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Background: The present study aimed to investigate oral cancer awareness and its related knowledge among residents in Beijing. Methods: A questionnaire survey was conducted among Beijing residents concerning their knowledge of oral cancer, and its prevention and treatment. Results: A total of 3055 questionnaires were completed, 45.8% by males and 54.2% by females. The ages of the respondents ranged from 15 to 93 years; 12.4% were smokers, 1.1% chewed betel nuts, and 82.5% brushed their teeth at least twice a day. Lung cancer was heard of by the most respondents, followed by gastric cancer and liver cancer; oral cancer was the least heard of. More than 60% of respondents were unaware of the risk factors and early signs of oral cancer. Conclusions: This survey demonstrated a general lack of public awareness and knowledge about oral cancer. Specific measures should be taken to improve public awareness of oral cancer and its prevention and treatment. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) is now a global public threat. Given the pandemic of COVID-19, the economic impact of COVID-19 is essential to add value to the policy-making process. We retrospectively conducted a cost and affordability analysis to determine the medical costs of COVID-19 patients in China, and also assess the factors affecting their costs. Methods: This analysis was retrospectively conducted in Shandong Provincial Chest Hospital between 24 January and 16 March 2020. The total direct medical expenditures were analyzed by cost factors. We also assessed affordability by comparing the simulated out-of-pocket expenditure of COVID-19 cases relative to the per capita disposable income. Differences between groups were tested by student t test and Mann-Whitney test when appropriate. A multiple logistic regression model was built to determine the risk factors associated with high cost. Results: A total of 70 COVID-19 patients were included in the analysis. The overall mean cost was USD 6827 per treated episode. The highest mean cost was observed in drug acquisition, accounting for 45.1% of the overall cost. Total mean cost was significantly higher in patients with pre-existing diseases compared to those without pre-existing diseases. Pre-existing diseases and the advanced disease severity were strongly associated with higher cost. Around USD 0.49 billion were expected for clinical manage of COVID-19 in China. Among rural households, the proportions of health insurance coverage should be increased to 70% for severe cases, and 80% for critically ill cases to avoid catastrophic health expenditure. Conclusions: Our data demonstrate that clinical management of COVID-19 patients incurs a great financial burden to national health insurance. The cost for drug acquisition is the major contributor to the medical cost, whereas the risk factors for higher cost are pre-existing diseases and severity of COVID-19. Improvement of insurance coverage will need to address the barriers of rural patients to avoid the occurrence of catastrophic health expenditure. [ABSTRACT FROM AUTHOR]

Vegetation restoration has been widely implemented as an effective approach to the control of soil erosion. However, severe soil desiccation is likely to occur if vegetation types and local precipitation conditions are not accounted for. In this study, an abandoned farmland and three typical vegetation types, including a natural shrubland, a plantation of black locust, and a natural oak secondary forest, were investigated to determine the characteristics of soil moisture in different hydrological years. The responses of soil moisture to precipitation were analysed at different timescales. Higher soil water contents were observed either in wet years or for natural vegetation types. The temporal response of soil moisture to precipitation was largely dependent on the timescale. At monthly scale, shallow soil moisture (0–100 cm) varied consistently with precipitation, whereas on interannual scale, precipitation is positively related to soil moisture along the whole profiles. Black locust and oak lands consumed more soil moisture than the shrubland, and severe soil desiccation developed in deep soil layers in the black locust plantation. The shrubland showed steeper regression slopes than other types for both the changes in soil water storage over time (ΔSWSt) versus the growing season precipitation and the difference in soil water storage with the abandoned farmland (ΔSWSv) versus the growing season precipitation, suggesting its higher adaptability to precipitation changes in this region. The results indicate that the shrubland develops optimal water use strategies through coevolution with local conditions and should be given precedence in vegetation restoration initiatives in this region. [ABSTRACT FROM AUTHOR]

Abstract: Partitioning of total soil respiration (R T) into autotrophic (R A) and heterotrophic (R H) components was undertaken in two typical (natural and artificial) forests on the temperate, semiarid Loess Plateau of China, to determine and compare temperature sensitivities between the two components. The natural secondary forest was dominated by oak (Quercus liaotungensis) while the artificial forest was a plantation of black locust (Robinia pseudoacacia). Soil CO2 efflux and different abiotic and biotic factors were measured during dormant and growing seasons. Temperature sensitivities of soil respiration components were investigated using the Q 10 function at diurnal and seasonal scales. The temperature sensitivities of autotrophic (R A) and heterotrophic (R H) respiration varied with the time scales (daily, seasonal, or annual) of the investigation, and were affected by other biological and environmental factors. The largest contribution of R A to R T was 46% in the oak forest and 60% in the black locust plantation during the growing season. During the dormant season it was as low as 12% in the oak forest and 6% in the black locust plantation. The Q 10 of R A for the black locust plantation was higher than for the oak forest during the growing season, but was lower during the dormant season. The Q 10 of R A in both forests was higher than that of R H at both diurnal and seasonal scales. Multiple regression analyses suggested that photosynthesis is an important parameter in soil respiration studies and that a multiple-factor model may be more suitable during the annual periods. [Copyright &y& Elsevier]

