, P&lt;0. 05)and 24. 2%(χ~2=30. 01, P&lt;0. 05)separately. The proportion of sales of low salt dishes in the unit canteen has increased steadily, reaching 16. 8% while the proportion of sales has dropped to 9. 2% in the hotel by the end of the intervention period(χ~2=44. 66, P&lt;0. 05).

CONCLUSION

The level of knowledge of reducing salt was improved by health education, and labeling less salt foods can promote reducing salt related behavior. The effect of comprehensive intervention measures for salt reduction in unit canteen is better than in the hotel. It was suggested that comprehensive intervention measures mainly consisting of salt reduction health education and labeling less salt foods should be used together in the catering units.

Genetic signature of hybridization between Chinese spot-billed ducks and domesticated ducks

In this study, we analyzed 93 whole genomes from Chinese spot-billed ducks (CSB), meat-type ducks (MET), and egg and dual purpose-type ducks (EDT) to characterize the genetic material flowing between the CSB and modern ducks. Using a frequency of shared identical-by-descent method, approximately 10.9 Mb introgression segments containing 140 genes were identified showing the signatures of introgression between CSB and EDT. Meanwhile, nearly 10.6 M introgression regions containing 149 genes were identified between CSB and MET. Based on the haplotypes tree of each segment, we found that the introgression between CSB and domesticated ducks was asymmetric with a high level of gene flow from domestic to CSB and a low level of migration in the opposite direction. Moreover, we identified several genes that were introgressions from CSB and showed the signature of positive selection, which may contribute to the breeding of modern ducks. Our results provide new insight into the evolution and breeding history of domestic ducks and may be useful for the future management of wild and domestic duck populations.

[Efficacy evaluation after 5 years of inoculation of 23 valent pneumococcal polysaccharide vaccine for the elderly aged 60 years old and above in Shanghai during 2013-2018]

Objective: To evaluate the efficacy of 23 valent pneumococcal polysaccharide vaccine (PPV23) inoculation against community-acquired pneumonia (CAP) among the elderly aged 60 years old and above in Shanghai. Methods: A prospective cohort study was conducted using a stratified random sampling from October 2013, in which 1 214 and 2 387 elderly people aged 60 and above were selected as the inoculation group and control group, respectively. And a unified questionnaire was used to investigate the basic information of the subjects in the inoculation group and the control group. From October 2013 to December 2018, the subjects were followed up at home or by telephone for a total of 20 times, mainly for whether they had CAP during the observation period. Multivariate logistic regression model was used to calculate RR and 95%CI of CAP incidence between inoculation group and control group for comparing. Results: There were 556 males (45.8%) in the inoculation group and 1 012 males (42.4%) in the control group. And the incidence density of CAP in the inoculation group was lower than that of the control group (0.848/100 person-years vs. 1.452/100 person-years), and the vaccine protection rate was 41.6%, with a statistically significant difference ［RR (95%CI)= 0.584 (0.428-0.790), P<0.001］. After adjusting for age, RR (95%CI) was 0.699 (0.507-0.956), and the difference was still statistically significant (P=0.025).Further stratified analysis showed that the vaccine protective rates of PPV23 in the 60-69 year-old group, the 70-79 year-old group and the ≥80 year-old group were 36.7%, 21.6% and 26.0%, respectively, but only in the 60-69 year-old group showed statistical difference (RR=0.633, 95%CI=0.399-0.990, P=0.045). Conclusion: To a certain extent, the incidence of CAP can be reduced by inoculation of PPV23 in elderly population aged 60 and above in Shanghai, and it should be further recommended in elderly population of low age.

Specification tests for covariance structures in high-dimensional statistical models

We consider testing the covariance structure in statistical models. We focus on developing such tests when the random vectors of interest are not directly observable and have to be derived via estimated models. Additionally, the covariance specification may involve extra nuisance parameters which also need to be estimated. In a generic additive model setting, we develop and investigate test statistics based on the maximum discrepancy measure calculated from the residuals. To approximate the distributions of the test statistics under the null hypothesis, new multiplier bootstrap procedures with dedicated adjustments that incorporate the model and nuisance parameter estimation errors are proposed. Our theoretical development elucidates the impact due to the estimation errors with high-dimensional data and demonstrates the validity of our tests. Simulations and real data examples confirm our theory and demonstrate the performance of the proposed tests.

[Analysis on the project personnel's attitude and its influential factors of 23-valent pneumococcal polysaccharide vaccination program for the elderly in Shanghai]

Objective: To understand the project personnel's attitude towards the 23-valent pneumococcal polysaccharide vaccination program for the elderly in Shanghai and its conversion to routine vaccination and to explore its influential factors, so as to provide reference for the further development of the program. Methods: In 2016, a one-to-one questionnaire survey was conducted among the people involved in the project in the 9 districts of Shanghai and the data of demographic characteristics, cognition of pneumococcal pneumonia and PPV23, evaluation of the project, support rate of the project and its conversion to routine vaccination of the project personnel were collected. Results: Among the 2005 respondents, 28.6% (574 persons) of them were male, 85.5% (1 714 persons) of them supported the free vaccination for the elderly, and 69.5% of them (1 394 persons) supported the routine vaccination. For the 23-valent pneumococcal polysaccharide vaccination program, people under 55 years old, in Qingpu District, with poor cognition of pneumonia and 23-valent pneumococcal polysaccharide vaccine (PPV23) or having lower evaluation of the project's scientificity or enforceability had lower support rate than others, and the OR (95%CI) were 0.38 (0.19-0.75), 0.21 (0.10-0.43), 0.16 (0.06-0.41) and 0.26 (0.10-0.69). People believing that the elderly were susceptible to pneumococcal pneumonia and PPV23 was safe and reliable, and those who were willing to vaccinate the elderly at home had higher support rate, and the OR (95%CI) were 2.30 (1.18-4.47), 2.84 (1.62-4.69) and 5.60 (3.74-8.38). For the program's conversion to routine vaccination, people under 35 years old, in Qingpu District, in the vaccination clinic, and those believing that the project was not scientific and difficult to implement had low support rate, and the OR (95%CI) were 0.56 (0.32-0.98), 0.48 (0.26-0.89), 0.26 (0.12-0.59), 0.58 (0.42-0.79) and 0.50 (0.30-0.81); people with technical secondary school or senior school, in Jiading, Putuo or Minhang District, believing that PPV23 was effective in the prevention of pneumococcal pneumonia in the elderly, and those who were willing to vaccinate the elderly with PPV23 had higher support rate, and the OR (95%CI) were 1.63 (1.11-2.39), 2.28 (1.71-3.03), 1.69 (1.25-2.28) and 4.10 (2.86-5.88). Conclusion: The support rate of pneumococcal vaccination project for the elderly in Shanghai needs to be improved, especially its conversion to the routine vaccination.

