Interpreting deep learning models for glioma survival classification using visualization and textual explanations.

BACKGROUND: Saliency-based algorithms are able to explain the relationship between input image pixels and deep-learning model predictions. However, it may be difficult to assess the clinical value of the most important image features and the model predictions derived from the raw saliency map. This study proposes to enhance the interpretability of saliency-based deep learning model for survival classification of patients with gliomas, by extracting domain knowledge-based information from the raw saliency maps. MATERIALS AND METHODS: Our study includes presurgical T1-weighted (pre- and post-contrast), T2-weighted and T2-FLAIR MRIs of 147 glioma patients from the BraTs 2020 challenge dataset aligned to the SRI 24 anatomical atlas. Each image exam includes a segmentation mask and the information of overall survival (OS) from time of diagnosis (in days). This dataset was divided into training ([Formula: see text]) and validation ([Formula: see text]) datasets. The extent of surgical resection for all patients was gross total resection. We categorized the data into 42 short (mean [Formula: see text] days), 30 medium ([Formula: see text] days), and 46 long ([Formula: see text] days) survivors. A 3D convolutional neural network (CNN) trained on brain tumour MRI volumes classified all patients based on expected prognosis of either short-term, medium-term, or long-term survival. We extend the popular 2D Gradient-weighted Class Activation Mapping (Grad-CAM), for the generation of saliency map, to 3D and combined it with the anatomical atlas, to extract brain regions, brain volume and probability map that reveal domain knowledge-based information. RESULTS: For each OS class, a larger tumor volume was associated with a shorter OS. There were 10, 7 and 27 tumor locations in brain regions that uniquely associate with the short-term, medium-term, and long-term survival, respectively. Tumors located in the transverse temporal gyrus, fusiform, and palladium are associated with short, medium and long-term survival, respectively. The visual and textual information displayed during OS prediction highlights tumor location and the contribution of different brain regions to the prediction of OS. This algorithm design feature assists the physician in analyzing and understanding different model prediction stages. CONCLUSIONS: Domain knowledge-based information extracted from the saliency map can enhance the interpretability of deep learning models. Our findings show that tumors overlapping eloquent brain regions are associated with short patient survival.

Cadmium, arsenic, and mineral nutrients in rice and potential risks for human health in South China.

Rice (Oryza sativa L.) is one of the most important staple food crops worldwide. For people fed on rice, toxic elements cadmium (Cd) and arsenic (As) and mineral nutrients in rice are pivotal to evaluate potential risks of harmful element intake and malnutrition. We collected rice samples of 208 cultivars (83 inbred and 125 hybrid) from fields in South China and determined Cd, As, As species, and mineral elements in brown rice. Chemical analysis shows that the average content of Cd and As in brown rice were 0.26 ± 0.32 and 0.21 ± 0.08 mg·kg-1, respectively. Inorganic As (iAs) was the dominative As species in rice. Rice Cd and iAs in 35.1% and 52.4% of the 208 cultivars exceeded rice Cd and iAs limits, respectively. Significant variations of rice subspecies and regions were found for Cd, As, and mineral nutrients in rice (P < 0.05). Inbred rice had lower As uptake and more balanced mineral nutrition than hybrid species. Significant correlation was observed between Cd, As versus mineral elements like Ca, Zn, B, and Mo (P < 0.05). Health risk assessment indicates that high risks of non-carcinogenic and carcinogenic of Cd and iAs, and malnutrition, in particular Ca, protein and Fe deficiencies, might be caused by rice consumption in South China.

Characterization of Litopenaeus vannamei secreted protein acidic and rich in cysteine -like in WSSV infection.

