6-year change in resting heart rate is associated with incident type 2 diabetes mellitus

BACKGROUND AND AIMS

Elevated resting heart rate (RHR) is associated with risk of type 2 diabetes mellitus (T2DM). However, the association of change in RHR (ΔRHR) and incident T2DM is not fully elucidated. We aimed to assess the dose-response association between 6-year ΔRHR and T2DM.

METHODS AND RESULTS

A total of 12155 non-T2DM participants ≥18 years old were enrolled during 2007-2008 and followed up during 2013-2014. ΔRHR was calculated by subtracting the baseline RHR from the RHR value at 6-year follow-up. Age-, sex-, and RHR-specific relative risks (RRs) and 95% confidence intervals (CIs) for the effect of ΔRHR on incident T2DM were calculated by using modified Poisson regression models. As compared with ΔRHR of 0 beats/min, the adjusted risk of T2DM was significantly increased with RHR increment and reduced with RHR reduction. ΔRHR was positively associated with future risk of T2DM [RR per unit increase: 1.03 (1.03-1.04)]. As compared with stable change in RHR group (-5<ΔRHR<5 beats/min), for ΔRHR ≤ -10 beats/min, -10<ΔRHR ≤ -5 beats/min, 5≤ΔRHR<10 beats/min, and ΔRHR ≥10 beats/min groups, the pooled adjusted RR (95% CI) of T2DM was 0.69 (0.55-0.86), 0.90 (0.73-1.11), 1.31 (1.07-1.61), and 1.90 (1.59-2.26), respectively. This significant association still existed on subgroup analyses based on age, sex, and baseline RHR and sensitivity analyses.

CONCLUSIONS

Dynamic RHR change was significantly associated with incident T2DM. Our study suggests that RHR may be a non-invasive clinical indicator for interventions aiming to reduce incident T2DM in the general population.

Abstract P2-08-33: A novel seven-gene signature predicts prognosis in early-stage triple-negative breast cancer

Purpose:

Chemotherapy remains the only systemic treatment option for patients with triple-negative breast cancer (TNBC). However, due to the heterogeneity of TNBC, not all patients benefit from chemotherapy, especially those with early-stage disease. In order to improve prognostic assessment and reduce unnecessary adjuvant systemic therapy in these patients, we have developed a novel seven-gene signature.

Experimental Design:

With the ComBat method, we integrated the results from 150 transcriptome microarrays samples and 246 RNA-seq samples of early-stage TNBC patients, and identified mRNAs associated with recurrence-free survival (RFS) using Lasso-Cox model, We further analyzed these TNBC samples and compared them with 60 paired normal breast tissues (40 samples from RNA-seq and 20 samples from microarrays) to identify tumor-specific mRNAs. Twenty-one overlapped mRNAs of the RFS-associated mRNAs and the tumor-specific mRNAs are selected as candidate mRNAs. An additional 371 samples of frozen primary tumors were then collected from early-stage TNBC patients (mean follow-up of 45 months) and randomly divided into two sets: a training set (n = 186) and a validation (n = 185) set. Expression level of candidate mRNAs in these samples were measured using RT-qPCR assays, and a seven-gene signature was built through all subset regression in the training set. The prognostic and predictive accuracy of our signature was tested in the validation set and other public databases (GSE5327, GSE2034 and METABRIC).

Results:

Twenty-one candidate mRNAs were identified in early-stage TNBC patients, from which we developed a novel seven-gene signature (recurrence risk score [mRNA signature] = 1.108*TMEM101 - 0.213*KRT5 - 0.315*ACAN - 0.464*LCA5 + 0.446*RPP40 - 0.373*LAGE3 - 0.257*CDKL2). Patients in the training set were classified into high- or low-risk group based on our seven-gene signature and an optimum cut-off score derived from x-tile. The patients in high-risk group were more likely to suffer from recurrence (HR, 2.718; 95% confidence interval [CI], 1.928–3.726, P= 0.001), and a time-dependent receiver operating curve showed that the seven-gene mRNA signature had a better prognostic value than the clinicopathologic risk factors in both training set and validation set. The prognostic and predictive accuracy of the signature was also validated in the METABRIC and two other public GEO databases (GSE5327 and GSE2034). The time-dependent receiver operating curve showed that this signature had an area under the curve (AUC) of 0.742 (95% CI, 0.705-0.773) in METABRIC, 0.716 (95% CI, 0.682-0.739) and 0.723 (95% CI, 0.683-0.756) in GSE5327 and GSE2034 respectively.

