Search

Onychomycosis, a fungal nail infection, is primarily caused by dermatophytes, yeasts, and non-dermatophyte moulds (NDMs). The incidence of this disease and the predominance of specific pathogens vary across different regions and evolve. This study aimed to elucidate the epidemiology of onychomycosis and the pattern of causative pathogens in Beijing, and to ascertain the in vitro antifungal susceptibility profiles of Trichophyton rubrum against itraconazole (ITR), terbinafine (TER), and fluconazole (FLU). Involving 245 patients of onychomycosis with positive fungal culture results, the study implemented internal transcribed spacer (ITS) sequencing of ribosomal DNA (rDNA) on all collected samples. The mean age of the participants was 37.93 ± 13.73 years, with a male-to-female ratio of 1.53:1. The prevalence of toenail infections was significantly higher than that of fingernails. Distal and lateral subungual onychomycosis (DLSO) were the most frequent clinical classifications. PCR results indicated that dermatophytes were the most prevalent pathogens, followed by yeasts and NDMs, among which T. rubrum was the most dominant dermatophyte. TER demonstrated high sensitivity to T. rubrum. However, in clinical settings, some patients with onychomycosis exhibit a poor response to TER treatment. The relationship between in vitro antifungal sensitivity and clinical effectiveness is complex, and understanding the link between in vitro MIC values and clinical efficacy requires further investigation.

Purpose of Review: Chronic abdominal wall pain is a poorly recognized cause of chronic abdominal pain, and patients frequently go misdiagnosed despite a battery of medical tests. The Carnett's test is a diagnostic tool used to distinguish between abdominal wall pain and visceral pain. This review synthesizes the current literature on the Carnett's test, merges the viewpoints of diverse writers, and evaluates and reports on the Carnett's test's applicability., Recent Findings: Several clinical investigations have established the usefulness of the Carnett's test in the diagnosis of chronic abdominal wall pain. Furthermore, the Carnett's test is quite useful in determining the depth of the mass and detecting psychogenic abdominal pain. However, its diagnostic use for acute abdominal pain is limited. The Carnett's test is a simple and safe point-of-care diagnostic technique, with several studies supporting its usefulness. Early detection of abdominal wall pain is critical for chronic abdominal wall pain therapy. Carnett's test is very useful in patients with chronic, unexplained local abdominal discomfort who are compliant and do not have a clear rationale for surgery., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Renal fibrosis (RF) is the end stage of several chronic kidney diseases. Its series of changes include excessive accumulation of extracellular matrix, epithelial-mesenchymal transition (EMT) of renal tubular cells, fibroblast activation, immune cell infiltration, and renal cell apoptosis. RF can eventually lead to renal dysfunction or even renal failure. A large body of evidence suggests that natural products in traditional Chinese medicine (TCM) have great potential for treating RF. In this article, we first describe the recent advances in RF treatment by several natural products and clarify their mechanisms of action. They can ameliorate the RF disease phenotype, which includes apoptosis, endoplasmic reticulum stress, and EMT, by affecting relevant signaling pathways and molecular targets, thereby delaying or reversing fibrosis. We also present the roles of nanodrug delivery systems, which have been explored to address the drawback of low oral bioavailability of natural products. This may provide new ideas for using natural products for RF treatment. Finally, we provide new insights into the clinical prospects of herbal natural products., Competing Interests: Declaration of Competing Interest The author declares no conflict of interest with this work., (Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

ANP32B, a member of the acidic leucine-rich nuclear phosphoprotein 32 family member B, is aberrantly expressed in various cancers, including colorectal cancer. However, the function and mechanism of action of ANP32B in colorectal cancer remain unclear. The present study therefore analyzed the expression of ANP32B and its activity in colorectal cancer patient samples and colorectal cancer cell lines. ANP32B expression was found to be significantly upregulated in colorectal cancer patient samples and cell lines. Upregulation of ANP32B enhanced colorectal cancer cell proliferation and migration, whereas downregulation of ANP32B suppressed colorectal cancer cell proliferation. RNA sequencing analysis of differentially expressed genes in ANP32B silenced colorectal cancer cells showed that histone PARylation factor 1 (HPF1), which protects against DNA damage by interacting with the anti-tumor target PARP1, was significantly downregulated. Luciferase promoter assays testing the regulatory association between ANP32B and HPF1 showed that ANP32B interacted with the HPF1 promoter. Analysis of colorectal cancer samples from The Cancer Genome Atlas showed that ANP32B and HPF1 expression were positively correlated, and recovery assays showed that ANP32B promoted colorectal cancer progression by up-regulating HPF1. Overexpression of ANP32B also reduced the sensitivity of colorectal cancer cells to PARP1 inhibitor, consistent with the oncogenic role of ANP32B. ANP32B may alter the sensitivity of colorectal cancer cells to PARP1 inhibitor via a mechanism associated with the HPF1 gene. In summary, these findings showed that ANP32B acted as a tumor promoter, potentiating both colorectal cancer malignancy and drug resistance. Targeting the ANP32B/HPF1 axis may have benefit for patients with colorectal cancer., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background: Sex and reproductive status differences exist in both non-alcoholic fatty liver disease (NAFLD) and body composition. Our purpose was to investigate the relationship between body composition and the severity of liver steatosis and fibrosis in NAFLD in different sex and reproductive status populations., Methods: This cross-sectional study included 880 patients (355 men, 417 pre-menopausal women, 108 post-menopausal women). Liver steatosis and fibrosis and body composition data were measured using FibroScan and a bioelectrical impedance body composition analyzer (BIA), respectively, and the following parameters were obtained: liver stiffness measurement (LSM), controlled attenuation parameter (CAP), waist circumference (WC), body mass index (BMI), percent body fat (PBF), visceral fat area (VFA), appendicular skeletal muscle mass (ASM), appendicular skeletal muscle mass index (ASMI), fat mass (FM), fat free mass (FFM), and FFM to FM ratio (FFM/FM). Multiple ordinal logistic regression (MOLR) was used to analyze the independent correlation between body composition indicators and liver steatosis grade and fibrosis stage in different sex and menopausal status populations., Results: Men had higher WC, ASM, ASMI, FFM, and FFM/FM than pre- or post-menopausal women, while pre-menopausal women had higher PBF, VFA, and FM than the other two groups (p < 0.001). Besides, men had greater CAP and LSM values (p < 0.001). For MOLR, after adjusting for confounding factors, WC (OR, 1.07; 95% CI, 1.02-1.12; P = 0.011) and FFM/FM (OR, 0.52; 95% CI, 0.31-0.89; P = 0.017) in men and visceral obesity (OR, 4.16; 95% CI, 1.09-15.90; P = 0.037) in post-menopausal women were independently associated with liver steatosis grade. WC and visceral obesity were independently associated with liver fibrosis stage in men (OR, 1.05; 95% CI, 1.01-1.09, P = 0.013; OR, 3.92; 95% CI, 1.97-7.81; P < 0.001, respectively)., Conclusions: Increased WC and low FFM/FM in men and visceral obesity in post-menopausal women were independent correlates of more severe liver steatosis. In addition, increased WC and visceral obesity were independent correlates of worse liver fibrosis in men. These data support the sex- and reproductive status-specific management of NAFLD., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: The thoracic wall lesions, particularly chest wall tuberculosis, and chest wall tumors and other pyogenic wall and actinomycetes infections, almost always present as a diagnostic challenge., Aim: To explore the value of ultrasound-guided biopsy combined with the Xpert Mycobacterium tuberculosis /resistance to rifampin (MTB/RIF) assay to diagnose chest wall tuberculosis., Methods: We performed a retrospective study of patients with chest wall lesions from March 2018 to March 2021. All patients received the ultrasound-guided biopsy for pathology examination, acid-fast Bacillus staining, mycobacterial culture, and Xpert MTB/RIF analysis. The sensitivity, specificity, and area under the curve (AUC) were calculated for these diagnostic tests, either individually or combined. Rifampicin resistance results were compared between the mycobacterial culture and the Xpert MTB/RIF assay., Results: In 31 patients with the chest wall lesion biopsy, 22 patients were diagnosed with chest wall tuberculosis. Of them, 3, 6, and 21 patients tested positive for mycobacterial culture, acid-fast stain, and Xpert MTB/RIF assay, respectively. The rifampicin resistance results of the 3 culture-positive patients were consistent with their Xpert MTB/RIF assay results. When considering the sensitivity, specificity, and AUC value, the Xpert MTB/RIF assay (95.5%, 88.9%, and 0.92, respectively) was a better choice than the acid-fast Bacillus stain (27.3%, 100.0%, and 0.64, respectively) and mycobacterial culture (13.6%, 100.0%, 0.57, respectively). No complications were reported during the procedure., Conclusion: Ultrasound guided biopsy combined with Xpert MTB/RIF has high value in the diagnosis of chest wall tuberculosis, and can also detect rifampicin resistance., Competing Interests: Conflict-of-interest statement: The authors declare that they have no competing interest., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

CuFeO 2 -modified biochars were prepared through co-precipitation and hydrothermal methods, and the composites had high efficiency removal for tetracycline (TC) from water. The CuFeO 2 -modified biochar with a 2:1 mass ratio of CuFeO 2 to BC450 (CuFeO 2 /BC450=2:1) demonstrated the best adsorption performance. The kinetic process of TC adsorption by CuFeO 2 /BC450=2:1 was well fitted with the intraparticle diffusion model, suggesting that the adsorption process was controlled by film and pore diffusion. Under the condition of neutral pH and 298 K, the maximum adsorption capacity of the Langmuir model of CuFeO 2 /BC450=2:1 was 82.8 mg·g -1 , which was much greater than that of BC450 (13.7 mg·g -1 ) and CuFeO 2 (14.8 mg·g -1 ). The thermodynamic data suggested that TC sorption onto CuFeO 2 /BC450=2:1 was a spontaneous and endothermic process. The removal of TC by CuFeO 2 /BC450=2:1 increased first and then decreased with increasing pH, and the maximum adsorption occurred under the neutral condition. The strong adsorption of TC by CuFeO 2 /BC450=2:1 could be attributed to better porosity, larger specific surface area, and more active sites (e.g., functional groups and charged surfaces). This work provided an efficient magnetic adsorbent for removing antibiotics.