PURPOSE: To describe the quality of life(QOL) in patients with oral cancer preoperatively, and to analyze the impact of sociodemo-graphic variables and clinical features on their QOL scores. METHODS: SF-36(Chinese version) and UW-QOL (version 4.0) were used to examine QOL of 97 consecutive patients with oral squamous cell carcinoma. These patients were divided into different groups according to sociodemographic variables(age, sex, education, comorbidity) and clinical features(tumor location, tumor stage or TNM stage). The differences between groups were analyzed by Mann-Whitney U test with SPSS12.0 software package. Independent-samples t test was used tor comparison between their scores of SF-36 and the normative QOL scores. RESULTS: ①Compared with the age- and sex-matched population-based sample, the older patients generally showed parallel QOL scores, while in patients <60 years , there was reduced QOL regarding the domains of RP, BP and RE; ②Tumor stage had the most powerful impact on QOL scores; ③The impact of sociodemographic variables (e.g. age, sex, comorbidity) on these QOL scores lied predominantly in parameters(e.g. VT, PF, RP and mood) reflecting the domains of physical complaints and psychological distress ; while the impact of clinical features (e.g. tumor location, tumor stage) on these QOL scores not only lied in specific problems related to oral cavity(e.g. chewing, swallowing, speech and taste), but also parameters reflecting the domains of physical complaints and psychological distress such as RP, BP and RE. CONCLUSION: A comparison with the normative QOL scores contributed to obtain more precise QOL information of patients with oral cancer. Clinical features appeared to have stronger impact on QOL than sociodemographic variables. Combination of general measures and head and neck-specific measures, for example, combination of SF-36 and UW-QOL, will evaluate QOL of oral cancer patients more comprehensively. [ABSTRACT FROM AUTHOR]

Forest soils are an important component of the global carbon cycle, as they sequester and store much more organic carbon than other terrestrial ecosystems. Thus, reliable information on the forest soil organic carbon (SOC), along with the factors that influence it, is crucial from the perspective of regional carbon budgets and climate modeling. Gansu Province in northwestern China is characterized by complex climatic gradients and diverse forest types, suggesting a large variability in the spatial distribution of SOC, yet the SOC stock in this region has not been comprehensively investigated because of insufficient soil profile data. Our study covered the entire forest area in the province via a regional-scale sampling campaign, and provided soil organic carbon density (SOCD) data obtained from 112 natural forests and 100 plantations. Influencing factors including forest type, forest stand age, soil type, litter carbon, climate, and topography were evaluated in both natural forests and plantations. The results indicated a SOC stock of 433.4 ± 13.2 Tg C and a SOCD value of 175.3 ± 33.0 Mg C ha−1 for the 0–100 cm layer at the regional scale. Specifically, the SOC stock and the forest area-weighted average SOCD in natural forests were estimated at 349.0 ± 16.5 Tg C and 207.3 ± 23.2 Mg C ha−1, which were about quadruple and double, respectively, of the values for the plantations. Regardless of natural forests and plantations, SOCD increased with both stand age class and elevation and decreased with mean annual temperature (MAT). SOCD also increased with mean annual precipitation (MAP) for natural forests with elevation <2500 m and for all plantations. The overall importance to SOCD of the explanatory variables increased with increasing soil depth in natural forests while decreased with increasing soil depth in plantations. Forest type, stand age, soil type, MAT, MAP, elevation, litter carbon, slope, and aspect explained 58 and 65% of the total variation in the SOCD at 100 cm depth in natural forests and plantations, respectively. In natural forests, the most important explanatory variable for the uppermost 30 cm was soil type, while it was MAT for the whole 100 cm; in plantations, the most prominent factors were forest type and elevation, regardless of the soil depth. These suggest that environmental changes will likely have different effects on SOCD in natural forests and plantations. • Forest soil organic carbon stock in a northwestern province in China was estimated. • Forest area-weighted SOCD in natural forests was double of the value for plantations. • Soil type was the top influencing factor on SOCD at 0–30 cm depth in natural forests. • MAT showed the greatest influence on SOCD at the whole 100 cm in natural forests. • Forest type and elevation are top influencing factors on SOCD at all depths for plantations. [ABSTRACT FROM AUTHOR]

Abstract: Forest ecosystems on the Loess Plateau are receiving increasing attention for their special importance in carbon fixation and conservation of soil and water in the region. Soil respiration was investigated in two typical forest stands of the forest–grassland transition zone in the region, an exotic black locust (Robinia pseudoacacia) plantation and an indigenous oak (Quercus liaotungensis) forest, in response to rain events (27.7mm in May 2009 and 19mm in May 2010) during the early summer dry season. In both ecosystems, precipitation significantly increased soil moisture, decreased soil temperature, and accelerated soil respiration. The peak values of soil respiration were 4.8 and 4.4μmolCO2 m−2 s−1 in the oak plot and the black locust plot, respectively. In the dry period after rainfall, the soil moisture and respiration rate gradually decreased and the soil temperature increased. Soil respiration rate in black locust stand was consistently less than that in oak stand, being consistent with the differences in C, N contents and fine root mass on the forest floor and in soil between the two stands. However, root respiration (R r) per unit fine root mass and microbial respiration (R m) per unit the amount of soil organic matter were higher in black locust stand than in oak stand. Respiration by root rhizosphere in black locust stand was the dominant component resulting in total respiration changes, whereas respiration by roots and soil microbes contributed equally in oak stand. Soil respiration in the black locust plantation showed higher sensitivity to precipitation than that in the oak forest. [Copyright &y& Elsevier]