Conclusion:

In this study, we developed a novel seven-gene signature which can provide additional prognostic information and may guidance in identifying early-stage TNBC patients eligible for adjuvant therapy or reduction of chemotherapy. To our knowledge, this is the first study investigating the prognostic potential of mRNA signature in early-stage triple-negative breast cancer. Our novel signature may provide an opportunity for de-escalating treatment in early-stage TNBC patients in the future.

Citation Format: Ren Y, Jiang Y, Zuo W, Xu X, Jin X, Ma D, Shao Z. A novel seven-gene signature predicts prognosis in early-stage triple-negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-33.

Effects of Phosphorus on Loosely Bound and Tightly Bound Extracellular Polymer Substances in Aerobic Granular Sludge

The stability of aerobic granular sludge (AGS) is closely related to its extracellular polymeric substances (EPS). In this study, the composition and physicochemical characteristics of EPS in AGS were determined to evaluate their roles in AGS stability. The study evaluated the influence of influent phosphorus concentration on EPS protein (PN), polysaccharide (PS) and orthophosphate content, zeta potential (ζ) and fluorescence spectrum (EEM) in loosely bound EPS (LB-EPS) and tightly bound EPS (TB-EPS). With higher influent phosphorus concentration, the PN, PS and orthophosphate content were higher, as was the zeta potential in TB-EPS, but it had less influence on LB-EPS. Three-dimensional, synchronous fluorescence spectroscopy and fluorescence region integral (FRI) showed that protein-like substances were the primary components of LB-EPS and TB-EPS. Phosphorus had a dynamic quenching effect on EPS at a concentration between 0 mg L–1 and 17.5 mg L–1, which is the indirect production of phosphorus by cations. An increased concentration of influent phosphorus was beneficial to AGS stability

A J-shaped relation of BMI and stroke: Systematic review and dose-response meta-analysis of 4.43 million participants

BACKGROUND AND AIM

Many studies have shown increased risk of stroke with greater adiposity as measured by body mass index (BMI), but questions remain about the shape of the dose-response relation. We conducted a systematic review and meta-analysis of prospective studies to clarify the strength and shape of the dose-response relation between BMI and risk of stroke.

METHODS AND RESULTS

PubMed and Embase databases were searched for articles published up to May 11, 2018. Random-effects generalized least-squares regression models were used to estimate study-specific dose-response association, and restricted cubic splines were used to model the association. We included reports of 44 prospective cohort studies describing 102 466 incident cases among 4 432 475 participants. With a 5-unit increment in BMI, the summary relative risk for stroke incidence was 1.10 (95% confidence interval, 1.06 to 1.13; I² = 88.0%). The dose-response relation was J-shaped (P_{non-linearity} <0.001). The risk was not increased at the low BMI range (<24 kg/m²), but was increased within the high BMI range (>25 kg/m²).

CONCLUSION

Both overweight and obesity increase the risk of stroke with a J-shaped dose-response relation, and the nadir of the curve was observed at BMI 23-24 kg/m².

Purinergic Signaling Modulates Survival/Proliferation of Human Dental Pulp Stem Cells

Human dental pulp stem cells (hDPSCs) reside in postnatal dental pulp and exhibit the potential to differentiate into odontoblasts as well as neurons. However, the intercellular signaling niches necessary for hDPSC survival and self-renewal remain largely unknown. The objective of this study is to demonstrate the existence of intercellular purinergic signaling in hDPSCs and to assess the impact of purinergic signaling on hDPSC survival and proliferation. hDPSCs were isolated from extracted third molars and cultured in minimum essential medium. To demonstrate responsiveness to ATP application and inhibitions by purinergic receptor antagonists, whole cell patch-clamp recordings of ATP-induced currents were recorded from cultured hDPSCs. Immunofluorescence and enzymatic histochemistry staining were performed to assess purinergic receptor expression and ectonucleotidase activity in hDPSCs, respectively. To determine the effects of purinergic signaling on hDPSC, purinergic receptor antagonists and an ectonucleotidase inhibitor were applied in culture medium, and hDPSC survival and proliferation were assessed with DAPI staining and Ki67 immunofluorescence staining, respectively. We demonstrated that ATP application induced inward currents in hDPSCs. P2X and P2Y receptors are involved in the generation of ATP-induced inward currents. We also detected expression of NTPDase3 and ectonucleotidase activity in hDPSCs. We further demonstrated that purinergic receptors were tonically activated in hDPSCs and that inhibition of ectonucleotidase activity enhanced ATP-induced inward currents. Furthermore, we found that blocking P2Y and P2X receptors reduced-and inhibition of ecto-ATPase activity enhanced-the survival and proliferation of hDPSCs, while blocking P2X receptors alone affected only hDPSC proliferation. Autocrine/paracrine purinergic signaling is essential for hDPSC survival and proliferation. These results reveal potential targets to manipulate hDPSCs to promote tooth/dental pulp repair and regeneration.

