[Data management and quality control strategies for population based cohort study]

Large-scale cohort study has unique advantages in the field of etiology research for its large sample size a multi-time point data, but it also brings great difficulty in data management and quality control at the same time. Recently, China has initiated a number of large-scale population cohort studies, posing enormous challenges to the management and quality control of related cohort data. This paper summarizes the existing experience and consensus in the field of cohort study in China from the characteristics of the cohort data, aiming at the types and main forms of the four main sources of questionnaire data, clinical diagnosis and treatment data, biological sample detection data and observation outcome data, from the data storage, circulation and transmission work.The contents and methods of queue data management are comprehensively summarized. Corresponding data quality control strategies are advised in the questionnaire evaluation, data logic verification, survey object sampling and multi-database review, etc. The goal of this review is to provide guidance for the management of data and the formulation of quality control strategies in the cohort study in China.

[Activation of HIF-1α/β-catenin signal pathway leads to radioresistance of prostate cancer cells]

Objective: To investigate the role of hypoxia-inducible factor-1α (HIF-1α) and β-catenin in radioresistance of prostate cancer (PCa) cells. Method: Two PCa cell lines, LNCaP and C4-2B, were grouped as: negative control (no treatment), HIF-1α overexpression group (transfected with HIF-1α plasmids), and β-catenin silencing group (transfected with HIF-1α plasmids and β-catenin-shRNA). Cell proliferation, cycle, invasion, and radiosensitivity were measured under normal or hypoxic condition. Radiosensitivity was tested in two mice PCa models (the LNCaP orthotopic BALB/c-nu mice model and the C4-2B subcutaneous SCID mice model). Results: In both LNCaP and C4-2B cells, HIF-1α transfection led to an enhanced β-catenin nuclear translocation, while β-catenin silencing inhibited the β-catenin nuclear translocation. Enhanced β-catenin nuclear translocation caused by HIF-1α overexpression resulted in enhanced cell proliferation and invasion, altered cell cycle distribution, reduced apoptosis, and improved non-homologous-end-joining (NHEJ) repair under irradiation condition. In vivo imaging of orthotopic models showed that HIF-1α overexpression LNCaP cells produced tumors with 3-fold volume (P=0.003 1) and 2-fold wet weight (P=0.039 4) than those by negative control cells at day 21, and β-catenin silencing cells aberrantly reduced both tumor volume (P=0.000 3) and wet weight (P=0.017 5) than HIF-1α overexpression cells. In addition, C4-2B subcutaneous models showed similar tumor promotion effects induced by HIF-1α overexpression (tumor volume: P=0.000 1 and wet weight: P=0.047 3) and suppressive effects by β-catenin silencing (tumor volume: P<0.000 1 and wet weight: P=0.022 1) as LNCaP orthotopic xenograft with regard to tumor volume and wet weight. Conclusions: HIF-1α overexpression enhanced β-catenin nuclear translocation, which led to the activation of the β-catenin/NHEJ signaling pathway and increased cell proliferation, invasion, and DNA repair. These results suggest that HIF-1α overexpression led to radioresistance of PCa cells.

[Study on the effects of total flavonoids from litchi nucleus on nuclear translocation of nuclear factor-kappa B and related protein expression in rat hepatic stellate cell]

Objective: The effect of total flavonoids of litchi (TFL) on nuclear translocation of nuclear factor-kappa B (NF- kappa B) in rat hepatic stellate cell line (HSC-T6) induced by transforming growth factor - beta 1 (TGF- beta 1) in vitro was studied to explore the mechanism of action of anti-hepatic fibrosis drugs. Methods: HSC-T6 was cultured in vitro, induced by TGFβ1 for 24 h, and then treated with TFL at 125, 250 and 500 μg/ml for 48 h. The effect of TFL on NF-κB nuclear translocation in HSC-T6 was observed by confocal laser microscopy. The effects of TFL on the expression of TLR4, p-IκB ɑ, p-NF-κB p65, NF-κB and Collagen I protein were detected by western blot. The expressions of TLR4 and p-NF-κB p65 were detected by immunofluorescence. Data were presented as mean±SEM. Homogeneity test of variance was performed and then followed by one-way analysis of variance (ANOVA). The multiple comparisons between groups were performed by LSD test. P < 0.05 was considered statistically significant. Results: Confocal laser scanning microscopy showed TFL inhibited the nuclear translocation of NF-κB in activated HSC-T6 in a concentration-dependent manner and TFL down regulated the protein expression levels of TLR4, p-IκB ɑ, p-NF-κB p65, NF-κB and collagen I protein in HSC-T6 in a concentration-dependent manner. Conclusion: The mechanism of TFL against hepatic fibrosis may be related to the inhibition of nuclear translocation of NF-κb in the activated HSC-T6 and the expression of TLR4, P-iκbɑ, P-nf-κb p65, NF-κb and collagen I protein in HSC-T6.