Goji (Lycium barbarum L.) also known as wolfberry, is one of important medicinal plants in China that has been in use for its medicinal properties and as food supplement for centuries. The abundant bioactive compounds in its fruit, leaves, and root bark are considered beneficial to human health. Phenolic compounds were extracted from different locations of Goji leaves, including tip bud leaves (GBL), young leaves in the middle (GYL), and old leaves at the base (GOL). The phenolics from Goji leaves using ethanolic condensation backflow extraction (EE), ultrasonic extraction (UE), and enzymatic extraction (ME) were prepared, and their polyphenol concentration and antioxidant ability were analyzed. Polyphenol in Goji leaf varied with different positions and extraction techniques. Total 47 phenolic compounds were identified by HPLC-MS, including 43 in GBL, 38 in GYL, and 26 in GOL. Chlorogenic acid, hyperoside, and rutin were the main phenols in Goji leaves, and the highest content of chlorogenic acid in GBL-UE was 2105.05 ± 77.25 µg /g. All Goji leaves showed significant antioxidant effect and polyphenol content, especially GBL that having the highest phenolic level and the stronger antioxidant capacity. Different extraction methods for different leaf positions could improve the extraction efficiency, UE and ME were found suitable for extracting GBL and GOL samples; EE and UE were suitable for extracting GBL samples. GBL exhibited better phenolics and better antioxidant attributes, which are suitable for the development of nutraceuticals and skincare products. [Display omitted] • 47 phenolic compounds were identified from Goji, including 43 in GBL, 38 in GYL, and 26 in GOL. • Chlorogenic acid and rutin were the main phenolic substances in Goji leaves. • The highest phenolic content was found in GBL, followed by GYL and the least in GOL. • For polyphenol extraction, UE and ME were suitable for GBL and GOL; EE and UE were suitable for GBL. • Our study provides a theoretical basis for the industrial utilization of Goji leaves. [ABSTRACT FROM AUTHOR]

Abstract: In the semiarid Loess Plateau region of China, ecosystems are frequently affected by water shortages. Late spring and early summer are periods when forest communities tend to suffer from soil drought. To clarify the water-use strategies of the main species in this area, the xylem sap flow of trees from three species in the field was monitored for three successive periods in summer using Granier-type thermal dissipation probes. Vapor pressure deficit (VPD), solar radiation (R s) and soil moisture had varying influences on sap flux density (F d) in the species. Normalized F d values could be fitted to VPD using an exponential saturation function, but the fit was better with a derived variable of transpiration (VT), an integrated index calculated from VPD and R s. From differences in model coefficients, the species were roughly divided into two types with contrasting drought sensitivity. The exotic Robinia pseudoacacia was defined as drought-sensitive type. It showed higher sapflow increases in response to rainfall, suggesting a high water demand and high influence of soil water conditions on transpiration. This species showed relatively late stomatal response to increasing VPD. The wide-peak pattern of diurnal sapflow course also suggests relatively low stomatal regulation in this species. The drought-insensitive type consisted of the naturally dominant Quercus liaotungensis and an indigenous concomitant species, Armeniaca sibirica, in the forest. The sap flow of these species was not very sensitive to changes in soil water conditions. The results suggest that typical indigenous species can manage the water consumption conservatively under both drought and wet conditions. Variations in water use strategies within indigenous species are also detected. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the relationship between lifestyle habits and health-related quality of life (HRQoL) among different ages who were initially diagnosed with breast cancer (within the first 2 weeks) and to determine the contribution of lifestyle habits factors on HRQoL. Methods: Patients with breast cancer were recruited from 22 hospitals in 11 provinces or municipalities in northern and eastern China. The Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) was used to measure HRQoL. Chi-square test, ANOVA, and multivariable generalized linear models were conducted to identify the differences in HRQoL between two age groups (age <50 years and ≥50 years) and to evaluate the contribution of lifestyle habits factors on HRQoL of patients with breast cancer. Results: About 1,199 eligible patients with breast cancer were used for analysis. Younger women (aged <50 years) appeared to show lower scores than older women (aged ≥50 years) in HRQoL subscales, including emotional well-being ( p = 0.003), functional well-being ( p = 0.006), breast cancer subscale ( p = 0.038), and FACT-B Total scores ( p = 0.028). Tea and alcohol consumption and being very satisfied with sleep and current life were the strongest predictors of higher HRQoL in younger group. Meanwhile, no coffee consumption, frequent participation in physical activities, high sleep satisfaction, and current life satisfaction were the key predictors of higher HRQoL in older women with breast cancer. Conclusion: The relationship of the nine lifestyle habit items with HRQoL differed among younger and older women. The associated variable of low HRQoL can help clinicians take intervention early in order to improve the prognosis of patients with breast cancer., 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 Zheng, Yu, Jia, Cui, Tian, Fan, Geng, Cao, Yang, Wang, Liang, Wang, Jiang, Duan, Wang, Li, Wang, Zhang, Jin, Tang, Li, Zhu, Zuo, Wang, Zhou, Xiang, Guo, Wang, Huang, Liu and Yu.)

