Meta-analysis and systematic review of the relationship between sex and the risk or incidence of poststroke aphasia and its types

OBJECTIVE

To analyse and discuss the association of gender differences with the risk and incidence of poststroke aphasia (PSA) and its types, and to provide evidence-based guidance for the prevention and treatment of poststroke aphasia in clinical practice.

DATA SOURCES

Embase, PubMed, Cochrane Library and Web of Science were searched from January 1, 2002, to December 1, 2023.

STUDY SELECTION

Including the total number of strokes, aphasia, the number of different sexes or the number of PSA corresponding to different sex.

DATA EXTRACTION

Studies with missing data, aphasia caused by nonstroke and noncompliance with the requirements of literature types were excluded.

DATA SYNTHESIS

36 papers were included, from 19 countries. The analysis of 168,259 patients with stroke and 31,058 patients with PSA showed that the risk of PSA was 1.23 times higher in female than in male (OR = 1.23, 95% CI = 1.19-1.29, P < 0.001), with a prevalence of PSA of 31% in men and 36% in women, and an overall prevalence of 34% (P < 0.001). Analysis of the risk of the different types of aphasia in 1,048 patients with PSA showed a high risk in females for global, broca and Wenicke aphasia, and a high risk in males for anomic, conductive and transcortical aphasia, which was not statistically significant by meta-analysis. The incidence of global aphasia (males vs. females, 29% vs. 32%) and broca aphasia (17% vs 19%) were higher in females, and anomic aphasia (19% vs 14%) was higher in males, which was statistically significant (P < 0.05).

CONCLUSIONS

There are gender differences in the incidence and types of PSA. The risk of PSA in female is higher than that in male.

[Clinicopathologic characteristics and prognostic analysis of testicular diffuse large B-cell lymphoma]

Objective: To analyze the clinicopathologic characteristics and prognosis of testicular diffuse large B-cell lymphoma (DLBCL) . Methods: A retrospective analysis was performed on 68 patients with testicular DLBCL admitted to Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine from October 2001 to April 2020. The gene mutation profile was evaluated by targeted sequencing (55 lymphoma-related genes) , and prognostic factors were analyzed. Results: A total of 68 patients were included, of whom 45 (66.2% ) had primary testicular DLBCL and 23 (33.8% ) had secondary testicular DLBCL. The proportion of secondary testicular DLBCL patients with Ann Arbor stage Ⅲ-Ⅳ (P<0.001) , elevated LDH (P<0.001) , ECOG score ≥ 2 points (P=0.005) , and IPI score 3-5 points (P<0.001) is higher than that of primary testicular DLBCL patients. Sixty-two (91% ) patients received rituximab in combination with cyclophosphamide, adriamycin, vincristine, and prednisone (R-CHOP) -based first-line regimen, whereas 54 cases (79% ) underwent orchiectomy prior to chemotherapy. Patients with secondary testicular DLBCL had a lower estimated 5-year progression-free survival (PFS) rate (16.5% vs 68.1% , P<0.001) and 5-year overall survival (OS) rate (63.4% vs 74.9% , P=0.008) than those with primary testicular DLBCL, and their complete remission rate (57% vs 91% , P=0.003) was also lower than that of primary testicular DLBCL. The ECOG scores of ≥2 (PFS: P=0.018; OS: P<0.001) , Ann Arbor stages Ⅲ-Ⅳ (PFS: P<0.001; OS: P=0.018) , increased LDH levels (PFS: P=0.015; OS: P=0.006) , and multiple extra-nodal involvements (PFS: P<0.001; OS: P=0.013) were poor prognostic factors in testicular DLBCL. Targeted sequencing data in 20 patients with testicular DLBCL showed that the mutation frequencies of ≥20% were PIM1 (12 cases, 60% ) , MYD88 (11 cases, 55% ) , CD79B (9 cases, 45% ) , CREBBP (5 cases, 25% ) , KMT2D (5 cases, 25% ) , ATM (4 cases, 20% ) , and BTG2 (4 cases, 20% ) . The frequency of mutations in KMT2D in patients with secondary testicular DLBCL was higher than that in patients with primary testicular DLBCL (66.7% vs 7.1% , P=0.014) and was associated with a lower 5-year PFS rate in patients with testicular DLBCL (P=0.019) . Conclusion: Patients with secondary testicular DLBCL had worse PFS and OS than those with primary testicular DLBCL. The ECOG scores of ≥2, Ann Arbor stages Ⅲ-Ⅳ, increased LDH levels, and multiple extra-nodal involvements were poor prognostic factors in testicular DLBCL. PIM1, MYD88, CD79B, CREBBP, KMT2D, ATM, and BTG2 were commonly mutated genes in testicular DLBCL, and the prognosis of patients with KMT2D mutations was poor.

[Clinical characteristics and prognosis of primary and secondary diffuse large B-cell lymphoma of the pancreas]

