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Background. Implantation of the MitraClip is a safe and effective therapy for mitral valve repair in patients ineligible for surgery or at high risk of adverse surgical outcomes. However, only limited information is available concerning sex differences in transcatheter mitral valve repair. We therefore sought to conduct a comprehensive meta-analysis of studies that investigated differences between men and women in outcomes following MitraClip implantation. Methods. The PubMed and Embase databases were searched until November 2019 for studies reporting outcomes after MitraClip implantation in women versus men. Outcomes included all-cause mortality and major complications at 30 days and one year of follow-up. Results. Six studies (n = 1,109 women; n = 1,743 men) were analyzed. At 30 days, women had a similar risk of postoperative complications, such as stroke, major bleeding, and pericardium effusion, without differences in all-cause mortality, procedure success, or MitraClip usage. At one year, the all-cause mortality, the reduction of mitral regurgitation, and the risk of rehospitalization for heart failure were also comparable between male and female patients. Conclusion. Gender disparity was not found in complications or prognosis of patients undergoing MitraClip implantation. This study suggests that gender should not be considered as a critical factor in the selection of patients as candidates for MitraClip implantation of concern during follow-up.

The sum of target lesions is routinely used to evaluate patient objective responses to treatment in the RECIST criteria, but it fails to address response heterogeneity across metastases. This study argues that spatiotemporal heterogeneity across metastases and organ-specific response is informative for drug efficacy and patient survival. We analyzed the longitudinal data of 11,404 metastatic lesions in 2,802 colorectal cancer patients from five phase III clinical trials. Initially, a metric Gower distance was applied to quantify response heterogeneity across metastases. Next, the spatiotemporal response heterogeneity across anatomic sites, therapies, and KRAS mutation status was assessed and examined for its association with drug efficacy and long-term patient survival. The response of metastatic lesions broadly differed across anatomic sites and therapies. About 60% of patients had at least one lesion respond contrarily from total tumor size. High interlesion heterogeneity was associated with shorter progression-free survival and overall survival. Targeted therapies (bevacizumab or panitumumab) combined with standard chemotherapy reduced interlesion heterogeneity and elicited more favorable effects from liver lesions (P < 0.001) than chemotherapy alone. Moreover, the favorable responses in liver metastases (> 30% shrinkage) were associated with extended patient overall survival (P < 0.001), in contrast to lesions in the lungs and lymph nodes. Altogether, the spatiotemporal response heterogeneity across metastases informed drug efficacy and patient survival, which could improve the current methods for treatment evaluation and patient prognosis. Significance: These findings support the modification of RECIST criteria to include individual lesion response to improve assessments of drug efficacy.

Heterogeneous nuclear ribonucleoproteins (hnRNPs) are RNA-binding proteins that are reported to play a crucial role in the pathogenic process of multiple malignancies. However, their expression patterns, clinical application significance and prognostic values in invasive breast carcinoma (BRCA) remain unknown. In this study, we investigated hnRNP family members in BRCA using accumulated data from Oncomine 4.5, UALCAN Web portal and other available databases. We explored the expression and prognostic value level of hnRNPs in BRCA. We further analyzed their association with the clinicopathological features of BRCA patients. Subsequently, we calculated the alteration frequency of hnRNPs, constructed the interaction network of hnRNPs, and examined the potential coexpression genes of hnRNPs, revealing that HNRNPU and SYNCRIP are the core molecular genes requiring further investigation for BRCA. We validated the immunohistochemistry (IHC) pattern to simulate clinical applications based on pathology. Cell function experiments conducted in vitro indicated that HNRNPU can promote epithelial-mesenchymal transition, functionally stimulating the invasion capacity and inhibiting the viability of invasive BRCA cells. In summary, our systematic analysis demonstrated that HNRNPU was the key molecule that played a fundamental role in BRCA metastasis, which may facilitate the development of new diagnostic and prognostic markers for the analysis of BRCA progression.

Objective To investigate the relationship between the neutrophil-to-lymphocyte ratio (NLR) of patients with non-small cell lung cancer (NSCLC) and their risk of developing brain metastases after adjusting for confounding factors. Methods A retrospective observational study of the general data of patients with NSCLC diagnosed from January 2016 to December 2020. Multivariate logistic regression was used to calculate the dominance ratio (OR) with 95% confidence interval (CI) for NLR and NSCLC brain metastases with subgroup analysis. Generalized summation models and smoothed curve fitting were used to identify whether there was a nonlinear relationship between them. Results In all 3 models, NLR levels were positively correlated with NSCLC brain metastasis (model 1: OR: 1.12, 95% CI: 1.01-1.23, P = .025; model 2: OR: 1.16, 95% CI: 1.04-1.29, P = .007; model 3: OR: 1.20, 95% CI: 1.05-1.37, P = .006). Stratified analysis showed that this positive correlation was present in patients with adenocarcinoma (LUAD) and female patients (LUAD: OR: 1.30, 95% CI: 1.10-1.54, P = .002; female: OR: 1.52, 95% CI: 1.05-2.20, P = .026), while there was no significant correlation in patients with squamous carcinoma (LUSC) and male patients (LUSC: OR:0.76,95% CI:0.38- 1.53, P = .443; male: OR:1.13, 95% CI:0.95-1.33, P = .159). Conclusion This study showed that elevated levels of NLR were independently associated with an increased risk of developing brain metastases in patients with NSCLC, and that this correlation varied by TYPE and SEX, with a significant correlation in female patients and patients with LUAD.

Purpose We developed a stereo task that is based on a motion direction discrimination to examine the role that depth can play in disambiguating motion direction. Methods In this study, we quantified normal adults’ static and dynamic (i.e., laterally moving) stereoscopic performance using a psychophysical task, where we dichoptically presented randomly arranged, limited lifetime Gabor elements at two depth planes (one plane was at the fixation plane and the other at an uncrossed disparity relative to the fixation plane). Each plane contained half of the elements. For the dynamic condition, all elements were vertically oriented and moved to the left in one plane and to the right in another plane; for the static condition, the elements were horizontally oriented in one plane and vertically oriented in another plane. Results For the range of motion speed that we measured (from 0.17°/s to 5.33°/s), we observed clear speed tuning of the stereo sensitivity (P = 3.0 × 10−5). The shape of this tuning did not significantly change with different spatial frequencies. We also found a significant difference in stereo sensitivity between stereopsis with static and laterally moving stimuli (speed = 0.67°/s; P = 0.004). Such difference was not evident when we matched the task between the static and moving stimuli. Conclusions We report that lateral motion modulates human global depth perception. This motion/stereo constraint is related to motion velocity not stimulus temporal frequency. We speculate that the processing of motion-based stereopsis of the kind reported here occurs in dorsal extrastriate cortex.

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BackgroundsTakayasu arteritis (TAK) is a chronic, granulomatous vasculitis correlated with tuberculosis (TB). The two diseases share similar pathological characteristics and clinical manifestations which increase the difficulty to diagnose. Active tuberculosis (ATB) has implications for treatment strategies in TAK patients. Therefore, the investigation of clinical features and potential risk factors of ATB in TAK patients is vital.MethodsThe study reviewed hospitalized patients diagnosed with TAK in our hospital from 2008, to 2021. TAK patients with ATB were enrolled as the case group. The control group was randomly selected in a 3:1 ratio. The clinical characteristics of TAK patients with and without ATB were compared. Multivariate logistic regression analysis was performed to determine risk factors for ATB in TAK patients.ResultsWe reviewed 1,789 patients and ultimately identified 30 (1.7%) ATB cases. TAK patients with ATB were more prone to develop symptoms including fever (p=0.001), fatigue (p=0.003), cough (p=0.037), expectoration (p8 mg/L (OR 9.108; 95% CI, 1.096–75.711; p=0.041) and positive T-SPOT.TB result (OR 68.669; 95% CI, 7.291–646.738; pConclusionOur study suggested that the diagnosis of ATB should be considered when TAK patients experienced symptoms including fever, fatigue, weight loss, etc. hsCRP >8 mg/L and positive T-SPOT.TB result were identified as independent risk factors for ATB in TAK patients.