Background: Although de novo stage IV breast cancer is so far incurable, it has entered an era of individualized treatment and chronic disease management. Based on systemic treatment, whether the surgical resection of primary or metastatic foci of de novo stage IV breast cancer can bring survival benefits is currently controversial. We aimed to explore the clinicopathological factors and current status of the management of de novo stage IV breast cancer in China to provide a reference for clinical decisions., Methods: Based on the assistance of Chinese Society of Breast Surgery, a retrospective study was conducted to analyze the clinical data of patients with de novo stage IV breast cancer in 33 centers from January 2017 to December 2018. The relationship between basic characteristic (age, menstrual status, family history, reproductive history, pathological type, estrogen receptor [ER] status, progesterone receptor [PR] status, human epidermal growth factor receptor 2 [HER2] status, Ki-67 percentage, and molecular subtype), and metastasis sites (lung metastasis, liver metastasis, and bone metastasis) was examined by Pearson Chi-square tests., Results: A total of 468 patients with de novo stage IV breast cancer were enrolled. The median age of the enrolled patients was 51.5 years. The most common pathological type of primary lesion was invasive carcinoma (97.1%). Luminal A, luminal B, HER2 overexpressing, and triple-negative subtypes accounted for 14.3%, 51.8%, 22.1%, and 11.8% of all cases, respectively. Age, PR status, and HER2 status were correlated with lung metastasis (χ2 = 6.576, 4.117, and 8.643 and P = 0.037, 0.043, and 0.003, respectively). Pathological type, ER status, PR status, and molecular subtype were correlated with bone metastasis (χ2 = 5.117, 37.511, 5.224, and 11.603 and P = 0.024, <0.001, 0.022, and 0.009, respectively). Age, PR status, HER2 status, Ki-67 percentage, and molecular subtype were correlated with liver metastasis (χ2 = 11.153, 13.378, 10.692, 21.206, and 17.684 and P = 0.004, <0.001, 0.001, <0.001, and 0.001, respectively). Combined treatment with paclitaxel and anthracycline was the most common first-line chemotherapy regimen for patients with de novo stage IV breast cancer (51.7%). Overall, 91.5% of patients used paclitaxel-containing regimens. Moreover, 59.3% of hormone receptor-positive patients underwent endocrine therapy., Conclusions: In 2018, 1.07% of patients from all studied centers were diagnosed with de novo stage IV breast cancer. This study indicated that 95.1% of patients received systemic therapy and 54.2% of patients underwent surgical removal of the primary lesion in China., (Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Objective: To identify atypical hyperplasia (AH) of the breast by shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS), and to explore the molecular fingerprinting characteristics of breast AH., Methods: Breast hyperplasia was studied in 11 hospitals across China from January 2015 to December 2016. All patients completed questionnaires on women's health. The differences between patients with and without breast AH were compared. AH breast lesions were detected by Raman spectroscopy followed by the SHINERS technique., Results: There were no significant differences in clinical features and risk-related factors between patients with breast AH (n = 37) and the control group (n = 2576). Fifteen cases of breast AH lesions were detected by Raman spectroscopy. The main different Raman peaks in patients with AH appeared at 880, 1001, 1086, 1156, 1260, and 1610 cm -1 , attributed to the different vibrational modes of nucleic acids, β-carotene, and proteins. Shell-isolated nanoparticles had different enhancement effects on the nucleic acid, protein, and lipid components in AH., Conclusion: Raman spectroscopy can detect characteristic molecular changes in breast AH lesions, and may thus be useful for the non-invasive early diagnosis and for investigating the mechanism of tumorigenesis in patients with breast AH.

Purpose: Adenoid cystic carcinoma (ACC) involving the skull base is difficult to treat and sometimes unresectable. The purpose of this study was to evaluate the efficacy and safety of 125 I radioactive seed interstitial brachytherapy for treatment of these patients., Materials and Methods: Patients with ACC involving the skull base treated by definitive 125 I brachytherapy from March 2008 through December 2018 at the Peking University Hospital of Stomatology (Beijing, China) were retrospectively identified. Overall survival (OS), as the primary efficacy indicator, and progression-free survival (PFS) and distant metastasis-free survival (DFS), as the secondary efficacy indicators, were analyzed by Kaplan-Meier survival analysis and Cox regression analysis. Adverse radiotherapy (RT) reactions, as safety indicators, were recorded., Results: Thirty-two patients with (r)T4b locally advanced disease were enrolled. The prescription dose (PD) was 60 to 120 Gy. The dose delivered to 90% of the target volume was 99.1 to 145.2 Gy, the percentage of the target volume receiving at least 100% of the PD was at least 88.2%, and the percentage of the target volume receiving at least 150% of the PD was smaller than 74.0%. Mean follow-up was 32 months (median, 21 months; range, 3 to 95 months). The 1- and 3-year OS rates were 93.3 and 62.6%, the 1- and 3-year PFS rates were 90.0 and 46.4%, and the 1- and 3-year DFS rates were 91.7 and 61.1%, respectively. Survival was significantly associated with local recurrence (P = .04) and distant metastasis except in the lung (P = .05). The rate of severe chronic adverse RT reactions was 3.1%; no severe acute adverse RT reactions were observed., Conclusion: 125 I brachytherapy appears to be an effective and safe treatment in the short-term for ACC involving the skull base and could be the preferred treatment for patients with prior RT. Local control with brachytherapy could provide survival benefit even in patients with lung metastasis., (Copyright © 2019 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Patients with nervous system disorders with an accurate nursing assessment can experience an improved prognosis and promotion of health. The lack of uniform terminology limits the accuracy of nursing in China. ICF constitutes a unified and standard language can help standardize nursing assessment terms. This study show that ICF is suitable for Chinese nursing practice by using ICF Clinical Checklist and ICF-linking-rules to map the nursing assessment terminology of neurological conditions with ICF.