[Safety evaluation of mass inoculation of 23 valent pneumococcal polysaccharide vaccine among elderly people aged 60 and above in Shanghai from 2013 to 2017]

Objective: To evaluate the safety of 23 Valent Pneumococcal Polysaccharide Vaccine (PPV23) among eldly people aged 60 and above in Shanghai. Methods: A total of 1 310 660 monitoring data of adverse events following immunization (AEFI) of PPV23 among people aged 60 and above were collected through the National AEFI Surveillance System from September 14, 2013 to December 31, 2017 in Shanghai. And the descriptive epidemiological methods were used for analysis. Results: 433 cases of AEFI were reported from September 14, 2013 to December 31, 2017, with the incidence rate of AEFI was 33.04/100 000 doses. The general reactions were reported as 392 cases (90.53%), with 17 cases of abnormal reactions (3.93%), 23 cases of coincidences (5.31%) and 1 case of psychogenic reactions (0.23%). The reported incidence rates of general reactions and abnormal reactions of free PPV23 inoculation among elderly people in urban areas were 41.31 per 100 000 doses and 1.91/100 000 doses, respectively, which were higher than those in suburban areas (24.18/100 000 doses, 1.32/100 000 doses) and exurban areas (27.84/100 000 doses, 0.59/100 000 doses). The reported incidence rate of general reaction in females (35.38/100 000 doses) was higher than that in males (24.06/100 000 doses), and the reported incidence rate of abnormal reaction in males (1.58/100 000 doses) was higher than that in females (1.03/100 000 doses). The reported incidence rates of general and abnormal reactions were the highest in 60-64 years old group (62.65/100 000 doses and 4.87/100 000 doses, respectively). In addition, all patients with general reactions or abnormal reactions were better or cured. Conclusion: PPV23 vaccination is safe among people aged 60 and above in Shanghai.

Off-Resonant Absorption Enhancement in Single Nanowires via Graded Dual-Shell Design

Single nanowires (NWs) are of great importance for optoelectronic applications, especially solar cells serving as powering nanoscale devices. However, weak off-resonant absorption can limit its light-harvesting capability. Here, we propose a single NW coated with the graded-index dual shells (DSNW). We demonstrate that, with appropriate thickness and refractive index of the inner shell, the DSNW exhibits significantly enhanced light trapping compared with the bare NW (BNW) and the NW only coated with the outer shell (OSNW) and the inner shell (ISNW), which can be attributed to the optimal off-resonant absorption mode profiles due to the improved coupling between the reemitted light of the transition modes of the leak mode resonances of the Si core and the nanofocusing light from the dual shells with the graded refractive index. We found that the light absorption can be engineered via tuning the thickness and the refractive index of the inner shell, the photocurrent density is significantly enhanced by 134% (56%, 12%) in comparison with that of the BNW (OSNW, ISNW). This work advances our understanding of how to improve off-resonant absorption by applying graded dual-shell design and provides a new choice for designing high-efficiency single NW photovoltaic devices.

A Microfluidic Approach for Cryoprotectant Screening: Preliminary Validation with Human Red Blood Cells

BACKGROUND

The application of microfluidics has overcome a series of long-term existing bottlenecks in the field of cryobiology. However, there is still no investigation regarding the on-chip rapid screening of cryoprotectant concentration optimization for the integration of the entire freeze, thaw and cell counting process.

OBJECTIVE

To establish an on-chip approach for rapid cryoprotectant screening and concentration optimization.

MATERIALS AND METHODS

Rapid freezing of red blood cells with glycerol and dimethyl sulfoxide was used to validate the proposed on-chip method.

RESULTS

The optimal cryoprotectant and its concentration can be determined with the described method, without the need of additional samplings and assays. The optimal concentration for glycerol and dimethyl sulfoxide used in the validation experiments was 10% (w/v).

CONCLUSION

The microfluidic approach can be used for rapid cryoprotectant screening and concentration optimization.

Genome-wide identification and characterization of microRNAs responding to ABA and GA in maize embryos during seed germination

MicroRNAs (miRNAs) are an important class of non-coding small RNAs that regulate the expression of target genes through mRNA cleavage or translational inhibition. Previous studies have revealed their roles in regulating seed dormancy and germination in model plants such as Arabidopsis thaliana, rice (Oryza sativa) and maize (Zea mays). However, the miRNA response to exogenous gibberellic acid (GA) and abscisic acid (ABA) during seed germination in maize has yet to be explored. In this study, small RNA libraries were generated and sequenced from maize embryos treated with GA, ABA or double-distilled water as control. A total of 247 miRNAs (104 known and 143 novel) were identified, of which 45 known and 53 novel miRNAs were differentially expressed in embryos in the different treatment groups. In total, 74 (37 up-regulated and 37 down-regulated) and 55 (23 up-regulated and 32 down-regulated) miRNAs were expressed in response to GA and to ABA, respectively, and a total of 18 known and 38 novel miRNAs displayed differential expression between the GA- and ABA-treated groups. Using bioinformatics tools, we predicted the target genes of the differentially expressed miRNAs. Using GO enrichment and KEGG pathway analysis of these targets, we showed that miRNAs differentially expressed in our samples affect genes encoding proteins involved in the peroxisome, ribosome and plant hormonal signalling pathways. Our results indicate that miRNA-mediated gene expression influences the GA and ABA signalling pathways during seed germination.