Background The ongoing COVID-19 pandemic postponed routine follow-up visits of many orthodontic patients, which compromised their treatment process and mental states. This study was aimed to assess orthodontic emergency occurrence and psychological states of Chinese orthodontic patients during this pandemic. Methods Orthodontic patients in China were invited to answer an anonymous online questionnaire from February 20, 2020 to March 5, 2020, when routine dental care was suspended in China. The questionnaire included self-assessment of oral hygiene and compliance, orthodontic emergencies, perceptions and feelings about COVID-19 and anxiety self-rating scale, etc. Collected data was statistically analyzed with Chi-square, independent t test and univariable generalized estimating equations regression analysis. Results A total of 1078 respondents (292 male; 786 female) from 30 provinces of China were included in this study. About one-third (33.67%) of patients reported that they encountered orthodontic problems during the pandemic. Patients with clear aligners reported fewer orthodontic problems than those with fixed appliances or removable appliances. Female patients, elder patients and patients who encountered orthodontic emergencies were more anxious than other patients. Conclusions The compliance and occurrence of orthodontic emergencies differed in patients with different orthodontic appliances. Patients with orthodontic emergencies exhibited higher anxiety states.

Over 50% of colorectal cancer patients develop resistance after a transient response to therapy. Understanding tumor resistance from an evolutionary perspective leads to better predictions of treatment outcomes. The objectives of this study were to develop a computational framework to analyze tumor longitudinal measurements and recapitulate the individual evolutionary dynamics in metastatic colorectal cancer (mCRC) patients. A stochastic modeling framework was developed to depict the whole spectrum of tumor evolution prior to diagnosis and during and after therapy. The evolutionary model was optimized using a nonlinear mixed effect (NLME) method based on the longitudinal measurements of liver metastatic lesions from 599 mCRC patients. The deterministic limits in the NLME model were applied to optimize the stochastic model for each patient. Cox proportional hazards models coupled with the least absolute shrinkage and selection operator (LASSO) algorithm were applied to predict patients' progression-free survival (PFS) and overall survival (OS). The stochastic evolutionary model well described the longitudinal profiles of tumor sizes. The evolutionary parameters optimized for each patient indicated substantial interpatient variability. The number of resistant subclones at diagnosis was found to be a significant predictor to survival, and the hazard ratios with 95% CI were 1.09 (0.79–1.49) and 1.54 (1.01–2.34) for patients with three or more resistant subclones. Coupled with several patient characteristics, evolutionary parameters strongly predict patients' PFS and OS. A stochastic computational framework was successfully developed to recapitulate individual patient evolutionary dynamics, which could predict clinical survival outcomes in mCRC patients. Significance: A data analysis framework depicts the individual evolutionary dynamics of mCRC patients and can be generalized to project patient survival outcomes.

A GGGGCC hexanucleotide repeat expansion in intron 1 of chromosome 9 open reading frame 72 (C9ORF72) gene is the most common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia. Repeat-associated non-ATG translation of dipeptide repeat proteins (DPRs) contributes to the neuropathological features of c9FTD/ALS. Among the five DPRs, arginine-rich poly-PR are reported to be the most toxic. Here, we generate a transgenic mouse line that expresses poly-PR (GFP-PR28) specifically in neurons. GFP-PR28 homozygous mice show decreased survival time, while the heterozygous mice show motor imbalance, decreased brain weight, loss of Purkinje cells and lower motor neurons, and inflammation in the cerebellum and spinal cord. Transcriptional analysis shows that in the cerebellum, GFP-PR28 heterozygous mice show differential expression of genes related to synaptic transmission. Our findings show that GFP-PR28 transgenic mice partly model neuropathological features of c9FTD/ALS, and show a role for poly-PR in neurodegeneration., Repeat-associated non-ATG translation of dipeptide repeat proteins (DPRs) contributes to disease manifestation in FTD/ALS associated with the hexanucleotide repeat expansion of the C9ORF72 gene. Here the authors show that a transgenic mouse line expressing poly-PR28 in neurons displays some signs of neuronal loss that mirrors that seen in the disease.

Amblyopia is a relatively common (incidence 3%) developmental disorder in which there is loss of vision as a consequence of a disruption to normal visual development. Although the deficit is monocular and known to be of cortical origin, the nature of the processing deficit is controversial. Human behavioral studies have identified two main deficits - a loss of contrast sensitivity and perceived spatial distortions. Here we use a multifocal fMRI approach to ascertain, in a group of anisometropic amblyopes, whether these two deficits have a single common cause or whether they are the result of two underlying independent cortical disorders. We found that fMRI magnitudes were attenuated in amblyopic eye stimulation, and that there was poor fidelity for co-localization of the activity clusters between the amblyopic and fellow-fixing eye stimulation. These effects varied across eccentricities and correlate with the degree of amblyopia but not with one another, suggesting two independent cortical deficits: a reduced responsiveness as well as reduced fidelity of spatial representation. These deficits are independent of eccentricity within the central field and consistent across early cortical visual areas.

Background：Alzheimer’s disease (AD) is a progressive, neurodegenerative disease of the brain. Serum homocysteine (Hcy) level is considered to be an important biomarker for AD, however, the status of Hcy in brain tissue and neuronal cells, and the association between brain and serum levels of Hcy in clinical AD patients currently remain unclear. Methods: The levels of Hcy and other biothiols such as cysteine (Cys) and glutathione (GSH) in clinical blood samples were evaluated using a non-cytotoxic and stable multi-signal fluorescent probe, ethyl (E)-3-(9-chloro-11-oxo-2,3,6,7-tetrahydro-1H,5H,11H-pyrano[2,3-f] pyrido[3,2,1 -ij]quinolin-10-yl)-2-cyanoacrylate (Probe 1), which were verified by ELISA. Results: Measurement by Probe 1 revealed a significant increase in Hcy level, and a decrease in Cys and GSH levels in PC12 cells treated with in Aβ1-42. The hippocampus and whole brain of APP/PS1 mice also showed a significant increase in Hcy level alongside the accumulation of age-related AD symptoms, while levels of Cys and GSH decreased simultaneously. This change was also observed in serum samples acquired from patients with AD. The upregulation of Hcy and the downregulation of Cys and GSH were reversed in the Aβ1-42-treated PC12 cells and the brain of APP/PS1 mice when supplemented with VB6, an important coenzyme in Hcy metabolism. Conclusions: Changes in Hcy, Cys and GSH levels in the brain of APP/PS1 mice and Aβ1-42-treated PC12 cells were observed in situ with a new fluorescent probe, which were consistent with the abnormal changes in Hcy, Cys and GSH levels in the serum of AD patients. VB6 supplementation was successful in ameliorating abnormal upregulation of Hcy in the brain of APP/PS1 mice and in Aβ1-42-treated PC12 cells.

Background. To explore the relationship between achievement motivation and job performance among physicians, this study investigated the impacts of different personality traits on job performance among the physicians. Methods. This cross-sectional study was conducted in 2017 and 1,523 physicians from eight tertiary grade A hospitals in Harbin, China. The type of data collected included the achievement motivation of the physicians, job performance, organizational commitment, personality traits, and other demographic variables. To assess and compare the demographic data, independent t -test and ANOVA were applied. Further, Pearson correlation coefficients were used to evaluate the correlation among the variables. Moderated mediation analysis was performed to test the correlation among the job performance, achievement motivation, organizational commitment, neuroticism, extraversion, openness, agreeableness, and conscientiousness. Results. Achievement motivation directly influences job performance and organizational commitment partially mediates the direct effects of achievement motivation on job performance. Additionally, our findings demonstrated that agreeableness and conscientiousness moderate the strength of the relationships between achievement motivation and job performance mediated by organizational commitment. Conclusion. We propose that hospital managers should pay attention to the personal growth of the physicians and improve their organizational commitment via creating a positive working climate and training for career planning and education. Moreover, managers should identify conscientiousness and agreeableness individuals and increase their responsibilities geared towards improving the performance of the organization.

