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The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is a worldwide non-interventional study of stroke prevention in patients with non-valvular AF.52,080 patients with newly diagnosed AF were prospectively enrolled from 2010 to 2016. 4121 (7.9%) of these patients were recruited in DACH [Germany (n = 3567), Austria (n = 465) and Switzerland (n = 89) combined], and 47,959 patients were from 32 countries in other regions worldwide (ORW). Hypertension was most prevalent in DACH and ORW (85.3% and 75.6%, respectively). Diabetes, hypercholesterolaemia, carotid occlusive disease and vascular disease were more prevalent in DACH patients vs ORW (27.6%, 49.4%, 5.8% and 29.0% vs 21.7%, 40.9%, 2.8% and 24.5%). The use of non-vitamin K antagonist oral anticoagulants (NOACs) increased more in DACH over time. Management of vitamin K antagonists was suboptimal in DACH and ORW (time in therapeutic range of INR ≥ 65% in 44.6% and 44.4% of patients or ≥ 70% in 36.9% and 36.0% of patients, respectively). Adjusted rates of cardiovascular mortality and MI/ACS were higher in DACH while non-haemorrhagic stroke/systemic embolism was lower after 2-year follow-up.Similarities and dissimilarities in AF management and clinical outcomes are seen in DACH and ORW. The increased use of NOAC was associated with a mismatch of risk-adapted anticoagulation (over-and-undertreatment) in DACH. Suboptimal control of INR requires educational activities in both regional groups. Higher rates of cardiovascular death in DACH may reflect the higher risk profile of these patients and lower rates of non-haemorrhagic stroke could be associated with increased NOAC use.

Prenatal stress (PS) can lead to impaired spatial learning and memory in offspring. Imperatorin (IMP) is a naturally occurring furanocoumarin with many pharmacological properties. However, the effects of IMP on cognitive impairment induced by PS and the underlying molecular mechanisms remain unclear. We investigated the protective effect of IMP treatment after PS on learning and memory deficits in female offspring at postnatal 60 days. After treating prenatally-stressed offspring with IMP (15 and 30 mg/kg) for 28 days, we found that IMP increased body weight and ameliorated spatial learning and memory and working memory deficits in female offspring rats. Meanwhile, hippocampal Glu and serum corticosterone levels in prenatally-stressed offspring were significantly decreased after IMP administration. Additionally, IMP treatment significantly increased BDNF, TrkB, CaMKII, and CREB mRNA expression in the hippocampus of offspring rats. Furthermore, PS-mediated induction of RKIP protein and mRNA expression and glucocorticoid receptor protein expression in the hippocampus of offspring rats were significantly decreased by IMP treatment, and the protein expression of BDNF and TrkB and relative levels of p-EKR/ERK, p-CaMKIIα/CaMKIIα, and p-CREB/CREB were remarkably increased after IMP treatment. Taken together, IMP can ameliorate PS-induced learning and memory deficits through BDNF/TrkB and ERK/CaMKIIα/CREB signaling pathway and hypothalamic-pituitary-adrenal axis.

To study the effect, treatment course and adverse reactions of Ningmitai Capsules (NMT) in the treatment of chronic prostatitis (CP).We searched the CNKI, Wanfang, COMDD and VIP databases, Cochrane Library, PubMed, EMBASE and Chinese academic conference papers for related articles before October 2019 on the treatment of CP with NMT, evaluated the quality of the literature with the Jadad Scale, and conducted a meta-analysis using the Stata14 software.Totally, 20 articles were included in this study, involving 3558 cases of CP, 1807 in the observation group and 1751 as controls. In the treatment of CP, NMT combined with quinolone, tetracycline or macrolide exhibited remarkably better effect than any of the above antibiotics used alone (RR ［95% CI］: 1.270 ［1.215－1.328］, 1.232 ［1.132－1.340］ and 1.239 ［1.130－1.359］, respectively) and the combination therapy also showed a higher total efficacy after 2, 4 and 8 weeks of medication (RR ［95% CI］: 1.256 ［1.185－1.330］, 1.245 ［1.165－1.330］ and 1.244 ［1.131－1.369］, respectively), though a little lower at 4 and 8 than at 2 weeks. There was no statistically significant difference in the incidence rate of adverse reactions between the NMT combination and antibiotics alone groups (P = 0.441).NMT combined with antibiotics, particularly with quinolone, is superior to antibiotics alone in the treatment of CP, though with no statistically significant difference in the incidence rate of adverse reactions between the two options. The length of medication does not inference the therapeutic effect.

Background: Pediatric intraspinal space-occupying lesions are relatively uncommon. However, these lesions can result in neurological disabilities due to misdiagnosis and delayed treatment. The main goal of the present study is to evaluate the clinical and radiological features and treatment options of pediatric intraspinal space-occupying lesions in order to improve the clinical recognition and management. Methods: Clinical data of 27 children with intraspinal space-occupying lesions who underwent surgery treatment in a tertiary-care hospital between 2010 and 2018 were retrospectively reviewed and analyzed. Results: Of these 27 patients, 14 (51.85%) were girls and 13 (48.15%) were boys. The most common age group affected was 10~14 years (62.96%, 9 girls and 8 boys in this age group). The mean age was 10.11 years old. Pain and weakness were the most common clinical symptoms. Preoperative magnetic resonance imaging (MRI) identified intramedullary (10 cases, 37.04%), intradural extramedullary (10 cases, 37.04%) and extradural (7 cases, 25.92%) lesions, respectively. The majority of the lesions were intraspinal tumors (23 cases, 85.19%). The histological diagnosis of tumors included embryonic residual tumors (6 cases, 22.22%), ependymoma (5 cases, 18.52%), primitive neuroectodermal tumors (PNET) (3 cases, 11.11%), schwannomas (2 cases, 7.4%), ganglioneuroma (1 case, 3.7%), Ewing’s sarc (1 case, 3.7%), B-cell non Hodgkin lymphoma (1 case, 3.7%), Hodgkin lymphoma (1 case, 3.7%), chondrosarcoma (1 case, 3.7%), ganglioglioma (1 case, 3.7%), and glioma (1 case, 3.7%). Conclusions: The incidence of pediatric intraspinal space-occupying lesions is low, and the clinical manifestation is lack of specificity. The prognosis for children with malignant tumors is poor and surgical resection is still the primary treatment option.