Lee Silverman Voice Treatment for dysarthria in patients with Parkinson's disease: a systematic review and meta-analysis

Approximately 89% of patients with Parkinson's disease (PD) suffer from dysarthria. Lee Silverman Voice Treatment (LSVT), a behavioral therapy, aims to improve speech and voice functions. The objective was to assess the effectiveness of LSVT compared with other/no speech interventions for dysarthria in patients with PD. Electronic databases, including PubMed, Embase and the Cochrane Library, were searched. The publication date of all included studies was before 6 March 2020. Only randomized controlled trials (RCTs) that evaluated the LSVT intervention compared with other/no speech intervention were considered. The data obtained from the included studies were described and the mean differences were calculated. Eight RCTs were included in this meta-analysis comparing LSVT with other/no speech interventions. In the comparison of LSVT versus no intervention, vocal intensity for sustained 'Ah' phonation, reading the 'Rainbow passage', monologue and describing a picture increased by 8.87, 4.34, 3.25 and 3.31 dB, respectively, after 1 month of therapy. Compared with the respiratory therapy group, the LSVT group also showed significant improvement in vocal intensity for sustained 'Ah' phonation, reading the 'Rainbow passage' and monologue immediately after treatment (13.39, 6.66 and 3.19 dB). Positive improvement still existed after 24 months. There was no difference in the therapeutic effect between face-to-face and online LSVT. The effectiveness of LSVT for dysarthria in patients with PD was verified in these trials. However, future RCTs with sufficient participants are essential to evaluate the effectiveness of LSVT for dysarthria.

NGS-based profiling reveals a critical contributing role of somatic D-loop mtDNA mutations in HBV-related hepatocarcinogenesis

BACKGROUND

Somatic mutations of mitochondrial DNA (mtDNA) have been extensively identified mainly by traditional Sanger sequencing technology in various cancer types. However, low detection sensitivity of traditional methods greatly limits the comprehensive profiling of mtDNA somatic mutations in cancers, especially in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Moreover, the functional roles of mtDNA mutation in HBV-related hepatocarcinogenesis have not been systematically revealed.

PATIENTS AND METHODS

Next-generation sequencing (NGS) platform was applied to profile the somatic mtDNA mutations of HCC and paired paratumor (non-HCC) tissues from a large cohort of 156 HBV-HCC patients.

RESULTS

Our data revealed the common existence of mtDNA mutation in both inflammatory and cancer tissues with significantly different mutation pattern. The mutation density (mutation number/region length) of D-loop region was much higher than that of other regions in both HCC and non-HCC tissues. Unexpectedly, the average mutation number in D-loop region of HCC tissues was significantly less than that of non-HCC tissues. In contrast, the heteroplasmy level of D-loop region mutations was significantly increased in HCC tissues, implying that the D-loop mutations might be positively selected in HCC tissues. Furthermore, our results indicated that the patients with D-loop mutations had a significantly lower mtDNA copy number and were more likely to relapse. In vitro experiments demonstrated that proliferation, invasion and metastasis ability of HCC cells with D-loop region mutations were significantly higher than those without D-loop region mutations.

CONCLUSION

These results emphasize the critical contributing role of somatic mtDNA D-loop mutations in HBV-related hepatocarcinogenesis.

Associations Between Salt-Restriction Spoons and Long-Term Changes in Urinary Na+/K+ Ratios and Blood Pressure: Findings From a Population-Based Cohort

Background There have been few studies on the relationship between long-term changes in sodium intake and blood pressure. A method of reducing sodium intake in a population that is known for high-sodium intake based on homemade cooking is also needed. Methods and Results Our study was based on a baseline survey of 15 350 individuals aged 18 to 69 years with multistage random sampling and a 3-year salt-restriction campaign across Shandong Province, China. We included 339 individuals from six districts/counties in this cohort study, and the 24-hour urinary sodium-potassium ratio (Na⁺/K⁺) served as an indicator of sodium intake. The average change in ratio was 2.39 (95% CI, 2.17-2.61) from 6.81 (95% CI, 6.41-7.21) at baseline to 4.41 (95% CI, 4.18-4.64) during the resurvey. Following a reduction from low to high quartiles of urinary Na⁺/K⁺ ratio, the average increases were 10.9 (95% CI, 8.9-12.9), 9.2 (95% CI, 6.9-11.5), 6.3 (95% CI, 4.0-8.6), and 5.3 (95% CI, 2.9-7.7) mm Hg for systolic blood pressure (P for trend=0.019) and 3.8 (95% CI, 2.4-5.2), 2.9 (95% CI, 1.7-4.2), 1.6 (95% CI, 0.4-2.8), and -0.3 (95% CI, -1.4-0.8) mm Hg for diastolic blood pressure (P for trend=0.002), respectively. A reduction in salt intake was evident for people using a 2-g salt-restriction spoon for cooking (-3.49 versus -2.22; P=0.027) after adjustment of confounding factors, compared with nonusers. Similar findings were obtained for other salt-restriction spoon-based indicators. Conclusions Our study indicated that using a salt-restriction spoon for cooking was associated with reduced salt intake that led to a blunting of blood pressure deterioration. This finding further supports the salt-restriction spoon-based strategy for people whose primary salt intake is from homemade cooking.

[Clinical features of intracranial vessel involvement in Takayasu's arteritis]

