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This paper aims to investigate corporations’ ESG for sustainable investment in China, with the moderating role of regional marketization. ESG is a form of business value for enterprises, including the three pillars of environmental, social, and governance, aimed at promoting the sustainable development of the economy and society. ESG is vital for corporations’ sustainable investment, but such influence is always limited by the level of regional marketization, which has been rarely studied by the previous literature. In this study, we use data from Chinese A-share listed companies from 2009 to 2021 to conduct an empirical analysis to examine whether ESG performance can improve firm investment and if the degree of regional marketization plays a moderating role. Furthermore, we identify the underlying mechanism of ESG performance influencing corporate investment. It has been discovered that ESG performance improves firm investment, and the impact of ESG performance on investment level enhancement is stronger in places with a higher level of marketization. The further tests still support our results. This study provides a reference to develop ESG and regional marketization to push corporations’ sustainable development.

Foreign-born Chinese American women (FBCAW) have the lowest mammography rates compared with other racial groups despite the overwhelming evidence of the benefits of screening. Message framing based on the prospect theory has shown significant but inconsistent effects on mammogram screening among ethnic minority groups.Using data from a randomized controlled trial, this secondary analysis aims to identify factors that interact with message framing to improve mammography screening in FBCAW.In the parent study, participants were randomized to receive either a gain- or loss-framed brochure that encouraged mammography screening. Data were collected at baseline and 2 months using validated questionnaires. For this secondary analysis, ordinal logistic regression was performed to identify moderation effects using both per-protocol and intention-to-treat principles.Participants predominantly had low income, a low level of English proficiency, and no insurance. Lack of access to mammography services, knowledge of making a mammogram appointment, knowledge of insurance coverage for breast cancer treatment, education levels, and mammogram history were significant moderators of the framing effects. Overall, the moderation effects were larger when using per-protocol analysis. Some moderation results under intention-to-treat analysis were different from those using per-protocol analysis.The persuasive effects of the loss- or gain-framed messages depend on the characteristics of FBCAW. Future studies can identify algorithms to select tailored messages that match individual FBCAW's characteristics to optimize the effects of framed messages.Findings of this study can guide healthcare providers, especially nurses, to choose different wording when communicating with their clients.

Background: Visual clarity during shoulder arthroscopy can ensure an efficient and effective performance of the procedure, and it is highly related to bleeding without a tourniquet. Tranexamic acid (TXA) is widely used in adult reconstruction procedures; however, its use in shoulder arthroscopic operations is a relatively novel topic. Purpose: To analyze the available literature on visual clarity, blood loss, pain control, functional outcomes, and complications after the administration of tranexamic acid in shoulder arthroscopic surgery. Methods: A literature search was performed to retrieve randomized controlled trials examining the use of tranexamic acid at the time of shoulder arthroscopic surgery. The literature search included the MEDLINE, Embase, Web of Science, and Cochrane Library databases. The primary outcomes included visual clarity, blood loss, and visual analog scale scores for pain. Secondary outcomes were operative time, irrigation amount used, postoperative shoulder swelling, the need for pressure increase, mean arterial pressure (MAP), functional outcomes, postoperative adverse effects such as deep venous thrombosis, and pulmonary embolism. The outcomes were pooled to perform a meta-analysis. Results: Seven prospective randomized controlled trials met the inclusion criteria for analysis. All of the included studies performed arthroscopic rotator cuff repair. No significant difference in visual clarity was observed (SMD (standardized mean difference), 0.45 [95% CI(confidence interval), −0.68, 1.59]; p = 0.44) nor in pain score (MD (mean difference), −0.46 [95% CI, −0.97, 0.05]; p = 0.08) between the TXA group and the control group. Two studies found no significant difference in blood loss between the TXA group and the control group. The meta-analysis from five studies demonstrated no significant difference between the TXA and control groups in operative time (MD, −3.51 [95% CI, −15.82, 8.80]; p = 0.58) or irrigation amount used (MD, −2.53 [95% CI, −5.93, 0.87]; p = 0.14). Two trials reported different statistical results in postoperative shoulder swelling. No significant differences regarding the need for pressure increase and MAP were reported between groups. No wound complications or infections or cardiac, thrombotic, or thromboembolic complications were recorded in either group. Conclusion: The use of intravenous or local TXA in shoulder arthroscopic surgery did not increase complications or thromboembolic events, but TXA had no obviously effect of reducing bleeding to obtain a clear visual field or pain release in patients undergoing shoulder arthroscopic surgery.