An entirely enclosed scanning tunnelling microscope capable of being fully immersed in liquid helium

We present an ultrahigh-vacuum (UHV)-sealed high-stability scanning tunnelling microscope (STM) that can be entirely immersed in liquid helium and readily used in a commercial Dewar or superconducting magnet. The STM head features a horizontal microscanner that can become standalone and ultrastable when the coarse approach inertial motor retracts. Low voltage is enough to operate the STM even at low temperature owing to the powerful motor. It is housed in a tubular chamber of 49 mm outer diameter, which can be pumped via a detachable valve (DV), UHV-sealed and remain sealed after the DV is removed. The entire so-sealed chamber can then be inserted into liquid helium, where in situ sample cleavage is done via vacuum bellow. This allows sample cleavage and STM measurements to take place in better UHV with higher cooling power. Quality atomic resolution images of graphite and charge density wave on 1T-TiSe₂ taken in ambient and 14 K conditions, respectively, are presented.

Effect of peer support on diabetes distress: a cluster randomized controlled trial

AIM

To investigate whether peer support would reduce diabetes distress and improve glycaemic control when added to usual diabetes education among adults with Type 2 diabetes in China.

METHODS

We conducted a cluster randomized trial involving 400 adults with Type 2 diabetes from eight communities in Nanjing. All participants received usual education for an average of 2 h each month from physicians, certified diabetes educators, dieticians, psychologists and podiatric nurses. Peer support was led by trained peer leaders and included diabetes knowledge- and skills-sharing at least once a month, as well as peer-to-peer communication. The primary outcome was diabetes distress measured using the Diabetes Distress Scale at 12 months. Secondary outcomes included fasting plasma glucose, 2-h postprandial glucose and HbA_1c concentration. Outcome data were collected from all participants at baseline, 6 months and 12 months.

RESULTS

From 2012 to 2013, there were 200 participants in each study arm at baseline. Compared with the usual education arm, the peer support with usual education arm had greater reductions in regimen-related distress (1.4 ± 0.6 vs 1.2 ± 0.4; P=0.004) and total distress (1.3 ± 0.4 vs 1.2 ± 0.3; P=0.038) at 6 months. At 12 months, the scores for emotional burden (1.2 ± 0.3 vs 1.4 ± 0.6; P=0.002), physician-related distress (1.1 ± 0.3 vs 1.3 ± 0.4; P=0.001) and total scores (1.2 ± 0.3 vs 1.3 ± 0.4; P=0.002) were significantly lower in the peer support with usual education arm than in the usual education arm. Fasting plasma glucose levels were lower in the peer support with usual education arm than in the usual education arm at 6 months (7.5 ± 1.95 vs 8.0 ± 2.2; P=0.044) and 12 months (7.0 ± 2.3 vs 7.6 ± 1.5; P=0.008).

CONCLUSIONS

Beyond the benefits of usual education, peer support was effective in reducing diabetes distress for Type 2 diabetes mellitus. (Clinical Trials Registry no: NCT02119572).

Combining the randomized response technique and the network scale-up method to estimate the female sex worker population size: an exploratory study

OBJECTIVES

Recall bias, barrier effects, transmission error, and response bias affecting the network scale-up method (NSUM) led the Joint United Nations Programme on HIV/AIDS and the World Health Organization to designate NSUM as a developing method for estimating the size of high-risk populations in 2010. The method has subsequently been adjusted for three of these biases. The present study, therefore, aimed to explore the combination of the randomized response technique (RRT) and NSUM to adjust the last remaining bias.