Carbon storage in the Loess Plateau is affected by land use. In order to assess the differences in soil organic carbon (SOC) and soil inorganic carbon (SIC) under different land use patterns in deep soil profiles, we investigated the distribution characteristics of SOC and SIC at 0-20.0 m soil depth at three locations in the northern Shaanxi province (i.e., an economical plantation in Mizhi, a reforestation area in Shenmu, and a wind break and sand fixation forest district in Yuyang). The results showed that the order for SOC content was:pruning jujube tree (2.00 g·kg -1 ) > jujube tree (1.54 g·kg -1 ) > Caragana (0.97 g·kg -1 ) > degraded artificial grassland (0.81 g·kg -1 ) > pine forests (0.70 g·kg -1 ) > natural grass field (0.45 g·kg -1 ), which indicated significant differences between SOC content and land use types ( P <0.05). Similarly, the order of SIC content was:pruning jujube tree (11.66 g·kg -1 ) > jujube tree (11.59 g·kg -1 ) > Caragana (9.62 g·kg -1 ) > degraded artificial grassland (8.07 g·kg -1 ) > pine forests (4.32 g·kg -1 ) > natural grass field (0.47 g·kg -1 ). There were no significant differences between SIC content and soil profiles under the economical plantation of Mizhi and the reforestation area of Shenmu. There were significant differences for SIC content between an artificial economic forest, an area returning farmland to a forest (grass) profile, and a windbreak and sand fixation forest ( P <0.05). The SIC densities for pruning jujube tree, jujube tree, Caragana, degraded artificial grassland, pine forest, and natural grass field were 6.19, 7.71, 10.70, 10.78, 5.91, and 1.03 times that of its corresponding SOC density, respectively. It has been concluded that the soil carbon storage was significantly different for different land use patterns, and the SIC content was much higher than the SOC content in the soil profile.

Purpose: Familial exudative vitreoretinopathy (FEVR) is a genetically and clinically heterogeneous disease, characterized by failure of vascular development of the peripheral retina. The symptoms of FEVR vary widely among patients in the same family, and even between the two eyes of a given patient. This study was designed to identify the genetic defect in a patient cohort of ten Chinese families with a definitive diagnosis of FEVR., Methods: To identify the causative gene, next-generation sequencing (NGS)-based target capture sequencing was performed. Segregation analysis of the candidate variant was performed in additional family members by using Sanger sequencing and quantitative real-time PCR (QPCR)., Results: Of the cohort of ten FEVR families, six pathogenic variants were identified, including four novel and two known heterozygous mutations. Of the variants identified, four were missense variants, and two were novel heterozygous deletion mutations [ LRP5 , c.4053 DelC (p.Ile1351IlefsX88); TSPAN12 , EX8Del]. The two novel heterozygous deletion mutations were not observed in the control subjects and could give rise to a relatively severe FEVR phenotype, which could be explained by the protein function prediction., Conclusions: We identified two novel heterozygous deletion mutations [ LRP5 , c.4053 DelC (p.Ile1351IlefsX88); TSPAN12 , EX8Del] using targeted NGS as a causative mutation for FEVR. These genetic deletion variations exhibit a severe form of FEVR, with tractional retinal detachments compared with other known point mutations. The data further enrich the mutation spectrum of FEVR and enhance our understanding of genotype-phenotype correlations to provide useful information for disease diagnosis, prognosis, and effective genetic counseling.

Objective: To assess the diagnostic value of the T-SPOT.TB test in cases of breast turberculosis (BTB) in China., Methods: We enrolled 13 female patients with primary BTB as the BTB test group and 10 healthy volunteers as the control group. The 2 groups underwent T-SPOT.TB tests and tuberculin skin tests (TSTs) before receiving a core-needle biopsy or excision biopsy. We then collected and analyzed T-SPOT.TB and TST data., Results: The sensitivity of the T-SPOT.TB test for detection of BTB (84.6%) was significantly greater than that of TST (53.8%) (P <.05); the specificity of each test (80.0% and 60.0%, respectively) for BTB was not significantly different (P >.05)., Conclusion: The T-SPOT.TB test could be a useful adjunct to current tests for diagnosis of BTB and could be used for early diagnosis of this condition., (Copyright© by the American Society for Clinical Pathology (ASCP).)

Objective: To understand the infection status of Fasciola and related risk factors in population of Binchuan County, Yunnan Province., Methods: In February and March, 2014, 6 natural villages from 2 administrative villages in Zhoucheng Town were selected as investigated sites, and the permanent residents aged ≥ 5 years were examined by ELISA for the serum antibody detection, and then the positive ones were examined by Kato-Katz technique and the hatching method for Fasciola egg detection. Meanwhile, the fascioliasis cases that checked out by the above methods were further surveyed, and the residents who with the same gender, similar age and negative results in the blood examination were selected as the controls, then the risk factors were explored through a case control study., Results: Totally 1 207 people were included in the blood examination, and 36 positives were found with a positive rate of 2.98%. Though the differences between the positive rates of the serum antibody in people with different genders and age were not statistically significant (χ2 = 1.686, 7.106, both P > 0.05) , those between the rates of people in different administrative villages and natural villages were statistically significant (χ2 = 4.103, 13.181, both P < 0.05). Two cases were determined as positives in fecal examinations with a positive rate of 6.45% (2/31), among which, 1 case was newly discovered. The case control study showed that OR values of eating out- purchased cold dish (4.30), raw mint (1.22) , raw leek (4.30) and drinking unboiled-water (3.75) were relatively higher, but all of them were not statistically significant (χ2 = 0.524, 0.046, 0.524, 1.571, all P > 0.05)., Conclusions: There is still sporadic Fasciola infection in Binchuan County. Eating raw vegetables and drinking unboiled water which are contaminated by Fasciola metacercariae may be the infection routes of local people, and to find out the exact entrance way is the key points for the infection control.