Objective: To analyze the clinical characteristics and prognosis of primary and secondary pancreatic diffuse large B-cell lymphoma (DLBCL) . Methods: Clinical data of patients with pancreatic DLBCL admitted at Shanghai Rui Jin Hospital affiliated with Shanghai Jiao Tong University School of Medicine from April 2003 to June 2020 were analyzed. Gene mutation profiles were evaluated by targeted sequencing (55 lymphoma-related genes). Univariate and multivariate Cox regression models were used to evaluate the prognostic factors of overall survival (OS) and progression-free survival (PFS) . Results: Overall, 80 patients were included; 12 patients had primary pancreatic DLBCL (PPDLBCL), and 68 patients had secondary pancreatic DLBCL (SPDLBCL). Compared with those with PPDLBCL, patients with SPDLBCL had a higher number of affected extranodal sites (P<0.001) and had higher IPI scores (P=0.013). There was no significant difference in the OS (P=0.120) and PFS (P=0.067) between the two groups. Multivariate analysis indicated that IPI intermediate-high/high risk (P=0.025) and double expressor (DE) (P=0.017) were independent adverse prognostic factors of OS in patients with pancreatic DLBCL. IPI intermediate-high/high risk (P=0.021) was an independent adverse prognostic factor of PFS in patients with pancreatic DLBCL. Targeted sequencing of 29 patients showed that the mutation frequency of PIM1, SGK1, BTG2, FAS, MYC, and MYD88 in patients with pancreatic DLBCL were all >20%. PIM1 (P=0.006 for OS, P=0.032 for PFS) and MYD88 (P=0.001 for OS, P=0.017 for PFS) mutations were associated with poor OS and PFS in patients with SPDLBCL. Conclusion: There was no significant difference in the OS and PFS between patients with PPDLBCL and those with SPDLBCL. IPI intermediate-high/high risk and DE were adverse prognostic factors of pancreatic DLBCL. PIM1, SGK1, BTG2, FAS, MYC, and MYD88 were common mutations in pancreatic DLBCL. PIM1 and MYD88 mutations indicated worse prognosis.

Longitudinal association between interparental conflict and risk-taking behavior among Chinese adolescents: testing a moderated mediation model

BACKGROUND

The interparental conflict has been associated with an increased adolescents' engagement in risk-taking behaviors. However, few studies have examined the potential mediation of deviant peer affiliation and the potential moderation of school climate. Grounded in the ecological system theory, this study aimed to explore the mediating role of deviant peer affiliation and the moderating role of school climate between the association of interparental conflict and risk-taking behavior.

METHODS

This study conducted a longitudinal design (3 time points, 3 months apart) with the sample comprising 550 middle school students in southeastern China (52.91% males; mean age at Time 1 = 15.37). The performed measurements encompassed interparental conflict (T1), deviant peer affiliation (T2), school climate (T3), risk-taking behavior (T1/T2/T3), and demographic information.

RESULTS

The moderated mediation model revealed that after controlling for T1/T2 risk-taking behavior, T1 interparental conflict was longitudinally and positively correlated with T3 risk-taking behavior through T2 deviant peer affiliation. Furthermore, moderated mediation analysis demonstrated that a positive school climate ameliorated the adverse impact of deviant peer affiliation on risk-taking behavior, thereby mitigating the indirect effect of interparental conflict on risk-taking behavior among adolescents.

CONCLUSIONS

Our findings propose a nuanced explanation of the processing mechanisms between interparental conflict and risk-taking behaviors among Chinese adolescents. The theoretical and practical implications of the findings are discussed.

Longitudinal association between poor parental supervision and risk-taking behavior: The role of self-control and school climate

INTRODUCTION

Although poor parental supervision has been associated with an increased adolescents' propensity for risk-taking behavior, few researchers have investigated nuanced mechanisms of how and for whom from the perspective of "family × school." Inspired by ecological system theory and self-control theory, this study aimed to investigate the mediating role of self-control and the moderating role of school climate between the link between poor parental supervision and risk-taking behavior.

METHODS

Four hundred and ninety-one Chinese adolescents (231 females, M_age  = 15.39 ± 1.36) were recruited to participate in a three-wave longitudinal study (3 months apart) and complete questionnaires regarding poor parental supervision (W1), school climate (W1), self-control (W2), and risk-taking behavior (W1/W3).

RESULTS

After controlling for W1 risk-taking behavior, our moderated mediation model indicated that W1 poor parental supervision was positively related to W3 risk-taking behavior by restraining the development of W2 self-control. Additionally, a high level of school climate as a protective factor buffered the negative impact of poor parental supervision on adolescents' self-control, further reducing risk-taking behavior.

CONCLUSION

Our findings shed light on the processing mechanisms between poor parental supervision and risk-taking behavior among Chinese adolescents and underscore the importance of effective preventions and interventions to facilitate adolescents' healthy development.

[Efficacy of a recombinant bovine basic fibroblast growth factor gel for the treatment of moderate dry eye: a multicenter randomized double-blind parallel controlled clinical trial]

