Diffusion-weighted MRI at the Late Stage after Radiotherapy for Evaluating Salivary Gland Injury.

OBJECTIVE: Salivary gland injury is the main complication of radiotherapy for nasopharyngeal carcinoma (NPC) patients. The purpose of this study was to evaluate the value of diffusion-weighted magnetic resonance imaging (DW-MRI) as a reliable tool to assess salivary gland function in NPC patients after radiotherapy. MATERIALS AND METHODS: This study analysed the MR images of 31 NPC patients at different time points within 2-3 years after radiotherapy. The changes in the apparent diffusion coefficient (ADC) and its relationship with radiation dose were analysed. RESULTS: Both the parotid and submandibular gland ADC values increased significantly 3-6 months after radiotherapy and then decreased gradually. The ADC value of the parotid gland was positively correlated with radiation dose at the late stage (P = 0.012, r = 0.359). The submandibular gland ADC change value (P = 0.035) and change ratio (P = 0.027) of the high radiation dose group were significantly lower than those of the low dose group at the late stage. CONCLUSION: The correlation between ADC values of parotid and submandibular glands and the radiation dose indicated that DW-MRI could be helpful in evaluating salivary gland injury after radiotherapy.

A case of liposarcoma with osteolysis of the maxilla as the first symptom and review of the literature.

Liposarcomas are extremely rare in the oral cavity and mainly observed in the buccal mucosa, tongue, floor of the mouth, gingiva, and lips, while those occurring in the jaws have not been reported so far. Clinically, the initial presentation of liposarcoma is usually a painless soft tissue mass. The aim of this study was to report a case of liposarcoma with osteolysis of the maxilla as the first symptom, and review the relevant literature to summarize its clinical features, imaging features, pathological features and treatment methods.

Neoadjuvant toripalimab combined with gemcitabine and cisplatin in resectable locally advanced head and neck squamous cell carcinoma (NeoTGP01): An open label, single-arm, phase Ib clinical trial.

BACKGROUND: Neoadjuvant programmed death receptor-1 (PD-1) inhibitors have drawn increasing attention in locally advanced head and neck squamous cell carcinoma (HNSCC). In this study, we investigated the safety and efficacy of gemcitabine and cisplatin (GP), combined with a PD-1 inhibitor, in patients with locally advanced HNSCC. MATERIALS AND METHODS: A total of 23 eligible patients were administered two cycles of toripalimab and GP followed by surgical resection. The primary endpoints were safety, treatment-related adverse events (TRAEs), and non-operation delay rates. The secondary endpoints consisted of pathological complete response (pCR) rate, major pathological response (MPR) rate, objective response rate (ORR), and R0 resection rate. RESULTS: The incidence of TRAEs from grades 1 to 4 was 43.5%, 34.8%, 13.0%, and 8.7%, respectively. Grade 3/4 TRAEs included neutropenia, fatigue, hyperglycemia, nausea and vomiting, decreased appetite, rash, and diarrhea. No treatment-related surgical delay was observed. The radiographic response rates were 5.0% (CR), 40.0% (PR), and 55.0% (SD). The ORR reached 45.0%. Eighteen patients underwent successful surgical resection. The R0 resection rate was 100%. The pathological response rates were 16.7% (pCR), 27.8% (MPR, two of five near-pCR), 16.7% (PPR), and 38.8% (NPR). CD4, CD8, CD20, and CD38 expression in the tumors significantly increased after neoadjuvant chemotherapy. The increase in CD20 levels after neoadjuvant treatment in patients with pCR/MPR was significantly higher than in patients with PPR/NPR. CONCLUSION: Triweekly neoadjuvant toripalimab-GP is feasible and achieves promising pCR and MPR rates in patients with resectable locally advanced HNSCC. TRIAL REGISTRATION: Chinese clinical trial registry, ChiCTR2100043743, Registered 27 Febrary 2021- Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=120570.

Multimodal fusion diagnosis of depression and anxiety based on CNN-LSTM model.

