Sub-region based radiomics analysis for prediction of isocitrate dehydrogenase and telomerase reverse transcriptase promoter mutations in diffuse gliomas

AIM

To enhance the prediction of mutation status of isocitrate dehydrogenase (IDH) and telomerase reverse transcriptase (TERT) promoter, which are crucial for glioma prognostication and therapeutic decision-making, via sub-regional radiomics analysis based on multiparametric magnetic resonance imaging (MRI).

MATERIALS AND METHODS

A retrospective study was conducted on 401 participants with adult-type diffuse gliomas. Employing the K-means algorithm, tumours were clustered into two to four subregions. Sub-regional radiomics features were extracted and selected using the Mann-Whitney U-test, Pearson correlation analysis, and least absolute shrinkage and selection operator, forming the basis for predictive models. The performance of model combinations of different sub-regional features and classifiers (including logistic regression, support vector machines, K-nearest neighbour, light gradient boosting machine, and multilayer perceptron) was evaluated using an external test set.

RESULTS

The models demonstrated high predictive performance, with area under the receiver operating characteristic curve (AUC) values ranging from 0.918 to 0.994 in the training set for IDH mutation prediction and from 0.758 to 0.939 for TERT promoter mutation prediction. In the external test sets, the two-cluster radiomics features and the logistic regression model yielded the highest prediction for IDH mutation, resulting in an AUC of 0.905. Additionally, the most effective predictive performance with an AUC of 0.803 was achieved using the four-cluster radiomics features and the support vector machine model, specifically for TERT promoter mutation prediction.

CONCLUSION

The present study underscores the potential of sub-regional radiomics analysis in predicting IDH and TERT promoter mutations in glioma patients. These models have the capacity to refine preoperative glioma diagnosis and contribute to personalised therapeutic interventions for patients.

[Dosimetric analysis of different optimization algorithms for three-dimensional brachytherapy for gynecologic tumors]

OBJECTIVE

To investigate the dosimetric difference between manual and inverse optimization in 3-dimensional (3D) brachytherapy for gynecologic tumors.

METHODS

This retrospective study was conducted among a total of 110 patients with gynecologic tumors undergoing intracavitary combined with interstitial brachytherapy or interstitial brachytherapy. Based on the original images, the brachytherapy plans were optimized for each patient using Gro, IPSA1, IPSA2 (with increased volumetric dose limits on the basis of IPSA1) and HIPO algorithms. The dose-volume histogram (DVH) parameters of the clinical target volume (CTV) including V200, V150, V100, D90, D98 and CI, and the dosimetric parameters D2cc, D1cc, and D0.1cc for the bladder, rectum, and sigmoid colon were compared among the 4 plans.

RESULTS

Among the 4 plans, Gro optimization took the longest time, followed by HIPO, IPSA2 and IPSA1 optimization. The mean D90, D98, and V100 of HIPO plans were significantly higher than those of Gro and IPSA plans, and D90 and V100 of IPSA1, IPSA2 and HIPO plans were higher than those of Gro plans (P < 0.05), but the CI of the 4 plans were similar (P > 0.05). For the organs at risk (OARs), the HIPO plan had the lowest D2cc of the bladder and rectum; the bladder absorbed dose of Gro plans were significantly greater than those of IPSA1 and HIPO (P < 0.05). The D2cc and D1cc of the rectum in IPSA1, IPSA2 and HIPO plans were better than Gro (P < 0.05). The D2cc and D1cc of the sigmoid colon did not differ significantly among the 4 plans.

CONCLUSION

Among the 4 algorithms, the HIPO algorithm can better improve dose coverage of the target and lower the radiation dose of the OARs, and is thus recommended for the initial plan optimization. Clinically, the combination of manual optimization can achieve more individualized dose distribution of the plan.

Image quality and evaluation ability of magnetic resonance imaging techniques for thyroid-associated ophthalmopathy: Dixon fat-suppression technique vs. spectral attenuated inversion recovery

Purpose

We aimed to compare two magnetic resonance imaging (MRI) techniques, Dixon and spectral attenuated inversion recovery (SPAIR) fat-suppression, in terms of image quality and suitability for evaluating thyroid-associated ophthalmopathy (TAO) lesion characteristics.

Methods

This cross-sectional, retrospective study involved 70 patients with TAO (140 eyes) who underwent orbital coronal MRI examinations, including Dixon-transverse relaxation (T2)-weighted imaging (T2WI) and SPAIR-T2WI, between 2020 and 2022. We compared the fat-suppression quality and artifacts, noise (N), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), signal intensity ratio (SIR) of extraocular muscles (SIR-EOM) and lacrimal glands (SIR-LG), and TAO activity evaluation efficiency.

Results

Dixon-T2WI showed a higher frequency of better subjective image quality and suitability for evaluating the characteristics of TAO lesions (65.7% vs. 14.3%) than SPAIR-T2WI. Fat-suppression quality and artifact scores were lower for Dixon-T2WI than for SPAIR-T2WI (p < 0.001). The N, SNR, and CNR values, EOM-SIR, and LG-SIR were higher for orbital coronal Dixon-T2WI than for SPAIR-T2WI (all p < 0.001). Clinical activity scores (CASs) showed positive correlations with SIR. The correlation between EOM-SIR and LG-SIR of orbital coronal Dixon-T2WI with CAS was higher than that of SPAIR-T2WI (0.590 vs. 0.493, all p < 0.001; 0.340 vs. 0.295, all p < 0.01). EOM-SIR and LG-SIR of Dixon-T2WI yielded a higher area under the curve than SPAIR-T2WI for evaluating TAO activity (0.865 vs. 0.760, p < 0.001; 0.695 vs. 0.617, p = 0.017).