Objective: To compare the clinical efficacy of a recombinant bovine basic fibroblast growth factor (rb-bFGF) gel and a gel matrix in the treatment of moderate dry eye. Methods: It was a prospective random double-blind controlled study. One hundred patients diagnosed as moderate dry eye in Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Beijing Tongren Hospital, Capital Medical University, Eye & ENT Hospital of Fudan University and Zhongshan Ophthalmic Center from August 2015 to April 2019 were divided into two groups: experimental group and control group. Two groups of patients were allocated to receive either a rb-bFGF gel or a gel matrix 4 times per day for 4 weeks. Subjective symptoms, break-up time of the tear film (BUT), Schirmer Ⅰ test (SⅠt) and corneal fluorescein sodium staining were assessed at baseline, 2 and 4 weeks after treatment. Bulbar impression cytology was evaluated at baseline and 4 weeks after treatment. Irritation of the rb-bFGF gel and the gel matrix was estimated after treatment. T test, Wilcoxon signed-rank test or Mann-Whitney U test was used for quantitative data, and Chi-square test was used for enumerative data. Results: Eighty-four subjects were included for statistical analyses after the exclusion of 16 subjects who were lost for followup, with an age of 43±14 years. There were 42 cases in the experimental group and the control group, respectively. There was no statistically significant difference between the two groups in demographic baseline characteristics before treatment (P>0.05). The total score of subjective symptoms was 7.17±3.60 and 5.95±3.25 at 2 and 4 weeks after therapy in the experimental group, which were lower than 9.48±3.88 before treatment (t=6.226, 6.563; both P<0.05); in the control group, it was 7.01±3.25 and 6.32±3.85 at 2 and 4 weeks after treatment, with a significant reduction in comparison with that before treatment (9.15±3.58; t=4.693, 4.726; both P<0.05). The median (lower quartile, upper quartile) BUT was 4.00 (2.40, 5.00) s and 4.64 (3.00, 5.00) s at 2 and 4 weeks after therapy in the experimental group, which were longer than 3.72 (2.00, 4.39) s before treatment (Z=-2.485, -3.152; both P<0.05). The BUT was 4.41 (2.79, 5.12) s at 2 weeks after therapy in the control group, which was of no statistical difference compared with 3.89 (2.09, 4.25) s before treatment (Z=-1.953, P>0.05). The BUT was 5.21 (3.00, 5.02) s at 4 weeks after therapy in the control group, which was longer than that before treatment (Z=-2.485, P<0.05). The SⅠt score was 7.31 (3.75, 10.00) mm and 8.50 (4.00, 11.00) mm at 2 and 4 weeks after therapy in the experimental group, which were significantly higher than 6.69 (2.00, 8.13) mm before treatment (Z=-2.031, -2.236; both P<0.05); in the control group, it was 6.82 (2.00, 8.25) mm and 6.86 (3.00, 9.25) mm at 2 and 4 weeks after therapy, which were not significantly increased compared with 6.50 (2.00, 7.75) mm before treatment (Z=-0.179, -1.161; both P>0.05). The corneal fluorescein sodium staining points were 5.00 (2.00, 5.00) and 3.71 (0.00, 5.00) at 2 and 4 weeks after therapy in the experimental group, which were significantly lower than 7.10 (5.00, 7.00) before treatment (t=-2.895, -4.639; both P<0.05); those in the control group were 5.52 (0.00, 7.00) and 6.19 (0.75, 6.25) at 2 and 4 weeks after treatment, with a significant reduction in comparison with 8.90 (5.00, 10.50) before treatment (t=-2.776, -1.991; both P<0.05). The differences in the average total score of subjective symptoms, BUT, SIt, and corneal fluorescein sodium staining points between both groups were not statistically significant at each time point. The impression cytology grade was decreased from 1.72 (1.00, 2.00) before treatment to 0.94 (0.00, 2.00) at 4 weeks after therapy in the experimental group (Z=-2.803, P<0.05). The staining grade of conjunctival imprinted cells in the control group was 1.42 (1.00, 2.00) at 4 weeks, which showed no statistical significance compared with 1.56 (1.00, 2.00) before treatment (Z=1.195, P>0.05). The impression cytology grade was significantly reduced in the experimental group compared with the control group at 4 weeks after treatment (Z=-3.308, P<0.05). The number of goblet cells was 10.90 (5.00, 20.00) at 4 weeks after therapy in the experimental group, which was significantly higher than 6.30 (5.00, 8.00) before treatment (Z=-2.383, P<0.05); in the control group, it was 8.36 (4.00, 12.00) at 4 weeks after treatment, with no significant increase in comparison with that before treatment [7.55 (5.00, 11.00)] (Z=-0.095, P>0.05). The number of goblet cells was not significantly increased in the experimental group compared with the control group at 4 weeks after treatment (Z=-1.162, P>0.05). Most patients indicated that the drug was non-irritating, and no patient had intolerable irritation affecting daily lives at 4 weeks after therapy; there was no difference between the two groups (Z=-0.290, P>0.05). Conclusions: Both the rb-bFGF gel and the gel matrix can effectively improve the symptoms and signs of moderate dry eye. However, compared with the gel matrix, the rb-bFGF gel shows obvious advantages in promoting conjunctival epithelial cell repair and increasing the number of goblet cells. (Chin J Ophthalmol, 2021, 57: 930-938).

Thyroid hormone resistance syndrome with P453T mutation in thyroid hormone receptor β gene: A pedigree report

RATIONALE

Thyroid hormone resistance syndrome (THRS) is an inherited condition characterized by reduced responsiveness of target tissues to thyroid hormone. Due to their nonspecific symptomatic manifestations, these patients can be misdiagnosed. This study reports a pedigree with THRS caused by a mutation in the thyroid hormone receptor β (THRβ) gene.

PATIENT CONCERN

The proband, a 36-year-old woman at 19+4 weeks of gestation, was referred to our hospital because of abnormal thyroid function results. She was diagnosed with hyperthyroidism in October 2015, and had been treated with methimazole until her pregnancy.

DIAGNOSIS

The proband and 2 of her children were diagnosed with THRS based on genetic analysis. Sequence analysis of the THRβ gene showed a heterozygous mutation C>A located at exon 10. The mutation results in a change in proline for threonine at amino acid position 453, P453T.

INTERVENTIONS

No treatment will fully and specifically correct the defect. All 3 patients were in normal metabolic status, and thus treatment was not required.

OUTCOMES

During a 2-year follow-up period, none of them had any complaints. The 20-year-old son (167 cm in height) and the 18-year-old daughter (150 cm in height) both had low academic performance.

LESSONS

Elevated serum thyroid hormone (TH) levels associated with nonsuppressed thyroid-stimulating hormone (TSH) levels usually leads to the diagnosis of THRS. Genetic analysis provides a short cut to diagnosis and the treatment should be based on the patient's clinical manifestations.

Chinese public's knowledge, perceived severity, and perceived controllability of COVID-19 and their associations with emotional and behavioural reactions, social participation, and precautionary behaviour: a national survey

BACKGROUND

The outbreak of the coronavirus disease-19 (COVID-19) has caused enormous stress among the public in China. Intellectual input from various aspects is needed to fight against COVID-19, including understanding of the public's emotion and behaviour and their antecedents from the psychological perspectives. Drawing upon the cognitive appraisal theory, this study examined three cognitive appraisals (i.e., perceived severity, perceived controllability, and knowledge of COVID-19) and their associations with a wide range of emotional and behavioural outcomes among the Chinese public.

METHODS

Participants were 4607 citizens (age range: 17-90 years, Mage = 23.71 years) from 31 provinces in China and they took part in a cross-sectional survey online.

