bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and Validation of an Individualized Autophagy-Clinical Prognostic Index in Gastric Cancer Patients
Authors: Qiu Jieping , Sun Mengyu , Wang Yaoqun , Chen Bo
Published: March 2020

Background: The purpose of this study is to perform bioinformatics analysis of autophagy-related genes in gastric cancer, and to construct a multi-gene joint signature for predicting the prognosis of gastric cancer.Methods: GO and KEGG analysis were applied for differentially expressed autophagy-related genes in gastric cancer, and PPI network was constructed in Cytoscpae software. In order to optimize the prognosis evaluation system of gastric cancer, we established a prognosis model integrating autophagy-related genes. We used single factor Cox proportional risk regression analysis to screen genes related to prognosis from 222 autophagy-related genes in The Atlas Cancer Genome (TCGA) gastric cancer cohort. Then, the generated genes were applied to the Least Absolute Shrinkage and Selection Operator (LASSO). Finally, the selected genes were further included in the multivariate Cox proportional hazard regression analysis to establish the prognosis model. According to the median risk score, patients were divided into high-risk group and low-risk group, and survival analysis was conducted to evaluate the prognostic value of risk score. Finally, by combining clinical features and prognostic gene signatures, a nomogram was established to predict individual survival probability.Results: GO analysis showed that the 38 differently expressed autophagy-related genes was enriched in cell growth, neuron death, and regulation of cell growth. KEGG analysis showed that the 38 differently expressed autophagy-related genes were related to platinum drug resistance, apoptosis and p53 signaling pathway. The risk score was constructed based on 4 genes (GRID2, ATG4D,GABARAPL2, CXCR4), and gastric cancer patients were significantly divided into high-risk and low-risk groups according to overall survival. In multivariate Cox regression analysis, risk score was still an independent prognostic factor (HR = 1.922, 95% CI = 1.573-2.349, P < 0.001). Cumulative curve showed that the survival time of patients with low-risk score was significantly longer than that of patients with high-risk score (P < 0.001). The external data GSE62254 proved that nomograph had a great ability to evaluate the prognosis of individual gastric cancer patients.Conclusions: This study provides a potential prognostic marker for predicting the prognosis of GC patients and the molecular biology of GC autophagy.
Clinical significance of extranodal extension in sentinel lymph node positive breast cancers
Authors: Yang Xia , Ma Xiaoxi , Yang Wentao , Shui Ruohong
Published: March 2020

Background The precise stage of lymph node (LN) metastasis is a strong prognostic factor in breast cancer, and sentinel lymph node (SLN) is the first station of nodal metastasis, whereas the clinical value of extranodal extension (ENE) in SLN are still in exploration.Objective Our study aimed to evaluate the predictive and prognostic values of ENE in SLN and to investigate the feasibility of ENE to predict non-SLN metastasis, disease free survival (DFS) and overall survival (OS) in clinical practice.Methods 183 cases of primary invasive breast cancer (cT1-2N0 breast cancer with 1-2 positive SLNs) underwent SLN biopsy and axillary lymph node dissection (ALND) between 2008 and 2015 were extracted from the pathology database of Fudan University Shanghai Cancer Center. Sections were reviewed for the microscopic features of SLN, including the number and pattern of SLN metastasis, SLNs positive ratio, nodal vascular invasion (NVI), and ENE. The associations between tumor features including ENE and non-SLN metastasis, DFS and OS were analyzed. Moreover, ENE was subclassified into circumferential (CD-ENE) and perpendicular (PD-ENE) and set a threshold as 2mm or 3mm to evaluate the prognostic value of ENE.Results 73/183 (39.9 %) cases were positive for ENE in SLN. Logistic regression analysis indicated that ENE, the number and pattern of SLN involvement, SLN positive ratio, and NVI were significantly associated with the presence of non-SLN metastasis in univariate analysis. ENE, higher number of SLN involvement, SLN macrometastasis, and NVI were significantly associated with a higher rate of non-SLN metastasis in multivariate analysis. Cox regression analysis showed ENE in SLN was associated with DFS and OS in univariable analysis, but not in multivariable analysis. Whereas the size of ENE (CD-ENE and PD-ENE) subdivided by 3mm (or 2mm) cutoff values were not found as strongly prognostic factors of DFS and OS as well.Conclusions Our study indicated that ENE in SLN was a predictor for non-SLN metastasis in breast cancers, patients with ENE in SLN had a higher rate of non-SLN metastasis. ENE in SLN was associated with DFS and OS in univariable analysis, but not in multivariable analysis. The size of ENE (CD-ENE and PD-ENE) which was classified by a 3mm (or 2mm) cutoff value had no significant prognostic values in this study. The prognostic value of ENE in SLN and the cutoff values of ENE in SLN in breast cancers need further investigation.
Original Clinical Investigation Multidisciplinary Treatment for Colorectal Liver Metastases in Elderly Patients
Authors: Hata Taigo , Mise Yoshihiro , Ono Yoshihiro , Sato Takafumi , Inoue Yosuke , Ito Hiromichi , Takahashi Yu , Yanaga Katsuhiko , Saiura Akio
Published: March 2020