Secreted protein acidic and rich in cysteine (SPARC) is an extracellular and non-structural glycoprotein. In shrimp, a significant function of SPARC in WSSV infection remains unclear. In this study, the full-length cDNA sequence of a secreted protein acidic and rich in cysteine -like was cloned from shrimp Litopenaeus vannamei (named as LvSPARC-L). LvSPARC-L contained an open reading frame of 1002 bp, encoding 333 amino acids. Bioinformatics analysis showed that LvSPARC-L contained a SPARC Ca2+-binding region in the C-terminus, a Kazal-type serine protease inhibitor domain and a BUD22 domain. Tissue distribution assay indicated that LvSPARC-L generally expressed in all tissues selected with a higher expression in hemocyte, stomach and pleoplod. In hepatopancreas and intestine, the relative expression of LvSPARC-L was significantly up-regulated following the WSSV challenge. Besides, the relative expression of viral immediately early gene IE1 and a late gene VP28 was significantly increased in the LvSPARCL-silenced shrimp. Furthermore, the relative expression of LvP53 and LvCaspase3 was extremely decreased in the stomach of dsLvSPARC-L treated shrimp, while that of LvP38 was not affected significantly. All data together suggest that LvSPARC-L might play an antiviral role by regulating apoptosis.

LvCSN5 is involved in WSSV infection via interaction with wsv006.

As an extremely virulent pathogen, white spot syndrome virus (WSSV) greatly threatens shrimp aquaculture worldwide. The interaction between virus and host is important for viral infection. In the present study, a yeast two-hybrid (Y2H) library was constructed to clarify the functions of wsv006, and the interaction between wsv006 and shrimp Litopenaeus vannamei (L. vannamei) was analyzed. Furthermore, we explored the role of the wsv006-interacting molecule L. vannamei COP9 constitutive photomorphogenic-like protein subunit 5 (LvCSN5) in WSSV infection. Y2H assay showed that wsv006 interacted with LvCSN5, and co-immunoprecipitation (Co-IP) assay confirmed such interaction. Multiple alignments of amino acid sequences with other species revealed that the LvCSN5 had high identity with Penaeusmonodon CSN5 (PmCSN5). LvCSN5 was mainly expressed in intestine, eye and hepatopancreas. In addition, the relative expression of LvCSN5 was significantly up-regulated both in intestine and hepatopancreas following the WSSV challenge. Besides, the relative expressions of IE1 and VP28, as well as the viral copy numbers were significantly increased in the LvCSN5-silenced shrimp. Our findings suggested that LvCSN5 was involved in WSSV infection by interacting with wsv006.

Indoor formaldehyde removal by three species of Chlorophytum comosum under dynamic fumigation system: part 2-plant recovery.

Spider plants (Chlorophytum comosum) are known to be among the most common easy mountable indoor plants capable of purifying indoor air by absorbing carbon monoxide, formaldehyde, xylene, and many other hazardous gases. In addition, these plants are non-toxic and safe for pets and children. This project is focused on the investigation of the spider plants' capability of the formaldehyde purification under laboratory-controlled parameters of the indoor air environment. Two scenarios including employment of fresh plants as well as recovered ones damaged by 7-day exposure of formaldehyde were considered. A special attention was made to the investigation of physiological indexes of the plant leaves after damage, and whether the spider plant could be reused after its recovery. The physiological characteristics of the recovery period of potted Chlorophytum comosum immediately after 7 days of fumigation with formaldehyde were studied. Eight physiological indexes of leaves including chlorophyll, free protein, relative conductivity, MDA (malondialdehyde, lipid peroxidation), SOD (superoxide dismutase), POD (peroxidase), T-AOC (total antioxidant capacity), and stomata were selected to monitor plants' recovery processes. The results of 30-day experimental runs showed that three species of spider plants were mostly recovered within 15 days. Repeated 7-day fumigation of plants, conducted to study their ability to effectively clean the air after regeneration, confirmed such ability; the efficiency at the first day was similar to the performance of the fresh plant. However, from the second day, the efficiency was dropped by 35-50% and remained at these levels for the rest of the exercise.

Cloning and characterization of Litopenaeus vannamei cystainB-like in WSSV infection.