Objective: To analyze clinical characteristics of intracranial vessel involvement in Takayasu's arteritis (TA). Methods: Retrospectively analyzed 135 hospitalized TA patients' clinical data in Beijing Anzhen Hospital from November 2012 to November 2018. Based on intracranial artery (IA) complicated or not, TA patients were divided into two groups:32 patients within involvement and 103 patients without involvement. The difference in comparison of imaging types, basic data and laboratory test were analyzed. Results: The proportion of TA patients with intracranial vascular involvement was 23.7% (32/135) and the most common site was internal carotid artery (intracranial segment) (59.4%, 19/32). The incidences of hypertension and coronary heart disease were significantly higher in TA patients with intracranial vascular involvement compared with the patients without intracranial involvement (46.9% vs 26.2%, 21.9% vs 6.8%, χ(2)=4.863, 4.460, all P<0.05). The rate of tocilizumab treatment in the intracranial vascular involved group was higher than that in the group without intracranial vascular involvement (40.6% vs 19.4%, χ(2)=5.945, P<0.05). The platelet count in patients with intracranial involvement group was significantly lower than that in patients without intracranial involvement group [(218±55)×10(9)/L vs (272±71)×10(9)/L, t=-3.570, P<0.01], while the hemoglobin [(130±17) vs (121±18) g/L, t=2.363, P<0.05] and triglyceride [1.22(0.75, 1.64) vs 0.92(0.63, 1.21) mmol/L, U=1 017.000, P<0.01] were significantly higher than those without intracranial vascular involvement. Moreover, coronary artery involvement presented more frequently in the intracranial vascular involved group than the group without intracranial vascular involvement (43.8% vs 14.6%, χ(2)=12.331, P<0.01). Logistic regression analysis showed that the incidence of intracranial vascular disease in TA patients with coronary artery involvement was 4 times higher than that in patients without coronary artery lesions (OR=3.965, 95%CI:1.584-9.926, P=0.003). Conclusion: The proportion of intracranial vascular involvement in TA is not rare, TA patients with cardiovascular risk factors should be considered to strengthen imaging examination of intracranial vessels.

Short- and mid-term outcomes of robotic versus thoraco-laparoscopic McKeown esophagectomy for squamous cell esophageal cancer: a propensity score-matched study

Controversy exists on the advantages of robotic McKeown esophagectomy (RME) versus thoraco-laparoscopic McKeown esophagectomy (TLME). The aim was to evaluate the short- and mid-term outcomes of RME and TLME in the treatment of patients with esophageal squamous cell carcinoma (ESCC). A consecutive series of 652 patients, 280 in RME and 372 in TLME, who underwent minimally invasive McKeown esophagectomy for ESCC at our department from November 2015 to June 2018 was analyzed. A propensity score-matched comparison with clinicopathological covariates was performed between the two groups. Complications were categorized based on the Esophagectomy Complications Consensus Group (ECCG) recommendation. To identify the recurrence, all patients with R0 resection were followed with a median follow-up period of 20.2 months (range 1-33 months). After propensity score matching, 271 patients were identified for each cohort. In the matched cohorts, two patients died within 90 days in TLME, whereas no patients died in RME. RME was associated with similar intraoperative blood loss (P = 0.895), but with shorter surgical duration (244.5 vs. 276.0 min, P < 0.001), shorter thoracic duration (85.0 vs. 102.9 min, P < 0.001) and lower thoracic conversions (0.7% vs. 5.9%, P = 0.001). In spite of the similar results on total and thoracic lymph nodes dissection, RME yielded more lymph nodes along recurrent laryngeal nerve (4.8 vs. 4.1, P = 0.012), as well as the higher incidence of recurrent nerve injury (29.2% vs. 15.1%, P < 0.001) when compared to TLME. Tumor recurrence occurred in 30 patients and was locoregional only in 9 (3.5%) patients, systemic only in 17 (6.7%) patients, and combined in 4 (1.6%) patients in RME, while in 26 patients and was locoregional only in 10 (10.6%) patients, systemic only in 7 (2.8%) patients, and combined in 9 (3.6%) patients in TLME. RME was associated with a lower rate of mediastinal lymph nodes recurrence (2.0% vs. 5.3%, P = 0.044). Overall and disease-free survival was not different between the two cohorts (P = 0.097 and P = 0.248, respectively). RME was shown to be a safe and oncologically effective approach with favorable short- and mid-term outcomes in the treatment of patients with ESCC.

Correlation between the hemoporfin-mediated photodynamic treatment response and the dermoscopy vascular pattern in patients with a port-wine stain: a prospective study

BACKGROUND

Vascular targeted photodynamic therapy (PDT) is a novel and promising therapy for the treatment of port-wine stains (PWS). There has been little prior exploration to our knowledge of how the dermatological vascular pattern may predict the response to PDT.

OBJECTIVES

To analyse whether the vascular pattern classifications of PWS by dermoscopy can predict the efficacy of PDT.

METHODS

This prospective cohort study included 163 patients with a clinical diagnosis of PWS who were treated twice with hemoporfin-mediated photodynamic therapy (HMME-PDT) at two-month intervals and followed up for 6 months. The vascular manifestations of dermoscopy with PWS were independently classified into 8 categories by 3 dermatologists. Images of the lesions were taken using VISIA, and the vascular patterns were imaged by dermoscopy by the same investigator. Images were captured before and after each treatment. The efficacy was evaluated with pre- and post-treatment VISIA images, and correlations between efficacy and vascular patterns were analysed by four dermatologists in a blinded and independent manner, between 10 January 2019 and 11 December 2019.

RESULTS

In the dermoscopy images for the whole cohort, dotted and globular vessels (15.3%), short clubbed vessels (18.4%) and curved vessels (12.9%) were highly associated with cure and beneficial treatment effects. Pale halos surrounding brown dots (8.0%) and arborizing vessels (9.8%) were mainly correlated with skin lesion alleviation. Mixed vessels (12.9%), a grey-whitish veil (11.7%) and reticular patterns (11.0%) were mainly associated with no effect. The differences between each subgroup were statistically significant (P = 0.000).

CONCLUSIONS

There is a clear correlation between the efficacy of PDT and the dermoscopy pattern in patients with PWS. Dermoscopy may therefore provide very useful clinical information prior to treatment in these cases. In addition, the vascular manifestations of PWS determined by dermoscopy help to predict response to PDT and manage patient expectations.

Acupuncture for recurrent urinary tract infection in women: a systematic review and meta-analysis

BACKGROUND

Increasing antibiotic resistance has motivated interest in non-antibiotic prophylaxis of recurrent urinary tract infections (rUTI).

OBJECTIVES

To conduct a systematic review of the current state of evidence of acupuncture for uncomplicated rUTI in women.

SEARCH STRATEGY

Nine databases (PubMed, Embase, CENTRAL, CINAHL, AMED, CBM, CNKI, CQVIP, Wanfang) were searched from inception to February 2019.

SELECTION CRITERIA

Randomised controlled trials (RCTs) evaluating the effects of acupuncture and related therapies for prophylaxis or treatment of uncomplicated rUTI in women were included.