Multi-parent crossover algorithms (MCAs) are widely used in solving optimization problems in many fields relying on encoding, crossover, variation and choice operators to produce iterative offspring chromosome. In this paper, a real-coded schema to support this genetic optimization process is considered. At each crossover stage, a linear combination of coefficients at the same scale hybridizes a fixed number of parent chromosomes. If parent chromosomes are iteratively selected, then coefficients will indicate these parent chromosomes: how to propagate. Essentially, all MCAs differentiate one algorithm from others through coefficient restriction. However, little work exists on analyzing techniques that efficiently create within-bound coefficients. The existing MCAs build coefficients following a uniform distribution, but at the same time, these coefficients violate constraints, thus propagating error. The error will cascade exponentially as the hybrid scale rises even slightly, leading to increased time consumption. To address this problem, an empirical distribution-based framework (EDBF) is proposed which takes multiple MCAs as its constituent members. Numerical results showed that proposed EDBF outperforms its members in terms of time consumption. As a general framework rather than a specific algorithm, EDBF is easy to implement and can easily accommodate any existing MCA.

Dams constructed by humans are important facilities for irrigation, flood control, and power generation. Recognizing the location and number of dams is crucial for studying the impact of human activities on ecosystem change. Although many countries and organizations have established their own dam datasets, it is only the tip of the iceberg of real dam construction. Therefore, effectively and accurately obtaining the geographic location of dams is still a significant problem to be solved. This article proposes an improved convolutional neural network (CNN) based framework to recognize global dams from high-resolution remotely sensed images. First, a dataset named the global dam detection dataset is built based on Google earth high-resolution images, and the dataset is used as the training and testing dataset for the CNN model. Second, an improved dam recognition method (HRLibra-RCNN) is proposed to detect dams on a global scale. Third, an application strategy for global dam recognition from large remote sensing images is established to recognize dams in seven regions around the world. Compared with two two-stage object recognition models (Faster-RCNN and Cascade-RCNN) and a single-stage target detection model (RetinaNet), the proposed method achieved the highest average precision of 79.4%, with the HRNet-40w backbone network structures achieving the highest average precision of 80.7%. The average precision of 70.8% and recall of 90.4% are achieved during the application stage. The dataset and framework developed in this study are the first attempts to combine remote sensing big data and the deep learning method to recognize dams at a global scale.

Objectives: Three-dimensional (3D) models were reconstructed based on computed tomography (CT) scan data and to analyze the morphometric characteristics of the nasal septum in Chinese individuals. Methods: Ninety-six healthy adults aged 20-83 years old without confirmed nasal disorders were enrolled in this study from 2014 to 2015. 3D models of the nasal septum were reconstructed based on their CT scan data, and 7 indices were used for the evaluation of the spacial structure of the nasal septum. Results: Data of the nasal septum revealed larger nasal septum volumes in males than those in females (P

Objective. The purpose of this study is to assess the efficacy and safety of the integration of Western medicine with traditional Chinese medicine (TCM) in patients with coronary heart disease (CHD) which is comorbid with anxiety and depression. Methods. Randomized controlled trials (RCTs) were searched in databases such as VIP, WanFang, CNKI, Embase, PubMed, and Cochrane Library from the inception of databases to November 2021. RCTs on treating CHD comorbid with anxiety and depression with the integration of TCM and Western medicine were retrieved, and publications were screened according to the screening criteria. Software RevMan 5.4 was utilized to analyze related indicators. Results. Thirteen eligible studies were included in this meta-analysis. They involved a total of 1460 cases, including 747 cases in the TCM and Western medicine group, and 713 cases in the control group. Meta-analysis results illustrated that the difference in the relief of angina pectoris in treating CHD comorbid with anxiety and depression with the integration of TCM and Western medicine was statistically significant (OR = 3.97, 95% CI [2.47, 6.39], P < 0.05 ), and HAMD score, HAMA score, and clinical effective rate were statistically significant (MD = −4.11, 95% CI [−5.10, 3.12]), (SMD = 1.88, 95% CI [2.53, 1.24]), (OR = 9.71, 95% CI [4.65, 20.28]). Conclusion. By combining TCM and Western medicine, the treatment of angina pectoris and CHD comorbid with anxiety and depression can alleviate anxiety and depression and can enhance patients’ quality of life.