Simplicillium species are widely distributed with a broad spectrum of hosts and substrates. Generally, these species are entomopathogenic or mycoparasitic. Notably, some isolates of Simplicillium lanosoniveum and Simplicillium obclavatum were obtained from human tissues. In this study, two fungi were isolated from the annular itchy patch of infected skin of a 46-year-old man with diabetes mellitus. Based on a combination of morphological characteristics and phylogenetic analysis, a novel species, Simplicillium sinense , was introduced herein. It morphologically differs from the remaining Simplicillium in the size of phialides and conidia. Additionally, it grows slowly on YPD at 37°C. Antimicrobial susceptibility testing presented that this fungus is resistant to most azole antifungals. Therefore, the diagnosis of tinea faciei was made, and after 2 weeks of being treated with oral terbinafine (250 mg, once a day) and topical terbinafine cream for 1 month, the rash was mainly resolved and no recurrence happened after 6 months of follow-up. Herein, Simplicillium sinense was introduced as a new fungal taxon. Meanwhile, a case of superficial infection caused by S. sinense was reported. So far, it is the third Simplicillium species obtained from human tissue. Meanwhile, terbinafine is recommended as the first-line antifungal treatment against Simplicillium infection., 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 © 2023 Yan, Ni, Gu, Liu, Sun and Yuan.)

Purpose: To investigate the mechanism of curcumin targeting miR-155-5p/TP53INP1 axis to induce oxidative stress to regulate salivary gland tumor cell proliferation and apoptosis., Methods: A253 cells were cultured by adding curcumin and transfected with miR-155-5p mimic and/or pcDNA3.1-TP53INP1. Cell proliferation was detected by CCK-8 assay cell apoptosis was detected by flow cytometry, cell migration ability was detected by scratch test. The targeting relationship between miR-155-5p and TP53INP1 was verified by dual luciferase reporter assay. miR-155-5p, TP53INP1 mRNA expression was detected by qRT-PCR. Western blot was performed to detect expression of TP53INP1, Caspase8, Caspase3, Bcl-2, Bax protein; and ELISA was used to determine SOD, Gpx, and MDA content. Statistical analysis was performed using SPSS 22.0 software package., Results: Dual luciferase reporter assay confirmed that TP53INP1 was a downstream target regulatory molecule of miR-155-5p. Compared with DMSO group, cell apoptosis, Caspase8, Caspase3, Bax protein expression and TP53INP1 expression were significantly increased in curcumin group, while Bcl-2 protein expression, miR-155-5p mRNA and number of cell migration were significantly decreased(P<0.05). Compared with curcumin + miR-155-5p mimic group, cell apoptosis, Caspase8, Caspase3, Bax protein expression was significantly increased in curcumin + pcDNA3.1-TP53INP1 group and curcumin + miR-155-5p mimic + pcDNA3.1-TP53INP1 group; Bcl-2 protein expression was significantly increased(P<0.05), SOD, GSH-PX activities and number of cell migration were significantly decreased and MDA content was significantly increased in curcumin+pcDNA3.1-TP53INP1 group (P<0.05)., Conclusions: Curcumin inhibited A253 cell proliferation and promoted A253 cell apoptosis. The mechanism may be related to targeting miR-155-5p/TP53INP1 axis to induce oxidative stress regulation.

COVID-19 is an immune-mediated inflammatory disease caused by SARS-CoV-2 infection, the combination of anti-inflammatory and antiviral therapy is predicted to provide clinical benefits. We recently demonstrated that mast cells (MCs) are an essential mediator of SARS-CoV-2-initiated hyperinflammation. We also showed that spike protein-induced MC degranulation initiates alveolar epithelial inflammation for barrier disruption and suggested an off-label use of antihistamines as MC stabilizers to block degranulation and consequently suppress inflammation and prevent lung injury. In this study, we emphasized the essential role of MCs in SARS-CoV-2-induced lung lesions in vivo , and demonstrated the benefits of co-administration of antihistamines and antiviral drug remdesivir in SARS-CoV-2-infected mice. Specifically, SARS-CoV-2 spike protein-induced MC degranulation resulted in alveolar-capillary injury, while pretreatment of pulmonary microvascular endothelial cells with antihistamines prevented adhesion junction disruption; predictably, the combination of antiviral drug remdesivir with the antihistamine loratadine, a histamine receptor 1 (HR1) antagonist, dampened viral replication and inflammation, thereby greatly reducing lung injury. Our findings emphasize the crucial role of MCs in SARS-CoV-2-induced inflammation and lung injury and provide a feasible combination antiviral and anti-inflammatory therapy for COVID-19 treatment.

Background: Acute respiratory distress syndrome (ARDS) is injury of alveolar epithelial cells and capillary endothelial cells caused by various factors, including endogenous and exogenous lung factors, leading to diffuse pulmonary interstitial and alveolar edema, and acute respiratory failure. ARDS involves alveolar epithelial cells and pulmonary interstitial capillary endothelial cells. Circulating endothelial cells (CECs) are the only marker that directly reflects vascular endothelial injury in vivo. There have been few studies on the correlation between peripheral blood CECs and ARDS at home and abroad. The lungs are the organs with the highest capillary density and the most endothelial cells, thus, it is speculated that when ARDS occurs, CECs are stimulated and damaged, and released into the circulatory system., Aim: To explore the correlation between CEC level and severity of ARDS in patients postoperatively., Methods: Blood samples were collected from all patients on day 2 (d2) and day 5 (d5) after surgery. The control group comprised 32 healthy volunteers. Number of CECs was measured by flow cytometry, and operation time was recorded. Changes in various indexes of patients were monitored, and diagnosis of ARDS was determined based on ARDS Berlin definition. We comprised d2 CECs in different groups, correlation between operation time and d2 CECs, ARDS of different severity by d2 CECs, and predictive value of d2 CECs for ARDS in postoperative patients., Results: The number of d2 CECs in the ARDS group was significantly higher than that in the healthy control group ( P < 0.001). The number of d2 CECs in the ARDS group was significantly higher than that in the non-ARDS group ( P < 0.001). The number of d2 CECs in the non-ARDS group was significantly higher than that in the healthy control group ( P < 0.001). Operation time was positively correlated with number of CECs on d2 (rs = 0.302, P = 0.001). The number of d2 CECs in the deceased group was significantly higher than that in the improved group ( P < 0.001). There was no significant difference in number of d2 CECs between patients with mild and moderate ARDS. The number of d2 CECs in patients with severe ARDS was significantly higher than that in patients with mild and moderate ARDS ( P = 0.041, P = 0.037). There was no significant difference in number of d5 and d2 CECs in the non-ARDS group after admission to intensive care. The number of d5 CECs was higher than the number of d2 CECs in the ARDS improved group ( P < 0.001). The number of d5 CECs was higher than the number of d2 CECs in the ARDS deceased group ( P = 0.002). If the number of CECs was > 1351/mL, sensitivity and specificity of predicting ARDS were 80.8% and 78.1%, respectively., Conclusion: Changes in number of CECs might predict occurrence and adverse outcome of ARDS after surgery, and higher numbers of CECs indicate worse prognosis of ARDS., Competing Interests: Conflict-of-interest statement: All authors declare that they have no competing interests., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Schizophrenia is a complex mental illness with genetic heterogeneity, which is often accompanied by alterations in brain structure and function. The neurobiological mechanism of schizophrenia associated with heredity remains unknown. Recently, the development of trans-scale and multi-omics methods that integrate gene and imaging information sheds new light on the nature of schizophrenia. In this article, we summarized the results of brain structural and functional changes related to the specific single-nucleotide polymorphisms (SNPs) in the past decade, and the SNPs were divided into non-coding regions and coding regions, respectively. It is hoped that the relationship between SNPs and cerebral alterations can be displayed more clearly and intuitively, so as to provide fresh approaches for the discovery of potential biomarkers and the development of clinical accurate individualized treatment decision-making., 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 Zhao, Xu, Wang, Yan, Cao, Yan, Chen, Jin, Zhang, Yin and Cui.)