Ultra-wideband bio-radar (UWB) is a new non-contact technology that can be used to screen for obstructive sleep apnea (OSA). However, little information is available regarding its reliability. This study aimed to evaluate the effectiveness of UWB and to determine if UWB could provide a novel and reliable method for the primary screening of sleep-related breathing disorders. Subjects with suspected OSA from the sleep center of the First Hospital of the China Medical University were assessed over the period of September 2018 to April 2019 for enrollment in the study. Three detection methods were simultaneously used, including the STOP-Bang questionnaire (SBQ), UWB, and standard polysomnography (PSG). The data were analyzed using a fourfold table, receiver operating characteristic curves, Spearman rank correlation coefficients, Bland–Altman plots, and epoch-by-epoch analysis. Of 67 patients, 56 were men, mean age was 43 ± 11 years, mean body mass index was 27.8 ± 4.8 kg/m2, and mean SBQ score was 4.8 ± 1.6. The apnea–hypopnea index (AHI) (r = 0.82, p

Purpose We investigate the orientation tuning of interocular suppression using a dichoptic masking paradigm in adult controls and amblyopes. Methods Fourteen adults with anisometropic or mixed amblyopia and 10 control adults participated in our study. Contrast sensitivity was measured by presenting a target Gabor in the tested eye and mean luminance in the untested eye (monocular) and by presenting a target in the tested eye and a bandpass oriented filtered noise in the other eye (masked). Interocular suppression was defined as the thresholds difference between the monocular and masked conditions for each eye. Interocular suppression was measured under parallel and orthogonal suppression configurations. The peak spatial frequency of the target and mask was 0.25 c/d in experiment 1 (low), 1.31 c/d in experiment 2 (mid), and 6.87 c/d in experiment 3 (high). Results The masking suppression induced by the amblyopic eye was less strong than that induced by the fellow eye. The suppression from the fellow eye was similar to that observed in the controls. Interocular suppression under parallel configuration was less strong than under orthogonal configuration in amblyopes at low and mid spatial frequency, but not at high spatial frequency. Conclusions We demonstrate that the abnormal interocular masking in amblyopia displays the expected characteristic of orientation selectivity expected of normal controls at low and mid spatial frequency, but not at high spatial frequency. The dichoptic masking imbalance between the eyes of amblyopes results in a net suppression of the amblyopic eye during binocular viewing, modeling clinical suppression.

Background Fetal double aortic arch (DAA) malformation is a rare congenital heart disease with few reported cases in the literature. We aimed to investigate the characteristics of prenatal ultrasound and postnatal computed tomography angiography (CTA) of DAA and to describe the associated anomalies and clinical outcomes to improve prenatal diagnosis and assist in perinatal management. Methods The obstetric ultrasound imaging databases of seven tertiary referral centers were reviewed retrospectively to identify fetuses with a prenatal diagnosis of DAA between January 2013 and December 2018. Ultrasonographic findings, associated anomalies, genetic abnormalities, postnatal CTA images, and long-term postnatal outcomes were evaluated. Results A total of 36 cases out of 40 prenatally diagnosed DAA fetuses were confirmed by postnatal diagnosis (fetal autopsy, CTA, and surgery). In this cohort of 36 confirmed cases, 24 (67%) were isolated anomalies, while 12 (33%) were associated with intracardiac or extracardiac anomalies, and 2 (6%) had a 22q11.2 chromosome deletion. Among nine cases of pregnancy termination with a fetal autopsy, 7 had other abnormalities. Among the remaining 27 live births, 16 (59%) were asymptomatic and 11 (41%) received surgical treatment due to tracheal or esophageal compression symptoms, all with satisfactory outcomes. Prenatal echocardiography showed that DAA was mainly characterized by a bifurcation of the ascending aorta into the right and left aortic arch and the formation of a complete O-shaped vascular ring around the trachea on the three-vessel tracheal view. A variant in the aortic arch branching pattern was found for the first time. The airway obstruction, branching pattern, and atretic arch of DAA were clearly shown by postnatal CTA. Conclusions Fetal DAA has unique features on prenatal echocardiography and postnatal CTA, and systematic prenatal examination and timely postnatal CTA evaluation are required. A certain proportion of intracardiac and extracardiac abnormalities are associated with DAA, but the probability of chromosome abnormalities is low, especially for isolated DAA.The clinical outcomes of isolated DAA are favorable, even if surgery is performed due to symptoms. Determining whether other malformations or chromosomal anomalies exist is crucial for prognosis evaluation and prenatal counseling.

INTRODUCTION The influence of sedation on the endoscopic detection rate of upper gastrointestinal (UGI) early cancer (EC) and precancerous lesions, including high-grade intraepithelial neoplasia (HGIN) and low-grade intraepithelial neoplasia, has not been assessed. The aim of this research is to assess whether the use of sedation can help improve the detection rate of UGI EC and precancerous lesions. The second objective is to evaluate its potential influencing factors. METHODS The study includes 432,202 patients from a multicenter database from January 2012 to July 2019. Information on endoscopic findings and histology biopsies was obtained from endoscopy quality-control system. Associations of sedation with the detection rate of EC and precancerous lesions were assessed. RESULTS The sedation group has a higher detection rate of UGI EC and HGIN compared with the no-sedation group, whereas the detection rate of low-grade intraepithelial neoplasia was similar between the 2 groups. There were more cases examined by using staining, image enhancement, or magnifying techniques in the sedation group (P < 0.001). And, the mean observation time was also longer in the sedation group (P < 0.001). The type 0-IIb esophageal HGIN and EC cases were significantly increased in the sedation group. No significant difference was detected on lesion subtypes for gastric HGIN and EC according to the Paris classification. More gastric HGIN and EC were detected at gastric body in the sedation group (P = 0.001). DISCUSSION Sedation may improve the endoscopic detection rate of EC and HGIN in the UGI tract probably through enhancing the use of accessary endoscopic techniques, prolonging observation time, and taking more biopsies in different locations (see Visual Abstract, Supplementary Digital Content 2, http://links.lww.com/AJG/B926).

Background To observe myocardial deformations in fetuses with isolated lower urinary tract obstruction (LUTO) and identify the correlation between myocardial deformation and the severity of obstruction. Methods The strain (S), strain rate in systole (SRs) and strain rate in diastole (SRd) of the left and right ventricles at the first examination were prospectively analyzed and compared between fetuses with isolated LUTO and gestational age (GA)-matched normal control fetuses. Multiple regression analyses were used to assess the obstructive factors for impaired strain and strain rate, and the independent variables included bladder volume, sum of the bilateral pelvic diameters, sum of the bilateral ureteral diameters, mean bilateral renal artery pulsatility index, and amniotic fluid index. Results Thirty-six fetuses with isolated LUTO and 36 normal controls were enrolled. Overall, decreased S, SRs and SRd of both ventricles were noted in fetuses with LUTO (p p Conclusions Fetuses with LUTO demonstrated decreased left and right myocardial deformation, and this impaired cardiac dysfunction was correlated with the urinary bladder volume. Evaluating the myocardial deformation in fetal LUTO could provide information to aid in parental counselling and intervention monitoring.

Background Hypoxia delays brain maturation and contributes to neurodevelopmental morbidity in fetuses with congenital heart defects (CHDs). Maternal hyperoxygenation (MH) can, in theory, promote oxygen/nutrient delivery to the fetal brain, owing to an improved heart structure/function and increased fetal oxygen content. We aimed to determine whether MH alters fetal cerebral hemodynamics in fetuses with CHD. Methods Twenty-eight fetuses with borderline small left hearts and 28 age-matched normal fetuses were enrolled and subdivided by gestational age (GA): 23+ 0 ~ 27+ 6 weeks and 28+ 0 ~ 36+ 6 weeks. The middle cerebral artery pulsatility index (MCA-PI), vascular index (VI), flow index (FI) and vascular/flow index (VFI) were measured with baseline room air, after 10 min of MH and after 10 min of recovery for all subjects. Results MCA-PI, VI, FI and VFI did not differ with MH in the normal fetuses. In fetuses with borderline small left hearts, MCA-PI increased and VI, FI and VFI significantly decreased during the 3rd trimester (from 1.44 ± 0.27, 3.19 ± 0.87, 56.91 ± 9.19, and 1.30 ± 0.33 at baseline to 1.62 ± 0.15, 2.37 ± 0.37, 45.73 ± 4.59, and 0.94 ± 0.15 during MH, respectively, P p > 0.05). These parameters returned to the baseline levels during the recovery phase. The change in cerebral perfusion depended on the baseline MCA-PI and increased the combined cardiac index (CCOi). Conclusions MH alters the cerebral hemodynamics of fetuses with borderline small left hearts during the third trimester. Further investigation is needed to determine whether MH may benefit brain growth and neurodevelopment in this high-risk population.

Purpose To assess the role of spatial frequency on binocular imbalance in binocular combination in adults with amblyopia. Methods Ten amblyopes (23 ± 4.9 [SD] years old; one deprivation, two mixed, seven anisometropia patients) and 10 age-matched normal adults (23 ± 2.3 years old) participated. The interocular contrast ratio (fellow eye/amblyopic eye, i.e., the balance point [BP]) that resulted in an equal contribution of both eyes in binocular combination was measured using a binocular orientation combination task at 0.5, 1, 2, and 4 cycles per degree (c/d). The extent of binocular imbalance was quantified as the absolute value of the BP on log scale (i.e., |logBP|). Results When the base contrast of the amblyopic eye was set at 100% (Experiment 1), the |logBP| was found to be significantly affected by stimulus spatial frequency (F(1.44, 26.01) = 51.6, P < 0.001, \({\rm{\eta }}_g^2\)= 0.40) and group (F(1, 18) = 66.97, P < 0.001, \({\rm{\eta }}_g^2\) = 0.74), the interaction between spatial frequency and group was also significant (F(1.44, 26.01) = 38.12, P < 0.001, \({\rm{\eta }}_g^2\)= 0.33). Such spatial frequency-dependent binocular imbalance remained present, even when the base contrast of the amblyopic eye was set at equal suprathreshold contrast levels across spatial frequencies (Experiment 2). Conclusions Binocular balance was more disrupted at higher spatial frequencies in binocular combination in amblyopia. This imbalance might not originate solely from the amblyopic eye's deficit in contrast sensitivity but is likely to be related to the difference in contrast sensitivity between the eyes.

