bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Ultrasound-assisted and Pure Fluoroscopy-guided Extracorporeal Shockwave Lithotripsy for Renal Stones
Authors: Chang Tsung-Hsin , Lin Wun-Rong , Tsai Wei-Kung , Chiang Pai-Kai , Chen Marcelo , Tseng Jen-Shu , Chiu Allen W
Published: May 2020

Background
In this study, we aimed to compare the efficacy and clinical outcomes of shock wave lithotripsy (SWL) for patients with renal stones using pure fluoroscopy (FS) or ultrasound-assisted (USa) localization with two lithotripters.
Methods
We retrospectively identified 425 patients with renal calculi who underwent SWL with either a LiteMed LM-9200 ELMA lithotripter (209 cases), which combined ultrasound and fluoroscopic stone targeting or a Medispec EM-1000 lithotripter machine (216 cases), which used fluoroscopy for stone localization and tracking. The patient demographic data, stone-free rates, stone disintegration rates, retreatment rates and complication rates were analyzed.
Results
The USa group had a significantly higher overall stone-free rate (43.6 vs. 28.2%, p < 0.001) and stone disintegration rate (85.6 vs. 64.3%, p < 0.001), as well as a significantly lower retreatment rate (14.8 vs. 35.6%, p < 0.001) and complication rate (1.9 vs. 5.5%, p = 0.031) compared with the FS group. This superiority remained significant in the stone size < 1 cm stratified group. In the stone size > 1 cm group, the stone-free rate (32.4 vs. 17.8%, p = 0.028), disintegration rate (89.2 vs. 54.8%, p = 0.031) and retreatment rate (21.6 vs. 53.4%, p < 0.001) were still significantly better in the USa group, however there was no significant difference in the complication rate. The most common complication was post-SWL-related flank pain.
Conclusion
Extracorporeal SWL using ultrasound combined with fluoroscopy for stone localization and real-time tracking, provides higher stone-free rates and stone disintegration rates, as well as lower retreatment rates and fewer complications.
A New Choice for the Use of the Stents for Transjugular Intrahepatic Portosystemic Shunt Creation: Viabahn ePTFE covered stent/bare metal stent combination
Authors: Liu Jiacheng , Meng Jie , Zhou Chen , Shi Qin , Yang Chongtu , Ma Jinqiang , Chen Manman , Xiong Bin
Published: May 2020

Background
Compare the clinical outcome of structure and function between insertion of transjugular intrahepatic portosystemic shunt (TIPS) created with the Viabahn ePTFE covered stent/bare metal stent (BMS) combination and Fluency ePTFE covered stent/BMS combination.
Methods
101 consecutive patients undergone TIPS procedure from February 2016 to August 2018 in our center were analyzed retrospectively, 64 subjects were enrolled in Viabahn group and 37 were Fluency group. We caculated the TIPS geometry characteristics and evaluated the related occurrence of shunt dysfunction, survival, overt hepatic encephalopathy (OHE) and variceal rebleeding.
Results
The technical success rate was 100%. After TIPS insertion, the rate of shunt dysfunction during the first 3 months was significantly different between Viabahn group and Fluency group, which were respectively 1.6% and 13.5% (p = 0.024). And multivariate analysis indicated that the angle of portalvenous inflow (α) (HR = 1.060, 95%CI = 1.009–1.112, p = 0.020) was the only predictor of shunt dysfunction. Besides, after 3 months following TIPS insertion, the α angle distinctly increased from 20.9°±14.3° to 26.9°±20.1° (p = 0.005) in Fluency group but stayed unchanged in Viabahn group (from 21.9°±15.1° to 22.9°±17.6°, p = 0.798).
Conclusions
The occurence of shunt dysfunction was related to the angle of portalvenous inflow (α), because of the slighter effect on α angle, after TIPS inplanation, Viabahn ePTFE covered stent/BMS combination was more stable in structure and promised higher short-term stent patency compared to Fluency ePTFE covered stent/BMS combination.
Determination of the ED95 of intrathecal hyperbaric prilocaine with sufentanil for scheduled cesarean delivery: A dose-finding study based on the continual reassessment method
Authors: Goffard Philippe , Vercruysse Yoann , Leloup Renaud , Fils Jean-François , Chevret Sylvie , Kapessidou Yota
Published: May 2020

BackgroundScheduled cesarean section is routinely performed under spinal anesthesia using hyperbaric bupivacaine. The current study was undertaken to determine the clinically relevant 95% effective dose of intrathecal 2% hyperbaric prilocaine co-administered with sufentanil for scheduled cesarean section, using continual reassessment method.MethodsWe conducted a dose-response, prospective, double-blinded study to determine the ED95 values of intrathecal hyperbaric prilocaine used with 2,5 mcg of sufentanil and 100 mcg of morphine for cesarean delivery. Each parturient enrolled in the study received an intrathecal dose of hyperbaric prilocaine determined by the CRM and the success or failure of the block was assessed as being the primary endpoint.ResultsThe doses given for each cohort varied from 35 to 50 mg of HP, according to the CRM, with a final ED95 lying between 45 and 50 mg of Prilocaine after completion of the 10 cohorts. Few side effects were reported and patients were globally satisfied.ConclusionsThe ED95 of intrathecal hyperbaric prilocaine with sufentanil 2.5 µg and morphine 100 µg for elective cesarean delivery was found to be between 45 and 50 mg. It may be an interesting alternative to other long-lasting local anesthetics in this context.Trial registrationThe study was registered on January 30, 2017 – retrospectively registered – and results posted at the public database clinicaltrials.gov (NCT03036384 – https://clinicaltrials.gov/ct2/show/NCT03036384).
Association between Pelvic Obliquity and Scoliosis, Hip Displacement and Asymmetric Hip Abduction in Children with Cerebral Palsy. A Cross-Sectional Registry Study
Authors: Hägglund Gunnar
Published: May 2020

