Multi-Omics Research Accelerates the Clarification of the Formation Mechanism and the Influence of Leaf Color Variation in Tea (Camellia sinensis) Plants

Tea is a popular beverage with characteristic functional and flavor qualities, known to be rich in bioactive metabolites such as tea polyphenols and theanine. Recently, tea varieties with variations in leaf color have been widely used in agriculture production due to their potential advantages in terms of tea quality. Numerous studies have used genome, transcriptome, metabolome, proteome, and lipidome methods to uncover the causes of leaf color variations and investigate their impacts on the accumulation of crucial bioactive metabolites in tea plants. Through a comprehensive review of various omics investigations, we note that decreased expression levels of critical genes in the biosynthesis of chlorophyll and carotenoids, activated chlorophyll degradation, and an impaired photosynthetic chain function are related to the chlorina phenotype in tea plants. For purple-leaf tea, increased expression levels of late biosynthetic genes in the flavonoid synthesis pathway and anthocyanin transport genes are the major and common causes of purple coloration. We have also summarized the influence of leaf color variation on amino acid, polyphenol, and lipid contents and put forward possible causes of these metabolic changes. Finally, this review further proposes the research demands in this field in the future.

[Effects of cognition-related lifestyles on early cognitive decline in community older adults in China]

Objective: To investigate the distribution characteristics of cognition-related lifestyles of elderly in communities and explore the integrated effects on early cognitive decline. Methods: The participants were from the Project of Prevention and Intervention of Neurodegenerative Disease for Elderly in China. A total of 2 537 older adults aged ≥60 years without dementia in the 2015 baseline survey and the 2017 follow-up survey were included. The information about their cognition-related lifestyles, including physical exercise, social interaction, leisure activity, sleep quality, smoking status, and alcohol consumption, were collected through questionnaire survey and the integrated scores were calculated. Multivariate logistic regression analysis was used to assess the association between integrated cognition-related lifestyle score and early cognitive decline. Results: In the 2 537 older adults surveyed, 28.7% had score of 5-6, while only 4.8% had high scores for all 6 healthy lifestyles. Significant differences in healthy lifestyle factor distributions were observed between men and women. Multivariate logistic regression model showed that the risks for early cognitive decline in the older adults who had lifestyle score of 4 and 5-6 were lower than that in those with lifestyle score of 0-3 (OR=0.683, 95%CI: 0.457-1.019; OR=0.623, 95%CI: 0.398-0.976; trend P=0.030). In the women, the risks for early cognitive decline was lower in groups with score of 4 and 5-6 than in group with score of 0-3 (OR=0.491, 95%CI: 0.297-0.812; OR=0.556, 95%CI: 0.332-0.929; trend P=0.024). Conclusion: Cognition-related healthy lifestyles are associated with significantly lower risk for early cognitive decline in the elderly, especially in women.

[Clinical characteristics and analysis of risk factors for heart injuries in 55 patients with lightning injury on plateau in Tibet Autonomous Region]

Objective: To explore the clinical characteristics and treatment outcomes of patients with lightning injury on plateau in Tibet Autonomous Region, and to analyze the risk factors for heart injuries in these patients. Methods: A retrospective case series study was conducted. From January 2008 to July 2023, 55 patients with lightning injury who met the inclusion criteria were admitted to the General Hospital of PLA Tibet Military Area Command. The gender, age, ethnicity, time of injury, location of injury (average altitude), activity at the time of injury, the occurrence of thermal burns on the body surface, the occurrence of complication, the occurrence of combined injury, underlying disease or physiological process before injury, length of hospital stay, treatment outcome, and effective rate of treatment were recorded. The patients were divided into juvenile group (11 cases), young group (28 cases), middle-aged group (14 cases), and elderly group (2 cases) according to age bracket, then the gender and ethnicity distribution of patients in the 4 groups were compared. According to the occurrence of heart injuries at admission, the patients were divided into heart injury group (44 cases) and non-heart injury group (11 cases), then the gender, age, ethnicity, average altitude of location of injury, length of hospital stay, the occurrence of complication, the occurrence of combined injury, site of thermal burns on the body surface, and area of thermal burns on the body surface in patients were compared between the two groups. Data were statistically analyzed with Mann-Whitney U test, chi-square test, or Fisher's exact probability test. The multivariate logistic regression analysis was conducted to screen the independent risk factors for heart injury in patients with lightning injury. Results: Among the 55 patients aged 10-68 years, 39 were male and 16 were female, including 47 Tibetans and 8 Hans. There were no statistically significant differences in gender or ethnicity distribution of patients among the 4 groups with different age brackets (P>0.05). Lightning injuries occurred from May to September, which mostly occurred in June and July. The incidence of lightning injury was higher in Chengguan District of Lhasa City (average altitude of 3 650 m) and Baqing County of Naqu City (average altitude of 4 500 m), being 20.0% (11/55) and 16.4% (9/55), respectively. A total of 96.4% (53/55) of the patients were engaged in outdoor activities when injured, such as grazing, digging Cordyceps, and harvesting highland barley. Among the 55 patients, 46 (83.6%) cases had thermal burns on the body surface, with burn area mainly being not more than 10% total body surface area and burn depth mainly being deep partial-thickness. Fifty-two (94.5%) patients had complications, with heart injury being the most common complication (44 cases, 80.0%). Twenty-two (40.0%) patients had 11 combined injuries, and traumatic brain injury was the most common combined injury. Seventeen (30.9%) patients had 11 underlying diseases or physiological processes before injury. The length of hospital stay of patients was 9 (5, 17) d. Among the 55 patients, 14 cases were cured and discharged, 40 cases were improved, and 1 case died, with effective rate of treatment of 98.2%. Compared with those in non-heart injury group, the proportion of complication occurrence (χ2=12.28), the proportion of trunk burns (χ2=5.15), and the average altitude of location of injury (Z=-2.38) of patients in heart injury group were increased significantly (P<0.05), while there were no significant changes in the other indicators (P>0.05). Multivariate logistic regression analysis showed that the average altitude at the location of injury was the independent risk factor for heart injury in patients with lightning injury (with odds ratio of 3.28, 95% confidence interval of 1.35-7.99, P<0.05). Conclusions: Lightning injuries on plateau in Tibet Autonomous Region mainly occur from May to September, with an average altitude of 4 500 m at the location of injury. Patients with lightning injury are injured when participating outdoor activities, and the affected patients are mainly mainly young male Tibetans. Most of the injuries are mild burns. Lightning injuries are complex and have many complications, with heart injury being the most common one. The average altitude at the location of injury is the independent risk factor for heart injury in patients with lightning injury.

[Impact of different diagnostic criteria for assessing mild micro-hepatic encephalopathy in liver cirrhosis: an analysis based on a prospective, multicenter, real-world study]

Objective: To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test. Methods: This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ (2) test. A kappa test was used to compare the consistency between groups. Results: After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea (Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences (P < 0.001). Conclusion: The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

[Association between smoking status and mortality risk among elderly people aged 60 and above in Beijing City]

Objective: To examine the association between smoking status and related mortality among elderly people aged 60 and above in urban and rural areas of Beijing City. Methods: Based on Beijing City Elderly Comprehensive Health Cohort Study from 2009 to 2014, a total of 4 499 eligible older adults included in the baseline survey were followed up and investigated to collect information on survival and death. The Cox proportional hazards regression model was used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs), and the dose-response relationship was estimated between the smoking index, the years of quitting and mortality. Results: The median (IQR) age of 4 499 subjects was 70.00 (10.00) years old, including 1 814 (40.32%) males. The proportion of non-smokers, former smokers and current smokers was 69.50% (3 127/4 499), 13.20% (594/4 499) and 17.30% (778/4 499), respectively. After adjusting for confounding factors such as demographic and sociological characteristics, lifestyle, etc., the results of multivariate Cox regression analysis showed that, compared to non-smokers, former smokers had a 30.6% increased risk of all-cause mortality [HR (95%CI): 1.306 (1.043-1.636)] and the HR (95%CI) of all-cause, malignant tumor and lung cancer mortality among current smokers has increased by 50.0% [HR (95%CI): 1.500 (1.199-1.877)], 80.3% [HR (95%CI): 1.803 (1.226-2.652)] and 212.6% [HR (95%CI): 3.126 (1.626-6.012)], respectively. The smoking index was positively associated with the increased risk of all-cause, malignant tumor and lung cancer mortality, while the years of smoking cessation were negatively associated with that risk (P<0.05). Conclusion: Smoking is associated with tobacco-related mortality among elderly people in Beijing City.