Background Limited data describe the therapeutic practice and outcomes of colorectal liver metastases (CRLMs) in elderly patients. We aimed to evaluate the impact of age on multidisciplinary treatment for CRLMs. Methods We reviewed treatment and outcomes for patients in different age groups who underwent initial hepatectomy for CRLMs from 2004 through 2012. Results We studied 462 patients who were divided into three groups by age: ≤ 64 years (n = 265), 65–74 years (n = 151), and ≥ 75 years (n = 46). The rate of major hepatectomy and incidence of postoperative complications did not differ between groups. Adjuvant chemotherapy was used less in the ≥ 75 -year group (19.6%) than that in the ≤ 64 (54.3%) or 65–74 age group (43.5%). Repeat hepatectomy for liver recurrence was performed less in the ≥ 75 -year group (35%) than in the ≤ 64 (57%) or 65–74 (66%) age group. The 5-year disease-specific survival (DSS) rate of 44.2% in the ≥ 75 -year group was lower than in the ≤ 64 (59.0%) or 65–74 (64.7%) age group. Multivariate analysis revealed age ≥ 75 years was an independent predictor of poor DSS. Conclusions Liver resection for CRLMs can be performed safely in elderly patients. However, repeat resection for recurrence are performed less frequently in the elderly, which may lead to the poorer disease-specific prognosis.
Meta-analysis and trial sequential analysis of LncRNA H19 polymorphic variants on susceptibility to cancer
Authors: Wang Kunpeng , Zhu Zheng , Wang Yiqiu , Zong Dayuan , Xue Peng , Gu Jinbao , Lu Daoyuan , Tu Chuanquan
Published: March 2020

Background: Although myriad researches upon the associations between LncRNA H19 polymorphic variants (rs2839698 G﹥A, rs3024270 C﹥G, rs2107425 C﹥T, rs2735971 A﹥G and rs217727 G﹥A) and the susceptibility to cancer have been conducted, these results remained contradictory and perplexing. Basing on that, a systematic review and updated meta-analysis was conducted to anticipate a fairly precise assessment about these associations. Methods: We retrieved the electronic databases EMBASE, PubMed and Web of Science for valuable academic studies before October 1st, 2019. Ultimately, 24 of which were encompassed after screening, and the available data was extracted and integrated. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) was adopted to evaluate the strength of these associations. For multi-level investigation, subgroup analysis derived from source of controls together with genotypic method was preformed. Eventually, 24 articles altogether embodying 52 studies were included. Results: The results illuminated that LncRNA H19 SNPs mentioned above were all irrelevant to cancer susceptibility. Nevertheless, crucial results were found concentrated in population-based control group when subgroup analysis by source of controls were performed in H19 mutation rs2839698 and rs2735971. Meanwhile, in the stratification analysis by genotypic method, apparent cancer risks were discovered by TaqMan method in H19 mutation rs2107425 and rs3024270. Then, trial sequential analysis (TSA) demonstrated that the results about such associations were firm evidence of effect, except rs2735971 polymorphism. Conclusion: Therefore, this meta-analysis indicated that LncRNA H19 SNPs were not associated with the susceptibility to human cancer. However, after the stratification analysis, inconsistent results still existed in different genotypic method and source of control. Thus, more high-quality studies on cancer patients of different factors were needed to confirm these findings.
Drug sensitivity of Plasmodium falciparum field isolates to selected antimalarial drugs in Ghana using the in-vitro DAPI assay
Authors: Ofori Michael Fokuo , Kploanyi Emma E. , Mensah Benedicta A. , Dickson Emmanuel K. , Baafour Eric Kyei , Gyabaa Sampson , Tetteh Mary , Koram Kwadwo A. , Abuaku Benjamin K. , Ghansah Anita
Published: March 2020

Background: Malaria continues to be a major health issue globally with nine out of ten cases reported in Africa. Although the current artemisinin derived combination therapies in Ghana are still efficacious against the Plasmodium falciparum parasite, compounding evidence of artemisinin and amodiaquine resistance in the African region establish the need for a full, up-to-date understanding and monitoring of antimalarial resistance to provide evidence for planning control strategies.Methods: The study was cross-sectional and was conducted during the peak transmission seasons of 2015, 2016, and 2017 in two study sites located in different ecological zones of Ghana involving children aged 0.5-14 years presenting with symptomatic uncomplicated Plasmodium falciparum (Pf) malaria with parasitaemia greater than 1000 parasites/µl of blood. Using in vitro 4-,6-diamidino-2-phenylindole (DAPI) drug sensitivity assays, 328 Pf parasites collected were used to investigate susceptibility to five selected antimalarial drugs: chloroquine, amodiaquine, dihydroartemisinin, artesunate and mefloquine.Results: The geometric mean B (GMIC50) of five drugs against the parasites collected from Cape Coast were 9.6, 23.6, 9.1, 3.5 and 8.1nM for chloroquine, amodiaquine, artemisinin, artesunate, and mefloquine respectively in 2015. There was a 2 fold increase in the GMIC50 levels of all the drugs against the isolates collected in 2016 as compared to the 2015 data from Cape Coast .The a of the five drugs against the parasites collected from Cape Coast were significantly higher than those isolates collected from Begoro in 2016 and 2017 (P<0.001) . The chloroquine resistance ranged between 1.9% and 9.1% among isolates collected from Cape Coast but remained 0% in Begoro over the period. High amodiaquine resistance levels were recorded at both sites whilst that of artesunate resistance ranged between 4 and 10% over the study period.Conclusions: The study has assessed the antimalarial drug sensitivities of Ghanaian Pf isolates collected over 3 consecutive years. The parasites showed variable resistance levels to all the drugs used over the period. The study has demonstrated the continual return of chloroquine-sensitive parasites. The in vitro DAPI assay is a useful method for monitoring individual drugs used in combinations in Ghana for the generation of data on their sensitivities over time.
Knowledge, Awareness and Practices of Malaria in Western Area Rural District, Sierra Leone: A Household-based Cross-sectional Survey in the Middle of National Malaria Strategic Plan (2016-2020)
Authors: WANG Lili , Yin Jianhai , Zheng Canjun , Smith Samuel Juana , Ngegba Esther , Huang Xiaoxia , Kamara Anitta , Chen Xia , Wang Xu , Luo Wei , Kan Biao
Published: March 2020