DATA COLLECTION AND ANALYSIS

Risk of bias was assessed, and the quality and strength of evidence evaluated using the GRADE framework. Results were reported as risk ratios (RR) for dichotomous outcomes or mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI).

MAIN RESULTS

Five RCTs involving 341 participants were included. Methodological quality of studies and strength of the evidence were low to moderate. The chance of achieving a composite cure with acupuncture therapies was greater than that with antibiotics (three studies, 170 participants, RR 1.92, 95% CI 1.31-2.81, I²  = 38%). The risk of UTI recurrence was lower with acupuncture than with no treatment (two studies, 135 participants, RR 0.39, 95% CI 0.26-0.58, I²  = 0%) and sham acupuncture (one study, 53 participants, RR 0.45, 95% CI 0.22-0.92).

CONCLUSIONS

Acupuncture appeared to be beneficial for treatment and prophylaxis of rUTIs, noting the limitations of the current evidence. Given the growing challenge of antibiotic resistance, there is a need for high-quality RCTs of non-pharmacological interventions such as acupuncture.

TWEETABLE ABSTRACT

This review found that acupuncture may improve treatment and prevent recurrence of urinary tract infection in women.

Association of a Province-Wide Intervention With Salt Intake and Hypertension in Shandong Province, China, 2011-2016

IMPORTANCE

High salt intake is associated with hypertension, which is a leading modifiable risk factor for cardiovascular disease.

OBJECTIVE

To assess the association of a government-led, multisectoral, and population-based intervention with reduced salt intake and blood pressure in Shandong Province, China.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study used data from the Shandong-Ministry of Health Action on Salt and Hypertension (SMASH) program, a 5-year intervention to reduce sodium consumption in Shandong Province, China. Two representative samples of adults (aged 18-69 years) were surveyed in 2011 (15 350 preintervention participants) and 2016 (16 490 postintervention participants) to examine changes in blood pressure, and knowledge, attitudes, and behaviors related to sodium intake. Urine samples were collected from random subsamples (2024 preintervention participants and 1675 postintervention participants) for measuring sodium and potassium excretion. Data were analyzed from January 20, 2017, to April 9, 2019.

INTERVENTIONS

Media campaigns, distribution of scaled salt spoons, promotion of low-sodium products in markets and restaurants, and activities to support household sodium reduction and school-based sodium reduction education.

MAIN OUTCOMES AND MEASURES

The primary outcome was change in urinary sodium excretion. Secondary outcomes were changes in potassium excretion, blood pressure, and knowledge, attitudes, and behaviors. Outcomes were adjusted for likely confounders. Means (95% CIs) and percentages were weighted.

RESULTS

Among 15 350 participants in 2011, 7683 (50.4%) were men and the mean age was 40.7 years (95% CI, 40.2-41.2 years); among 16 490 participants in 2016, 8077 (50.7%) were men and the mean age was 42.8 years (95% CI, 42.5-43.1 years). Among participants with 24-hour urine samples, 1060 (51.8%) were men and the mean age was 40.9 years (95% CI, 40.5-41.3 years) in 2011 and 836 (50.7%) were men and the mean age was 40.7 years (95% CI, 40.1-41.4 years) in 2016. The 24-hour urinary sodium excretion decreased 25% from 5338 mg per day (95% CI, 5065-5612 mg per day) in 2011 to 4013 mg per day (95% CI, 3837-4190 mg per day) in 2016 (P < .001), and potassium excretion increased 15% from 1607 mg per day (95% CI, 1511-1704 mg per day) to 1850 mg per day (95% CI, 1771-1929 mg per day) (P < .001). Adjusted mean systolic blood pressure among all participants decreased from 131.8 mm Hg (95% CI, 129.8-133.8 mm Hg) to 130.0 mm Hg (95% CI, 127.7-132.4 mm Hg) (P = .04), and diastolic blood pressure decreased from 83.9 mm Hg (95% CI, 82.6-85.1 mm Hg) to 80.8 mm Hg (95% CI, 79.4-82.1 mm Hg) (P < .001). Knowledge, attitudes, and behaviors associated with dietary sodium reduction and hypertension improved significantly.

CONCLUSIONS AND RELEVANCE

The findings suggest that a government-led and population-based intervention in Shandong, China, was associated with significant decreases in dietary sodium intake and a modest reduction in blood pressure. The results of SMASH may have implications for sodium reduction and blood pressure control in other regions of China and worldwide.

Factors associated with the utilization of community-based diabetes management care: A cross-sectional study in Shandong Province, China

Background

Community-based diabetes management is known to be an important strategy for global diabetes control. In China, community-based diabetes management care, including regular blood glucose tests and guidance on medicine use, dietary control, and physical exercise provided by primary health institutions (PHIs), as one of the key contents of the national essential public health services (EPHS), was implemented since 2009 when the new round of health system reform was initiated. This study aimed to investigate the utilization of community-based diabetes management care services, and explore the factors influencing utilization from both patients’ and providers’ points of view.

Methods

In total, 2520 type-2 diabetes mellitus (DM) patients registered for EPHS were selected from 63 PHIs in eight counties of Shandong province, China, using multi-stage stratified sampling. Of those, 2166 patients (response rate: 85.4%) completed face-to-face structured questionnaires on their utilization of community-based diabetes management care services. Further, 63 PHIs were surveyed on diabetes care delivery, and 444 primary healthcare providers were purposively sampled from those PHIs to measure their knowledge of diabetes management care delivery, using a self-developed questionnaire. Descriptive statistics were used to analyze the delivery and utilization of diabetes management care services. Multilevel logistic regression models were used to analyze the factors associated with patients’ utilization of diabetes management services.

Results

All 63 PHIs reported that all the required four diabetes management services were provided through EPHS. However, only 49.6% of the patients reported they fully used these services, with no statistically significant difference between urban and rural patients. Patients who had higher knowledge of diabetes and better self-efficacy in controlling the condition, were more likely to fully utilize diabetes management care. A larger number of PHI health staff per 1000 population was associated with better utilization of care.