Background Great efforts have been made to prevent the spread of COVID-19, including national initiatives to promote the change of personal behaviors. The lessons learned from the 2003 SARS outbreak indicate that knowledge and attitudes about infectious diseases are related to panic among the population, which may further complicate efforts to prevent the spread of infectious diseases. Misunderstandings may result in behaviors such as underestimation, panic, and taking ineffective measures to avoid infection; these behaviors are likely to cause the epidemic to spread further. Objective The purpose of this study is to assess public health perceptions and misunderstandings about COVID-19 in China, and to propose targeted response measures based on the findings to control the development of the epidemic. Methods The study was conducted in April 2020 through an online survey, with participants in 8 provinces in Eastern, Central, and Western China. We designed a questionnaire with a health knowledge section consisting of 5 questions (4 conventional questions and 1 misleading question) on clinical features of and preventive measures against COVID-19. Descriptive statistics, chi-square analysis, binary logistic regression, and Mantel-Haenszel hierarchical analysis were used for statistical analysis. Results In total, 4788 participants completed the survey and the mean knowledge score was 4.63 (SD 0.67), gained mainly through experts (76.1%), television (60.0%), newspapers (57.9%), and opinions (46.6%) and videos (42.9%) from social media. Compared to those who obtained information from only 1 or 2 channels, people who obtained information from >3 channels had increased health perception and a better ability to identify misleading information. Suggestions from experts were the most positive information source (χ2=41.61), while information on social media was the most misleading. Those aged >60 years (OR 1.52, 95% CI 1.10-2.11), those with a lower or middle income (OR 1.36, 95% CI 1.00-1.83), those not working and not able to work (OR 1.83, 95% CI 1.04-3.21), those with a household income 2 suspected symptoms (OR 2.95, 95% CI 1.50-5.80) were more likely to be misled by videos on social media, but the error correction effect of expert advice was limited in these groups. Conclusions Multiple information channels can improve public health perception and the identification of misleading information during the COVID-19 pandemic. Videos on social media increased the risk of rumor propagation among vulnerable groups. We suggest the government should strengthen social media regulation and increase experts’ influence on the targeted vulnerable populations to reduce the risk of rumors spreading.

Nurses play an important role in medical and health services but anxiety among those in this profession is widespread. Anxiety not only damages the physical and mental health of the individual, but also reduces the efficiency of their work and the quality of care, ultimately impacting on patient care. Therefore, it is necessary to elucidate the factors that lead to anxiety and explore measures to reduce the impact these factors have on nurses.The purpose of this study was to investigate the serial-multiple mediation of psychological capital (PsyCap), organizational commitment, job burnout, and anxiety among Chinese female nurses.A cross-sectional stratified cluster sampling study.The study consisted of 1354 Chinese female nurses from two tertiary grade A hospitals in Heilongjiang Province, China.The Zung Self-Rating Anxiety Scale, the Chinese psychological capital questionnaire, the Chinese Maslach Burnout Inventory, and the Chinese Employee Organizational Commitment Questionnaire were used to gather data. Descriptive analysis, independent-samples T-test, one-way analysis of variance, Spearman correlation analyses, ordinary least-squares regression and the bootstrap method were used to analyze data.The prevalence rate of anxiety among nurses was found to be 41.1%, and there were significant differences in anxiety symptoms in age (F = 15.54, p 0.001) and marital status (F = 5.41, p 0.001), but not education (F = 1.50, p = 0.224) among nurses. Overall, the serial-multiple mediation of organizational commitment and job burnout in the relationship between PsyCap and anxiety was found to be statistically significant.The results of the present study showed that positive PsyCap was sequentially associated with increased organizational commitment first, and then decreased job burnout, which was in turn related to reduced symptoms of anxiety among female nurses.

Background As of September 17, 2021, coronavirus disease 2019 (COVID-19) has infected more than 226 million people in a worldwide pandemic, with conservative estimates suggesting that there are more than 204 million convalescent patients with COVID-19. Previous studies have indicated that patients in the recovery phase exhibit decreased function of multiple organs. In China, traditional Chinese medicine (TCM) treatment is recommended in the rehabilitation period of COVID-19; however, the safety and efficacy of such treatment remain to be confirmed. Aim of study The present study aimed to evaluate the efficacy and safety of Bufei Huoxue (BFHX) in restoring the functional status and exercise tolerance of patients recovering from COVID-19. Methods A total of 131 patients in the rehabilitation period of COVID-19 infection were randomly divided into a Bufei Huoxue (BFHX) group (n = 66) and a placebo group (n = 65). BFHX or placebo was given orally three times a day (1.4 g/dose) for 90 days. The primary outcomes was to evaluate improvements in exercise tolerance and imaging manifestations on chest computed tomography (CT). Results After the exclusion of two patients who withdrew prior to receiving any medications, 129 patients were recruited, including 64 patients in the BFHX group and 65 patients in the placebo group. After 3 months of treatment, the BFHX group exhibited greater attenuation of pneumonia lesions on chest CT than the placebo group (P, Graphical abstract Image 1

Recently, it has been shown that short-term monocular deprivation in adult humans can temporally shift the ocular dominance in favor of the deprived eye. It is not clear whether this form of ocular dominance plasticity can be explained by cortical contrast adaptation, which is known to be orientationally selective. Here we show that if only one eye is deprived of a limited band of orientations for a short period of 2.5 h, the deprived eye’s contribution to binocular function at all orientations rather than just those corresponding to the previously deprived orientations is strengthened. This isotropic enhancement is quite different from the orientational enhancement previously reported and suggests a separate neuroplastic mechanism specific to binocular function.

Background To investigate the differences in cardiovascular disease, extracardiac anomalies and outcomes between fetuses with levocardia and dextrocardia. Methods Clinical demographics, prenatal features, postnatal characteristics and the outcomes of fetuses with levocardia or dextrocardia were recorded and analyzed. Results Sixty-five fetuses with dextrocardia and thirty-eight fetuses with levocardia were enrolled. Right ventricle outlet obstruction, atrioventricular septal defect and intestinal malrotation were common in both groups. Univentricular physiology, transposition of the great arteries and esophageal atresia were more frequent in fetuses with levocardia, whereas abnormal pulmonary venous connection, double outlet of right ventricle, left ventricle outlet obstruction and brain abnormalities were more frequent in the dextrocardia group. The accuracy of evaluating cardiac malformations was high, but the sensitivity in assessing extracardiac abnormalities was low. Conclusions Although the disorders have certain overlapping features, there are several differences between fetuses with levocardia and dextrocardia. These findings might improve patient counseling and perinatal management.

We aimed to assess differences in myocardial deformation in fetuses at risk for coarctation (CoA) and the effects of maternal hyperoxygenation on deformation.Fetal echocardiography and velocity vector imaging were performed prospectively and serially in 48 fetuses with a small aortic isthmus and 48 gestation age-matched normal fetuses. Fetuses with a small aortic isthmus were randomly divided into two groups: one group with and the other group without maternal supplemental oxygen administration. The strain (S) and strain rate (SR) in the left ventricle (LV) and right ventricle (RV) were measured and compared between the groups. Regression analyses were performed to identify potential factors associated with myocardial deformation.Compared with normal fetuses, fetuses with a small aortic isthmus exhibited a lower S and SR at baseline. A negative correlation was found between aortic isthmus velocity-time integrals and S and SR at baseline (P .05). In the group that received supplemental oxygen therapy, the S and SR in both the LV and RV increased as a function of time, especially 4 weeks after the initiation of oxygen therapy (P .05). The duration of oxygen therapy and increased combined cardiac index were associated with increased myocardial deformation (P .05).Myocardial deformation appears abnormal in those at risk for CoA beginning in utero, and chronic oxygen therapy appears to increase deformation measures. These findings may improve patient counseling and perinatal management.