BackgroundThe malaria epidemic is high in Sierra Leone, and the implementation of the National Malaria Strategic Plan (2016-2020) has reached its middle stage. In order to guide the interventions more specifically in future, a household-based cross-sectional survey was conducted to understand the public perception of knowledge, attitudes and practices of malaria and its control.MethodsThree communities (Grafton, Jui and Kossoh) in Western Area Rural District within close proximity to Sierra Leone’s capital city of Freetown were included. Households were randomly selected and interviewed with a structural questionnaire covering malaria infection, diagnosis, treatment and prevention, as well as the knowledge of malaria prevention, in collaboration with the National Malaria Control Program of the Ministry of Health and Sanitation, Sierra Leone.ResultsA total of 262 qualified questionnaires were included. The average cost for meals per day is around 30000 Leones in each household. The awareness rate of having heard of malaria is 98.1% (257/262) and knowing mosquito biting as its main route of transmission is 86.6% (227/262) respectively. And 80.9% (212/262) of the respondents sought health advice or treatment for the illness, and similar percentage of them could be tested for malaria, mostly through RDTs. A great demand of long-lasting insecticidal nets (72.1%) was raised to fulfill the high shortage (61.8%, 162/262) in households, and of them there were 66 families having children under five years old.Conclusion﻿Malaria burden is still high. Although public awareness of malaria prevention sounds well in this survey, the fact that the use of preventive measures against malaria is low in households within the three communities. It is suggested that an advanced campaign should be carried out to scale up not only the knowledge on malaria but also the actual usage of malaria prevention measures.
Supply of and demand for radiologic technologist personnel in Taiwan: an analysis of 20 years
Authors: Tyan Yeu-Sheng , Chou Ying-Hsiang , Tsai Hui-Yu , Chen Tou-Rong
Published: March 2020

Background: Currently, nine universities and one junior college offer radiologic technologist (RT) programs (RTPs) in Taiwan. The curriculum, certificate examination, and licensing of RTs in RTPs in Taiwan are similar to those for RTPs in Japan and Korea. The present study explored the supply of and demand for RTs over the past 20 years and identified predictive indicators of trends affecting the numbers of RTs supplied and demanded.Methods: The present study involved web-based research. The analyzed data were publicly available information downloaded from the websites of relevant statistical departments in Taiwan. The study employed specific medical devices or examinations used in hospitals to determine the demand for RTs. Long-term (1999–2018) and short-term (2014–2018) trends were analyzed. The change rates were calculated using compound annual growth rate (CAGR). Pearson’s product–moment correlation coefficient or Spearman’s rank correlation coefficient was used to evaluate two groups of continuous variables. Kolmogorov–Smirnov and Shapiro–Wilk tests were used to test normally distributed data.Results: During 1999–2018, the annual numbers of students and graduates in RTPs were 2654 ± 350 and 516 ± 109, respectively, with corresponding CAGRs of 2.2% and 3.7%. During 2014–2018, the annual numbers of students and graduates in the RTPs were 2908 ± 67 and 605 ± 55, respectively, with corresponding CAGRs of −0.7% and 2.4%. During 1999–2018, the annual numbers of examinees and qualified personnel were 1228 ± 174 and 372 ± 62, respectively. The CAGRs for the number of qualified personnel were −1.5% and −4.7% during 1999–2018 and 2014–2018, respectively. The number of specific medical devices increased from 599 in 2000 to 1057 in 2018, whereas that of specific medical examinations increased from 1.7 million in 2000 to 5.3 million in 2018.Conclusion: During 2014–2018, 605 students graduated from RTPs annually, with approximately 375 annually becoming qualified personnel in Taiwan. The increase in the numbers of specific medical devices and examinations resulted in an annual increase of 204 new positions for RTs.
Osteotomies combined with soft tissue procedures for symptomatic flexible flatfoot deformity in children
Authors: WEN Xiaodong , Nie Guanghua , Zhao Hongmou , Lu Jun , Liang Xiaojun , Wang Xinwen , Liang Jingqi , Zhang Yan , Guo Rui , Li Yi
Published: March 2020

Background: The indications for surgery, timing, and procedure in children with flexible flatfoot deformity remain controversial. For marked deformities, combined procedures are preferred to correct multiple plane deformities. Thus, this study aimed to evaluate the outcomes of osteotomies combined with soft tissue procedures in children with flexible flatfoot aged 9-14 years.Methods: From July 2014 to October 2017, 28 children (47 feet) with flexible flatfoot with an average age of 11.7±2.1 (range 9-14) years underwent osteotomy combined with soft tissue surgery. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Foot and Ankle Outcome Score (FAOS) were used to evaluate the preoperative and postoperative clinical outcomes. The talo-navicular coverage angle (TNCA) and talar–first metatarsal angle (T1MA) on the foot anteroposterior view, calcaneal pitch angle and Meary’s angle on the foot lateral view, and calcaneus valgus angle (CVA) on the Saltzman view were also observed.Results: All patients were followed up for an average duration of 29.7±8.6 months. Mean AOFAS and FAOS significantly improved from 56.6±8.0 and 47.4±9.5 preoperatively to 88.4±3.9 and 83.2±6.8 at final follow-up (P<0.001). respectively. There were statistically significant differences between preoperative and postoperative scores in all FAOS subscales (P<0.001). Radiographic parameters, such as TNCA (P<0.001) and T1MT (P<0.001) on foot AP views, calcaneal pitch angle (P=0.014) and Meary,s angle (P<0.001) on foot lateral views, and CVA (P<0.001) on Saltzman views, were significantly improved. All patients and their parents were satisfied with the functional outcomes.Conclusion: Osteotomies combined with soft tissue procedures are an effective strategy for flexible flatfoot deformity in children, as it results in favorable radiographic and functional outcomes.
Pilot investigation into osteotome hard surface coating and cutting-edge degradation
Authors: White David , Bartley Jim , Whittington Christopher , Garcia Lorenzo M. G. , Chand Kaushik , Turangi Celine
Published: March 2020