Conclusion

Although community-based diabetes management services are well available to Chinese DM patients under the framework of EPHS, the actual utilization of diabetes management services among the patients was poor. The size of the PHI workforce, patients’ knowledge and self-efficacy in controlling diabetes, were important predictors of utilization, and could be enhanced to improve control of diabetes.

Pro-inflammatory immunological effects of adipose tissue and risk of food allergy in obesity: Focus on immunological mechanisms

Over the past three decades, the number of obese people has risen steadily. The chronic low-grade inflammatory state and the non-specific activation of the immune system have contributed greatly to the development of obesity-related immunology. Food allergy as a kind of inflammatory disease with abnormal immune response may be associated with obesity. This review begins with the pro-inflammatory immunological effects of adipose tissue in obesity, and explains the possible effects of obesity on food allergy. In short, obesity not only directly causes imbalance of allergic-related immune cells in adipose tissue, but also indirectly causes this consequence through affecting expression of adipocytokines and peroxisome proliferator-activated receptor gamma (PPARγ) in adipose tissue. As a result, circulating levels of pro-inflammatory factors which are partly derived from adipose tissue increase, which might cause intestinal barrier injury. Therefore, obesity may increase the risk of food allergy.

Catastrophic health expenditure: a comparative study between hypertensive patients with and without complication in rural Shandong, China

BACKGROUND

Some previous studies have assessed catastrophic health expenditure (CHE) in households with hypertensive patients, but few have examined the difference of CHE in hypertensive patients with and without complications. The purpose of this study is to compare the incidence and determinants of CHE between hypertensive patients with and without complications.

METHODS

Data of this study were from a cross-sectional study in Shandong Province in China in 2016. Of the recruited 3457 hypertensive patients registered in the NCDs management system in the sampling villages, 3113 completed the survey, with a response rate of 90.05%.CHE was defined as out-of-pocket payments for hypertensive care that equaled or exceeded 40% of the household capacity to pay (non-food expenditure). Hypertension complications (e.g., stroke, coronary heart disease, hypertensive kidney disease, etc.) were collected in this study, which was categorized into 0 (no), 1(single), and 2 and more according to the types of hypertensive complications. We employed Chi-square test to explore associated factors and logistic regression model to identify the determinants of CHE.

RESULTS

The incidence of CHE and impoverishment is 13.6 and 10.8% among hypertensive patients. The incidence of CHE with one complication is 25.3% (Ρ = 0.000, OR = 2.29) and 47.3% (P = 0.000, OR = 3.60) in patients with two or more complications, which are both statistically higher than that in patients without complication (6.1%). Across all types of patients, income levels are inversely related to the incidence of CHE. Patients who use outpatient or inpatient service are more likely to experience CHE (Ρ = 0.000). Factors including living arrangements, family size, educational attainment are found to be significantly associated with CHE in some subgroups (Ρ <0.05).

CONCLUSIONS

CHE and impoverishment incidence among hypertensive patients are both high in rural China. Patients with hypertensive complication are at higher catastrophic risk than those without complication. More attention needs to be paid to households with hypertension patients, especially for those with hypertension complications.

Economic growth and suicide rate changes: A case in China from 1982 to 2005

Objectives

It is to estimate the trend of suicide rate changes during the past three decades in China and try to identify its social and economic correlates.

Methods

Official data of suicide rates and economic indexes during 1982–2005 from Shandong Province of China were analyzed. The suicide data were categorized for the rural / urban location and gender, and the economic indexes include GDP, GDP per capita, rural income, and urban income, all adjusted for inflation.

Results

We found a significant increase of economic development and decrease of suicide rates over the past decades under study. The suicide rate decrease is correlated with the tremendous growth of economy.

Conclusion

The unusual decrease of Chinese suicide rates in the past decades is accounted for within the Chinese cultural contexts and maybe by the Strain Theory of Suicide.

Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in China

OBJECTIVE

There is a high prevalence of poor glycaemic control among patients with type 2 diabetes (T2DM) in China. This study aimed to explore both organisational and individual characteristics associated with glycaemic control among patients with T2DM.

DESIGN

Cross-sectional survey.

SETTING

Shandong Province, China.

PARTICIPANTS

The participants were 2166 patients with T2DM and 337 healthcare providers from 36 urban communities and 36 rural villages in Shandong Province.

PRIMARY AND SECONDARY OUTCOME MEASURES

Multistage stratified sampling procedures were used to measure demand-side individual demographic, clinical and self-management characteristics, and supply-side organisational characteristics, and the status of glycaemic control. Multilevel logistic regression analysis was performed to assess key determinants of glycaemic control.

RESULTS

Only 42.8% of the patients with T2DM achieved good glycaemic control. Age, income, hypertension and self-efficacy were significantly positive predictors of optimal glycaemic control, while duration of diabetes, antidiabetic drugs and monitoring of blood glucose were significantly negative predictors of that. Private VCs (OR=0.48, 95% CI 0.29 to 0.82, p<0.01) and lack of healthcare providers (OR=0.69, 95% CI 0.53 to 0.89, p<0.01; OR=0.71, 95% CI 0.52 to 0.98, p<0.05) were significantly negative predictors of optimal glycaemic control, while diabetes knowledge level of healthcare providers (OR=1.36, 95% CI 1.02 to 1.83, p<0.05; OR=1.45, 95% CI 1.00 to 2.10, p<0.05) and kinds of antidiabetic drugs (OR=1.37, 95% CI 0.97 to 1.93, p<0.1; OR=1.46, 95% CI 1.07 to 2.00, p<0.05) were significantly positive predictors of that.

CONCLUSIONS

Glycaemic control was suboptimal among patients with T2DM in China. The determinants of failing to achieve good glycaemic control included both organisational and individual characteristics. Potential interventions that target patients, providers and the healthcare organisations should be taken to improve the glycaemic control and health outcome among patients with T2DM.