Cystatins B is an endogenous cysteine cathepsin inhibitor. In shrimp, cystatins B-like (CSTB-L) has not been characterized and its role in WSSV infection is largely unknown. In this study, a full-length 699 bp CSTB-L sequence with 291 bp open reading frame encoding a 96 amino acid from L.vannamei (Lv) was first cloned. The tissue distribution assay indicated that LvCSTB-L presented ubiquitous expression in most examined tissues, with the most predominant expression in the hepatopancreas and the weakest expression in the muscles. LvCSTB-L transcripts could be induced in the intestine and hepatopancreas by WSSV challenge. The relative expression level of IE1 and VP28 in the LvCSTB-L knockdown shrimp were increased significantly. In addition, the shrimp cumulative mortality was remarkably (p < 0.01) increased after LvCSTB-L knockdown. Moreover, following the LvCSTB-L silencing, significant decreases in the mRNA levels of p53, p38, caspase3, STAT and ERK were also observed. The results suggested that LvCSTB-L could play positively roles in antiviral immune response by JAK-STAT, MAPK and apoptotic pathway. These findings would further our understanding of shrimp antiviral response, and therefore help for virus control and prevention.

C1q/tumor necrosis factor-related protein-1 attenuates microglia autophagy and inflammatory response by regulating the Akt/mTOR pathway.

AIMS: C1q/tumor necrosis factor-related protein-1 (CTRP1) is a newly identified adiponectin paralog that modulates metabolism and inflammation. However, the cerebral function of CTRP1 remains unknown. This study aimed to determine its role and mechanism in cerebral ischemia and reperfusion injury. MAIN METHODS: Serum level of CTRP1 as well as high-sensitivity C reactive protein (hs-CRP) in stroke patients was measured by ELISA assay. The levels of TNF-α, IL-1ß, and IL-6 were analyzed using ELISA kits. Quantitative RT-PCR, western blot analysis were conducted to detect indicated genes. KEY FINDINGS: CTRP1 was significantly upregulated in sera from patients with stroke and positive correlation with hs-CRP. CTRP1 was significantly upregulated in BV2 microglia exposed to oxygen and glucose deprivation and reperfusion (OGD/R). Knockdown of CTRP1 by si-CTRP1 transfection markedly enhanced OGD/R-induced autophagy and accelerated the inflammatory response in BV2 cells, as indicated by increased expression of LC3-II/LC3-I and beclin1, as well as increased concentration of the proinflammatory cytokines TNF-α, IL-1ß, and IL-6. However, recombinant CTRP1 or overexpression of CTRP1 attenuated OGD/R-induced autophagy and inflammatory response in BV2 cells. Further study demonstrated that knockdown of CTRP1 decreased, while recombinant CTRP1 increased the phosphorylation of Akt and mTOR in BV2 cells. IGF-1, which activates PI3-kinase and MEK1/2, abolished the promotive effect of si-CTRP1, while inhibition of Akt with A6730 reversed the inhibitory effect of recombinant CTRP1 on BV2 cells autophagy and inflammation response. SIGNIFICANCE: CTRP1 inhibited microglia autophagy and inflammation response by regulating the Akt/mTOR pathway.

Identification of a group D anti-lipopolysaccharide factor (ALF) from kuruma prawn (Marsupenaeus japonicus) with antibacterial activity against Vibrio parahaemolyticus.