RESULTS

The results showed that the public's emotional and behavioural reactions were slightly affected by the outbreak of COVID-19. Moreover, the public had limited participation in the events regarding COVID-19 but actively engaged in precautionary behaviour. In addition, results of structural equation model with latent variables revealed that the three appraisals were differentially related to the outcome variables (i.e., negative emotion, positive emotion, sleep problems, aggression, substance use, mobile phone use, social participation, and precautionary behaviour).

CONCLUSIONS

The findings highlight the utility of cognitive appraisal, as a core process of coping stress, in explaining the public's emotion and behaviour in the encounter of public health concern. Practically, the findings facilitate the government and practitioners to design and deliver targeted intervention programs to the public.

Chinese public's knowledge, perceived severity, and perceived controllability of COVID-19 and their associations with emotional and behavioural reactions, social participation, and precautionary behaviour: a national survey

BACKGROUND

The outbreak of the coronavirus disease-19 (COVID-19) has caused enormous stress among the public in China. Intellectual input from various aspects is needed to fight against COVID-19, including understanding of the public's emotion and behaviour and their antecedents from the psychological perspectives. Drawing upon the cognitive appraisal theory, this study examined three cognitive appraisals (i.e., perceived severity, perceived controllability, and knowledge of COVID-19) and their associations with a wide range of emotional and behavioural outcomes among the Chinese public.

METHODS

Participants were 4607 citizens (age range: 17-90 years, Mage = 23.71 years) from 31 provinces in China and they took part in a cross-sectional survey online.

RESULTS

The results showed that the public's emotional and behavioural reactions were slightly affected by the outbreak of COVID-19. Moreover, the public had limited participation in the events regarding COVID-19 but actively engaged in precautionary behaviour. In addition, results of structural equation model with latent variables revealed that the three appraisals were differentially related to the outcome variables (i.e., negative emotion, positive emotion, sleep problems, aggression, substance use, mobile phone use, social participation, and precautionary behaviour).

CONCLUSIONS

The findings highlight the utility of cognitive appraisal, as a core process of coping stress, in explaining the public's emotion and behaviour in the encounter of public health concern. Practically, the findings facilitate the government and practitioners to design and deliver targeted intervention programs to the public.

[Is conjunctival congestion in patients infected with 2019 novel coronavirus definitely related to the novel coronavirus]

This article was published ahead of print on the official website of Chinese Journal of Ophthalmology on April 14, 2020. Currently, it is commonly reported that coronavirus disease 2019 (COVID-19) patients are associated with conjunctival congestion and other symptoms, and the transmission route and high-risk eye diseases and high-risk working status are speculated. Are conjunctival congestion and conjunctiva-related symptoms in patients with 2019 novel coronavirus definitely related to the novel coronavirus? Conjunctival congestion is one of the common clinical signs of various types of conjunctivitis. The symptoms and signs of conjunctivitis in COVID-19 patients may be attributed to a variety of factors. Therefore, conjunctival symptoms should not be linked to 2019 novel coronavirus without evidence. ( Chin J Ophthalmol, 2020, 56: 571-572).

[Suggestions for disinfection of ophthalmic examination equipment and protection of ophthalmologist against 2019 novel coronavirus infection]

At present, the prevention and treatment of 2019 Novel Coronavirus (2019-nCoV) in China has reached a critical stage. It is extremely important to disinfect ophthalmic examination instruments and protect ophthalmic medical care during the epidemic period to reduce cross-infection in clinical practice and reduce the infection risk of ophthalmic medical staff. (Chin J Ophthalmol, 2020, 56: 0001).

[Efficacy of RCDOP regimen in the treatment of patients with diffuse large B-cell lymphoma]

Objective: To investigate the efficacy of RCDOP (Rituximab, cyclophosphamide, liposome doxorubicin, vincristine and prednisone) regimen in patients with de novo diffuse large B-cell lymphoma (DLBCL), especially in those patients with multiple extra-nodal involvement or Bulky diseases. Methods: A total of 87 newly diagnosed DLBCL patients who received RCDOP regimen from October 2012 to October 2017 were enrolled into this study. Survival functions were estimated using the Kaplan-Meier method and compared by the log-rank test, and χ(2) tests were used for categorical data. Results: Among the 87 DLBCL patients treated with RCDOP regimen, 81 patients achieved complete remission (CR) or partial remission (PR), with ORR as 93.1%. Patients were further classified into groups, according to the risk factors, such as IPI scores, multiple extra-nodal involvement, bulky disease, age>60, tumor Ki-67>80%, elevated serum LDH level and advanced Ann Arbor stage. The progression-free survival (PFS, P=0.084) and overall survival (OS, P=0.515) had no statistical difference among the IPI low risk (0-1 score) group, intermediate risk (2-3 scores) group and high risk (4-5 scores) group. Similarly, no statistical difference were fou nd in PFS and OS of patients with extra-nodal involvements ≥2 (P=0.303 and P=0.624), with bulky disease (P=0.518 and P=0.466), with age>60 (P=0.600 and P=0.183), with elevated serum LDH level (P=0.054 and P=0.880), with advanced Ann Arbor stage (P=0.075 and P=0.286), and with tumor Ki-67 over 80% (P=0.190 and P=0.109), when compared with those of patients without these risk factors. Conclusion: RCDOP can improve the therapeutic effect and prognosis of DLBCL patients with certain high risk factors, such as intermediate and high IPI risks, multiple extra-nodal involvements, bulky disease, age over 60, elevated LDH level, advanced Ann Arbor stage and tumor Ki-67 over 80%.