Lasik is a common surgery for treating anisometropia. In this study, we asked a specific question: what’s the effect of Lasik surgery on anisometropes’ sensory eye dominance? Fifteen myopic anisometropes (mean age: 23 ± 6.9 years old; 6 females) participated in our experiment. We quantitatively measured participants’ sensory eye dominance before and after the Lasik surgery using a binocular phase combination paradigm. We found no significant change of sensory eye dominance within 16 weeks (measured between 8 to 96 days, for one or two repetitions) after the surgery (t(14) = −1.44, p = 0.17). A further following on eight patients showed that patients’ two eyes were much more balanced at 16 weeks or more (measured one or two times between 112 to 408 days) after the surgery (t(7) = −3.79, p = 0.007). Our results suggest that the benefit of Lasik surgery on anisometropes’ sensory eye dominance is not immediate, a long-term ‘adaptation’ period (16 weeks or more) is necessary to enable the surgery to be truly effective.

Daytime sleepiness is a common symptom of obstructive sleep apnea (OSA) and is more common in men, but the underlying mechanism remains unclear. The aim of this study was to assess whether or not sex differences in daytime sleepiness persisted after controlling for age and OSA severity and to explore the factors contributing to daytime sleepiness in patients with OSA. A total of 104 pairs of patients with OSA, matched by age and apnea-hypopnea index (AHI), were enrolled in this retrospective study. Demographic data were collected; daytime sleepiness was measured by the Epworth Sleepiness Scale (ESS); and polysomnography (PSG) was performed on each participant. These measurements were compared between sexes, and the factors affecting daytime sleepiness were explored with correlation and multivariate linear regression analyses. Men had significantly higher ESS scores (p = 0.021) than women. Regarding demographics, BMI, neck/height ratio, and proportion of habitual smoking and alcohol intake were significantly higher in men. Regarding PSG findings, men had more rapid eye movement sleep, a longer mean apnea-hypopnea duration, and a longer mean apnea duration (MAD). Regression analysis showed that two sex-associated variables, habitual smoking (β = 0.189, p = 0.006) and MAD (β = 0.154, p = 0.024), had the strongest association with ESS scores. Further analysis revealed that MAD was significantly influenced by apnea index (β = 0.306, p

Background. Paraquat is a widely used nonselective and fast-acting contact herbicide worldwide. This study identified the early predictor of mortality in patients with acute paraquat poisoning. Methods. Twenty-nine patients with acute paraquat poisoning admitted at Nanjing Drum Tower Hospital from January 2018 to August 2020 were included in this study. The early predictor of mortality in patients with acute paraquat poisoning based on the blood tests was identified by correlation, logistic regression, and receiver operating characteristic (ROC) analyses. Result. 15 of the 29 patients died after poisoning. Compared to the survivors, the neutrophilic granulocyte ratio, leukocyte count, ALB, and Crea of the nonsurvivors were significantly higher with p value < 0.05, while the lymphocyte ratio and eGFR(MDRD) of the nonsurvivors were remarkably lower with p value < 0.01. Moreover, the neutrophil-to-lymphocyte ratio (NLR) was remarkably upregulated in the nonsurvivors. The area under the ROC curve (AUC) of the neutrophilic granulocyte ratio, lymphocyte ratio, leukocyte count, ALB, Crea, eGFR(MDRD), and NLR to predict the mortality in patients with acute paraquat poisoning was 0.8905 (95% CI: 0.7589-1.022), 0.8643 (95% CI: 0.7244-1.004), 0.8500 (95% CI: 0.7133-0.9867), 0.7286 (95% CI: 0.5338-0.9233), 0.8167 (95% CI: 0.6620-0.9713), 0.8714 (95% CI: 0.7330-1.010), and 0.8667 (95% CI: 0.7277-1.006), respectively. More interestingly, we also evaluated the diagnostic values of the different combinations of six blood test biomarkers by logistic regression analysis. According to the results of the logistic regression analysis, the AUCs for the combination of the neutrophilic granulocyte ratio, leukocyte count, and eGFR(MDRD) were the largest with 0.986 (95% CI: 0.952-1), and the sensitivity and specificity were 100% and 100%. Conclusion. This study demonstrated that the combination of the neutrophilic granulocyte ratio, leukocyte count, and eGFR(MDRD) could serve as an ideal early predictor of mortality in patients with acute paraquat poisoning. However, further research is needed to draw a clear conclusion.

This study aimed to analyze the early and mid-term outcomes of aortic valve replacement with bovine pericardium in the treatment of aortic valve regurgitation.From January 2015 to March 2018, 36 patients (19 men; mean ± standard deviation [SD] age, 46.70 ± 16.60 years) underwent aortic valve replacement with bovine pericardium. The bovine pericardium was intraoperatively measured and shaped using an Ozaki template, according to the shape and size of the individual patient's aortic valve leaflets. Additional procedures were performed, including ventricular septal defect repair in 5 cases, mitral valve reconstruction in 6 cases, tricuspid valve reconstruction in 6 cases, and coronary artery bypass grafting in 3 cases.There were no perioperative deaths. One elderly patient with postoperative respiratory failure recovered after symptomatic treatment. One patient with frequent ventricular tachycardia after intraoperative cardiac re-jump underwent intra-aortic balloon counterpulsation (IABP), and the IABP device was successfully removed on the second postoperative day. Within the first 6 months of follow-up, there were no death events, no reoperation events, and no additional thromboembolic events. Follow-up echocardiography was performed for 6 months, with average left ventricular ejection fraction of 62.01 ± 3.21%, mean transvalvular pressure gradient of 11.17 ± 4.90 mmHg, and mean aortic valve velocity of 1.60 ± 0.58 m/s. Compared with the preoperative transthoracic echocardiography findings, the results at the six-month follow-up were statistically significant (P0.05). Mild aortic valve regurgitation occurred in 2 patients (5.56%), whereas other patients had no or only minimal aortic valve regurgitation (n = 34, 94.44%). Moderate aortic valve regurgitation occurred in one patient at 9 months after the initial operation. This was found to be due to infective endocarditis, and a biological valve was finally implanted.Aortic valve replacement with bovine pericardium in the treatment of aortic valve regurgitation is feasible, and good early and mid-term results are achieved. Long-term results need to be followed up in the future.

Natural astaxanthin is the strongest antioxidant ever discovered, with many biological functions, and it is widely used in the fields of health food and biomedical research. In the present study, we aimed to investigate the plasma concentration, distribution and safety of astaxanthin from Haematococcus pluvialis in pregnant mice. In the acute studies, the oral LD50 of astaxanthin was greater than 20 g/kg·bw. In mouse bone marrow micronucleus test, 10 g/kg·bw astaxanthin did not cause damage to chromosomes and mitotic apparatus of pregnant mice. After treatment with a single dose of 500 mg/kg·bw astaxanthin, the concentration of astaxanthin in plasma reached the maximum at 8 h (55.7 μg/L), which was completely metabolized after 48 h. In the repeat-dose toxicity test, 100, 250 and 500 mg/kg·bw astaxanthin showed no abnormalities in terms of body and organ weight as well as hematological and biochemical parameters in clinical observation throughout the pregnancy. During pregnancy, the liver accumulated the highest content of astaxanthin, while the eye exhibited the least. The results indicated that administration of astaxanthin from H. pluvialis throughout pregnancy had no adverse effect on mice.

Type D personality is a psychosocial risk factor for cardiovascular events and in-stent restenosis (ISR), but the mechanisms involved are not well understood. This study aimed to evaluate the effects of dietary patterns on the association between Type D personality and ISR in patients with coronary artery disease treated with percutaneous coronary intervention (PCI).This cross-sectional study comprised a total of 230 post-PCI patients who were assessed for Type D personality, depression, dietary patterns, physical activity and medication adherence via self-administered questionnaires. ISR was assessed by coronary angiography.Type D personality (odds ratio [OR], 3.35; 95% confidence interval [CI], 1.05-10.71, p=0.042), low fruit intake (OR, 0.30; 95% CI, 0.12-0.68, p=0.008) and low vegetable intake (OR, 0.48, 95% CI, 0.27-0.91, p=0.021) were independent risk factors for ISR after adjustment for psychosocial, lifestyle and cardiovascular risk factors. Mediation analyses revealed that Type D personality had a significant direct effect on the development of ISR (p0.05). In addition, nutrients in fruits and vegetables, including vitamin C, vitamin E and fiber, were important mediators of the relationship between Type D personality and ISR (p0.05), the percentage of total indirect effect was 24.65%.These findings suggested that the low intake of fruit and vegetables in Type D patients can predict ISR. The healthy dietary interventions to supply vitamin C, vitamin E and fiber may help to improve the prognosis in post-PCI patients with Type D personality.