Understanding the controls on composition changes and porosity evolution in the critical zone of shale remains a major challenge. The aim of the present study is to develop a model of the changes in mineral compositions, chemical compositions and nanopore formation in shale during the initial weathering stage. To understand these processes, we selected a Silurian shale profile rich in pyrite and organic matter located in South China. Based on X-ray diffraction (XRD) and bulk elemental data, the variations in mineralogical and chemical compositions with depth were studied. To characterize the full pore size spectrum and to gain insight into the nature of secondary pores and their relationship with weathering, nuclear magnetic resonance (NMR) measurements and petrographic observations were combined with scanning electron microscopy (SEM) imaging. The results show that Al and K are enriched slightly, while Ca and Na are depleted in the upper part of the weathering profile. Si, Mn and Ti are relatively stable from the bottom to the top of the profile. Quartz, feldspar, mica, illite and chlorite are the main minerals in the parent rock, and they are relatively stable along the profile. The rock density gradually decreases from 2.6 g/cm³ to 2.1 g/cm³ from the bottom to the top, and the color of the shales changes from black to grayish yellow, but no secondary minerals are detected. The chemical weathering of black shale is dominated by the oxidation of pyrite and organic matter, giving rise to color variation and nanopore formation. The increase in interparticle pores at the nanometer-micron scale is initiated by the dissolution of easily weathered components such as organic matter and pyrite. The removal of clay minerals and tiny particles by groundwater seepage may be the main cause of porosity enhancement during the initial weathering stage. This study suggests that nanoporosity may play an important role in the process of fluid-rock interaction within black shale during the initial weathering stage.

Objective: To evaluate the effect of clinic standardized blood pressure measurement model (SBPM) applying to first blood pressure measurement among community population aged 35 years old and above. Methods: SBPM was implemented in the community health service center of Dapuqiao street, Huangpu district of Shanghai from June 1, 2018, and the data between June 1 and December 31, 2018 was used as the SBPM data. The first-diagnosis blood pressure measurement data in this center between June 1 and December 31, 2017 was used as the conventional measurement (CM) model data. The detection rate of elevated blood pressure under SBPM was standardized according to the gender and age distribution of subjects in CM. The equilibrium of the value distribution of the end digit of blood pressure value in different pressure-measuring models and difference of elevated blood pressure rate of subjects with different characteristics and seasons were analyzed by using the χ(2) test, and the difference of standardized elevated blood pressure rate in different pressure-measuring models was analyzed by using the U test. Results: The SBPM included 1 548 subjects and 639 (41.28%) of them were males. The CM included 2 952 inpatients and 1 196 (40.51%) of them were males. The frequency of the end digit of blood pressure in SBPM ranged from 9.04% to 10.72%, and both systolic and diastolic blood pressure showed a balanced distribution of end digit ( P values were 0.996 and 0.981 respectively). The frequency of blood pressure end digital in the CM ranged from 0.37% to 67.92%, and both systolic and diastolic blood pressure showed an unbalanced distribution (both P values <0.001). The crude rate and standardized elevated blood pressure rate in SBPM were 23.19% (359/1 548) and 23.05%, which were higher than that in CM, about 7.22% (213/2 952) (both P values <0.001). The elevated blood pressure rate in SBPM in summer, autumn and winter was 18.85% (141/748), 26.72% (152/591) and 31.58% (66/209), respectively, which was higher than that in CM, about 6.28% (91/1 450), 7.20% (82/1 139) and 11.02% (40/363), respectively (all P values <0.001). Conclusion: The quality of blood pressure data and the efficiency of hypertension screening of SBPM are better than those of CM when applying to first blood pressure measurement among community population aged 35 years old and above.

Objective: To analyze the effect of influenza vaccination intervention among key populations of chronic disease management in communities of Shanghai. Methods: A total of 50 787 patients aged ≥60 with diabetes, hypertension and chronic obstructive pulmonary disease (COPD) in Huangpu, Yangpu, Baoshan and Qingpu districts of Shanghai from January 2013 to August 2017 were selected as the intervention group, and 52 268 people from key populations with chronic disease management in Xuhui, Hongkou, Jiading and Fengxian districts were selected as the control group according to the geographical location and economic level. The intervention group accepted follow-up and health education of influenza vaccination via chronic disease outpatient based on information system. The implementation time of the intervention was from September 2017 to January 2018. The basic information and diagnosis information of two groups, and intervention completion of the intervention group were obtained from Shanghai chronic disease management information system and hospital record system. Results: The age of the intervention group and the control group were (76.76±8.33) and (77.97±8.51) years old, respectively ( P< 0.001); and there were statistical differences in gender, occupational and influenza vaccination rate between the two groups ( P< 0.001). A total of 28 644 (56.40%) subjects of the intervention group received intervention. There was no significant difference in age composition between finished and unfinished intervention groups ( P= 0.095), and there was significant difference in gender composition ( P= 0.044). Before the intervention, the vaccination rate of the intervention group was 0.75% (382 subjects) which was lower than that of the control group with 1.02% (533 subjects) (χ(2)=20.96, P< 0.001). After the intervention, the vaccination rate of the intervention group was 1.73% (496 subjects) which was higher than that of the control group with 1.42% (744 subjects) (χ(2)=11.65, P= 0.001). Subjects that were male, younger, uptake of influenza vaccine before the intervention, received intervention and professional and technical personnel were more likely to take influenza vaccine, with OR (95 %CI ) 1.29 (1.13-1.47), 0.97 (0.96-0.98), 260.30 (215.21-314.83), 1.85 (1.61-2.11) and 1.48 (1.10-1.99), respectively. Conclusion: Influenza vaccination intervetion raised the vaccination rate of key population of chronic disease management. Male, younger, those who had been vaccinated before the intervention, who received the intervention, and professional and technical personnel were more likely to be vaccinated.

A novel aromatic compound, grandiuvarone B (5-acetoxy-3-benzoyloxymethyl-5H-oxepin-4-one), along with a known compound grandiuvarone A (5-acetoxy-6-benzoyloxymethyl-5H-oxepin-4-one) were isolated from methanol extracts of Desmos chinensis leaves. Their structures were determined by various spectroscopic techniques including nuclear magnetic resonance (NMR), high-resolution electrospray ionisation mass spectrometry (HR-ESI-MS) and circular dichroism (CD). Grandiuvarone A and grandiuvarone B are isomers and the S configuration of grandiuvarone B was reported for the first time. We then determined their antifungal activity against Aspergillus flavus . Results revealed that grandiuvarone B exhibited better antifungal activity against A. flavus , with MIC values of 0.01 mg/mL compared to grandiuvarone A (MIC values of 0.02 mg/mL). In the presence of each active compound at 160 μg/g of aquafeed, A. flavus growth was completely inhibited. Grandiuvarone B also showed antibacterial activity against the plant pathogen Ralstonia solanacearum .

Non-methane organic compounds (NMOCs) are major ozone precursors in atmospheric photochemical reactions. The working face of a landfill is a significant source of fugitive NMOC emissions. In order to control tropospheric ozone pollution, it is necessary to minimize NMOCs, and this requires identification of contributing substances. In this study, gas samples were collected from the working face of a landfill and analyzed. Their ozone formation potential was calculated using the propylene-equivalent concentration method and the maximum incremental reactivity method. In total, 36 kinds of substances met the standard for detection frequency and concentration. The average annual concentration of NMOCs was about 10000 μg·m -3 , with total concentration greatest in summer. Concentrations of materials were as follows:oxygenated compounds > sulfur compounds > halogenated hydrocarbons > benzene series > hydrocarbons. Based on the results of the two calculation methods, ethanol, m-xylene, propylene, ethyl acetate, and n-pentane were found to be significant ozone formation contributors across the whole year. The pattern for spring was similar. Contributors to high ozone formation were ethanol, 1-butene, toluene, cyclohexane, and styrene in summer and spring, while ethanol contributed very significantly in winter. The propylene-equivalent concentration method was found to be more suitable for estimating ozone formation potential from the working face.

Objective: The aim of this study was to investigate the expression of micro ribonucleic acid-411-5P (miR-411-5p) in non-small cell lung cancer (NSCLC), and to explore the effect of miR-411-5p on the biological behavior of NSCLC cells as well as the underlying molecular mechanism., Patients and Methods: Quantitative Real Time- Polymerase Chain Reaction (qRT-PCR) was used to detect the expression level of miR-411-5p in NSCLC tissues and cells. MiR-411-5p mimics and relevant controls were transfected into NSCLC cells according to the instructions of Lipidosome 2000. Transfected cells were divided into the experimental group and the control group. The transfection efficiency of each group was detected by qRT-PCR. After miR-411-5p overexpression, methyl thiazolyl tetrazolium (MTT) assay, flow cytometry, and transwell assay were used to detect the biological changes of cells in each group. Bioinformatics predicted that pumilio homolog 1 (PUM1) was the target gene of miR-411-5p. Subsequently, the mRNA and protein expression level of PUM1 in each group was detected by qRT-PCR and Western blotting, respectively. Dual-luciferase reporter assay was used to validate the target regulatory relationship between miR-411-5p and PUM1., Results: The results of qRT-PCR showed that miR-411-5p was relatively lowly expressed in NSCLC tissues and cells. After miR-411-5p overexpression, MTT results revealed that the proliferation of NSCLC cells was decreased. Flow cytometry results indicated that the apoptosis rate of NSCLC cells was increased, and cell cycle was arrested in the G0-G1 phase. Meanwhile, the transwell assay demonstrated that the migration and invasion abilities of NSCLC cells were decreased. Bioinformatics predicted that PUM1 was the target gene of miR-411-5p. After miR-411-4p was overexpressed in NSCLC cells, qRT-PCR and Western blotting showed that both the mRNA and protein expression levels of PUM1 were up-regulated. Moreover, dual-luciferase reporter assay demonstrated that miR-411-5p could significantly inhibit the luciferase activity of wild-type PUM1-3'-untranslated region (3'-UTR). However, it exhibited no effect on the luciferase activity of cells transfected with mutant plasmids., Conclusions: MiR-411-5p may be involved in regulating the biological function of NSCLC cells via targeting PUM1. In addition, miR-411-5p may serve as a potential target for the molecular therapy of NSCLC.