[Prognostic significance of NCCN-International Prognostic Index (NCCN-IPI) for patients with peripheral T-cell lymphoma treated with CHOP-based chemotherapy]

目的

明确美国国家综合癌症网络国际预后指数（NCCN-IPI）对外周T细胞淋巴瘤（PTCL）患者化疗后的预后评估价值。

方法

回顾性分析2003年1月至2013年5月接受CHOP或CHOP样方案化疗的162例初治PTCL患者的临床资料，采用国际预后指数（IPI）和NCCN-IPI进行危险分层和预后评估。

结果

①162例患者预期5年总生存（OS）和无进展生存（PFS）率分别为33%和20%，中位OS和PFS时间分别为17.0和9.2个月。②多因素分析提示美国东部肿瘤协作组体能状态评分（ECOG评分）≥2分（PFS：HR＝2.418，95%CI 1.535～3.809，P<0.001；OS：HR＝2.347，95%CI 1.435～3.839，P＝0.001）和存在特定的结外病变部位（PFS：HR＝1.800，95%CI 1.216～2.665，P＝0.003；OS：HR＝1.608，95%CI 1.054～2.454，P＝0.027）是影响患者PFS和OS的独立危险因素；ALK⁺是影响间变性大细胞淋巴瘤患者PFS（HR＝0.424，95%CI 0.184～0.975，P＝0.043）及OS（HR＝0.276，95%CI 0.087～0.877，P＝0.029）的独立预后良好因素。③NCCN-IPI低危组患者的生存率显著高于IPI低危组患者（5年OS率74%对54%，χ²＝5.041，P＝0.025；5年PFS率50%对38%，χ²＝5.295，P＝0.021），差异均有统计学意义。

结论

NCCN-IPI较IPI对低危PTCL患者具有更好的预后判断意义，可作为PTCL患者有效的预后分层工具。

[Efficacy and prognostic analysis of 98 cases of relapsed/refractory diffuse large B-cell lymphoma treated with second-line regimens]

Objective: To evaluate the efficacy and prognostic factors of second-line regimens for patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). Methods: A retrospective analysis was performed in 98 patients with relapsed/refractory DLBCL who were treated with salvage regimens in Rui Jin Hospital from July 2004 to June 2016. Overall response rate (ORR) was evaluated after all treatment finished. Overall survival (OS) was analyzed by Kaplan-Meier method and multivariate by Cox proportional hazards models. Results: There were 60 males and 38 females with a median age of 55.5 (15-77) years. 48 (49.0%) patients responded to chemotherapy, and 32 (32.7%) patients achieved complete remission (CR). Factors affecting ORR were progression disease or refractory/relapse status less than 12 months after diagnosis (χ(2)=5.878, P=0.015) , IPI intermediate-high/high risk (χ(2)=5.930, P=0.015) and NCCN-IPI intermediate-high/high risk (χ(2)=4.961, P=0.026). No significance difference was observed in ORR between germinal-center B-cell type (GCB) and non-GCB (χ(2)=0.660, P=0.417). One-year and 2-year OS rates were 51.0% and 31.5%, with median OS at 13.17 months, respectively. Multivariate analysis indicated NCCN-IPI intermediate-high/high risk[HR=2.176 (95%CI 1.338-3.538) , P=0.002] and response to chemotherapy [HR=0.273 (95%CI 0.165-0.452) , P<0.001] were independent prognostic factors for survival. Conclusion: NCCN-IPI is a valid predictor of outcome for patients with relapse/refractory DLBCL. Response to chemotherapy is an independent prognostic factor for better survival.

[Influence of blue light from visual display terminals on human ocular surface]

Objective: To investigate the influence of blue light from visual display terminals (VDTs) on human ocular surface. Methods: Prospective intervention test Thirty volunteers were recruited to watch videos on the same VDT in a dark environment, about 40 cm from the screen. Volunteers were supposed to watch videos in the night shift mode that reduces the amount of blue light for 1 hour. At the same time of the second day, they watched the same videos on the VDT in the normal mode for 1 hour. Tear film break-up time (BUT), corneal fluorescein staining scores, lipid layer thickness (LLT), times of blinking in 19.1 seconds and the ratio of partial blinking in 19.1 seconds were measured before and after each watching. Meanwhile, volunteers were asked to complete a questionnaire about their subjective experience after watching. Results: BUT, corneal fluorescein staining scores and LLT showed no significant decreases in the volunteers after they watched videos on the VDT in the night shift mode [BUT before watching: (8.08±3.15)s, BUT after watching in the night shift mode: (5.31±2.49)s, t=-0.52, P>0.05], but there were significant decreases after they watched videos in the normal mode [BUT after watching in the normal mode: (3.35±1.95) s, t=2.40, P<0.05]. At the same time, there was a significant difference between night shift mode and normal mode[BUT after watching in the night shift mode (5.31±2.49)s, BUT after watching in the normal mode: (3.35±1.95)s, t=3.67, P<0.05). Times of blinking and the ratio of partial blinking in 19.1 seconds were increased modestly after watching in 2 different modes, but there was no significant difference(times of blinking after watching in the night shift mode were 5.55±3.27, times of blinking after watching in the normal mode were 5.93±3.59, t=-0.92, P>0.05). The questionnaire results showed that 70.0%(21) of the volunteers reported mild discomfort including eye dryness, itching, pain, foreign body sensation, redness and asthenopia, 46.7%(14) reported no difference between the 2 modes, 36.7%(11) preferred the night shift mode, 16.6%(5) felt better with the normal mode, and 80.0%(24) would like to try the night shift mode in their daily life. Conclusions: Use of VDTs for a short period of time can lower the stability of tear film. The night shift mode may cause less damage to the ocular surface than the normal mode. High-energy blue light from VDTs can be a risk factor in the ocular surface damage, but the damage is reversible. (Chin J Ophthalmol, 2018, 54: 426-431).