The level of total adiponectin, a mixture of different adiponectin forms, has been reported associated with breast cancer risk with inconsistent results. Whether the different forms play different roles in breast cancer risk prediction is unclear. To examine this, we measured total and high molecular weight (HMW) adiponectin in a case-control study (1167 sets). Higher circulating HMW adiponectin was negatively associated with breast cancer risk after adjusting for menopausal status and family history of breast cancer (P=0.024). We analyzed the relationship between adiponectin and breast cancer risk in 6 subgroups. Higher circulating HMW adiponectin was also negatively associated with breast cancer risk (P=0.020, 0.014, 0.035) in the subgroups of postmenopausal women, negative family history of breast cancer, BMI>=24.0. Total adiponectin was positively associated with breast cancer (P=0.028) in the subgroup of BMI<=24.0. Higher HMW/total adiponectin ratio was negatively associated with breast cancer (P=0.019) in the subgroup of postmenopausal women. Interestingly, in the subgroup of women with family history of breast cancer, higher circulating total and HMW adiponectin were positively associated with breast cancer risk (P=0.034, 0.0116). This study showed different forms of circulating adiponectin levels might play different roles in breast cancer risk. A higher circulating HMW adiponectin is associated with a decreased breast cancer risk, especially in postmenopausal, without family history of breast cancer or BMI>=24.0 subgroups, whereas higher circulating HMW adiponectin levels is a risk factor in women with a family history of breast cancer. Further investigation of different forms of adiponectin on breast cancer risk is needed.

Objective: In esophageal cancer, depth of wall penetration, reflected by T classification, represents the most important prognostic variable. Our study aimed to investigate the impact of tumor length, measured as the longitudinal length, on the outcome of esophageal squamous cell carcinoma (ESCC) patients., Methods: The survival data of 362 ESCC patients who underwent surgical resection as the primary treatment between 1999 and 2007 were collected retrospectively. Receiver-operator characteristic analysis was applied to identify the optimal cut-off values., Results: 4.0 cm was identified as the optimal cut-off value within the whole group. Tumor length greater than 4.0 cm was associated with increasing T stage (P=0.001), N stage (P=0.046), and tumor differentiation (P=0.033). Univariate analysis and multivariate analysis both found that tumor length greater than 4.0 cm was associated with worse overall survival compared with shorter tumors (P<0.001). It appeared to have a greater impact on N0-N1 (P<0.001, P=0.026, respectively) than N2-N3 and appeared to have a higher impact on the lower-stage patients than the higher-stage patients., Conclusions: Tumor length proved to be an independent prognostic parameter for ESCC patients, especially for node-negative and lower-stage patients. More attention should be paid to its role in the management of ESCC.

Objective: To evaluate the effectiveness of deep brain stimulation (DBS) of the globus pallidus internus (GPi) on tic severity and common comorbidities in patients with severe Tourette syndrome that is refractory to pharmacological treatment and psychotherapy., Patients and Methods: We retrospectively assessed the long-term clinical outcomes of 13 patients with treatment-refractory Tourette syndrome who underwent DBS targeting the GPi at the Beijing Tiantan Hospital from January 1, 2006, through May 31, 2013. The primary outcome was a change in tic severity as measured by the Yale Global Tic Severity Scale, and the secondary outcome was a change in associated behavioral disorders and mood as measured by the Gilles de la Tourette Syndrome-Quality of Life Scale assessment., Results: Compared with baseline, the mean reduction in the total Yale Global Tic Severity Scale scores at last follow-up (mean, 41.9 months; range, 13-80 months) was 52.1% (range, 4.3%-83.6%), and the mean improvement rates at 1 month, 6 months, 12 months, 18 months, 24 months, 30 months, and 36 or more months were 11.8%, 20.0%, 26.8%, 36.7%, 44.7%, 49.0%, and 56.7%, respectively. A paired-sample t test revealed significant improvement of tic symptoms after 6 months of DBS programming (P<.05). The Gilles de la Tourette Syndrome-Quality of Life Scale score improved by a mean of 45.7% (range, 11.0%-77.2%)., Conclusion: This study is currently the largest reported GPi DBS case series of patients with treatment-refractory TS with the longest follow-up. Our results support the potential beneficial effect of GPi DBS on disabling tic reduction and improvement of quality of life., (Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)

Background: Inherited genetic defects play an important role in congenital hearing loss, contributing to about 60% of deafness occurring in infants. Hereditary nonsyndromic hearing loss is highly heterogeneous, and most patients with a presumed genetic etiology lack a specific molecular diagnosis., Methods: By whole exome sequencing, we identified responsible gene of family 4794 with autosomal recessively nonsyndromic hearing loss (ARNSHL). We also used DNA from 56 Chinese familial patients with ARNSHL (autosomal recessive nonsyndromic hearing loss) and 108 ethnicity-matched negative samples to perform extended variants analysis., Results: We identified MYO15A c.IVS25+3G>A and c.8375 T>C (p.V2792A) as the disease-causing mutations. Both mutations co-segregated with hearing loss in family 4794, but were absent in the 56 index patients and 108 ethnicity-matched controls., Conclusions: Our results demonstrated that the hearing loss of family 4794 was caused by novel compound heterozygous mutations in MYO15A.