BackgroundOsteotomes are bone cutting tools commonly reused in orthopedic surgical procedures. Despite undergoing rigorous cleaning, visual inspection and sterilization procedures between every use, the condition of the cutting blade edge is commonly not qualitatively assessed. Subjective feedback from surgeons suggests a large variation in osteotome cutting edge sharpness is found during use. This study seeks to investigate the retention of osteotome cutting-edge sharpness by comparing the wear resistance of as-supplied, electroless nickel, and titanium nitride coated osteotomes following a series of bone cutting tests.MethodsChanges in edge sharpness were assessed using visual inspection, depth penetration testing that quantified change in the blade sharpness index and scanning electron microscopy visual analysis. Visual inspection of each osteotome blade edge was then compared to qualitative blade sharpness index measurement.ResultsAfter use, no cutting-edge damage or change in blade sharpness was detected by visual examination of all three osteotomes however the as-supplied osteotome demonstrated 50% loss of blade sharpness index compared to 30% and 15% reduction for the electroless nickel and titanium nitride coated osteotomes respectively. This finding was supported by scanning electron microscopy evaluation that found greater mechanical damage had occurred along the cutting-edge of the as-supplied osteotome compared to the two coated with wear resistant materials.ConclusionsThe rapid loss of blade sharpness found in the as-supplied osteotome supports the degradation in cutting performance frequently reported by surgeons. The findings from this study demonstrates blade sharpness index better detects cutting edge wear compared to visual inspection. Results from this pilot study also suggest the coating of osteotomes in hard-wearing biocompatible materials assists in retaining cutting edge sharpness over multiple uses. Further study using a larger sample size is required to validate these findings.
Patterns, Management and Outcomes of Traumatic Pelvic Fracture: Insights from A Multicenter Study
Authors: Abdelrahman Husham , El-Menyar Ayman , Keil Holger , Alhammoud Abduljabbar , Ghouri Syed Imran , Babikir Elhadi , Asim Mohammad , Muenzberg Matthias , Al-Thani Hassan
Published: March 2020

Purpose we aimed to describe traumatic pelvic fracture in multinational level 1 trauma centers. Methods We conducted a retrospective analysis for all patients with traumatic pelvic fracture (TPF) between 2010 and 2016 at 2 trauma centers in Qatar and Germany. Results A total of 2112 patients presented with traumatic pelvic injuries of which 1814 (85.9%) sustained TPF, males dominated (76.5%) with a mean age of 41.2±21.1 years. Falls, motor vehicle crashes and pedestrians were the most frequent mechanisms involved. Chest (37.3%) was the most commonly associated injured region, with mean injury severity score (ISS) of 16.5±13.3. Hemodynamic instability was observed in 44%, blood was needed in a third, massive transfusion in a tenth and intensive care admission in a quarter of cases. Tile classification was possible in 1228 patients (type A in 60%, B in 30% and C in 10%). Patients with type C had higher rates of associated injuries, ISS, pelvis abbreviated injury score (AIS), more need for blood transfusion, massive transfusion protocol activation, prolonged hospital stay, higher rate for surgery, complications, and mortality (p<0.001). Two-thirds of patients were managed conservatively while a third needed surgical fixation. The median length of hospital and intensive care stay were 15 and 5 days, respectively. In-hospital complications were few and the overall mortality rate was 4.7% (86 patients). Conclusion pelvic fracture is a common injury. It needs a careful multidisciplinary and systematic approach to address the associated complexities and polytrauma nature in order to improve the associated outcomes both on a short and long-term basis.
Comparison of child and family reports of health-related quality of life in pediatric acute lymphoblastic leukemia patients after induction therapy
Authors: Nakajima Shohei , Sato Iori , Soejima Takafumi , Koh Katsuyoshi , Kato Motohiro , Okamoto Yasuhiro , Imamura Toshihiko , Maeda Miho , Ishida Yasushi , Kamibeppu Kiyoko
Published: March 2020

Purposes: To determine the health-related quality of life (HRQOL) of children with acute lymphoblastic leukemia (ALL) during induction therapy, clarify the agreement between child self-reported and family proxy-reported HRQOL, and examine the related factors of HRQOL, especially child age, family attendance, and children’s social relationships outside of the family. Methods: We analyzed questionnaire data (2012–2017) from the Japanese Pediatric Leukemia/Lymphoma Study Group’s ALL-B12. Participants were children with B-cell Precursor ALL aged 5–18 and their families. Participants answered the Pediatric Quality of Life Inventory TM (PedsQL TM ) Generic Core Scales (PedsQL-G) and Cancer Module (PedsQL-C) to measure pediatric HRQOL. We calculated the differences between child self-reported and family proxy-reported subscale scores along with intraclass correlation coefficients (ICC). We conducted multiple regression analyses according to all participant pairs and age groups (young child, school age and adolescent), with ICCs for all PedsQL-G subscales (ICC-G) and all PedsQL-C subscales (ICC-C) as the outcome variables. Results: Five hundred twenty-two pairs of children and their families were analyzed. We observed a moderate level of agreement on most PedsQL subscales between the child self-reports and family proxy-reports; however, worry had the weakest agreement for all PedsQL subscales (ICC = .32). The agreement of ICC-C was positively related to family attendance for the young child group ( B = .185, p = .003). Conclusion: We observed some differences between child self-reports and family proxy-reports of HRQOL of children with ALL, suggesting that both parties should be administered HRQOL measurements during treatment.
Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study
Authors: Yu Yong-hui , Wang Li , Lu Qing-hua , Wang Li-ling , Huang Xiao-yang , Fan Xiu-fang , Ding Yan-jie , Zhang Cheng-yuan , Liu Qiang , Sun Ai-rong , Zhao Yue-hua , Yao Guo , Li Cong , Liu Xiu-xiang , Wu Jing-cai , Yang Zhen-ying , Chen Tong , Ren Xue-yun , Li Jing , Bi Mei-rong , Peng Fu-dong , Geng Min , Qiu Bing-ping , Zhao Ri-ming , Niu Shi-ping , Zhu Ren-xia , Chen Yao , Gao Yan-ling , Deng Li-ling
Published: March 2020