Anti-lipopolysaccharide factor (ALF), which belongs to the antimicrobial peptide (AMP) family, has become a relatively new weapon to combat severe infections and has been demonstrated to be active against bacteria, fungi and some viruses. In the present study, a new ALF of group D (MjALF-D; GenBank accession No. MN416688) from Marsupenaeus japonicus was detected. MjALF-D encodes a polypeptide with 124 aa, and the peptide contains a 26-residue signal peptide and a lipopolysaccharide-binding domain (LBD). The structure of MjALF-D was found to consist of three α-helices, four ß-sheets and random coils. qRT-PCR analysis revealed that MjALF-D expression was primarily observed in the stomach and was universally upregulated in both the gill and stomach after challenge by lipopolysaccharide (LPS) and Vibrio parahaemolyticus. Moreover, rMjALF-D can inhibit the growth of V. parahaemolyticus. rMjALF-D could destroy the bacterial membrane and lead to cytoplasmic leakage investigated by scanning electron microscopy (SEM) and transmission electron microscopy (TEM), which may be the mechanism by which rMjALF-D inhibits V. parahaemolyticus. Additionally, rMjALF-D showed distinct binding or antibacterial ability after direct incubation with V. parahaemolyticus or bacterial genomic DNA and a certain effect on the protein expression of it. Together, these results indicated that rMjALF-D possessed the antibacterial activity against V. parahaemolyticus and the potential involvement in the innate immune response of M. japonicus.

Indoor formaldehyde removal by three species of Chlorphytum Comosum under the long-term dynamic fumigation system.

Gaseous formaldehyde removal efficiency and physiological characteristics of leaves were investigated through a dynamic fumigation system. Three different species of potted Chlorophytum Comosum, (Green Chlorophytum Comosum for its green leaves), CC (Combined the leaves of Chlorophytum Comosum with leaves half green and half white) and PC (Purple Chlorophytum Comosum for its purple leaves), were exposed to formaldehyde for 7 days. The results showed formaldehyde removal efficiencies in the daytime were 71.07% ± 0.23, 84.66% ± 0.19, and 46.73% ± 0.15 at 1 ppm for GC, CC, and GC plants, respectively, and were 36.21% ± 0.24, 62.15% ± 0.19, and 34.97% ± 0.11 at night. This might be due to higher plant physiological activities (e.g., photosynthesis, respiration, and transpiration) during the daytime than at night. Ten physiological indicators of leaves were chosen to evaluate the 7-day fumigation process, which were chlorophyll, free protein, relative conductivity, malondialdehyde (MDA), hydrogen peroxide (H2O2), hydroxyl radical, superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), and total antioxidant capacity (T-AOC). Eight of these indicators increased, while chlorophyll decreased by 22.16%, 6.95%, and 25.32%, and CAT decreased by 18.9%, 17.8%, and 25.30% for GC, CC, and PC respectively. Among all the increasing physiological indicators, relative conductivity and MDA showed the greatest increase by 279.32% and 155.56% for PC. A 15-day recovery study was also conducted using MDA and T-AOC as indicators. The results showed that all the tested plants could be tolerant up to the 8 ppm of formaldehyde concentration for 7 days under dynamic fumigation and needed 10-15 days for self-recovery.

A Gas Leakage Localization Method Based on a Virtual Ultrasonic Sensor Array.

In traditional sensory array-based acoustic emission methods that are used for gas leakage localization, the localization resolution depends on the spatial aperture of the array, that is, the number of sensors. Most of the existing methods use small arrays that can only achieve low-resolution localization results because of limitations such as the amplitude and phase consistency, the complexity and cost of the system. This paper reports the first application of a virtual phased array for gas leakage detection to obtain high-resolution localization results. This method uses a virtual linear ultrasonic sensor array composed of only two sensors to acquire leakage signals. Then, we use the virtual beamforming algorithm based on the cross-power spectrum to estimate the location of the leakage source. Several experiments were conducted to evaluate the effectiveness and operability of the proposed method. The impacts of various factors on the performance of the localization technique are compared and discussed, including factors such as the number of sensors and the distance between the leak hole and virtual array. The results demonstrate that the proposed method accurately and reliably localizes gas leakages.

Overexpression of microRNA-301b accelerates hippocampal microglia activation and cognitive impairment in mice with depressive-like behavior through the NF-κB signaling pathway.