Dendritic cells (DCs) are antigen-presenting cells that can activate T cells and initiate a primary immune response. Personalized DC vaccines have demonstrated a modest antitumor potential in some clinical pilot studies. However, those vaccines are difficult to manufacture and have a limited antitumor response. In this study, a lentiviral vector-programmed DC vaccine with high antitumor responses is developed. By transfecting with a lentiviral vector, the DC vaccine is loaded with MG-7 antigen (MG-7Ag). Three representative gastric cancer cell lines, such as KATO-3, MKN45, and SNU16, are used to estimate the in vitro cytotoxic effect of the MG-7Ag DC vaccine. Furthermore, we examine the in vivo antitumor efficacy of specific cytotoxic T lymphocytes (CTLs) induced by the MG-7Ag DC vaccine in patient-derived xenograft (PDX) mice models. The current data demonstrate that the MG-7Ag DC vaccine induced a potent CTL activity. Those CTLs have a significant cytotoxic effect on both KATO-3 and MKN45 with high level of MG-7 expression. In addition, MG-7Ag DC vaccine-mediated CTLs significantly inhibit the growth of tumor xenografts in nude mice. The MG-7Ag DC vaccine activate the cytotoxic effect of lymphocytes and can be employed as a vaccine in gastric cancer immunotherapy.

Fractures are the most common type of unintentional injury in children, with traumatic upper limb fractures accounting for approximately 80% of all childhood fractures. Many epidemiological investigations of upper limb fractures in children have been conducted, but with the development of society, the patterns of childhood fractures may have changed. This study aimed to analyze the epidemiology and economic cost factors of upper limb fractures in Chinese children.We retrospectively reviewed children with upper limb fractures or old upper limb fractures hospitalized between December 1, 2015, and December 31, 2019, in 22 tertiary children's hospitals, under China's Futang Research Center of Pediatric Development. We used the ICD10 codes on the front sheet of their medical records to identify cases and extracted data on age, sex, injury cause, fracture site, treatment, the year of admission and discharge, visiting time, and various costs during hospitalization from the medical record.A total of 32,439 children (21,478 boys and 10,961 girls) were identified, of whom 32,080 had fresh fractures and 359 had old fractures. The peak age was 3-6 years in both sexes. A total of 4788 were infants, 14,320 were preschoolers, 10,499 were in of primary school age, and 2832 were adolescent. Fractures were most frequent in autumn (August to October). Admissions peaked at 0 o'clock. Among the 32,080 children with fresh upper limb fractures, the most common fracture site was the distal humerus, with a total of 20,090 fracture events including 13,134 humeral supracondylar fractures and 4914 lateral humeral condyle fractures. The most common cause of injuries was falling over. The most common joint dislocation accompanying upper limb fractures occurred in the elbow, involving 254 cases. Surgery was performed in 31,274 children, and 806 did not receive surgery. Among those with clear operative records, 10,962 children were treated with open reduction and 18,066 with closed reduction. The number of cases was largest in the East China region (Anhui Province, Shandong Province, Jiangsu Province, Zhejiang Province, and Fujian Province), with 12,065 cases overall. Among the 359 children with old fractures, 118 were admitted with a diagnosis of "old humerus fracture," accounting for the highest proportion; 244 underwent surgical open reduction, 16.16% of whom had osteotomy. For the children with fresh fractures, the average total hospital cost was 10,994 yuan, and the highest average total hospital cost was 14,053 yuan, for humeral shaft fractures. For the children with old fractures, the average total hospital cost was 15,151 yuan, and the highest average total hospital cost was 20,698 yuan, for old ulna fractures. Cost of materials was the principle factor affecting total hospital cost, followed by surgery and anesthesia costs, both in children with fresh fractures and those with old fractures. Significant differences were observed in all hospital costs (P 0.001) except treatment costs (P = 0.702), between children with fresh fractures and those with old fractures. Among the 32,439 children, full self-payment accounted for the highest proportion of all payment methods, involving 17,088 cases, with an average cost of 11,111 yuan.Information on the epidemiological characteristics of childhood fractures suggests that health and safety education and protective measures should be strengthened to prevent upper limb fractures in children. For both fresh and old fractures, the cost of materials was the principal factor affecting total hospital cost, followed by surgery and anesthesia costs. The overall average total hospital cost is higher in children with old fractures than in children with fresh fractures. Among all children, full self-payment, at 53% of children, accounted for the highest proportion of all payment methods. Hospital costs are a headache for those families who will pay on their own. It can lead to a delayed treatment and unhealed fractures or malunion in some children. Therefore, the child trauma care system and training on fractures need to be improved, to reduce the late presentation of fractures. These combined measures will improve children's quality of life, reduce the expenditure of families, and decrease the public health burden. To provide better medical services for children, authorities must improve the allocation of health resources, establish a comprehensive medical security system for children, and set up more child trauma centers.