Background Pelvic obliquity (PO) is common in individuals with cerebral palsy (CP). I analysed the prevalence of PO in a population of children with CP and its associations with scoliosis, hip displacement and asymmetric range of hip abduction.Methods Over a 5-year period all pelvic radiographs from the Swedish surveillance programme for CP and the recorded data for scoliosis and hip abduction in children from southern Sweden at Gross Motor Function Classification System (GMFCS) levels II–V were analysed. PO and hip displacement calculated as migration percentage (MP) were measured on supine pelvic radiographs and compared with side difference in hip abduction. Statistical analyses comprised chi-squared testing and binominal confidence intervals.Results In total, 337 children were analysed, of whom 79 had a PO of ≥5°. The proportion of children with PO increased from 16% in GMFCS level II to 34% in level V. Scoliosis combined with PO was reported in 38 children, of whom 34 (89%, 95% confidence interval [CI] 80–99%) had the convexity opposite the high side of the PO. Asymmetric abduction with PO was reported in 45 children, of whom 40 (89%, CI 79–99%) had reduced abduction on the high side of the PO. Asymmetric MP of ≥5% with PO was seen in 62 children, of whom 50 had higher MP on the high side of the PO (81%, CI 71–90%). Children in GMFCS levels II–IV more often had isolated infra-pelvic association with PO (47% versus 19% in GMFCS V, P = 0.025), while combined supra- and infrapelvic association was more common in GMFCS level V (65% versus 30% in GMFCS II–IV, P = 0.004). Isolated infrapelvic or no association was seen in 74% of children ≤10 years of age while 76% of children ≥11 years old had suprapelvic or combined supra- and infrapelvic association with PO (P = 0.0001).Conclusions There was a strong association between the high side of the PO and the side of scoliosis, highest MP and lowest range of abduction when PO was measured in supine position. PO was more often associated with infrapelvic factors. PO was seen in young children indicating the need for early awareness of this complication.
Characterizing glycosyltransferases by a combination of sequencing platforms applied to the leaf tissues of Stevia rebaudiana
Authors: zhang shaoshan , Liu Qiong , Lyu Chengcheng , chen Jinsong , xiao Renfeng , chen Jingtian , Yang Yunshu , zhang Huihui , Hou Kai , Wu Wei
Published: May 2020

Background: Stevia rebaudiana (Bertoni) is considered one of the most valuable plants because of the steviol glycosides (SGs) that can be extracted from its leaves. Glycosyltransferases (GTs), which can transfer sugar moieties from activated sugar donors onto saccharide and nonsaccharide acceptors, are widely distributed in the genome of S. rebaudiana and play important roles in the synthesis of steviol glycosides. Results: Six stevia genotypes with significantly different concentrations of SGs were obtained by induction through various mutagenic methods, and the contents of seven glycosides (stevioboside, Reb B, ST, Reb A, Reb F, Reb D and Reb M) in their leaves were considerably different. Then, NGS and single-molecule real-time (SMRT) sequencing were combined to analyse leaf tissue from these six different genotypes to generate a more complete and correct full-length transcriptome of S. rebaudiana. Two phylogenetic trees of glycosyltransferases (SrUGTs) were constructed by the neighbour-joining method and successfully predicted the functions of SrUGTs involved in SG biosynthesis. With further insight into glycosyltransferases (SrUGTs) involved in SG biosynthesis, the weighted gene co-expression network analysis (WGCNA) method was used to characterize the relationships between SrUGTs and SGs, and forty-four potential SrUGTs were finally obtained, including SrUGT85C2, SrUGT74G1, SrUGT76G1 and one SrUGT91D2, which have already been reported to be involved in the glucosylation of steviol glycosides, illustrating the reliability of our results.Conclusion: Combined with the results obtained by previous studies and those of this work, we systematically characterized glycosyltransferases in S. rebaudiana and forty-four candidate SrUGTs involved in the glycosylation of steviol glucosides were obtained. Moreover, the complete and correct full-length transcriptome obtained in this study will provide valuable support for further research investigating S. rebaudiana.
Metabolic and transcriptome responses of RNAi-mediated AMPKα knockdown in Tribolium castaneum
Authors: Jiang Heng , Zhang Nan , Ji Caihong , Meng Xiangkun , Qian Kun , Zheng Yang , Wang Jianjun
Published: May 2020