BACKGROUND Glomerulonephritis commonly causes kidney failure. Immunosuppressant treatment may be diabetogenic, but data on hyperglycaemia in glomerulonephritis treated with usual clinical care are scant. AIM To assess the epidemiology, risk factors and outcomes for new-onset diabetes among patients with glomerular disease (NODAG). METHODS A single-centre retrospective cohort of nondiabetic adults diagnosed with glomerulonephritis between January 2011 and July 2015. Clinical, laboratory and pharmacotherapy data were retrieved from electronic medical records. Using modified American Diabetes Association criteria, the primary outcome of NODAG was present if fasting venous glucose was ≥7 mmol/L for at least two readings, HbA1c was ≥6.5% or if patient required antidiabetic medications. Secondary outcomes were end-stage renal disease, cardiovascular disease and death. RESULTS NODAG occurred in 48 patients (10.7%); 22 required antidiabetic medication at median 6.2 (interquartile range 1.7, 20.0) months after glomerulonephritis diagnosis. Patients with NODAG had higher prebiopsy fasting glucose, greater proteinuria and lower fasting high-density lipoprotein cholesterol levels. Methylprednisolone and cyclophosphamide were more commonly used among patients with NODAG. In multivariate logistic regression, greater proteinuria (odds ratio 1.08 (95% confidence interval 1.01, 1.16), P = 0.02) and methylprednisolone use (odds ratio 4.02 (95% confidence interval 1.76, 9.18), P = 0.001) were significantly associated with NODAG, independent of the triglyceride/high-density lipoprotein cholesterol ratio as a surrogate measure of insulin resistance. Median follow up was 39.6 (26.9, 57.2) months. Secondary outcomes were not significantly different in patients with and without NODAG. CONCLUSION Proteinuria and methylprednisolone were associated with incident diabetes among patients with glomerular disease treated with usual care. At-risk patients should be appropriately counselled and monitored for hyperglycaemia.

Background Connexin 43 (Cx43) plays a central role in the inflammatory response and wound healing. Targeting Cx43 expression reduces inflammation in a variety of injuries. The expression pattern of Cx43 has not been described for many inflammatory skin diseases. Objectives To describe the expression patterns of Cx43 in eczema, psoriasis, Steven‐Johnson syndrome/toxic epidermal necrolysis. Methods Archival skin biopsies from patients with eczema, psoriasis, and Steven‐Johnson syndrome/toxic epidermal necrosis were identified and examined, with sister sections stained for Cx43 and imaged by confocal microscopy. All samples were compared to age and site‐matched normal skin controls. Results Epidermal Cx43 is reduced in acute eczema, absent in regions of spongiosis, and is highly elevated in subacute and chronic eczema. In plaque psoriasis, Cx43 is overexpressed in areas with psoriasiform hyperplasia with a fish‐scale‐like appearance but is lost in regions surrounding neutrophil microabscesses. Cx43 staining is strong in the neutrophils within these microabscesses. In SJS/TEN, Cx43 expression is elevated in areas bordering normal tissue but is rapidly lost in areas of keratinocyte necrosis. Conclusions Dynamic changes in Cx43 levels are seen in inflammatory skin diseases and may represent future potential therapeutic targets., Connexin 43 (Cx43) plays a central role in the inflammatory response and wound healing. Targeting Cx43 expression reduces inflammation in a variety of injuries. Here we examine the changes in Cx43 protein levels in the epidermis in eczema, psoriasis, Steven‐Johnson Syndrome/Toxic Epidermal necrolysis.

Background: This study aimed to describe biomarkers using the comprehensive index of biomarker (CIB) based on consistency rate in both case control (Youden index, Yen) and cohort study (Crc) to determine the efficacy of a biomarker. Methods: The CIB is the geometric mean of Yen and Crc. The simulated data were generated to observe CIB features of sensitivity, specificity, and receiver operating characteristic (ROC) analysis for biomarkersResults: CIB was found to be related to the CRC values ROC analysis. The higher Spe could indicate better diagnostic power and the higher Sen could indicate better joint action for biomarkers with the same Yen. Although Yen is the common index used to evaluate the effectiveness of a biomarker, unfortunately, the Yen value was significantly larger than CIB value under the moderate Spe, showing overestimation.Conclusion: The CIB with combination of consistency in both case control and cohort study could be more reasonable. The CIB could provide a better understanding of the power of a biomarker and would be better at evaluating biomarkers from new systems or concepts.

Introduction Periodic surveys on tobacco use patterns and other aspects of tobacco use among school-going adolescents in Malaysia provide information on the effectiveness of anti-smoking measures implemented. However, such information is limited in Malaysia. We investigated the prevalence of smoking and other related aspects among middle-secondary school students in Malaysia from the years 2003-2016 to fill this gap. Methods We analyzed data from the Global Youth Tobacco Survey (GYTS) 2003, GYTS 2009, and the Tobacco and Electronic Cigarette Survey among Malaysia Adolescents (TECMA) 2016. The surveys employed multistage sampling to select representative samples of adolescents attending secondary school in Malaysia. Data were collected using a pre-validated self-administered anonymous questionnaire adopted from the GYTS. Results Between 2003 and 2016, major changes occurred in which there were reductions in the prevalence of ever smoking, current smoking, and susceptibility to smoking. Reductions were also observed in exposure to SHS in public places and in the home. The proportion of school-going adolescents who support a ban on smoking in public places increased between 2013 to 2016, and there was a significant reduction in the proportion of respondents that were offered 'free' cigarettes by tobacco company representatives. However, there was no difference in the proportion of adolescents who initiated smoking before the age of 10 years and current smokers seeking advice to quit smoking across the time period. Conclusions Our study indicates that the smoking policies and measures have been effective in reducing smoking prevalence, secondhand smoke exposure, and access to cigarettes, among school-going adolescents in Malaysia. However, measures to reduce smoking initiation and increase smoking cessation need to be strengthened to reduce the burden of smoking-related diseases in Malaysia in the long-term.

