Enhancing Older Household Consumption: The Impact of Long-Term Care Insurance in China.

OBJECTIVES: Household consumption significantly affects the quality of life and successful aging of older adults. However, prior research has often overlooked the connection between household consumption and long-term care insurance (LTCI). This study aims to investigate the influence of LTCI on consumption patterns within older Chinese households. METHODS: We used harmonized data from the China Health and Retirement Longitudinal Study and merged it with data from cities that implemented LTCI in China. We analyzed a total of 6,494 households consisting of individuals who were 60 years of age or older. To ensure accurate and stable research findings, we employed a series of difference-in-differences models. RESULTS: We found that LTCI has a significant impact on consumption levels, including total and per capita consumption within older households. Furthermore, our research demonstrates that LTCI significantly enhances enjoyable consumption across the consumption types. Through a heterogeneous analysis, it is shown that LTCI has a unique effect on both the total and enjoyable consumption of urban older households and also promotes comprehensive consumption improvements in older rural and disabled households. DISCUSSION: These findings highlight the crucial role of LTCI in improving the financial security and well-being of older households. They also have considerable policy implications for dealing with the challenges of an aging population.

Spontaneous massive fetomaternal hemorrhage: two case reports and a literature review of placental pathology.

BACKGROUND: Massive fetomaternal hemorrhage (FMH) is a rare event during pregnancy that may cause severe fetal anemia or death. CASE PRESENTATION: This paper reports two cases of fetomaternal hemorrhage with unexplained reasons. Both cases required emergency caesarean sections for non-reassuring fetal status and were treated with neonatal blood transfusion. Fetomaternal hemorrhage was confirmed via maternal Kleihauer-Betke test. CONCLUSION: We found parenchymal pallor, increased nucleated red blood cells (nRBCs), and syncytial knots (SKs) in the placentas, which are compatible with fetal anemia. Immunohistochemical staining indicated VEGF, CD34, and CD31 expression in the endothelial cells of the capillaries, characteristic of massive FMH placenta. This article also reviews the particular histopathological changes in FHM placenta according to the placental lesion classification system.

Involvement of CD40-CD40L and ICOS-ICOSL in the development of chronic rhinosinusitis by targeting eosinophils.

Background: Chronic rhinosinusitis (CRS), whose prevalence and pathogenesis are age-related, is characterized by nasal tissue eosinophil infiltration. CD40-CD40 ligand (CD40L) pathway involves in the eosinophil-mediated inflammation, and inducible co-stimulator (ICOS)-ICOS ligand (ICOSL) signal can strengthen CD40-CD40L interaction. Whether CD40-CD40L and ICOS-ICOSL have a role in the development of CRS remains unknown. Objectives: The aim of this study is to investigate the association of CD40-CD40L and ICOS-ICOSL expression with CRS and underlying mechanisms. Methods: Immunohistology detected the expression of CD40, CD40L, ICOS, and ICOSL. Immunofluorescence was performed to evaluate the co-localizations of CD40 or ICOSL with eosinophils. Correlations between CD40-CD40L and ICOS-ICOSL as well as clinical parameters were analyzed. Flow cytometry was used to explore the activation of eosinophils by CD69 expression and the CD40 and ICOSL expression on eosinophils. Results: Compared with the non-eCRS subset, ECRS (eosinophilic CRS) subset showed significantly increased CD40, ICOS, and ICOSL expression. The CD40, CD40L, ICOS, and ICOSL expressions were all positively correlated with eosinophil infiltration in nasal tissues. CD40 and ICOSL were mainly expressed on eosinophils. ICOS expression was significantly correlated with the expression of CD40-CD40L, whereas ICOSL expression was correlated with CD40 expression. ICOS-ICOSL expression positively correlated with blood eosinophils count and disease severity. rhCD40L and rhICOS significantly enhanced the activation of eosinophils from patients with ECRS. Tumor necrosis factor-α (TNF-α) and interleukin-5 (IL-5) obviously upregulated CD40 expression on eosinophils, which was significantly inhibited by the p38 mitogen-activated protein kinase (MAPK) inhibitor. Conclusions: Increased CD40-CD40L and ICOS-ICOSL expressions in nasal tissues are linked to eosinophils infiltration and disease severity of CRS. CD40-CD40L and ICOS-ICOSL signals enhance eosinophils activation of ECRS. TNF-α and IL-5 regulate eosinophils function by increasing CD40 expression partly via p38 MAPK activation in patients with CRS.