Depression is a condition with a complex etiological pattern, whose effective treatments are highly limited. MicroRNAs (miRNAs) have been investigated in intensive studies owing to their involvement in pathophysiology of mood disorders. The current study aimed to elucidate the role of miR-301b in hippocampus in mouse models of depressive-like behavior. Microarray-based prediction identified the differentially expressed gene neuronal pentraxin II (NPTX2) related to mental depression. Next, the putative miR-301b binding sites on the 3'UTR of NPTX2 were verified. Then the effect of miR-301b on cognitive function of mice with depressive-like behavior was analyzed using the Morris water maze test. In addition, the regulation of miR-301b to NPTX2 and activation of NF-κB signaling pathway was assessed. Following that, the microglia activation and inflammation in hippocampus were evaluated, with the expressions of inflammatory factors being examined. At last, microglia were flow cytometrically sorted and the inflammatory reaction was also assessed in vitro. The obtained findings revealed that miR-301b targeted and negatively regulated NPTX2. Moreover, overexpressed miR-301b activated the NF-κB signaling pathway, as reflected by increasing protein expressions of p-NF-κB. Upregulated miR-301b accelerated cognitive impairment in mice with depressive-like behavior. In addition, overexpression of miR-301b activated microglia and stimulated inflammation in hippocampus, accompanied by enhanced release of tumor necrosis factor-α (TNF-α), interleukin-Iß (IL-Iß) and cyclooxygenase-2(COX-2). Taken together, the evidence provided by the current study indicated that overexpression of miR-301b augmented hippocampal microglia activation, thus exacerbating cognitive impairment and inflammation in mice with depressive-like behavior by activating the NF-κB signaling pathway.

[Correlation of the grades of histologic prostatic inflammation with the risk of prostate cancer in biopsy specimens from men with total PSA of 4－10 µg/L].

OBJECTIVE: To investigate the association of the grades of histologic prostatic inflammation (HPI) with prostate cancer in biopsy specimens for male patients with total serum PSA (tPSA) of 4－10 µg/L. METHODS: We performed prostate biopsy for 200 patients with tPSA of 4－10 µg/L from January 2015 to December 2017. We determined the location, extent and intensity of HPI and analyzed the correlation of the grades of HPI with the risk of prostate cancer. RESULTS: Of the 200 biopsy specimens, BPH was detected in 169 (84.5%) and PCa in 31 (15.5%). Statistically significant differences were found in the positive rates of PCa between grades 1, 2 and 3 HPI, which were 19.3%, 25.8% and 54.8% based on the location (P < 0.01), 77.4%, 19.4% and 3.2% based on the extent (P < 0.01), and 51.6%, 29.0% and 19.4% based on the intensity of the lesion (P < 0.01), but not in the positive rates of BPH (P > 0.05). Multivariate logistic regression analysis showed that the risk of PCa was correlated negatively with the location (95% CI: 0.052－0.407, OR = 0.113, P = 0.001, r = －2.078) and extent of HPI (95% CI: 0.068－0.819, OR = 0.231, P = 0.023, r = －1.526) but not correlated with its intensity (95% CI: 0.796－4.193, OR = 1.804, P = 0.215). The positive predictive value, negative predictive value, sensitivity and specificity of the combined application of the location and extent of HPI in differentiating PCa from BPH were 51.2%, 90.3%, 91.5% and 50.8%, respectively. CONCLUSIONS: The location and extent of HPI are negatively while its intensity is not correlated with the risk of PCa. The grading of HPI based on its location and extent could help reduce the repetition of prostate biopsy.

Evaluation of smoking cessation intervention in patients with chronic diseases in smoking cessation clinics.