Long noncoding RNA (lncRNA) CRNDE has been broadly implicated in many malignancies. The aim of this study was to explore the function and potential mechanisms of CRNDE in nasopharyngeal carcinoma (NPC). Here, we discovered that CRNDE level was increased in NPC tissues and cell lines. Additionally, elevated CRNDE positively correlated with large tumor size, advanced TNM stage, distant metastasis, EBV infection and worse prognosis. Furthermore, depletion of CRNDE significantly impaired the capacity of proliferation, migration and invasion in NPC cells. Mechanically, CRNDE could serve as a molecular sponge of miR-3163 to regulate the expression of TWIST1. Importantly, the inhibitory effects of CRNDE knockdown on cell proliferation and metastasis were blocked by silence of miR-3163 or restoration of TWIST1 expression. Overall, our data highlighted that CRNDE could promote NPC progression via altering miR-3163/TWIST1 axis, suggesting CRNDE as a potential prognostic biomarker and therapeutic target for NPC treatment.

Natural and non‐natural factors have combined effects on the trajectory of COVID‐19 pandemic, but it is difficult to make them separate. To address this problem, a two‐stepped methodology is proposed. First, a compound natural factor (CNF) model is developed via assigning weight to each of seven investigated natural factors, that is temperature, humidity, visibility, wind speed, barometric pressure, aerosol, and vegetation in order to show their coupling relationship with the COVID‐19 trajectory. Onward, the empirical distribution based framework (EDBF) is employed to iteratively optimize the coupling relationship between trajectory and CNF to express the real interaction. In addition, the collected data is considered from the backdate, that is about 23 days—which contains 14‐days incubation period and 9‐days invalid human response time—due to the nonavailability of prior information about the natural spreading of virus without any human intervention(s), and also lag effects of the weather change and social interventions on the observed trajectory due to the COVID‐19 incubation period; Second, the optimized CNF‐plus‐polynomial model is used to predict the future trajectory of COVID‐19. Results revealed that aerosol and visibility show the higher contribution to transmission, wind speed to death, and humidity followed by barometric pressure dominate the recovery rates, respectively. Consequently, the average effect of environmental change to COVID‐19 trajectory in China is minor in all variables, that is about −0.3%, +0.3%, and +0.1%, respectively. In this research, the response analysis of COVID‐19 trajectory to the compound natural interactions presents a new prospect on the part of global pandemic trajectory to environmental changes., Key Points The response of COVID‐19 trajectory to natural and non‐natural factors is separated through compound natural factor modelCompound natural factor (CNF) exhibits the sensitive response to COVID‐19 trajectoryAerosol and visibility show the higher contribution to transmission, wind speed to death, and humidity followed by barometric pressure dominate the recovery rates, respectivelyReduction in CNF value could help delay the spread of virus, but increase the death and decrease the recovery

Since mid-March 2020, global COVID-19 pandemic has experienced an exponential growth in process from sporadic to sudden outbreaks. This paper selects the 8-day surge data of daily cases, death and recovery rates (March 19-26, 2020) from 18 countries with severe pandemic situation to discuss the impact of 9 factors of both socioeconomic and natural on the pathogen outbreak. Moreover, the paper also elaborates analysis and comparison of relatively slow 4-week (February 1-29, 2020) data of China’s surge cases to determine the relationship between social and natural factors and on the spread of pandemic, which provides an effective reference for delaying and controlling the pandemic development.