Recently, mobile edge computing has received widespread attention, which provides computing infrastructure via pushing cloud computing, network control, and storage to the network edges. To improve the resource utilization and Quality of Service, we investigate the issue of task offloading for End-EdgeCloud orchestrated computing in mobile networks. Particularly, we jointly optimize the server selection and resource allocation to minimize the weighted sum of the average cost. A cost minimization problem is formulated underjoint the constraints of cache resource and communication/computation resource of edge servers. The resultant problem is a Mixed-Integer Non-linear Programming, which is NP-hard. To tackle this problem, we decompose it into simpler subproblems for server selection and resource allocation, respectively. We propose a low-complexity hierarchical heuristic approach to achieve server selection, and a Cauchy-Schwards Inequality based closed-form approach to efficiently determine resource allocation. Finally, simulation results demonstrate the superior performance of the proposed scheme on reducing the weighted sum of the average cost in the network.

Introduction We investigated the prevalence of children's exposure to secondhand smoke (SHS) in the car of their parents/guardians and the associated factors. Methods A self-administered validated questionnaire was used to obtain data from the nationally representative samples of school-going adolescents aged 11-19 years in Malaysia. Prevalence rates were computed and chi-squared tests and multiple logistic regression were conducted. Results Of the participants, 23.3% reported exposure to SHS at least once in the car of their parents/guardians during the last 7 days before the survey. The prevalence and likelihood of SHS exposure were significantly higher in Malays, descendants of natives of Sabah and Sarawak, schools in rural areas, females, and current smokers. However, age group and knowledge on the harmful effects of SHS were not significant after adjusting for confounding effects. Conclusions A substantial proportion of school-going adolescents were exposed to secondhand smoke in the car of their parents/guardians. This highlights the need for effective tobacco control measures to include health promotion and smoke-free car regulations to be introduced to prevent severe health hazards and to reduce smoking initiation among non-smoking adolescents.

This work introduces an unprecedented flash flood that resulted in nine casualties in Shimen Valley, China, 2015. Through field survey and numerical simulation, the causes of the disaster are systematically analyzed, finding that the intense storm, terrain features, and the large woody debris(LWD) played important roles. The intense storm induced fast runoff and, in turn, high discharges as a result of the steep catchment surfaces and channels. The flood flushed LWD and boulders downstream until blockage occurred in a contraction section, forming a debris lake. When the debris dam broke, a dam break wave rapidly propagated to the valley mouth, washing people away. After considering the disaster-inducing factors, measures for preventing similar floods are proposed. The analysis presented herein should help others manage flash floods in mountain areas.

Aim Increasing demands for care provision to older adults require good physical and mental health among caregivers. Few studies have examined the health status and correlates of quality of life among caregivers of older adults. The present study therefore sought to examine the prevalence of chronic physical conditions, psychological distress, and correlates of physical and mental quality of life among caregivers of older adults (≥60 years) in Singapore. Methods Participants were 285 informal caregivers who were providing care to an older relative. Participants were recruited at the Institute of Mental Health, Singapore, and they completed self-report measures on chronic physical morbidity, psychological distress, and physical and mental quality of life. Multiple regression models were constructed to examine correlates of physical and mental quality of life. Results More than half of the caregivers had at least one chronic physical condition (58.6%) and psychological distress (52.6%). Chronic physical morbidity, psychological distress, and secondary education status were associated with lower physical quality of life. Psychological distress, younger age, primary education status, and more time spent caregiving were associated with lower mental quality of life. Conclusion Poor physical and mental health among caregivers may impair their ability to provide adequate care to older adults with progressive medical needs. It is important for medical practitioners not to neglect the physical and mental health of caregivers through continued assessment of chronic physical morbidity, psychological distress, and quality of life.

Homeobox protein Hox-C8 (HOXC8) is a member of Hox family. It is expressed in the dermal papilla of the skin and is thought to be associated with the hair inductive capacity of dermal papilla cells. In the present study, we isolated and characterized a full-length open reading frame of HOXC8 cDNA from the skin tissue of Liaoning cashmere goat, as well as, established a phylogenetic relationship of goat HOXC8 with that of other species. Also, we investigated the effect of methylation status of HOXC8 exon 1 at anagen secondary hair follicle on the cashmere fiber traits in Liaoning cashmere goat. The sequence analysis indicated that the obtained cDNA was 1134-bp in length containing a complete ORF of 729-bp. It encoded a peptide of 242 amino acid residues in length. The structural analysis indicated that goat HOXC8 contained a typical homeobox domain. The phylogenetic analysis revealed that Capra hircus HOXC8 had a closer genetic relationship with that of Ovis aries, followed by Bos Taurus and Bubalus bubalis. The methylation analysis suggested that the methylation degree of HOXC8 exon 1 in anagen secondary hair follicle might be involved in regulating the growth of cashmere fiber in Liaoning cashmere goat. Our results provide new evidence for understanding the molecular structural and evolutionary characteristics of HOXC8 in Liaoning cashmere goat, as well as, for further insight into the role of methylation degree of HOXC8 exon 1 regulates the growth of cashmere fiber in goat.

Objectives: This study aimed to examine correlations between lumbar kinematics, functional disability and fear avoidance beliefs among adults with nonspecific chronic low back pain (LBP). Methods: This cross-sectional study was conducted between March and December 2014. A total of 32 adults diagnosed with nonspecific chronic LBP were recruited from outpatients attending either an orthopaedic clinic at a university hospital or a private physiotherapy clinic in Malaysia. Lumbar kinematics were measured using sensors attached at the first lumbar (L1) and second sacral (S2) vertebrae levels. The Oswestry Disability Index (ODI) and Fear-Avoidance Beliefs Questionnaire (FABQ) were used to assess degree of functional disability and fear avoidance beliefs, respectively. Results: For maximum range of motion, positive correlations were observed between ODI scores and right lateral flexion and right rotation ( P = 0.01 each), although there was a negative correlation with left rotation ( P = 0.03). With maximum angular velocity, ODI scores were positively correlated with right and left lateral flexion L1 ( P = 0.01 and

