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Rong Liu,1,* Tingfen Ji,1,2,* Yixia Jiang,1 Hequan Li1 1Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Lishui People’s Hospital, Lishui, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hequan Li, Email lihequan@zju.edu.cnPurpose: Recurrent inflammatory fevers with multisystem involvement occur clinically and may indicate an autoimmune disease.Case: We present a young male diagnosed with pulmonary embolism who experienced recurrent fever during hospitalization and was unresponsive to antibiotics and antipyretics. A follow-up history revealed chronic oral and genital ulcers, leading to a final diagnosis of Behçet’s disease.Conclusion: The patient’s temperature normalized rapidly after corticosteroid therapy, and infection markers returned to normal. Complete remission was achieved with immunosuppression and glucocorticoid therapy. Reporting characteristics, treatment experience, and outcomes of such cases are essential to inform future diagnosis and management strategies.Keywords: fever, Behçet’s disease, pulmonary embolism, atrial mass

Ling Wei,1,* Qiyan Chen,2,3,* Lu Yang,2,3 Tongzhen Ji,4 Wenjing Peng,5 Bing Shao,2 Hui Li2 1Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China; 3National Center for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China; 4Department of Clinical Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, People’s Republic of China; 5College of Animal Husbandry and Veterinary Medicine, Jinzhou Medical University, Jinzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hui Li; Bing Shao, Email lihui@bjcdc.org; shaobingch@sina.comObjective: The emerging epidemic of extended-spectrum β-lactamase-producing E. coli (ESBL-EC) is a global public health crisis. ESBL-EC infections are increasing worldwide and contribute to morbidity and mortality among newborn infants. However, the antimicrobial resistance characteristics and clonal transmission of maternal and neonatal ESBL-EC isolates need to be further deciphered.Materials and Methods: We performed phenotypic and genotypic characterization of 33 ESBL-EC isolates from pregnant women and newborn during 2019– 2020.Results: Minimum inhibitory concentrations of 17 antimicrobial agents showed that all isolates were multidrug-resistant (MDR) and had a resistance rate of 100% to ampicillin, and mild resistance to florfenicol, gentamicin, ceftazidime, and amoxicillin-clavulanate. Additionally, imipenem, meropenem, polymyxin, and tigecycline exhibited good activity against the tested ESBL-EC isolates with low MIC50 (0.06– 1 μg/mL) and MIC90 (0.06– 1 μg/mL). Whole genome sequencing indicated that ESBL-EC isolates contained diverse antimicrobial resistant genes (blaCTX-M, blaTEM, blaSHV, tetA, etc.) and toxin genes (ompA, csg, fimH, hybtA, etc.). blaCTX-M genes were the main ESBL genotype. ST1193 (18.2%) was the second most abundant ST among the ESBL-EC isolates (ST131 was the most common, with 30.3%), and this is the first report of its mother-to-infant colonization transmission in China.Conclusion: These findings revealed the occurrence of high-risk ST1193 clone among ESBL-EC isolates from pregnant women and newborn colonization in China. Further national or regional multicenter studies are needed to assess the dissemination and evolution of ESBL-EC ST1193 clone as a nosocomial pathogen in China.Keywords: ESBL, E. coli, antibiotic resistance, colonization transmission, ST1193 clone