Neutrophil infiltration is frequently observed in lung cancer tissues. Extracellular RNAs (exRNAs) may facilitate tumor progression. The present study investigated the cross‑talk of tumor exRNAs and neutrophil extracellular traps (NETs) in lung cancer. Lewis lung carcinoma (LLC) cells were cultured with the deprived sera. And the cell culture supernatants (CCS) were analyzed in vitro and in vivo. The results revealed that exRNAs from lung cancer CCS promoted the inflammatory cytokine interleukin‑1β and reduced the vascular cell adhesion molecule‑1 expression in lung epithelial cells. Lung cancer CCS‑treated epithelial cells induced the production of NETs. By contrast, NETs reduced the tight junction protein claudin‑5 in epithelial cells. Furthermore, NETs caused the necrosis of epithelial cells, which resulted in the release of exRNAs. In mice, lung cancer cells instilled in the lung recruited neutrophils and initiated NETs. In patients with lung cancer, NETs were also observed. These results suggested that exRNAs in the cell culture supernatant may indirectly induce NETs and contribute to lung cancer oncogenesis.

OBJECTIVE To investigate the blood flow Doppler parameters of the anterior cerebral artery (ACA) in foetuses with hypoplastic left heart syndrome (HLHS). METHODS Doppler parameters (peak systolic velocity [PSV], end-diastolic velocity [EDV], time-averaged maximum velocity [TAMXV] and pulsatility index [PI]) and biometric parameters were measured in two anatomical segments of the ACA (S1 and S2) and in the middle cerebral artery (MCA) in 35 HLHS foetuses and 73 gestational age-matched normal foetuses. Correlations between the cerebral artery PIs and head circumference (HC) were assessed. RESULTS Both EDV and TAMXV of the ACA and MCA in the HLHS group were significantly higher than in the normal group (P < .05). The PI of the ACA and MCA in the HLHS group were significantly lower than in the normal group (P < .05). ACAS1PI and ACAS2PI in the HLHS foetuses with retrograde blood flow in the aortic isthmus (AoI) were significantly lower than those of HLHS foetuses without retrograde blood flow in the AoI (P < .05). ACAS2PI was significantly lower than ACAS1PI in the HLHS foetuses with retrograde blood flow in the AoI (P = .047). The abnormal rates of ACAS1 and ACAS2 were significantly higher than that of the MCA (P < .05) in the HLHS group. The HC and biparietal diameter were significantly lower in the HLHS group than in the control group (P < .05). HC was correlated with the PIs of ACAS1, ACAS2 and the MCA in the HLHS group (P < .05). CONCLUSION A redistribution of foetal cerebral blood flow appeared in HLHS, and the measurement of ACA PI might provide early information on brain hypoxia.

With the frequent occurrence of campus violence, scholars have devoted increasing attention to college students’ aggression. This study aims to estimate the prevalence of aggression in Chinese university students and identify factors that could influence their aggression. We can thus find methods to reduce the incidence of college students’ aggression in the future. A multi-stage stratified sampling procedure was used to select university students (N = 4565) aged 16–25 years in Harbin. The Aggression Questionnaire, the Adolescent Self-Rating Life Events Checklist and the Social Support Revalued Scale were used to collect data. Females reported lower levels of aggression than males (p

Background: Conflicting data have been reported related to the impact of atrial fibrillation (AF) on outcomes after transcatheter mitral valve repair with MitraClip (MC) implantation. In this study, we assessed the prognosis of MC-treated patients according to the presence of pre-existing AF. Methods: Randomized and observational studies reporting outcomes of pre-existing AF or sinus rhythm in patients undergoing MC treatment were identified with an electronic search. Outcomes of interest were short-and long-term mortality, stroke, bleeding, rehospitalization, myocardial infarction (MI), cardiogenic shock, acute procedure success, the hospital stay, and the number of Clips implanted. Results: Eight studies (8466 individuals) were eligible. Compared to sinus rhythm, long-term mortality, the risk of bleeding, rehospitalization, and longer hospital stay were significantly higher in AF groups, whereas similar correlations were found in the analysis of other outcomes. Conclusion: AF may be related with worse outcomes in patients undergoing MC implantation, including long-term mortality, major bleeding, and rehospitalization. AF should be taken into account when referring a patient for MC treatment.

OverviewThe mental health problems of adolescents with human immunodeficiency virus (HIV) are important. It is of great significance to explore which factors can affect the self-evaluation and understanding of adolescents with HIV.ObjectiveWe found that adolescents with HIV have a lower level of self-concept than healthy adolescents. This study aimed to determine the factors influencing self-concept among adolescents with HIV in China.SettingA questionnaire was distributed among a total of 290 adolescents in Henan Province, China. One hundred and forty questionnaires were distributed in the case group (adolescents with HIV) and the control group (healthy adolescents) was issued 150 questionnaires.The Piers-Harris Children’s Self-concept Scale, the Perceived Stress Scale, the Perceived Social Support Scale and the Simplified Coping Style Questionnaire were adapted for a Chinese population. Differences between the groups were tested for significance using Student’s t-test, and analysis of variance was used to test continuous variables. The relationship between environmental personality factors and adolescent self-concept was examined by Pearson correlation analysis. Hierarchical linear regression analysis was used to model the effects of environmental personality factors on self-concept.ResultsThe self-concept total score among adolescents with HIV was significantly lower than healthy adolescents (pConclusionsThe self-concept of adolescents with HIV is related to perceived stress, perceived social support and coping style. These findings underline the significance of self-concept among adolescents infected with HIV.

To provide useful information for diagnosing and predicting fetal intraabdominal extralobar pulmonary sequestration (IEPS), a retrospective review of diagnostic approaches was conducted. Ultrasonography was performed serially in 21 fetuses with IEPS from 2005 to 2017. Prenatal sonographic features, treatment, and outcomes of each case were evaluated and collected. These cases of IEPS were also compared to 43 cases previously reported by other researchers from 1986 to 2017. Of the 21 sonographic features, 14 (67%) were hyperechoic, 21 (100%) were well circumscribed, and 17 (81%) depicted a mass that shifted with fetal breaths/hiccups non-synchronized with adjacent organs (sliding sign). Feeding arteries were detected prenatally in 18 patients (86%). The lesion volume was 10.17 ± 4.66 cm3, the congenital cystic adenomatoid malformation volume ratio and cardiothoracic ratio were in normal range. The gestational age at diagnosis, location and echotexture of the lesion, and rate of surgical treatment were similar to previous studies, but with a significantly higher rate of detected feeding arteries (P P

Recent laboratory findings suggest that short-term patching of the amblyopic eye (i.e., inverse occlusion) results in a larger and more sustained improvement in the binocular balance compared with normal controls. In this study, we investigate the cumulative effects of the short-term inverse occlusion in adults and old children with amblyopia. This is a prospective cohort study of 18 amblyopes (10-35 years old; 2 with strabismus) who have been subjected to 2 hours/day of inverse occlusion for 2 months. Patients who required refractive correction or whose refractive correction needed updating were given a 2-month period of refractive adaptation. The primary outcome measure was the binocular balance which was measured using a phase combination task; the secondary outcome measures were the best-corrected visual acuity which was measured with a Tumbling E acuity chart and converted to logMAR units and the stereoacuity which was measured with the Random-dot preschool stereogram test. The average binocular gain was 0.11 in terms of the effective contrast ratio (z=−2.344, p=0.019, 2-tailed related samples Wilcoxon Signed Rank Test). The average acuity gain was 0.13 logMAR equivalent (t17=4.76, p<0.001, 2-tailed paired samples t-test). The average stereoacuity gain was 339 arc seconds (z=−2.533, p=0.011). Based on more recent research concerning adult ocular dominance plasticity, we conclude that inverse occlusion in adults and old children with amblyopia does produce long-term gains to binocular balance and that acuity and stereopsis can improve in some subjects.