Background
The AMP-activated protein kinase (AMPK) is an intracellular fuel sensor for lipid and glucose metabolism. In addition to the short-term regulation of metabolic enzymes by phosphorylation, AMPK may also exert long-term effects on the transcription of downstream genes through the regulation of transcription factors and coactivators. In this study, RNA interference (RNAi) was conducted to investigate the effects of knockdown of TcAMPKα on lipid and carbohydrate metabolism in the red flour beetle, Tribolium castaneum, and the transcriptome profiles of dsTcAMPKα-injected and dsEGFP-injected beetles under normal conditions were comparatively analyzed by RNA-sequencing.
Results
RNAi-mediated suppression of TcAMPKα increased whole-body triglyceride (TG) level and the ratio between glucose and trehalose, as was confirmed by in vivo treatment with the AMPK-activating compound, 5-Aminoimidazole-4-carboxamide1-β-D-ribofuranoside (AICAR). A total of 1184 differentially expressed genes (DEGs) were identified between dsTcAMPKα-injected and dsEGFP-injected beetles. These include genes involved in lipid and carbohydrate metabolism as well as insulin/insulin-like growth factor signaling (IIS). Real-time quantitative polymerase chain reaction analysis confirmed the differential expression of selected genes. Interestingly, metabolism-related transcription factors such as sterol regulatory element-binding protein 1 (SREBP1) and carbohydrate response element-binding protein (ChREBP) were also significantly upregulated in dsTcAMPKα-injected beetles.
Conclusions
AMPK plays a critical role in the regulation of beetle metabolism. The findings of DEGs involved in lipid and carbohydrate metabolism provide valuable insight into the role of AMPK signaling in the transcriptional regulation of insect metabolism.
Conserved gene reactivity revealed in cnidarian innate immunity during zoonotic infection
Authors: Seneca Francois , Davtian David , Boyer Laurent , Czerucka Dorota
Published: May 2020

Cnidarians - the most primitive tissue-forming animals - can get infected with pathogens, defend themselves and heal. Recent sequencing projects on cnidarians have unveiled a rich innate immunity gene repertoire but little is known about their involvement in the host’s response against live pathogens over time. Vibrio parahaemolyticus (Vp) is a zoonotic threat originating from the ocean, which causes pandemics, and economic struggle to society. Here, we advance our understanding of the innate immunity from the transcriptome-wide response of a basal marine metazoan to infection with Vp. The dynamic of the response was assessed in a time series experiment following the gene activity of the anemone Aiptasia pallida strain CC7 infected or not with the Vp clinical strain O3:K6 and compared to the gene expression profile under LPS treatment. ResultsRNA-sequencing, gene expression and functional analyses detected hundreds of genes responsive to the Vp infection after 1, 3, 6 and 12 hours, including very few shared with the response to LPS. Members of the NOD-like receptor, C-type lectin receptor, and RIG-I-like receptor PRR families were responsive to the infection, but none from the canonical TLR family. A TLR-like pathway represented by MyD88, TRAF6, NF-κB and AP-1 was actively regulated in response to the infection but not by LPS, suggesting an alternative PAMP-PRR trigger to this pathway. Other activated pathways involving TNFRs likely lead to apoptosis which was enzymatically confirmed. Recently proposed novel innate immune genes in actinarians including CniFLs and NGs showed positive expression to infection.Conclusions Several innovations consisting of: possible neofunctionalization, conservation of signaling pathways over conservation of particular key genes, and involvement of lineage-specific immunity genes, denote the innate immune response to live pathogen in Aiptasia. Transduction of immune signals through a TLR-like pathway is supported. Two TNFR pathways could possibly lead to an inflammatory response and apoptosis, which we suggest takes place to fend off bacterial infection in Aiptasia. These results reveal the anemone’s innate immunity genes responsive to bacterial infection as well as potential novel candidates for future evolutionary as well as functional studies.
Opportunities and Risks of Terminological Ambiguity: The Perception of Value in Value-Based Healthcare – A Multi-Method Study
Authors: Wolf Axel , Bååthe Fredrik , Nilsson Kerstin , Andersson Erichsen , Wikström Ewa , Erlandsson Fredrik
Published: May 2020

BackgroundValue-based healthcare (VBHC) argues healthcare needs to be refocused to maximize value creation, defining value as the value quota (VQ) of outcomes important for the patient divided by the cost of the care. Value is central to the VBHC concept but could be an ambiguous term for professionals wanting to adopt the concept in an implementation process. We set out to explore the perception of value amongst different stakeholders who implement VBHC.Methods The perception of value, cost and VBHC was analysed using content analysis of semi-structured interviews from 19 clinicians and non-clinicians involved in implementation of VBHC. In addition, we exemplified the value quota (VQ) with data from a clinical trial to exemplify the possible association between patient reported outcome measurements (Kansas City Cardiomyopathy Questionnaire and the EQ5D ), their perception of care (n=248) and cost. ResultsClinicians described value as a dynamic concept dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. Value for non-clinicians appeared more driven by the interplay between the outcome and cost or resources. The quantitative data suggested a poor association between patients’ perception of value and VQ. ConclusionsOur findings indicate that there is great variation in how different stakeholders (clinicians, non-clinicians) perceive the key concept of value when implementing VBHC. The most dominant influence was the voice of clinicians, focusing on increasing treatment efficacy and improving medical outcomes but having a limited focus on cost and what matters to patients. Moreover, patients’ own perception of value provided during a care period was poorly connected to the calculated value quota. If the concept of value is defined primarly by clinicians’ own assumptions, there is a clear risk that history will simply be repeated and the need for innovation will not be met. A single-minded focus on value” could therefore result in missing the target. The patients’ and non-clinicians’ perception of value must also be integrated with the clinical perception, if VBHC is going to deliver on the promise to increase healthcare efficiency and effectiveness.
Clinical Significance of coexisting histological diffuse type in stage II/III gastric cancer: A retrospective study
Authors: Tanaka Hiroaki , Yoshii Mami , Miki Yuichiro , Tamura Tatsuro , Toyokawa Takahiro , Shibutani Masatsune , Nagahara Hisashi , Yashiro Masakazu , Muguruma Kazuya , Hirakawa Kosei , Ohira Masaichi
Published: May 2020