Conclusion

Dixon-T2WI yields higher image quality than SPAIR-T2WI. Furthermore, it has a stronger ability to evaluate TAO inflammation than SPAIR, with higher sensitivity and specificity in active TAO staging.

Pregnancy outcome after in-vitro fertilization/intracytoplasmic sperm injection in women with congenital uterus didelphys

OBJECTIVE

To investigate the pregnancy and obstetric outcomes of patients with congenital uterus didelphys who achieved clinical pregnancy after in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).

METHODS

This was a retrospective matched-cohort study of 83 infertile patients with uterus didelphys who underwent IVF/ICSI and achieved clinical pregnancy from January 2005 to December 2018 at our center. For each patient in the study group, three control patients with normal uterine morphology who underwent IVF/ICSI in 2018 were selected randomly. Patients in the two groups were matched for number of gestational sacs, maternal age, infertility type, cause of infertility, fertilization method, endometrial thickness 1 day before embryo transfer and number of embryos transferred. The classification of congenital uterine anomalies was based on the American Fertility Society system (1988). The pregnancy and obstetric outcomes of the didelphic and control groups were compared separately for singleton and twin pregnancies, and for all pregnancies combined.

RESULTS

In singleton pregnancies, women with uterus didelphys had increased risk of preterm birth (odds ratio (OR), 4.68; rate difference (RD), 0.14; P < 0.001), Cesarean section (OR, 2.80; RD, 0.17; P = 0.016) and birth weight < 2500 g (OR, 4.06; RD, 0.10; P = 0.017) compared to women with normal uterine morphology. In twin pregnancies, the presence of uterus didelphys was associated with increased risk of preterm delivery (OR, 4.79; RD, 0.37; P = 0.006), perinatal mortality (OR, 3.16; RD, 0.19; P = 0.043) and birth weight < 2500 g (OR, 9.57; RD, 0.35; P = 0.001).

CONCLUSIONS

The presence of uterus didelphys was associated with significantly increased risk of some adverse pregnancy outcomes compared to pregnancies with normal uterine morphology in women who underwent IVF/ICSI. A twin pregnancy in women with uterus didelphys was associated with worse perinatal outcome. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Dietary Supplement Use during Pregnancy: Perceptions versus Reality

This study aimed to examine the prevalence, associated factors and perceptions of dietary supplement use among pregnant Chinese women. A cross-sectional study was conducted to collect data about prevalence, purchase channels, perceptions, and related factors of dietary supplement use from 572 pregnant women, through a face-to-face survey, using a self-designed questionnaire. Of the respondents, 94.8% used at least one dietary supplement, whereas 29.8% used more than four supplements in the previous month. The majority of the pregnant women were highly educated (81.2% had a bachelor’s degree or above) and had the perception that dietary supplements could prevent and improve (89.2%), or treat, nutrition-related diseases (78.7%). Multivariate analysis showed that pregnant women who had used multiple (more than four) supplements were more likely to have a larger gestational age, received fertility treatment, more prenatal visits, and hypothyroidism during pregnancy. Furthermore, pregnant women not only purchased dietary supplements through hospitals (72.6%) and pharmacies (45.1%), but overseas Daigou or online purchases (31.8%) were also a major channel of purchase. A high prevalence of dietary supplement use during pregnancy was observed, with extensive and repeated consumption of nutrients. Pregnant women’s craze for dietary supplements calls for more comprehensive guidelines in China.

Association between Free Sugars Intake and Excessive Daytime Sleepiness among Chinese Adolescents

This study aimed to investigate the prevalence of excessive daytime sleepiness (EDS) and explore the association between free sugars intake and EDS. In this cross-sectional study, a total of 1517 middle school students (808 boys and 707 girls) aged 12~14 years were recruited. The study was conducted in Changsha city, China. Adolescents completed an online questionnaire, including the Epworth Sleepiness Scale (ESS), sleep characteristics, a 12-item Food Frequency Questionnaire (FFQ), and other self-reported information. The ESS score ≥ ten was defined as EDS. The anthropometric indices, including height, weight, and waist circumference, were measured and recorded by uniformly trained assistants. Statistical analyses included the Chi-square test and binary logistic regression model. The mean ESS score and free sugars consumption were 6.8 ± 3.9 points and 53.1 ± 44.7 g/d, respectively. The prevalence of EDS among adolescents was 22.5%, and more girls than boys had EDS (26.1% vs. 19.4%, p < 0.05). An exceeded free sugars intake was positively associated with EDS, with the adjusted Odds Ratio (OR) with its 95% Confident Interval (95% CI) of 1.366 (1.060~1.761, p < 0.05). EDS and excessive consumption of free sugars are commonly found among Chinese adolescents. Further studies are needed to confirm whether free sugars restriction can be meaningful to improve daytime drowsiness in those with EDS.

Fate and transport in environmental quality

Changes in pollutant concentrations in environmental media occur both from pollutant transport in water or air and from local processes, such as adsorption, degradation, precipitation, straining, and so on. The terms "fate and transport" and "transport and fate" reflect the coupling of moving with the carrier media and biogeochemical processes describing local transformations or interactions. The Journal of Environmental Quality (JEQ) was one of the first to publish papers on fate and transport (F&T). This paper is a minireview written to commemorate the 50th anniversary of JEQ and show how the research interests, methodology, and public attention have been reflected in fate and transport publications in JEQ during the last 40 years. We report the statistics showing how the representation of different pollutant groups in papers changed with time. Major focus areas have included the effect of solution composition on F&T and concurrent F&T, the role of organic matter, and the relative role of different F&T pathways. The role of temporal and spatial heterogeneity has been studied at different scales. The value of long-term F&T studies and developments in modeling as the F&T research approach was amply demonstrated. Fate and transport studies have been an essential part of conservation measure evaluation and comparison and ecological risk assessment. For 50 years, JEQ has delivered new insights, methods, and applications related to F&T science. The importance of its service to society is recognized, and we look forward to new generations of F&T researchers presenting their contributions in JEQ.