BACKGROUND: In recent years, more and more people suffer from depression and anxiety. These symptoms are hard to be spotted and can be very dangerous. Currently, the Self-Reported Anxiety Scale (SAS) and Self-Reported Depression Scale (SDS) are commonly used for initial screening for depression and anxiety disorders. However, the information contained in these two scales is limited, while the symptoms of subjects are various and complex, which results in the inconsistency between the questionnaire evaluation results and the clinician's diagnosis results. To fully mine the scale data, we propose a method to extract the features from the facial expression and movements, which are generated from the video recorded simultaneously when subjects fill in the scale. Then we collect the facial expression, movements and scale information to establish a multimodal framework for improving the accuracy and robustness of the diagnosis of depression and anxiety. METHODS: We collect the scale results of the subjects and the videos when filling in the scales. Given the two scales, SAS and SDS, we construct a model with two branches, where each branch processes the multimodal data of SAS and SDS, respectively. In the branch, we first build a convolutional neural network (CNN) to extracts the facial expression features in each frame of images. Secondly, we establish a long short-term memory (LSTM) network to further embedding the facial expression feature and build the connections between various frames, so that the movement feature in the video can be generated. Thirdly, we transform the scale scores into one-hot format, and feed them into the corresponding branch of the network to further mining the information of the multimodal data. Finally, we fuse the embeddings of these two branches to generate inference results of depression and anxiety. RESULTS AND CONCLUSIONS: Based on the score results of SAS and SDS, our multimodal model further mines the video information, and can reach the accuracy of 0.946 in diagnosing depression and anxiety. This study demonstrates the feasibility of using our CNN-LSTM-based multimodal model for initial screening and diagnosis of depression and anxiety disorders with high diagnostic performance.

Interactive short-term effects of meteorological factors and air pollution on hospital admissions for cardiovascular diseases.

A substantial number of studies have demonstrated the association between air pollution and adverse health effects. However, few studies have explored the potential interactive effects between meteorological factors and air pollution. This study attempted to evaluate the interactive effects between meteorological factors (temperature and relative humidity) and air pollution ([Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text]) on cardiovascular diseases (CVDs). Next, the high-risk population susceptible to air pollution was identified. We collected daily counts of CVD hospitalizations, air pollution, and weather data in Nanning from January 1, 2014, to December 31, 2015. Generalized additive models (GAMs) with interaction terms were adopted to estimate the interactive effects of air pollution and meteorological factors on CVD after controlling for seasonality, day of the week, and public holidays. On low-temperature days, an increase of [Formula: see text] in [Formula: see text], [Formula: see text], and [Formula: see text] was associated with increases of 4.31% (2.39%, 6.26%) at lag 2; 2.74% (1.65%, 3.84%) at lag 0-2; and 0.13% (0.02%, 0.23%) at lag 0-3 in CVD hospitalizations, respectively. During low relative humidity days, a [Formula: see text] increment of lag 0-3 exposure was associated with increases of 3.43% (4.61%, 2.67%) and 0.10% (0.04%, 0.15%) for [Formula: see text] and [Formula: see text], respectively. On high relative humidity days, an increase of [Formula: see text] in [Formula: see text] was associated with an increase of 5.86% (1.82%, 10.07%) at lag 0-2 in CVD hospitalizations. Moreover, elderly (≥ 65 years) and female patients were vulnerable to the effects of air pollution. There were interactive effects between air pollutants and meteorological factors on CVD hospitalizations. The risk that [Formula: see text], [Formula: see text], and [Formula: see text] posed to CVD hospitalizations could be significantly enhanced by low temperatures. For [Formula: see text] and [Formula: see text], CVD hospitalization risk increased in low relative humidity. The effects of [Formula: see text] were enhanced at high relative humidity.

Rural-urban differences in associations between air pollution and cardiovascular hospital admissions in Guangxi, southwest China.

Epidemiological studies found that exposure to air pollution increases cardiovascular hospitalizations. However, studies on rural-urban differences in associations between hospitalizations for cardiovascular diseases and air pollution are limited. The generalized linear model (GLM) was applied to investigate the associations between cardiovascular hospitalizations and air pollution (SO2, NO2, PM2.5, PM10, CO, and O3) in Guangxi, southwest China, in 2015 (January 1-December 31). The relative risk of pollutants (SO2, NO2) on cardiovascular hospital admissions was significantly different between urban and rural areas. The effect of SO2 on cardiovascular hospitalizations was higher in urban areas than in rural areas at lag0 to lag3 and cumulative lag01 to lag03. In urban areas, there were positive associations between NO2 and cardiovascular hospitalizations at lag0, lag1 and cumulative lag01, lag02. In contrast, the effect of NO2 on cardiovascular hospitalizations was not significant in rural areas. Urban residents were more sensitive than rural residents to SO2 and NO2. Subgroup analyses showed statistically significant differences between rural and urban areas in the association between SO2 and NO2 and cardiovascular hospitalizations for males. For age groups, people aged ≥ 65 years appeared to be more vulnerable to SO2 and NO2 in urban areas. The effects of PM2.5 PM10, CO, and O3 on cardiovascular hospitalizations were consistently negative for all groups. Our findings indicated that there were rural-urban differences in associations between cardiovascular hospitalizations and air pollutants. In rural areas, the risk of cardiovascular hospitalizations was mainly influenced by SO2. Therefore, we expect to pay attention to protecting people from air pollution, particularly for those aged ≥ 65 years in urban areas.