Cisplatin resistance frequently occurs in esophageal squamous cell carcinoma (ESCC). The underlying mechanism for cisplatin resistance in ESCC remains largely obscure. Here we report that entinostat reversed cisplatin resistance in ESCC both in vitro and in vivo by induction of apoptosis and inhibition of cell proliferation, accompanied by a decrease of multidrug resistance gene 1 (MDR1), P-Src, Mcl-1, Cyclin D1 and an increase of cleaved PARP. MDR1 expression was associated with worsen survival of ESCC patients with cisplatin-based chemotherapy. Dasatinib potentiated entinostat to overcome cisplatin resistance. By inhibiting Src, dasatinib reduced the expression of MDR1 and Mcl-1. Furthermore, Obatoclax, an inhibitor of Mcl-1, obviously decreased the expression of MDR1, suggesting that entinostat might surmount cisplatin resistance in ESCC via a Src-Mcl-1-MDR1 pathway. Interestingly, cisplatin also enhanced the effect of entinostat both in vitro and in vivo. Our data disclose a molecular basis that entinostat reverses cisplatin resistance, and provide a promising strategy with combinatorial drugs to treat cisplatin resistant ESCC patients., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objective: To analyze the complications of adenotonsilectomy assisted with coblation in children. Method: Complications of 2 089 cases of children with adenoid and tonsil surgery assisted with coblation, in our hospital nearly 10 years, were analyzed by epidemiological methods through the method of retrospective analysis. Result: ①the sex ratio of male to female was 2.08：1, average age (5.87±3.12) years old, and most of 2 089 cases 76.35% (1 595/2 089) were 3-7 years old; ②all cases underwent adenoidectomy. Different surgery methods of tonsil consisted of three groups as partial resection associated with ablation was 69.17% (1 445/2 089), ablation (channeling) alone was 22.26% (465/2 089) and total resection was 8.57% (179/208). The amount of bleeding in operation was (8.52±3.18)ml, average operation time was (30.15±8.26) minutes, the postoperative pain score was (3.77±1.61); ③The incidence of postoperative complications: postoperative bleeding (all were secondary bleeding cases) rate was 0.24% (5/2 089), recurrence rate was 0.14% (3/2 089), prevertebral lymphadenitis was 0.96% (20/2 089), the other was 0.29% (torus hyperplasia in 2 cases, dyspnea in 2 cases, 1 cases of angle of mouth burned, nasopharyngeal adhesion in 1 cases). Postoperative fever rate was 9.81% (205/2 089). Conclusion: coblation technique is a good method for the treatment of children's adenoids and tonsil diseases with high efficiency and low complications. But improving the operation procedure proficiency level and skills of operation is an important link to reduce complications., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: With the help of new technologies like 64-slice spiral CT, including latest AW4.4, 2D nodule comparing and analyzing technology, MPR and 3D technology, MIP technology and the technology of analyzing pulmonary vascular density by the method of perfusion scanning, we performed characteristic analysis of ground-glass opacities (GGO) for the early diagnosis of lung cancer., Patients and Methods: We selected 62 patients suspected of lung cancer, whose conventional CT showed that they were patients with GGO. With the help of the new technologies of 64-slice spiral CT provided by GE Company, prospective scans were made and 2 to 4 times of review were arranged. After that, the patients were treated with surgery or needle biopsy to get lesion's pathological results. After several scans, the results including lesion's form, density, blood supply, peripheral sign, doubling time and tissue perfusion were drawn to make a comparison. Based on the results, comparative analysis on GGO's characteristics was made from morphological and functional perspectives., Results: 41 patients (66.1%) were pathologically diagnosed with cancer, 10 were diagnosed with inflammation, 7 with fibrosis, and 4 with edema, hemorrhage and other lesions. The comparisons were made between the tumor groups' clinical manifestations (sex, age, symptoms including smoking, coughing, and expectoration), and the difference had no statistical significance (p>0.05). Conventional CT scan showed that the shape of GGO was irregular and it showed spiculated sign and pleural indentation. The proportion of the patients with vessel convergence in the tumor group was significantly higher than that of the non-tumor group (p<0.05). However, the comparisons between lesions' number, location (superior lobe of the right lung), diameter, edge (blur) and lobulation were made to get a difference ratio (p>0.05) which had no statistical significance. Tumor group's doubling time was significantly short, and its perfusion parameters including BF, BV, MTT, and PS were increased significantly (p<0.05)., Conclusions: The new 64-slice CT technology has great value in the diagnosis of the tumorous GGO.

Aim: To observe the effect of targeted therapy with 64-slice spiral computed tomography (CT) combined with cryoablation for liver cancer., Methods: A total of 124 patients (142 tumors) were enrolled into this study. According to the use of dual-slice spiral CT or 64-slice spiral CT as a guide technology, patients were divided into two groups: dual-slice group ( n = 56, 65 tumors) and 64-slice group ( n = 8, 77 tumors). All patients were accepted and received targeted therapy by an argon-helium superconducting surgery system. The guided scan times of the two groups was recorded and compared. In the two groups, the lesion ice coverage in diameter of ≥ 3 cm and < 3 cm were recorded, and freezing effective rate was compared. Hepatic perfusion values [hepatic artery perfusion (HAP), portal vein perfusion (PVP), and the hepatic arterial perfusion index (HAPI)] of tumor tissues, adjacent tissues and normal liver tissues at preoperative and postoperative four weeks in the two groups were compared. Local tumor changes were recorded and efficiency was compared at four weeks post-operation. Adverse events were recorded and compared between the two groups, including fever, pain, frostbite, nausea, vomiting, pleural effusion and abdominal bleeding., Results: Guided scan times in the dual-slice group was longer than that in the 64-slice group ( t = 11.445, P = 0.000). The freezing effective rate for tumors < 3 cm in diameter in the dual-slice group (81.58%) was lower than that in the 64-slice group (92.86%) (χ 2 = 5.707, P = 0.017). The HAP and HAPI of tumor tissues were lower at four weeks post-treatment than at pre-treatment in both groups (all P < 0.05), and those in the 64-slice group were lower than that in the dual-slice group (all P < 0.05). HAP and PVP were lower and HAPI was higher in tumor adjacent tissues at post-treatment than at pre-treatment (all P < 0.05). Furthermore, the treatment effect and therapeutic efficacy in the dual-slice group were lower than the 64-slice group at four weeks post-treatment (all P < 0.05). Moreover, pleural effusion and intraperitoneal hemorrhage occurred in patients in the dual-slice group, while no complications occurred in the 64-slice group (all P < 0.05)., Conclusion: 64-slice spiral CT applied with cryoablation in targeted therapy for liver cancer can achieve a safe and effective freezing treatment, so it is worth being used., Competing Interests: Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript.

Objective: This study aims to explore the clinical effect of adenoidectomy and tonsillectomy assisted with ablation on children. Method: The investigation took the form of retrospective review of 2 089 cases of children applied with adenoidectomy and tonsillectomy assisted with ablation in our hospital in recent 10 years. We obtained data of these children with epidemiological methods based on analyzing the status of general information and operation selections, and then analyzing the scores of snoring and breath preoperation and postoperation. Result: ①General information of 2 089 cases followed with: the ratio of male and female was 2.08∶1，the average onset age was（5.87±3.12）years old, mostly ranged from 3 to 7 years old, which consists of 76.35%（1595/2089）of the group.②Different surgery methods of tonsil consisted of three groups as: partial resection associate with ablation was 69.17%(1445/2089), ablation alone was 22.26%(465/2089) and partial resection alone was 8.57%(179/2089) of the group.③A high level scores of snoring and breath more frequently found in preoperative cases than in postoperative cases( P <0.01).There are no differentiation among the scores of above three groups( P >0.05).The postoperative effect evaluation were related to allergic rhinitis, recurrent of tonsillitis, obesity, circular occipital hyperplasia and nasopharyngeal adhesion. Conclusion: The results suggested that surgery assisted with ablation has its advantage in adenoidectomy and tonsillectomy. Individual therapy for different children will improve the curative effect and relieve the pain of operation, thus is worth a wide application., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: This study aimed to investigate the epidemiology of diabetes in adults from Shanghai, aged 35 and older, in 2013., Methods: We estimated the diabetes prevalence in a representative sample of 18,736 adults who were selected through a multistage stratified cluster sampling process. A standard questionnaire containing questions about demographic characteristics and lifestyle factors was distributed. After an overnight fast of at least 10 hours, a venous blood sample was collected from each participant. For each patient without a history of diabetes, another blood sample was drawn 120 min after an oral glucose tolerance test to identify undiagnosed diabetes and prediabetic condition., Results: Among Shanghai residents aged 35 and above, the overall weighted prevalence of diabetes was 17.6% [95% confidence interval (CI): 16.4%-18.8%]. The prevalences were 19.3% in men and 15.8% in women as well as 19.1%, 15.4%, and 16.1% in urban, suburban, and rural residents, respectively. In addition, the weighted prevalence of prediabetes was 16.5% (95% CI: 15.3%-17.8%), with the prevalences of 16.5% in men, 16.6% in women, 15.2% in urban residents, 18.0% in suburban residents, and 18.5% in rural residents. Among all patients with diabetes, 68.1% (95% CI: 64.3%-71.6%) were aware of their status, 63.5% (95% CI: 60.0%-66.9%) received diabetes treatment, but only 35.1% (95% CI: 32.4%-37.8%) had adequate glycemic control., Conclusion: In Shanghai, diabetes and prediabetes are highly prevalent. However, 1/3rd of diabetes cases are undiagnosed, and the rate of glycemic control is low., (Copyright © 2016 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.)