Purpose To assess interocular delays in amblyopes with stereopsis and to evaluate the relationship between interocular delays and the clinical characteristics. Methods Twenty amblyopes with stereopsis (median, 400 arcseconds) and 20 controls with normal or corrected to normal visual acuity (≤0 logMAR) and normal stereopsis (≤60 arcseconds) participated. Using a rotating cylinder defined by horizontally moving Gabor patches, we produced a spontaneous Pulfrich phenomenon in order to determine the interocular delays, that is, the interocular phase difference at which ambiguous motion in plane was perceived. Two spatial frequencies—a low (0.95 cycles/degree [c/d]) and a medium (2.85 c/d) spatial frequency—were tested. Results The absolute interocular delays of the amblyopic group was significantly longer than that of the controls at both low or medium spatial frequencies (P < 0.01). However, the interocular delays was not always in favor of the fellow eye: 35% of the amblyopes (7/20) showed a faster processing of the amblyopic eye than that of the fellow eye at 0.95 c/d and 29.5% (5/17) at 2.85 c/d. No significant correlation was found between interocular delays and the clinical characteristics (e.g., age, treatment history, stereoacuity, and magnitude of anisometropia) in this amblyopic cohort. Conclusions The interocular delays in amblyopes with stereopsis might result from either a faster or slower processing of the amblyopic eye relative to the fellow eye. This work provides important additional information for binocular processing of dynamic visual stimuli in amblyopia. However, the special role between this form of interocular delays and patients’ clinical characteristics remains unknown.

Photodynamic therapy (PDT) is a promising cancer treatment modality that can selectively target unresectable tumors through optical activation of cytotoxic agents, thus reducing many side effects associated with systemic administration of chemotherapeutic drugs. However, limited light penetration into most biological tissues have so far prevented its widespread adoption beyond dermatology and a few other oncological applications in which a fiber optic can be threaded to the desired locations via an endoscopic approach (e.g., bladder). In this paper, we introduce an ultrasonically powered implantable microlight source, μLight, which enables in-situ localized light delivery to deep-seated solid tumors. Ultrasonic powering allows for small receiver form factor (mm-scale) and power transfer deep into the tissue (several centimeters). The implants consist of piezoelectric transducers measuring 2 × 2 × 2 mm3 and 2 × 4 × 2 mm3 with surface-mounted miniature red and blue LEDs. When energized with 185 mW/cm2 of transmitted acoustic power at 720 kHz, μLight can generate 0.048 to 6.5 mW/cm2 of optical power (depending on size of the piezoelectric element and light wavelength spectrum). This allows powering multiple receivers to a distance of 10 cm at therapeutic light output levels (a delivery of 20–40 J/cm2 light radiation dose in 1–2 hours). In vitro tests show that HeLa cells irradiated with μLights undergo a 70% decrease in average cell viability as compared to the control group. In vivo tests in mice implanted with 4T1-induced tumors (breast cancer) show light delivery capability at therapeutic dose levels. Overall, results indicate implanting multiple µLights and operating them for 1–2 hours can achieve cytotoxicity levels comparable to the clinically reported cases using external light sources.

To investigate hemodynamic parameters in 2 anatomical segments (S1 and S2) of anterior cerebral artery (ACA) in normal pregnancy during the second and third trimester of gestation. Methods: The peak systolic velocity (PSV), end diastolic velocity (EDV), time-average maximum velocity (TAMAXV), peak systolic velocity/end diastolic velocity (S/D), resistance index (RI), and pulsation index (PI) in S1 and S2 of fetal anterior cerebral artery (ACA) in 288 normal pregnant women were detected by power Doppler and pulsed Doppler. Multiple regression models were fitted to estimate the relation between Doppler variables and gestational age. The differences of hemodynamic parameters between ACAS1 and ACAS2 were compared. Results: The PSV, EDV, and TAMAXV of ACAS1 and ACAS2 were positively correlated with the weeks of pregnancy (P0.001), all fitted with the cubic curve. The S/D, PI, and RI values of ACAS1 and ACAS2 were not correlated with gestational ages (P0.05). The PSV, TAMAXV, S/D, PI, and RI of ACAS1 were significantly higher than those of ACAS2, while EDV in ACAS1 was lower than that in ACAS2 (P0.05). Conclusion: The velocity parameters (PSV, EDV, TAMAXV) of the 2 anatomical segments (ACAS1 and ACAS2) are increased with the increase of gestational age in normal pregnant fetus during the second and third trimester of gestation, and the resistance parameters (S/D, PI, RI) are not significantly correlated with gestational age. Distribution of blood flow is different in the blood supply territory between ACAS1 and ACAS2.目的：探讨中晚孕期正常妊娠胎儿大脑前动脉(anterior cerebral artery，ACA)2个解剖节段(S1和S2)血流动力学参数与孕周的相关性。方法：经常规超声检查后用能量多普勒及脉冲多普勒分别检测288例20~40周正常妊娠胎儿ACA(ACAS1和ACAS2)的收缩期峰值流速(peak systolic velocity，PSV)、舒张末期血流速度(end diastolic velocity，EDV)、时间-平均最大流速(time-average maximum velocity，TAMAXV)、收缩期峰值血流速度/舒张末期血流速度(systolic blood flow velocity/end-diastolic blood flow velocity，S/D)、阻力指数(resistance index，RI)及搏动指数(pulsation index，PI)；将各参数与孕周的关系分别绘制散点图，拟合多种回归模型，选出最佳拟合曲线并得出相关公式；并对比分析ACAS1与ACAS2各血流动力学指标间的差异性。结果：ACAS1和ACAS2的PSV，EDV，TAMAXV与妊娠周数均呈正相关(P0.001)，均以Cubic曲线拟合优度最佳；ACAS1和ACAS2的S/D，PI，RI值与孕周均无相关关系(P0.05)；ACAS1的PSV，TAMAXV，S/D，PI及RI值均明显高于ACAS2， ACAS1的EDV值低于ACAS2(P0.05)。结论：中晚孕期正常妊娠胎儿ACA两个解剖节段(ACAS1和ACAS2)速度参数(PSV，EDV，TAMAXV)随孕周增加而增高，阻力参数(S/D，PI，RI)与孕周无明显相关性。ACAS1与ACAS2供血区域存在血流差异性分布。.

To study the blood flow parameters for 2 anatomical segments of posterior cerebral artery (PCA) in normal singleton fetal. Methods: The blood flow velocity parameters peak systolic velocity (PSV), end diastolic velocity (EDV), time-average maximum velocity (TAMAXV), velocity time integral (VTI) and resistance parameters systolic peak velocity and end diastolic velocity ratio (S/D), pulsatility index (PI), resistance index (RI) for 2 anatomical segments in PCA were recorded. The first segment of the PCA (PCAS1) was recorded between the origin of PCA and the proximal part of the posterior communicating artery. The second segment of the PCA (PCAS2) was recorded at the distal part of the posterior communicating artery. The blood parameters in both PCAS1 and PCAS2 were analyzed by using Pearson correlation and multiple curves fitting with gestational age (GA). Paired student's t test was performed to compare the difference in blood parameter between PCAS1 and PCAS2. Results: The blood flow velocity parameters in both PCAS1 and PCAS2 were increased with the GA (P0.0001), with the best fitted curves of Quadratic curve (P0.0001). There were no correlations between resistance parameters in PCA and GA (P0.05). Resistance parameters in PCAS1 were higher than those in PCAS2 (P0.05). Conclusion: The blood flow velocity parameters in both PCAS1 and PCAS2 are increased with GA. The resistance parameters in both PCAS1 and PCAS2 do not change with GA. Study on the velocities and resistance in these 3 arterial branches provides a more comprehensive evaluation on the process of brain circulation.目的：研究正常胎儿大脑后动脉(posterior cerebral artery，PCA)两个解剖节段的血流参数随孕周变化规律。方法：用多普勒检测132例正常单胎胎儿PCA两个解剖节段，PCA由基底动脉发出至后交通动脉之前节段(the first segment of posterior cerebral artery，PCAS1)和PCA与后交通动脉汇合之后节段(the second segment of posterior cerebral artery，PCAS2)的速度参数[收缩期峰值流速(peak systolic velocity，PSV)、舒张末期流速(end diastolic velocity，EDV)、时间-平均最大速度(time-average maximum velocity，TAMAXV)、速度时间积分(velocity time integral，VTI)]以及阻力参数[收缩期峰值流速与舒张末期流速比值(systolic peak velocity and end diastolic velocity ratio，S/D)、搏动指数(pulsatility index，PI)、阻力指数(resistance index，RI)]。将PCAS1和PCAS2血流参数分别与孕周行Pearson相关分析及多种曲线拟合，并对比分析两节段间的血流参数差异。结果：PCAS1和PCAS2速度参数随孕周增长而增加(P0.0001)，速度参数与孕周均以Quadratic曲线拟合度最高(P0.0001)。PCAS1和PCAS2阻力参数与孕周无明显相关性(P0.05)。PCAS1阻力明显高于PCAS2(P0.05)。结论：正常胎儿PCA两个节段速度参数均与孕周存在正相关关系，阻力参数与孕周不存在相关关系，两节段存在阻力差异。对正常胎儿PCA血流参数的研究可完善胎儿脑循环的评估，为高危妊娠的监测提供有力的根据及补充。.