Background The objective of this study was to evaluate the association between admission hypothermia and neonatal outcomes in very low-birth weight (VLBW) infants in multiple neonatal intensive care units (NICUs) in China. Methods Since January 1, 2018, a neonatal homogeneous cooperative research platform has been established. The platform collects clinical data in a prospective manner on preterm infants with birth weights (BWs)<1500 g and gestational ages (GAs)<34 weeks born in 28 NICUs in Shandong Province. These infants were divided into normothermia, mild or moderate/severe hypothermia groups according to the World Health Organization (WHO) classifications of hypothermia. Associations between outcomes and hypothermia were tested in a bivariate analysis, followed by a stepwise logistic regression analysis. Results A total of 1247 VLBW infants were included in this analysis, of which 1100 infants (88.2%) were included in the hypothermia group, 554 infants (44.4%) in the mild hypothermia group and 546 infants (43.8%) in the moderate/severe hypothermia group. Small for gestational age (SGA), caesarean section, a low Apgar score at 5 min and intubation in the delivery room (DR) were related to admission hypothermia (AH). Mortality was the lowest when their admission temperature was 36.5~37.5°C, and after adjustment for maternal and infant characteristics, mortality was significantly associated with AH. Compared with infants with normothermia (36.5~37.5°C), the adjusted ORs of all deaths increased to 4.148 (95% CI 1.505-11.437) and 1.806 (95% CI 0.651-5.009) for infants with moderate/severe hypothermia and mild hypothermia, respectively. AH was also associated with a high likelihood of respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH), and late-onset neonatal sepsis (LOS). Conclusions AH is still very high in VLBW infants in NICUs in China. SGA, caesarean section, antenatal steroid use, a low Apgar score at 5 min and intubation in the DR were associated with increased odds of hypothermia. Moderate/severe hypothermia was associated with mortality and poor outcomes, such as RDS, IVH, LOS, etc.
Thyroid autoimmunity has no negative impact on insulin dynamics in pre-diabetic patients with normal thyroid function
Authors: Alexandraki Krystallenia , Boutzios Georgios , Antonopoulou Ioanna , Bartsioka Lamprini Iro , Moschouris Panagiotis , Karapanagioti Angeliki , Mavroeidi Vasiliki , Makrilakis Konstantinos , Duntas Leonidas , Kaltsas Gregory , Liatis Stavros
Published: March 2020

Background The association of autoimmune thyroid disease (AITD) with diabetes mellitus (DM) type 1 (DM1) has been previously documented. However, there is paucity of data regarding the association of AITD and DM type 2 (DM2). The aim of the study was to shed light on the role of AITD on DM2, we studied the impact of AITD in euthyroid patients with pre-diabetes. Methods Euthyroid pre-diabetic patients were defined by impaired fasting glucose (IFG) (≥100mg/dl) and/or glucose intolerance (IGT) [glucose 120min post-oral glucose tolerance test (OGTT) ≥140mg/dl]. We assessed static and dynamic insulin resistance (IRI) and insulin secretion indices (ISI), and the disposition index (DI). Age, gender, waist circumference, waist-to-height ratio, body mass index, anti-hypertensive and hypolipidemic treatment were recorded. Results Out of 166 patients studied (132 females) 53 (31.9%) had AITD; IFG prevalence was similar to non-AITD patients (92.2% versus 94.3%, p=0.55). In contrast, IGT was less prevalent in AITD compared to non-AITD patients (9.4% versus 28.3%, p=0.008). IRI did not differ between the two groups. The dynamic ISI: area under the curve (AUC) of insulin-to-glucose ratio (IncAUCins/glu), 1 st -phase and 2 nd -phase insulin release, and the DI showed a worse insulin secretion in non-AITD compared to AITD patients [0.54 (0.49, 0.2-2.42) versus 0.45 (0.41, 0.09-2.07), p = 0.029; 1029.3 (837.1, 323-2614.2) versus 864.3 (826.9, -282.5-2772.5), p=0.033; 354.8 (268.4, 132.8-851.1) versus 286.5 (254.7, 24.7-906.3), p=0.035; 0.09 (0.09, 0.006-0.55) versus 0.07 (0.06, -0.01-0.51), p=0.02, respectively]. On the other hand, hsCRP was higher in AITD versus non-AITD individuals [2.8 (5, 0-16) versus 1.2 (3, 0-13), p=0.008]. Conclusion Although individuals with prediabetes and AITD presented with higher levels of low-grade inflammation, their dynamic ISI and the DI, were less impaired, implying a better dynamic insulin secretion in patients with established abnormality of carbohydrate metabolism who carry an additional autoimmune metabolic component.
Abortive Retroperitoneal Ectopic Pregnancy Followed Up by Ultrasound: A Case Report
Authors: Ye Tiantian , Yu Liang , Jiang Yuxin , Xia Yu
Published: March 2020