The high-k poloidal scattering system for NSTX-U

An 8-channel, high-k poloidal far-infrared (FIR) scattering system is under development for the National Spherical Torus eXperiment Upgrade (NSTX-U). The 693 GHz poloidal scattering system replaces a 5-channel, 280 GHz high-k toroidal scattering system to study high-k electron density fluctuations on NSTX-U. The FIR probe beam launched from Bay G is aimed toward Bay L, where large aperture optics collect radiation at 8 simultaneous scattering angles ranging from 2° to 15°. The reduced wavelength in the poloidal system results in less refraction, and coupled with a new poloidal scattering geometry, extends measurement of poloidal wavenumbers from the previous limit of 7 cm^-1 up to >40 cm^-1. Steerable launch optics coupled with receiver optics that can be remotely translated in 5 axes allow the scattering volume to be placed from r/a = 0.1 out to the pedestal region (r/a ∼ 0.99) and allow for both upward and downward scattering to cover different regions of the 2D fluctuation spectrum.

Liquid crystal polymer receiver modules for electron cyclotron emission imaging on the DIII-D tokamak

A new generation of millimeter-wave heterodyne imaging receiver arrays has been developed and demonstrated on the DIII-D electron cyclotron emission imaging (ECEI) system. Improved circuit integration, improved noise performance, and enhanced shielding from out-of-band emission are made possible by using advanced liquid crystal polymer (LCP) substrates and monolithic microwave integrated circuit (MMIC) receiver chips. This array exhibits ∼15 dB additional gain and >30× reduction in noise temperature compared to previous generation ECEI arrays. Each LCP horn-waveguide module houses a 3 × 3 mm GaAs MMIC receiver chip, which consists of a low noise millimeter-wave preamplifier, balanced mixer, and IF amplifier together with a local oscillator multiplier chain driven at ∼12 GHz. A proof-of-principle partial LCP instrument with 5 poloidal channels was installed on DIII-D in 2017, with a full proof-of-principle system (20 poloidal × 8 radial channels) installed and commissioned in early 2018. The enhanced shielding of the LCP modules is seen to greatly reduce the sensitivity of ECEI signals to out-of-band microwave noise which has plagued previous ECEI studies on DIII-D. The LCP ECEI system is expected to be a valuable diagnostic tool for pedestal region measurements, focusing particularly on electron temperature evolution during edge localized mode bursting.

Performance evaluation of histone deacetylases in lungs of mice exposed to ovalbumin aerosols

This study was to investigate expression levels and functional activities of histone deacetylases (HDACs) with potential therapeutic targets selected in animal model of allergic asthma. Mice were sensitized and then challenged with saline (control) or ovalbumin (OVA) for 8 weeks. Airway resistance was determined by increasing concentrations of acetyl-β-methacholine chloride (0 - 50 mg/ml). The number of cells and cytokine production in bronchoalveolar lavage fluid (BALF) were determined by ELISA. Pathological changes of lung specimens were examined by histochemical staining methods under the light microscope. Expression and quantification of HDACs in lungs were measured using immunohistochemistry and Western blotting analysis. HDAC activity was identified using colorimetric and fluorometric methods. The OVA-treated mice had a significant enhancement in airway resistance with a large number of cells and increased interleukin (IL)-4 and -5 levels in BALF. Morphologically, an infiltration of inflammatory cells into epithelial layer with mucus accumulation and subepithelial fibrosis were seen in the OVA-exposed lungs. The expression levels for HDAC1, HDAC5, HDAC6, and HDAC8 were significantly elevated with weak induction of HDAC 2-4, which was identical with their catalytic activities detected in the lungs. In contrast, HDAC1 and HDAC5 activities were higher than others in the lungs. Individual HDACs are differently regulated in expression levels and functional activities in animal model of allergic asthma. Selective targeting of HDAC1/5 offers an opportunity to improve therapeutic effects of the disease.