Yaolin Wang,1– 3,&ast; Kai Zhao,4,5,&ast; Nanling Wu,1– 3 Tao Ji,1– 3 Gaowei Su,1– 3 Xiaojie Cui,1– 3 Yushan Dong,1– 3 Xiuxia Chen1– 3 1NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 3Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 4Department of Anesthesiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, Anhui, People’s Republic of China; 5Department of Anesthesiology, Anhui Provincial Hospital, Hefei, Anhui, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiuxia Chen, Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Medical University, Xuzhou, Jiangsu, 221000, People’s Republic of China, Tel +86 18052268332, Email cxxlxy@sina.comPurpose: This study was designed to investigate the effects of different doses of butorphanol on postoperative shivering and quality of recovery in elderly patients.Patients and Methods: A total of 147 elderly patients (aged 60 or older) scheduled for elective transurethral resection of the prostate were enrolled in the current study. Patients were randomly and evenly assigned into four groups: Group C (0.9% normal saline), Group B1 (butorphanol 0.01 mg/kg), Group B2 (butorphanol 0.02 mg/kg) and Group B3 (butorphanol 0.03 mg/kg). All drugs were diluted to 5mL and injected intravenously slowly 5 min before induction of anesthesia. The primary outcome measure was the incidence of postoperative shivering in the post-anesthesia care unit. Quality of Recovery-40 (QoR-40) scores were assessed on postoperative day (POD) 1, 2 and 3. Perioperative core and skin temperature, extubation time and adverse events were also recorded.Results: Patients among the four groups had comparable baseline characteristics. Compared with Group C, the incidence of shivering was significantly lower in Group B2 and B3 (P = 0.006 and P = 0.005, respectively). The QoR-40 scores on POD1 were significantly higher in all butorphanol groups than that in Group C (P < 0.0083). In Group B2 and B3, patients experienced lower pain intensity (P < 0.001). In addition, the incidence of catheter-related bladder discomfort (CRBD) was lower in all butorphanol groups than in Group C (P < 0.0083).Conclusion: Butorphanol 0.02 or 0.03 mg/kg could effectively prevent the occurrence of postoperative shivering in elderly patients scheduled for transurethral resection of the prostate, provided effective postoperative recovery and postoperative analgesia.Keywords: butorphanol, elderly patients, postoperative shivering, recovery quality, postoperative pain

Tian Wang,1,&ast; Feng Lin,2,&ast; Yujing Huang,2 Guowei Qian,2 Wenxi Yu,2 Haiyan Hu,2 Tong Ji,3 Lina Tang,2 Yang Yao2 1The Eighth People’s Hospital of Shanghai, Shanghai, People’s Republic of China; 2Shanghai Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai, People’s Republic of China; 3Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yang Yao; Lina Tang, Shanghai Sixth People’s Hospital, Shanghai Jiaotong University, No. 600 Yishan Road, Xuhui Distinct, Shanghai, 200233, People’s Republic of China, Tel +86 2164369181 ; +86 2164701361, Email yangyao_6@hotmail.com; Tina_8042@hotmail.comPurpose: The options for the second-line treatment of metastatic osteosarcoma are still limited. Anlotinib is a multi-kinase inhibitor which has shown promising efficacy and good tolerability in various cancer types. This retrospective study was conducted to evaluate the efficacy and safety of anlotinib combined with gemcitabine/docetaxel (GD) in patients with metastatic osteosarcoma who have failed first-line chemotherapy.Patients and Methods: The data of patients who received anlotinib combined with GD or GD were collected. The primary endpoint was progression-free survival. Secondary endpoints included objective response rate and safety.Results: From July 2013 to November 2020, a total of 32 patients were enrolled, 13 received anlotinib combined with GD and 19 received GD. Median PFS was 9.0 months (95% CI 6.7– 39.1) in the combination group and 5.0 months (95% CI 1.2– 6.7) in the chemotherapy group. ORR were 38.4% and 15.8%, DCR were 69.2% and 38.1% in the combination and chemotherapy group, respectively. The most common adverse events included fatigue (78.9% in the combination group vs 69.2% in the chemotherapy group), hypertension (46.2% vs 10.5%), diarrhea (38.5% vs 21.1%), hypothyroidism (38.5% vs 15.8%), neutropenia (23.1% vs 36.8%) and AST elevation (30.8% vs 21.1%). The most common grade 3 or worse adverse events included hand-foot reaction (7.7% vs 5.3%), hypothyroidism (15.4% vs 0), neutropenia (0 vs 10.5%).Conclusion: The combination of anlotinib and GD showed favorable efficacy with manageable toxicities compared with GD in the second-line treatment for metastatic osteosarcoma. This combination therapy deserves further investigations in patients with osteosarcoma.Keywords: anlotinib, refractory metastatic osteosarcoma, combination therapy

