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Coix seed is a kind of widespread cereal, and it is used as a folk medicine in China. The present work focuses on the analysis of changes in triacylglycerols (TAGs) content and mycotoxins of coix seed during the processing and storage period for its quality control. Using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UHPLC-Q-TOF-MS) and high-performance liquid chromatography coupled with evaporative light-scattering detector (HPLC-ELSD) techniques, 42 lipid components in coix seeds were identified, and seven molecular species of TAG in coix seeds from different localities in China were measured and compared, respectively. A correlation analysis between the morphological features and TAGs contents revealed the integrity instead of the particle size of the seed, displaying a highly positive correlation with its quality. The higher contents of TAGs in hulled coix seed than in polished coix seed proposed an alternative processing way. During storage, the changes in TAGs contents of seeds indicated that the storage period should be less than 3 months, and the intact seeds could maintain lipid stability better than the powder. Furthermore, the air humidity and temperature should be controlled during coix seed storage to prevent the production of mycotoxins. These results provide significant insight into the effective control of coix seed quality during processing and storage. [ABSTRACT FROM AUTHOR]

Purpose. To validate the potential of bioresorbable implantation in secondary revisional reconstruction after inadequate primary orbital fracture repair, with assessment of pre- and postoperative clinical characteristics and computed tomography image findings. Methods. A retrospective chart review was conducted on 16 consecutive patients treated for orbital fractures at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, with inadequate prior surgeries between July 2010 and June 2017; patients who had suffered orbital blowout fractures had undergone primary surgeries elsewhere. Secondary repair of orbital fractures used bioresorbable material following unsatisfactory primary orbital repair. Patients' demographics, degree of enophthalmos, ocular motility, diplopia test results, primary implants, and surgical complications were reviewed. Results. All 16 patients had primary orbital implants consisting of Medpor, titanium mesh, hydroxyapatite, or poly-L-lactide. Of the 16 cases, 14 had malpositioned implants posteriorly and two had implant infections. Findings following primary surgery included enophthalmos (12/16), diplopia (9/16), intraorbital abscess (2/16), and ocular movement pain (1/16). Mean preoperative enophthalmos was 3.8 ± 0.8 mm. Secondary reconstruction resulted in a mean reduction of enophthalmos by 3.1 ± 0.9 mm (P<0.01). Nine in ten patients experienced improvements in postoperative ocular motility and diplopia following secondary surgery. Intraorbital abscesses and eyeball movement-associated pain were cured. Conclusions. This study demonstrates that secondary orbital reconstruction of previously repaired orbital fractures using bioresorbable material can achieve excellent functional and aesthetic results with minimal complications. Bioresorbable material should be considered in secondary orbital reconstruction when clinically indicated. [ABSTRACT FROM AUTHOR]

Background: The management of severe mental disorder (SMD) patients in communities is an important initiative of healthcare reform in China. Yet the effects in terms of risk behavior of patients are unclear, particularly in rural areas. This study aims to examine high risk behaviors, changing trends, and possible associated factors among SMD patients in the rural areas of western China. Methods: This analysis examined incidence rate (IR) of high risk behavior of 121,830 managed SMD patients in rural area of Sichuan province, based on data from the national system from 2006 to 2013. Register rate, high risk behavior IR, and time distribution and area distribution of high risk behavior were described. Two-level Poisson regression model was used to analyze associates of high risk behavior of patients, which include demographic characteristics at individual level, socio-economic condition and health system indicators at region level. Results: It was revealed that 6804 (5.58%) of managed patients were involved in 17,220 high risk behavior events, which gave an overall IR of 0.0998 (per person year) on the basis of 172,564 person years of follow-up. The IR varied widely across municipalities, in the range of 0.0305–0.3397. The IR of high risk behavior in the cohort had increased since 2006, and peaked by 2011, at 0.2392. At the individual level, males aged 25 to 44, who were unmarried and in poverty, illiterate or semiliterate, had a family history of mental disorders and antipsychotic treatments, longer duration illnesses, were associated with an increased IR risk. At the regional level, higher psychiatric practitioner visits and the lower annual net income of rural residents per capita, were associated with an increased IR risk. Conclusions: This is the first large prospective study that revealed the current situation of the register rate, high risk behavior incidence rate in SMD patients in rural area of western China, and examined associates and the differences of high risk behavior of patients among municipalities. The findings may provide evidences that lead to guide prevention and control for risk behavior in SMD patients in rural areas of China, as well as to improve mental health services for this population. It could provide some reference for other developing countries too. [ABSTRACT FROM AUTHOR]