Effectiveness, treatment completion and safety of sofosbuvir/ledipasvir and paritaprevir/ritonavir/ombitasvir + dasabuvir in patients with chronic kidney disease: an ERCHIVES study

BACKGROUND

Chronic kidney disease (CKD) was a relative contraindication to hepatitis C virus (HCV) treatment in the interferon/ribavirin era.

AIM

To determine the efficacy, tolerability and safety of sofosbuvir/ledipasvir (SOF/LDV) and paritaprevir/ritonavir/ombitasvir/dasabuvir (PrOD) regimens in persons with CKD.

METHODS

We identified persons initiated on a SOF/LDV or PrOD regimen from October 30, 2014 to April 30, 2016. We excluded those with missing HCV genotype or eGFR values. We determined treatment completion and sustained virologic response (SVR) rates, and proportion developing worsening renal function or grade 3/4 haematologic toxicity.

RESULTS

Among 13 663 persons on SOF/LDV±ribavirin, 14% and 1% persons had CKD Stage 3 and 4-5 respectively, 67.8% completed treatment, 98.2% achieved SVR. Treatment completion or SVR rates did not decline with advanced CKD or ribavirin administration. Among 3961 persons on PrOD±ribavirin, 9% and 3% persons had CKD Stage 3 and 4-5, respectively, 74.0% completed treatment and 98.2% achieved SVR. A decrease in treatment completion rates was seen in CKD stage 4-5 and those on ribavirin, but this did not impact SVR rates. A >10 mL/min/1.73 m² drop in eGFR from baseline was observed in 30%-38% of persons with baseline eGFR ≥60 mL/min/1.73 m² , but in only 0%-6% with CKD4-5. Grade 3/4 anaemia was more frequent in persons with CKD4-5, but ribavirin co-administration did not appear to affect this.

CONCLUSIONS

SOF/LDV and PrOD achieved high SVR rates in CKD population. Treatment completion rates were lower than expected. A decline in eGFR and development of anaemia were observed in a substantial proportion of persons, but the clinical implications remain unclear.

[Constituent and workload of service providers engaged in cancer screening: findings and suggestions from a multi-center survey in China]

Objective: To understand the constituent and workload of service providers engaged in cancer screening in China and provide evidence for the assessment of the sustainability of national cancer screening project. Methods: Using either questionnaire or online approach, the survey was conducted in 16 provinces, where Cancer Screening Program in Urban China (CanSPUC) was conducted, from 2014 to 2015. The medical institutes surveyed included hospitals [71.1% were class Ⅲ(A) hospitals], centers for disease control and prevention (CDCs) and community centers where cancer screening was undertaken during 2013-2015. The questionnaire survey was conducted among the staffs responsible for the overall coordination, management and implementation of the screening project to collect the information about the allocation, workload and compensation of the service providers from different specialties. Results: A total of 4 626 staffs were surveyed in this study, their average age was (37.7±9.5) years, and males accounted for 31.0%. Human resources allocated differed with province. The number of senior staff ranged from 6 (Chongqing) to 43 (Beijing) among the 8 comparable provinces. Among the staffs surveyed, 2 192 were from hospitals, 431 were from CDCs and 1 990 were from community centers, and the staffs who complained heavy workload accounted for 19.9%, 24.6% and 34.1% respectively (P<0.001). Among 227 staffs for overall coordination, 376 management staffs and 3 908 staffs for implementation, those who complained heavy workload accounted for 23.6%, 22.3% and 28.2% respectively (P<0.001). A total of 3 244 staffs (73.8%) got compensations for heavy workload. The compensation types were manly labor fee linked with workload (67.5%) and labor fee regardless workload (26.6%). Conclusion: The province specific differences in human resources allocation indicated the differences in screening project's organizing pattern and capability. It is suggested to conduct routine cancer screening (using specialized staffs), reduce the workload of the first line and community staffs and increase the compensation for the service providers for the sustainability of cancer screening project in China.