[The surgical effect of secondary esotropia with diplopia after orbital decompression for thyroid-associated ophthalmopathy]

Objective: To evaluate the effect of extraocular muscle surgery in treating secondary esotropia with diplopia after orbital decompression for thyroid-associated ophthalmopathy (TAO). Methods: Retrospective case series study. Eleven secondary esotropic patients with diplopia after orbital decompression for TAO who underwent extraocular muscle surgery during March 2016 and October 2018 in Tianjin Eye Hospital were included. All patients had new onset esotropia after decompression surgery and underwent strabismus surgery. Deviation angle, diplopia, and ocular movement were observed preoperatively and postoperatively. Surgeries were carried out under the monitored anesthesia care combined with local anesthesia, and the eye alignment was adjusted to orthotropia with no diplopia in the operation with the technique of intraoperative adjustable suture and forced duction test results. All the patients were followed up. Results: The ages of the patients were from 26 to 42 years (1 male and 10 females). The deviation angles were 10-98 prism diopter. Orbital CT scan showed that the horizontal rectus thickness was increased at different levels, and the thickness of the medial rectus was increased more than that of the lateral rectus. Two patients had monocular medial rectus recession only, 2 had bilateral medial rectus recession only, 2 had monocular medial rectus recession combined with lateral rectus resection, and the other 5 had bilateral medial rectus recession with monocular lateral rectus resection. The recession of medial rectus muscle was 3.5 to 7.5 mm in 11 patients and 2.0 to 6.0 mm in 7 patients with the resection of lateral rectus muscle. Diplopia of the 11 patients disappeared with orthotropia at primary gaze position after the extraocular muscle surgery. The limitation of abduction changed from preoperative (-1.91±1.04) to postoperative (-0.64±0.81). All the patients were satisfied with the surgical results. At the end of the follow-up (6 to 24 months), the results of the patients were stable, and no over-correction was found. Conclusion: Extraocular muscle surgery with intraoperative adjustable suture technique can effectively treat TAO patients with secondary esotropia with diplopia after orbital decompression. (Chin J Ophthalmol, 2020, 56: 183-188).

[Prognostic value of Montreal Cognitive Assessment in heart failure patients]

Objective: To explore the occurrence of cognitive impairment in Chinese heart failure (HF) patients and it's impact on prognosis. Methods: In this prospective observational study, a total of 990 HF patients were enrolled from 24 hospitals in China during December 2012 to November 2014. All patients were administrated with the interview-format Montreal Cognitive Assessment (MoCA), according to which they were divided into MoCA<26 (with cognitive impairment) group and MoCA≥26 (without cognitive impairment) group. Baseline data were collected and a 1-year follow up was carried out. Univariate and multivariate logistic or Cox regression were performed for 1-year outcomes. Results: Cognitive impairment was evidenced in 628 patients (63.4%) and they were more likely to be older, female, and with higher proportion of New York Heart Association(NYHA) class Ⅲ-Ⅳ, chronic obstructive pulmonary disease (COPD), ischemic heart disease, while body mass index (BMI), education level, and medical insurance rate were lower (all P<0.05) as compared to patients in MoCA≥26 group. The rate of percutaneous intervention, device implantation, cardiac surgery and evidence-based medications were significantly lower in MoCA<26 group than in MoCA≥26 group (all P<0.05). During the 1-year follow up, patients in the MoCA<26 group had higher all-cause mortality (10.2%(64/628) vs. 2.2%(8/362), P<0.01), cardiovascular mortality (5.9%(37/628) vs. 0.8%(3/362), P<0.01) and major adverse cardiac and cerebrovascular events (MACCE) (9.6%(60/628) vs. 2.5%(8/362), P<0.01) than patients in the MoCA≥26 group. In univariate regression, MoCA<26 was associated with increased all-cause mortality (HR(95%CI):4.739(2.272-9.885), P<0.01), cardiovascular mortality (HR(95%CI):7.258(2.237-23.548), P=0.001) and MACCE (OR(95%CI):4.143(2.031-8.453), P<0.01). After adjustment by multivariate regression, MoCA<26 was indicated as an independent risk factor for all-cause mortality (HR(95%CI): 6.387(2.533-16.104), P<0.01), cardiovascular mortality (HR(95%CI): 10.848(2.586-45.506), P=0.001) and MACCE (OR(95%CI): 4.081(1.299-12.816), P=0.016), while not for re-hospitalization for HF (OR(95%CI):1.010(0.700-1.457), P=0.957). Conclusions: Cognitive impairment is common in HF patients,and it is an independent prognostic factor for 1-year outcomes. Routine cognitive function assessment and active intervention are thus recommended for HF patients.

Self-accelerated corrosion of nuclear waste forms at material interfaces

The US plan for high-level nuclear waste includes the immobilization of long-lived radionuclides in glass or ceramic waste forms in stainless-steel canisters for disposal in deep geological repositories. Here we report that, under simulated repository conditions, corrosion could be significantly accelerated at the interfaces of different barrier materials, which has not been considered in the current safety and performance assessment models. Severe localized corrosion was found at the interfaces between stainless steel and a model nuclear waste glass and between stainless steel and a ceramic waste form. The accelerated corrosion can be attributed to changes of solution chemistry and local acidity/alkalinity within a confined space, which significantly alter the corrosion of both the waste-form materials and the metallic canisters. The corrosion that is accelerated by the interface interaction between dissimilar materials could profoundly impact the service life of the nuclear waste packages, which, therefore, should be carefully considered when evaluating the performance of waste forms and their packages. Moreover, compatible barriers should be selected to further optimize the performance of the geological repository system.

[Surgical selection and metastatic warning of splenic lymph node dissection in advanced gastric cancer radical surgery: a prospective, single-center, randomized controlled trial]