The interactions between aflatoxin-producing fungi and bacteria have opened up a new avenue for identifying biological agents suitable for controlling aflatoxin contamination. In this study, we analysed the interactions between A. flavus and the bacterium Burkholderia gladioli M3 that coexist in rice that is naturally contaminated with A. flavus. Our results showed that a cell-free culture filtrate (CCF) and the metabolite bongkrekic acid of the M3 strain potently suppressed the mycelial growth and spore production, and then affected the production of aflatoxin of A. flavus. Bongkrekic acid secreted by the M3 strain exhibited higher antifungal activity than did analogues. The CCF of the M3 strain and its metabolite bongkrekic acid can inhibit the growth of A. flavus, but the metabolites of A. flavus, aflatoxins, exerted no inhibitory effect on the growth of the M3 strain. Furthermore, we determined that the M3 cells could use the dead mycelia of A. flavus as energy sources for reproduction, while A. flavus could not grow in a solution containing dead M3 cells. In summary, these results indicated that B. gladioli has a competitive advantage in survival when it coexists with its fungal partner A. flavus., (Copyright © 2015 The British Mycological Society. Published by Elsevier Ltd. All rights reserved.)

Background: The footprint of most prostheses is designed according to Caucasian data. Total disc replacement (TDR) has been performed widely for cervical degenerative diseases in China. It is essential to analyze the match sizes of prostheses footprints and Chinese cervical anatomic dimensions in our study., Methods: The anatomic dimensions of the C4-C7 segments of 138 patients (age range 16-77 years) in a Chinese population were measured by computed tomography scans. We compared the footprints of the most commonly used cervical disc prostheses (Bryan: Medtronic, Minneapolis, MN, USA; Prestige LP: Medtronic, Fridley, Minnesota, USA; Discover: DePuy, Raynham, MA, USA; Prodisc-C: Synthes, West Chester, PA, USA) in China with Chinese cervical anatomic dimensions and assessed the match of their size., Results: The mismatch of available dimensions of prostheses and anatomic data of cervical endplates ranged from 17.03% (C4/C5, Prestige LP, Prodisc-C) to 57.61% (C6/C7, Discover) in the anterior-posterior (AP) diameter, and 35.51% (C4/C5, Prodisc-C, Prestige LP) to 94.93% (C6/C7, Bryan) in the center mediolateral (CML) diameter. About 21.01% of endplates were larger than the largest prostheses in the AP diameter and 57.25% in the CML diameter. All available footprints of prostheses expect the Bryan with an unfixed height, can accommodate the disc height (DH), however, 36.23% of the middle DH was less than the smallest height of the prostheses. The average disc sagittal angles (DSAs) of C4-C7 junctions were 5.04°, 5.15°, and 4.13° respectively. Only the Discover brand had a built-in 7° lordotic angle, roughly matching with the DSA., Conclusions: There is a large discrepancy between footprints of prostheses and Chinese cervical anatomic data. In recent years, possible complications of TDR related with mismatch sizes are increasing, such as subsidence, displacement, and heterotopic ossification. Manufacturers of prostheses should introduce or produce additional footprints of prostheses for Chinese TDR.

This study aims to explore the effects and advantages of coblation combined with microscopy to treat epiglottis cysts. Ninety patients with epiglottis cysts were randomly assigned to three groups: the first group: marsupialisation + electric coagulation group, n = 30; the second group: marsupialisation + coblation, n = 30; and the third group: marsupialisation + coblation + microsurgery, n = 30. To compare the cure rate, intraoperative bleeding volume, postoperative pain, operation time and postoperative complications were investigated among these three groups. The comparison among three procedures showed a significant difference for intraoperative bleeding volume, operation time and postoperative pain (P < 0.05), whereas no significant difference was observed for cure rate (P > 0.05). These three procedures are effective in treating epiglottis cysts. Microscopic surgery with coblation has the advantages of less bleeding, short procedure duration, less pain and few complications. Thus, microscopic surgery is worthy of clinical application.

MiR172 is an important microRNA that regulates floral development in various plants and downregulates AP2 family members to relieve the stress on floral determinacy, leading to phase transition from vegetative to reproductive growth. In this work, PCR with primers designed based on the rice miR172 sequence was used to isolate two miR172-like transcripts from Phalaenopsis hybrida (PhmiR172-1 and PhmiR172-2) that were very similar to Oryza miR172d and Arabidopsis miR172b. RT-PCR indicated that the levels of these two transcripts were negatively correlated with the level of the Phalaenopsis AP2 (PhAP2) gene in stem, root, pedicel and sepal, and that both were co-expressed with PhAP2 in young buds. Overproduction of PhmiR172-2 in Arabidopsis led to early flowering. The homologous cloning method used to isolate the Phalaenopsis miR172-like transcripts can be used to isolate miRNAs from other species. These PhmiR172 transcripts may be used to accelerate the flowering of orchids.

Loss of mitotic checkpoint of cells contributes to chromosomal instability and leads to carcinogenesis. Mitotic arrest deficient 1 (MAD1) is a key component in mitotic checkpoint signalling. In this study, we identified a novel MAD1 interacting partner, proline-rich acidic protein 1 (PRAP1), using yeast-two hybrid screening, and investigated its role in mitotic checkpoint signalling in hepatocellular carcinoma (HCC). We demonstrated the physical interaction of PRAP1 with MAD1 and of PRAP1 with MAD1 isoform MAD1β, using a co-immunoprecipitation assay. Moreover, stable expression of PRAP1 in mitotic checkpoint-competent HCC cells, BEL-7402 and SMMC-7721, induced impairment of the mitotic checkpoint (p < 0.01), formation of chromosome bridges (p < 0.01) and aberrant chromosome numbers (p < 0.001). Interestingly, ectopic expression PRAP1 in HCC cells led to significant under-expression of MAD1. In human HCC tumours, 40.4% (23/57) of HCCs showed under-expression of PRAP1 protein as compared with their corresponding non-tumorous livers; up-regulation of MAD1 protein was significantly associated with down-regulation of PRAP1 (p = 0.030). Our data revealed that PRAP1 is a protein interacting partner of MAD1 and that PRAP1 is able to down-regulate MAD1 and suppress mitotic checkpoint signalling in HCC., (Copyright © 2013 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.)

Background: In many parts of the world, including in China, extreme heat events or heat waves are likely to increase in intensity, frequency, and duration in light of climate change in the next decades. Risk perception and adaptation behaviors are two important components in reducing the health impacts of heat waves, but little is known about their relationships in China. This study aimed to examine the associations between risk perception to heat waves, adaptation behaviors, and heatstroke among the public in Guangdong province, China., Methods: A total of 2,183 adult participants were selected using a four-stage sampling method in Guangdong province. From September to November of 2010 each subject was interviewed at home by a well-trained investigator using a structured questionnaire. The information collected included socio-demographic characteristics, risk perception and spontaneous adaptation behaviors during heat wave periods, and heatstroke experience in the last year. Chi-square tests and unconditional logistic regression models were employed to analyze the data., Results: This study found that 14.8%, 65.3% and 19.9% of participants perceived heat waves as a low, moderate or high health risk, respectively. About 99.1% participants employed at least one spontaneous adaptation behavior, and 26.2%, 51.2% and 22.6% respondents employed <4, 4-7, and >7 adaptation behaviors during heat waves, respectively. Individuals with moderate (OR=2.93, 95% CI: 1.38-6.22) or high (OR=10.58, 95% CI: 4.74-23.63) risk perception experienced more heatstroke in the past year than others. Drinking more water and wearing light clothes in urban areas, while decreasing activity as well as wearing light clothes in rural areas were negatively associated with heatstroke. Individuals with high risk perception and employing <4 adaptation behaviors during heat waves had the highest risks of heatstroke (OR=47.46, 95% CI: 12.82-175.73)., Conclusions: There is a large room for improving health risk perception and adaptation capacity to heat waves among the public of Guangdong province. People with higher risk perception and fewer adaptation behaviors during heat waves may be more vulnerable to heat waves.