BackgroundRibosomal DNA (rDNA) transcription by the RNA polymerase I (Pol I) is a rate-limited step for ribosome synthesis, which is critical for cell growth, cell differentiation, and tumorigenesis. Meanwhile rDNA transcription is modulated by DNA methylation and histone epigenetic modification. Though with great progress in epigenetic research recently, it still remains much uncertain about the relationship of histone variant epigenetic modification and rDNA transcription.ResultsIn this study, epigenetic profiles of silent rDNA in next-generation sequencing datasets were examined. We found that the chaperone of histone variant H3.3, the alpha-thalassemia/mental retardation X-linked syndrome protein (ATRX)/death domain-associated protein (DAXX) complex, and methyltransferase SET domain bifurcated 1 (Setdb1, also known as ESET) help maintain H3.3K9me3 modifications among the promoter and coding regions of silent rDNA. Our experiments further confirmed that DAXX depletion leads to the conversion of silent rDNA into upstream binding factor-bound active rDNA and the release of rDNA transcriptional potency. Support for this model is provided by data from a low-grade glioma in which ATRX is lost and a higher level of ribosomal biosynthesis, nucleolus activity, and proliferation are observed.ConclusionsWe demonstrate a model of epigenetic regulation for rDNA with roles for the ATRX/DAXX complex and H3.3/H3K9me3 modifications identified. Thus, loss of ATRX/DAXX may represent a driving force for tumorigenesis due to its contribution to the release of rDNA transcriptional potency.

BACKGROUND Community-acquired pneumonia (CAP) is a common infectious disease. Inflammatory reaction and prognosis assessment in adult CAP patients are useful for CAP site of care decisions. Most CAP patients were diagnosed in an out-patient or emergency department, so a simple, cheap and rapidly available measurement to assess inflammatory reaction and prognosis has the prospect of broad application. The aim of this study was to investigate the usefulness of plasma D-Dimer in assessment of inflammatory reaction and prognosis in adult CAP patients. METHODS A retrospective study was conducted. All adult patients with a primary diagnosis of CAP were included and were evaluated by peripheral plasma D-Dimer test. All of the measurement data were analyzed with paired t-test and the enumeration data were analyzed with χ2 test. Correlative factor analysis was performed between D-Dimer levels and serum inflammatory markers (WBC, hs-CRP, PCT) and prognostic indexes (ICU admission and 30-day mortality). Receiver operating characteristic curves (ROC) were used to evaluate the sensitivity and specificity of D-Dimer in predicting ICU admission and/or 30-day mortality. RESULTS One hundred fifty patients were included. Compared with non-D-Dimer elevated group, serum inflammatory markers (WBC, hs-CRP, PCT) and prognostic indexes (ICU admission and 30-day mortality) were elevated in the D-Dimer elevated group (p < 0.05). D-Dimer had positive correlation with serum inflammatory markers (WBC, hs-CRP, PCT), the rates of ICU admission and 30-day mortality, and scores of CURB-65. The AUC of ROC curve of D-Dimer was 0.880 (95% CI 0.823 to 0.936), the sensitivity was 80.4% and specificity was 79.8%, D-Dimer levels are superior to hs-CRP and PCT in predicting 30-day mortality and/or ICU admission according to AUCs of the ROC curves. CONCLUSIONS Elevated plasma D-Dimer in adult CAP patients is associated with an increased inflammatory reaction and ICU admission and 30-day mortality. It can be a simple, cheap, and rapidly available measurement to assess inflammatory reaction and prognosis in adult CAP patients.

pstrongemBackground/em/strong: Scoring systems including CURB-65 and Pneumonia Severity Index (PSI) and novel or traditional biomarkers including procalcitonin (PCT) and c-reactive protein (CRP) are very significant for understanding the severity and prognosis in community-acquired pneumonia (CAP) patients, while prognostic items are useful for CAP prognostication and point-of-care decisions. The aim of this study was to investigate the usefulness of peripheral blood routine items in predicting ICU admission and 30-day mortality in CAP patients./ppstrongemMethods/em/strong: A retrospective study was conducted. All adult patients with a primary diagnosis of CAP were included and peripheral blood routine tests were evaluated. Univariate analysis and multivariate logistic regression analysis were used to explore association of risk factors with 30-day mortality among CAP patients. Receiver operating characteristic curves (ROC) were used to evaluate the sensitivity and specificity of peripheral blood routine items and compared with CURB-65 scores in predicting ICU admission and/or 30-day mortality./ppstrongemResults/em/strong: One hundred fifty patients were included and compared with non-ICU admission patients. There was a statistically significant difference in age, co-existing illness, RDW, WBC, and CURB-65 scores ranking in ICU admission patients (p0.05). In multivariate logistic regression analysis, we found RDW, WBC, and CURB-65 ≥ 3 scores increased the risk of 30-day mortality by 4.01, 1.65, and 3.43 times, respectively. The area under the curve (AUC) of ROC curves of RDW combined with WBC and CURB-65 was 0.786 (95% CI 0.701 to 0.876) and 0.836 (95% CI 0.764 to 0.908), respectively and the sensitivity was 84.0% and 60.0%, respectively, and the specificity 66.7% and 93.7%, respectively./ppstrongemConclusions/em/strong: Elevated RDW and WBC increased mortality in adult CAP patients, RDW combined with WBC had a better sensitivity than CURB-65 scores in predicting ICU admission and/or mortality in CAP patients./p.

Prenatal stress (PS) can lead to impaired spatial learning and memory in offspring. Imperatorin (IMP) is a naturally occurring furanocoumarin with many pharmacological properties. However, the effects of IMP on cognitive impairment induced by PS and the underlying molecular mechanisms remain unclear. We investigated the protective effect of IMP treatment after PS on learning and memory deficits in female offspring at postnatal 60 days. After treating prenatally-stressed offspring with IMP (15 and 30 mg/kg) for 28 days, we found that IMP increased body weight and ameliorated spatial learning and memory and working memory deficits in female offspring rats. Meanwhile, hippocampal Glu and serum corticosterone levels in prenatally-stressed offspring were significantly decreased after IMP administration. Additionally, IMP treatment significantly increased BDNF, TrkB, CaMKII, and CREB mRNA expression in the hippocampus of offspring rats. Furthermore, PS-mediated induction of RKIP protein and mRNA expression and glucocorticoid receptor protein expression in the hippocampus of offspring rats were significantly decreased by IMP treatment, and the protein expression of BDNF and TrkB and relative levels of p-EKR/ERK, p-CaMKIIα/CaMKIIα, and p-CREB/CREB were remarkably increased after IMP treatment. Taken together, IMP can ameliorate PS-induced learning and memory deficits through BDNF/TrkB and ERK/CaMKIIα/CREB signaling pathway and hypothalamic-pituitary-adrenal axis.