STUDY DESIGN

RRT was used in an NSUM survey to estimate the population proportion of female sex workers (FSWs) in Taiyuan, China, in 2012.

METHODS

Multiplier method estimates and national-level estimates of the population proportion of FSWs were used as criteria to assess the aforementioned results.

RESULTS

Successful interviews were completed with 96.4% of the respondents selected for the NSUM survey. The NSUM estimate fell within the range of the national-level estimates of the population proportion of FSWs in Asia and was close to the estimate yielded by the multiplier method.

CONCLUSIONS

In the present study, the combination of RRT and NSUM obtained a high response rate and produced a reliable estimate of the size of a high-risk population.

[Correlation of Genetic Polymorphism, Alcoholic Beverage Type and Ethanol Metabolism]

OBJECTIVES

To explore the effects of ADH1B and ALDH2 gene polymorphism and type of alcoholic beverage on ethanol metabolism, to provide data support for cases involving the interpretation of ethanol metabolism or back calculation of blood ethanol concentration in forensic practice.

METHODS

A total of 81 volunteers were selected. The genotypes of ADH1B, ADH1C and ALDH2 were obtained by a multiplex SNaPshot genotyping method. Each subject was administered with 1.0 g/kg of alcohol. About 1 mL venous blood was collected before and after the alcohol consumption at 30 min, 45 min, 1 h, 1.5 h, 2 h, 3 h, 4 h, 5 h, 6 h, 7 h and 8 h, respectively. The concentrations of ethanol and acetaldehyde in blood were determined by headspace gas chromatography. The peak times of blood ethanol concentration （T_max）, the peak mass concentrations of ethanol （C_max）, the area under curve （AUC） of ethanol （AUC_ethanol）, AUC_acetaldehyde and ethanol elimination rates （_β） were calculated. In order to eliminate the influence of ADH1C, the ADH1C*1/*1 carriers were grouped based on the genotype of ADH1B and ALDH2. The data of each group were evaluated by one-way analysis of variance and pairwise comparison tests were performed by least significant difference method. The gene interactions were evaluated by two-way analysis of variance. Each parameter of three kinds of alcoholic beverage （white wine, red wine and beer） among groups was analysed by variance analysis with randomized block design.

RESULTS

There were no differences in the value of T_max and C_max between the groups with different ADH1B and ALDH2 genotype. The differences in the values of AUC_ethanol, _β and AUC_acetaldehyde among some groups carrying different ADH1B and ALDH2 genotype had statistical significance, while no significant difference was observed in these parameters when one individual taking same dose of different alcoholic beverage type.

CONCLUSIONS

The ethanol metabolism is associated with the related gene polymorphism, which is barely affected by alcoholic beverage type.

Interpreting carbapenem susceptibility testing results for Pseudomonas aeruginosa

OBJECTIVES

Carbapenems are among the most powerful antipseudomonal agents. Limited data is available on drug susceptibility testing by routine methods (disc diffusion and Etest) for meropenem and doripenem. We aimed to compare the in vitro activity of imipenem, meropenem, and doripenem against Pseudomonas aeruginosa.

METHODS

A total of 311 P. aeruginosa strains isolated from respiratory specimens in 170 patients who developed ventilator-associated pneumonia in two intensive care units were collected over a period of 31 months. The susceptibility of these isolates to imipenem, meropenem, and doripenem were determined by Etest and disc diffusion method.

RESULTS

Considering either all isolates or only the first isolates recovered per patient (311 and 170 respectively), the susceptibility rate for doripenem was higher than that for meropenem and imipenem. When MICs determined by Etest were converted into interpretative categories (S, I, R) using French (CA-SFM) guidelines, a poor correlation was observed for meropenem and doripenem. The percentages of correlation with the disc diffusion method were 90.6% and 89.7% for imipenem, 80.5% and 82.6% for meropenem, and 80.5% and 73.3% for doripenem, for the first isolates and all isolates, respectively. The rate of minor errors was as high as 17.7% and 16.1% for meropenem and 17.7% and 25.7% for doripenem for the first isolates and all isolates, respectively.

CONCLUSION

The accuracy of disc diffusion using CA-SFM guidelines appears unsatisfactory for all three carbapenems justifying guideline update for P. aeruginosa and carbapenems.