Background: Since 1965, the Laurén classification has been used most commonly for gastric adenocarcinoma, with two types, intestinal type and diffuse type. Signet ring cell carcinoma (Sig) and non-solid poorly differentiated adenocarcinoma (Por2) are the histological forms of diffuse type and are often found in advanced tumors, and they seem to be associated with a poor prognosis. S-1 based adjuvant chemotherapy for patients with stage II/III gastric cancer has generally been accepted in Japan, but histological type does not alter treatment strategy. The aim of the present study was to investigate the prognostic impact of the histopathologic mixture of Sig and Por2 in patients with stage II/III gastric cancer treated with S-1 adjuvant chemotherapy.Methods: The clinicopathological data of 968 gastric carcinoma patients who underwent gastrectomy between 2007 and 2016 at our department were retrospectively analyzed. In this study, tumors containing Sig or Por2 were classified as Diffuse type, and those not containing them were classified as Intestinal type.Results: There were 307 cases of Diffuse type and 661 of Intestinal type. Diffuse type included 189 cases with Sig. Pathological diagnosis of Sig was an independent risk factor for peritoneal recurrence in patients with stage II/III. Patients with Diffuse type had worse overall survival than those with Intestinal type in Stage III. Of the patients who received S-1 adjuvant chemotherapy, the prognosis of Stage III patients with Sig but not Por2 was Significantly worse compared to patients with Intestinal type.Conclusions: The coexistence of Signet ring cell carcinoma in the primary tumor was associated with a poor prognosis in patients with stage III gastric cancer. These findings suggest that, because mixed Sig gastric cancer had a high risk of peritoneal recurrence even if adjuvant chemotherapy were performed, the pathological diagnosis should be considered when determining the therapeutic strategy for adjuvant chemotherapy in stage III gastric cancer.
Single-cell sequencing reveals the intermediate cell state and function of dermal papilla cells in the hair follicle cycle of cashmere goats
Authors: Yang Feng , Liu Zhihong , Che Tianyu , Guo Juntao , Xie Yuchun , Li Hegang , Wang Zhixin , Zhao Jinshan , li jinquan
Published: May 2020

Background:

Human hair loss and regeneration has stimulated interest in the natural hair cycle worldwide; however, such research is difficult because the periodicity of human or mouse hair is not visually obvious. Dermal papilla cells (DP cells) play an important role in the development of hair follicles, but knowledge of the differentiation and mechanisms of DP stem cells during transition through the hair follicle cycle are still limited, although some studies have reported that DP cells may have an intermediate cell state during differentiation, the classification and function of specific cell states are not clear.
Results:

Here, we used cashmere goats, that have obvious periodicity of hair follicles, as model animals and, based on unbiased single cell RNA sequencing, we identified and isolated DP cell data. Pseudotime ordering analysis was used to successfully construct a DP cell lineage differentiation trajectory and revealed the sequential activation of key genes, signaling pathways, and functions involved in cell fate decisions. At the same time, we analyzed the mechanisms of different cell fates and revealed the function of four different intermediate cells: Intermediate cells 10 showed important functions in the growth of cashmere and maintenance of cashmere attachment to the skin; intermediate cells 1 revealed important functions in the process of apoptosis and cashmere shedding of secondary hair follicles; intermediate cells 0 initiated new follicular cycles and completed the migration of hair follicles and the occurrence of cashmere; and intermediate cells 15 are suggested to be DP progenitor cells.
Conclusions:

In development and apoptosis, inner bulge cells not only earlier than outer bulge cells, but occurred faster and was more thorough,this helps a deeper understanding of the role of bulge cells. Pseudogenes play another important role in function which promoted the competitive endogenous RNA (ceRNA) hybridization of pseudogenes.In different hair follicle cycles, DP cells will differentiate into different intermediate state cells and perform different functions, and the marker genes of the cells also changed. Intermediate cells 10 showed important functions in the growth of cashmere and maintenance of cashmere attachment to the skin; intermediate cells 1 revealed important functions in the process of apoptosis and cashmere shedding of secondary hair follicles; intermediate cells 0 initiated new follicular cycles and completed the migration of hair follicles and the occurrence of cashmere; and intermediate cells 15 are DP progenitor cells, this conclusion provides an unprecedented deeper understanding of the function of DP cells.
The Pathological Features of Hip Abductor Tendon Tears – A Cadaveric Study
Authors: Zhu Mark , Smith Brittany , Krishna Sanjeev , Musson David S. , Riordan Peter R. , McGlashan Sue R. , Cornish Jillian , Munro Jacob T.
Published: May 2020