Background. Cancer-related fatigue (CRF) is a subjective and distressing symptom, and its associated factors in developing countries remain ambiguous. The goal of this study was to determine the prevalence of and factors associated with CRF among cancer patients in China. Methods. This study was designed as a cross-sectional study to determine the prevalence of and factors associated with CRF among cancer patients in eastern China, regardless of their diagnoses. Data were collected by using a questionnaire survey (including demographic information and brief fatigue inventory) after informed written consent was obtained. A chi-square test was used to analyze the correlations between single categorical factors and CRF, and multiple logistic regression analysis was used to evaluate the associations of potential risk factors with the presence of CRF. Results. Out of a total population of 1,938 cancer patients, 1,749 had completed the study questionnaire; 52.07% (n = 904) reported clinically significant fatigue (score ≥4 on Brief Fatigue Inventory). Four hundred twenty-seven (48.47%) patients younger than age 58 years (the median age) and 475 (55.69%) patients age 58 years or older reported clinically significant fatigue. In multivariate analysis, higher sleep quality (p < .01) was negatively associated with CRF, whereas never engaging in physical exercise (p < .01) and higher clinical stage of cancer (p < .01) were positively associated factors that could increase the odds of CRF. Conclusion. The results of this study suggest that effective management of the two changeable contributing factors of CRF may reduce CRF and thus could be used as references for CRF management.

Glomerulonephritis commonly causes kidney failure. Immunosuppressant treatment may be diabetogenic, but data on hyperglycaemia in glomerulonephritis treated with usual clinical care are scant.To assess the epidemiology, risk factors and outcomes for new-onset diabetes among patients with glomerular disease (NODAG).A single-centre retrospective cohort of nondiabetic adults diagnosed with glomerulonephritis between January 2011 and July 2015. Clinical, laboratory and pharmacotherapy data were retrieved from electronic medical records. Using modified American Diabetes Association criteria, the primary outcome of NODAG was present if fasting venous glucose was ≥7 mmol/L for at least two readings, HbA1c was ≥6.5% or if patient required antidiabetic medications. Secondary outcomes were end-stage renal disease, cardiovascular disease and death.NODAG occurred in 48 patients (10.7%); 22 required antidiabetic medication at median 6.2 (interquartile range 1.7, 20.0) months after glomerulonephritis diagnosis. Patients with NODAG had higher prebiopsy fasting glucose, greater proteinuria and lower fasting high-density lipoprotein cholesterol levels. Methylprednisolone and cyclophosphamide were more commonly used among patients with NODAG. In multivariate logistic regression, greater proteinuria (odds ratio 1.08 (95% confidence interval 1.01, 1.16), P = 0.02) and methylprednisolone use (odds ratio 4.02 (95% confidence interval 1.76, 9.18), P = 0.001) were significantly associated with NODAG, independent of the triglyceride/high-density lipoprotein cholesterol ratio as a surrogate measure of insulin resistance. Median follow up was 39.6 (26.9, 57.2) months. Secondary outcomes were not significantly different in patients with and without NODAG.Proteinuria and methylprednisolone were associated with incident diabetes among patients with glomerular disease treated with usual care. At-risk patients should be appropriately counselled and monitored for hyperglycaemia.

Thoracolumbar fractures are among the most common type of traumatic spine fractures. Surgical treatment is necessary if stability or neurological function is impaired.1 Restoration of the vertebral column stability and decompression of the spinal canal are the main goals of surgical treatment.2 Posterior short-segment fixation has the advantage of using a less extensive approach with less blood loss and complications without compromising the quality of stabilization, and spares healthy mobile segments in fusion, and thus preserves mobility.3 Traditional short-segment fixation (TSSF) is a widely used technique in the treatment of unstable thoracolumbar fractures. It not only provides distraction and compression forces that facilitate 3-dimensional correction and firm fixation, but it also preserves motion segments.4 It can offer several advantages: immediate stability, restoration of the vertebral height and deformity angle, and prevention of late neurological injury.5 However, TSSF has been associated with a high rate of failure.6 The latter is usually associated with implant failure and loss of reduction of kyphosis. Posterior fixation including the fractured vertebra (PFFV) is a novel idea used to overcome the shortcomings of TSSF. The technique avoids the suspension effect and quadrilateral effect, dispensing the internal fixing load and reducing the correction degree losses and internal fixation fractures, and it shows good efficacy in clinical application.7 However, there are still only a few randomized controlled studies7 and the relevant theory requires further investigation. The purpose of this study is to compare the clinical effectiveness of PFFV and TSSF in the treatment of thoracolumbar fracture.

Long noncoding RNAs (lncRNAs) are a novel class of eukaryotic transcripts. They are thought to act as a critical regulator of protein-coding gene expression. Herein, we identified and characterized 13 putative lncRNAs from the expressed sequence tags from secondary hair follicle of Cashmere goat. Furthermore, we investigated their transcriptional pattern in secondary hair follicle of Liaoning Cashmere goat during telogen and anagen phases. Also, we generated intracellular regulatory networks of upregulated lncRNAs at anagen in Wnt signaling pathway based on bioinformatics analysis. The relative expression of six putative lncRNAs (lncRNA-599618, -599556, -599554, -599547, -599531, and -599509) at the anagen phase is significantly higher than that at telogen. Compared with anagen, the relative expression of four putative lncRNAs (lncRNA-599528, -599518, -599511, and -599497) was found to be significantly upregulated at telogen phase. The network generated showed that a rich and complex regulatory relationship of the putative lncRNAs and related miRNAs with their target genes in Wnt signaling pathway. Our results from the present study provided a foundation for further elucidating the functional and regulatory mechanisms of these putative lncRNAs in the development of secondary hair follicle and cashmere fiber growth of Cashmere goat.