[Association analysis between sex hormone levels and all-cause mortality in Hainan female centenarians]

Objective: To investigate the distribution characteristics of sex hormones and their relationship with all-cause mortality in Hainan female centenarians. Methods: All the subjects were from China Hainan Centenarian Cohort Study. A total of 717 female centenarians were included in the final analysis. Kaplan-Meier method was used to draw the survival curve, and Cox proportional hazard regression was used to analyze the relationship between sex hormones and survival time. Results: The M(Q1, Q3) of estradiol and progesterone among female centenarians was 32.60 (18.40, 58.70) pmol/L and 0.62 (0.32, 1.01) nmol/L. The estradiol (pmol/L) and progesterone (nmol/L) in the survival and death groups were 26.65 vs.37.80, 0.54 vs.0.69, respectively, with statistical differences (P<0.05). Cox multivariate analysis showed that estradiol and progesterone were significantly associated with death (P<0.05), the hazard ratio (HR) of estradiol Q4 was 1.58 (95%CI: 1.17-2.15), and the HR of progesterone Q3 was 1.53 (95%CI: 1.10-2.12), HR for Q4 was 1.63 (95%CI: 1.15-2.32). Subgroup and cross-analysis showed that estradiol was statistically significant with hypertension, diabetes, and low high-density lipoprotein cholesterol (P<0.05), and progesterone interacted with diabetes (P=0.016), while testosterone interacted with low high-density lipoprotein cholesterol (P=0.034). Conclusion: It is suggested that the estrogen levels of female centenarians in Hainan were associated with a higher mortality risk and an increased risk of cardiovascular metabolic disease (such as diabetes, hypertension, and abnormal lipid metabolism).

[Multimodal imaging features of acute macular retinopathy in patients with COVID-19]

Objective: To investigate the multimodal imaging characteristics of acute macular retinopathy (AMR) and/or parafoveal acute middle maculopathy (PAMM) in patients with coronavirus disease 2019 (COVID-19). Methods: It was a cross-sectional study. Eight patients (15 eyes) diagnosed with AMN and/or PAMM, who presented for their initial visit at Kaifeng Eye Hospital between December 17 and December 31, 2022 and were also confirmed positive for COVID-19, were enrolled as the observation group. The patients were classified into four types based on swept-source optical coherence tomography (SS-OCT) findings. Fifteen healthy volunteers (15 eyes) without ocular or systemic diseases were recruited as the healthy control group, and one eye was randomly selected for analysis. All participants underwent detailed ophthalmic examinations, including best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, fundus photography (FP), intraocular pressure measurement, fundus infrared imaging, OCT and OCT angiography (OCTA). The foveal avascular zone (FAZ) area of the macular center was measured. General information and multimodal imaging findings were collected and analyzed. The superficial capillary plexus vessel density (SCP-VD) and deep capillary plexus vessel density (DCP-VD) were measured in circular areas with diameters of 1.0 mm, >1.0 mm and ≤3.0 mm, and>3.0 mm and ≤6.0 mm centered on the foveal center, recorded as SCP-VD1.0, 3.0, 6.0 and DCP-VD1.0, 3.0, 6.0. Statistical analyses were performed using t-tests, Mann-Whitney U tests, and chi-square tests. Results: The observation group consisted of 6 males (11 eyes) and 2 females (4 eyes) with a mean age of (26.87±11.56) years. The healthy control group included 11 males (11 eyes) and 4 females (4 eyes) with a mean age of (28.75±12.30) years. There were no statistically significant differences in age and gender distribution between the two groups (all P>0.05). All patients in the observation group experienced high fever (≥39.0 ℃) and developed ocular symptoms during the febrile period or within 24 hours after fever resolution. Among all patients, there were 5 cases (7 eyes) of Type Ⅰ, 1 case (1 eye) of Type Ⅱ, 3 cases (4 eyes) of Type Ⅲ, and 2 cases (3 eyes) of Type Ⅳ. In Type Ⅲ and Ⅳ, 3 cases (4 eyes) exhibited weakly reflective cystic spaces in the outer plexiform or outer nuclear layers, and fundus photography revealed multiple gray or reddish-brown lesions in the macular region. One case (1 eye) showed retinal superficial hemorrhage. Cotton wool spots were observed in 2 cases (4 eyes). Fundus infrared imaging showed that Type Ⅰ manifested as weak reflectivity lesions in the parafoveal central zone, with the tip pointing towards the fovea. Type Ⅱ showed no apparent abnormalities in the macular region, while Type Ⅲ and Ⅳ displayed map-like weak reflective lesions spanning the foveal center. OCTA findings demonstrated that SCP-VD1.0 in the observation group was 6.93% (4.77%, 6.93%), significantly lower than the healthy control group's 10.66% (8.05%, 10.55%) (U=174.00, P=0.016). SCP-VD3.0 in the observation group was 37.14% (32.15%, 43.48%), also lower than the healthy control group's 43.06% (38.95%, 46.55%) (U=174.00, P=0.016). DCP-VD3.0 in the observation group was 48.20% (46.11%, 50.33%), lower than the healthy control group's 51.10% (50.04%, 53.02%) (U=188.00, P=0.009). DCP-VD6.0 in the observation group was 49.27% (47.26%, 51.67%), lower than the healthy control group's 52.43% (50.07%, 53.82%) (U=70.00, P=0.004). There were no significant differences in SCP-VD6.0 and DCP-VD1.0 between the two groups (both P>0.05). Conclusions: Acute macular retinopathy in patients with COVID-19 can involve all retinal layers and present as segmental hyper-reflectivity on SS-OCT. Fundus infrared imaging reveals weak reflectivity in the affected area, fundus photography shows multiple gray or reddish-brown lesions in the macular region, and OCTA demonstrates a decrease in SCP-VD and DCP-VD.

[Status of HVPG clinical application in China in 2021]

Objective: The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China. Methods: This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems. Results: According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%). Conclusion: Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

[Prevalence of malnutrition among elderly in the community of China: a Meta-analysis]

Objective: The prevalence of malnutrition in the community-dwelling older population of China was analyzed by Meta-analysis. Methods: Papers on the nutrition of community-dwelling elderly (≥60 years old) in China from August 1, 2011, to July 31, 2021, were retrieved through PubMed, Embase, the Cochrane Library, Web of Science, Wanfang Digital Database and China National Knowledge Infrastructure Database. Malnutrition was defined by nutritional assessment and screening tools of different studies. The random-effect model was fitted to calculate the prevalence. Subgroup analysis and inter-group difference analysis were performed according to the data included in the paper. Results: A total of 13 articles met the inclusion criteria, including 19 938 participants ≥60 years old. There are a total of seven methods for diagnosing criteria and defining malnutrition. The prevalence of malnutrition reported in papers varies greatly (2.4%-52.5%), of which seven pieces reported the prevalence of malnutrition risk (21.3%-67.0%). The Meta-analysis shows that the combined prevalence of malnutrition and risk of malnutrition was 41.2% (95%CI: 29.5%-54.0%, I²=99.6%, P<0.05) in the community-dwelling older population of China. The prevalence after 2017 is lower than that before 2017 (29.6% vs. 66.6%, χ²=274.20, P<0.05). The prevalence of men was lower than that of women (44.9% vs. 52.2%, χ²=10.67, P=0.001). The prevalence of non-living alone is lower than that of the older population living alone (41.2% vs. 49.6%, χ²=14.23, P<0.05). Conclusion: Malnutrition is common among the community-based older people in China. The prevalence of malnutrition is higher among older women and the elderly who live alone.