BackgroundThe hip abductors are crucial in maintaining pelvic stability. Tears in these tendons are common and often debilitating. There is uncertainty regarding both the histological and macroscopic features of hip abductor tears. This study aims to clarify both the macroscopic and microscopic features of the tendon and enthesis in hip abductor tendon tears.MethodsThirty-six cadavers with an average age of 81 were dissected, and the hip abductor mechanisms removed en-bloc. The presence, location and size of the tears were recorded and analysed. The samples were processed into histological blocks and viewed using both transmitted and polarised light. Tendon histology was graded using the modified Movin’s score in three sections (deep, middle and superficial layers) and the enthesis graded separately using 5-point criteria. Analysis of variance was used to confirm histological features associated with tears.ResultsTears were found in 24 of 36 samples (67%). The most common finding was an isolated tear in the gluteus minimus (46%), followed by concurrent gluteus medius and gluteus minimus tears (33%). Histology revealed significantly more degeneration in both the tendon (p = 0.0005) and enthesis (p = 0.0011) when tears were present. Furthermore, these changes were concentrated in the deeper layers of the tendon (p = 0.0002) and enthesis (p = 0.003).ConclusionThis study demonstrated degeneration as the primary pathology underlying hip abductor tendon tears. Degenerative changes occur in both the tendon and enthesis, with the deeper layers predominantly affected. These findings are important for guiding surgical repair techniques and to aid the development of novel materials and biologics.
Effect of Biomechanical Properties on Myopia: a Study of New Corneal Biomechanical Parameters
Authors: Han Fang , Li Mengdi , Wei Pinghui , Ma Jiaonan , Jhanji Vishal , Wang Yan
Published: May 2020

Background: To investigate corneal stress-strain index (SSI), a marker for material stiffness and corneal biomechanical parameters in myopic eyes.Methods: A total of 1056 myopic patients were included in this study. Corvis ST was used to measure SSI. Corneal biomechanics was evaluated using the first and second applanation time (A1-time and A2-time), maximum deflection amplitude (DefAmax), deflection area(HCDefArea)and peak distance at highest concavity (HC-time, HC-DefA, and HC-PD), integrated radius (IR) whole eye movement (WEM), stiffness parameter (SP), biomechanically corrected intraocular pressure (BIOP), and Corvis Biomechanical Index (CBI). Scheimpflug tomography was used to obtain mean keratometery (Km) and central corneal thickness (CCT). All participants were divided into two groups according spherical equivalent (SE) (low myopia: SE≤3.00D and high myopia: SE ≥ 6.00D).Results: The mean SSI value was 0.854±0.004. The SSI has positive correlation with A1-time((r=0.272), HC-time (r=0.218), WEM(r=0.288),SP(r=0.316)，CBI(r=0.199)，CCT (r=0.125), BIOP(r=0.230)and SE (r=0.313)(all p values＜0.01) . The SSI had a negative correlation with HCDefA (r=-0.721), HCDefArea (r=-0.665),HC-PD(r=-0.597),IR (r=-0.555), DefAmax (r=-0.564)and Km (r=-0.103) (all p values＜0.01).There were significant differences in SSI (t=8.960, p＜0.01) and IR(t=-3.509, p＜0.01)between low myopia group and high myopia group.Conclusions: In different grades of myopia, the SSI values were lower in eyes with higher spherical equivalent. It indicates that the mechanical strength of the cornea may compromise in high myopia. The SSI was positively correlated with the spherical equivalent and It may provide a new way to study the mechanism of myopia.
Chorionic villus-derived mesenchymal stem cell-mediated autophagy promotes proliferation and invasiveness of trophoblasts under hypoxia by activating the JAK2/STAT3 signalling pathway
Authors: Chu Yijing , Yue Chongyu , Peng Wei , Chen Weiping , Zhang Yan , He Guifang , Liu Changchang , Zhang Ning , Li Jing , Liu Ling , Gao Guoqiang , Yao Ke , Li Yan , Hu Xiaoyu , Wang Xiaofei , Han Rendong , Huang Yuxiang , Ye Yuanhua
Published: May 2020

Objectives Trophoblast dysfunction during pregnancy is fundamentally involved in preeclampsia. The aim of this study was to understand how human chorionic villous mesenchymal stem cells (CV-MSCs) operate in regulation of trophoblast function.Materials and Methods We treated trophoblasts with CV-MSC supernatant under hypoxic conditions, and transcriptome and pathway analyses of trophoblasts were performed. Western blotting and PCR analysis were used to examine the JAK2, STAT3 and autophagy associated protein expression levels in trophoblasts.Results The CV-MSC supernatant treatment markedly enhanced proliferation, invasion and autophagy. The RNA-seq revealed JAK2/STAT3 signalling as an upstream regulator, and STAT3 mRNA and protein levels increased during CV-MSC treatment. Inhibition of JAK2/STAT3 signalling reduced autophagy, survival and invasion of trophoblasts even in the presence of CV-MSCs, and blocking autophagy did not affect STAT3 activation in trophoblasts treated with CV-MSCs. Importantly, overexpression of STAT3 increased the levels of autophagy in trophoblasts; thus, it regulated positively autophagy in hypoxic trophoblasts. Human placental explants also proved our finding, in which STAT3 was activated and LC3B-II levels were increased by CV-MSC treatment.Conclusions Our data suggest that CV-MSC-dependent activation of JAK2/STAT3 signalling is a prerequisite for upregulation of autophagy in trophoblasts.
COVID-19: epidemiology and preventive measures in Jiangsu province, China
Authors: Chen Yi , Liu JiaShu , Yang ChangRui , Ai Zi-sheng , Zhang AiHong
Published: May 2020

Background: To investigate the epidemiological features of coronavirus disease 2019(COVID-19) and the prevention measures in Jiangsu Province.