The objective of this study was to introduce application of the Richards equation on modelling and prediction of stand diameter distribution. The long-term repeated measurement data sets, consisted of 309 diameter frequency distributions from Chinese fir (Cunninghamia lanceolata) plantations in the southern China, were used. Also, 150 stands were used as fitting data, the other 159 stands were used for testing. Nonlinear regression method (NRM) or maximum likelihood estimates method (MLEM) were applied to estimate the parameters of models, and the parameter prediction method (PPM) and parameter recovery method (PRM) were used to predict the diameter distributions of unknown stands. Four main conclusions were obtained: (1) R distribution presented a more accurate simulation than three-parametric Weibull function; (2) the parameters p, q and r of R distribution proved to be its scale, location and shape parameters, and have a deep relationship with stand characteristics, which means the parameters of R distribution have good theoretical interpretation; (3) the ordinate of inflection point of R distribution has significant relativity with its skewness and kurtosis, and the fitted main distribution range for the cumulative diameter distribution of Chinese fir plantations was 0.4∼0.6; (4) the goodness-of-fit test showed diameter distributions of unknown stands can be well estimated by applying R distribution based on PRM or the combination of PPM and PRM under the condition that only quadratic mean DBH or plus stand age are known, and the non-rejection rates were near 80%, which are higher than the 72.33% non-rejection rate of three-parametric Weibull function based on the combination of PPM and PRM.

Background: Punctate palmoplantar keratoderma (PPPK) is a rare autosomal dominant skin disorder characterised by numerous hyperkeratotic papules irregularly distributed on the palms and soles. To date, no causal gene for this disease has been identified., Methods: We performed exome sequencing analysis of four affected individuals and two unaffected controls from one Chinese PPPK family where disease locus was mapped at 8q24.13-8q24.21 by our previous linkage analysis., Results: We identified a novel heterozygous mutation in COL14A1 gene (c.4505C→T (p.Pro1502Leu)), which located within the linkage region that we previously identified for PPPK. The mutation was shared by the four affected individuals, but not for the two controls of the family. Sanger sequencing confirmed this mutation in another four cases from this family. This mutation was invisible in the normal controls of this family as well as the additional 676 unrelated normal controls and 781 patients with other disease. The shared COL14A1 mutation, p.Pro1502Leu, is a missense substitution at a highly conserved amino acid residue across multiple species., Conclusions: The power of combining exome sequencing and linkage information in the study of genetics of autosomal dominant disorders, even in simplex cases, has been demonstrated. Our results suggested that COL14A1 would be a casual gene for PPPK, which was helpful for advancing us on understanding of the pathogenesis of PPPK.

Background: Leishmaniasis is a vector-borne disease, which is still endemic in the west and northwest area of China. Canines are the major reservoirs of Leishmania, the etiological agent of human visceral leishmaniasis. Phlebotomus chinensis is the main transmission vector of zoonotic visceral leishmaniasis (ZVL)., Methods: In this study, rK39 dip-stick, ELISA and PCR methods were used to investigate the prevalence of canine leishmaniasis (CanL) in Beichuan County, Sichuan Province, China., Results: Among the 86 dogs which were included in the study, 13 dogs were positive using the dip-stick test (15.12%), while 8 dogs were positive using ELISA (9.30%) and 19 dogs were positive for PCR (22.03%). In total, 32 dogs were positive for one or more tests (37.21%). Interestingly, phylogenetic analysis based on the partial 7SL RNA fragment provided evidence that an undescribed Leishmania species, which is clearly a causative agent of CanL and human visceral leishmaniasis, does exist in China. This result is consistent with our previous study., Conclusions: Our work confirmed that canine leishmaniasis is still prevalent in Beichuan County. Further control is urgently needed, as canine leishmaniasis is of great public health importance. The phylogenetic analysis based on 7SL RNA segment provides evidence for the existence of an undescribed Leishmania sp. in China.

Leishmaniasis is a geographically widespread disease, caused by protozoan flagellates of the genus Leishmania. This disease still remains endemic in China, especially in the west and northwest frontier regions. To date, the phylogenetic relationships among Chinese Leishmania isolates are still unclear, and the possible taxonomic diversity remains to be established. In this study, the ITS1-5.8S fragments of ten isolates collected from different foci in China were determined. To infer the phylogenetic relationships among them, seven sequences of Chinese Leishmania isolates retrieved from GenBank were also included. Both parsimony and Bayesian analyses reveal an unexpected but strongly supported clade comprising eight newly determined isolates, which is sister to other members of subgenus Leishmania. In combination with genetic distance analysis, this provides evidence of the occurrence of an undescribed species of Leishmania. Our results also suggest that (1) the isolate IPHL/CN/77/XJ771 from Bachu County, Xinjiang Uygur Autonomous Region is not Leishmania infantum but Leishmania donovani; (2) the status referring to an isolate MRHO/CN/88/KXG-2 from a great gerbil in Karamay as Leishmania turanica, formerly based on multilocus enzyme electrophoresis, is recognized; (3) an earlier finding demonstrating the L. donovani identity of isolate MHOM/CN/80/801 from Kashi city is corroborated; (4) the three isolates from eastern Jiashi County, Xinjiang Uygur Autonomous Region, causing desert type of zoonotic visceral leishmaniasis (see Wang et al., Parasitol Int (in press), 2010), belong to L. donovani instead of L. infantum. In addition, the results of this study make an important contribution to understanding the heterogeneity and relationships of Chinese Leishmania isolates, further indicating that the isolates from China may have had a more complex evolutionary history than expected.