DLX6 promotes cell proliferation and survival in oral squamous cell carcinoma.

OBJECTIVE: Distal-less homeobox 6 (DLX6) has been reported to play important roles in the development of craniofacial structures, inner ear, limb, and brain. We found in our previous investigation that DLX6 was significantly highly expressed in oral cancer tissues in The Cancer Genome Atlas database. This study aimed to explore its roles and regulation mechanism in oral squamous cell carcinoma. MATERIALS AND METHODS: We analyzed the expression of DLX6 and its association with overall survival in OSCC by real-time quantitative PCR. Besides, clone formation, proliferation, and apoptosis were detected after knocking down DLX6 and microarray analysis was performed to explore the possible regulatory mechanism. RESULTS: DLX6 was overexpressed in oral cancer tissues and was associated with advance tumor stage and poor prognosis. In vitro studies have shown that DLX6 promotes proliferation and inhibits cell apoptosis in oral cancer cells. Microarray analysis along with Western blotting results indicated that DLX6 significantly associated with malignant tumors and may regulate OSCC cells proliferation through EGFR-CCND1 axis. CONCLUSION: DLX6 promotes cell proliferation and suppresses cell apoptosis in oral cancer cells. EGFR-CCND1 pathway might be the potential mechanism participating in the regulating axis.

Interpreting Depression From Question-Wise Long-Term Video Recording of SDS Evaluation.

Self-Rating Depression Scale (SDS) questionnaire has frequently been used for efficient depression preliminary screening. However, the uncontrollable self-administered measure can be easily affected by insouciantly or deceptively answering, and producing the different results with the clinician-administered Hamilton Depression Rating Scale (HDRS) and the final diagnosis. Clinically, facial expression (FE) and actions play a vital role in clinician-administered evaluation, while FE and action are underexplored for self-administered evaluations. In this work, we collect a novel dataset of 200 subjects to evidence the validity of self-rating questionnaires with their corresponding question-wise video recording. To automatically interpret depression from the SDS evaluation and the paired video, we propose an end-to-end hierarchical framework for the long-term variable-length video, which is also conditioned on the questionnaire results and the answering time. Specifically, we resort to a hierarchical model which utilizes a 3D CNN for local temporal pattern exploration and a redundancy-aware self-attention (RAS) scheme for question-wise global feature aggregation. Targeting for the redundant long-term FE video processing, our RAS is able to effectively exploit the correlations of each video clip within a question set to emphasize the discriminative information and eliminate the redundancy based on feature pair-wise affinity. Then, the question-wise video feature is concatenated with the questionnaire scores for final depression detection. Our thorough evaluations also show the validity of fusing SDS evaluation and its video recording, and the superiority of our framework to the conventional state-of-the-art temporal modeling methods.

Synergistic effects of gaseous pollutants on hospital admissions for cardiovascular disease in Liuzhou, China.