Kai Zhao,1,&ast; Yushan Dong,1,&ast; Gaowei Su,1 Yaolin Wang,1 Tao Ji,1 Nanling Wu,1 Xiaojie Cui,1 Wenzhan Li,1 Yanming Yang,1 Xiuxia Chen1,2 1Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiuxia Chen, Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People’s Republic of China, Tel +86 18052268332, Fax +0516-8346-9496, Email cxxlxy@sina.comPurpose: Lidocaine has been gradually used in general anesthesia. This study was designed to investigate the effect of systemic lidocaine on postoperative quality of recovery (QoR) in patients undergoing supratentorial tumor resection, and to explore its brain-injury alleviation effect in neurosurgical anesthesia.Patients and Methods: Sixty adult patients undergoing elective supratentorial tumor resection. Patients were randomly assigned either to receive lidocaine (Group L: 1.5 mg/kg bolus completed 10 min before anesthesia induction followed by an infusion at 2.0 mg/kg/h) or to receive normal saline (Group C: received volume-matched normal saline at the same infusion rate). Primary outcome measures were Quality of Recovery-40 (QoR-40) scores on postoperative day (POD) 1 and 2. Plasma concentrations of S100B protein (S100B), neuron specific enolase (NSE), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) before anesthesia induction and at the end of surgery were assessed. Visual Analogue Scale (VAS) scores were assessed at 1, 2, 6, 12, 24 and 48 h after surgery. Perioperative parameters and adverse events were also recorded.Results: Patients between two groups had comparable baseline characteristics. Global QoR-40 scores on POD 1 and POD 2 were significantly higher (P < 0.001) in group L (165.5± 3.8 vs 173.7± 4.7) than those in group C (155.6± 4.0 vs 163.2± 4.5); and scores of physical comfort, emotional state, and pain in group L were superior to those in group C (P < 0.05). In group L, patients possessed lower plasma concentration of pro-inflammatory factors (IL-6, TNF-α) and brain injury-related factors (S100B, NSE) (P < 0.05), consumed less remifentanil and propofol, and experienced lower pain intensity. Multiple linear regression analysis demonstrated age and pain were correlated with postperative recovery quality.Conclusion: Systemic lidocaine improved early recovery quality after supratentorial tumor resection with general anesthesia, and had certain brain-injury alleviation effects. These benefits may be attributed to the inflammation-alleviating and analgesic properties of lidocaine.Keywords: lidocaine, brain neoplasm, supratentorial tumor resection, recovery quality, brain protection, postoperative pain

Lin Mei,1,&ast; Xiaodan Li,1,&ast; Shengcai Wang,1,&ast; Run Si,2 Tingting Ji,1 Zhifei Xu,3 Yun Peng,4 Yue Liu,4 Hongbin Li,1 Jie Zhang,1 Yongli Guo,5 Jinghong Tian,6 Guifei Zhou,2 Huifang Huang,2 Jun Tai,1,7,&ast; Jiangang Liu,8,9 Xin Ni1 1Department of Otolaryngology, Head and Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China; 2School of Computer and Information Technology, Beijing Jiaotong University, Beijing, People’s Republic of China; 3Department of Respiration, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing, People’s Republic of China; 4Department of Radiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China; 5Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health (NCCH), Beijing, People’s Republic of China; 6Department of Neurorehabilitation, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China; 7Department of Otorhinolaryngology, Children’s Hospital, Capital Institute of Pediatrics, Beijing, People’s Republic of China; 8Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing, People’s Republic of China; 9Key Laboratory of Big Data-Based Precision Medicine (Beihang University), Ministry of Industry and Information Technology of the People’s Republic of China, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jiangang LiuBeijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Beijing, 100191, People’s Republic of ChinaEmail jgliu@buaa.edu.cnXin NiDepartment of Otolaryngology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nanlishilu, Beijing, People’s Republic of ChinaTel +86-139-1011-1999Email nixin@bch.com.cnObjective: To investigate the impacts of obstructive sleep apnea (OSA) on white matter (WM) integrity and cognitive functions of pediatric patients with different levels of OSA severity.Methods: Fifty-eight children with OSA and thirty-four healthy controls (HC) were recruited. All participants underwent diffusion tensor imaging (DTI) examination, polysomnography (PSG), and neurocognitive assessments. Patients were divided into mild OSA (MG) and moderate-severe OSA (SG) groups. WM integrity, PSG data, and neurocognitive assessment scores were compared among those groups.Results: For apnea hypopnea index (AHI), obstructive apnea hypopnea index (OAHI), arousal index, SpO2 nadir, and attention, SG was worse than both MG and HC with MG worse than HC. For baseline SpO2 and intelligence, SG was worse than both MG and HC with no significant difference between MG and HC. Impaired WM integrity was observed in bilateral anterior thalamic radiation, bilateral inferior fronto-occipital fasciculus, bilateral inferior longitudinal fasciculus, right superior longitudinal fasciculus, right hippocampus, left cingulate gyrus, right uncinate fasciculus, callosum forceps major, and callosum forceps minor only for SG than for HC. WM integrity was significantly correlated with OSA severity and neurocognitive assessment scores only for SG, but not for MG.Conclusion: Decreased baseline SpO2, WM impairment, and intelligence decline were all observed only for SG, but not for MG, implying an associated relationship among decreased SpO2, WM impairment and WM impairment. Thus, for SG, additional assessments of brain damage and cognitive function decline are needed for prognostic evaluation of OSA.Keywords: diffusion tensor imaging, obstructive sleep apnoea, children, tract-based spatial statistics, white matter