• Cloned the CDS of SsPDAT1 from Sapium sebiferum (L.) Roxb. • Identified the PDAT enzymatic activity of SsPDAT1 in yeast. • Overexpression of SsPDAT1 from Sapium sebiferum could result in a significant increase of oil and linoleic acid content in Brassica napus. Sapium sebiferum (L.) Roxb. plays an important role in traditional Chinese medicine and is one of major woody oil tree in China. Phospholipid: diacylglycerol acyltransferase 1 (PDAT1), as an important catalytic enzyme for the formation of triacylglycerol (TAG), is mainly responsible for the transfer of an acyl group from the sn-2 position of phospholipids to the sn-3 position of sn-1, 2-diacylglycerol (DAG) to produce TAG and sn-1 lysophospholipids. The importance of PDAT1 in triacylglycerol biosynthesis has been illustrated in previous research, and at least 67 PDAT1 sequences have been identified from 31 organisms. However, little is known about the gene encoding PDAT1 in S. sebiferum (SsPDAT1), which is involved in seed oil biosynthesis. To explore the functional characteristics of SsPDAT1 , we cloned and analyzed the full-length cDNA in the coding region of SsPDAT1, which consists of 2040 bp and encodes a putative protein of 680 amino acid (aa) residues. Thin-layer chromatography (TLC) analysis showed that recombinant SsPDAT1 could restore TAG accumulation in TAG-deficient mutant yeast (Saccharomyces cerevisiae) H1246, which revealed the enzyme activity of SsPDAT1. Moreover, transgenic Brassica napus L. W10 plants overexpressing SsPDAT1 showed significant increases of 19.6–28.9 % in linoleic acid levels but decreases of 27.3–37.1 % in linolenic acid. Furthermore, the total oil content increased by 8.1 %–10.8 % in SsPDAT1 transgenic seeds. These results confirmed the role of SsPDAT1 in stabilizing oil biosynthesis and suggested that SsPDAT1 could be exploitable to specifically regulate the oil composition of plants. These experimental results provide a new concept that may enable the industrial development of plants with high-linoleic-acid oil through overexpression of SsPDAT1 in S. sebiferum L. [ABSTRACT FROM AUTHOR]

Background: As stroke has become the leading cause of death and disability in China, it has induced a heavy disease burden on society, families, and patients. Despite much attention within the literature, the effect of multiple risk factors on length of stay (LOS) and inpatient costs in China is still not fully understood., Aim: To analyse the association between the number of risk factors combined and inpatient costs among adults with stroke and explore the mediating effect of LOS on inpatient costs., Methods: A retrospective cross-sectional study was conducted among stroke patients in a tertiary hospital in Nantong City from January 2018 to December 2019. Lifestyle factors (smoking status, exercise), personal disease history (overweight, hypertension, dyslipidemia, diabetes mellitus, atrial fibrillation), family history of stroke, and demographic characteristics were interviewed by trained nurses. Inpatient costs and LOS were extracted from electronic medical records. Hierarchical multiple linear regression models and mediation analysis were used to examine the direct and indirect effects of the number of risk factors combined for stroke on inpatient costs., Results: A total of 620 individuals were included, comprising 391 ischaemic stroke patients and 229 haemorrhagic stroke patients, and the mean age was 63.2 years, with 60.32% being male. The overall mean cost for stroke inpatients was 30730.78 CNY ($ 4444.91), and the average length of stay (LOS) was 12.50 days. Mediation analysis indicated that the greater number of risk factors was not only directly related to higher inpatient costs (direct effect = 0.16, 95%CI:[0.11,0.22]), but also indirectly associated with inpatient cost through longer LOS (indirect effect = 0.08, 95% CI: [0.04,0.11]). Furthermore, patients with high risk of stroke had longer LOS than those in low-risk patients, which in turn led to heavier hospitalization expenses., Conclusions: Both the greater number of risk factors and high-risk rating among stroke patients increased the length of stay and inpatient costs. Preventing and controlling risk behaviors of stroke should be strengthened., (© 2024. The Author(s).)