Previous studies demonstrated that short-term exposure to gaseous pollutants (nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3)) had a greater adverse effect on cardiovascular disease. However, little evidence exists regarding the synergy between gaseous pollutants and cardiovascular disease (CVD). Therefore, we aimed to estimate the effect of individual gaseous pollutants on hospital admissions for CVD and to explore the possible synergistic effects between gaseous pollutants. Daily hospitalization counts for CVD were collected from January 1, 2014, to December 31, 2015. We also collected daily time series on gaseous pollutants from the Environment of the People's Republic of China, including NO2, SO2, and O3. We used distributed lag nonlinear models (DLNMs) to assess the association of individual gaseous pollutants on CVD hospitalization, after controlling for seasonality, day of the week, public holidays, and weather variables. Then, we explored the variability across age and sex groups. In addition, we analyzed the synergistic effects between gaseous pollutants on CVD. Extremely low NO2 and SO2 increase the risk of CVD in all subgroup at lag 7 days. The greatest effect of high concentration of SO2 was observed in male and the elderly (≥ 65 years) at lag 3 days. Greater effects of high concentration of O3 were more pronounced in the young (< 65 years) and female at lag 3 days, while the effect of low concentration of O3 was greater in male and the young (< 65 years) at lag 0 day. We found a synergistic effect between NO2 and SO2 for CVD, as well as between SO2 and O3. The synergistic effects of NO2 and SO2 on CVD were stronger in the elderly (≥ 65) and female. The female was sensitive to synergistic effects of SO2-O3 and NO2-O3. Interestingly, we found that there was a risk of CVD in the susceptible population even for gaseous pollutant concentrations below the National Environmental Quality Standard. The synergy between NO2 and SO2 was significantly associated with cardiovascular disease hospitalization in the elderly (≥ 65). This study provides evidence for the synergistic effect of gaseous pollutants on hospital admissions for cardiovascular disease.

Development and validation of a GRGPI model for predicting the prognostic and treatment outcomes in head and neck squamous cell carcinoma.

Background: Head and neck squamous cell carcinoma (HNSCC) is among the most lethal and most prevalent malignant tumors. Glycolysis affects tumor growth, invasion, chemotherapy resistance, and the tumor microenvironment. Therefore, we aimed at identifying a glycolysis-related prognostic model for HNSCC and to analyze its relationship with tumor immune cell infiltrations. Methods: The mRNA and clinical data were obtained from The Cancer Genome Atlas (TCGA), while glycolysis-related genes were obtained from the Molecular Signature Database (MSigDB). Bioinformatics analysis included Univariate cox and least absolute shrinkage and selection operator (LASSO) analyses to select optimal prognosis-related genes for constructing glycolysis-related gene prognostic index(GRGPI), as well as a nomogram for overall survival (OS) evaluation. GRGPI was validated using the Gene Expression Omnibus (GEO) database. A predictive nomogram was established based on the stepwise multivariate regression model. The immune status of GRGPI-defined subgroups was analyzed, and high and low immune groups were characterized. Prognostic effects of immune checkpoint inhibitor (ICI) treatment and chemotherapy were investigated by Tumor Immune Dysfunction and Exclusion (TIDE) scores and half inhibitory concentration (IC50) value. Reverse transcription-quantitative PCR (RT-qPCR) was utilized to validate the model by analyzing the mRNA expression levels of the prognostic glycolysis-related genes in HNSCC tissues and adjacent non-tumorous tissues. Results: Five glycolysis-related genes were used to construct GRGPI. The GRGPI and the nomogram model exhibited robust validity in prognostic prediction. Clinical correlation analysis revealed positive correlations between the risk score used to construct the GRGPI model and the clinical stage. Immune checkpoint analysis revealed that the risk model was associated with immune checkpoint-related biomarkers. Immune microenvironment and immune status analysis exhibited a strong correlation between risk score and infiltrating immune cells. Gene set enrichment analysis (GSEA) pathway enrichment analysis showed typical immune pathways. Furthermore, the GRGPIdel showed excellent predictive performance in ICI treatment and drug sensitivity analysis. RT-qPCR showed that compared with adjacent non-tumorous tissues, the expressions of five genes were significantly up-regulated in HNSCC tissues. Conclusion: The model we constructed can not only be used as an important indicator for predicting the prognosis of patients but also had an important guiding role for clinical treatment.

Deep 3D-CNN for Depression Diagnosis with Facial Video Recording of Self-Rating Depression Scale Questionnaire.

The Self-Rating Depression Scale (SDS) questionnaire is commonly utilized for effective depression preliminary screening. The uncontrolled self-administered measure, on the other hand, maybe readily influenced by insouciant or dishonest responses, yielding different findings from the clinician-administered diagnostic. Facial expression (FE) and behaviors are important in clinician-administered assessments, but they are underappreciated in self-administered evaluations. We use a new dataset of 200 participants to demonstrate the validity of self-rating questionnaires and their accompanying question-by-question video recordings in this study. We offer an end-to-end system to handle the face video recording that is conditioned on the questionnaire answers and the responding time to automatically interpret sadness from the SDS assessment and the associated video. We modified a 3D-CNN for temporal feature extraction and compared various state-of-the-art temporal modeling techniques. The superior performance of our system shows the validity of combining facial video recording with the SDS score for more accurate self-diagnose.

