[Accuracy comparision of abdominal enhanced CT and endoscopic ultrasound in the staging of gastric cancer after neoadjuvant chemotherapy: a post hoc analysis of a randomized clinical trial].

Objective: To compare the accuracy of abdominal enhanced CT and endoscopic ultrasound in the staging of gastric cancer after neoadjuvant chemotherapy (yc stage). Methods: Clinic data of 86 locally advanced gastric cancer patients admitted in Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute from April 2015 to November 2017 were analyzed retrospectively. Totally 86 patients completed both abdominal enhanced CT and endoscopic ultrasound after neoadjuvant chemotherapy. There were 60 males and 26 females, aged (57.8±9.7) years (range: 32 to 76 years). The diagnostic accuracy of abdominal enhanced CT and endoscopic ultrasound for yc stage were calculated by the area under the multiclass receiver operation characteristic curve (M-AUC), retrospectively. McNemar test was used to compared the diagnostic sensitivity. Results: The M-AUC of ycT stage evaluated by abdominal enhanced CT (CT-ycT stage) and by endoscopic ultrasound (EUS-ycT stage) was 0.614 and 0.704, respectively. For middle and lower gastric cancer, the M-AUC of CT-ycT stage was 0.599 and 0.613, respectively, while EUS-ycT stage was 0.558 and 0.709, respectively. For tumor in the lesser and non-lesser curvature, the M-AUC of CT-ycT stage was 0.630 and 0.607, respectively, while EUS-ycT stage was 0.616 and 0.749, respectively. For patients in CT-ycT1-CT-ycT4, there was no statistically significant difference in the sensitivity between CT-ycT stage and EUS-ycT stage (2/18, 2/15, 52.8%(19/36), 8/13 vs. 0, 4/15, 55.6%(20/36), 7/13; χ(2)=2.00, P=0.157; χ(2)=2.00, P=0.157; χ(2)=0.08, P=0.782; χ(2)=0.33, P=0.564). The M-AUC of ycN stage evaluated by abdominal enhanced CT (CT-ycN stage) was 0.654, while ycN stage evaluated by endoscopic ultrasound (EUS-ycN stage) was 0.533. For patients in CT-ycN0, there was statistically significant difference in the sensitivity between CT-ycN stage and EUS-ycN stage (12.7%(7/55) vs. 5.5%(3/55); χ(2)=4.00, P=0.046). For patients in CT-ycN1, N2, and N3, there was no statistically significant difference in the sensitivity between CT-ycN stage and EUS-ycN stage (2/19, 1/10, 0 vs. 1/19, 1/10, 0; χ(2)=1.00, P=0.317; the other P cannot be estimated). Conclusions: There was no significant difference between the diagnostic efficacy of abdominal enhanced CT and endoscopic ultrasound for yc stage of gastric cancer. Considering the invasiveness of ultrasound gastroscopy, it should not be recommend for patients after neoadjuvant chemotherapy routinely.

[Study on surveillance data of adverse events following immunization of seasonal influenza vaccine in China during 2015-2018 influenza season].

Objective: To analyze the occurrence features of adverse events following immunization (AEFI) of Seasonal Influenza Vaccines (InfV) used in China, 2015-2018 influenza season. Methods: InfV (including concurrent administered with other vaccines) AEFI data were collected through the Chinese national AEFI information system during 2015.9.1-2018.8.31 (excluding Chinese Hong Kong, Macao and Taiwan data). The vaccine lot release data were collected from National Institutes for Food and Drug Control published database. Time periods of three influenza season were 2015.9.1-2016.8.31, 2016.9.1-2017.8.31, 2017.9.1-2018.8.31. The vaccines used and included in this analysis were trivalent inactivated influenza vaccine (IIV3)-Split, IIV3-Split (Children) and IIV-subnit. The incidence of AEFI were calculated (per 100 000 release doses), and epidemiological characteristic were analyzed using descriptive methodology. Results: A total of 8 464 InfV AEFIs were collected in 2015-2018 influenza season from National AEFI Information System, in which 5 646 were IIV3-split, with the rate of 10.64/100 000 release doses, 2 818 were IIV3-split (Children), with the rate of 9.355/100 000 release doses. The most common symptom was fever (axillary temperature ≥37.1 ℃) within vaccine reactions, with a number of 6 207 cases. In which, there were 3 554 cases with fever (axillary temperature ≥38.6 ℃) and the estimated reporting rate was 4.274/100 000 release doses. In all rare vaccine reactions, the most common diagnosis was anaphylactic rash(442, 0.531/100 000 release doses) and angioedema (70, 0.084/100 000 release doses). Even the rates of serious rare vaccine reactions were low, febrile Convulsion (27, 0.032/100 000 release doses) and Henoch-Schönlein Purpura(HSP) (21, 0.025/100 000 release doses) were relatively common in serious rare vaccine reactions during the study period. Conclusion: The estimated rate of rare vaccine reactions related toInfV was relatively low. In all vaccine reactions, fever was the most common symptoms. The most common diagnosis of non-serious rare vaccine reaction were anaphylactic rash and angioedema. The incidence of serious rare vaccine reactions was low.