Objective: To evaluate the myocutaneous sliding flap for restructuring the eyelid of divided nevus, thus optimizing the aesthetic outcome., Design: A retrospective clinical study., Participants: Clinical data from patients with a small or medium-sized divided nevus of the eyelids between January 2015 and December 2018 in the Shanghai Ninth People's Hospital were reviewed., Methods: The safety and efficacy of a surgical approach using a myocutaneous sliding flap were evaluated based on postoperative features and complications., Results: This study included 53 patients with an average age was 21.6 years (range, 2-68 years). The lesions involved the inner canthus in 5 patients (9.43%) and the lateral canthus in 14 patients (26.42%). Three (5.66%) patients had undergone primary surgery elsewhere. Overall, the eyelid margins were in good shape postoperatively at an average follow-up of 22.7 months, and there were no obvious eyelid deformities, lagophthalmos, or other unacceptable complications postoperatively. The nevi were benign intradermal (60.38%), junctional (16.98%), and compound types (22.64%) without malignant transformation, as confirmed by pathologic examination. No malignant transformation was observed until the end of the follow-up period., Conclusion: A myocutaneous sliding flap can provide an appropriately size pedicle graft and achieve satisfactory cosmetic results for divided eyelid nevus., (Copyright © 2021. Published by Elsevier Inc.)

Introduction: This study was aimed to assess the prevalence of hyperuricemia and its associated risk factors among hypertensive patients in Southwest China., Methods: From September 2013 to March 2014, a multistage, stratified sampling was conducted on 3505 hypertensive people aged 50-79 years who lived in urban communities within Chengdu and Chongqing, using a questionnaire and performing physical and biochemical measurements., Results: In the study population, approximately 18.2% of all hypertensive participants had hyperuricemia (638/3505), with a prevalence rate of 21.5% in men and 16.2% in women (p < 0.05). Multivariate logistic regression analysis showed that aging, without spouse, current drinking, preferring hotpot, hypertriglyceridemia, BMI ≥ 25 kg/ m 2 , and central obesity were all positively correlated with hyperuricemia, whereas female gender was negatively correlated with hyperuricemia. The prevalence of hyperuricemia among hypertensive patients in urban adults aged 50-79 years in southwestern China was high, while levels of awareness were extremely low., Discussion: Improved hyperuricemia health knowledge should be delivered to improve public awareness of the disease and it may need aggressive strategies aiming at the prevention and treatment of hyperuricemia. It is may necessary to encourage people to check blood uric acid levels when they first time to be diagnosed with hypertension, especially in the elderly., (© 2021. The Author(s).)

Study Objectives: Sleep-disordered breathing (SDB) is prevalent and associated with an increased risk of morbidity and mortality. However, whether SDB has an adverse impact on wound healing in patients with diabetic foot ulcers (DFUs) is uncertain. The purpose of this study was to investigate the association of SDB with wound healing in patients with DFUs., Methods: A total of 167 patients with DFUs were enrolled between July 2013 and June 2019 at West China Hospital (Chengdu, China) to assess the association of SDB with wound healing, ulcer recurrence, and all-cause mortality., Results: Whereas there was no significant association between apnea-hypopnea index (AHI) and wound healing, total sleep time (per hour: hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.01-1.30; P = .029), sleep efficiency (per 10%: HR, 1.20; 95% CI, 1.04-1.37; P = .012), and wakefulness after sleep onset (per 30 minutes: HR, 0.89; 95% CI, 0.82-0.97; P = .008) were associated with wound healing. Total sleep time (per hour: odds ratio, 0.71; 95% CI, 0.51-0.97; P = .035) and sleep efficiency (per 10%: odds ratio, 0.68; 95% CI, 0.47-0.97; P = .033) were also associated with ulcer recurrence. Mean oxygen saturation (per 3%: HR, 0.68; 95% CI, 0.49-0.94; P = .021) and percentage of sleep time with oxygen saturation < 90% (per 10%: HR, 1.25; 95% CI, 1.03-1.53; P = .026) were significantly associated with mortality., Conclusions: SDB is highly prevalent in patients with DFUs but its severity, as conventionally measured by AHI, is not associated with wound healing. Sleep fragmentation and hypoxemia are stronger predictors of poor wound healing, high ulcer recurrence, and increased risk of death in patients with DFUs., (© 2021 American Academy of Sleep Medicine.)