Background: Ectopic pregnancy can be life-threatening. Most of ectopic pregnancy located in the fallopian tube. But retroperitoneal ectopic pregnancies are extremely rare.Results: We report a 29-year-old Chinese woman with amenorrhea for 50 days presented to emergency department for abdominal pain. Her serum β-hCG level was 1675mIU/ml. Transvaginal sonography showed irregular anechoic area in uterine cavity without pregnancy sac echo. And nothing wrong was found in bilateral adnexa. Abdominal ultrasound showed a mixed echo region behind the pancreas. The clinical diagnosis was retroperitoneal ectopic pregnancy. The patient's vital signs remained stable with the mass size continue decreased . Because of the huge surgery risk, the mass was followed up by ultrasound closely.Conclusions: 5 months after bleeding, the fourth ultrasound follow-up examination showed the mass disappeared completely and serum β-hCG level was normal .
Assessing intake and consumption level of spices among urban and rural households of Ludhiana district of Punjab, India
Authors: Bhathal Simranpreet Kaur , Kaur Harpreet , Bains Kiran , Mahal Amrit Kaur
Published: March 2020

Background: Spices are the esoteric food adjuncts that are used for enhancing the sensory quality of the food in Punjabi diets and add many health benefits. Estimating the intake of spices at the individual level is a challenging task as they are consumed in very small quantities as compared to other foods. The present study was aimed to assess the intake and spices consumption level of spices among adult women.Methods: A study was carried out among 100 urban and 100 rural households from Ludhiana district of Punjab, India to collect the information regarding the frequency, spice usage, portion sizes using a spice intake questionnaire. The commonly used 25 spices in Punjabi diets were selected to assess their dietary intake at the individual level among households. Results: Spice consumption frequency was more in urban households in comparison to rural households. The maximum mean consumption frequency score among urban and rural households was observed for red chilli powder (5.00) and turmeric powder (5.00). A maximum of 76 % of urban and 72 % of rural households preferred to use the unroasted form of spices. The highest mean intake and range was observed for red chilli powder (3.19 g with range 0.35-5.23 g, respectively) among urban women and (2.41 g with range 0.25-3.75 g, respectively) for rural women. Spice intake from individual dishes showed the maximum number of portion sizes for red chilli powder were from dhal<vegetable<curry preparations among urban and vegetable<dhal<curry preparation among rural households. Average urban adult women consumed 10.04 g of spices per day which was higher as compared to spices per day for rural adult women (7.68 g).Conclusions: The study concluded that assessment of spices intake at the individual level among urban and rural households with the frequency of usage and portion sizes, the form of spices used to provide the quantifying intake of spices at the individual level and show higher consumption of spices among urban households and compared to rural households which could provide numerous health benefits.
IL-32 Induces Epithelial-mesenchymal Transition in Human Pulmonary Alveolar Epithelial Cells by Triggering Endoplasmic Reticulum Stress
Authors: Liu Gang , Gong Ling , Zhu Honglan , Li Caihong , Li Pengmei , Liu Changlu , Tang Hongbo , Wu Kaifeng , Wu Jie , Liu Daishun
Published: March 2020

BackgroundEpithelial-mesenchymal transition (EMT) is a key process in the onset and development of idiopathic pulmonary fibrosis (IPF) with unclear mechanisms. Our previous studies found that bleomycin and tunicamycin could induce ER stress and consequently trigger EMT accompanying with IL-32 overexpression. This study was aimed to investigate the effects of IL-32 on EMT and ER stress to elucidate the pathogenesis of IPF.MethodsHuman lung adenocarcinoma A549 cells were treated with recombinant human (rh)IL-32, IL-32 siRNA and EMT inducer tunicamycin, or 4-phenylbutyric acid (4-PBA), respectively. Then the cell morphology was observed and the expression of ER-related markers and EMT-related markers were detected by RT-qPCR or western blotting.ResultsStimulation of A549 cells with rhIL-32 led to a morphological change from a pebble-like shape to an elongated shape in a portion of the cells, accompanied by down regulated expression of the epithelial cell marker E-cadherin and up regulated expression of the mesenchymal cell markers N-cadherin, vimentin, and Zeb-1. However, these rhIL-32 induced changes were inhibited by the ER stress inhibitor 4-PBA. Suppression of IL-32 expression with siRNA inhibited TM-induced EMT. Further stimulation of the A549 cells with rhIL-32 demonstrated an increase in the expression of GRP78, although this increase was also inhibited by 4-PBA. ConclusionsThese results suggest that IL-32 induces EMT in A549 cells by triggering ER stress. These results suggest that IL-32 may be a novel marker for IPF.
Identification of miRNA-mRNA regulatory modules involved in lipid metabolism and seed development in a woody-oil tree (Camellia oleifera)
Authors: Wu Bo , Ruan Chengjiang , Shah Asad Hussain , Liu Sihei
Published: March 2020