[Mediation effect of DNA methylation in associations between birth weight and adulthood obesity in women in China].

Objective: To evaluate the possible mediation effect of DNA methylation in the associations between birth weight and adulthood obesity in women in China. Methods: A cross-sectional survey was conducted in 1 602 women with genetic relationship in urban area of Shanghai during March-December 2016. Information about their birth weight, birth length, current lifestyle and disease history were collected and body measurement was conducted at the interview. DNA methylation at specific sites of GNASAS, IGF2, IGF2-R, IL10 and LEP were measured using bisulphite pyrosequencing. Generalized estimating equations models with restricted cubic spline functions were used to estimate the associations of birth weight with BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-hip ratio (WHtR) in adulthood, and their associations with DNA methylation were evaluated using multilevel linear models. Multilevel structural equation models were used to evaluate the mediation effect of DNA methylation. Results: A significant non-linear association was observed between birth weight and WC as well as WHtR (P<0.05). Lower birth weight was associated with higher level of methylation at IGF2-DMR (CpG1, 2), IGF2-R (CpG8, 10, 13, 16 and 17), with ß coefficients and 95%CI being -4.35 (-7.30- -1.39), -4.50 (-7.59- -1.41), -2.33 (-4.60- -0.05), -1.78 (-3.88- -0.33), -2.58 (-4.82- -0.34), -2.03 (-4.00- -0.06) and -1.87 (-3.73- -0.01), respectively, but related with a lower level of methylation at LEP CpG16 (ß=4.19, 95%CI: 0.37- 8.00). Lower level of methylation at IGF2-DMR (CpG7), IGF2-R (CpG3, 5, 8, 9, 10, 14, 17, 19) and LEP (CpG3, 8, 10) was associated with larger WC, with ß coefficients ranging from -0.016 to -0.040 (all P<0.05). Methylation at IGF2-R CpG8 was observed to mediate the association of birth weight and WC, and could explain 3.3% of the association. Conclusion: Our results suggested that DNA methylation might mediate the effect of nutrition in uteri on adulthood central obesity in women in China.

Tracking and predicting hand, foot, and mouth disease (HFMD) epidemics in China by Baidu queries.

Hand, foot, and mouth disease (HFMD) is highly prevalent in China, and more efficient methods of epidemic detection and early warning need to be developed to augment traditional surveillance systems. In this paper, a method that uses Baidu search queries to track and predict HFMD epidemics is presented, and the outbreaks of HFMD in China during the 60-month period from January 2011 to December 2015 are predicted. The Pearson correlation coefficient (R) of the predictive model and the mean absolute percentage errors between observed HFMD case counts and the predicted number show that our predictive model gives excellent fit to the data. This implies that Baidu search queries can be used in China to track and reliably predict HFMD epidemics, and can serve as a supplement to official systems for HFMD epidemic surveillance.

ORMDL3 variants associated with bronchiolitis susceptibility in a Chinese population.

Recent studies revealed common genetic risks for both viral bronchiolitis and asthma. Genome-wide association studies revealed that rs7216389 in the ORMDL3 gene is associated with childhood asthma. We conducted a case-control study examining the associations between ORMDL3 polymorphisms (rs7216389, rs12603332, and rs11650680) and bronchiolitis susceptibility/viral findings among 247 infant bronchiolitis cases and 190 healthy controls. We genotyped single nucleotide polymorphisms by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry and detected respiratory viruses with multiplex reverse transcriptase-polymerase chain reaction. Only the genotype and allele frequencies of rs7216389 significantly differed between bronchiolitis and controls. The frequencies of the TT homozygote and the T allele of rs7216389 were significantly higher in the bronchiolitis patients (P = 0.0325; P = 0.0089, respectively). Polymorphisms were not associated with bronchiolitis severity. Cases were further stratified by viral infection, but no significant differences in the ORMDL3 genotype between the virus-detected group (e.g., respiratory syncytial virus alone, respiratory virus alone, virus detected) and no-virus-detected group were observed. Bronchiolitis is associated with the ORMDL3 gene in Chinese children, and there were no significant associations between genetic variations and disease severity or respiratory viruses. The TT homozygote and the T allele of rs7216389 in ORMDL3 increased bronchiolitis risk. The rs7216389 polymorphism may be a predictor for identifying infants with predisposition to virus-induced wheezing to persistent asthma.