[Clinical study on the relationship between the exosomes in bronchoalveolar lavage fluid and plasma and the severity of lung injury and outcome in early acute respiratory distress syndrome patients]

Objective: To investigate the relationship between the levels of exosomes in bronchoalveolar lavage fluid (BALF) and plasma and the severity of lung injury and its outcome in patients with acute respiratory distress syndrome (ARDS). Methods: Patients who were admitted to the Department of Critical Care Medicine, Zhongda Hospital Affiliated to Southeast University and received invasive mechanical ventilation were selected from August 2020 to April 2021, and they were divided into ARDS group and non-ARDS group. Finally, 33 ARDS patients were included, including 18 males and 15 females, aged (65.5±15.5) years; 10 non-ARDS patients, 8 males and 2 females, aged (57.2±15.3) years. The BALF and plasma of the two groups of patients were collected within 24 hours after enrollment, and the total exosomes of the samples were collected by ultracentrifugation. Nanoparticle tracking analysis (NTA) was used to detect and compare the differences in exosome content between the two groups. Correlation of content with the severity and prognosis of lung injury in ARDS patients. Results: There was no significant difference in gender and age between ARDS group and non-ARDS group (both P>0.05). The exosome in plasma of ARDS group was significantly higher than that of non-ARDS group [(25.3±1.2)/ml vs (24.2±1.6)/ml, P=0.031], while the exosomes in BALF of ARDS group was also higher than that of non-ARDS group [(26.5±1.6)/ml vs (24.6±1.1)/ml, P=0.001]. The exosomes in BALF of patients with ARDS caused by intrapulmonary causes was higher than that in ARDS group caused by extrapulmonary causes [(26.9±1.5)/ml vs (25.2±0.9)/ml, P=0.01], and the infection caused by bacterial shows that the highest exosome level in BALF. The exosomes in the BALF of the mild ARDS group was significantly lower than that of the severe ARDS group [(25.7±1.3)/ml vs (27.2±1.5)/ml, P=0.038]; the exosomes in BALF of ARDS patients was negatively correlated with P/F ratio (r=-0.38, P=0.03); and it was positively correlated with Murray lung injury score (r=0.47, P=0.01). However, the static compliance levels, length of hospital stay, duration of mechanical ventilation, and 28-day outcome were not associated with the exosomes in BALF. Conclusion: Compared with non-ARDS patients, ARDS patients have significantly higher levels of exosomes in BALF and plasma, there is a certain correlation between exosomes derived from BALF and the severity of lung injury in ARDS.

[Cardiometabolic disease patterns among elderly patients with colorectal cancer in China]

Objective: To explore the distribution patterns of cardiometabolic diseases (CMD) in elderly patients with colorectal cancer, and provide a reference for the prevention and treatment of cardiovascular metabolic diseases in these patients. Methods: Clinical data of 3 894 elderly patients with colorectal cancer from January 2008 to March 2018 admitted in the Chinese PLA General Hospital were recruited and the incidence rate of CMD was retrospectively analyzed. The influence factors of elderly patients with colorectal cancer combined with CMD were analyzed by multivariate Logistic regression model. Results: The morbidity rate of CMD in elderly patients with colorectal cancer is 33.4% (1 301/3 894), among them, the morbidity rate of the male was 31.9% (768/2 409), and that of the female was 35.9% (533/1 485). There was not significant difference between these two sex (P=0.074). The morbidity rates of CMD in patients of 65-74 years, 75-84 years and ≥85 years were 30.6% (754/2 462), 37.0% (479/1 294) and 49.3% (68/138), respectively, with significant differences (P<0.001). Multiple Logistic regression analysis revealed that female (OR=1.213, 95%CI: 1.056-1.394), age (75-84 years group: OR=1.344, 95%CI: 1.164-1.552; ≥85 years group: OR=2.345, 95%CI: 1.651-3.331) and body mass index (BMI 18.5-24.9 kg/m(2) group: OR=1.319, 95%CI: 1.065-1.638; ≥25 kg/m(2) group: OR=2.041, 95%CI: 1.627-2.561) were independent risk factors for elderly colorectal cancer patients with CMD. Conclusion: The morbidity rate of CMD in elderly patients with colorectal cancer increases with age and it is urgent to strengthen multidisciplinary cooperation and develop reasonable treatment plans to extend the survival and life quality of these patients.

[Differential on N6-methyladenosine modification of circRNA in early inflammation of silicosis]

Objective: To explore the difference of methylation of circRNA related m6A in early inflammation of silicosis and to elucidate the underlying molecular mechanism of circRNA involved in the process of silicosis. Methods: The activation markers of macrophages were detected by Western blotting (WB) in THP-1-derived macrophages. The cell viability was detected with CCK8, by which the stimulation concentration and time of silica were determined. The methylation of total RNA was determined by colorimetry, and the expression of RNA m6A methylase, demethylase and reading protein were detected by Western blotting in mouse model of silicosis. The differential expression of m6A modified circRNA in lung tissues form silicosis and control mice was obtained through Arraystar m6A circRNA epigenetic transcriptome Chip and verified by RT-PCR. Results: The concentration of SiO(2) at 50 μg/cm(2) had the most significant effect on the activation markers and activity of macrophages. Compared with the control group, SiO(2) increased the total RNA m6A level of macrophages, and there were significant differences in the expression of methylase METTL3 and reading protein YTDHF3. High throughput sequencing analysis showed that compared with the control group, the methylation levels of 132 circRNA m6A in the lung of silicosis model mice were increased, while the methylation levels of 296 circRNA m6A were decreased, and then the target circSLC2A13 was screened based on the basic expression. Further verification showed that SiO(2) significantly increased the expression of circSLC2A13 and m6A modification in macrophages. Conclusion: The methylation of circRNA m6A is involved in the activation of macrophages in early inflammation of silicosis.

[Prevalence of diabetes and associated factors in Hainan centenarians]

Objective: To investigate basic characteristics of diabetes prevalence and associated factors in centenarians in Hainan province of China. Methods: All the subjects were from China Hainan Centenarian Cohort Study. A total of 1 002 centenarians were included in the final analysis, who were divided into three groups: diabetes group, impaired fasting glucose (IFG) group, and normal glucose group according to the guideline. Results: The average age of centenarians was (102.77±2.55) years, and the proportion of females was 82.0%. There were 95 centenarians who suffered from diabetes, and the prevalence rate was 9.5%. There were 81 centenarians who had IFG, and the prevalence rate was 8.1%. The mean fasting plasma glucose (FPG) level of centenarians was (5.12±1.44) mmol/L, while 43.5% of centenarians had FPG levels ranging from 4.00 to 5.00 mmol/L and 22.1% of centenarians had the FPG levels ranging from 5.00 to 6.00 mmol/L. Increased triglyceride level and abdominal obesity might be associated with the risk for diabetes. Conclusion: The glycometabolism in centenarians in Hainan was better than that in other age groups, and no gender specific difference was observed.

[Distribution characteristics of blood lipid profile in Hainan centenarians]

Objective: To explore the prevalence of lipid profile and the influencing factors of dyslipidemia in centenarians in Hainan province, and provide basic data for the study of the lipid profile in centenarians. Methods: The data of this study were from the baseline data of China Hainan Centenarian Cohort Study from June 2014 to December 2016. A total of 1 002 centenarians were recruited. According to the guidelines for the prevention and treatment of dyslipidemia in Chinese adults in 2016, the prevalence of lipid profile were described and the prevalence of dyslipidemia with different clinical classifications were compared, and the main influencing factors were analyzed. Results: The median levels of TC, TG, LDL-C and HDL-C were 4.60 mmol/L, 1.05 mmol/L, 2.77 mmol/L and 1.41 mmol/L, respectively, in centenarians in Hainan. Blood lipid profile level was higher in females than in males. With the increase of BMI, TC, TG and LDL-C increased significantly, while HDL-C decreased significantly. The total prevalence of dyslipidemia was 19.1%. Smoking, BMI and area distribution were the main influencing factors of dyslipidemia. Conclusion: The prevalence of dyslipidemia in centenarians in Hainan was at a low level compared with other countries, and the blood lipid profile level was higher in females than in males.