BackgroundTea oil camellia ( Camellia oleifera ), an important woody oil tree, is a source of seed oil of high nutritional and medicinal values and has been being widely planted in southern China. However, there is no report on the identification of miRNAs involved in lipid metabolism and seed development in high- and low-oil cultivars of tea oil camellia. Thus, we explored the roles of miRNAs in the critical period of oil formation and accumulation in tea oil camellia, and identified miRNA-mRNA regulatory modules involved in lipid metabolism and seed development. ResultsSixteen small RNA libraries for high- and low-oil cultivars of the critical period of oil biosynthesis were constructed. A total of 196 miRNAs, including 156 known miRNAs from 35 families and 40 novel miRNAs, were identified, and 55 significantly differentially expressed miRNAs were found, which included 34 up-regulated miRNAs and 21 down-regulated miRNAs. An integrated analysis of miRNA and mRNA transcriptome sequence data and qRT-PCR-based information was performed and revealed that nine miRNA-mRNA regulatory modules were related to lipid metabolism, such as the negative regulatory modules of ath-miR858b- MYB82 / MYB3 / MYB44 represses seed oil biosynthesis and a positive regulation module of csi-miR166e-5p- S-ACP - DES6 for formation and accumulation of oleic acid. Twenty-tree miRNA-mRNA regulatory modules were involved in the regulation of seed size, such as a negative regulatory module of hpe-miR162a_L-2- ARF19 involved in early seed development. Twelve miRNA-mRNA regulatory modules regulating growth and development were identified, such as the negative regulatory modules of han-miR156a_L+1- SPL4 / SBP2 promoting early seed development. The targeting relationship of the cpa-miR393_R-1-AFB2 regulatory module were verified by luciferase activity assays. ConclusionMultiple microRNAs (miRNAs) were identified to involve in developing seeds of tea oil camellia, especially discovering several miRNA-mRNA regulatory modules involving in seed development and lipid metabolism. These data provide important theoretical value and a scientific basis for the genetic improvement of new varieties of tea oil camellia in the future.
Accuracy of cone-beam computed tomography for the evaluation of mandible invasion by oral squamous cell carcinoma
Authors: Wang Zezheng , Zhang Shuang , Pu Yumei , Wang Yuxin , Lin Zitong , Wang Zhiyong
Published: March 2020

Purpose: Surgery for oral cancer with mandibular invasion requires an accurate preoperative assessment. Although cone-beam computed tomography (CBCT), which yields high spatial resolution, is used widely for mandibular examinations, evidence supporting its accuracy for the evaluation of malignant mandibular invasion is insufficient. Therefore, this study aimed to explore the accuracy of CBCT for the preoperative assessment of mandibular invasion.Methods: Thirty mandibular specimens acquired via mandibulectomy for oral squamous cell carcinoma (OSCC) treatment were collected. The excised samples were marked and subjected to CBCT imaging. Hematoxylin–eosin staining was used for histopathological assessment. Mandibular invasion was estimated based on CBCT and pathologic findings. Invasive borders were delineated via histopathological examination and CBCT and merged to compare the extent of invasion.Results: Although CBCT predicted the excised mandible invasion with 100% accuracy, it predicted nerve invasion with only 69.2% accuracy. The bone samples exhibited significant shrinkage (8.9%) due to tissue processing. This bone mass shrinkage led to a tendency of CBCT to underestimate the extent of invasion, with a mean difference of 2.97 mm.Conclusion: CBCT can reliably assess mandibular invasion, but is much less accurate for the estimation of nerve invasion. Given the potential for underestimation of the extent of mandibular invasion, CBCT would be better used to determine the extent of osteotomy.
Serum D-dimer, Albumin and Systemic Inflammatory Response Markers in Ovarian Clear Cell Carcinoma and Their Prognostic Implications
Authors: Chen Wei , Zhong Siyuan , Shan Boer , Zhou Shuling , Wu Xiaohua , Yang Huijuan , Ye Shuang
Published: March 2020

Background The study aims to evaluate whether preoperative systemic inflammatory response (SIR) markers or other hematologic variables, such as albumin, D-dimer, carbohydrate antigen 125 play a role in predicting chemotherapy response and survival outcome in patients with ovarian clear cell carcinoma (OCCC). Methods Preoperative leukocyte differential counts, platelet, serum albumin, plasma D-dimer and CA-125 levels were measured in patients with FIGO IC-IV ovarian clear cell cancer. The correlations of these hematologic biomarkers with clinicopathological features, chemotherapy response, and survival outcomes were further analyzed. Survival time was estimated using the Kaplan-Meier model, whereas Cox regression was conducted for multivariate analysis.Results Among the 84 patients, 28.6% were classified as platinum-resistant and 69.0% as platinum sensitive. Preoperative CA125, albumin, D-dimer, and neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio were significantly correlated with FIGO stage, residual tumor, and platinum response. Platelet to lymphocyte ratio was not related to platinum response ( P =0.060). The median follow-up time was 28 months (range, 1 to 128 months). Preoperative CA125, albumin, and D-dimer were significant prognostic factors for overall survival (OS) and progression-free survival (PFS). In the univariate analysis, only NLR had prognostic significance for PFS ( P =0.007). Multivariate analysis indicated that D-dimer > 3.27 ( P = 0.001 for OS; P = 0.040 for PFS) and albumin <39.6 ( P = 0.005 for OS and P = 0.041 for PFS) retained significance.Conclusions Preoperative NLR has some predictive value for platinum resistance in patients with IC-IV stage OCCC, but has little predictive effect on prognosis. Elevated D-dimer and reduced albumin might be potential biomarkers for worse response to first-line platinum-based chemotherapy and poor clinical outcomes.
Preliminary study of calcium homeostasis modulator 1 involved in trigeminal neuralgia
Authors: Liu Yi , Li Keji , Huang Dong , Yan Xuebin
Published: March 2020