Li Zhang,1,2,&ast; Tong Ji,1,2,&ast; Fei Sun,2 Yun Li,1 Zhe Tang,1,2 Lina Ma1,2 1Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People’s Republic of China; 2Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Lina Ma; Zhe Tang Email malina0883@126.com; tangzhe@sina.comObjective: The comprehensive geriatric assessment (CGA) is an integral tool used to identify vulnerable older adults in need of individualized plans to delay the course of diseases and monitor treatment outcomes. We previously developed and validated a 68-item frailty index (FI) based on the CGA in a large, older, Chinese population. However, substantial time is needed to evaluate the 68 items. Therefore, we aimed to develop and validate a simplified FI for use in Chinese older population.Design: Longitudinal study.Setting and Participants: Data were drawn from the Beijing Longitudinal Study of Aging. The study was conducted in 2004 with 1808 participants evaluated using the CGA and was followed-up for 13 years. Mortality was recorded at 3, 5, 8, 10, and 13 years intervals.Measures: 27-Item, 50-item, and 68-item frailty indices were investigated. A Cox proportional hazards model and area under the curve of the receiver operating characteristic (AUC-ROC) were calculated to compare mortality predictions.Results: The FI was positively correlated with age in males (r = 0.174, P < 0.001) and females (r = 0.270, P < 0.001). The mean baseline FI was 0.225 ± 0.085 (range: 0.04– 0.56) as evaluated by the 27-item FI, 0.181 ± 0.117 (range: 0.02– 0.62) by the 50-item FI, and 0.167 ± 0.101 (range: 0.02– 0.59) by the 68-item FI. Cox regression models showed that mortality was significantly higher in frail people than in non-frail people for all 3 indices (p< 0.001). The AUCs of the 68-item FI, 50-item FI, and 27-item FI for predicting mortality were 0.720, 0.717, and 0.677, respectively (p< 0.001).Conclusion: The 27-item FI is reasonable to expect that the AUC of the indices with the higher items number is inferior to the performance of the indices with higher number of items (FI50 and FI68). But 27-item maybe used as a tool to identify frail older adults and predict mortality in clinical and primary care practices in China.Keywords: frailty index, older adults, comprehensive geriatric assessment, mortality