P–357 The risk factors for early pregnancy loss based on a logistic model following 13,977 infertile patients after in vitro fertilization

Study question

What are the risk factors for early pregnancy loss (EPL) after in vitro fertilization-embryo transfer (IVF-ET)?

Summary answer

The maternal age, gestational sac diameter, embryonic length, yolk sac diameter, heart rate of day 27–29 and endometrium thickness on transfer day were risk factors. What is known already: The first routine ultrasound scan is commonly arranged on day 27–29 after IVF-ET in most reproductive centers in China to determine the location and viability of the embryo. Individual maternal factors, such as a high maternal age (MA) and abnormal ultrasound parameters such as embryonic bradycardia and excessively large or small yolk sac diameter (YSD) have been shown to be associated with pregnancy failures. However, few studies focused on the risk factors of the IVF population, and little is known about the clinical meaning of ultrasound indicators of 27–29 days after transplantation.

Study design, size, duration

This was a retrospective study in a single reproductive centre. The infertile patients included in this study underwent IVF treatment between June 2016 to December 2017. Participants/materials, setting, methods: During this period, 13,977 women were identified with a singleton pregnancy by TVS at day 27–29 after IVF-ET. The gestational sac diameter (GSD), embryonic length (EL), embryonic heart rate (EHR) and YSD and the presence of intrauterine hematoma (IUH) were measured. The clinical characteristics were also collected. The first trimester pregnancy outcome of these women was noted at 12 weeks of gestation. A backward Wald logistic regression model was established to screen the risk factors.

Main results and the role of chance

1,926 cases of spontaneous miscarriage ≤12 weeks of gestation, which were assigned as EPL and 12,051 women with an ongoing pregnancy for &gt;12 weeks of gestation.

When compared with the ongoing pregnancy group, the MA, infertility duration and transfer cycle were significantly higher, and the day–14 human chorionic gonadotrophin and the endometrium (EM) thickness on transfer day were significantly lower in the EPL group (p &lt; 0.001). Based on the TVS measurements, the GSD (18.5±3.6 vs. 13.2±4.8 mm), EL (3.5±0.9 vs. 1.2±1.6 mm), YSD (3.6±0.4 vs. 2.6±1.5 mm) and EHR (114.5±12.2 vs. 42.4±53.5 bpm) were significantly greater in the ongoing pregnancy group than those in the EPL group (p &lt; 0.001). The incidence of IUH (16.0% vs. 18.8%, P = 0.002) was also markedly higher in the EPL group

MA, GSD, EL, YSD, EHR and EM on transfer day finally entered the logistic model after stepwise screening. The probability of EPL was: exp(z)/(1 + exp(z)), where z = 2.432 + (0.092 × MA) - (0.074 × EM) - (0.114 ×GSD) - (0.245 × EL) - (0.034 × HR) - (0.159 × YSD).

Limitations, reasons for caution

Data on smoking and clinical symptoms such as vaginal bleeding or abdominal pain were not included in the final analysis which might be possible risk factors. These predictors were derived from an IVF population, the situation may not be the same in the general population.

Wider implications of the findings: The risk factors for EPL after IVF-ET are clearly identified in this study. The logistic model which incorporates readily available data that are routinely collected in clinical practice could be used for calculating the risk of EPL and effectively guide subsequent medical plans.

Trial registration number

None

P–405 The diagnosis and management of heterotopic intramural pregnancy after in vitro fertilization-embryo transfer: six-case series

Study question

What are the ultrasonic characteristics of heterotopic intramural pregnancy (HIMP)? How to manage and what about the clinical outcomes of HIMP?

Summary answer

Expectant management may be a considerable choice for an non-viable intramural pregnancy (IMP). Most intrauteine pregnancies (IUPs) of HIMPs seems to have good outcomes.

What is known already

Heterotopic pregnancy (HP) post in vitro fertilization is very rare in infertility women, with a prevalence of 0.04%. HIMP is one of the rarest types of HP, where one gestational sac (GS) is embedded within the endometrial cavity and the other one GS is implanted in the myometriun. HIMP was firstly and only described by Jiangtao Lyu et al. in 2018. So far, little is known about its natural history and ultrasonic imaging characteristics. And there is no consensus regarding the ultrasound diagnosis and clinical management for HIMP due to few evidence-based medicine records.

Study design, size, duration

A retrospective observational study was conducted of 6 infertile women who obtained a HIMP through in vitro fertilization-embryo transfer (IVF-ET) between January 2009 and December 2019 at our reproductive centre.

Participants/materials, setting, methods

Six infertile women conceived a HIMP via IVF-ET were retrospectively retrieved between January 2009 and December 2019 at the Reproductive and Genetic Hospital of CITIC-Xiangya (Changsha City, China). The ultrasound diagnosis, clinical management and pregnancy outcome of these cases were analysed. The ultrasound findings, therapeutic methods and clinical outcomes were obtained from the hospital’s electronic medical records. This study was approved by the local ethics committee. Main results and the role of chance: Six women with HIMPs were retrospectively analysed. Among them, 5 cases were revealed by ultrasound scans; however, one case was misdiagnosed. The diagnostic accuracy was 83.3%.