Spatiotemporal variations of asthma admission rates and their relationship with environmental factors in Guangxi, China.

OBJECTIVE: The study aimed to determine if and how environmental factors correlated with asthma admission rates in geographically different parts of Guangxi province in China. SETTING: Guangxi, China. PARTICIPANTS: This study was done among 7804 asthma patients. PRIMARY AND SECONDARY OUTCOME MEASURES: Spearman correlation coefficient was used to estimate correlation between environmental factors and asthma hospitalisation rates in multiple regions. Generalised additive model (GAM) with Poisson regression was used to estimate effects of environmental factors on asthma hospitalisation rates in 14 regions of Guangxi. RESULTS: The strongest effect of carbon monoxide (CO) was found on lag1 in Hechi, and every 10 µg/m3 increase of CO caused an increase of 25.6% in asthma hospitalisation rate (RR 1.26, 95% CI 1.02 to 1.55). According to the correlation analysis, asthma hospitalisations were related to the daily temperature, daily range of temperature, CO, nitrogen dioxide (NO2) and particulate matter (PM2.5) in multiple regions. According to the result of GAM, the adjusted R2 was high in Beihai and Nanning, with values of 0.29 and 0.21, which means that environmental factors are powerful in explaining changes of asthma hospitalisation rates in Beihai and Nanning. CONCLUSION: Asthma hospitalisation rate was significantly and more strongly associated with CO than with NO2, SO2 or PM2.5 in Guangxi. The risk factors of asthma exacerbations were not consistent in different regions, indicating that targeted measures should differ between regions.

Autophagy inhibits TLR4-mediated invasiveness of oral cancer cells via the NF-κB pathway.

OBJECTIVES: Toll-like receptor 4 (TLR4) is abnormally expressed in oral cancer tissues and promotes cancer cell invasion. The purpose of this study was to clarify the mechanism by which autophagy regulates oral cancer invasion through the TLR4-NF-κB pathway. SUBJECTS AND METHODS: We examined TLR4 expression in oral cancer tissues and analysed the relationship between its expression and clinicopathological features. The invasion and migration of LPS-stimulated oral cancer cells with up- or downregulation of TLR4 expression was detected in addition to NF-κB signalling and autophagy levels. Furthermore, the role of autophagy in regulating TLR4-mediated cell invasiveness was explored by silencing the expression of key autophagy genes ATG7 and p62. RESULTS: We found that TLR4 overexpression was closely related to cervical lymphatic metastasis and poor survival. TLR4 activated the NF-κB pathway to promote the invasiveness of OSCC cells, and autophagy partly inhibited invasiveness by suppressing the NF-κB pathway. We observed that p62 translocated from the cytoplasm to the nucleus when autophagy was activated by LPS. Finally, silencing p62 further promoted LPS-mediated cell invasiveness. CONCLUSION: Toll-like receptor 4 significantly enhanced the invasiveness of OSCC cells. Autophagy may regulate cell invasiveness through the NF-κB pathway by modulating both the cytoplasmic and nuclear levels of p62.

Hotspot detection and socio-ecological factor analysis of asthma hospitalization rate in Guangxi, China.

BACKGROUND: Asthma is a major public health concern throughout the world. Numerous researches have shown that the spatial-temporal patterns of asthma are inconsistent, leading to the suggestion that these patterns are determined by multiple factors. This study aims to detect spatial-temporal clusters of asthma and analyze socio-ecological factors associated with the asthma hospitalization rate in Guangxi, China. METHODS: Asthma hospitalization and socio-ecological data for 88 counties/municipal districts in Guangxi, China in 2015 was collected. Space-time scan statistics were applied to identify the high-risk periods and areas of asthma hospital admissions. We further used GeoDetector and Spearman correlation coefficient to investigate the socio-ecological factors associated with the asthma hospitalization rates. RESULTS: There were a total of 7804 asthma admissions in 2015. The high-risk period was from April to June. The age groups of 0-4 and ≥65 years were both at the highest risk, with hospital admission rates of 45.0/105 and 46.5/105, respectively. High-risk areas were found in central and western Guangxi with relative risk (RR) values of asthma hospitalizations greater than 2.0. GDP per capita and altitude were positively associated with asthma hospitalizations, while air pressure and wind speed had a negative association. The explanatory powers of these factors (i.e., GDP per capita, altitude, air pressure, wind speed) were 22%, 20%, 14% and 10%, respectively. CONCLUSIONS: The GDP per capita appears to have the strongest correlation with asthma hospitalization rates. High-risk areas were identified in central and western Guangxi characterized by high GDP per capita. These findings may be helpful for authorities developing targeted asthma prevention policies for high-risk areas and vulnerable populations, especially during high-risk periods.