Background: The aim of this study was to observe the changes in the expression of calcium homeostasis modulator 1 (CALHM1) in the trigeminal nucleus of the trigeminal neuralgia (TN) rats with the infraorbital nerve-chronic constrictive nerve injury (ION-CCI) and to explore the role of CALHM1 in TN.Methods: Thirty SD rats were randomly assigned to 5 groups, namely normal control group (Control group), sham operation group (Sham group), TN model group (ION-CCI group), ruthenium red treatment group (RuR group) and control group of ruthenium red (NS group), with 6 rats in each group. An animal model was established by loosely ligating the rat's infraorbital nerve with a chrome gut in the ION-CCI group, while mice in the sham group were only exposed to the nerve and did not receive ligature. The rats in the RuR group were intraperitoneally injected with 0.5 mg/kg of CALHM1 inhibitor ruthenium red on the 9th day after the infraorbital nerve ligation, while the rats in NS group were intraperitoneally injected with an equal volume of normal saline on the 9th day after surgery. All experimental rats were tested for pain behavior 1 day before surgery, 1, 3, 5, 7, 9, 11 and 14 days after surgery, including the mechanical pain threshold of VonFrey filament in the trigeminal innervated skin area and number of faces captured in video recording. The expression of CALHM1 in the trigeminal spinal nucleus was detected on the 15th day after operation in all experimental groups.Results: The expression of CALHM1 in the trigeminal spinal nucleus of the ION-CCI group was significantly higher than that of control group and sham group on the 3rd and 15th day after modeling. The intraperitoneal injection of CALHM1 inhibitor ruthenium red increased the mechanical pain threshold of ION-CCI rats and significantly reduced the number of scratches, but did not change the expression of CALHM1 in the trigeminal spinal nucleus.Conclusion: The expression of CALHM1 protein in the trigeminal spinal nucleus is involved in the central sensitization of TN pain, which can be induced by elevated expression. Moreover, the hyperalgesia can be improved by using CALHM1 inhibitor.
With versus Without Primary Tumor Radiotherapy in Patients with Unresectable Stage IV Rectal or Rectosigmoid Cancer: A Propensity Score Matching Analysis for Survival
Authors: Wang Gang , Wang Ling Wen , Jin Jie Hai , Dong min Hong , Chen wei Wei , Li kai Xiao , Li dong Guo , Li lei Lei
Published: March 2020

Background: To evaluate the impact of primary tumor radiotherapy on survival in patients with unresectable metastatic rectal or rectosigmoid cancer. Methods: Form September 2008 to September 2017, 350 patients with unresectable metastatic rectal or rectosigmoid cancer were retrospectively reviewed in our center. All patients received at least 4 cycles of chemotherapy, and were divided into two groups according to with primary tumor radiotherapy or without. 163 patients received primary tumor radiotherapy, and the median radiation dose was 56.69Gy(50.4-60). Survival curves were estimated from the Kaplan–Meier procedure to roughly compare survival among two groups. Subsequently, 18-month survival was used as the outcome variable for this study. This study mainly evaluated the impact of primary tumor radiotherapy on survival of these patients through a series of multivariate Cox regression analyses after propensity score matching (PSM). Results: The median follow-up time was 21 months. All 350 patients received a median of 7 cycles of chemotherapy (range 4-12), 163 (46.67%) patients received primary tumor radiotherapy for local symptoms. The Kaplan–Meier survival curves showed a significant overall survival (OS) advantage for primary tumor radiotherapy group to without radiotherapy (20.07 vs 17.33 months; P=0.002). In this study, multivariate Cox regression analysis after adjusted covariates, multivariate Cox regression analysis after PSM, and inverse probability of treatment weighting (IPTW) analysis and propensity score (PS)-adjusted model analysis consistently showed that primary tumor radiotherapy could effectively reduce the risk of death for these patients at 18 months (HR: 0.62, 95% CI 0.40-0.98; HR:0.79, 95% CI:0.93-1.45; HR: 0.70, 95% CI 0.55-0.99 and HR: 0.74, 95% CI:0.59-0.94). Conclusion: Compared with patients with stage IV rectal or rectosigmoid cancer who did not receive primary tumor radiotherapy, received primary tumor radiotherapy reduced the risk of death in these patients. The radical doses（59.4Gy/ 33 fractions or 60Gy/ 30 fractions） of radiation for primary tumors might be considered for unresectable metastatic rectal or rectosigmoid cancer, not just for relieve symptoms. Keywords: Stage IV Rectal cancer, primary tumor radiotherapy, propensity score matching.
Imaging features of evolving COVID-19 infection on computed tomography: Initial experience in Zhuhai, China.
Authors: Zhang Yaqin , Pang Pengfei , Ma Han , Chen Binghui , Li Yingqin , Jiang Guanmin , Cai Zeyu , Qin Yujuan , Chughtai Aamer , Shan Hong
Published: March 2020

Objectives To retrospectively analyze the most common imaging features on CT at baseline and as they evolve with time as the disease progresses or resolves in a cohort of patients affected with 2019 coronal virus disease (COVID-19) pneumonia in Zhuhai, China.Methods We evaluated 38 patients with COVID-19 in the authors’ institution from Jan 1 to Jan 31, 2020. Cases were confirmed by real-time RT-PCR and were analyzed for epidemiological, demographic, clinical, and radiological features. Outcomes were followed up until Feb 18, 2020. Results 38 initial scans and 62 follow-up scans were obtained. 28 (74%) patients had the history of travel to or residence in Hubei Province of China in 14 days prior to the illness onset. Common findings included ground-glass opacification (GGO), sometimes mixed with consolidation, and interlobular septal and intralobular interstitial thickening. Follow-up imaging often demonstrated peripheral GGO and consolidations spreading to the remainder of the lungs and the increasing consolidative component reflecting the progression of the disease. 8 patients (21%) whose swabs or serum were positive for COVID-19 had no imaging findings on CT throughout the disease course. After treatment the serum and sputum tests became negative for COVID-19 in 32(84%) cases. 28(74%) patients were discharged and three (8%) of them were transferred to the Observation Ward, while seven (18%) patients were kept in Isolation Ward. Conclusion The commonest pattern observed was GGO alone or GGO mixed with consolidation predominantly in lower and peripheral lungs. The follow-up CT scan is crucial for the diagnosis and evaluation of the disease process.