[Epidemic characteristics and trend analysis of the COVID-19 in Hubei province]

Objective: By describing and analyzing the epidemic characteristics and trends of the attack rate, the crude mortality and relevant indexes in Hubei province during the pandemic of COVID-19 to provide comprehensive evaluations of the epidemic trends and the effects of intervention measures. Methods: Based on the case data reported in Hubei province during the COVID-19 epidemic, combined with the important time of major interventions and event, the cumulative attack rate, the sequential increase rate of new cases, baseline increase rate of new cases, the observation- confirmed case conversion rate, the cumulative crude mortality, the daily severe case rate, and the ratio of death to severe were used to describe and analyze the epidemic characteristics in different phases of the COVID-19 epidemic. Results: The epidemic experienced an outbreak phase from January 10 to February 3 with large amount of case reported, a peak phase from February 4 to February 19 with continuous increasing number of new cases and deaths, a platform phase from February 20 to March 3 with balanced diagnosis and treatment number, and a descending phase from March 4 to March 18 with decreased diagnosis and increased treatment number. Up to March 18, the cumulative attack rate of the COVID-19 epidemic in Hubei province increased from 0.03/10 000 on January 19 to 11.46/10 000, from 0.04/10 000 on January 10 to 45.13/10 000 in Wuhan city, and from 0.002/ 10 000 on January 20 to 3.70/ 10 000 in other areas of Hubei province other than Wuhan city. The increase rate of new cases fluctuated during the epidemic period and reached the highest at February 12 in Hubei province. The cumulative crude mortality in Hubei Province increased rapidly from 1.01% on January 19 to 5.13% on January 26, then decreased to 2.54% on February 13, and then slowly increased to 4.62% on March 18, and similar trend was also observed in Wuhan city. The daily severe rate in Hubei Province increased from 26.88% on January 27 to 34.27% on March 18. The ratio of death to severe decreased from 7.37% on January 23 to 0.35% on March 18. Conclusions: The epidemic cycle of COVID-19 in Hubei province proposed to be 60 days, which was about 1.76 times of the combination of the longest incubation period or isolation period (14 d) and the average hospitalization time of confirmed patients in Hubei province (20 d). It suggested that the major anti-epidemic decisions made in China were effective.

[One case of pyoderma gangrenosum in the lower limbs in Tibetan Plateau treated with vacuum sealing drainage combined with irrigation of oxygen loaded fluid]

A 54 years old male patient with chronic leg ulcers was admitted in our hospital in November 2017. He was diagnosed as pyoderma gangrenosum by the pathological examination. Then the wound was treated with simple vacuum sealing drainage combined with irrigation of oxygen loaded fluid. This therapy overcame the shortage of hypoxia in the Tibetan Plateau on wound healing, resulting in a better wound healing. The patient was eventually cured and discharged from hospital.

[Advances in the research of effects of autologous platelet-rich plasma on the treatment of burn wounds]

Autologous platelet-rich plasma (PRP) is plasma with high concentration of platelet extracted from autologous blood. After activation, growth factors involved in wound healing are released from PRP. Current clinical investigations have demonstrated that the application of PRP seems to enhance the clinical outcome of plastic surgery, oral implantology, maxillofacial region and bone repair, and cardio-thoracic surgery. PRP can stimulate angiogenesis and promote fibroblast proliferation, therefore the application of PRP has shown good results in wound healing. However, up to date there is few current clinical researches on application of PRP on wound healing in burn patients. The application of PRP is not currently standardized, and the effects in burn wounds are poorly understood. This review is to determine if the application of PRP can enhance the clinical outcome of burns and scar formation.

[China Hainan Centenarian Cohort Study: study design and preliminary results]

Objective: To investigate the health status, functional ability, mental psychology, health care and other longevity-related characteristics of individuals aged ≥100 years as well as risk factors in Hainan province, China. Methods: China Hainan Centenarian Cohort Study (CHCCS) is a community-based, prospective cohort study to establish multi-dimensional database consisting of questionnaire findings, anthropometric parameters and biological specimens as well as imaging features. With the household registration information provided by the Department of Civil Affairs of Hainan province, a baseline survey was conducted in centenarians in 18 counties in Hainan with the oldest old in 5 counties as controls between 2014 and 2017. The survey included face to face interview, physical examination and biological specimen collection. After the baseline survey, the participants of CHCCS were followed up at an interval of 2 years to collect the information about their living status, disease status or major death causes. Results: According to the information provided by the Department of Civil Affairs of Hainan province in 2014, the survey found that 1 473 centenarians were still living. By December 2016, 1 002 of them had agreed to be surveyed. The average age of 722 centenarians with complete information in the baseline survey was (102.7±2.7) years, the majority of them were females (83.0%), widows (88.8%), in Han ethnic group (84.5%), lived with family members (87.8%), illiterates (89.7%) and farmers (81.0%). Conclusion: CHCCS has provided longevity-related information of the large longevity population and collected the valuable and rare biological specimens with great urgency to establish an interdisciplinary platform and base for longevity, senility and healthy aging research.

[Evaluation of activities of daily living and related factors in community elderly people in urban and rural areas of Beijing]

Objective: To evaluate the activities of daily living (ADL) and related factors in community elderly people in urban and rural areas of Beijing. Methods: A population-based cross-sectional study was conducted in Haidian and Miyun districts of Beijing using two-stage random cluster sampling method between 2011 and 2014. Results: A total of 4 499 community elderly people (1 815 males, 2 684 females) aged 60-95 years were included in the study. The mean age was (70.3±6.7) years. Compared with the participants from urban area, the participants from rural area had lower education level (85.2% had education level primary school), but higher level of smoking (22.8%) and drinking (43.1%). The ADL disability rate was higher in rural area than in urban area (12.4% vs. 11.8%, P=0.039). And it increased significantly with age (P<0.05). Multivariate logistic regression showed besides urban-rural difference (P=0.031), age (P=0.013), education level (P=0.015), physical activity (P=0.001) and stroke (P<0.001) were related factors influencing ADL disability. Conclusions: The ADL disability was relatively low in the community elderly people in Beijing, and there was significant difference between rural area and urban area. Older age, lower education level and physical inactivity and stroke were related factors.

[Study on sleep quality and related determinants among centenarians in Hainan province]

Objective: To investigate the sleep quality and related determinants among centenarians in Hainan. Methods: A cross-sectional study of centenarians from 16 cities/counties was carried out in Hainan province between June 2014 and June 2016. Data related to demography, chronic diseases and lifestyles of the centenarians were collected. Pittsburg sleep quality index (PSQI) was used to assess the quality of sleep while multivariable logistic Regression model was used to determine the risk factors on the quality of sleep. Results: Of the 730 centenarians in this study, 225 suffered from sleep disorders (30.8%). The average score of PSQI was (6.44±3.05), with the top three problems related to sleep as sleep inefficiency (48.5%), sleep latency (35.5%), and daytime dysfuntion (20.6%) among the centenarians. Results from the multivariate logistic analysis showed that incontinence, cardiovascular disease and chronic pain were risk factors, while habitual afternoon nap, and regular diet appeared as protective factors (P<0.05), related to sleep disorder. Conclusions: Quality of sleep had been a problem to the centenarians in Hainan. Intervention on risk factors of sleep disorder should be helpful on these centenarians.

[Healthy aging and the progress in the research of geriatric epidemiology]

In recent years, great effort has been made in the promotion of healthy aging in China. The core indicator of a country's healthy aging is the level of body health, mental health, social adaptation and quality of life (QOL) of the elderly. This paper summarizes the concept and the progress in the research of healthy ageing and the leading role of geriatric epidemiology. Articles on column "Pay attention to function and health of elderly" analyze the basic conditions affecting the QOL of the elderly, such as disability, comorbidity and Alzheimer disease prevalence, in the elderly in China and related risk factors to describe the severity of different health problems affecting the QOL of the elderly in different areas of China and provide essential data for developing effective health approaches and conducting targeted intervention foe healthy aging.