Objective: To investigate the risk factors and behavior features related to chronic diseases among adults in Shanghai., Methods: A total of 15 516 subjects aged over 18 years old were selected from the investigation project on chronic diseases and relevant risk factors in Shanghai in 2010. Questionnaire were used to investigate the general information of the subjects, such as behavior features as smoking, drinking, diet, physical activity as well as the prevalence and control of chronic diseases as hypertension and diabetes. The physical examination included height, weight, waist circumference, blood pressure, blood glucose and blood lipids., Results: Being preprocessed by complex weighting method, the data showed that the overweight rate of Shanghai adults aged above 18 was 32.4% (5288), separately 32.2% (2506) and 32.5% (2782) (χ(2) = 0.10, P = 0.844) in urban and rural areas; the obesity rate was 8.8% (1538), separately 8.7% (738) and 8.8% (800) (χ(2) = 0.06, P = 0.901) in urban and rural areas. The overweight rate was separately 36.0% (2888) in males and 28.6% (2400) in females (χ(2) = 96.61, P < 0.01); while the obesity rate was separately 8.7% (745) in males and 8.9% (793) in females (χ(2) = 0.06, P = 0.851). Abdominal obesity rate was 44.3% (7419), separately 47.8% (3892) in males and 40.6% (3527) in females (χ(2) = 81.23, P < 0.01), 46.5% (3703) in urban areas and 42.6% (3716) in rural areas (χ(2) = 24.37, P = 0.069). Current smoking rate was 25.0% (3813), separately 48.4% (3722) and 1.2% (91) in males and females (χ(2) = 4572.06, P < 0.01); 23.6% (1609) and 26.0% (2204) in urban and rural areas (χ(2) = 11.92, P = 0.018). The regular smoking rate was 22.1% (3402). The rate of having the habit of drinking at least once a month in males was 39.5% (3102), separately 35.1% (1262) and 42.7% (1840) in urban and rural areas (χ(2) = 45.98, P = 0.012). The rate of drinking almost every day was 16.3% (1380), and the percentage of excessive alcohol consumption was 28.9% (2483). The percentage in group of subjects aging between 45-59 years old was 38.5% (1191), which was higher than that in any other groups (22.8% (641) in group aging 18-44 years old and 22.9% (651) in group aging ≥ 60 years old) (χ(2) = 241.38, P < 0.01). The percentage of over-drinking in rural area was higher than that in urban area, which was 33.5% (1578) and 22.8% (905) respectively (χ(2) = 117.12, P < 0.01). The percentage of once over-drinking was 11.3% (903). It was higher in group aging between 45-49 years old (15.3% (461)) than in other groups (9.0% (222) in group aging 18-44 years old and 8.2% (220) in group aging ≥ 60 years old) (χ(2) = 78.21, P < 0.01). It was also higher in rural area (13.5% (605)) than in urban area (8.3% (298)) (χ(2) = 51.74, P < 0.01). There were 75.0% (11 993) of the Shanghai adults never took physical activity. And the most important problems in dietary habit were insufficient intake of dairy products (98.0%, 15 218), vegetables (53.0%, 7864) and fruits (84.6%, 13 372), excess consumption of sodium (52.0%, 8257) and oil (51.7%, 7884)., Conclusion: The risk factors of chronic diseases were highly prevalent in Shanghai. The prevalence of risk factors as overweight or obesity, lack of physical activity, smoking, over-drinking and unhealthy dietary habits were higher among adults living in suburban areas than those living in urban areas; the prevalence was also higher among the young adults than that among the elderly people, higher among males than that among females.

Objective: To evaluate the clinical effectiveness and influential factors of maxillary rehabilitation with zygomatic implant and prosthesis after tumor resection., Methods: Thirty-six patients with maxillary defects were collected prospectively in this study and received zygomatic implant and prosthesis for maxillary rehabilitation in the Department of Stomatology of the Municipal Hospital, Taizhou, Zhejiang, China from March 2007 to May 2010. The speech intelligibility (SI) and masticatory efficiency of pre-rehabilitation and post-rehabilitation at one, 6, 12, and 24 months were measured. The relationships between the following factors (oro-nasal communication, hard-palate resection, soft-palate resection, retention teeth) and SI value were analyzed. The relationships between the following factors (oro-nasal communication, retention teeth, the extent of maxillary defect, tumor recurrence) and absorbance value were analyzed., Results: The SI values and absorbance values of post-rehabilitation at one, 6, 12, and 24 months were higher than that of pre-rehabilitation values (p<0.05). Linear regression analysis revealed that oro-nasal communication had a highly significant influence on the SI value of pre-rehabilitation (p<0.05), while soft-palate resection had a highly significant influence on that of post-rehabilitation (p<0.05). Oro-nasal communication had a highly significant influence on the absorbance value of pre-rehabilitation (p<0.05), while maxillary defect had a highly significant influence on that of post-rehabilitation (p<0.05)., Conclusion: Zygomatic implant and prosthesis improved the near and long-term effectiveness of phonetic and masticatory function, and elevated life quality of patients with maxillary tumor resection. Zygomatic implant and prosthesis are an effective rehabilitation remedy for maxillary defects resulting from tumor resection.

A novel antifreeze protein AFP72 cDNA (GenBbank accession No. AY929389) was obtained by RT-PCR from Tenebrio molitor. The 216 bp fragment encodes a protein of 72 amino acid residues. Sequence analysis revealed that the cDNA displays a high degree of homology with T. molitor antifreeze proteins, ranging up to 90.78%. Recombinant plasmids pMAL-p2X-afp72 and pMAL-c2X-afp72 were transferred into E. coil TBI to induce a MBP fusion protein by IPTG. The target fusion protein was released from the periplasm and cytoplasm by the cold osmotic shock procedure and sonication respectively. The content of the fusion protein came up to 38.9 and 41.5% of the total dissolved protein, respectively. The fusion protein was purified through an amylose affinity column, and incised by factor Xa. Molecular sieve chromatography was used to achieve a high state of purity of the target protein. The purified target protein displayed a single band in SDS-PAGE. The fusion protein was shown to increase resistance to low temperatures in bacteria. This finding could help in further investigations of the properties and function of antifreeze proteins.

Objective: To investigate the risk perception of heat wave, and further explore its related factors in Guangdong province., Methods: A total of 2183 adults were selected by a multi-stage sampling method in Guangdong province. Each subject was interviewed in their home with a structured questionnaire by a well trained investigator from September to November, 2010. The questionnaire contained socio-demographic characteristics, heat wave related knowledge, risk perception of heat wave, etc. Chi-square test and multivariate logistic regression were employed in this study., Results: The average age of total 2183 participants was (39.31 ± 14.16) years, among which 53.37% (1165/2183) were males, and 48.74% (1064/2183) were selected from urban. About 38.11% (832/2183) of participants heard about heat wave, and 38.52% (841/2183) of subjects thought the heat wave had higher impact on their health (risk perception score of heat wave ≥ 5 points). About 81.91% (1788/2183) of all participants thought the weather in most recent years was hotter than several years ago. Among these people, 30.48% (545/1788) thought the main reason of weather becoming hotter was due to emission of carbon dioxide, and 26.51% (474/1788) thought it was due to air pollution. Results from the multivariate logistic regression showed that the risk perception score of heat wave were higher in subjects with higher education (OR = 2.16, 95%CI: 1.41 - 3.30), from urban(OR = 1.37, 95%CI: 1.10 - 1.72), with higher score of trust(OR = 1.08, 95%CI: 1.01 - 1.14) and participants with higher score of heat wave related knowledge (OR = 1.39, 95%CI: 1.27 - 1.52). Furthermore, compared to hierarchist, egalitarian (OR = 1.73, 95%CI: 1.30 - 2.29), individualist (OR = 1.93, 95%CI: 1.41 - 2.65) and fatalist (OR = 1.80, 95%CI: 1.41 - 2.29) also had higher risk perception score of heat wave., Conclusion: There is a lack of knowledge and risk perception to heat wave among the residents in Guangdong province. Risk perception of heat wave was higher in people who were from urban, had higher level of trust on government, experts and media, had higher health-related knowledge score, and non-hierarchists.

Objective: To explore the relationship between distorted weight perception and suicide ideation among normal weight adolescents in Guangdong province., Methods: This study used the data of Guangdong Provincial Youth Health Risk Behavior Survey in 2004 and 2007. To identify the association between distorted weight perception and suicide ideation, a logistic regression analysis was performed. The effects of age, economic status, mother's education, mental health, and depression were also adjusted., Results: A total of 12 729 people participated in this study, 6096 males and 6633 females. The prevalence of suicide ideation among normal weight adolescents was 13.58% (1729/12 729) in the past 12 months, with higher prevalence in girls (16.15%, 1071/6633) than that in boys (10.79%, 658/6096) (χ(2) = 77.71, P = 0.00). It was common that the adolescents misperceived their weight. Only 44.93% (5719/12 729) of normal weight students correctly perceived their body weight while 43.52% (5540/12 729) of them overestimated their weight and 11.43% (1455/12 729) underestimated their weight. The distorted weight perception in girls (65.58%, 4350/6633) was higher than that in boys (43.39%, 2645/6096) (χ(2) = 993.91, P = 0.00). Distorted weight perception was significantly associated with suicide ideation after controlling for factors age, economic status, mother's education, mental health, and depression. The students who overestimate their body weight were more likely to have suicide ideation than that who correctly perceived their weight (OR = 1.43, 95%CI: 1.27 - 1.61)., Conclusion: The prevalence of distorted weight perception was high and it significantly associated with suicide ideation.