Objective To develop Z scores for the trachea and main bronchi in normal fetuses. Methods This was a prospective cross-sectional study in 823 normal singleton fetuses. The tracheal diameter immediately proximal to the bifurcation and the left and right main bronchial diameters were measured from their inner to inner edge in the coronal view. Z scores were created for the trachea and main bronchial diameters using gestational age (GA), femur length (FL), and biparietal diameter (BPD) as independent variables. Results Between gestational weeks 20 and 40, the inner diameters of the trachea, left principal bronchi (LPB), and right principal bronchi (RPB) increased from 1.8 to 4.7 mm, 0.8 to 2.2 mm, and 0.9 to 2.3 mm, respectively. A simple linear regression equation was fitted to model the mean of each diameter. There was however significant heteroscedasticity of the standard deviation (SD) with increasing GA, FL, or BPD. Eventually, the following formula was used to calculate Z scores for the diameters: [measured value - equation for mean]/equation for SD. Conclusion We have developed Z scores for the fetal trachea and main bronchi by applying standard statistical methods. These Z scores may be useful to evaluate the early development of the respiratory system.

In this study, we investigated the effect of optical treatment on sensory eye balance in anisometropic amblyopia. Fourteen individuals (age: 13.7 ± 8.4 years old) with previously untreated anisometropic amblyopia were enrolled in the study. The average magnitude of their anisometropia (spherical equivalent) was 4.02 ± 1.19 DS. Their best corrected monocular visual acuity and sensory eye balance were measured before and after a 2-month period of full refractive correction (i.e., our optical treatment). Spectacle-corrected distance visual acuity (at 5 m) was measured monocularly using the Tumbling E Chart. Sensory eye balance was quantitatively assessed using a binocular phase-combination paradigm to determine the interocular contrast ratio at which the two eyes were balanced in binocular sensory combination (i.e., the balance point). We found that both interocular contrast ratio at the balance point (p = 0.006) and visual acuity of the amblyopic eye (p < 0.001) were significantly improved after 2 months of optical treatment, often referred to as refractive adaptation. We conclude that sustained optical treatment improves interocular sensory balance in anisometropic amblyopia as well as monocular acuity. Optical treatment is a passive form of binocular therapy and a necessary first step in treating the binocular dysfunction that characterizes amblyopia.

Recent genome-wide association studies have revealed the HLA region on chromosome 6p21 as a susceptibility locus for hepatitis B virus (HBV) infection, a finding subsequently replicated in independent samples. However, only limited single nucleotide polymorphisms (SNPs) were analyzed in most of these studies, and it remains to be determined which SNPs contribute to the detected association. After genotyping 140 SNPs within this genomic region in a total of 1657 HBV-positive patients and 1456 HBV-negative controls, we conducted a series of genetic epidemiological and bioinformatics analysis, including individual SNP-based association analysis, haplotype-based association analysis, and conditional analysis. We identified 76 SNPs and 5 LD blocks in HLA-DP/DQ clusters that are significantly associated with HBV infection, with the smallest P value being 3.88 × 10(-18) for rs9277535 in HLA-DPB1. With conditional analysis, we further revealed that the genes contributing to the effects of variants in HLA-DP/DQ on infection are independent of each other, and the LD block 5 in the 3'-UTR region of HLA-DPB1 had a predominant effect in the association of HLA-DP with HBV infection. We also found that the SNPs in the 3'-UTR region of HLA-DPB1 were significant between the subgroups of inactive HBV carrier, chronic hepatitis B, or hepatic cirrhosis from the case group and the spontaneous HBV-clearance subgroup from the control group. Finally, we did further association analysis of SNPs in this region with different subgroups from the case group, which revealed no association of these SNPs with the progression of HBV-related diseases. In sum, we showed, for the first time, that the HLA-DP/DQ clusters contribute independently to HBV infection, and the 3'-UTR region of HLA-DPB1 represents an important functional region involved in HBV infection.

To verify the clinical efficacy on postmenopausal osteoporosis treated with acupoint injection of salmon calcitonin.Ninety patients of postmenopausal osteoporosis were randomized into three groups, 30 cases in each one. In the acupoint injection group, Shenshu (BL 23) and Zusanli (ST 36) were selected bilaterally. The injection 4 mL was prepared with salmon calcitonin 100 U (1 mL) and 0.9% sodium chloride injection. Each acupoint was stimulated with the injection, 1 mL. In the blank group, 0.9% sodium chloride injection was applied to bilateral Shenshu (BL 23) and Zusanli (ST 36), 1 mL at each acupoint. In the intramuscular injection group, salmon calcitonin 100 U was injected at gluteus maximus. The treatment was given once every two days in the patients of the three groups and lasted for 2 months. The levels of bone mineral density (BMD), bone alkaline phosphatase (NBAP), C-terminal telopeptides of typeⅠcollagen (CTX), urine calcium/creatinine (Ca/Cr) and the symptom score of osteoporosis were detected in the patients of the three groups before and after treatment.In the patients of the three groups, NBAP and BMD in lumbar vertebra after treatment were higher than those before treatment (allSalmon calcitonin injec-tion at Zusanli (ST 36) and Shenshu (BL 23) achieves significant efficacy on postmenopausal osteoporosis, stimulating osteoblast activity and inhibiting bone absorption of osteoclast.

To investigate the evolution of left ventricular global strain in anterior myocardial infarction patients treated with emergency percutaneous coronary intervention (PCI). Methods: A total of 54 patients with PCI were enrolled as a PCI group. Forty healthy subjects were enrolled as a control group. Dynamic cardiac images were collected. All of these images were analyzed off-line by velocity vector imaging (VVI) software. N-terminal pro-B-type natriuretic peptide (NT-proBNP) was measured with an electrochemiluminescence immunoassay through the Elecsys 1010/2010 system. Correlation analysis were undertaken between VVI and NT-proBNP levels in blood. Results: In PCI group, only globle longitudinal strain (GLS) was significantly increased 3 day after operation (P0.05). GLS and globle circumferencial strain (GCS) were markedly increased 6 months after operation (P0.05). In PCI group, left ventricular GLS 1 d to 6 months after PCI shows positive correlation with lgNT-proBNP levels (r=0.66, P0.001). GLS value was -12.50% at the 3rd day after operation, indicating the improvment of cardiac function in the first and sixth month after PCI. Conclusion: The change of Left ventricular globle longitudinal systolic function after emergency PCI may be more sensitive to the improvement of myocardial stunning after STEMI reperfusion; GLS value (-12.50%) at the 3rd day after operation predict the improvment of cardiac function in the first and sixth months after PCI.目的：应用速度向量成像(velocity vector imaging，VVI)技术探讨前壁急性ST段抬高型心肌梗死(ST-elevation myocardial infarction，STEMI)患者首次急诊经皮冠状动脉介入治疗(percutaneous coronary intervention，PCI)术后左心室整体纵向应变(global longitudinal strain，GLS)与整体环向应变(global circumferencial strain，GCS)动态演变及其临床价值。方法：PCI组前壁STEMI患者54例行首次急诊PCI术，对照组40例行冠状动脉造影术。采集术前与术后各时间点二维动态超声心动图，启动VVI软件分析。同时抽取部分对象静脉血测定血浆N-末端脑钠肽原(N-terminal pro-B-type natriuretic peptide，NT-proBNP)浓度。研究PCI组整体应变术后演变，并分析PCI组左心室整体纵向应变与血浆NT-proBNP的相关性。结果：PCI术后3 d GLS显著升高(P0.05)，术后6个月GLS与GCS均显著增高(P0.05)。术后多时间点左室GLS与血浆NT-proBNP呈正相关(r=0.66，P0.001)。急诊PCI术后3 d左室GLS收缩期峰值–12.50%可评价术后1及6个月血浆NT-proBNP改变。结论：左室整体纵向应变动态演变可为间接评价急性前壁STEMI急诊PCI术后心肌顿抑功能提供参考，术后3 d左室整体纵向应变–12.50%有望预测术后1，6个月心功能改善。.

Several studies have shown that short-term monocular patching can induce ocular dominance plasticity in normal adults, in which the patched eye becomes stronger in binocular viewing. There is a recent study showing that exercise enhances this plasticity effect when assessed with binocular rivalry. We address one question, is this enhancement from exercise a general effect such that it is seen for measures of binocular processing other than that revealed using binocular rivalry? Using a binocular phase combination task in which we directly measure each eye’s contribution to the binocularly fused percept, we show no additional effect of exercise after short-term monocular occlusion and argue that the enhancement of ocular dominance plasticity from exercise could not be demonstrated with our approach.