FMNL2 destabilises COMMD10 to activate NF-κB pathway in invasion and metastasis of colorectal cancer

BACKGROUND

Diaphanous-related formins (DRFs), actin necleator, have been known to participate in the progression of cancer cells. We previously reported that FMNL2 (Formin-like2), a member of DRFs, was a positive regulator in colorectal cancer (CRC) metastasis, yet proteins and pathways required for the function of this pro-invasive DRFs remain to be identified.

METHODS

The relationship between FMNL2 and COMMD10 was examined using Co-IP, GST pull-down, immunofluorescence and in vitro ubiquitination assay. The in vitro and in vivo function of COMMD10 in CRC was evaluated using CCK-8 proliferation assay, plate colony formation, cell cycle, apoptosis and animal models. The inhibition of NF-κB signalling by COMMD10 was detected using dual-luciferase reporter assay and western blotting. Co-IP, GST pull-down and nuclear protein extraction assay were performed to evaluate the effect on p65 by COMMD10. Real-time PCR and western blotting were performed to detect expressions of FMNL2, COMMD10 and p65 in paired tissues.

RESULTS

FMNL2 targets COMMD10 for ubiquitin-mediated proteasome degradation in CRC cells. COMMD10 targets p65 NF-κB (nuclear factor-κB) subunit and reduces its nuclear translocation, thereby leading to the inactivation of NF-κB pathway and suppression of CRC invasion and metastasis. Inhibition of NF-κB signalling by COMMD10 is necessary for FMNL2-mediated CRC cell behaviours. Downregulation of COMMD10 predicts poor prognosis of CRC patients. The expressions of FMNL2, COMMD10 and p65 are highly linked in CRC tissues.

CONCLUSIONS

These data demonstrate that the FMNL2/COMMD10/p65 axis acts as a critical regulator in the maintenance of metastatic phenotypes and is strongly associated with negative clinical outcomes.

Increased risk of hepatitis B virus reactivation in systemic lupus erythematosus patients receiving immunosuppressants: a retrospective cohort study

Objective We aimed to investigate risk of hepatitis B virus reactivation in systemic lupus erythematosus patients with different hepatitis B virus infection statuses receiving immunosuppressive therapy. Methods We retrospectively analyzed systemic lupus erythematosus patients with positive hepatitis B surface antigen or anti-hepatitis B core IgG antibody who underwent immunosuppressive therapies from January 2001 to December 2012 at a medical center in Taiwan for evidence of hepatitis B virus reactivation. Results During this period, 906 out of 3125 patients who were diagnosed with systemic lupus erythematosus received screening tests for hepatitis B virus. Thirty-eight patients were identified as hepatitis B surface antigen-positive. Fifteen of 38 (39.5%) hepatitis B surface antigen-positive patients developed hepatitis B virus reactivation, and 53.3% of these patients experienced severe hepatitis flare. Three of 157 hepatitis B surface antigen-negative/anti-hepatitis B core IgG antibody-positive patients (1.9%) experienced hepatitis B surface antigen seroreversion after immunosuppressive therapy. Five patients received prophylactic or preemptive antiviral therapy and none of them developed hepatitis B virus flares. A daily dose of prednisolone greater than 5 mg was a risk factor for hepatitis B reactivation by multivariate logistic analysis. Conclusions The risk of hepatitis B virus reactivation is high in lupus patients receiving immunosuppressive therapy. Antiviral prophylaxis or preemption can effectively reduce the incidence of hepatitis B virus reactivation in lupus patients.

Down-regulation of DAB2IP promotes colorectal cancer invasion and metastasis by translocating hnRNPK into nucleus to enhance the transcription of MMP2

DOC-2/DAB2 interacting protein (DAB2IP) is a RasGAP protein that shows a suppressive effect on cancer progression. Our previous study showed the involvement of transcription regulation of DAB2IP in metastasis of colorectal cancer (CRC). However, the molecular mechanisms of DAB2IP in regulating the progression of CRC need to be further explored. Here, we identified heterogeneous nuclear ribonucleoprotein K (hnRNPK) and matrix metalloproteinase 2 (MMP2) as vital downstream targets of DAB2IP in CRC cells by two-dimensional fluorescence difference gel electrophoresis and cDNA microassay, respectively. Mechanistically, down-regulation of DAB2IP increased the level of hnRNPK through MAPK/ERK signaling pathway. Subsequently, translocation of hnRNPK into nucleus enhanced the transcription activity of MMP2, and therefore promoted invasion and metastasis of CRC. Down-regulation of DAB2IP correlated negatively with hnRNPK and MMP2 expressions in CRC tissues. In conclusion, our study elucidates a novel mechanism of the DAB2IP/hnRNPK/MMP2 axis in the regulation of CRC invasion and metastasis, which may be a potential therapeutic target.

Disseminated Cutaneous Trichosporonosis in an Adult Bone Marrow Transplant Patient

The Trichosporon species are yeast-like opportunistic pathogens in immunocompromised patients. Trichosporon asahii infections have been reported in pediatric bone marrow transplant (BMT) patients. However, its incidence is low in the adult literature. A 52-year-old Chinese woman who was diagnosed with acute myeloid leukemia received induction chemotherapy and underwent allogenic bone marrow transplant, which was complicated by a relapse and required salvage chemotherapy. She developed persistent non-neutropenic fever secondary to presumed hepatosplenic candidiasis. Antifungal therapy with fluconazole and anidulafungin was administered. She remained febrile and tender dusky nodules appeared over all the four limbs. Histopathological examination and fungal culture identified T. asahii. Oral voriconazole was initiated with complete resolution of her lesions. The Trichosporon species is a frequently isolated yeast species from cancer patients. Voriconazole has become the first choice agent against Trichosporon. We highlight the increased awareness and clinical suspicion required for diagnosis and subsequent management in similar adult patients.

[A systematic review and Meta-analysis on influencing factors related to the quality of sleep among community population aged 60 and older, in China]

Objective: To systematically evaluate the influencing factors on quality of sleep among community elderly population aged ≥60 years in China. Methods: Literature review was conducted using databases of PubMed, EMbase, CBM, CNKI and Wanfang to collect data regarding influencing factors on quality of sleep. Both qualitative and quantitative analysis were performed to pool the eligible studies. Results: Sixteen cross-sectional studies were included. Data from both qualitative and quantitative analysis showed that the elderly population who had ever married (OR=0.72, 95%CI: 0.52-0.98) or lived with other people (OR=0.78, 95%CI: 0.70-0.87) had better quality of sleep but it was worse when with chronic diseases (OR=2.24, 95%CI: 1.39-3.61). The effects of age and sex on the quality of sleep in the elderly was not yet conclusive. Studies on life style, social support and psychological factors appeared scarce. Conclusion: The protective factors on quality of sleep among community elderly population aged ≥60 years in China appeared as: ever had married or lived with others while chronic diseases were risk factors in reducing the quality of sleep.

[Reliability and validity of a newly developed tool to be used for the comprehensive geriatric assessment on community elderly]

OBJECTIVE

To evaluate the reliability and validity of a comprehensive geriatric assessment tool set for community elderly.

METHODS

A sample of 574 community elderly (231 males, 343 females) aged 60 to 94 years, were included in the study. Split-half reliability and Chronbach' s α coefficient were used to test the reliability, with Face validity tested by Delphi method. Construct validity was tested, using the Factor Reliability.

RESULTS

The split-half reliability coefficient appeared as 0.706. The Chronbach' s α coefficient was 0.652 for the whole questionnaire. The authority coefficient was 0.876, and the Kendall coefficient was 0.408 (P<0.001). Six factors were identified through factor analysis and the factor loading matrix showed that the construct validity was good.

CONCLUSION

The tool was recognized as a reliable and validated measure for the comprehensive assessment on community elderly.