This study aimed to evaluate the effects of psychological intervention and psychological plus drug intervention on smoking cessation among male smokers with single chronic diseases.A total of 509 male smokers were divided into psychological group (n = 290) and psychological plus drugs (n = 219) groups according to their will. The physicians provided free individual counseling and follow-up interviews with brief counseling for all the subjects. In addition to mental intervention, patients in psychological plus drug group also received bupropion hydrochloride or varenicline tartrate to quit smoking. Outcomes were self-reported, regarding the 7-day point prevalence on abstinence rate and continuous abstinence rates at 1-, 3-, and 6-month follow-up period. Data analyses were performed using intention-to-treat analysis and per protocol analysis.With regards to the 3 follow-up time points, 7-day point-prevalence abstinence rate in psychological plus drugs group was all higher than that in the psychological intervention group. Additionally, the 3-month continuous abstinence rate (21.4%) of the 6-month follow-up in the psychological group was not significantly higher than that (26.9%) in the psychological plus drugs group (P >.05 for all). Fagerström test score, stage of quitting smoking, perceived confidence or difficulty in quitting, and chronic disease types were independently correlated with 3-month continuous abstinence in the 6-month follow up (P <.05 for all). The results were similar between intentional analysis and protocol analysis.The psychological intervention and psychological plus drugs intervention exerted good effects on smoking cessation in a short time (1 month). Nevertheless, the advantages did not appear during long-time (6 months) follow-up.

Increased nucleoside diphosphate kinase activity induces white spot syndrome virus infection in Litopenaeus vannamei.

Nucleoside diphosphate kinase (NDK), which has the same sequence as oncoprotein (OP) in humans, can induce nucleoside triphosphates in DNA replication by maintenance of the deoxynucleotide triphosphate (dNTP's) and is known to be regulated by viral infection in the shrimp Litopenaeus vannamei. This paper describes the relationship between NDK and white spot syndrome virus (WSSV) infection. The recombinant NDK was produced by a prokaryotic expression system. WSSV copy numbers and mRNA levels of IE1 and VP28 were significantly increased in shrimp injected with recombinant NDK at 72 h after WSSV infection. After synthesizing dsRNA-NDK and confirming the efficacy of NDK silencing, we recorded the cumulative mortality of WSSV-infected shrimp injected with NDK and dsRNA-NDK. A comparison between the results demonstrated that silencing NDK delayed the death of shrimps. These findings indicate that NDK has an important role influencing the replication of WSSV replication in shrimp. Furthermore, NDK may have potential target as a new therapeutic strategy against WSSV infection in shrimp.

Additional follow-up telephone counselling and initial smoking relapse: a longitudinal, controlled study.

OBJECTIVES: Smoking cessation services can help smokers to quit; however, many smoking relapse cases occur over time. Initial relapse prevention should play an important role in achieving the goal of long-term smoking cessation. Several studies have focused on the effect of extended telephone support in relapse prevention, but the conclusions remain conflicting. DESIGN AND SETTING: From October 2008 to August 2013, a longitudinal, controlled study was performed in a large general hospital of Beijing. PARTICIPANTS: The smokers who sought treatment at our smoking cessation clinic were non-randomised and divided into 2 groups: face-to-face individual counselling group (FC group), and face-to-face individual counselling plus telephone follow-up counselling group (FCF group). No pharmacotherapy was offered. OUTCOMES: The timing of initial smoking relapse was compared between FC and FCF groups. Predictors of initial relapse were investigated during the first 180 days, using the Cox proportional hazards model. RESULTS: Of 547 eligible male smokers who volunteered to participate, 457 participants (117 in FC group and 340 in FCF group) achieved at least 24 h abstinence. The majority of the lapse episodes occurred during the first 2 weeks after the quit date. Smokers who did not receive the follow-up telephone counselling (FC group) tended to relapse to smoking earlier than those smokers who received the additional follow-up telephone counselling (FCF group), and the log-rank test was statistically significant (p=0.003). A Cox regression model showed that, in the FCF group, being married, and having a lower Fagerström test score, normal body mass index and doctor-diagnosed tobacco-related chronic diseases, were significantly independent protective predictors of smoking relapse. CONCLUSIONS: Within the limitations of this study, it can be concluded that additional follow-up telephone counselling might be an effective strategy in preventing relapse. Further research is still needed to confirm our findings.

Cloning of Litopenaeus vannamei CD63 and it's role in white spot syndrome virus infection.