Five cases of HIMP were diagnosed at initial scan. The diagnostic time ranged from 22 to 38 days after ET (5 + 6 - 7 + 6 weeks). Among them, an intramural GS was observed in all 5 cases; embryonic cardiac activity (ECA) was detected in one case by the followed-up scans; there was a yolk sac only in one case; an empty GS was noted in 3 cases. An IUP was revealed in all 6 cases, and ECA was observed in 5 cases at the initial diagnosis or later. A GS with a yolk sac only was showed in one case.

Among the 5 diagnostic women, one case with a live IMP was treated with laparoscopy at 8 + 1 weeks, 4 cases were managed expectantly. Of them, the IUPs of 4 cases delivered live infants and one case managed expectantly experienced miscarriage. In one case, IMP was misdiagnosed as interstitial pregnancy at day–28 scan. Exploratory laparoscopy and foetal reduction were performed at 8 + 2 weeks. Laparoscopy confirmed an IMP and the retained IUP delivered a live infant.

Limitations, reasons for caution

The case numbers are too few to draw any objective conclusions, because of the extreme rarity of HIMP. Thus, a further multi-centre larger prospective study will help to confidently illustrate the clinical significance, and effective and appropriate management method for women with a HIMP.

Wider implications of the findings: Our study showed that HIMP may not be as rare as previously reported. Increased awareness of this condition, better comprehension of the diagnostic criteria and improved resolution of ultrasound equipment may result in more frequent and accurate detection of HIMP, which will be helpful for early management to preserve IUP.

Trial registration number

Not applicable.

[Choices of emergency treatment and surgical method for ruptured abdominal aortic aneurysms]

Objective: To investigate the emergency management process of ruptured abdominal aortic aneurysm (RAAA), and analyze the perioperative mortality factors of different surgical methods. Methods: The emergency data and hospitalization data of 91 patients with ruptured abdominal aortic aneurysm in Xiangya Hospital of Central South University from June 2010 to June 2019 were retrospectively analyzed.Twelve of the patients died preoperatively due to excessive blood loss, and the remaining 79 patients were hospitalized for open surgery (OSR) or endovascular repair (EVAR).The differences in age, time to hospital arrival, emergency preparation time, first creatinine value, emergency infusion volume, preoperative drop in blood pressure, preoperative use of vasoactive drugs and iliac artery involvement were compared between preoperative death group (n=12) and preoperative survival group (n=79), OSR group (n=50) and EVAR group (n=29), postoperative death group (n=23) and postoperative survival group (n=56). Results: Seventy-nine patients received open surgery or endovascular repair, and 23 died after operation. Age, time to hospital arrival, first creatinine value and emergency infusion volume were (77±11) years, (18±5)h, (469±150) μmol/L, (4 140±1 743) ml in the preoperative death group and (70±10) years, (12±8) h, (228±174) μmol/L, (1 358±1 211) ml in the preoperative survival group, respectively, and the differences were statistically significant (all P<0.05). There were no significant differences in preoperative data, intraoperative treatment and postoperative perioperative mortality between the open surgery group and the endovascular repair group (all P>0.05). The intraoperative blood loss, operation time and aortic occlusion rate in the endovascular repair group were 100 (50, 175) ml, (3.2±0.9) h, 13.8%, respectively, which were better than that in the open surgery group 1700 (600, 3425) ml, (5.2±1.1) h, 100%. The differences were statistically significant (all P<0.05). Age, emergency preparation time, first creatinine value, emergency infusion volume, blood pressure decline rate and vasoactive drug utilization rate in the death group were (77±8) years, (4.1±1.7) h, (456±172) μmol/L, (2 024±1 687) ml, 100%, 100%, respectively, and (68±10) years, (2.7±2.2) h, (135±26) μmol/L, (1 085±825) ml, 21.4%, 12.5% in the survival group, respectively. The differences were statistically significant (all P<0.05). Conclusions: Age, emergency preparation time, first creatinine value, emergency infusion volume, decreased blood pressure and use of vasoactive drugs are all associated with perioperative death in patients with ruptured abdominal aortic aneurysm. EVAR surgery is a better choice if conditions exist.

Field Ecology and Food Suitability of Tarsonemus spp. (Acari: Tarsonemidae)

Tarsonemus bakeri Ewing (Acari: Tarsonemidae) is a species of mite commonly associated with citrus in many countries including the United States. A short report in 1942 suggested this species is phytophagous, but it has not been reported as a pest in citrus or any other crop since then. A single survey of 78 orchards in three growing regions in California demonstrated that Tarsonemus spp. mites were only associated with leaf samples that had visible sooty mold. A seasonal population study in one citrus orchard showed that all life stages of Tarsonemus spp. were present year-round on leaves and fruit, with the population on fruit reaching a peak in December (59.7 ± 15.2 mites per fruit). Results from a food suitability study showed that the population declined sharply on both plastic and leaf substrate when the mites were not provided a supplementary food source. When supplementary food was provided in the form of Alternaria, honeydew, molasses, or combinations of these, mites survived and multiplied throughout the 29-d study, irrespective of the substrate. Tarsonemus bakeri were found on excised, decaying leaves collected from an orchard. These studies verify that Tarsonemus spp. are associated only with sooty mold in citrus orchards. T. bakeri populations cannot sustain themselves on leaf tissue alone, indicating that they are nondamaging to citrus and therefore need not be considered a phytosanitary concern by importing countries.

Triglyceride-Glucose Index and Extracellular Volume Fraction in Patients With Heart Failure

Background: The triglyceride–glucose (TyG) index had been proposed as a reliable surrogate marker of insulin resistance. We aimed to evaluate the association between TyG index and myocardial fibrosis, which was quantified by extracellular volume (ECV) fraction using cardiovascular magnetic resonance (CMR) examination, and their prognostic value in patients with heart failure (HF).