Pilot study of a novel nanobody 68 Ga-NODAGA-SNA006 for instant PET imaging of CD8+ T cells.

PURPOSE: Positron emission tomography (PET) with specific diagnostic probes for quantifying CD8+ T cells has emerged as a powerful technique for monitoring the immune response. However, most CD8+ T cell radiotracers are based on antibodies or antibody fragments, which are slowly cleared from circulation. Herein, we aimed to develop and assess 68 Ga-NODAGA-SNA006 for instant PET (iPET) imaging of CD8+ T cells. METHODS: A novel nanobody without a hexahistidine (His6) tag, SNA006-GSC, was designed, site-specifically conjugated with NODAGA-maleimide and radiolabelled with 68 Ga. The PET imaging profiles of 68 Ga-NODAGA-SNA006 were evaluated in BALB/c MC38-CD8+/CD8- tumour models and cynomolgus monkeys. Three volunteers with lung cancer underwent whole-body PET/CT imaging after 68 Ga-NODAGA-SNA006 administration. The biodistribution, pharmacokinetics and dosimetry of patients were also investigated. In addition, combined with immunohistochemistry (IHC), the quantitative performance of the tracer for monitoring CD8 expression was evaluated in BALB/c MC38-CD8+/CD8- and human subjects. RESULTS: 68 Ga-NODAGA-SNA006 was prepared with RCP > 98% and SA > 100 GBq/µmol. 68 Ga-NODAGA-SNA006 exhibited specific uptake in MC38-CD8+ xenografts tumours, CD8-rich tissues (such as the spleen) in monkeys and CD8+ tumour lesions in patients within 1 h. Fast washout from circulation was observed in three volunteers (t1/2 < 20 min). A preliminary quantitative linear relationship (R2 = 0.9668, p < 0.0001 for xenografts and R2 = 0.7924, p = 0.0013 for lung patients) appeared between 68 Ga-NODAGA-SNA006 uptake and CD8 expression. 68 Ga-NODAGA-SNA006 was well tolerated by all patients. CONCLUSION: 68 Ga-NODAGA-SNA006 PET imaging can instantly quantify CD8 expression with an ideal safety profile and is expected to be important for dynamically tracking CD8+ T cells and monitoring immune responses for individualised cancer immunotherapy. TRIAL REGISTRATION: NCT05126927 (19 November 2021, retrospectively registered).

Automated tumor proportion scoring for PD-L1 expression based on multistage ensemble strategy in non-small cell lung cancer.

INTRODUCTION: Programmed cell death ligand-1 (PD-L1) expression is a promising biomarker for identifying treatment related to non-small cell lung cancer (NSCLC). Automated image analysis served as an aided PD-L1 scoring tool for pathologists to reduce inter- and intrareader variability. We developed a novel automated tumor proportion scoring (TPS) algorithm, and evaluated the concordance of this image analysis algorithm with pathologist scores. METHODS: We included 230 NSCLC samples prepared and stained using the PD-L1(SP263) and PD-L1(22C3) antibodies separately. The scoring algorithm was based on regional segmentation and cellular detection. We used 30 PD-L1(SP263) slides for algorithm training and validation. RESULTS: Overall, 192 SP263 samples and 117 22C3 samples were amenable to image analysis scoring. Automated image analysis and pathologist scores were highly concordant [intraclass correlation coefficient (ICC) = 0.873 and 0.737]. Concordances at moderate and high cutoff values were better than at low cutoff values significantly. For SP263 and 22C3, the concordances in squamous cell carcinomas were better than adenocarcinomas (SP263 ICC = 0.884 vs 0.783; 22C3 ICC = 0.782 vs 0.500). In addition, our automated immune cell proportion scoring (IPS) scores achieved high positive correlation with the pathologists TPS scores. CONCLUSIONS: The novel automated image analysis scoring algorithm permitted quantitative comparison with existing PD-L1 diagnostic assays and demonstrated effectiveness by combining cellular and regional information for image algorithm training. Meanwhile, the fact that concordances vary in different subtypes of NSCLC samples, which should be considered in algorithm development.