White Spot Syndrome Virus (WSSV) is currently the most serious shrimp pathogen, which has brought huge losses to shrimp industry worldwide. CD63 of shrimp belongs to the tetraspanin superfamily, which plays an important role in signal transduction and immune process. In this paper, CD63 cDNA sequence of Litopenaeus vannamei was cloned using RACE method. The amplified sequence is 1472 bp, with its ORF 744 bp, encoding 247 amino acids. Bioinformatics analysis showed that the sequence of LvCD63 has 93% similarity with Penaeus monodon and 92% similarity with Fenneropenaeus chinensis. Real-time PCR analysis showed that the mRNA levels of LvCD63 expressed in the tissues of hemocytes, gill, epithelial tissue, heart, lymphoid, hepatopancreas, stomach, intestines, muscle and nerve. Among these tissues the highest expression level was showed in the tissue of haemolymph, followed by epithelial tissue, hepatopancreas, and nerve. The lowest expression level of LvCD63 was appeared in the muscle tissue. After WSSV challenge, the expression levels of LvCD63 were both up-regulated in the tissues of gill and epithelial. However the expression level of LvCD63 in hepatopancreas was down-regulated. Far-western blot analysis showed that LvCD63 interacts with VP28, and both VP28N and VP28C fragments interact with LvCD63. Flow cytometry analysis showed that LvCD63 was present on the surface of hemocytes and it is required for binding of WSSV virions. Neutral experiments in vivo showed that LvCD63LEL delayed WSSV infection in shrimp.

Effectiveness of additional follow-up telephone counseling in a smoking cessation clinic in Beijing and predictors of quitting among Chinese male smokers.

BACKGROUND: No previous studies have investigated whether additional telephone follow-up counseling sessions after face-to-face counseling can increase quitting in China, and whether this strategy is feasible and effective for promoting smoking cessation is still unclear. METHODS: A non-randomized controlled study was conducted in Beijing. We compared the quit rates of one group which received face-to-face counseling (FC) alone (one session of 40 min) to another group which received the same face-to-face counseling plus four follow-up sessions of brief telephone counseling (15-20 min each) at 1 week, 1, 3 and 6 month follow-up (FCF). No smoking cessation medication was provided. From October 2008 to August 2013, Chinese male smokers who sought treatment in a part-time regular smoking cessation clinic of a large general hospital in Beijing were invited to participate in the present study. Eligible male smokers (n = 547) were divided into two groups: FC (n = 149) and FCF (n = 398). Main outcomes were self-reported 7-day point prevalence and 6 month continuous quit rates at 12 month follow-up. RESULTS: By intention to treat, at 12 month follow-up, the 7-day point prevalence and 6 month continuous quit rates of FC and FCF were 14.8 % and 26.4 %, and 10.7 % and 19.6 % respectively. The adjusted odds ratios (95 % confidence intervals) of quitting in FCF compared to FC was 2.34 (1.34-4.10) (P = 0.003) and 2.41 (1.28-4.52) (P = 0.006), respectively. Stepwise logistic regression showed that FCF, being married, unemployed and a lower Fagerström score were significant independent predictors of 6 month continuous quitting at 12 month follow-up. CONCLUSIONS: Using systematically collected data from real-world practice, our smoking cessation clinic has shown that the additional telephone follow-up counseling sessions doubled the quit rate.

Effectiveness of varenicline and counselling for smoking cessation in an observational cohort study in China.