[Diagnostic imaging of primary hepatic neuroendocrine tumors and treatment with transarterial chemoembolization: analysis of 6 cases]

Objective: To investigate the imaging diagnosis, treatment and prognosis of primary hepatic neuroendocrine tumors. Methods: The clinical features, imaging manifestations, histopathological and immunohistochemical findings and interventional therapy of 6 patients identified with pathologically confirmed primary hepatic neuroendocrine tumors were retrospectively analyzed, and the related literatures were reviewed. Results: All 6 patients presented with symptoms of abdominal pain. 4 patients had solitary hepatic mass and 2 patients had multiple hepatic masses. Magnetic resonance imaging showed low signal intensity on T1 weighted imaging, high signal intensity on T2 weighted imaging and clear boundary; the arterial phase of enhancement scan was uneven and enhanced, and portal venous phase or delayed phase showed continuous enhancement, surrounded by ring enhanced capsule. A pathological diagnosis was primary neuroendocrine tumor of the liver. After interventional treatment, 6 patients had some therapeutic effects. Among them, 4 patients underwent multiple interventional therapies, followed by 4 years of follow-up has shown satisfactory results. Conclusion: Primary hepatic neuroendocrine tumors are very rare and their imaging manifestations are specific. Eventually, relies on pathological and immunohistochemical diagnosis. Transarterial chemoembolization therapy can bring satisfactory results in the treatment of primary hepatic neuroendocrine tumor.

d-Glucose and amino acid deficiency inhibits casein synthesis through JAK2/STAT5 and AMPK/mTOR signaling pathways in mammary epithelial cells of dairy cows

Amino acids and energy deficiency lead to lower milk protein content in dairy cows. However, the known mechanisms involved in this process do not adequately explain the variability of milk protein concentration in the mammary gland. We hypothesized that a deficiency in d-glucose (d-Glc) or AA would inhibit casein synthesis by regulating signaling pathways in mammary epithelial cells. Cow mammary epithelial cells (CMEC) were subjected to combinations of 1 of 3 concentrations of d-Glc (0, 2.50, or 17.5 mM) and 1 of 3 concentrations of AA (0, 1.03, or 7.20 mM). The effect of each mixture on cell cycle stage was assessed by flow cytometry. The expression levels of β-casein and κ-casein (encoded by CSN2 and CSN3) were measured by quantitative real-time PCR and Western blotting. Phosphorylation of Janus kinase 2 (Jak2), signal transducer and activator of transcription 5a (Stat5a), AMP-activated protein kinase (AMPK), mammalian target of rapamycin (mTOR), ribosomal protein S6 kinase 1 (S6K1), and eukaryotic factor 4E-binding protein 1 (4EBP1) were analyzed by Western blotting. The percentages of cells in the DNA postsynthetic (G2) and DNA synthesis (S) phases would decrease, with the level of d-Glc or AA declining individually, but no interaction was observed between the d-Glc and AA effects. The CSN2 and CSN3 mRNA and protein were downregulated when d-Glc or AA decreased individually from 17.5 to 2.50 mM or from 7.20 to 1.03 mM, but d-Glc deficiency had a greater effect according to the regression analysis. The phosphorylation ratio of Jak2 (Tyr^1007/1008), Stat5a (Tyr⁶⁹⁴), mTOR (Ser²⁴⁴⁸), S6K1 (Thr³⁸⁹), and 4EBP1 (Thr³⁷) was downregulated with the level of d-Glc or AA decline, whereas the phosphorylation ratio of AMPK (Thr^183/172) was upregulated. And the change of d-Glc level had a more marked effect than AA in regulating the activity of these signaling protein above according to the regression analysis. Thus, d-Glc or AA deficiency likely reduced casein transcription via inhibition of the Jak2/Stat5 pathway, and reduced translation via suppression of the mTOR pathway by activation of AMPK, but d-Glc deficiency had a more marked effect. These indicated that deficiency of AA, and especially Glc, suppressed proliferation of CMEC and casein gene and protein expression, associated with inhibition of JAK2/STAT5 and AMPK/mTOR signaling pathways.

[Forensic Psychiatric Assessment for Organic Personality Disorders after Craniocerebral Trauma]

OBJECTIVES

To explore the occurrence and the differences of clinical manifestations of organic personality disorder with varying degrees of craniocerebral trauma.

METHODS

According to the International Classification of Diseases-10, 396 subjects with craniocerebral trauma caused by traffic accidents were diagnosed, and the degrees of craniocerebral trauma were graded. The personality characteristics of all patients were evaluated using the simplified Neuroticism Extraversion Openness Five-Factor Inventory （NEO-FFI）.

RESULTS

The occurrence rate of organic personality disorder was 34.6% while it was 34.9% and 49.5% in the patients with moderate and severe craniocerebral trauma, respectively, which significantly higher than that in the patients （18.7%） of mild craniocerebral trauma （P<0.05）. Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences （P<0.05） in the patients of mild craniocerebral trauma with personality disorder; the neuroticism, extraversion, agreeableness and conscientiousness scores showed significantly differences （ P>0.05） in the patients of moderate and severe craniocerebral trauma with personality disorder. The agreeableness and conscientiousness scores in the patients of moderate and severe craniocerebral trauma with personality disorder were significantly lower than that of mild craniocerebral trauma, and the patients of severe craniocerebral trauma had a lower score in extraversion than in the patients of mild craniocerebral trauma.

CONCLUSIONS

The severity of craniocerebral trauma is closely related to the incidence of organic personality disorder, and it also affects the clinical features of the latter, which provides a certain significance and help for forensic psychiatric assessment.

[Relationship between serum uric acid level and metabolic syndrome in Uygur children and adolescents with overweight or obesity]

OBJECTIVE

To study the relationship between serum uric acid (SUA) level and metabolic syndrome (MS) in Uygur children and adolescents with overweight or obesity.

METHODS

A total of 173 Uygur children or adolescents who were either overweight or obese and 200 controls with normal body weight were included in the study. Body weight, height, waist circumference, fasting blood glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and SUA were measured.