Defect Filling Method of Sensor Encapsulation Based on Micro-Nano Composite Structure with Parylene Coating.

The demand for waterproofing of polymer (parylene) coating encapsulation has increased in a wide variety of applications, especially in the waterproof protection of electronic devices. However, parylene coatings often produce pinholes and cracks, which will reduce the waterproof effect as a protective barrier. This characteristic has a more significant influence on sensors and actuators with movable parts. Thus, a defect filling method of micro-nano composite structure is proposed to improve the waterproof ability of parylene coatings. The defect filling method is composed of a nano layer of Al2O3 molecules and a micro layer of parylene polymer. Based on the diffusion mechanism of water molecules in the polymer membrane, defects on the surface of polymer encapsulation will be filled and decomposed into smaller areas by Al2O3 nanoparticles to delay or hinder the penetration of water molecules. Accordingly, the dense Al2O3 nanoparticles are utilized to fill and repair the surface of the organic polymer by low-rate atomic layer deposition. This paper takes the pressure sensor as an example to carry out the corresponding research. Experimental results show that the proposed method is very effective and the encapsulated sensors work properly in a saline solution after a period of time equivalent to 153.9 days in body temperature, maintaining their accuracy and precision of 2 mmHg. Moreover, the sensors could improve accuracy by about 43% after the proposed encapsulation. Therefore, the water molecule anti-permeability encapsulation would have broad application prospects in micro/nano-device protection.

FlowCell-enriched circulating tumor cells as a predictor of lung cancer metastasis.

Lung cancer is the most fetal malignancy due to the high rate of metastasis and recurrence after treatment. A considerable number of patients with early-stage lung cancer relapse due to overlooked distant metastasis. Circulating tumor cells (CTCs) are tumor cells in blood circulation that originated from primary or metastatic sites, and it has been shown that CTCs are critical for metastasis and prognosis in various type of cancers. Here, we employed novel method to capture, isolate and classify CTC with FlowCell system and analyzed the CTCs from a cohort of 302 individuals. Our results illustrated that FlowCell-enriched CTCs effectively differentiated benign and malignant lung tumor and the total CTC counts increased as the tumor developed. More importantly, we showed that CTCs displayed superior sensitivity and specificity to predict lung cancer metastasis in comparison to conventional circulating biomarkers. Taken together, our data suggested CTCs can be used to assist the diagnosis of lung cancer as well as predict lung cancer metastasis. These findings provide an alternative means to screen early-stage metastasis.

Ultrathin and Robust Micro-Nano Composite Coating for Implantable Pressure Sensor Encapsulation.

Implantable pressure sensors enable more accurate disease diagnosis and real-time monitoring. Their widescale usage is dependent on a reliable encapsulation to protect them from corrosion of body fluids, yet not increasing their sizes or impairing their sensing functions during their lifespans. To realize the above requirements, an ultrathin, flexible, waterproof while robust micro-nano composite coating for encapsulation of an implantable pressure sensor is designed. The composite coating is composed of a nanolayer of silane-coupled molecules and a microlayer of parylene polymers. The mechanism and principle of the composite encapsulation coating with high adhesion are elucidated. Experimental results show that the error of the sensors after encapsulation is less than 2 mmHg, after working continuously for equivalently over 434 days in a simulated body fluid environment. The effects of the coating thickness on the waterproof time and the error of the sensor are also studied. The encapsulated sensor is implanted in an isolated porcine eye and a living rabbit eye, exhibiting excellent performances. Therefore, the micro-nano composite encapsulation coating would have an appealing application in micro-nano-device protections, especially for implantable biomedical devices.

HMGA1 in cancer: Cancer classification by location.