A new locus regulating MICALL2 expression was identified for association with executive inhibition in children with attention deficit hyperactivity disorder

Impaired executive inhibition is a core deficit of attention deficit hyperactivity disorder (ADHD), which is a common childhood-onset psychiatric disorder with high heritability. In this study, we performed a two-stage genome-wide association study of executive inhibition in ADHD in Han Chinese. We used the Stroop color-word interference test to evaluate executive inhibition. After quality control, 780 samples with phenotype and covariate data were included in the discovery stage, whereas 922 samples were included in the replication stage. We identified one new significant locus at 7p22.3 for the Stroop word interference time (rs11514810, P=3.42E-09 for discovery, P=0.01176 for replication and combined P=5.249E-09). Regulatory feature analysis and expression quantitative trait loci (eQTL) data showed that this locus contributes to MICALL2 expression in the human brain. Most genes in the network interacting with MICALL2 were associated with psychiatric disorders. Furthermore, hyperactive-impulsive-like behavior was induced by reducing the expression of the zebrafish gene that is homologous to MICALL2, which could be rescued by tomoxetine (atomoxetine), a clinical medication for ADHD. Our results suggested that MICALL2 is a new susceptibility gene for executive inhibition deficiency related to hyperactive-impulsive behavior in ADHD, further emphasizing the possible role of neurodevelopmental genes in the pathogenic mechanism of ADHD.

[Analysis of the factors associated with the long-term curative effect and prognosis of primary vaginal carcinoma]

Objective: To investigate the clinical factors that affect the prognosis of patients with primary vaginal cancer. Methods: Clinical data of 118 primary vaginal cancer patients with pathological diagnosis and clinical follow-up data from the Department of Gynecology of Liaoning Cancer Hospital & Institute from 1999 to 2014 were collected and retrospectively analyzed. The relationship of prognosis and factors including age, history of hysterectomy, pathological types, International Federation of Gynecology and Obstetrics (FIGO) stage, tumor size, tumor location and therapeutic methods were analyzed, respectively. Results: The median survival time of the 118 patients was 93 months. The survival rates of 1, 3, 5, 10 and 15-year were 89.7%, 68.1%, 60.4%, 37.3% and 19.0%, respectively.The results of univariate analysis showed that the FIGO stage, pathological types, tumor size, therapeutic methods and tumor location were related to the prognosis of patients with primary vaginal cancer (all P<0.05), while the patients' age, history of hysterectomy were not (all P>0.05). The results of Cox multivariate regression analysis indicated that FIGO stage (P=0.008), tumor location (P=0.001) and therapeutic methods (P=0.007) were independent prognostic factors of the patients with primary vaginal cancer. Conclusions: Prognostic factorsofpatients with primary vaginal cancer include FIGO stage, pathological types, tumor size, therapeutic methods and tumor location. Among them, therapeutic methods and tumor location are the independent prognostic factors.

Design, synthesis and biological activities of new brassinosteroid analogues with a phenyl group in the side chain

We have prepared and studied a series of new brassinosteroid derivatives with a p-substituted phenyl group in the side chain. To obtain the best comparison between molecular docking and biological activities both types of brassinosteroids were synthesized; 6-ketones, 10 examples, and B-lactones, 8 examples. The phenyl group was introduced into the steroid skeleton by Horner-Wadsworth-Emmons. The docking studies were carried out using AutoDock Vina 1.05. Plant biological activities were established using different brassinosteroid bioassays in comparison with natural brassinosteroids. Differences in the production of the plant hormone ethylene were also observed in etiolated pea seedlings after treatment with new brassinosteroids. The most active compounds were lactone 8f and 6-oxo derivatives 8c and 9c, their biological activities were comparable or even better than naturally occurring brassinolide. Finally the cytotoxicity of the new derivatives was studied using human normal and cancer cell lines.