RESULTS

The overweight and obesity groups had significantly higher SUA levels (235 ± 42 and 285 ± 42 μmol/L respectively) than the control group (199 ± 32 μmol/L; P<0.01). The subjects with SUA levels of 300-349 μmol/L and ≥ 350 μmol/L had significantly higher incidence of MS, overweight/obesity, hypertension and dyslipidemia than those with SUA levels of <250 μmol/L and 250-299 μmol/L (P<0.01). There were significant differences in SUA levels between groups with different MS components. SUA level was significantly increased in groups with more MS components (P<0.01). Every 1 kg/m2 increment in body mass index (BMI) was associated with 5.74 μmol/L increase in SUA level, according to a multivariate regression analysis.

CONCLUSIONS

Uygur children and adolescents who are either overweight or obese have higher SUA levels than those with normal body weight. The incidence of MS and its components rises with increasing SUA level. BMI has a positive relationship with SUA.

IL-23 promotes osteoclastogenesis in osteoblast-osteoclast co-culture system

The aim of this study was to determine the effect of IL-23 on the activity and proliferation of osteoclasts (OC) in co-culture with osteoblasts (OB). OB and OC were individually separated from the skull and femoral bone of a SD rat. OB-OC co-culture with IL-23 added was designed as the experimental group, while the OB-OC co-culture without IL-23 was the control group. In the experimental group, five different concentrations of IL-23 were added, and the cells were then cultured for 24, 48 and 72 h. For each concentration at these three time points, cell proliferation, tartrate-resistant acid phosphatase (TRAP) activity and the lacunae in the bone slices were evaluated, compared with control group at the same time points. Compared to the control group, proliferation and TRAP activity of OC were significantly increased at 24, 48 and 72 h with addition of 0.5 to 10 ng/mL IL-23 (P<0.05). In addition, a dose- and time-dependent correlation between the effect of IL-23 and osteoclastogenesis was noticed though the comparison. Moreover, the area of lacunar resorption in each experimental group was significantly larger than in the control group (P<0.05). In conclusion, IL-23 promotes the proliferation, TRAP activity and bone resorption of OC in OB-OC co-culture.

Transparency and stability of Ag-based metal-dielectric multilayers

We fabricated and tested periodic metal (Ag)-dielectric (SiO2 or TiO2) multilayers with transparency bands in the visible range. For samples with Ag-TiO2 interfaces, the optical properties exhibited relatively poor predictability, likely due to oxidation of the Ag layers. Ag/SiO2-based multilayers were found to be more predictable and stable, but the relatively low refractive index of SiO2 limits their inherent transparency and pass-band bandwidth. We show that termination of the multilayer with a single high-index layer reduces the admittance mismatch with the ambient media, and thus improves the properties of the transparency band.

High expression of interleukin-1beta in the corneal epithelium of MRL/lpr mice is under the control of their genetic background

MRL/Mp mice bearing the Fas deletion mutant gene, lpr (MRL/lpr), spontaneously develop polyarthritis, sialoadenitis and dacryoadenitis, resembling rheumatoid arthritis (RA), and also corneal involvement such as keratopathy and scleritis, which is a major complication in RA patients. In this study, we found that the expression levels of IL-1beta and MMP-1 mRNAs in cornea were high in both MRL/lpr and MRL/Mp-+/+ strains of mice at an age younger than when they develop any inflammatory lesions. This was not true of other inbred strains, even those bearing the lpr gene, and also not of (NZB x NZW) F1 lupus mice. There was no significant difference in the expression of IL-1alpha and TGFbeta in cornea in these strains. Using crosses between MRL/lpr and C3H/HeJ-lpr/lpr (C3H/lpr) mice, at least the expression of IL-1beta was found to be under the control of the MRL genetic background, likely with a recessive mode of inheritance. Considering that IL-1beta in cornea was detected particularly in the epithelial layer, the high expression of IL-1beta in cornea is most likely involved in the genetic predisposition for corneal involvement and possibly also for arthritis in an MRL strain of mice.

[Sequence analysis of the late region of human papillomavirus type 6 genome]

OBJECTIVE

To study variations of genome late region of human papillomavirus type 6 (HPV-6) isolated from Chinese patients with condyloma acuminatum.

METHODS

Using overlap PCR design, major capsid protein (L1) and minor capsid protein (L2) genes were separately amplified from clinical samples following HPV type determination, and were further assembled into HPV-6 genome late region sequences after inserting into plasmid and sequencing.

RESULTS

Two sequences (GenBank accession number AY015006, AY015008) of HPV-6 late region were assembled, which are 2,869 bp long covering 35% HPV-6 genome and with complete open reading frames (ORFs) for L1 and L2. Compared with prototype sequence, nine point mutations were found, including four missense mutations, three of which were located in L2 ORF. Phylogenetic analysis indicated that the cloned sequences are classified into HPV-6b.

CONCLUSIONS

HPV-6 genome late region, especially in L1 ORF, is very conserved (variation rate < 0.28%). The mutation from A to G at position 7081 in HPV-6 genome and from G to A at 7099 may represent region characteristics. This is the first report that describes sequence variations among genome late region of HPV-6 isolated from Chinese patients.

Interleukin-6 regulation of matrix metalloproteinase (MMP-2 and MMP-9) and tissue inhibitor of metalloproteinase (TIMP-1) expression in malignant non-Hodgkin's lymphomas

We showed previously that human malignant non-Hodgkin's lymphomas (NHL) degrade extracellular matrix (ECM) components through the action of metalloproteinases and that elevated expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) correlated with a poor clinical outcome in patients with NHL. In the present study we sought to investigate whether there is any correlation between the expression of gelatinases (MMP-2 and MMP-9), TIMP-1, and the expression of cytokines and growth factors such as interleukin-1beta (IL-1beta), IL-6, IL-10, tumor necrosis factor alpha (TNF-alpha), transforming growth factor beta (TGFbeta), and basic fibroblast growth factor (bFGF) in human NHL. In lymphoma tissues obtained from 32 patients, elevated expression of IL-6 correlated significantly with elevated messenger RNA (mRNA) levels of MMP-9, MMP-2, and TIMP-1. Moreover, in human lymphoid cell lines of B- and T-cell origin (Raji, Jurkat, and NC-37), IL-6 stimulated production of MMP-9 and MMP-2 but not TIMP-1. In the Matrigel invasion assay IL-6 significantly upregulated transmigration of Raji and Jurkat cells, which in turn was inhibited by recombinant human TIMP-1 and anti-MMP-9 and MMP-2 antibodies. We postulate that IL-6 may play a role in the clinical aggressiveness of human NHL by stimulating MMP production.