Kun Li,1,&ast; Bin Huang,2,&ast; Tao Ji,3 Shao-Gan Xu,3 Wen Jiang4 1Department of Anesthesiology, General hospital of central theater command of the People’s Liberation Army, Wuhan, Hubei Province, 430070, People’s Republic of China; 2The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, 510515, People’s Republic of China; 3Department of Thoracic Cardiovascular Surgery, General Hospital of Central Theater Command of People’s Liberation Army, Wuhan, Hubei Province, 430070, People’s Republic of China; 4Department of Health Medicine, General hospital of central theater command of the People’s Liberation Army, Wuhan, Hubei Province, 430070, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wen Jiang; Shao-Gan XuGeneral hospital of central theater command of the People’s Liberation Army, 627#, Wuluo Road, Wuchangqu, Wuhan, Hubei, 430070, People’s Republic of ChinaTel +86 17720529297Fax +86 27-50772388Email zbzqzyyjw@163.com; whzyyxsg@163.comAbstract: At the moment, the SARS-CoV-19 pandemic is still attacking the health of humanity, and vaccines are the primary health strategy to eradicate this global challenge. So, with the exception of the SARS-CoV-2 vaccine, no vaccine for any disease has been brought to clinical use so quickly. Therefore, even with strict management, it can still bring some special adverse effects. One of the most notable is the adverse cardiovascular reactions to SARS-CoV-2 vaccines. No case reports of individuals with irreversible arrhythmia complications following the SARS-CoV-2 vaccine have been found in the available literature. We report the first case of a postoperative man with Marfan syndrome with atrial fibrillation after receiving the SARS-CoV-2 vaccine.Keywords: SARS-CoV-2, vaccine, adverse reactions, arrhythmology

Zhongjing Lv,1,2,* Kun Wu,1,3,* Xing Qin,1,3 Jian Yuan,2 Ming Yan,1,3 Jianjun Zhang,1,3 Lizhen Wang,1,4 Tong Ji,1,3 Wei Cao,1,3 Wantao Chen1,3 1Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Department of Stomatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou City, Jiangsu Province, People’s Republic of China; 3Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, People’s Republic of China; 4Department of Oral Pathology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wantao Chen; Wei CaoDepartment of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Key Laboratory of Stomatology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of ChinaEmail chenwantao2002@hotmail.com; caowei561521@hotmail.comBackground: In our previous study, serine protease inhibitor Kazal-type 5 (SPINK5), which encodes the product of serine protease inhibitor lymphoepithelial Kazal-type-related inhibitor (LEKTI) was found to be down-regulated in head and neck squamous cell carcinoma (HNSCC) using oligonucleotide microarrays. However, the function and clinical implications of SPINK5/LEKTI remain obscure in HNSCC.Methods: The endogenous expression level of SPINK5/LEKTI was further verified in 9 HNSCC cell lines and HNSCCs by means of reverse transcription-polymerase chain reaction, real-time PCR, Western blotting and immunohistochemistry. The biological function of SPINK5/LEKTI was investigated in vitro and in vivo experiments. Kaplan–Meier survival analysis and Cox proportional hazards regression model were used to determine the correlation between SPINK5/LEKTI expression and clinical outcome.Results: Down-regulation expression of SPINK5/LEKTI was found in six out of nine HNSCC cell lines and in 85.7% HNSCC specimens (P< 0.0001). Upon silencing of SPINK5/LEKTI, the cell proliferation, plate colony formation and cell invasion of WU-HN6 cells were significantly increased, while exogenous overexpression of SPINK5/LEKTI, the proliferation, plate colony and invasion of WU-HN13 and HN30 cells were remarkably inhibited with the arrest of G1 cell cycle (P=0.0001, P=0.003, respectively). HNSCC patients with lower LEKTI levels had significantly inferior overall survival compared to those patients with higher LEKTI (P=0.0017) by Kaplan–Meier survival analysis. Univariate and multivariate Cox proportional hazards regression model analysis revealed that LEKTI expression was an independent prognostic predictor for HNSCC patients (HR=0.114, 95% CI:0.044– 0.292, P< 0.001).Conclusion: Our results demonstrate that SPINK5/LEKTI might be a tumor suppressor in HNSCCs and serve as an independent prognostic predictor for HNSCC patients.Keywords: SPINK5/LEKTI, biological function, head and neck squamous cell carcinoma, prognostic predictor