[The correlation between radiological classification and clinical audiometry in otosclerosis]

Objective:The aim of this study is to explore the correlation between radiological classification on HRCT and effects on surgery with hearing improvement in otosclerosis. Method:Thirty three patients (66 ears) with otosclerosis were enrolled to this study, who would be done operation using Fischs stapes surgery technique. All patients were classified according to axial HRCT preoperatively. All patients were evaluated by pure tone test preoperatively and 6 months postoperatively. Correlation between radiological classification and hearing effects were studied. Result:Six months after the surgeries, both of air conduction thresholds and bone conduction thresholds in 33 patients were significantly improved than those before the surgeries (P<0.01). Compared with mixed type otosclerosis, window type otosclerosis had significantly lower bone conduction threshold preoperatively and postoperatively. Conclusion:Fischs stapes surgery technique have perfect effects on improving otosclerosis air conduction threshold, as well as bone conduction threshold.

Dentinal mineralization is not limited in the mineralization front but occurs along with the entire odontoblast process

The mineralization-front theory is historically rooted in mineralization research fields for many decades. This theory is widely used to describe mineralization events in both osteogenesis and dentinogenesis. However, this model does not provide enough evidence to explain how minerals are propagated from the pulp-end dentin to dentin-enamel junction (DEJ). To address this issue, we modified the current research approaches by a) extending the mineral deposition windows of time from minutes to hours, instead of limiting the mineralization assay on days and weeks only; b) switching a regular fluorescent microscope to a more powerful confocal microscope; in which both mineral deposition rates and detail mineral labeling along with dentin tubules can be documented; and c) using reporter mice, including the Gli1-CreERT2 activated tomato and the 2.3 Col1-GFP to mark odontoblast processes combined with mineral dye injections. Our key findings are: 1) Odontoblast-processes, full of numerous mini-branches, evenly spread to entire dentin matrices with a high density of processes and a large diameter of the main process at the predentin-dentin junction; and 2) The minerals deposit along with entire odontoblast-processes and form many individual mineral collars surrounding odontoblast processes. As a result, these merged collars give rise to a single labeled line at the dentin-predentin junction, in which the dental tubules are wider in diameter and denser in odontoblast processes compared to other dentin areas. We therefore propose that it is the odontoblast-process that directly contributes to mineralization, which is not simply limited in the mineralization front at the edge of dentin and predentin, but occurs along with the entire odontoblast process. These new findings will shed new light on our understanding of dentin structure and function, as well as the mechanisms of mineralization.

[Effects of bimodal intervention on the development of auditory and speech ability in infants with unilateral cochlear implantation]

Objective: To explore the effects of bimodal intervention on the development of auditory and speech ability in the infants with unilateral cochlear implantation(CI). Methods: Total 35 bilateral profound sensorineural hearing loss infants with unilateral CI, aged 0.7 to 2.8 years old, were selected. The subjects were divided into two groups: the group with unilateral CI(cochlear implant alone, n= 15), and the bimodal group with CI and contralateral fitting hearing aid(n= 20). Their auditory and speech abilities were estimated at the different time points after switch-on(the 0th, 0.5th, 1st, 3rd, 6th, 12th, 18th, and 24th month, respectively) using Infant Toddler-Meaningful Auditory Integration Scale(IT-MAIS), Meaningful Use of Speech Scale(MUSS), Categories of Auditory Performance(CAP), and Speech Intelligibility Rating(SIR) scores. Results: The IT-MAIS scores of bimodal group after switch-on were higher than unilateral CI group(the 0.5th, 1st, 3rd, 6th, 12th, and 18th month), the statistical significances were identified at the 0.5th, 1st, 3rd, 6th, and 12th month, respectively(P<0.05). The CAP scores of bimodal group before CI operation and after switch-on(the 0.5th, 1st, 3rd, 6th, 12th, 18th and 24th month)were higher than unilateral CI group, the statistical significances were seen at the 3rd, 6th, 12th, 18th and 24th month after switch-on(P<0.05). The MUSS scores of bimodal group after switch-on were higher than unilateral CI group(the 1st, 3rd, 6th, 12th, 18th and 24th month), the statistical significances were found at the 12th, 18th and 24th month, respectively(P<0.05). The SIR scores of bimodal group after switch-on were higher than unilateral CI group(the 3rd, 6th, 12th, 18th and 24th month), and significant differences appeared at the 12th, 18th and 24th month after switch-on(P<0.05). Conclusion: Bimodal intervention could be helpful to the development of auditory and speech ability of infants.