Background: Signal transducer and activator of transcription 3 (STAT3) is usually constitutively activated in a variety of malignancies. It directly contributes to tumorigenesis, invasion, and metastasis. The surgical treatment of breast cancer has made no breakthroughs in terms of treatment effect, in spite of its long history. Current biotherapies bring a note of optimism to breast cancer treatment. To explore the possibility of a siRNA targeted STAT3 blocking treatment for over-activated tumor cells, we evaluated the efficacy of a STAT3 siRNA on human breast cancer cells in vitro and in vivo., Methods: Three MCF-7 human breast cancer cell lines were tested: control MCF-7 cells, non-specific siRNA transfected MCF-7 cells and STAT3 siRNA transfected MCF-7 cells. Expression of STAT3 in MCF-7 cells was inhibited by RNA interference (RNAi). The STAT3 mRNA and protein levels were detected by semi-quantity RT-PCR and Western blotting. Cell proliferation and apoptosis were determined by MTT method and flow cytometry. The three groups of MCF-7 cells mentioned above were transplanted subcutanuously into nude mice and their tumorgenic ability observed. The STAT3 mRNA and protein levels of the samples from tumors in different groups were determined by semi-quantity RT-PCR and Western blotting and compared., Results: In STAT3 siRNA transfected MCF-7 cells, the expressions (STAT3/β-actin) of STAT3 mRNA (0.327 ± 0.020) and protein (0.153 ± 0.006) were significantly lower than that in control MCF-7 cells (mRNA 1.093 ± 0.018, protein 1.374 ± 0.022) and non-specific siRNA transfected MCF-7 cells (mRNA 1.035 ± 0.050, protein 1.320 ± 0.033) (P < 0.05). MTT showed that cell proliferation was significantly reduced and the cell growth inhibition ratio in the STAT3-siRNA group was (44.00 ± 5.10)%, significantly higher than that in non-specific siRNA transfected MCF-7 cells ((16.10 ± 1.05)%, P < 0.05). Flow cytometry results showed that more apoptosis was observed in the STAT3-siRNA group. The rate of apoptosis was (14.79 ± 0.22)%, much higher than in control MCF-7 cells (7.06 ± 0.71) and non-specific siRNA transfected MCF-7 cells (8.45 ± 0.43) (P < 0.05). The tumor growth in the STAT3 siRNA transfected MCF-7 cells was significantly slower than in the two control groups. On the 22th day after transplantation the tumor weight ((21.40 ± 10.57) mg) and volume ((41.15 ± 12.17) mm(3)) in the STAT3 siRNA transfected group were significantly lower than in control group (weight (88.60 ± 12.16) mg, volume (118.45 ± 24.68) mm(3)) and non-specific siRNA transfected group (weight (57.20 ± 21.86) mg, volume (101.36 ± 21.90) mm(3)) (P < 0.05). Both the STAT3 mRNA and protein levels in the tumors from the STAT3 siRNA transfected group were significantly lower than in the tumors from the two control groups., Conclusions: STAT3 siRNA can effectively silence the STAT3 gene in vitro and in vivo, increase cell apoptosis rate and significantly decrease cell proliferation, which inhibits the growth of breast cancer cell in vitro. Tumor growth of xenograft mice is significantly inhibited. The results obtained in vivo are in consistency with those in vitro. STAT3 may be a novel therapeutic target for breast cancer and RNA interference has potential clinical application.

Objective: To study the association between temperature and daily mortality from June 1, 2006 to December 31, 2009 in Guangzhou., Methods: Time series approach was used to estimate the impact of temperature on the rates of total and cause-specific daily mortality. We fitted generalized additive Poisson regression using non-parametric smooth functions to control for the long-term time trend, day of week, air pollution and other weather variables., Results: A slight sloping U-like relationship between the total mortality and temperature was found, with an optimum average temperature (temperature with lowest mortality risk) value of 19.7°C in Guangzhou. For temperature above the optimum value, the relative risk of total mortality increased by 3.0% (RR=1.030, 95%CI: 1.011-1.050) for each increase of degree in Celsius. For average temperature below the optimum value, the relative risk of total mortality and diseases of circulatory system had a 3.3% (RR=0.967, 95%CI: 0.936-0.997) decrease and a 3.6% (RR=0.964, 95%CI: 0.935-0.994) increase, for each degree of Celsius increase, respectively., Conclusion: Our findings showed that the temperature had an impact on the daily mortality in Guangzhou. Countermeasures needed to be taken to reduce the temperature related mortality.

Objective: To observe the effect of signal transducers and activators of transcription 3 (STAT3) gene silence on the growth of breast cancer cell line MCF7 in vitro and in vivo and discuss the feasibility and effectiveness of STAT3 used as gene therapeutic target for breast cancer., Methods: Human breast cancer cell line MCF7 cells were divided into 3 groups: mock control group, control group transfected with scrambled sequence siRNA, and experimental group transfectod with STAT3 siRNA. The STAT3 mRNA and protein levels were detected by semi-quantity RT-PCR and Western blotting, respectively. The cell proliferation and apoptosis were examined by MTT method and flow cytometry. MCF7 cells treated with STAT3-siRNA were transplanted subcutaneously in nude mice and their tumorgenic ability was observed. The STAT3 mRNA and protein levels of the samples from nude mice of different groups were detected by semi-quantity RT-PCR and Western blotting and compared., Results: After treatment with STAT3-siRNA, STAT3 mRNA (0.327 ± 0.020 vs. 1.035 ± 0.050, 1.093 ± 0.018) and ptotein (0.153 ± 0.006 vs. 1.320 ± 0.033, 1.374 ± 0.022) levels in the MCF7 cells transfected with STAT3-siRNA were significantly lower than that in the two control groups (P < 0.05). MTT assay showed that after transfection of the STAT3-siRNA into MCF7 cells, cell proliferation was significantly reduced and the cell growth inhibition ratio in the STAT3-siRNA group was (44.00 ± 5.10)%, significantly higher than that in the control group (16.1 ± 1.05)% (P < 0.05). Flow cytometry results suggested that more apoptosis was observed in the STAT3-siRNA group. The apoptosis rate was (14.79 ± 0.22)%, much higher than that in the control group [(7.06 ± 0.71)%, (8.45 ± 0.43)%, P < 0.05]. The tumor growth in the experimental group was significantly slower than that in the two control groups. 0n the 22th day after transplantation, the tumor weight [(21.4 ± 10.6) mg vs. (88.6 ± 12.2) mg, (57.2 ± 21.9) mg] and volume [(41.15 ± 12.17) mm³ vs. (118.45 ± 24.68) mm³, (101.36 ± 21.90) mm³] in the experimental group were significantly lower than that in the two control groups (P < 0.05). The STAT3 mRNA and protein levels of the samples from nude mice in the experimental group were significantly lower than that in the two control groups., Conclusion: siRNA targeting STAT3 can inhibit the proliferation of MCF7 cells in vitro and in vivo. STAT3 may become a novel therapeutic target for breast cancer.

GH18 chitinase is a multi-gene family. The family plays important physiological roles in Crustacea, e.g. ecdysis and defense against pathogen. However, data about GH18 family are rather limited in Crustacea. In the study, different cloning strategies were adopted to clone chitinase genes of Litopenaeus vannamei, which is the most widely cultured shrimp. Seven chitinase family members were identified. Analysis of domain architectures showed the repeated CBM18 modules and catalytic domain of enzymatically inactive chitolectin in Crustacea for the first time. Comparing to the three known groups of crustacean chitinase, four of the seven members are located on new evolutionary clades thus enriched the chitinase family of Crustacea. Tissue expression profiles were investigated in eight tissues. Expression of CHT5 and CHID1 were both detected in the hemocyte by which the innate immunity activity was carried out. The domain architectures, evolutionary relationships and tissue expression patterns all provide reasonable explanation for the existence of multiple genes in crustacean chitinase family., (2010 Elsevier Ltd. All rights reserved.)

Objective: To understand the prevalence of suicide attempts and its related risk factors in Guangdong province to provide scientific basis information for suicide intervention., Methods: Multi-stage stratified random sampling method was used to select the sample. 42 streets or towns were selected from 21 counties or districts through randomly sampling. 4 communities were then chosen from every selected town or district, followed by 40 families chosen from every village or community. Questionnaire was used to collect data on suicide attempts and its related risk factors. SPSS 16.0 was used for data analysis., Results: 6625 peoples were participated in the study. The 12-month incidence of suicidal attempts was 0.8%. It was higher for females (1.1%) than that for males (0.5%), and the 25 - 35 years (1.6%) age group was among the highest. There was no significant difference between the prevalence rates in urban or rural residents., Results: from multivariate analysis showed that factors as: being female (OR = 2.1), experienced negative events of life (OR = 15.5), in poor sleeping condition (OR = 1.6), feeling lonely (OR = 1.5) and anxiety (OR = 1.8) were high risk for suicide attempts., Conclusion: Suicide attempts in Guangdong province exhibited a high prevalence with complicated influencing factors. Comprehensive countermeasures are needed to prevent and reduce suicidal behaviors.