OBJECTIVE: This thesis studies on epidemiological characteristics of patients with nasal bone fractures. METHOD: This thesis retrospectively studies on 2 881 patients with nasal bone fractures. The characteristics, causes, and fracture types are collected and reviewed retrospectively. The type of nasal bone fracture is classified according to Fred's classification, and SPSS 25.0 software is used in statistical analysis. RESULT: The sex ratio of nasal bone fracture between males and females is 2.44 : 1, male cases are obviously more than female cases. The group aged 19-29 years occupies the largest proportion, accounted for 35.54%. Traffic accident was the leading cause of the nasal bone fracture, accounting for 33.84%. The second cause was violent assault, 24.12% totally. The number of patients suffering nasal bone fractures combined with maxilla frontal process fractures is higher than that of simple nasal bone fractures. Type Ⅱ fracture is significantly more common in patients with other types nasal bone fractures. Logistic regression analysis for simple nasal bone fracture showed that the relative risk of simple nasal bone fracture is lower in men than in women, and the risk of simple nasal fractures decreased with age increasing. Compared with traffic accident, the relative risk of simple nasal bone fracture is higher in violence injury, sports injury and collision injury. CONCLUSION: The distribution of the nasal fractures of the inpatients has certain characteristics in terms of individual characteristics, injury cause and fracture types, which is worthy of further strategic study on prevention and treatment of the nasal fractures.

Long noncoding RNAs (lncRNAs) were demonstrated to play important roles in gene regulation and cancer progression. However, the functional roles of lncRNAs and the detailed mechanisms underlying gastric cancer (GC) progression remain largely unclear. Here, we identified a novel cancer-related lncRNA, termed lncRNA GCMA (Gastric Cancer metastasis-associated lncRNA), which was upregulated in GC tissues with lymph node metastasis (LNM) compared with tissues without LNM. High expression of GCMA was significantly associated with poor prognosis of patients with GC. Luciferase assays, bioinformatics analyses and chromatin immunoprecipitation (ChIP) assays indicated that SP1 transcription factor directly bound to the GCMA promoter region and activated its transcription. Functionally, upregulation of GCMA dramatically promoted GC cells proliferation, migration and invasion in vitro, whereas knockdown of GCMA elicited the opposite function. Consistently, stable knockdown of GCMA inhibited tumor proliferation, invasion and metastasis in vivo. Mechanistically, by using bioinformatics analyses, RNA binding protein immunoprecipitation (RIP) assays, luciferase assays and western-blot assays, GCMA was demonstrated to function as a competing endogenous RNA (ceRNA) via competitively absorbing miR-124 and miR-34a to upregulate slug and snail, thereby induced epithelial-mesenchymal transition (EMT) and GC cell metastasis in vitro and in vivo. Collectively, these results demonstrate that GCMA functions as an oncogenic lncRNA that may serve as a potential prognostic biomarker for GC and shed new lights on targeted therapy of GC in the future.

Long noncoding RNAs have been demonstrated to contribute to the development and progression of various cancers. However, the underlying regulatory mechanisms of KCNQ1OT1 in tumorigenesis of maxillary sinus squamous cell carcinoma (MSSCC) remain unknown. Herein, we found that KCNQ1OT1 expression was markedly upregulated in MSSCC tissues and MSSCC cell line (IMC-3) by using quantitative reverse transcription-polymerase chain reaction. Loss-of-function experiments revealed that the deletion of KCNQ1OT1 inhibited cell proliferation, migration, and invasion. Moreover, we confirmed KCNQ1OT1 could directly interact with miR-204 by bioinformatic prediction and dual luciferase assay, and miR-204 inhibitor markedly reversed MSSCC tumor phenotypes induced by shKCNQ1OT1. Finally, we demonstrated that KCNQ1OT1/miR-204 facilitated MSSCC progression by regulating Eph receptor A7 (EphA7). Taken together, these results revealed a novel regulatory mechanism KCNQ1OT1/miR-204/EphA7 axis, which could provide a new understanding of MSSCC tumorigenesis and develop potential targets for MSSCC therapy.