[Physical activity level and its influence factors among residents in one suburb district of Beijing]

OBJECTIVE

To study the physical activity level and its influence factors among residents in one suburb of Beijing, so as to provide specific interventions for different people in different circumstances and to provide reference for health relevant policy-making in the future.

METHODS

In the study, 7 319 subjects aged 18 years or above were involved. The self-designed questionnaires based on Health Belief Model (HBM) had acceptable validity and reliability. The physical activity levels were calculated to classify sufficient or insufficient amount by a thousand-step equivalent greater than or equal to 6 or 10. Multiple variable Logistic regression was used to explore the influence factors of the physical activity among the residents.

RESULTS

The residents' median amount of physical activity in the suburb district of Beijing were 9.1 thousand-step equivalent with quartile of (3.8, 20.4). The percentages of the thousand-step equivalent greater than or equal to 6 or 10 were 63.7% and 47.7%, respectively. The median amounts of physical activity from work or household chores, transportation and recreation physical activities were 4.0, 1.0, 0.0 and the components of the total amount of physical activity from those were 61.7%, 18.3% and 20.1%, respectively. There were 8.6% residents whose life did notinvolve moderate or vigorous intensity activities. By using factor analysis, five factors were extracted from the scale based on the HBM; These factors together contributed to 63.7% of the sum of the squared loadings. The differences of physical activity levels on education level, age, gender, self-efficacy, cues, subjective and objective barriers were statistically significant (P<0.05).Those who were female, with older age, lower education level, higher self-efficacy, fewer cues, fewer subjective and objective barriers preferred to do more physical activities.

CONCLUSION

The physical activity levels among the residents in the suburb district of Beijing are moderate and high, and most amount of physical activities from work or household chores. Those who are male and whose ages are from 18 to 29 years and whose education levels are of university or above should be focused on intervention. Specific interventions should be developed for different people in different situations; More attention should be paid to improve the residents' self-efficacy and reduce the subjective and objective barriers of physical activity, and we also should actively advocate people to have more leisure exercise so as to improve the physical activity level among all residents.

[Study on incidence and risk factors of fall in the elderly in a rural community in Beijing]

OBJECTIVE

To investigate the incidence of fall in the old farmers of Miyun county in Beijing.

METHODS

The old farmers who lived in Jugezhuang and Fengjiayu townships of Miyun county were selected for a questionnaire survey to collect the information about the incidence of fall and their health status.

RESULTS

A total of 2 397 old farmers, including 967 males and 1 430 females, were surveyed. Fall occurred in 347 old farmers(14.5%). The difference in the incidence of fall was significant between males(9.6%)and females(17.8%). A total of 282 falls occurred in courtyards, 45 falls occurred in field/hilly areas. Among the falls occurred, 216(27.2%)led to injuries. The most common site of injuries was hip(45 falls). Logistic regression analysis showed that physical exercise and high income were protective factors, but difficult standing up and walking, visual problem and stroke were the risk factors. In the males, the special risk factor was mid cognitive impairment, and in the females, the special risk factor was urinary incontinence, but afternoon nap was a protective factor.

CONCLUSION

The incidence of fall in the rural community was relatively high with distinct area distribution, which has caused serious influence on the mental and physical health of the elderly.

[Management of valgus or varus knee deformity with fixator assist nailing technique and distal femur osteotomy]

OBJECTIVE

To discuss the result of treating valgus or varus knee deformity with fixator assist nailing (FAN) technique and distal femur osteotomy(DFO).

METHODS

In this retrospective study, 14 patients with 17 limbs, 12 valgus and 5 varus knee deformity were treated with DFO and FAN. The average age of the patients was 23 (17-44) years . The unilateral external fixator was mounted on the lateral side of femur, the minimal invasive distal femoral osteotomy was performed. After the deformity was corrected, the intramedully nail was inserted to fix the femur. None of the patients need bone autograft. The preoperation and postoperation lateral distal femur angle (LDFA), mechanical axis deviation (MAD) and range of motion (ROM) were measured and analyzed.

RESULTS

All the 14 patients were followed-up for 12-72 months (average 34 months). The osteotomy site united in 3-5 months (average 3.5 months) postoperatively. According to Paley's functional scores, 12 patients were excellent, 2 patients were good. We achieved desired postoperative MAD ( from medial 15 mm to lateral 10 mm) in 15 limbs of 12 patients. The LDFA in 11 limbs was corrected to normal (84°-90°). The ROM was not significantly changed before and after operation in the both groups. No infection or neuro-vascular injury occurred.

CONCLUSION

The FAN technique is an effective method to treat valgus knee or varus knee deformity in young patients with DFO.

Management of functional nonretentive fecal incontinence in children: Recommendations from the International Children's Continence Society

BACKGROUND

Fecal incontinence (FI) in children is frequently encountered in pediatric practice, and often occurs in combination with urinary incontinence. In most cases, FI is constipation-associated, but in 20% of children presenting with FI, no constipation or other underlying cause can be found - these children suffer from functional nonretentive fecal incontinence (FNRFI).

OBJECTIVE

To summarize the evidence-based recommendations of the International Children's Continence Society for the evaluation and management of children with FNRFI.

RECOMMENDATIONS

Functional nonretentive fecal incontinence is a clinical diagnosis based on medical history and physical examination. Except for determining colonic transit time, additional investigations are seldom indicated in the workup of FNRFI. Treatment should consist of education, a nonaccusatory approach, and a toileting program encompassing a daily bowel diary and a reward system. Special attention should be paid to psychosocial or behavioral problems, since these frequently occur in affected children. Functional nonretentive fecal incontinence is often difficult to treat, requiring prolonged therapies with incremental improvement on treatment and frequent relapses.

Regulatory role of B-cell maturation antigen on the toxic effect of chromium ions on human SaOS-2 osteoblasts

Metal prostheses of artificial joints undergo wear, producing numerous metal particles and ions, such as Cr³⁺ . Cr³⁺ is considered a key factor leading to aseptic loosening. Many studies focus on the effect of Cr³⁺ on osteoblasts; however, little is known about the effect of Cr³⁺ on the B-cell maturation antigen (BCMA) in the osteoblasts. In this study, we first demonstrated the BCMA expressed in human SaOS-2 osteoblasts through reverse transcriptase-PCR, Western blot, and immunocytochemical analyses. Cr³⁺ decreased alkaline phosphatase (ALP), osteocalcin (OC), cell mineralization, and collagen type I mRNA and protein expression. Moreover, Cr³⁺ has an inhibitive effect on the expression of the BCMA in human SaOS-2 osteoblasts. However, after we upregulated the expression of the BCMA, ALP, OC, cell mineralization, and collagen type I mRNA and protein expression were increased. Overall, this study demonstrates that the BCMA is involved in human SaOS-2 osteoblast osteogenetic metabolism and plays a regulatory role on the toxic effect of chromium ions on human SaOS-2 osteoblasts.

Complex relation among Health Belief Model components in TB prevention and care

OBJECTIVES

This study aims to explore the relationships among components of the Health Belief Model, tuberculosis (TB) preventive behavior, and intention of seeking TB care.

STUDY DESIGN

Cross section study.

METHODS

Using convenience sampling, 1154 rural-to-urban migrant workers were selected between the ages of 18-50 years in six urban areas of three provinces in China. The survey was conducted by individual, face-to-face interviews with a standardized questionnaire. Lisrel 8.7 was used to conduct path analysis.

RESULTS

The knowledge and benefits components of the Health Belief Model predicted preventive behaviors: cover nose/mouth when coughing or sneezing (β = 0.24, 0.33 respectively), evade others' coughs (β = 0.13, 0.25) and also predicted seeking TB care (β = 0.27, 0.19). Susceptibility and severity also predicted seeking TB care (β = 0.12, 0.16). There were also important relationships among model components. Knowledge of TB predicted both susceptibility (β = 0.32-0.60) and severity (β = 0.41-0.45). Further, each of susceptibility (β = 0.30) and severity (β = 0.41) predicted perceived benefits of preventive care.