Chronic kidney disease in Chinese postmenopausal women: A cross-sectional survey

INTRODUCTION

Despite advances in the management of chronic kidney disease (CKD), there is ongoing uncertainty regarding the prevalence of CKD in postmenopausal women. This study was designed to investigate both CKD prevalence and related risk factors in a cohort of postmenopausal Chinese women.

MATERIALS AND METHODS

A cross-sectional survey was administered to a nationally representative sample of female Chinese participants, including a total of 47,204 subjects, among whom were 8573 self-reported postmenopausal women. CKD was defined as either an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2 body surface area or else the presence of albuminuria. All subjects completed a questionnaire that included items related to their lifestyles and medical histories. Data were collected on blood pressure, serum creatinine, urinary albumin, and urinary creatinine. Risk factors correlated with the presence of CKD were analyzed using logistic regression analysis.

RESULTS

Results showed that the adjusted prevalence of an eGFR of < 60 mL/min/1.73 m2 among this postmenopausal survey cohort was 5.3% (95% confidence interval: 4.7-6.1) and of albuminuria, 12.4% (11.7-13.1). The overall prevalence of CKD in this postmenopausal cohort was 16.6% (15.8-17.4). Factors associated with kidney pathology included nephrotoxic drug use, history of cardiovascular disease, hyperuricemia, hypertension, and diabetes (the lower limit of multivariable adjusted odds ratios > 1).

CONCLUSION

The current study revealed a high prevalence of CKD in Chinese postmenopausal women. These results provide baseline data for disease prevention and treatment.

How wildfire risk is related to urban planning and Fire Weather Index in SE France (1990-2013)

Wildfires burn >450,000ha of forest every year in Euro-Mediterranean countries. Many fires originate in the Wildland Urban Interface (WUI) where housing density and weather conditions affect fire occurrence. Housing density is determined by long term land use policies while weather conditions evolve quickly. The first objective was to quantify the impacts of land use policy on WUI characteristics and fire risk in SE France during 1990-2012. The second objective was to quantify how Fire Weather Index (FWI) is related to fire occurrence. WUI was mapped from 1990, 1999, and 2012 building layers and crossed with a NDVI derived vegetation layer. In all, 12 WUI categories were derived: 4 building density classes and 3 vegetation layers. The I87 FWI was based on daily temperature, wind speed, relative humidity and soil water content. Despite a 30% increase in the number of new buildings, WUI area increased by only 5% as new housing filled in open space in existing WUI area. This trend can be linked to national level urban planning legislation and forest fire protection laws. Major driver variables determining housing location were aspect, slope, and distance to city centers. Fire frequency and burned area were nonlinearly related to FWI: 73% of the 99 fires occurred during weeks with FWI values ≥90 even though these accounted for only 44% of all weeks. Burned area was even more sensitive to FWI since 97% of total burned area occurred during weeks with mean FWI values ≥90. All days with burned areas >100ha had FWI values >150. The study demonstrated that WUI legislation can be an efficient tool to limit WUI fire risk. FWI results suggest the predicted increase in extreme summer heat events with global warming could increase burned area as firefighting resources are stretched beyond capacity.

Associations between air pollution, climate factors and outpatient visits for eczema in West China Hospital, Chengdu, south-western China: a time series analysis

BACKGROUND

Eczema is one of the most common inflammatory dermatoses that can be provoked as a result of external and internal factors. With dense population and rapid economic development of China, air pollution is still a serious problem and the prevalence of eczema has been elevating.

OBJECTIVE

To determine the association and lagged effects between environmental factors and the outpatient visits for eczema.