Development of an empirical model to predict malaria outbreaks based on monthly case reports and climate variables in Hefei, China, 1990-2011

Malaria remains a significant public health concern in developing countries. Drivers of malaria transmission vary across different geographical regions. Climatic variables are major risk factor in seasonal and secular patterns of P. vivax malaria transmission along Anhui province. The study aims to forecast malaria outbreaks using empirical model developed in Hefei, China. Data on the monthly numbers of notified malaria cases and climatic factors were obtained for the period of January 1st 1990 to December 31st 2011 from the Hefei CDC and Anhui Institute of Meteorological Sciences, respectively. Two logistic regression models with time series seasonal decomposition were used to explore the impact of climatic and seasonal factors on malaria outbreaks. Sensitivity and specificity statistics were used for evaluating the predictive power. The results showed that relative humidity (OR = 1.171, 95% CI = 1.090-1.257), sunshine (OR = 1.076, 95% CI = 1.043-1.110) and barometric pressure (OR = 1.051, 95% CI = 1.003-1.100) were significantly associated with malaria outbreaks after adjustment for seasonality in Hefei area. The validation analyses indicated the overall agreement of 70.42% (sensitivity: 70.52%; specificity: 70.30%). The research suggested that the empirical model developed based on disease surveillance and climatic conditions may have applications in malaria control and prevention activities.

Identification of Functional Genetic Polymorphisms at IL-10 Promoter Region and their Association with Risk of Ischemic Stroke in Chinese Han Population

BACKGROUND

Pleiotropic cytokine interleukin-10 (IL-10) has been suggested as modifying risk for atherosclerosis. Promoter region genetic polymorphism of IL-10 gene is known to be associated with the level of IL-10 production. Through these effects, they might be involved with the ischemic stroke (IS). Our aim was to assess the nature of the functional polymorphisms in IL-10 promoter and any links with IS in Chinese Han population.

METHODS

The IL-10 -1082 G>A, -819 C>T and -592 C>A functional polymorphisms were determined by TaqMan SNP Genotyping assays in 1296 subjects (648 IS patients diagnosed by CTs or/and magnetic resonance imaging (MRI) and 648 normal healthy controls from Chinese Han Population). Multivariate logistic regression analysis was used to show the association between the IL-10 genotypes and the IS events.

RESULTS

We found that the CC genotype of -819 C>T was more common in controls than IS subjects (P<0.05, corrected for multiple testing) in the Han population. CC carriage may be associated with the decreased risk of IS in the Han ethnic group (OR 0.65, 95% CI 0.43-0.97). In addition, the CC genotype in -592 C>A and GG genotype in -1082 G>A are all extremely low in Chinese Han cases and controls.

CONCLUSIONS

The G allele frequency at the -1082 promoter region of IL-10 was rare in Chinese Han population which are diffierent from American/European populations.. IL-10 -819 C>T may be an independent protective factor for IS in the Chinese Han population.

Dietary vitamin C intake and the risk of hip fracture: a dose-response meta-analysis

The meta-analysis suggested that dietary vitamin C was statistically inversely associated with the risk of hip fracture (overall OR = 0.73, 95% CI = 0.55-0.97, I ² = 69.1%) and with the increase of 50 mg/day vitamin C intake, the risk of hip fracture will reduce by 5% (OR = 0.95, 95% CI 0.91-1.00, P = 0.05).

INTRODUCTION

Previous studies had inconsistent findings regarding the association between vitamin C intake and the risk of hip fracture. Therefore, we conducted a meta-analysis to evaluate the association of dietary vitamin C intake and the risk of hip fracture.

METHODS

Relevant studies were identified by searching PubMed, Embase, and Web of Science up to December 2016. Additional articles were identified from reviewing the reference lists of relevant articles. The summary relative risks (RRs) or odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by random effects model. Funnel plot and Egger's test were used to test publication bias.

RESULTS

The total six articles containing 7908 controls and 2899 cases of hip fracture were included in this meta-analysis. By comparing the highest versus the lowest categories of vitamin C intake, we found that dietary vitamin C was statistically correlated with the risk of hip fracture [overall OR = 0.73, 95% CI = 0.55-0.97, I ² = 69.1%]. A linear dose-response association showed that the increase with vitamin C intake of 50 mg/day statistically reduced by 5% (OR = 0.95, 95% CI 0.91-1.00, P = 0.05) the risk of hip fracture.

CONCLUSIONS

In conclusion, the results of current meta-analysis strongly support that increasing dietary vitamin C intake can decrease the risk of hip fracture. In order to verify the association of vitamin C intake and hip fracture risk, further well-designed largely randomized controlled trials (RCTs) are needed.