Background: Polysomnography (PSG) is the gold standard for diagnosis of sleep-disordered breathing (SDB). But it is impractical to perform PSG in all patients with diabetes. The objective was to develop a clinically easy-to-use prediction model to diagnosis SDB in patients with diabetes., Methods: A total of 440 patients with diabetes were recruited and underwent overnight PSG at West China Hospital. Prediction algorithms were based on oxygen desaturation index (ODI) and other variables, including sex, age, body mass index, Epworth score, mean oxygen saturation, and total sleep time. Two phase approach was employed to derivate and validate the models., Results: ODI was strongly correlated with apnea-hypopnea index (AHI) (r s = 0.941). In the derivation phase, the single cutoff model with ODI was selected, with area under the receiver operating characteristic curve (AUC) of 0.956 (95%CI 0.917-0.994), 0.962 (95%CI 0.943-0.981), and 0.976 (95%CI 0.956-0.996) for predicting AHI ≥5/h, ≥15/h, and ≥30/h, respectively. We identified the cutoff of ODI 5/h, 15/h, and 25/h, as having important predictive value for AHI ≥5/h, ≥15/h, and ≥30/h, respectively. In the validation phase, the AUC of ODI was 0.941 (95%CI 0.904-0.978), 0.969 (95%CI 0.969-0.991), and 0.949 (95%CI 0.915-0.983) for predicting AHI ≥5/h, ≥15/h, and ≥30/h, respectively. The sensitivity of ODI ≥5/h, ≥15/h, and ≥25/h was 92%, 90%, and 93%, respectively, while the specificity was 73%, 89%, and 85%, respectively., Conclusions: ODI is a sensitive and specific tool to predict SDB in patients with diabetes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Chen, Tang, Wang, Chen, Gao, Ma, Zha, Lei, Tang and Ran.)

Objectives: Diabetic foot ulcers (DFUs) are a considerable burden on patients and the healthcare service system. Patients with DFUs have many risk factors that might contribute to obstructive sleep apnea (OSA). The purposes of this study were to assess the prevalence of OSA and associated features in patients with DFUs. Methods: Between July 2017 and June 2019, we recruited 245 consecutive patients who sought for treatment at West China Hospital because of DFUs. Polysomnography data from 127 Patients were included in the final analysis. Results: Of the 127 patients, with a median age of 64 years (interquartile range, 55-73 years; range, 36-86 years) and a mean body mass index (BMI) 24.09 ± 0.37 kg/m 2 , 91 (72%) were men. The prevalence of OSA [apnea-hypopnea index (AHI) ≧5/h] was 92% in men and 97% in women ( P = 0.304). Moderate to severe OSA (AHI ≧15/h) was noted in 44 men (48%) and 26 women (72%) ( P = 0.015). The risk factors associated with the severity of OSA were sex, age, smoking, alcohol use, and duration of diabetes. After multivariable adjustment, duration of diabetes and age were independent predictive factors of the severity of OSA. No significant association was observed between BMI, waist circumference, Epworth score, and the severity of OSA. There were no significant associations between OSA and ischemic heart disease, cerebral infarction, hypertension, diabetic retinopathy, diabetic kidney disease, and peripheral artery disease. Conclusions: The prevalence of OSA was high in patients with DFUs, with moderate to severe OSA accounting for more than half of the patients. Age and duration of diabetes were independent predictive factors of the severity of OSA., (Copyright © 2020 Chen, Ma, Tang, Zha, Wang, Chen, Lei, Li, Tang and Ran.)