B4GALNT1 enhances cell proliferation and growth in oral squamous cell carcinoma via p38 and JNK MAPK pathway.

BACKGROUND: Beta-1,4-N-Acetyl-Galactosaminyltransferase 1 (B4GALNT1) was reported to play an important role in the development of the central nervous systems. We found higher expression of B4GALNT1 in oral squamous cell carcinoma (OSCC) tissues compared to the paired normal adjacent tissues in the TCGA database. This study aimed to investigate whether there was a potential relationship between B4GALNT1 and OSCC tumorigenesis and further explored the possible regulation mechanism. METHODS: Gene expression level was analyzed by means of real-time quantitative PCR and further cell function experiments were performed including cell proliferation and apoptosis test, cell cycle distribution detection after silencing B4GALNT1 by transfection with B4GALNT1-shRNA lentivirus. Western Blotting was carried out to explore the possible molecular mechanism. RESULTS: The present study confirmed the overexpression of B4GALNT1 in OSCC. Compared to the control group, cell proliferation after silencing B4GALNT1 was significantly inhibited and cell apoptosis percentage was significantly higher. Besides, the knockdown of B4GALNT1 resulted in cell cycle arrest at G1 phase in our experiment. CONCLUSIONS: B4GALNT1 enhances the proliferation and suppress the apoptosis of OSCC cells probably through JNK and p38 signaling pathway.

A method for hand-foot-mouth disease prediction using GeoDetector and LSTM model in Guangxi, China.

Hand-foot-mouth disease (HFMD) is a common infectious disease in children and is particularly severe in Guangxi, China. Meteorological conditions are known to play a pivotal role in the HFMD. Previous studies have reported numerous models to predict the incidence of HFMD. In this study, we proposed a new method for the HFMD prediction using GeoDetector and a Long Short-Term Memory neural network (LSTM). The daily meteorological factors and HFMD records in Guangxi during 2014-2015 were adopted. First, potential risk factors for the occurrence of HFMD were identified based on the GeoDetector. Then, region-specific prediction models were developed in 14 administrative regions of Guangxi, China using an optimized three-layer LSTM model. Prediction results (the R-square ranges from 0.39 to 0.71) showed that the model proposed in this study had a good performance in HFMD predictions. This model could provide support for the prevention and control of HFMD. Moreover, this model could also be extended to the time series prediction of other infectious diseases.

Spatial-temporal variation and risk factor analysis of hand, foot, and mouth disease in children under 5 years old in Guangxi, China.

BACKGROUND: Hand, foot and mouth disease (HFMD) incidence is a critical challenge to disease control and prevention in parts of China, particularly Guangxi. However, the association between socioeconomic factors and meteorological factors on HFMD is still unclear. METHODS: This study applied global and local Moran's I to examine the spatial pattern of HFMD and series analysis to explore the temporal pattern. The effects of meteorological factors and socioeconomic factors on HFMD incidence in Guangxi, China were analyzed using GeoDetector Model. RESULTS: This study collected 45,522 cases from 87 counties in Guangxi during 2015, among which 43,711 cases were children aged 0-4 years. Temporally, there were two HFMD risk peaks in 2015. One peak was in September with 7890 cases. The other appeared in May with 4687 cases of HFMD. A high-risk cluster was located in the valley areas. The tertiary industry, precipitation and second industry had more influence than other risk factors on HFMD incidence with explanatory powers of 0.24, 0.23 and 0.21, respectively. The interactive effect of any two risk factors would enhance the risk of HFMD. CONCLUSIONS: This study suggests that precipitation and tertiary industry factors might have stronger effects on the HFMD incidence in Guangxi, China, compared with other factors. High-risk of HFMD was identified in the valley areas characterized by high temperature and humidity. Local government should pay more attention and strengthen public health services level in this area.

Hospitalization costs of treating colorectal cancer in China: A retrospective analysis.