Neuronal cell apoptosis is an important pathological change in Alzheimer's disease (AD). Hydrogen sulfide (H(2)S) is known to be a novel gaseous signaling molecule and a cytoprotectant in many diseases including AD. However, the molecular mechanism of the antiapoptosis activity of H(2)S in AD is not yet fully understood. The aim of the present study is to evaluate the inhibitory effects of H(2)S on Abeta (Aβ)-induced apoptosis and the molecular mechanisms underlying primary neuron cells. Our results showed that sodium hydrosulfide (NaHS), a donor of H(2)S, significantly ameliorated Aβ-induced cell apoptosis. NaHS also reversed the Aβ-induced translocation of the phosphatase and tensin homologs deleted on chromosome 10 (PTEN) from the cytosol to the mitochondria. Furthermore, H(2)S increased the level of p-AKT/AKT significantly. Interestingly, the antiapoptosis effects of H(2)S were blocked down by specific PI3K/AKT inhibitor wortmannin. In conclusion, these data indicate that H(2)S inhibits Aβ-induced neuronal apoptosis by attenuating mitochondrial translocation of PTEN and that activation of PI3K/AKT signaling pathway plays a critical role in H(2)S-mediated neuronal protection. Our findings provide a novel route into the molecular mechanisms of neuronal apoptosis in AD.

To obtain the high-resolution multitemporal precipitation using spatial downscaling technique on a precipitation dataset may provide a better representation of the spatial variability of precipitation to be used for different purposes. In this research, a new downscaling methodology such as the global precipitation mission (GPM)-based multitemporal weighted precipitation analysis (GMWPA) at 0.05° resolution is developed and applied in the humid region of Mainland China by employing the GPM dataset at 0.1° and the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) 30 m DEM-based geospatial predictors, i.e., elevation, longitude, and latitude in empirical distribution-based framework (EDBF) algorithm. The proposed methodology is a two-stepped process in which a scale-dependent regression analysis between each individual precipitation variable and the EDBF-based weighted precipitation with geospatial predictor(s), and to downscale the predicted multitemporal weighted precipitation at a refined scale is developed for the downscaling of GMWPA. While comparing results, it shows that the weighted precipitation outperformed all precipitation variables in terms of the coefficient of determination (R2) value, whereas they outperformed the annual precipitation variables and underperformed as compared to the seasonal and the monthly variables in terms of the calculated root mean square error (RMSE) value. Based on the achieved results, the weighted precipitation at the low-resolution (e.g., at 0.75° resolution) along-with the original resolution (e.g., at 0.1° resolution) is employed in the downscaling process to predict the average multitemporal precipitation, the annual total precipitation for the year 2001 and 2004, and the average annual precipitation (2001–2015) at 0.05° resolution, respectively. The downscaling approach resulting through proposed methodology captured the spatial patterns with greater accuracy at higher spatial resolution. This work showed that it is feasible to increase the spatial resolution of a precipitation variable(s) with greater accuracy on an annual basis or as an average from the multitemporal precipitation dataset using a geospatial predictor as the proxy of precipitation through the weighted precipitation in EDBF environment.

Chinese American women have lower rates of mammography screening compared with non-Hispanic White women. Although the extent of perceived barriers, as conceptualized by the Health Belief Model, have been shown to distinguish between currently non-adherent Chinese American women who have ever and never had a mammogram, it is less clear which types of perceived barriers differentiate them. One hundred twenty-eight Chinese American women in the New York metropolitan area who had not had a mammogram in the past year completed baseline assessments for a mammography framing intervention study. Demographics, medical access variables, and perceived barriers to mammography (lack of access, lack of need for screening, and modesty) were used to predict mammography history (ever versus never screened). Fifty-five women (43%) reported having been screened at least once. A sequential logistic regression showed that English speaking ability and having health insurance significantly predicted mammography history. However, these control variables became non-significant when the three barrier factors were included in the final model. Women who reported a greater lack of access (