Methods: Information of all novel coronavirus pneumonia conﬁrmed cases in Jiangsu was collected from the oﬃcial website of Jiangsu Commission of Health. All data were entered into Excel and Python3 for statistical analysis. Epidemiological characteristics of novel coronavirus pneumonia conﬁrmed cases from January 10, 2020 to March 18 in Jiangsu province were retrospectively analyzed. Meanwhile, the preventive measures of Jiangsu Commission of Health and the people’s Government of Jiangsu Province were also analyzed.

Results: 631 COVID-19 cases were diagnosed in Jiangsu Province, covering 13 cities in Jiangsu. Before February 1, the conﬁrmed cases were mainly imported cases, and after February 1, community transmission cases became main part of conﬁrmed cases. There were more male patients than females, and most patients were in the group of 30-70 years old, 49 patients (7.8%) with mild symptom and 572 patients (90.6%) with common type accounted for the majority. The cumulative mortality rate was 0% and the cure rate was 100%. Reasonable treatments, timely and eﬀective preventive measures were taken to eﬀectively improve cure rate and to prevent the spread of the epidemic, all measures ensure the health and life safety of the people.

Conclusion: The preventive measures in Jiangsu Province were timely and eﬀective, the epidemic situation in Jiangsu Province had been well controlled.
Use of endometriosis fertility index to predict non-ART pregnancy and live birth after endometriosis surgery based on optimal stratification
Authors: Fan Jiaying , Qin Kang , Li Kuanrong , Li Xiaojun , Morse Abraham N , Xie Jingying , Liang Huiying , Yang Yan , Liao Yunsheng , Liu huishu , Li Qingfeng
Published: May 2020

Backround: The EFI, which was previously developed and validated externally, has shown predictive accuracy of non-ART pregnancy following surgery in infertile women with endometriosis. But up to now it was less accurate among the patients with lower scores based on the classification of the original literature. In addition, so far the only study has reported a strong association between the EFI and the live birth. However, the analysis of that study was done in women undergoing surgery rather than in those who had conceived post-operatively. Methods: 501 infertile women undergoing laparoscopic treatment of endometriosis were recruited and followed up for post-operative pregnancy outcomes. The associations of EFI with non-ART pregnancy and with live birth were investigated with survival analysis and the Cochrane-Armitage test. The optimal cut-offs for EFI were determined using the Maximally Selected Rank Statistics (Maxstat). Result(s): The follow-up rate was 92.4% with a mean duration of 38.5 months (range: 14.4-67.4 months). A total of 270 women (58.3%) conceived without ART, 187 (69.3%) had a live birth. A statistically significant association of EFI with non-ART pregnancy rate was observed (hazard ratio: 1.29, 95% confidence interval: 1.19-1.36; 95% confidence interval: 0.57-0.65). The Maxstat method suggested optimal EFI strata of 4, 6 and 8. The cumulative non-ART pregnancy rates 3 years after surgery were 15.0%, 47.1%, 67.6% and 73.6% for EFI scores of 0-4, 5-6, 7-8 and 9-10, respectively (Log-rank p < 0.001). No statistical differences were seen in the live birth rates and the time to pregnancy in the four EFI groups. Conclusion: The EFI is predictive of post-operative non-ART pregnancy but not live birth among non-ART pregnancies. ART might be advisable to women with an EFI score <4 immediately after surgery and to women who have not achieved non-ART pregnancy after 12 months despite a high EFI.
Desirable features in a decision aid for prenatal screening – what do pregnant women and their partners think? A mixed methods pilot study
Authors: Agbadje Titilayo Tatiana , Rahimi Samira Abbasgholizadeh , Côté Mélissa , Tremblay Andrée-Anne , Diallo Mariama Penda , Elidor Hélène , Herron Alex Poulin , Djade Codjo Djignefa , Legare France
Published: May 2020

Background

To help pregnant women and their partners make informed value-congruent decisions about Down syndrome prenatal screening, our team developed two successive versions of a decision aid (DAv2017 and DAv2014). We aimed to assess pregnant women and their partners’ perceptions of the usefulness of the two DAs for preparing for decision making, their relative acceptability and their most desirable features.
Methods

This is a mixed methods pilot study. We recruited participants of study (women and their partners) when consulting for prenatal care in three clinical sites in Quebec City. To be eligible, women had to: (a) be at least 18 years old; (b) be more than 16 weeks pregnant; or having given birth in the previous year and (c) be able to speak and write in French or English. Both women and partners were invited to give their informed consent. We collected quantitative data on the usefulness of the DAs for preparing for decision making and their relative acceptability. We developed an interview grid based on the Technology Acceptance Model and Acceptability questionnaire to explore their perceptions of the most desirable features. We performed descriptive statistics and deductive analysis.
Results