The H19 transcript (imprinted maternally expressed transcript) is well-known as long noncoding RNA (lncRNA), and it is thought to be associated with the inductive capacity of dermal papilla cells for hair-follicle reconstruction. In this study, we isolated and characterized a lncRNA-H19 transcript from the secondary hair follicle of Liaoning cashmere goat. Also, we investigated its transcriptional pattern and methylation status of H19 gene in secondary hair follicle of this breed during different stages of hair follicle cycle. Nucleotide composition analysis indicated that guanine (G) and cytosine (C) are the dominant nucleotides in the lncRNA-H19 transcript of Liaoning cashmere goat with the highest frequency distribution (11.25%) of GG nucleotide pair. The regulatory network showed that lncRNA-H19 transcript appears to have remarkably diverse regulatory relationships with its related miRNAs and the potential target genes. In secondary hair follicle, the relative expression of lncRNA-H19 transcript at the anagen phase is significantly higher than that at both telogen and catagen phases suggesting that lncRNA-H19 transcript might play essential roles in the formation and growth of cashmere fiber of goat. Methylation analysis indicated that the methylation of the promoter region of H19 gene most likely participates in its transcriptional suppression in secondary hair follicle of Liaoning cashmere goat.

The enantioselective environmental behavior of the chiral fungicides benalaxy and furalaxyl in agricultural soils in China was studied. Although sorption onto soils was non-enantioselective, the leaching of benalaxy and furalaxyl was enantioselective in soil columns. The concentrations of the S-enantiomers of both fungicides in the leachates were higher than the R-enantiomers. This can be attributed to enantioselective degradation of the two fungicides in the soil column. Enantioselective degradation of the two fungicides was verified by soil dissipation experiments, and the R-enantiomers degraded faster than the S-enantiomers in partial soils. The half-life was 27.7-57.8 days for S-benalaxyl, 20.4-53.3 days for R-benalaxyl, 19.3-49.5 days for S-furalaxyl and 11.4-34.7 days for R-furalaxyl. The degradation process of the two fungicide enantiomers followed the first-order kinetics (R(2)0.96). Compared to furalaxyl, benalaxyl degraded more slowly and degradation was less enantioselective. These results are attributed to the influence of soil physicochemical properties, soil microorganisms, and environmental factors.

Background Previous studies showed improvement in heart function by injecting bone marrow mesenchymal stem cells (BMSCs) after AMI. Emerging evidence suggested that both the number and function of BMSCs decline with ageing. We designed a randomized, controlled trial to further investigate the safety and efficacy of this treatment. Methods Patients with ST-elevation AMI undergoing successful reperfusion treatment within 12hours were randomly assigned to receive an intracoronary infusion of BMSCs (n=21) or standard medical treatment (n=22) (the numbers of patients were limited because of the complication of coronary artery obstruction). Results There is a closely positive correlation of the number and function of BMSCs vs. the cardiac function reflected by LVEF at baseline (r=0.679, P=0.001) and at 12-month follow-up (r=0.477, P=0.039). Six months after cell administration, myocardial viability within the infarct area by 18-FDG SPECT was improved in both groups compared with baseline, but no significant difference in the BMSCs compared with control groups (4.0±0.4% 95%CI 3.1–4.9 vs. 3.2±0.5% 95%CI 2.1–4.3, P=0.237). 99mTc-sestamibi SPECT demonstrated that myocardial perfusion within the infarct area in the BMSCs did not differ from the control group (4.4±0.5% 95%CI 3.2–5.5 vs. 3.9±0.6% 95%CI 2.6–5.2, P=0.594). Similarly, LVEF after 12 and 24months follow-up did not show any difference between the two groups. In the BMSCs group, one patient suffered a serious complication of coronary artery occlusion during the BMSCs injection procedure. Conclusions The clinical benefits of intracoronary injection of autologous BMSCs in acute STEMI patients need further investigation and reevaluation.

Wheat is one of the most important crops in the world. Its yield is greatly influenced by global climate change and scarcity of water in the arid and semi-arid areas of the world. So, exploration of gene resources is of importance to wheat breeding in order to improve the crop ability of coping with abiotic stress environment. Wild relatives of wheat are rich repositories of beneficial genes that confer tolerance or resistance not only to drought but also to other environmental stresses. In the present study, the changes in leaf relative water content (RWC), free proline content, and malondialdehyde (MDA) accumulation of five wild wheat species including T. boeticum (YS-1L), T. dicoccum var. dicoccoides (YS-2L), T. araraticum (ALLT), and two cultivated varieties of T. turgidum ssp. durum (MXLK and 87341), with two well-known common wheat cultivars (SH6 and ZY1) possessing strong drought resistance and sensitiveness, respectively, as references were investigated during 3-day water stress and 2-day recovery , in order to assess the drought tolerance of these wild wheat species. The laboratory experiment was conducted under two water regimes (stress and non-stress treatments). Stress was induced to hydroponically grown two weeks old wheat seedlings with 20% PEG 6000. Stress treatment caused a much smaller decrease in the leaf RWC and rise in MDA content in YS-1L compared to the other wheat species. From the data it was obvious that YS-1L was the most drought tolerant among studied species having signifi - cantly higher proline and RWC while lower MDA content under water stress conditions. The order of water stress tolerance of these species according to the three parameters is: YS-1L > YS-2L > SH6 > 87341 > ZY1 > MXLK > ALLT. We speculate that the observed drought stress tolerance at a cellular level was associated with the ability to accumulate proline and high water level conservation.

Bone morphogenetic protein 4 (BMP4) is a member of the bone morphogenetic protein family (BMPs). It is involved in the development and cycle of hair follicle, as well as, is thought to be a potential candidate gene for cashmere traits in goats. In the present study, we isolated and characterized a full-length open reading frame (ORF) of BMP4 cDNA from the skin tissue of Liaoning cashmere goat, and investigated the transcriptional pattern and methylation status of BMP4 gene in skin tissue of this breed during different stages of hair follicle cycle. The sequence analysis indicated that the isolated cDNA was 1264-bp in length containing a complete ORF of 1230-bp. It encoded a precursor peptide of 409 amino acids with a signal peptide of 19 amino acids. The structural analysis indicated that goat BMP4 contains typical TGF-β propeptide and TGF-β domains. In skin tissue, BMP4 is generally transcribed in an ascendant pattern from anagen to telogen. The methylation level of 5′ flanking regulatory region of BMP4 gene might be involved in its mRNA expression in skin tissue: a higher BMP4 methylation level in skin coincides with a lower expression of BMP4 mRNA. These results from the present work provided a foundation for further insight into the functional and regulatory characteristics of BMP4 in the development and cycle of hair follicle in Liaoning Cashmere goat.