Objective: To provide basic information for epidemiological research of gastrointestinal (GI) malignant tumors., Methods: Data of GI cancer diagnosed in 15 hospitals of Heilongjiang province between January 1998 and December 2007 were analyzed retrospectively. The data mainly involved the age of onset, initial symptoms, pathological types, clinical staging and types of surgical procedure., Results: Gastric cancer was the most common type (45.8%) among the 33,540 GI cancer cases, then were rectal cancer (27.3%) and colon cancer (26.8%). Right colon cancer cases were more common than the left ones (1.3:1.0), particularly in people over 80 (2.1:1.0). Only 1.3% of colorectal cancer could be found in age under 30 years old. In patients aged 50 to 70, advanced gastric cancer accounted for 70.6%, advanced colon cancer 73.4% and advanced rectal cancer 72.4%. Well-moderately differentiated adenocarcinoma in early gastric cancer was 49.7%, early colon cancer 77.3% and rectal cancer 83.2%. Patients undergone radical excision in early gastric cancer accounted for 69.1%, advanced gastric cancer 79.9%, left colon cancer 91.9%, right colon cancer 83.9% and in rectal cancer for 88.3%., Conclusions: People aged 50 to 70 tend to get GI cancer in Heilongjiang province. Gastric cancer is the most common GI cancer. Radical excision is the main choice of therapy.

Although the incidence of stomach cancer has been declining, it remains the second leading cause of cancer death worldwide. Potential protective effects of allium vegetables against cancer have been reported by a few epidemiologic studies in Chinese populations, but the sample sizes of these studies were relatively small. We examined the associations between allium vegetable consumption and stomach cancer in a large population-based case-control study in Shanghai (750 cases and 750 age- and gender-matched controls) and Qingdao (201 cases and 201 age- and gender-matched controls). Epidemiological data were collected by a standard questionnaire, and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression in SAS. After adjusting for matching variables, education, body mass index, pack-years of smoking, alcohol drinking, salt intake, and fruit and vegetable intake, inverse relationships with dose response pattern were observed between frequency of onion intake and stomach cancer in Qingdao (P for trend=0.02) and Shanghai (P for trend=0.04) populations. In Shanghai, negative dose-response relationships were observed between monthly intake of onions (P=0.03) or garlic stalks (P=0.04) and distal, but not cardia cancer. A negative association was also noted between intake of garlic stalks (often vs. never) and risk of stomach cancer in Qingdao (OR=0.30; 95% CI: 0.12-0.77). Our results confirm protective effects of allium vegetables (especially garlic and onions) against stomach cancer.

Objective: To explore the influence of early completely reversal vascular rejection on late rejection., Methods: The data of 1062 patients who received their first cadaveric transplants between May 1988 and March 2003 were analyzed respectively. The patients were divided into 2 groups: group with vascular rejection occurring within 1 month postoperatively (n = 45), and group without vascular rejection (n = 1017). Follow up was performed for at least 6 months. The influence of demographic characteristics (transplant age, sex), transplant variables (complement dependent cytotoxicity test, cold/warm ischemia time), and post-transplant variables (immunosuppressive agents for the prevention of acute rejection,) were analyzed., Results: There were no differences in the age at transplantation, sex, complement dependent cytotoxicity test, cold/warm ischemia time, immunosuppression agent protocol, and serum creatinine during follow-up between the recipients of these two groups. Late rejection, including acute interstitial rejection, borderline rejection, and chronic rejection, occurring one month after transplantation was 2.22% (1/45) in the vascular rejection group, significantly lower than that of the no vascular rejection group (12.59%, 128/1017, P = 0.034), Conclusion: Early completely reversal vascular rejection can reduce the rate of late rejection.

The aim of this report is to investigate the relationship between Type A behavior patterns and the likelihood of falling among community-dwelling elderly, and to compare differences in the prevalence, reasons, locations, injuries and frequency of falls between Type A and non-Type A personalities. Persons aged 60 or older living in 3 communities of Nanjing, China participated in a baseline survey conducted in 2000 (n=879), and falling incidents were followed for 1 year. The survey employed a self-administered questionnaire designed to elicit demographic data, current health problems and medications taken, intake of alcohol, exercise habits, physical function, environmental hazards and Type A behavior patterns. Several factors associated with falling such as health condition, physical function and environmental factors did not differ between the Type A and non-Type A groups except in the male tendency toward heart disease and their inability to walk fast. The results of logistic regression analyses showed that a Type A behavior pattern was independently associated with falling in males but not in females. Findings in the present study suggest that a Type A behavior pattern might play an important role in the rate of falling incidents in elderly males, since some characteristics of this personality pattern might lead to risk-taking behavior. More studies are needed to evaluate the association of certain behavior patterns with falling incidents.