Tong Ji,1,2,* Li Zhang,1,* Zhe Tang,2 Fei Sun,2 Yun Li,1 Lina Ma1 1Department of Geriatrics, Xuanwu Hospital, Capital Medical University, China National Clinical Research Center for Geriatric Medicine, Beijing 100053, People’s Republic of China; 2Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing Institute of Geriatrics, Beijing 100053, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lina Ma; Zhe Tang Email malina0883@126.com; tangzhe@sina.comObjective: Normal-weight obesity (NWO) is characterized by high body fat percentage (BFP) in individuals with normal body mass index (BMI). This condition may increase the risk of serious health problems, such as cardiovascular diseases, diabetes, insulin resistance, hypertension, and metabolic syndrome. However, the prevalence of NWO in older adults in Beijing remains unclear. This study aimed to investigate the prevalence of overweight and obesity among older adults in Beijing, using three obesity assessment indicators: BMI, waist circumference, and BFP.Design: Cross-sectional study.Setting and Participants: Data were obtained from the 2012 Beijing Longitudinal Study of Aging, which used a stratified, sectional, random, and cluster sampling method.Methods: Questionnaires, physical examinations, and laboratory tests were completed. Obesity was divided into four categories based on combinations of BMI and BFP: non-obese, muscle-type obesity, NWO and fatty obesity.Results: A total of 2393 community-dwelling older adults with an average age of 72.98± 8.09 years old were recruited. Of them, 1051 were male (43.92%) and 1245 were living in rural areas (52.03%). The prevalence of overweight and obesity among older people in Beijing was 35.5% and 16.1%, respectively. When the sample was divided according to obesity classification, the proportion of muscular obesity, NWO and adipose obesity was 14.7%, 10.7%, and 41.8%, respectively. The prevalence of central obesity was 62.3%. The prevalence of obesity decreased with age, but it was higher in females than in males as well as among individuals living in urban areas than in individuals living in rural areas.Conclusion: The prevalence of NWO was 10.7% among older adults in Beijing and increased with age. Older adults who are female or living in urban areas should be instructed to take measures aimed at reducing body fat and increasing muscle strength.Keywords: obesity, normal-weight obesity, body fat percentage, older adults

Lina Ma,1,* Yanhong Xu,1,2,* Yaxin Zhang,1 Tong Ji,1 Yun Li1 1Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, People’s Republic of China; 2Department of Geriatrics, Miyun Teaching Hospital of Capital Medical University, Beijing 101500, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lina MaDepartment of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, #45 Changchun Street, Xicheng District, Beijing 100053, People’s Republic of ChinaEmail malina0883@126.comBackground: Metabolic inflammation plays an important role in the pathogenesis of atherosclerosis, type 2 diabetes, non-alcoholic fatty liver disease, and obesity. The above metabolic disorders often coexist and are closely related with systemic low-grade inflammation. Metabolic inflammatory syndrome (MIS), a cluster of these four metabolic disorders, is a novel concept that is thought to be a better predictor of coronary heart disease than metabolic syndrome. Adiponectin is an adipokine that increases insulin sensitivity and antioxidation as well as has an anti-atherosclerosis effect. It is unclear whether adiponectin is associated with MIS. The objective of this study was to assess whether circulating adiponectin can be used as an indicator for MIS in elderly adults.Methods: A total of 136 elderly inpatients were divided into two groups: the MIS group and the non-MIS group. Characteristics, inflammatory markers, blood lipid metabolism, insulin resistance, and circulating adiponectin levels were assessed and compared between the two groups. Logistic regression analysis was used to explore the association between the associated factors and MIS.Results: MIS patients were more likely to have a higher body mass index, have a higher fasting blood glucose level, be smokers, have fundus arteriosclerosis, have lower levels of adiponectin (4044.90 ± 3906.82 ng/mL vs 8503.89 ± 3523.89 ng/mL, p < 0.001), and have higher levels of inflammation (white blood cell and C-reactive protein) than non-MIS patients. Multiple factor analysis showed that lower adiponectin levels (OR = 22.937, p < 0.001) were independently associated with MIS. Adiponectin levels were lower in the vascular disease (2673.29 ± 1930.05 ng/mL vs 7194.38 ± 4615.83 ng/mL, p = 0.001), atherosclerosis (2374.14 [1496.41– 4263.90] ng/mL vs 6037.48 [3865.61– 10,373.60] ng/mL, p < 0.001), and type 2 diabetes (2391.73 [1386.41– 4069.68] ng/mL vs 8916.03 [5801.14– 12,724.45] ng/mL, p < 0.001) subgroups than in the non-MIS group.Conclusion: Lower adiponectin levels in serum are associated with MIS. Low adiponectin may be used as a biomarker for atherosclerosis in patients with MIS.Keywords: metabolic inflammatory syndrome, adiponectin, atherosclerosis, type 2 diabetes, obesity, inflammation, elderly patients