Overall, 23 couples and 16 individual women participated in the study. The majority of participants were between 25 and 34 years old (79% of women and 59% of partners) and highly educated (66.7% of women and 54% of partners had a university-level education). DAv2017 scored higher for usefulness for preparing for decision making (86.2 ± 13 out of 100 for DAv2017 and 77.7 ± 14 for DAv2014). For most dimensions, DAv2017 was more acceptable than DAv2014 (e.g. the amount of information was found “just right” by 80% of participants for DAv2017 against 56% for DAv2014). However, participants preferred the presentation and the values clarification exercise of DAv2014. In their opinion, neither DA presented information in a completely balanced manner. They suggested adding more information about raising Down syndrome children, replacing frequencies with percentages, different values clarification methods, and a section for the partner.
Conclusions

A new user-centered version of the prenatal screening DA will integrate participants’ suggestions to reflect end users’ priorities.
Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion
Authors: He Zhongyuan , Zhou Kai , Tang Ke , Quan Zhengxue , Liu Shaoyu , Su Bao
Published: May 2020

Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease.Material and methods : We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence ( SWD ) group and a normal wound healing group, and into an surgical site infection(SSI)group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses.Results: A total of 554 patients were enrolled in the study.The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl and postoperative serum albumin:<3.0 g/dl were significantly related to SWD (P<0.05). There were also significant differences between the surgical site infection (SSI) groups in terms of preoperative serum albumin <3.5 g/dl(P=0.001), postoperative serum albumin <3.5 g/dl (P<0.023) and <3.0 g/dl(P<0.001).Additionally, the increased hospitalization costs and length of hospitalization were statistically significant for patients with perioperative hypoproteinemia.Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to steroid use,perioperative hypoalbuminemia, which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.
The effect of autophagy and mitochondrial fission on Harderian gland is greater than apoptosis in male hamsters during different photoperiods
Authors: Wang Zhe , Xu Jinhui , Mou Junjie , Zhao Xiangyu , Geng Xiaocui , Wu Ming , Xue Huiliang , Chen Lei , Xu Laixiang
Published: May 2020

Background: Photoperiod is one of the important factors of mammalian seasonal rhythm. As an important photosensitive organ in addition to the eyes and pinecones, Harderian gland (HG) may respond to seasonal light cycle changes. Here, we studied the morphological differences in the HG of male striped dwarf hamsters (Cricetulus barabensis), a small mammal with annual rhythm under different photoperiods (short photoperiod, SP; moderate photoperiod, MP; long photoperiod, LP), and further investigated the molecular mechanisms related to these morphological differences.Results: Results showed that body weight, carcass weight, and HG weight were lower in the SP and LP groups than that in MP group. Terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) staining showed that random DNA fragmentation was observed in all three groups. The protein expression of bax/bcl2 and cytochrome C all have no significant difference between three groups, indicated that the level of apoptosis remained stable. Protein aggregation and mRNA expression of LC3 as well as the protein expression of LC3II/LC3I in the SP group were higher than that in the MP group. P62 protein aggregates and protein expression were lower in long photoperiod than other two groups. These results suggested that autophagy level was the lowest in MP group. The protein expression of ATP synthase and mitochondrial fission factor showed highest in MD group, while citrate synthase, dynamin-related protein1, and fission1 remain unchanged during three groups. These indicate that the mitochondrion fission and energy function are slightly reduced in SD and LD groups.Conclusion: In summary, since the fact that there is no significant change in the level of apoptosis in HGs under different photoperiods, the significant up-regulation of autophagy level in the long and short photoperiod may be the main factor leading to the loss of HG weight as well as the reduced mitochondrial energy supply.
Triple therapy combined with ventriculoperitoneal shunts can improve neurological function and shorten hospitalization time in non-HIV cryptococcal meningitis patients with increased intracranial pressure
Authors: Li Min , Liu Jia , Deng Xuhui , Gan Qingzhou , Wang Yijie , Xu Xiaofeng , Jiang Ying , Peng Fuhua
Published: May 2020

Background
Raised intracranial pressure (ICP) and insufficient antifungal regimens, are the two main factors result to unsatisfactory outcomes in non-HIV cryptococcal meningitis (CM) patients. In this study, we try to discuss that whether triple therapy of amphotericin B (AmB), fluconazole (Flu), 5-flucytosine (5-FC) plus ventriculoperitoneal shunts (VPS) is superior to AmB, 5-FC, Flu plus intermittent lumbar puncture in induction therapy in non-HIV CM patients with increased ICP.
Methods
We reviewed 66 clinical records from non-HIV CM patients with increased ICP. The demographic and clinical characteristics, BMRC staging, cerebrospinal fluid profiles (CSF), brain magnetic resonance imaging, treatment, and outcomes of these individuals were retrospectively analyzed. All non-HIV CM patients with increased ICP (≥ 25 cmH2O) were divided into two groups, including 27 patients treated with triple antifungal agents and 39 patients treated with the same triple therapy plus VPS.
Results
Triple therapy plus VPS group had a significantly higher frequency of satisfactory outcomes. More patients in triple therapy plus VPS group have CSF sterilization at 10 weeks follow-up. And patients in triple therapy plus VPS group present with lower CSF opening pressure, less CSF cryptococci count and CSF culture positive, and lower BMRC staging scores one week after VPS. Patients in triple therapy plus VPS group got the improvement in neurological function circumstances evaluated by comparing the BMRC staging before and after VPS. Triple therapy plus VPS group patients had shorter hospital stay.
Conclusions
Triple antifungal agents combined with VPS can effectively reduce ICP, have faster rate of clearance of Cryptococcus, improve nerve function, shorten hospitalization time and get better outcomes in non-HIV CM patients with increased ICP. Our study indicated that triple therapy plus early VPS is maybe the optimal treatment for non-HIV CM patients with increased ICP.
The impact of social support and living alone on health literacy – A national population study from Denmark
Authors: Kirkeby Mette Jørgine , Svendsen Majbritt Tang , Bak Carsten Kronborg , Hansen Claus Dalsgaard , Andersen Johan Hviid , Torp-Pedersen Christian
Published: May 2020