The high mobility group A1 (HMGA1) gene plays an important role in numerous malignant cancers. HMGA1 is an oncofoetal gene, and we have a certain understanding of the biological function of HMGA1 based on its activities in various neoplasms. As an architectural transcription factor, HMGA1 remodels the chromatin structure and promotes the interaction between transcriptional regulatory proteins and DNA in different cancers. Through analysis of the molecular mechanism of HMGA1 and clinical studies, emerging evidence indicates that HMGA1 promotes the occurrence and metastasis of cancer. Within a similar location or the same genetic background, the function and role of HMGA1 may have certain similarities. In this paper, to characterize HMGA1 comprehensively, research on various types of tumours is discussed to further understanding of the function and mechanism of HMGA1. The findings provide a more reliable basis for classifying HMGA1 function according to the tumour location. In this review, we summarize recent studies related to HMGA1, including its structure and oncogenic properties, its major functions in each cancer, its upstream and downstream regulation associated with the tumourigenesis and metastasis of cancer, and its potential as a biomarker for clinical diagnosis of cancer.

The expression level of miR-203 in patients with gastric cancer and its clinical significance.

BACKGROUND: The clinical significance of miR-203 and its prognostic value have not been investigated in gastric cancer. METHODS: We assessed miR-203 expression in 141 gastric cancer samples and 141 paired non-cancerous samples by real-time PCR and calculated using the 2-ΔΔCt method. Differences between groups were examined for statistical significance by Student's t-test. Survival curves were computed by the Kaplan-Meier method, and differences between survival curves were compared by the log rank test. RESULTS: The expression of miR-203 was significantly lower in gastric cancer samples compared to non-cancerous samples (P<0.0001). Low miR-203 expression was found to be closely correlated with advanced stage (p=0.005), and lymph node involvement (p=0.009). Kaplan-Meier analysis with the log-rank test indicated that low miR-203 expression had a significant impact on overall survival (39.4% vs. 62.5%; P=0.043) and progression-free survival (32.5% vs. 58.6%; P=0.023). Furthermore, multivariate analysis revealed that miR-203 expression level was independent prognostic factors for overall survival (HR=2.73, 95% CI: 1.69-8.91; P=0.01), as well as progression-free survival (HR=4.19, 95% CI: 2.91-10.12; P=0.005). CONCLUSION: Our data validate an important clinical significance of miR-203 in gastric cancer, and reveal that it might be a potential prognostic factor for gastric cancer. Large- scale and long-term follow-up studies are needed to confirm the significance of miR-203 in gastric cancer.

JC virus existence in Chinese gastrointestinal carcinomas.

The John Cunningham virus (JCV) infects a large proportion of the population worldwide and may cause progressive multifocal leukoencephalopathy upon immunodeficiency. Recent reports provided evidence of its oncogenetic role in malignancies. In this study, JCV was examined by targeting T antigen, viral protein and agnoprotein in paraffin-embedded or frozen gastrointestinal carcinomas and paired non-neoplastic mucosa (NNM) samples by nested-PCR followed by Southern blot analysis. In addition, the expression of JCV T antigen, ki-67, caspase-3, p53, Rb and ß-catenin was studied by immunohistochemistry on tissue microarrays. The positive rate of JCV T antigen was higher in paraffin-embedded gastrointestinal carcinomas compared to adjacent NNM by nested-PCR followed by Southern blot analysis (36.9 vs. 16.9%, P<0.05), while there was no difference in other viral oncogenes regardless of whether they were paraffin-embedded or frozen samples. Immunohistochemically, T antigen was detectable in 9.6% (13/135) of carcinoma cases, which was higher than its positive rate in NNM (0.8%, 1/126, P<0.01). However, the genomic JCV DNA existence or its T antigen expression was not correlated with age, gender, tumor size, histological types, lymph node metastasis, expression of ki-67, caspase-3, p53, Rb and ß-catenin of gastric carcinomas (P>0.05). In conlusion, JCV T antigen may be involved in gastrointestinal carcinogenesis as an oncogene in China.

The pathobiological behaviors and prognosis associated with Japanese gastric adenocarcinomas of pure WHO histological subtypes.