Severe liver failure causes coagulopathy and high bleeding risk. Albumin dialysis with Molecular Adsorbent Recirculating System (MARS) (Gambro, Lund, Sweden) is useful for treatment. However, anticoagulation during its use is of uncertain value. We omitted heparin-saline priming and intradialytic heparin and examined its effects. Albumin dialysis was performed in critically ill patients with intermittent circuit saline flushes (2664 ± 2420 mL per treatment). A total of 12 patients (M : F = 10:2; age 49 ± 9 years) were thus treated: 6 for fulminant hepatic failure and 6 for acute-on-chronic liver failure. The overall hospitalization duration was 31 ± 30 days. A total of 44 treatment sessions were performed (average 8 ± 7 sessions per patient). Prescribed versus achieved MARS duration were 13 ± 3 versus 11 ± 4 h, P

Objective: To evaluate the role of posterior fixation including the fractured vertebra (PFFV) for the treatment of thoracolumbar vertebral fractures. Methods: Sixty-seven patients that sustained a single-level thoracolumbar fracture were included in this retrospective study carried out in the Wuxi People’s Hospital, Wuxi, China between August 2010 and June 2013. Thirty-two cases were treated with PFFV, and 35 cases were treated with traditional short-segment fixation (TSSF). All patients were periodically followed-up with clinical and radiologic evaluation. Cobb’s angle and vertebral body height were analyzed and compared, and the operational time, intra-operational blood loss, and the Denis pain scale scores were also compared. Results: Compared with preoperative angles, the Cobb’s angles were reduced and the vertebral body height of the fractured vertebra was increased after operation at a statistically significant level. Twelve months post-operative, the loss of Cobb’s angle and vertebral body height in the PFFV group was significantly less than that in the TSSF group. There was no statistical significance in the Denis pain scale score 12 months post-operatively between the 2 groups. Conclusion: Selective adoption of PFFV is helpful not only for stabilization of fractures and restoration of anatomy, but also maintaining the effectiveness of the restoration with good functional outcome.

Hepatitis B virus (HBV) infection is a major health problem worldwide. This virus and its hosts are often fated to continual co-evolutionary interactions. Codon usage analysis has significance for studies of co-evolution between viruses, their hosts, and mRNA translation. Adaptation of the overall codon usage pattern of HBV to that of humans is estimated using the synonymous codon usage value (RSCU), and the synonymous codon usage biases for the translation initiation region (TIR) of HBV are analyzed by calculation of the usage fluctuation of each synonymous codon along the TIR (the first 50 codon sites of the whole coding sequence of HBV). With respect to synonymous codon usage, our results demonstrated that HBV had no significant tendency to select over-represented codons, but had a significant tendency to select certain under-represented codons in the viral genome. Within the three common HBV hosts, 14 of 59 codons had a similar usage pattern, suggesting that mutation pressure from this DNA virus played an important role in the formation of virus synonymous codon usage. In addition, there was no obvious trend for the codons with relatively low energy to be highly selected in the TIR of HBV, suggesting that the synonymous codon usage patterns for the TIR might not be affected by the nucleotide sequence secondary structure; however, synonymous codon usage in the TIR of HBV was influenced by the overall codon usage patterns of the hosts to some degree. Our results suggest that mutation pressure from HBV plays an important role in the formation of synonymous codon usage of the viral genome, while translation selection from the hosts contributes to virus translational fine-tuning.

The use of adult stem cells is limited by the quality and quantity of host stem cells. It has been demonstrated that Wharton’s jelly–derived mesenchymal stem cells (WJMSCs), a primitive stromal population, could integrate into ischemic cardiac tissues and significantly improve heart function. In this randomized, controlled trial, our aim was to assess the safety and efficacy of intracoronary WJMSCs in patients with ST-elevation acute myocardial infarction (AMI). In a multicenter trial, 116 patients with acute ST-elevation MI were randomly assigned to receive an intracoronary infusion of WJMSCs or placebo into the infarct artery at five to seven days after successful reperfusion therapy. The primary endpoint of safety: the incidence of adverse events (AEs) within 18 months, was monitored and quantified. The endpoint of efficacy: the absolute changes in myocardial viability and perfusion of the infarcted region from baseline to four months, global left ventricular ejection fraction (LVEF) from baseline to 18 months were measured using F-18-fluorodeoxyglucose positron emission computed tomography (F-18-FDG-PET) and 99mTc-sestamibi single-photon emission computed tomography (99mTc-SPECT), and two-dimensional echocardiography, respectively. During 18 months follow-up, AEs rates and laboratory tests including tumor, immune, and hematologic indexes were not different between the two groups. The absolute increase in the myocardial viability (PET) and perfusion within the infarcted territory (SPECT) was significantly greater in the WJMSC group [6.9 ± 0.6 % (95 %CI, 5.7 to 8.2)] and [7.1 ± 0.8 % (95 %CI, 5.4 to 8.8) than in the placebo group [3.3 ± 0.7 % (95 %CI, 1.8 to 4.7), P

A Gla domain-mutated protein C variant, QGNSEDY, modified at positions 10-12, 23, 32-33, and 44, having enhanced affinity for negatively charged phospholipid and increased anticoagulant potential, was used to elucidate the importance of the interaction between the Gla domain and the phospholipid for the ability of activated protein C (APC) to inactivate factor Va (FVa). FVa degradation by wild type (WT)-APC and QGNSEDY-APC yielded similar fragments on Western blotting; QGNSEDY-APC was, however, considerably more efficient. The kinetic parameters for individual APC-mediated cleavages in FVa, i.e. at Arg-306 and Arg-506, were investigated at high and low phospholipid concentrations in the presence and absence of protein S. FVa variants 306Q679Q and 506Q679Q, which can only be cleaved at Arg-506 and Arg-306, respectively, were used. In the absence of protein S, QGNSEDY-APC was 17.8- and 4-fold more efficient than WT-APC in cleaving at Arg-306 and Arg-506, respectively, at high phospholipid. Similar values were obtained at low phospholipid. In the presence of protein S, QGNSEDY-APC was 6.8- and 3.2-fold more active than WT-APC in cleaving at Arg-306 and Arg-506, respectively, at high phospholipid. At low phospholipid, the corresponding values were 14- and 6.5-fold. In conclusion, the modification of the Gla domain in QGNSEDY-APC yielded increased rates of cleavage at both sites in FVa, the increase being particularly pronounced for the Arg-306 site in the absence of protein S. The results obtained with QGNSEDY-APC provide insights into the importance of the APC-phospholipid interaction for the APC-mediated cleavages at Arg-306 and Arg-506 in FVa.