Expression of matrix metalloproteinases (MMP-2 and -9) and tissue inhibitors of metalloproteinases (TIMP-1 and -2) in acute myelogenous leukaemia blasts: comparison with normal bone marrow cells

We compared the expression of matrix metalloproteinases (MMP-2 and MMP-9) and tissue inhibitors of metalloproteinases (TIMP-1 and TIMP-2) in bone marrow acute myelogenous leukaemia (AML) blasts and leukaemic cell lines (HEL, HL-60, K-562 and KG-1) with their expression in normal bone marrow cells. All AML samples and leukaemic cell lines tested expressed MMP-9 and/or MMP-2 mRNA and, accordingly, these gelatinases were secreted into media. Moreover, TIMP-1 and TIMP-2 mRNA and secreted proteins were demonstrated in all the AML samples. Although all the leukaemic cell lines expressed TIMP-1, the HL-60 cells also expressed TIMP-2. In contrast, normal steady-state bone marrow immature progenitor cells (CD34+ cells) did not express or secrete either MMP-2 or MMP-9, but more mature mononuclear cells from normal bone marrow expressed and secreted MMP-9. Also, normal bone marrow CD34+ cells and mononuclear cells expressed TIMP-1 and TIMP-2 mRNA, but these proteins were not detectable by reverse zymography. Furthermore, whereas bone marrow fibroblasts and endothelial cells secreted only latent MMP-2, the activated form of this enzyme was found in media conditioned by cells obtained from long-term cultures of normal and AML bone marrow adherent layers. Our finding of up-regulated production of gelatinases, TIMP-1 and TIMP-2 by leukaemic cells suggests that these proteins may be implicated in the invasive phenotype of AML.

Cutis laxa arising from frameshift mutations in exon 30 of the elastin gene (ELN)

Congenital cutis laxa, a rare syndrome with marked skin laxity and pulmonary and cardiovascular compromise, is due to defective elastic fiber formation. In several cases, skin fibroblast tropoelastin production is markedly reduced yet reversed in vitro by transforming growth factor-beta treatment. We previously showed that this reversal was due to elastin mRNA stabilization in one cell strain, and here this behavior was confirmed in skin fibroblasts from two generations of a second family. cDNA sequencing and heteroduplex analysis of elastin gene transcripts from three fibroblast strains in two kindreds now identify two frameshift mutations (2012DeltaG and 2039DeltaC) in elastin gene exon 30, thus leading to missense C termini. No other mutations were present in the ELN cDNA sequences of all three affected individuals. Transcripts from both alleles in each kindred were unstable and responsive to transforming growth factor-beta. Exons 22, 23, 26A, and 32 were always absent. Since exon 30 underwent alternative splicing in fibroblasts, we speculate that a differential splicing pattern could conceivably lead to phenotypic rescue. These two dominant-acting, apparently de novo mutations in the elastin gene appear to be responsible for qualitative and quantitative defects in elastin, resulting in the cutis laxa phenotype.

Transforming growth factor-beta reverses a posttranscriptional defect in elastin synthesis in a cutis laxa skin fibroblast strain

Skin fibroblasts from two cases of autosomal recessive cutis laxa (CL), having insignificant elastin production and mRNA levels, were challenged with transforming growth factor beta-1 (TGF-beta 1). Elastin production was brought from undetectable values to amounts typical of normal human skin fibroblasts in a dose-dependent fashion. Basic fibroblast growth factor (100 ng/ml) alone or in combination with TGF-beta 1 reduced elastin production and mRNA expression in CL skin fibroblasts more extensively than in normal cells. In situ hybridization showed that these effects were at the transcript level. One of the CL strains was examined in detail. Transcription rates for elastin were similar in normal and CL and unchanged by TGF-beta 1 or TGF-beta 2 (10 ng/ml), while in CL elastin mRNA half-life was increased > 10-fold by TGF-beta 2 and reduced 6-fold after TGF-beta 2 withdrawal, as compared with a control strain. Cycloheximide partially reversed elastin mRNA instability. These data are consistent with a defect in elastin mRNA stability that requires synthesis of labile factors or intact translational machinery, resulting in an extremely low steady state level of mRNA present in this strain of CL. Furthermore, TGF-beta can relieve elastin mRNA instability in at least one CL strain and elastin production defects in both CL strains.

Trial of deltamethrin impregnated bed nets for the control of malaria transmitted by Anopheles sinensis and Anopheles anthropophagus

In 1985-1987, a field trial of malaria control using deltamethrin impregnated mosquito nets was carried out with 4,450 people in the Buji district, Bao'an County, Guangdong Province, China. The vectors were exophilic Anopheles sinensis (80%) and the endophilic and anthropophilic An. anthropophagus (20%). The first impregnation of the nets was in June 1985 and the second in April 1986. About 87% of the population slept under treated nets. The indoor vector density decreased by 93% and remained at the same level during the second year. During the second year the average monthly malaria incidence was 1.3% for January-June, a decrease of 74.6% as compared with pretreatment data, and 0.85% from July to December, a decrease of 92.7%. In April 1986 and April 1987, the treatment was extended to the whole Buji District, which has a total population of approximately 40,000. The average monthly malaria incidence (April-December 1986 and 1987) was 0.54% and 0.17%, a decrease of 64.7% and 89% respectively as compared with the same period for the previous year.