METHODS

Data of daily outpatient visits for eczema at the clinics of dermatology in West China Hospital within the last 5 years were collected. Data of environmental factors of Chengdu during the same period, including temperature, relative humidity, barometric pressure, wind speed and air pollutants concentrations like sulphur dioxide (SO₂ ), nitrogen dioxide (NO₂ ) and particular matter (PM₁₀ ), were gathered. The distributed lag nonlinear model was used to statistically examine the relationship between eczema and environmental factors and their lagged effects.

RESULTS

Correlation analysis showed that eczema outpatient visits were positively correlated with the air pollutants and were negatively correlated with relative humidity. The barometric pressure and wind speed influenced the outpatient visits in association with air pollutants.

CONCLUSION

This study provides evidence that environmental factors like relative humidity and multiple air pollutants influence the incidence and prevalence of eczema and have lagged effects.

Adjuvant radiotherapy for positive lymph nodes of oesophageal squamous cell carcinoma: Can it earn promising benefits at long-term follow-up?

PURPOSE

The value of adjuvant radiotherapy for patients with positive lymph nodes after curative resection of oesophageal squamous cell carcinoma is controversial. This study aims to investigate its long-term benefits in a specific cohort.

PATIENTS AND METHODS

The charts between 1990 and 2003 from patients with positive lymph nodes were retrospectively reviewed. Those subjects were divided into adjuvant radiotherapy and surgery alone groups, with two subgroups defined by radiation dose (cutoff value: 50Gy). Overall survival, disease-free survival and locoregional recurrence-free survival were compared between two groups, with predictive factors of overall survival analysed meanwhile.

RESULTS

In sum, 175 matched patients with 1:2 ratios for group balance were enrolled for final analysis. During the follow-up (median: 37.0 months), 143 (81.7%) deaths were recorded, with 70.6% of deaths from cancer progression. The median overall survival time (19.5, 4 to 172 months) was not significantly different between the two groups (18.9 vs. 20.0 months, P=0.179). However, the disease-free survival time was significantly shorter in the adjuvant radiotherapy group than that in the control group (median, 11.5 vs. 14.9 months; P=0.001), with the locoregional recurrence-free survival time impressively prolonged (median: 18.3 vs. 16.5 months; P=0.022). Age (P=0.030), number (P=0.005) and ratio (P=0.002) of positive lymph nodes were associated with overall survival, but radiation dose was not (P=0.204).

CONCLUSION

Adjuvant radiotherapy with low- or high-dose did not improve survival compared with surgery alone. However, radiotherapy was effective to control locoregional recurrence, and could be applied as salvage therapy when recurrence event occurred.

[Preference on screening frequency and willingness-to-pay for multiple-cancer packaging screening programs in urban populations in China]

Objective: From an actual cancer screening service demanders' perspective, we tried to understand the preference on screening frequency and willingness-to-pay for the packaging screening program on common cancers and to evaluate its long-term sustainability in urban populations in China. Methods: From 2012 to 2014, a multi-center cross-sectional survey was conducted among the actual screening participants from 13 provinces covered by the Cancer Screening Program in Urban China (CanSPUC). By face-to-face interview, information regarding to preference to screening frequency, willingness-to-pay for packaging screening program, maximum amount on payment and related reasons for unwillingness were investigated. Results: A total of 31 029 participants were included in this survey, with an average age as (55.2±7.5) years and median annual income per family as 25 000 Chinese Yuan. People's preference to screening frequency varied under different assumptions ( " totally free" and "self-paid" ). When the packaging screening was assumed totally free, 93.9% of residents would prefer to take the screening program every 1 to 3 years. However, the corresponding proportion dropped to 67.3% when assuming a self-paid pattern. 76.7% of the participants had the willingness-to-pay for the packaging screening, but only 11.2% of them would like to pay more than 500 Chinese Yuan (the expenditure of the particular packaging screening were about 1 500 Chinese Yuan). The remaining 23.3% of residents showed no willingness-to-pay, and the main reasons were unaffordable expenditure (71.7%) and feeling'no need'(40.4%). Conclusions: People who participated in the CanSPUC program generally tended to choose high-frequency packaging screening program, indicating the high potential acceptance for scale-up packaging screening, while it needs cautious assessments and rational guidance to the public. Although about seven in ten of the residents were willing to pay, the payment amount was limited, revealing the necessity of strengthening individual's awareness of his or her key role in health self-management, and a reasonable payment proportion should be considered when establishing co-compensation mechanism.