Purpose: Although antiproliferative drugs have been used to prevent scarring after filtration surgery in patients with glaucoma, there are complications associated with their use. In the present study, the authors investigated whether small interfering RNA (siRNA)-mediated gene silencing of Skp2 can be used to increase p27(kip1) level and inhibit cell proliferation in rabbit Tenon's capsule fibroblast (rTF)., Methods: A plasmid containing Skp2 siRNA was used to decrease the high constitutive level of Skp2 protein in rTF, which can lead to consequent degradation of p27(kip1). Cell proliferation was assayed by immunocytochemistry using antibodies against 59-bromodeoxyuridine (BrdU) and proliferating cell nuclear antigen (PCNA). Skp2 siRNA was delivered to a trabeculectomy animal model to study the effect on rTF proliferation in vivo., Results: Immunocytochemistry and Western blot analysis showed a decreased level of Skp2 and an increased level of p27(kip1) in cells transfected with pSkp2 siRNA but not in vehicle transfection and uninfected cells in vitro and in vivo. MTT assay showed that cell viability significantly declined in rTF transfected with Skp2 siRNA. Skp2 siRNA-transfected cells showed significantly less BrdU- and PCNA-positive staining than control cells in vitro and in vivo. Infiltration bleb was detected in the Skp2 siRNA group 14 days after trabeculectomy., Conclusions: Skp2 siRNA inhibited cell proliferation and decreased cell viability of rTF in vivo and in vitro. These findings suggest that siRNA-mediated gene silencing of Skp2 can be a novel gene therapy to treat scarring after glaucoma surgery by the suppression of p27(kip1) downregulation.

Aim: To investigate the feasibility and safety of monopolar electrocautery shovel (ES) in laparoscopic total mesorectal excision (TME) with anal sphincter preservation for rectal cancer in order to reduce the cost of the laparoscopic operation, and to compare ES with the ultrasonically activated scalpel (US)., Methods: Forty patients with rectal cancer, who underwent laparoscopic TME with anal sphincter preservation from June 2005 to June 2007, were randomly divided into ultrasonic scalpel group and monopolar ES group, prospectively. White blood cells (WBC) were measured before and after operation, operative time, blood loss, pelvic volume of drainage, time of anal exhaust, visual analogue scales (VAS) and surgery-related complications were recorded., Results: All the operations were successful; no one was converted to open procedure. No significant differences were observed in terms of preoperative and postoperative d 1 and d 3 WBC counts (P=0.493, P=0.375, P=0.559), operation time (P=0.235), blood loss (P=0.296), anal exhaust time (P=0.431), pelvic drainage volume and VAS in postoperative d 1 (P=0.431, P=0.426) and d 3 (P=0.844, P=0.617) between ES group and US group. The occurrence of surgery-related complications such as anastomotic leakage and wound infection was the same in the two groups., Conclusion: ES is a safe and feasible tool as same as US used in laparoscopic TME with anal sphincter preservation for rectal cancer on the basis of the skillful laparoscopic technique and the complete understanding of laparoscopic pelvic anatomy. Application of ES can not only reduce the operation costs but also benefit the popularization of laparoscopic operation for rectal cancer patients.

Aim: To investigate the effects of thymosin alpha1 (Talpha1) on the differentiation, maturation and function of tumor lysate-pulsed dendritic cells (LyDCs) in vitro, and to study the antitumor effects on tumor models of the nude mice bearing colon cancer in vivo., Methods: Immature DCs (imDCs) were prepared routinely from human peripheral blood mononuclear cells. The LyDCs were prepared from the imDCs loaded with lysate of HT-29 tumor cell line. The phenotypes of imDCs and LyDCs pre- or post-stimulated by Talpha1 were analyzed by flow cytometry. Autologous T cells were cocultured with LyDCs in the presence or absence of Talpha1 2 days later. IL-12 secretion of LyDCs and IFN-gamma secretion of the activated T cells in the supernatants were measured by ELISA. The in vitro cytotoxicity of antigen specific cytotoxic T lymphocytes (CTLs) induced by LyDCs which were treated with Talpha1 was evaluated by MTT assay. A humanized nude mice model bearing colon cancer was established. The in vivo antitumor activity was evaluated in the humanized nude mice after the treatment with LyDCs plus Talpha1 or LyDCs alone., Results: The expression levels of HLA-DR, CD80, CD86 and CD83 in imDCs and LyDCs were markedly up-regulated after the stimulation with Talpha1 respectively (P<0.01). The levels of IL-12 and IFN-gamma were also significantly increased in the presence of Talpha1 (P<0.05 and P<0.01, respectively). Cytotoxicity induced by LyDCs treated with Talpha1 was significantly enhanced (P<0.01) as compared with LyDCs in vitro. The humanized cellular immunity was successfully established in the nude mice model. On the 58 th day after the inoculation of tumor cells, the inhibitory rate of tumor growth was significantly higher in the group treated with LyDCs plus Talpha1 than that in the group treated with LyDCs alone (60.41% and 37.20%, respectively; P<0.01)., Conclusion: Talpha1 can induce the functional maturation of DCs and enhance the immune response of CD4+Th1 arm and cytotoxicity induced by LyDCs. Talpha1 has a synergistic antitumor effect. It might be a promising adjuvant candidate for DC-based immunotherapy of gastrointestinal carcinomas.

Background & Objective: Lymph node micrometastasis in early gastric cancer is being widely discussed. Cytokeratin (CK) staining is an important way to distinguish epithelial cancer cells. This study was to investigate the correlations of epithelial cadherin (E-cad) expression to lymph node micrometastasis, and clinicopathologic features of early gastric cancer, and to evaluate its clinical significance., Methods: Morphology of 4522 lymph nodes from 162 patients with early gastric cancer was observed with HE staining and CK immunostaining. E-cad expression in 135 primary lesions of these patients was detected by immunohistochemistry. The correlations of E-cad expression to clinicopathologic features were analyzed., Results: The detection rate of lymph node metastasis by CK staining was significantly higher than that by HE staining (26.5% vs. 6.8%, P<0.001). CK immunostaining detected 32 cases of lymph node micrometastasis which were missed by HE staining. Lymph node micrometastasis was frequently found in primary tumors with a diameter of more than 1.0 cm, in those that were poorly differentiated, deeply invaded (for example, to the submucosa), showed lymphatic or vascular invasion, and in those that showed loss of E-cad expression (P<0.05). The reduced expression rate of E-cad in primary tumor was 57.0%, closely correlated to lymph node micrometastasis. The 5-year survival rate was significantly lower in the patients with lymph node micrometastasis than in those without such metastasis (93.6% vs. 100%, P<0.01)., Conclusion: Primary tumor more than 1.0 cm in diameter, poor differentiation, deep invasion, lymphatic or vascular invasion, and loss of E-cad expression are risk factors for lymph node metastasis in early gastric cancer.

Aim: To explore the efficiency of antitumor immunity induced by autologous dendritic cells (DCs) transfected with total RNA of autologous gastric cancer cells., Methods: Short-term cultured primary gastric cancer cells were prepared. DCs in peripheral blood mononuclear cells (PBMCs) from gastric cancer patients were induced with rhGM-CSF, rhIL-4 and TNF-alpha. The mature DCs transfected with total RNA of autologous gastric cancer cells were subjected to activate autologous T cells transforming into CTLs, and the activity of CTLs was detected by using CCK-8 kit. The immunological function of DCs were evaluated by flow cytometry and mixed lymphocyte culture(MLC) assay. The levels of IFN-gamma and IL-12 were detected by ELISA., Results: Mature DCs transfected with total RNA of autologous gastric cancer cells not only highly expressed costimulatory molecules (CD80, CD83 and CD86) and (MHC-I and MHC-II), but also powerfully stimulated allogenic or autologous T cell proliferation. The level of IL-12 secreted by mature DCs transfered with tumor RNA was notably higher than those secreted by untransfered and immature DCs, and the rate of killing autologous gastric cancer cells by CTLs was markedly higher than that of killing allogenic tumor cells., Conclusion: Mature DCs transfected with autologous gastric cancer cell total RNA can induce and activate high antigen-specific CTLs directed at autologous gastric cancer cells in vitro.

Objective: To clarify the clinicopathologic characteristics of micrometastasis in lymph nodes and microinvasion in primary lesion for the treatment options with regard to submucosal gastric cancer., Methods: 1945 lymph nodes and 68 primary tumors resected from 79 patients with submucosal gastric cancer were examined. Two consecutive sections were prepared for simultaneous staining with HE and immunostaining with anti-cytokeratin antibody (CAM 5.2), respectively., Results: The incidence of nodal involvement in 79 patients with submucosal gastric cancer was increased from 13% (10/79 patients) by HE staining to 34% (27/79 patients) by cytokeratin immunostaining. Micrometastasis in the lymph nodes were found in 17 of 69 patients (25%) with cancer-free nodes examined by HE staining. Microinvasion to the muscularis properia was found in 11 of 68 patients (16%) who were histologically diagnosed as submucosal gastric cancer. Survival analysis demonstrated a worse 5-year survival in the patients with micrometastasis in lymph nodes (82%) and with microinvasion to muscularis properia (73%). A higher incidence of nodal involvement was found in submucosal cancers of large size (> 2 cm; 43%), a depressed type (48%), lymphatic invasion (73%), and deeper submucosal invasion (submucosal 3; 53%). A higher incidence of microinvasion was found with the diffused-type carcinoma (33%)., Conclusions: Cytokeratin immunostaining is useful for detecting micrometastasis and microinvasion in submucosal gastric cancer. Tumor size, microscopic type, lymphatic invasion, and the depth of submucosal invasion are strongly associated with lymph node involvement. Micrometastasis in lymph nodes and microinvasion in primary lesion indicate an unfavorable outcome of the patients with submucosal gastric cancer.