Objective: To investigate the surgical options for splenic lymph node dissection in patients with advanced gastric cancer undergoing radical total gastrectomy, and to evaluate the sentinel effect of No. 4s lymph node on splenic lymph node metastasis. Methods: A prospective, single-center, randomized and controlled study was carried out (Trial registration, No.NCT02980861). Enrollment criteria: (1) >18 years old and <65 years old; (2) gastric adenocarcinoma locating in the proximal or corpus; (3) preoperative clinical staging as cT2-4aN0-3M0; (4) D2 radical total gastrectomy feasible judged before operation; (5) physical ability score 0 to 1; (6) I to III of ASA classification. Pregnant or lactating women, patients with severe mental illness or previous history of upper abdominal surgery, those suffered from other malignant tumors in the past 5 years, or heart and lung system diseases judged to affect surgery before operation, those receiving preoperative chemotherapy, radiotherapy or targeted therapies, and distant metastases being found during surgery were excluded. According to above criteria, 222 patients at The First Medical Center of Chinese PLA General Hospital from December 2016 to December 2017 were enrolled prospectively and were randomly divided into the laparoscopic splenic hilar lymph node dissection group (laparoscopic group, n=114) and the open splenic hilar lymph node dissection group (open group, n=108). The result of rapid frozen immunohistochemistry of harvested No.4s lymph nodes was used to evaluate the sensitivity and specificity of sentinel effect on splenic hilar lymph node metastasis. The surgical parameters, postoperative recovery parameters, and complication rates were compared between the two groups. Results: There were 80 males and 34 females in the lapascopic group with a mean age of (56.1±10.2) years, and 69 males and 39 females in the open group with a mean age of (58.4±10.9) years. There were no significant differences in baseline data between the two groups (all P>0.05). Total blood loss was less in the laparoscopic group [(96.3±82.4) ml vs. (116.6±101.9) ml, t=1.124, P<0.001], and the amount of bleeding from the splenic hilar lymph nodes dissected was also less than that in the open group [(25.3±17.8) ml vs. (59.5±36.4) ml, t=1.172, P<0.001]. However, the operation time, the time of splenic hilar lymph node, the number of lymph node dissected and number of splenic hilar lymph node dissected were not significantly different between the two groups (all P>0.05). As compared to the open group, the laparoscopic group had shorter time to the first flatus [(1.3±1.2) days vs. (1.6±1.5) days, t=1.665, P=0.021], shorter time to fluid diet [(4.6±1.4) days vs. (4.9 ± 1.6) days, t=1.436, P=0.007], shorter time to remove nasogastric tube [(3.9±2.6) days vs. (4.3±2.4) days, t=0.687, P<0.001] and shorter hospital stay [(10.3±6.6) days vs. (12.1±7.2) days, t=0.697, P<0.001]. Complication rate was 14.0% (16/114) and (12.0%) ((1)3/108) in the laparoscopic group and the open group, respectively, without significant difference (χ(2)=6.723, P=0.331). The sensitivity of the No. 4s lymph node for the prediction of splenic hilar lymph node metastasis reached 89.5%, and the specificity reached 99.6%. Conclusions: Laparoscopic technique is safe and feasible in the treatment of splenic hilar lymph node dissection in advanced gastric cancer. The No.4s lymph node examination has good sentinel effect on predicting the metastasis of splenic hilar lymph nodes.

Ultra-small and biocompatible platinum nanoclusters with peroxidase-like activity for facile glucose detection in real samples

The highly sensitive glucose detection based on the peroxidase-like properties of nanoclusters has been gained great interest. In this work, Pericarpium Citri Reticulatae polysaccharide (PCRP) stabilized platinum nanoclusters (Pt-PCRP NCs) were prepared by a green method in which potassium tetrachloroplatinate and PCRP were simply mixed without addition of other agents. Platinum nanoclusters (Pt NCs) had ultra-small size of 1.26 ± 0.34 nm. The hydrodynamic size of Pt-PCRP NCs was 29.7 nm, and zeta potential of which was -12.0 mV. Pt-PCRP NCs showed high biocompatibility toward HeLa cells and red blood cells. In addition, Pt-PCRP NCs catalyzed the decomposition of H₂O₂ to produce •OH, which further oxidized colorless 3,3'5,5'-tetramethylbenzidine (TMB) to blue oxidized 3,3',5,5'-tetramethylbenzidine (oxTMB), exhibiting peroxidase-like property. The kinetics followed the Michaelis-Menten equation. More importantly, the colorimetric method for glucose detection using Pt-PCRP NCs had high selectivity and low detection limit for 0.38 μM. The established method based on Pt-PCRP NCs was used to precisely detect glucose detection in human serum, saliva, and sweat. Taken together, the prepared ultra-small and biocompatible Pt-PCRP NCs have good potential glucose applications in clinical diagnosis in the future.

Cardiovascular Diseases Deaths Attributable to High Sodium Intake in Shandong Province, China

Background

High sodium intake elevates blood pressure and thereby raises cardiovascular diseases (CVDs). Sodium intake is high in northern China, including Shandong province where the SMASH (Shandong‐Ministry of Health Action on Sodium and Hypertension) is currently underway.

Methods and Results

Blood pressure values and sodium intake measurements using 24‐hour urinary excretion were collected from the 2011 SMASH baseline survey, which was conducted in 20 counties/districts using a multistage stratified cluster random sampling method. We derived cause‐specific mortality from the Shandong Death Registration System (SDRS) during the same year and used population‐attributable fraction to estimate annual CVDs deaths attributable to high sodium intake (mediated through elevated systolic blood pressure) and CVD deaths averted by achieving different sodium‐reduction targets. Overall, 16 100 (95% uncertainty intervals, 11 000–22 600) CVD deaths among adults aged 25 to 69 years, including 5600 (4000–6500) for ischemic heart disease and 9000 (6700–11 600) for stroke, were attributable to higher sodium intake (2000 mg/day or 5.0 g/day of salt as a reference) in Shandong in 2011, accounting for 19.9% (13.7–25.0%) of total CVD deaths. The benefit of CVD deaths from sodium reduction is considerable with 8800 (6400–13 600), 6700 (4900–11 600), and 8500 (6000–10 800) averted, respectively, if sodium intake was reduced from the 2011 baseline to 3500 mg/day, 4000 mg/day, or reduced by 30%.

Conclusions

Nearly 20% of CVD deaths among adults aged 25 to 69 years could be attributable to the systolic blood pressure–raising effect of high sodium intake in Shandong in 2011. Potential benefits from population reduction of sodium intake are considerable.

Two d10 luminescent metal–organic frameworks as dual functional luminescent sensors for (Fe3+,Cu2+) and 2,4,6-trinitrophenol (TNP) with high selectivity and sensitivity

Two luminescent 3D supramolecular structures which serve as effective luminescent sensors for Fe³⁺, Cu²⁺ and TNP via luminescent quenching have been synthesized under solvothermal conditions.