// Wenxue Zhang 1, 2, 3, 4 , Dongyan Zhao 5 , Qingqing Qi 1, 2 , Xin Long 1, 2 , Yueyue Li 1, 2 , Peng Wang 1, 2 , Yanbo Yu 1, 2 , Lixiang Li 1, 2 , Yiyuan Sun 1, 2 , Zhen Li 1, 2 , Yanqing Li 1, 2 and Xiuli Zuo 1, 2 1 Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, China 2 Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, China 3 Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China 4 Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China 5 Department of Gastroenterology, General Hospital of Puyang Oilfield, Puyang 457000, China Correspondence to: Xiuli Zuo, email: zuoxiuli@sina.com Keywords: NMDARs; NR2B; proBDNF; visceral hypersensitivity; diarrhea-predominant irritable bowel syndrome Received: December 01, 2016 Accepted: January 02, 2018 Published: January 02, 2018 ABSTRACT Colonic mucosal N-methyl-D-aspartate receptors (NMDARs) contribute to visceral hypersensitivity in diarrhea-predominant irritable bowel syndrome (IBS-D) by increasing the production of brain-derived neurotrophic factor (BDNF). We investigated which of the multiple NMDAR subtypes and BDNF isoforms are responsible for this effect. Immunohistochemistry and Western blotting were used to detect levels of colonic mucosal NR2A-D subunits and the precursor (proBDNF) and mature (mBDNF) forms of BDNF in 67 participants. Only NR2B subunit expression was elevated in the colonic mucosa of IBS-D patients, in parallel with increased total BDNF and proBDNF expression. Expression of 15 kDa mBDNF was not detected in the colonic mucosa. NR2B, total BDNF and proBDNF levels correlated with abdominal pain scores. Quantitative real-time PCR and Western blotting showed that NMDAR activation substantially induced total BDNF/proBDNF expression in HT-29 cells, while the NMDAR inhibitor MK-801 and the NR2B subunit antagonist Ro25-6981 each completely blocked these effects. Thus, colonic mucosal NR2B-containing NMDARs may contribute to visceral hypersensitivity in IBS-D patients by upregulating BDNF, especially proBDNF.

Objectives This study examined the role of women's perceptions about the relative pros versus cons (decisional balance) of mammography in moderating Chinese American women's responses to gain- and loss-framed messages that promote mammography. Methods One hundred and forty-three Chinese American women who were currently nonadherent to guidelines for receiving annual screening mammograms were randomly assigned to read either a gain- or loss-framed culturally appropriate print brochure about mammography screening. Mammography screening was self-reported at a 2-month follow-up. Results Although there was not a main effect for message frame, the hypothesized interaction between message frame and decisional balance was significant, indicating that women who received a framed message that matched their decisional balance were significantly more likely to have obtained a mammogram by the follow-up than women who received a mismatched message. Conclusions Results suggest that decisional balance, and more generally, perceptions about mammography, may be an important moderator of framing effects for mammography among Chinese American women. Practice implications The match between message frame and decisional balance should be considered when attempting to encourage Chinese American women to receive mammography screening, as a match between the two may be most persuasive.

Atresiaplasty is still a challenge for otolaryngologist, although the operation technique has been modified several times over the past decades. This study describes a reliable flap technique for combining atresiaplasty with total auricular reconstruction by performing the total auricular reconstruction with the MEDPOR framework at the same time as the atresiaplasty for patients with microtia and congenital aural atresia. We performed a prospective study of the medical records of 18 consecutive patients with congenital aural atresia. All the patients had a Jahrsdoerfer grade of 6 or higher, and the mean age was 9.7 years. Atresiaplasty with the new flap technique was performed in 19 ears in our department from January 1, 2011, through July 31, 2013. Among the postoperative ears, 17 ears (89.5 %) had the excellent outcomes, without infections and stenosis. Only two ears (10.5 %) had postoperative stenosis and atresia after infection, respectively. There were no other complications. We concluded that the new flap technique combining atresiaplasty and total auricular reconstruction yielded satisfactory canal patency, low infection rates, and favorable cosmetic results, with acceptable rates of complications. This novel flap technique is a valuable option in the armamentarium of microtia and atresia surgeons.

Although proton pump inhibitors (PPIs) have been used widely, acid-related diseases are still associated with a huge burden on the health care system. Recently, the efficacy and safety of a new acid suppressant named vonoprazan in the treatment of acid-related diseases have been evaluated by a series of studies. As a novel potassium-competitive acid blocker, vonoprazan may provide reversible acid suppression by preventing K+ from binding to gastric H+/K+-ATPase. It has been clinically used for the short-term treatment of gastroesophageal reflux disease (GERD), peptic ulcer disease and Helicobacter pylori (H. pylori) infection in Japan. The healing rate of GERD and gastric ulcers by vonoprazan is more than 95 and 90%, respectively; also, it is effective in curing PPI-resistant GERD. It increases H. pylori eradication rate to more than 88% as part of both first-line and second-line therapy. It is also effective in the eradication of clarithromycin-resistant H. pylori strains. All of these short-term studies show vonoprazan is safe and well-tolerated. As a safe and effective acid inhibitor, vonoprazan might be a novel alternative in the treatment of acid-related diseases.