We have theoretically studied spin- and valley-transport properties in a silicene quantum structure with a square magnetic barrier modulated by off-resonant circularly polarized light (OCPL). The result shows that in the magnetic quantum structure, valley and spin filtering can be realized simultaneously with appropriate OCPL at small incident angles. More interestingly, at normal incidence, Klein tunneling is observed in the K ′ valley. Besides, it is also found that valley polarization can be inverted by reversing the sign of the staggered potential or the chirality of OCPL. Nevertheless, the direction of spin polarization can only be modulated by the chirality of OCPL. These findings provide the potential applications for constructing novel type of silicene devices. [ABSTRACT FROM AUTHOR]

Background: Osteosarcoma (OS) is the most common primary bone malignancy with a high propensity for local invasion and distant metastasis. Limited by the severe toxicity of conventional agents, the therapeutic bottleneck of osteosarcoma still remains unconquered. Flavokawain B (FKB), a kava extract, has been reported to have significant anti-tumor effects on several carcinoma cell lines both in vitro and in vivo. Its efficacy and low toxicity profile make FKB a promising agent for use as a novel chemotherapeutic agent.Results: In the current study, we investigated the anti-proliferative and apoptotic effects of FKB against human osteosarcomas. Exposure of OS cells to FKB resulted in apoptosis, evidenced by loss of cell viability, morphological changes and the externalization of phosphatidylserine. Apoptosis induced by FKB resulted in activation of Caspase-3/7, -8 and -9 in OS cell lines, 143B and Saos-2. FKB also down-regulated inhibitory apoptotic markers, including Bcl-2 and Survivin and led to concomitant increases in apoptotic proteins, Bax, Puma and Fas. Therefore, the induction of apoptosis by FKB involved both extrinsic and intrinsic pathways. FKB also caused G2/M phase cell cycle arrest, which was observed through reductions in the levels of cyclin B1, cdc2 and cdc25c and increases in Myt1 levels. Furthermore, migration and invasion ability was decreased by FKB in a dose-dependent manner. The cytotoxicity profile showed FKB had significant lower side effects on bone marrow cells and small intestinal epithelial cells compared with Adriamycin.Conclusions: Taken together, our evidence of apoptosis and cell cycle arrest by FKB treatment with less toxicity than the standard treatments provides an innovative argument for the use of FKB as a chemotherapeutic and chemopreventive compound. In vivo experiments utilizing FKB to reduce tumorigenesis and metastatic potential will be crucial to further justify clinical application. © 2013 Ji et al.; licensee BioMed Central Ltd.

Wencheng Ding,1,* Teng Ji,1,* Wei Xiong,2 Tian Li,1 Demin Pu,1 Rong Liu1 1Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 2Department of Pharmacology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China *These authors contributed equally to this work Purpose: In this study, we investigated the effect of Realgar on the apoptosis of HPV16-positive cervical cells in vitro. Methods: The effect of Realgar on the apoptosis of HPV16-positive cervical cells was investigated by annexin V-fluorescein isothiocyanate/propidium iodide staining and growth inhibition assays using HPV16-positive cervical cancer cell line SiHa and HPV16-positive immortalized cervical epithelial cell line S12. The expression of genes was measured by real-time PCR, and the expression of corresponding proteins was detected by Western blotting. The adhesion and invasion of cells were detected by adhesion assay and Transwell invasion assay, respectively. Results: The Realgar inhibited the proliferation and induced the apoptosis of SiHa and S12 cells in a dose- and time-dependent manner. The Realgar suppressed the expression of HPV16 E7 and caspase-3. The Realgar suppressed the adhesion and invasion of both cells. Conclusion: The Realgar induced apoptosis, inhibited the proliferation of HPV16-positive cell lines through a HPV16 E7-dependent pathway, and inhibited cell adhesion and invasion. Keywords: Realgar, antitumor, human papillomavirus, E7