Methods: In this retrospective cohort study, 103 hospitalized HF patients were included. ECV fraction was calculated using CMR measurements and T1 mapping. TyG index was calculated using fasting triglyceride and blood glucose. The primary outcome events were defined as all-cause mortality and HF hospitalization during follow-up.

Results: During the median follow-up of 12.3 months, 39 patients (37.9%) experienced primary outcome events and had higher levels of TyG index, N-terminal pro–B-type natriuretic peptide (NT-proBNP), and ECV fraction compared with those without events. Multivariate linear regression analysis showed that the TyG index was the significant factor determined for ECV fraction (r_partial = 0.36, P = 0.01). In multivariate Cox regression analysis, presence of diabetes [hazard ratio (HR) = 1.28, 95% confidence interval (CI) = 1.01–1.62], higher TyG index (HR = 2.01, 95% CI = 1.03–4.01), ECV fraction (HR = 1.73, 95% CI = 1.04–2.88), and NT-proBNP (HR = 2.13, 95% CI = 1.08–4.20) were independent risk factors for the primary outcome events.

Conclusions: TyG index is a novel biomarker of myocardial fibrosis in HF patients and can be considered as a useful risk stratification metric in the management of HF.

The Relationship between Restrained Eating, Body Image, and Dietary Intake among University Students in China: A Cross-Sectional Study

This study aims to explore the association between restrained eating, body image, and dietary intake among Chinese college students. This cross-sectional study included 1301 college students at two universities in Hunan Province. Electronic questionnaires were used to collect information including students’ demographic characteristics, restrained eating, perception of body weight, body satisfaction, and dietary intake. Anthropometric measurements were collected to calculate body mass index (BMI). The prevalence of high restrained eating was 52.8%. Students who were dissatisfied with their bodies or overestimated their body weight showed a higher tendency toward high restrained eating (p < 0.05). Students with high restrained eating tended to eat fruits and eggs more frequently, while the frequency of eating domestic animals and poultry, sugar-sweetened beverages, and fast food were the opposite. Moreover, high restrained eating was a risk factor for low dietary diversity (odds ratio (OR) = 1.384, 95% confidence interval: 1.002~1.912). The high incidence of restrained eating among Chinese college students and its energy-restricted diets that may lead to possible health implications require attention. Further studies are needed to investigate the characteristics of college students’ restrained eating to tailor appropriate interventions for forming positive body images and promoting healthy eating behaviors, thus, improving dietary quality.

Xiangshao granules can relieve emotional symptoms in menopausal women: a randomized controlled trial

OBJECTIVE

This study aimed to investigate the safety and efficacy of Xiangshao granules for treating emotional disorders in perimenopausal and postmenopausal women.

METHODS

The current investigation was a double-blind, randomized, placebo-controlled, multicenter trial that included 300 perimenopausal and postmenopausal Chinese women aged 40-60 years. Participants received either a placebo (n = 150) or Xiangshao granules (n = 150) for 8 weeks. Outcome measures included Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) scores, which were assessed at baseline, 4 weeks, and 8 weeks. The primary efficacy variables were changes in HAMD and HAMA scores after 8 weeks.

RESULTS

After 8 weeks, the mean HAMD scores decreased from 15.0 to 7.9 in the Xiangshao group and from 16.3 to 10.0 in the placebo group, and the respective mean reductions in HAMA scores were from 16.0 to 8.5 and from 17.1 to 10.9. Clinical improvements in symptoms of both depression and anxiety after 8 weeks differed significantly in the two groups (p < 0.05). The cure rate was significantly higher in the Xiangshao group. There were no significant differences in the rates of adverse events in the two groups.

CONCLUSIONS

Xiangshao granules can relieve symptoms of depression and anxiety significantly and safely.

Association between Emotional Eating, Depressive Symptoms and Laryngopharyngeal Reflux Symptoms in College Students: A Cross-Sectional Study in Hunan

This study aims to explore associations between emotional eating, depression and laryngopharyngeal reflux among college students in Hunan Province.

METHODS

This cross-sectional study was conducted among 1301 students at two universities in Hunan. Electronic questionnaires were used to collect information about the students' emotional eating, depressive symptoms, laryngopharyngeal reflux and sociodemographic characteristics. Anthropometric measurements were collected to obtain body mass index (BMI).

RESULTS

High emotional eating was reported by 52.7% of students. The prevalence of depressive symptoms was 18.6% and that of laryngopharyngeal reflux symptoms 8.1%. Both emotional eating and depressive symptoms were associated with laryngopharyngeal reflux symptoms (AOR = 3.822, 95% CI 2.126-6.871 vs. AOR = 4.093, 95% CI 2.516-6.661).

CONCLUSION

The prevalence of emotional eating and depressive symptoms among Chinese college students should be pay more attention in the future. Emotional eating and depressive symptoms were positively associated with laryngopharyngeal symptoms. The characteristics of emotional eating require further study so that effective interventions to promote laryngopharyngeal health among college students may be formulated.

Curative effects of vancomycin and cefotaxime combined with gamma globulin respectively in neonatal septicemia and their influences on PCT, CRP and hs-CRP

OBJECTIVE

To explore the curative effects of vancomycin and cefotaxime combined with gamma globulin respectively in neonatal septicemia and their influences on PCT, CRP, and hs-CRP, so as to provide references for clinical treatment.