Japan is a high-risk region for gastric carcinoma with a comparatively early stage and favorable prognosis. To clarify the pathobiological behaviors and prognosis of Japanese gastric adenocarcinoma, we analyzed the clinicopathological characteristics of different WHO subtypes of carcinomas. The expression of ki-67, CPP32, p53, FHIT, maspin, parafibromin, GRP78, GRP94, EMMPRIN, VEGF, P-GSK3beta-ser9, fascin, cortactin, Arp2, Arp3 MUC-2, MUC-5AC and MUC-6 was examined using immunohistochemistry and tissue microarrays. The majority of cases were well-, poorly-, or moderately-differentiated subtype, whereas the minority were papillary or signet ring cell carcinoma (SRC). Patients with poorly-differentiated or SRC carcinoma were predominantly young and female. Poorly-differentiated and mucinous carcinomas were larger, with deeper invasion, more venous or lymphatic invasion, frequent lymph node involvement and peritoneal dissemination, or higher staging. The SRC group exhibited weaker expression of ki-67, CPP32, p53, parafibromin, GRP78, GRP94, P-GSK3beta-ser9, VEGF or cortactin. The moderately-differentiated subtype exhibited lower expression of FHIT and Arp3 positivity. The poorly-differentiated group showed weaker expression of CPP32, EMMPRIN, MUC-2, MUC-5AC, and MUC-6. Survival analysis indicated that the patients with poorly-differentiated or mucinous subtypes had a lower cumulative survival rate than those with papillary, well-, moderately-differentiated, or SRC carcinomas (P<0.05). The age, invasive depth, lymphatic invasion, peritoneal dissemination, and WHO classification were independent prognostic factors for carcinoma patients (P<0.05). It was suggested that poorly-differentiated and mucinous subtypes are more aggressive and of unfavorable prognosis among Japanese gastric carcinomas. Lower levels of proliferation and apoptosis, as well as alterations in tumor suppressor genes, mucin production and ER stress protein played important roles in the pathogenesis of poorly-differentiated and SRC carcinomas.

Arp2/3 overexpression contributed to pathogenesis, growth and invasion of gastric carcinoma.

BACKGROUND: Tumor metastasis depends on cell adhesion, motility and deformability, resulting from quantitative alterations and rearrangement of actin-related protein (Arp) 2 and 3. The aim of this study was to clarify the roles of both molecules in tumorigenesis and progression of gastric carcinomas. PATIENTS AND METHODS: Immunohistochemistry (IHC) was employed on tissue microarray containing gastric carcinomas, adjacent metaplasia and gastritis using antibodies against Arp2 and Arp3 with a comparison of their expression with clinicopathological parameters of carcinomas. Gastric carcinoma cell lines (MKN28, AGS, MKN45, KATO-III and HGC-27) were studied for Arp2 and Arp3 protein by IHC. RESULTS: Both proteins were expressed at low levels in gastritis compared with carcinomas (p < 0.05). Arp2 was more frequently expressed in intestinal metaplasia than in carcinoma and gastritis (p < 0.05). Most gastric carcinoma cell lines showed expression at different levels. Expression was positively correlated with tumor size, depth of invasion, venous invasion, Union Internationale Contre le Cancer (UICC) staging and expression of cortactin or fascin (p < 0.05), but not with age, sex, lymphatic invasion or lymph node metastasis (p > 0.05). There was stronger positivity of Arp3 in intestinal- than diffuse-type carcinomas (p < 0.05). A positive relationship between Arp2 and Arp3 proteins was noted (p < 0.05). Univariate analysis indicated that the cumulative survival rate of patients with positive Arp2 or Arp3 expression was not different from those without their expression (p > 0.05). Multivariate analysis showed that age, depth of invasion, lymphatic invasion, lymph node metastasis, UICC staging and Lauren's classification were independent prognostic factors for carcinomas (p < 0.05). CONCLUSION: Aberrant expression of Arp2 and Arp3 is possibly involved in pathogenesis, growth, invasion and progression of gastric carcinomas. Distinct Arp3 expression underlies the molecular mechanisms for the differentiation of intestinal- and diffuse-type carcinomas. They were considered as objective and effective markers to indicate the pathobiological behaviors of gastric carcinomas.