Background: The complexity of demands regarding health literacy in present society requires knowledge and competences within health care, disease prevention, and health promotion in order to retain and obtain good health. Health literacy is mentioned in the literature to be part of the social determinants of health, however the mechanisms behind this association are still unclear. The objective of the present study was to investigate the effect of social support and living alone on health literacy.Methods: A cross-sectional study was conducted based on a randomly selected sample of 15,728 Danish citizens aged 25 or older. Information on health literacy, social support and living alone was gathered through a nationwide questionnaire during December 2016 and February 2017 and linked to administrative registry data. Multinomial regression was used to assess associations.Results: Adequate health literacy was seen in 60.3% of the respondents and more men (59.5%) than women (40.5%) had inadequate health literacy. Lower social support was associated with higher inadequate health literacy levels and problematic health literacy among respondents with lower opportunity for practical help when being ill. Men, younger respondents, and respondents with lower educational attainment had higher risks of problematic and inadequate health literacy. No associations were found between living alone and health literacy.Conclusions: The results from this study shed light on the mechanisms of social context and its relation to health literacy. But it also gives new insight to mechanisms behind the relationship between social support and health outcomes. We suggest that health literacy might be on the causal pathway between functional social support and health. We further recommend that future studies on social relationships and health should include measures of health literacy and multidimensional measures of social support.
Cost-Effectiveness Analysis of Dabigatran, Rivaroxaban and Warfarin in the Prevention of Stroke in Patients with Atrial Fibrillation in China
Authors: Wei Hongtao , Cui Can , Cui Xiangli , Liu Yi , Li Dandan
Published: May 2020

Background and objective: To evaluate the cost-effectiveness of new anticoagulants and warfarin in the prevention of stroke in Chinese patients with atrial fibrillation. Methods: the Markov model was constructed to compare the quality of life years of patients with dabigatran 110 and 150mg, twice a day, rivaroxaban 20mg, once a day, warfarin 3-6mg, once a day drug cost, and the cost of examination after taking the drug and the incremental cost of other treatments. Results: the total cost of warfarin, rivaroxaban, dabigatran for 110mg bid and 150mg bid was 37806.08 yuan, 210977.4 yuan, 167906.1 yuan and 244050.1 yuan, respectively. The QALYs available were 11.07 years, 15.46 years, 12.4 years and 15 years, respectively. The cost-effectiveness analysis of three new oral anticoagulants and warfarin showed that rivaroxaban compared with warfarin The incremental cost effectiveness ratio (ICER) is 39446.77 yuan / QALY, which is the advantage scheme and warfarin is the expansion disadvantage scheme. Conclusion: In Chinese patients with AF, although warfarin is cheaper, rivaroxaban has a better cost-effectiveness advantage from an economic point of view.
Nomogram for individually predicting overall survival in rectal neuroendocrine tumors
Authors: Feng Xingyu , Wei Gengzhou , Wang Wei , Zhang Yu , Zeng Yujie , Chen Minhu , Chen Ye , Chen Jie , Zhou Zhiwei , Li Yong
Published: May 2020

Background This study was designed to develop a nomogram that predicts the overall survival (OS) of rectal neuroendocrine tumors (NETs).Methods 310 patients with rectal neuroendocrine tumors in 5 hospitals in southern China were retrospectively analyzed. All the patients were assigned to the training set. A multivariable analysis using Cox proportional hazards regression was performed using the training set. And a nomogram was constructed. The validation set was performed using the data from Surveillance, Epidemiology, and End Result (SEER) databases of America (n=547).Results In the training set, the nomogram exhibited improved discrimination power compared with the WHO grade guidelines (Herrell’s C-index, 0.907 vs 0.809; p<0.001 ), and also improved compared with the seventh AJCC TNM classification (Herrell’s C-index, 0.907 vs 0.829; p<0.001 ). In the SEER validation sets, discrimination was also excellent (C-index, 0.824 vs 0.734 and 0.824 vs 0.766 respectively compared with G grade and TNM classification; both p <0.001). Calibration of the nomogram predicted survival corresponding closely with the actual survival. Conclusions We developed a nomogram predicting 1-, 3-year OS for rectal neuroendocrine tumors. Validation revealed excellent discrimination and calibration, suggested good clinical utility.