PATIENTS AND METHODS

181 patients with neonatal septicemia admitted to Huangshi Maternity and Child Health Hospital from April 2012 to August 2014 were selected as the study subjects. Patients treated with vancomycin combined with gamma globulin were selected as group A (96 cases) and those treated with cefotaxime combined with gamma globulin were selected as group B (85 cases). The improvement time of clinical symptoms (milk rejection, nervous system symptoms, body temperature), hospital stays, mortality, medicine curative effects, adverse reactions, complications, and levels of serum CRP, PCT, and hs-CRP of patients before and after treatment were compared between the two groups.

RESULTS

The improvement time of clinical symptoms like body temperature, milk rejection, and neurological symptoms, as well as hospital stays in group A were lower than those in group B (p<0.05); the total effective rate of medicine curative effects in group B was better than that in group A (p<0.05); there was no significant difference in levels of serum CRP, PCT, and hs-CRP between the two groups before treatment (p>0.05); after treatment, levels of serum CRP, PCT, and hs-CRP in both groups decreased significantly, and levels of serum CRP, PCT, and hs-CRP in group B decreased more significantly than those in group A (p<0.05).

CONCLUSIONS

Cefotaxime combined with gamma globulin in the treatment of patients with neonatal septicemia has short improvement time in clinical symptoms, high total effective rate of drugs, low mortality, fewer adverse reactions and complications, and can significantly reduce levels of serum CRP, PCT, and hs-CRP, which is worthy of further promotion and application in clinical practice.

STIL is upregulated in nasopharyngeal carcinoma tissues and promotes nasopharyngeal carcinoma proliferation, migration and invasion

Nasopharyngeal carcinoma (NPC) is the most common primary malignancy that originates from the nasopharynx. Some regulatory networks involved in nasopharyngeal carcinoma have been reported, but the relevant genes have not been fully identified. We have used mRNA microarray to identify differential expression genes between NPC tissues and adjacent normal tissues. Then high-content shRNA screening was carried out to screen the genes that may control proliferation in nasopharyngeal carcinoma. Cell proliferation was monitored by MTT assays and Celigo image cytometry in vitro and subcutaneous transplantation model in vivo. Flow cytometric analysis was carried out to detect the distribution of cell cycle stages and apoptosis. Transwell assay was performed to measure the migratory and invasive capacities of NPC cells. We identified 20 genes that potentially play an important role in the proliferation of nasopharyngeal carcinoma by mRNA microarray and functional analysis. The result of high-content shRNA screening indicated that STIL had the greatest effect on reducing the proliferation rate of NPC cells. The analysis of The Cancer Genome Atlas (TCGA) data showed that STIL was upregulated in several human cancer tissues, and higher STIL expression level was correlated with shorter survival time. STIL knockdown also inhibited NPC cell migration and invasion, promoted G1/S phase transition and apoptosis. Three genes including ITGA2, SMAD2, JAK1, associated with molecular mechanisms of cancer were influenced by downregulating STIL. Our study confirmed STIL as a key regulator that promotes the proliferation of NPC, providing insight into the molecular mechanisms of nasopharyngeal carcinoma and suggesting a novel therapeutic strategy.

Mental health symptoms among rural adolescents with different parental migration experiences: A cross-sectional study in China

In rural regions of China, the rural-to-urban migrant worker population and their left-behind children-60 million children who remain in home villages-have diversified the rural adolescence experience in terms of family life, compounding known mental health disparities. This study examined the impact of a comprehensive panel of home- and school-related variables on the prevalence of three common mental health complaints among rural adolescents. Data were collected using a self-formulated questionnaire administered to 1347 seventh grade students in a rural county of Hunan Province in Fall 2017. The prevalence of mental health symptoms was 10-18%. Bullying, loneliness, and stress from home and school environments were risk factors; good life satisfaction and willingness to reach out to adult and peer social networks were protective. Being a left-behind child was only significantly associated with depression symptoms, and notably, none of the other variables specific to left-behind children were found to be influential on mental health outcomes. These results suggest that the school-related factors included in our analysis accounted for a share of the risk typically explained by home-related factors alone. Schools may therefore be reliable settings for mental health programs in rural areas with ever more unpredictable home environments.

Cross-cultural adaption and validation of the Chinese version of the Child Food Neophobia Scale

OBJECTIVE

To adapt the Child Food Neophobia Scale (CFNS) cross-culturally for use among 12-36-month-old Chinese toddlers and to perform a preliminary assessment of its construct validity and reliability.

BACKGROUND

Food neophobia is the fear of eating new or unfamiliar foods, which affects the type and quality of individual dietary intake, especially during early childhood. However, measurements of child food neophobia have rarely been reported in China due to a lack of reliable and valid measurements.

METHODS

The CFNS was translated and adapted into a Chinese version (CFNS-CN) through a forward translation, reconciliation, a back translation, expert review and pretesting. The construct validity and reliability of the CFNS-CN were tested in 390 caregivers of 12-36 months old Chinese toddlers through convenience sampling in Changsha Maternal and Child Health Care Hospital, Hunan Province, China. The internal consistency, confirmatory factor analysis (CFA) and reliability were estimated.

RESULTS

The kappa coefficients indicated moderate to perfect agreement between the test and retest, and Cronbach's α coefficient was 0.91. A normal χ²/df, CMIN/DF=3.302, Comparative Fit Index, CFI=0.993, Tucker-Lewis Index, TLI=0.986 and root mean square error of approximation, RMSEA=0.077 were found. The CFA results showed that the model indicators were acceptable. High food neophobia was observed in 25.1% of individuals.

CONCLUSION

The CFNS-CN showed good internal consistency reliability and construct validity. The CFNS-CN may become an effective tool for assessing food neophobia in Chinese toddlers.

TRIAL REGISTRATION

This trial was pre-registered at the China Clinical Trial Registration Center under registration number ChiCTR1800015890.