BACKGROUND: The objective of this study was to explore the influence factors of hospitalization costs of treating colorectal cancer in China. And the study provides new estimates on hospitalization costs and length of hospital stay for patients with colorectal cancer in China. METHODS: Data for inpatient hospitalization associated with colorectal cancer were obtained from a 3-tier hospital in Guangdong Province and were analyzed post hoc. We conducted descriptive statistical methods, Wilcoxon rank-sum tests (for 2 groups) and the Kruskal-Wallis test (for more than 2 groups) to analyze the hospitalization costs of treating colorectal cancer. RESULTS: The analysis included 8021 patients (female: 40.54%; mean age; 61.80 ±â€Š13.28 years; male: 59.46%; mean age: 61.80 ±â€Š13.28 years). The overall mean length of hospital stay was 11.35 days. Over the 5 years, the mean length of hospital stay showed a small decrease from 12.22 days in 2012 to 10.69 days in 2016, while per-day costs showed a trend of increase between 2012 and 2015 (increase from < 1190.94 to < 1382.50). The mean length of hospital stay was statistically significant difference was found for sexes (P = .039) and insurance status (P < .001). The mean hospitalization costs were < 16,279.58. Mean hospitalization costs were different among the UEBMI, the URBMI and the Unspecified (< 17,114.58, < 15,555.05, and < 17,735.30, respectively; P < .001). CONCLUSION: The study showed that hospitalization costs increase were associated with a small decreasing length of hospital stay and increasing per-day hospitalization costs. Moreover, the proportion of the hospitalization costs reimbursed by insurances increased. For inpatients with UEBMI, it possibly lead to over treatment and the medical expense rise which result in medical resources waste and significant society costs. The rising hospitalization costs may lead to a remarkably increased financial burden in the future in China.

An individual patient data meta-analysis on the effect of chemotherapy on survival in patients with craniofacial osteosarcoma.

Chemotherapy improves the survival of patients with long bone osteosarcomas. However, the benefits of chemotherapy in the treatment of craniofacial osteosarcoma (CFOS) are still controversial. We searched PubMed and EMBASE from February 1997 to December 2016 to identify studies on CFOS. The individual patient data of these studies were pooled into a meta-analysis. Univariate and multivariate survival analyses were performed. Thirteen studies with a total of 184 patients met our inclusion criteria. Positive resection margin was a poor prognostic factor for CFOS in the univariate and multivariate survival analyses. Chemotherapy improved overall survival (OS) and disease-specific survival (DSS) in patients with CFOS who had tumors in the maxilla, positive resection margins, or high-grade tumors. Patients with local tumor recurrence had better OS and DSS when treated with chemotherapy. Chemotherapy improves survival in patients with CFOS with adverse factors, such as tumors with positive margins, high-grade tumors, and recurrent tumors.

LncRNA UCA1/miR-124 axis modulates TGFß1-induced epithelial-mesenchymal transition and invasion of tongue cancer cells through JAG1/Notch signaling.

Tongue cancer remains a massive threat to public health due to the high rate of metastasis. Tumor cell epithelial-mesenchymal transition (EMT), which can be induced by transforming growth factor ß1 (TGFß1), has been regarded as a significant contributor to cancer invasion and migration. In our previous study, long noncoding RNA (lncRNA) MALAT1/miR-124/JAG1 axis modulates the growth of tongue cancer. In addition to metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), another lncRNA, urothelial cancer associated 1 (UCA1), can promote EMT and cancer metastasis. In the present study, UCA1 was overexpressed in tongue cancer tissues and cell lines. UCA1 overexpression was correlated to the poorer prognosis of patients with tongue cancer. UCA1 knockdown significantly suppressed TGFß1-induced tongue cancer cell invasion and EMT by decreasing vimentin and increasing E-cadherin. Regarding the molecular mechanism, UCA1 could directly bind to microRNA-124 (miR-124) and negatively regulate each other. UCA1 knockdown ameliorated, whereas miR-124 inhibition exacerbated TGFß1-induced EMT and invasion in tongue cancer cells through miR-124 downstream jagged 1 (JAG1) and Notch signaling. Moreover, miR-124 inhibition partially impaired the effect of UCA1 knockdown. In tongue cancer tissues, miR-124 expression was remarkably decreased, whereas JAG1 mRNA expression was increased. miR-124 was negatively correlated with UCA1 and JAG1. UCA1 and JAG1 were positively correlated. In summary, we provided a novel mechanism by which the EMT process and cancer cell invasion in tongue cancer could be modulated from the perspective of lncRNA-miRNA-mRNA regulation.