We report the thermal CVD from ethylene over graphite at 850 °C in which multiwalled carbon nanotubes grow at defect sites on the graphite surface. Pretreatments for rich defect formation are prese...

This study was conducted to evaluate the efficacy and safety of rituximab and Bortezomib in relapsed or refractory indolent B cell non-Hodgkin's lymphoma (NHL). Treatments consisted of rituximab 375 mg/m(2), i.v. on days 1, 8, 15, and 22 of cycle 1 and on day one of cycles 2-5, bortezomib 1.6 mg/m(2), given by intravenous injection (3-s to 5-s bolus) on days 1, 8, 15, and 22 of a maximum of five cycles. The primary end points were the overall survival (OS) and progression-free survival (PFS). Secondary endpoints included response rate (ORR; CR) and toxicities. From January 2008 to December 2010, 60 successive patients at Tianjin cancer hospital lymphoma department were enrolled in this study. All patients were recurrent or refractory indolent B cell NHL, including follicular lymphoma grades 1-2 (n = 35), small lymphocytic lymphoma/chronic lymphocytic leukemia (LL/CLL; n = 16) and marginal zone lymphoma (n = 9). The median follow-up time was 30 months (range 12-48). The overall response rate was 70.0 %, with a CR/CRu rate of 31.7 %. The 2-year OS and PFS of all patients were 75.0 and 41.0 %, respectively. Grade 3-4 neutropenia and thrombocytopenia occurred in 10 and 3.3 % of patients, respectively. Higher IPI and refractory disease were independently associated with worse survival and PFS. RB chemotherapy in patients with refractory or relapsed indolent B cell NHL was effective with low toxicity.

An integrated model is proposed for involute gear pair combining the mixed elastodhydrodynamic lubrication (EHL) theory for finite line contact with surface temperature rise equations considering tribo-dynamic loading behaviors. The film stiffness and viscous damping as well as the friction force are taken into account. The surface topography of tooth flank measured by 3D surface profiler is also included to solve the local temperature and pressure distribution in the contact area. The results show that the temperature distributions in different meshing positions along the line of action exhibit dissimilar characteristics due to the varying of dynamic load and the changing slip-to-roll ratio, which denotes the relationship between sliding velocity and rolling velocity on the tooth flank. Besides, the maximum of temperature is likely to appear at different sides of the gear tooth width as the gear pair meshes along the line of action. Moreover, with the increasing surface roughness, the ratio of asperity contacts becomes larger, so more heat generates from the contact area and leads to higher temperature rise.

To the Editor: We read with great interest the recent paper1 on renal biopsy findings among Indigenous Australians, a nationwide survey involving 1026 biopsies in which the authors compared the biopsy pattern among the Indigenous population living in remote/very remote (R/VR) areas with those living in the city and the non-Indigenous Australians. Referring to the prevalence of primary glomerulonephritis (GN), it was reported that IgA nephritis was well represented among all Indigenous biopsies though lower proportion among the R/VR aborigines. Substantial numbers of Indigenous people had diffuse proliferative GN, including higher proportion of post-infectious GN. The proportions of membranous GN were lower in the R/RV biopsies. This biopsy pattern of Indigenous Australians is reminiscent of the biopsy patterns of many countries in the 1980s. It is in marked contrast to the present day patterns in which the prevalence of diffuse proliferative GN, including post-infectious GN, is low and the prevalence of membranous GN is high.2 We have reported the biopsy prevalence in Singapore over three decades from the 1970s to 2000s where diffuse proliferative GN had decreased from 32 to 7% and membranous GN has increased from 3 to 11%. Australia and the rest of the developed world have reported similar findings nationwide. We would suggest that the pattern of primary GN among the Indigenous biopsies is a reflection of the socioeconomic conditions prevailing among the R/VR Aborigines compared with those living in the city. This is a trend reflecting the degree of development of the R/VR population in less developed housing facilities with exposure to parasitic, bacterial, and other infective agents predisposing to mesangial proliferative GN, consistent with the hygiene hypothesis.3

An integrated model for gear pair that combines the dynamic load with the mixed elastohydrodynamic lubrication (EHL) theory is proposed in this paper covering the film squeeze effect as well as the friction force generated from the rough surfaces. Comparisons between the two models of load which are, respectively, based on minimum elastic potential energy (MEPE) criterion and dynamic motion equations built up in this paper are discussed. The results show that at low speed the loads calculated by the two models are similar. However, with increasing speed, the load exhibits dynamic characteristics gradually and reaches the highest value at resonant speed. Besides, the effects of the helix angle and the lubricant viscosity are also analyzed. Increasing the ambient viscosity could intensify the film stiffness and viscous damping. Gear with larger helix angle could weaken the impact phenomenon at the shift points where one tooth-pair disengages. Moreover, it is symmetric with regard to the pressure and film thickness across the face width for spur gear. Differently, the pressure for helical gear has a higher value at the dedendum of pinion where the film becomes thinner. In addition, speeding up the pinion would generally result in higher dynamic load and film pressure but thicker film thickness.

To the Editor: We read with great interest the above article,1 in which the authors had accrued data from a population survey of chronic kidney disease (CKD) in a rural population in Sri Lanka. Our experience in Singapore in the 1970s2 was very similar to the Sri Lankan study in which Lim et al.2 conducted a community survey of the population. The prevalence of proteinuric CKD was also low, i.e., 0.63%.