Dietary Supplement Use Among Chinese Primary School Students: A Cross-Sectional Study in Hunan Province

Dietary supplement use is increasing globally, especially among children. However, few studies have been conducted to examine dietary supplement use among Chinese children. The aim of this study was to examine the prevalence of dietary supplement use and the associated factors in primary school students. A cross-sectional study was conducted in four primary schools in Hunan province, China. A total of 706 Chinese parents/caregivers of school children aged 6–12 years old were enrolled. Self-administrated questionnaires were used to collect information about the children’s dietary supplement use, and their socio-demographic characteristics. The prevalence of dietary supplement use in primary school students was 20.4%. Calcium (16.7%), vitamin C (9.2%), and vitamin D (8.5%) were the most commonly used types of dietary supplement. The main reasons for parents/caregivers to purchase dietary supplements for their children were immunity improvement (43.6%), and for growth promotion (36.5%). Some caregivers (26.4%) purchased dietary supplements online, including from dubious or unknown sellers. However, 37.5% of caregivers did not receive formal guidance on supplementation even if they purchased their supplements through formal channels. Parents/caregivers were unclear about the appropriate choices for children’s dietary supplement use. Guidelines and counseling regarding dietary supplements for children may be helpful in public health work.

Note: Thermal conductivity measurement of individual porous polyimide fibers using a modified wire-shape 3ω method

Porous polyimide fiber enjoys a good reputation as a high temperature resistant thermal insulation material in an aircraft-carrier, a spacecraft, and other military sophisticated products. Understanding its thermal conductivity is especially important for the design optimization and thermal management in these applications. In this study, a modified wire-shape 3ω method is developed to measure the thermal conductivity of individual porous polyimide fibers, utilizing a platinum layer heater/thermometer deposited along the circumferential direction of the fiber. The new method is first validated using a platinum wire with known thermophysical properties such as thermal conductivity at room temperature and then applied to porous polyimide fibers with diverse porosities. The thermal conductivity of porous polyimide fibers at room temperature is 0.06-0.15 W m^-1 K^-1, which reflects a good thermal insulation performance.

Food Suitability and Population Dynamics of Lorryia formosa (Acari: Tydeidae)

Lorryia formosa Cooreman (Acari: Tydeidae) is a species of mite commonly associated with citrus in many countries including the United States. A survey report in 1957 suggested phytophagous nature, while other studies claimed that L. formosa populations are associated with honeydew producing insects and sooty mold and it acts as a sanitizing agent. We investigated the effect of various diets on the survival and progeny production of L. formosa on excised leaves and the survival and potential to cause feeding damage to leaves of potted plants in a greenhouse study. A 2-yr field survey of a mandarin orchard was also conducted to elucidate the seasonal infestation, damage potential and population structure of L. formosa in a natural habitat. Results showed that all L. formosa adults and immatures died in less than 14 d on excised leaves, did not survive beyond 7 d on potted citrus plants alone, and caused no observable feeding damage to leaves or fruit. When sugar water, honeydew, or cottony cushion scale, Icerya purchasi Maskell (Hemiptera: Margarodidae), was present, adults and immatures survived the duration of the experiments and produced additional generations. The field survey showed that all stages of L. formosa were present in a mandarin orchard throughout the year and insecticide applications affected but did not eliminate mite populations. Fruit generally had a greater percentage infestation of mites (44.8 ± 4.0) than leaves (16.0 ± 4.7). These studies confirmed that L. formosa cannot sustain a population on leaf tissue alone and is nondamaging to citrus in California.

Soil organic matter as sole indicator of soil degradation

Soil organic matter (SOM) is known to play vital roles in the maintenance and improvement of many soil properties and processes. These roles, which largely influence soil functions, are a pool of specific contributions of different components of SOM. The soil functions, in turn, normally define the level of soil degradation, viewed as quantifiable temporal changes in a soil that impairs its quality. This paper aims at providing a generalized assessment of the current state of knowledge on the usefulness of SOM in monitoring soil degradation, based on its influence on the physical, chemical and biological properties and processes of soils. Emphasis is placed particularly on the effect of SOM on soil structure and availability of plant nutrients. Although these properties are discussed separately, the soil system is of dynamic and interactive nature, and changes in one property will likely affect other soil properties as well. Thus, functions of SOM almost always affect various soil properties and processes and engage in multiple reactions. In view of its role in soil aggregation and erosion control, in availability of plant nutrients and in ameliorating other forms of soil degradation than erosion, SOM has proven to be an important indicator of soil degradation. It has been suggested, however, that rather than the absolute amount, temporal change and potential amount of SOM be considered in its use as indicator of soil degradation, and that SOM may not be an all-purpose indicator. Whilst SOM remains a candidate without substitute as long as a one-parameter indicator of soil degradation is needed, narrowing down to the use of its labile and microbial components could be more appropriate, since early detection is important in the control and management of soil degradation.

Accumulation of mercury and cadmium in rice from paddy soil near a mercury mine

Paddy soil and rice (Oryza sativa L.) in the Wanshan mining area in Guizhou Province, China, have been contaminated by toxic trace metals such as cadmium (Cd) and mercury (Hg). The present study examined correlations between the types and physicochemical parameters of the soil and the contents of trace metals and the different forms of Hg in rice. The health risks of consuming contaminated rice from the Wanshan mining area were also assessed. Sequential extraction procedures were used to investigate the chemical behavior of Hg in the soil. The results showed that Hg and Cd were the most abundant trace metals in the Wanshan mining area. The toxic methylmercury (MeHg) content was substantial in brown rice, and the total amounts of total Hg (THg), diethylenetriaminepentaacetic acid-Hg, and water-soluble Hg varied in the rhizosphere and non-rhizosphere soils. An antagonistic interaction between Mn in brown rice, straw, and husk and MeHg in brown rice was also shown. An analysis of calculated dietary intake, target hazard quotients, and hazard indexes showed a potential risk of transferring Hg, MeHg, and Cd to humans when rice from the Wanshan mining area is consumed. Therefore, it must be concluded that consuming contaminated rice near the Wanshan mining area is a potential threat to human health.