Background Altered visceral sensation is common in irritable bowel syndrome (IBS) and nerve growth factor (NGF) participates in visceral pain development. Sodium butyrate (NaB) could induce colonic hypersensitivity via peripheral up-regulation of NGF in animals. Enteric glial cells (EGCs) appear to be an important source of NGF. Whether butyrate could induce visceral hypersensitivity via increased EGC-derived NGF is still unknown. Methods CRL-2690 cells were used for transcriptome analyses after butyrate treatment. Rats received butyrate enemas to induce colonic hypersensitivity. Colorectal distention test was performed to assess visceral sensitivity. Immunofluorescence studies were used to evaluate the co-expression of glial fibrillary acidic protein (GFAP) and NGF or growth associated protein 43 in animal model. NGF expression in rat colon was also investigated. In vitro, CRL-2690 cells were stimulated with NaB or trichostatin A (TSA). NGF or GFAP expression was also examined. Key results Transcriptome analyses showed that butyrate induced marked changes of genes expression related to neurotrophic signaling pathways. NaB-treated rats showed increased visceral sensitivity. An improved NGF expression level was observed in NaB-treated rats. Meanwhile, a 2.1-fold increase in co-expression of GFAP and NGF was also determined in rats received NaB enemas. In cultured cells, both NaB and TSA treatment could cause obvious NGF expression. Thus, butyrate might regulate EGC function via histone deacetylase inhibition. Conclusions & inferences Butyrate-EGC interplay may play a pivotal role in regulation of NGF expression and the development of colonic hypersensitivity in IBS-like animal model.

Upregulation of programmed death 1 ligand 1 (PD-L1) in cancer cells and its ligation to PD-1 on T cells facilitates cancer cell escape from immune surveillance. Therapies with PD-1 or PD-L1 antibodies have resulted in marked clinical responses in various cancer types. Hence, modulators that inhibit PD-L1 expression in cancer cells may serve as a novel strategy by which to enhance host immune responses. In the present study, we investigated the effects of miR-375 on PD-L1 expression in head and neck squamous cell carcinoma (HNSCC) cells by qRT-PCR and western blot analyses. We confirmed that miR-375 inhibited IFN-γ-induced PD-L1 surface expression in HNSCC cells, and we observed that Janus kinase 2 (JAK2) is a bona fide target of miR-375 and further activated signal transducer and activator of transcription 1 (STAT1). Additionally, miR-375-mediated inhibition of PD-L1 expression was dependent on the JAK2/STAT1 pathway. Therefore, by attenuating PD-1/PD-L1 signaling, miR-375 may also serve as a modulator to increase the cell immune responses to HNSCC.

Background To investigate the effects of twice daily short-message-based re-education (SMRE) before taking medicine for Helicobacter pylori (H pylori) eradication. Materials and methods Treatment-naive patients with H pylori infection were prescribed 14-day quadruple regimen consisting of lansoprazole 30 mg, colloidal bismuth pectin 200 mg, amoxicillin 1000 mg, and clarithromycin 500 mg twice daily. Patients were randomly allocated to SMRE group or control group. Patients in control group received oral and written instructions at outpatient clinic. In contrast, patients in the SMRE group received extra short messages including dosage and time of administration twice daily. Successful H pylori eradication was assessed using the 13 C-urea breath test 6 weeks after treatment. The compliance, adverse events, and patient satisfaction were also analyzed. Results A total of 310 patients were enrolled in the intention-to-treat (ITT) and 283 in the per-protocol (PP) analysis. For young patients, the eradication rates were significantly higher in SMRE group than those in control group in PP analysis (88.6% vs 71.2%, P = 0.036), while for patients of all age groups, the eradication rate improvements were not statistically significant. The eradication rates in SMRE group and control group were 74.2% and 67.7% (P = 0.211) in ITT analysis and 82.1% and 73.4% (P = 0.078) in PP analysis, respectively. The compliance in SMRE group was significantly better than that in control group (84.8% vs 72.8%, P = 0.011). Conclusions Twice daily SMRE could improve the eradication rate in young population, as well as the compliance with treatment during H pylori eradication.