CONCLUSION

Thus, a path from knowledge, through severity and susceptibility, and then through benefits predicted prevention and TB care seeking behaviors.

Ebp1 protein expression in cervical cancer tissue and its significance

The objectives of this study were to observe the changes in expression of ErbB-3 binding protein (Ebp1) in cervical cancer and to investigate their clinic significance. We detected the expression level of Ebp1 in cancerous and adjacent tissues from 56 patients with cervical cancer. We identified 21 Ebp1 positive samples (37.5%) from among the 56 cervical cancer tissue samples and 5 Ebp1 positive samples (8.9%) in the corresponding adjacent tissues; the difference was statistically significant (P < 0.05). No statistically significant (P > 0.05) differences in the rates of positive Ebp1 expression were found between patients under 60 years of age and those equal to or over this age. No statistically significant differences (P > 0.05) were found between patients whose tumor diameters were under 5 cm and those with tumor diameters over 5 cm. No statistically significant differences (P > 0.05) in the Ebp1 positive rates were found among the cervical cancer samples when stratified by grade (I, II, or III). Together, these results demonstrate that Ebp1 protein expression is upregulated in cervical cancer tissues but is not related to clinical pathologic factors such as patient age or tumor size or differentiation level, suggesting that Ebp1 plays an important role in the genesis and growth process of cervical cancer.

Association of the IFNAR1-17470 and IL-10-592 cytokine variants with susceptibility to chronic hepatitis B viral infections in a Chinese population

An association between the sequence variants of cytokine genes and various clinical outcomes in subjects infected with the hepatitis B virus (HBV) has been demonstrated. However, the results are inconsistent and inconclusive. Further studies in other populations and the evaluation of a greater number of individuals may contribute to a better understanding of the influence of the cytokine genetic variants on the evolution of HBV infections. This study was performed to explore the relationships between the sequence variants of TNF-A-308, IFNAR1-17470, and IL-10-592 and the susceptibility to chronic hepatitis B (CHB) in a Chinese population. A total of 160 patients with CHB and 124 individuals who had spontaneously recovered (SR) from hepatitis B were enrolled in the present study. The variants at TNF-A-308, IFNAR1-17470, and IL-10-592 were determined by PCR-restriction fragment length polymorphism analysis and were confirmed by bidirectional DNA sequencing. Significant differences were found between the CHB and the SR groups in the frequency and distribution of the genotypes of both IFNAR1-17470 and IL-10-592 genes. In comparison with the CHB patients with the IFNAR1-17470 G/G variant, the odds ratio (OR) of the CHB patients with the IFNAR1-17470 C/C variant developing chronic hepatitis was 2.06 (95%CI = 1.03-4.14). In addition, the OR of the patients with CHB having the IL-10-592 C/C variant developing chronic hepatitis was 2.77 (95%CI = 1.13-4.57) when compared with that of the patients with the IL-10-592 A/A variant. In conclusion, sequence variants of both the IFNAR1-17470 and IL-10-592 genes were correlated with susceptibility to CHB.

Effects of high thoracic epidural anesthesia on ischemic cardiomyopathy cardiac function and autonomic neural function

We aimed at observing the effects of high thoracic epidural anesthesia (HTEA) on cardiac structure and function, heart rate variability (HRV), and QT interval variation (QTV) in ischemic cardiomyopathy (ICM) patients with chronic heart failure. We divided 30 ICM patients into HTEA (N = 16) and control (N = 14) groups.The control group was treated with medication, and the HTEA group was treated with HTEA and medication for 4 weeks. We measured the changes in the left-ventricular end-diastolic diameter (LVEDd) and left-ventricular ejection fraction (LVEF) before and after treatment by using echocardiography and examined changes in HRV and QTV using ambulatory electrocardiogram. HTEA significantly narrowed the LVEDd, improved LVEF, significantly increased the HRV, and significantly reduced the QTV in the ICM group compared to the control group. HTEA significantly narrowed the ventricular chamber diameter size of ICM patients, enhanced myocardial contractility, increased myocardial electrical stability, and improved the cardiac structure and function.

An orthogonal neural network for function approximation

This paper presents a new single-layer neural network which is based on orthogonal functions. This neural network is developed to avoid the problems of traditional feedforward neural networks such as the determination of initial weights and the numbers of layers and processing elements. The desired output accuracy determines the required number of processing elements. Because weights are unique, the training of the neural network converges rapidly. An experiment in approximating typical continuous and discrete functions is given. The results show that the neural network has excellent performance in convergence time and approximation error.

Modified total trapezial and partial trapezoidal excision and ligament reconstruction tendon interposition reduces symptoms in isolated scaphotrapezial-trapezoid arthritis of the wrist

Trapezial excision arthroplasty with ligament reconstruction and tendon interposition (LRTI) modified to include proximal trapezoid excision was performed on 12 wrists in 10 patients with symptomatic, isolated scaphotrapezial-trapezoid (STT) arthritis. Wrist range of motion, lateral pinch and grip strength, and analog pain scores were measured pre- and post-operatively. Mean follow-up was 18 (11-42) months. Post-operatively, reported pain scores uniformly decreased (p < 0.0001). Mean range of wrist flexion increased from 48 to 53° (p < 0.05) and extension from 51 to 55° (p < 0.05). There was also an overall increase in mean grip strength from 15.6 to 19.2 kg and pinch strength from 3.5 to 4.3 kg. Modified Mayo Wrist Scores were excellent in six cases, good in three, and fair in one. Our results suggest that modified total trapezial, partial trapezoidal excision and LRTI could be an effective surgical alternative in cases of isolated STT arthritis.

Validation of the seventh edition of the American Joint Committee on Cancer tumor-node-metastasis (AJCC TNM) staging in patients with stage II and stage III colorectal carcinoma: analysis of 2511 cases from a medical centre in Korea

AIM

The sixth and seventh editions of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) system for patients with stage II and stage III colorectal carcinoma (AJCC-6 and AJCC-7) were compared.

METHOD

Between 2000 and 2007, 2511 stage II/III colorectal carcinoma patients received primary surgical resection at the Asan Medical Center (Seoul, Korea). All patients were staged using AJCC-6 and AJCC-7 TNM systems. Patients with synchronous or other cancers, those given preoperative chemotherapy or radiotherapy and those in whom fewer than 12 lymph nodes were resected, were excluded. Overall survival (OS) and disease-free survival (DFS) were compared.

RESULTS

Of 2511 patients, 255 (10.2%) had different stages in the AJCC-6 and AJCC-7. For the AJCC-7, the 5-year OS by stage was 94.2% for stage IIA, 88.8% for stage IIB, 83.5% for stage IIC, 91.8% for stage IIIA, 81.8% for stage IIIB and 72.0% for stage IIIC. The OS and the DFS were not significantly different for the new substages IIB (n = 57) and IIC (n = 34) (P = 0.34 and P = 0.87, respectively). For the 187 patients with stage T3N2a cancer, the OS and the DFS were significantly different from stage IIIB other than T3N2a (P = 0.008 and P = 0.01, respectively) and there were no statistically significant differences in OS between the T3N2a group and the IIIC group (P = 0.46).

CONCLUSION

The study indicates that AJCC-7 has better prognostic validity than AJCC-6 for staging of patients with stage II and stage III colorectal carcinoma.

Rapamycin protects heart from ischemia/reperfusion injury independent of autophagy by activating PI3 kinase-Akt pathway and mitochondria K(ATP) channel

OBJECTIVES

The purpose of this study was to investigate potential roles of rapamycin, a macrocytic lactone produced by Streptomyces hygroscopicus, in myocardial ischemia/reperfusion (I/R) injury.

METHODS

Male Wistar rats were pretreated with three different doses of rapamycin (0.25, 2, and 5 mg/kg). Then, isolated rat hearts were exposed to 40 min of global ischemia followed by 120 min of reperfusion using a Langendorff apparatus. Western blot analysis was used to examine changes in the expression levels of ERK1/2 and Akt kinases and LC3 -II/I (a marker of autophagy). The area of myocardial infarction and cardiac function were evaluated.