E-selectin gene polymorphism (A561C) and essential hypertension. Meta-analysis in the Chinese population

BACKGROUND

The A561C polymorphism of the E-selectin gene (SELE) has been reported to be associated with essential hypertension (EH) in several studies; however, results among these studies were inconsistent. Here, we conducted a meta-analysis to explore the association of the A561C polymorphism with EH.

METHODS

Publications were retrieved through searching PubMed, Web of Science, the China National Knowledge Infrastructure (CNKI), China Biological Medicine, and the Wanfang database. Odds ratios (OR) and 95 % confidence intervals (CI) were calculated to estimate the strength of association of A561C with EH. Subgroup analysis was also performed to assess ethnic discrepancies. A total of seven studies comprising 2,127 EH patients and 2,078 controls were analyzed.

RESULTS

In the dominant model analysis, we found significant associations between the A561C polymorphism and EH in all subjects (CC+AC vs. AA, OR = 1.96, 95 %CI 1.57-2.44, P heterogeneity = 0.381), in a Han Chinese subgroup (CC+AC vs. AA, OR = 2.38, 95 %CI 1.73-3.29, P heterogeneity = 0.269), and in non-Han Chinese minorities (CC+AC vs. AA, OR = 1.62, 95 %CI 1.19-2.21, P heterogeneity = 0.84).

CONCLUSION

The findings suggest that C allele carriers of the SELE gene polymorphism (A561C) might be predisposed to EH in the Chinese population. Further investigations in other ethnic populations should be conducted to verify these findings.

Review: placenta-specific microRNAs in exosomes - good things come in nano-packages

MicroRNAs (miRNAs) are small noncoding RNA gene products that commonly regulate mRNA expression by repression of translation and/or transcript decay. Whereas common and unique types of miRNAs are expressed by the placenta during pregnancy, the functions of most placental miRNA species are unknown. In addition to their intracellular silencing function, miRNAs are also released to the extracellular space and systemic circulation, where they can potentially target cells to regulate mRNA and protein expression, providing a non-hormonal means of intercellular communication that contributes to tissue homeostasis and disease pathophysiology. This review centers on extracellular miRNAs that originate in trophoblasts and that could mediate crosstalk between the feto-placental unit and the mother during pregnancy. We specifically detail the function of miRNAs from the primate-specific chromosome 19 miRNA cluster. These miRNAs are highly expressed in human placentas and in the serum of pregnant women. They are also packaged into extracellular vesicles of diverse sizes, including exosomes, and endow non-trophoblastic cells with resistance to a variety of viruses.

Value of transvaginal sonography in diagnosing heterotopic pregnancy after in-vitro fertilization with embryo transfer

OBJECTIVES

To assess the value of transvaginal sonography (TVS) in the diagnosis of heterotopic pregnancy (HP) in the first trimester after in-vitro fertilization with embryo transfer (IVF-ET).

METHODS

This was a retrospective review of women undergoing IVF-ET between January 2005 and December 2011. Women were diagnosed with an HP using TVS if a visible intrauterine gestational sac was observed with any of the following: (i) an inhomogeneous adnexal mass; (ii) an empty extrauterine gestational sac seen as a hyperechoic ring; or (iii) a yolk sac and/or fetal pole with or without cardiac activity in an extrauterine sac.

RESULTS

Overall, 16 483 consecutive women who underwent IVF had TVS during the study. Of these, 174 cases were diagnosed on TVS as having an HP, and 10 cases were missed. Fifty-two cases were treated expectantly and were excluded from the analysis. Three types of ultrasonographic presentation of ectopic pregnancy (EP) were seen in HP patients, with a gestational sac found in 70 cases, a ring sign in 21 and an adnexal mass in 31. The sensitivity and specificity of TVS for the detection of HP were 92.4 and 100%, respectively, with positive and negative predictive values of 100 and 99.9%. The HP cases comprised 103 tubal EPs and 29 non-tubal EPs. In 93 patients (70.5%), their intrauterine pregnancy resulted in a live birth, 37 patients (28.0%) suffered an early miscarriage and two patients (1.5%) had a late miscarriage.

CONCLUSION

Early TVS performed by an experienced sonographer has a high sensitivity for making the correct diagnosis of HP after IVF-ET.

Effects of degradable MG-ND-ZN-ZR alloy on osteoblastic cell function

This study aimed to investigate the effects of a novel patented Mg-3Nd-0.2Zn-0.4Zr (weight %, JDBM) alloy on osteoblastic cell function, as these cells play an important role in bone repair and remodeling. The associated effects of the JDBM alloy on osteoblastic cell function involving cell adhesion, cell proliferation, and mineralization were investigated using scanning electron microscopy (SEM), MTT assay and ambramycin staining, respectively. At the same time, the in vitro degradation behavior of the JDBM alloy in cell culture medium was evaluated by the weight-loss method and SEM. Pure magnesium was used as control. The results showed that osteoblastic cells cultured on JDBM alloy samples manifested better cell adhesion, improved cell proliferation and increased mineralization ability, compared with cells seeded on pure magnesium samples. Our data indicate that the JDBM alloy has excellent bioactivity, improving the cell function of osteoblastic cells seeded on it.