RESULTS

Our results demonstrated that rapamycin mediates cardioprotection in a dose-dependent manner in isolated rat hearts during myocardial I/R injury. Significant a autophagy was induced by rapamycin during I/R. Both, the mitochondrial K(ATP)-channel blocker 5-hydroxydecanoate (5-HD) and the PI3K inhibitor LY294002 (LY) abolished the protection afforded by rapamycin completely, while the inhibitors alone did not influence the infarct size in control hearts. However, the ERK1/2 inhibitor PD98059(PD) and the blocker of autophagy 3-methyladenine (3-MA) had no effect on rapamycin-mediated cardioprtection.

CONCLUSIONS

Cardioprotection afforded by rapamycin involves the PI3K pathway and the activation of mitochondrial K(ATP)-channels, but is independent of rapamycin-induced autophagy. This study may have significant impact on clinical practice.

[Atorvastatin use and coronary flow reserve in patients with coronary slow flow]

OBJECTIVE

To investigate the impact of statin use on coronary flow reserve (CFR) in patients with slow coronary flow.

METHODS

A total of 91 patients with chest pain and coronary slow flow but normal coronary angiography were included in this study, patients were divided into statin group (atorvastatin 20 mg/d for 8 weeks, n = 51) and non-statin group (n = 40), 26 healthy subjects with normal angiography and negative exercise ECG test served as normal controls. Blood cholesterol was measured. Doppler coronary flow velocity and Doppler reserve measurement of distal left anterior descending were recorded at rest and adenosine infusion (140 microgxkg(-1)xmin(-1)) induced hyperemia state, CFR was calculated by the ratio of maximal hyperemia and baseline peak diastolic coronary flow velocity (hCFV and bCFV) before and after atorvastatin treatment.

RESULTS

(1) Eight weeks later, total cholesterol and LDL-C levels were significantly lower in statin group than in non-statin group and control group [TC (3.83 +/- 0.80) mmol/L vs. (5.30 +/- 1.18) mmol/L vs. (5.32 +/- 1.17) mmol/L, P < 0.05; LDL-C (2.26 +/- 0.64) mmol/L vs. (3.28 +/- 0.85) mmol/L vs. (3.30 +/- 0.82) mmol/L, P < 0.05]. (2)Baseline CFR levels were significantly lower in statin group and non-statin group than that in control group (2.32 +/- 0.30 vs. 2.25 +/- 0.33 vs. 3.15 +/- 0.34, P < 0.05). Compared with non-statin group and statin group before treatment, 8 weeks statin treatment was associated with reduced bCFV [(26.06 +/- 3.22) cm/s vs. (29.02 +/- 3.36) cm/s and (26.06 +/- 3.22) cm/s vs. (28.43 +/- 3.40) cm/s, P < 0.05], increased hCFV [(77.63 +/- 8.96) cm/s vs. (65.17 +/- 7.22) cm/s and (77.63 +/- 8.96) cm/s vs. (64.58 +/- 6.26) cm/s, P < 0.05] and increased CFR (3.07 +/- 0.29 vs. 2.28 +/- 0.35 and 3.07 +/- 0.29 vs. 2.32 +/- 0.30, P < 0.05). bCFV, hCFV and CFR of statin group post treatment were similar to those of controls (P > 0.05).

CONCLUSION

Patients with coronary slow flow were associated with lower CFR which could be significantly improved by statin therapy.

Tetracycline production with sweet potato residue by solid state fermentation

For saving energy in antibiotic production and reducing the amount of agricultural wastes, solid state fermentation was used in this study to produce tetracycline with sweet potato residue by Streptomyces viridifaciens ATCC 11989. It was found that the optimal media for tetracycline production were sweet potato residue 100 g, organic nitrogen (rice bran, wheat bran, or peanut meal) 20 g, (NH(4))(2)SO(4) 2.4 g, KH(2)PO(4) 0.4 g, CaCO(3) 1.8 g, NaCl 0.6 g, MgCl(2) 0.8 g, soluble starch 10 g, methionine 0.2 g, histidine 0.8 g, and monosodium glutamate 1.6 g with initial moisture content 68-72%, and initial pH 5.8-6.0. Each gram of dry weight substrate was inoculated with 1.0 x 10(8) conidia and incubated at 26 degrees C for 5-7 days, producing 4720 mug of total tetracycline equivalent potency. When incubated at 26 degrees C with the initial moisture content 68%, the conidia in solid media germinated on the second day, mycelia grew abundantly on the third day and reached stationary phase on the sixth day. The antibiotic production was consistent with the morphogenesis of S. viridifaciens: activity could be detected on the third day, had the maximal potency on the sixth day, and decreased slightly on the tenth day. (11-3-88 tly).

IL-10 promoter gene polymorphisms and sustained response to combination therapy in Taiwanese chronic hepatitis C patients

BACKGROUND AND AIMS

Host genetic factors may affect clinical outcomes of hepatitis C virus (HCV) infection; however, the possible mechanisms remain largely unknown. The role of immunopathogenesis in chronic hepatitis C leads to extensive exploration of host immunity including inflammatory cytokines.

METHODS

We examined interleukin 10 (IL-10) promoter gene polymorphisms at positions -1082, -819, and -592 relative to transcription start site and studied their association with response to 24 weeks of pegylated interferon plus ribavirin treatment in 143 chronic hepatitis C patients, of whom 97 (67.8%) achieved a sustained virologic response (SVR). In addition, 134 healthy adults were used as controls.

RESULTS

Of chronic hepatitis C patients, 111 (77.6%) were genotype 1 infection, 32 (22.4%) were genotype 2 infection. Patients with sustained virologic response were younger and had higher pretreatment ALT levels than those without. No statistical difference was found between chronic hepatitis C patients who achieved SVR or not in terms of gender, HCV genotype, pretreatment HCV RNA levels, and severity of liver disease. The serum IL-10 levels were comparable between healthy controls and chronic hepatitis C patients as well as between HCV patients with and without SVR. The distribution of IL-10 promoter gene polymorphisms at positions -1082, -819, and -592 relative to transcription start site was comparable between HCV patients and healthy controls as well as HCV patients with and without SVR. A high frequency of ATA haplotype of common IL-10 promoter gene SNPs was found in both chronic hepatitis C patients (70.3%) and healthy controls (69.8%). However, ATA haplotype was not associated with SVR in chronic hepatitis C patients.

CONCLUSIONS

Our data fail to demonstrate the influence of IL-10 promoter gene polymorphisms on the response to combination therapy in Taiwanese chronic hepatitis C patients. The impact of genetic variations in IL-10 haplotype on the response to anti-HCV treatment among different ethnic populations deserves further examination.

Application of recA and rpoB sequence analysis on phylogeny and molecular identification of Geobacillus species

AIMS

Some Geobacillus species have highly similar 16S rRNA gene sequences, making 16S rDNA sequence analysis-based identification problematic. To overcome this limitation, recA and rpoB sequence analysis was evaluated as an alternative for distinguishing Geobacillus species.

METHODS AND RESULTS

The phylogram of 16S rRNA gene sequences inferred from the neighbour-joining method showed that nine clusters of Geobacillus species were characterized with bootstrap values >90%. The recA and rpoB sequences of 10 reference strains in clusters V, VIb and VIc were amplified and sequenced using consensus primers. Alignment of recA sequences in clusters V, VIb and VIc revealed three types of recA genes, consistent with the putative amino acid sequences and in vivo recA splicing analysis. The phylogram constructed from rpoB sequences showed more divergence than that constructed from 16S rRNA gene sequences.

CONCLUSIONS

recA and rpoB sequence analysis differentiated closely-related Geobacillus species and provided direct evidence for reclassifying some species dubiously categorized as Geobacilli. Additionally, this study revealed three types of recA genes in the different Geobacillus species.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study highlights the advantage of recA and rpoB sequence analysis to supplement 16S rRNA gene sequence analysis for efficient and convenient determination of Geobacillus species.