OBJECTIVES: To evaluate the effectiveness of varenicline for smoking cessation in Chinese smokers in a real world cessation clinic practice. DESIGN: A prospective observational study. SETTING: Beijing, China. PARTICIPANTS: A total of 924 smokers (883 men and 41 women) who attended a smoking cessation clinic of a large general hospital were assessed with data from structured questionnaires at baseline and follow-up at 1, 3 and 6 months. Trained physician counsellors provided free individual counselling for all subjects and follow-up interviews with brief counselling. 332 subjects additionally prescribed varenicline according to their own choice were compared with those without varenicline. MAIN OUTCOME MEASURES: Primary outcomes were self-reported 7-day point prevalence abstinence rate and 3-month continuous abstinence rate at 6-month follow-up. Secondary outcomes were 7-day point prevalence abstinence rates at 1 and 3-month follow-up, and 1-month continuous abstinence rate at 3-month follow-up. RESULTS: By intention-to-treat, the 7-day point prevalence abstinence rate with varenicline and counselling at 6 months was significantly higher than counselling only (37.0% vs 23.1%; OR, 1.75; 95% CI 1.46 to 2.62; p=0.001). The 3-month continuous abstinence rate at 6 months was higher with varenicline (33.1% vs 18.4%; OR, 2.04; 95% CI 1.61 to 2.99; p<0.001). Varenicline also showed better secondary outcomes. CONCLUSIONS: Varenicline prescription in the smoking cessation clinic appeared to be effective with doubling of quit rates in Chinese smokers in a real world cessation clinic practice. CLINICAL TRIAL REGISTRATION: NCT01935505; Results.

Relationship between education levels and booster counselling sessions on smoking cessation among Chinese smokers.

OBJECTIVES: Although various effective interventions are available to help individuals quit smoking, the effect of educational levels on cessation rates has rarely been studied, and of the few intervention studies on this topic, the results have been conflicting. DESIGN AND SETTING: From October 2008 to August 2013, a partly retrospective non-randomised study was conducted in a smoking cessation clinic of a large general hospital in Beijing, China. PARTICIPANTS: In total, 547 Chinese smokers who sought treatment were divided into two groups: a face-to-face counselling group (FC, n=149) and an FC group subjected to four telephone follow-up sessions (FCF, n=398). OUTCOMES: We evaluated self-reported cessation rates by day 7 and after 6 and 12 months and stratified the two groups by education levels. RESULTS: The 7-day and 6-month and 12-month continuous cessation rates of smokers of low education levels in the FC group at the time of the 12-month follow-up were 12.5%, 7.1% and 7.1%, respectively, which were lower than those of the highly educated smokers (16.1%, 12.9% and 9.7%, respectively). The results were opposite for the FCF group. The corresponding results for the highly educated smokers of the FCF group were 25.0%, 17.2% and 10.3%, respectively, which were lower than those for the smokers of low education levels (28.3%, 22.9% and 18.1%, respectively). However, significant differences were observed only among the FCF group participants who had experienced 12 months of continuous abstinence, and the crude OR for these individuals was recorded at 0.52 (0.29 to 0.93), p=0.03. A stepwise logistic regression showed that education levels may play a role in various intervention methods. Being married and higher Fagerström test scores were also predictors of cessation tendencies. CONCLUSIONS: Education levels may affect the benefits of booster counselling sessions on smoking cessation among Chinese smokers.

[Impact of intervention on tobacco related knowledge, attitudes and practice of smokers].

OBJECTIVE: To evaluate the impact of intervention on tobacco related knowledge, attitudes and practice of smokers. METHODS: An observational study was conducted among the smokers seeking counsel at smoking cessation clinic in our hospital from October 2008 to August 2013. First, a face to face counsel and mental intervention for more than 30 minutes was given to smoker, then 4 interventions through telephone call for 15-20 minutes for each time were conducted 1 week later, 1 month later, 3 months later and 6 months later, respectively. The controls were smokers receiving health examination in our hospital. No interventions were conducted among them. The tobacco related knowledge, attitudes and practice at baseline survey and follow up 1 year later were compared between intervention group and control group. RESULTS: The intervention group included 414 smokers and the control group included 213 smokers. Intentional analysis indicated that the awareness/acceptance rates of 5 items about tobacco related knowledge and attitudes at follow up 1 year later was higher than those at baseline survey in intervention group. The smoking cessation rate was 27.3% in intervention group and 4.7% in control group. Multivariate logistic regression analysis indicated that the smoking cessation rate was positively correlated with intervention, female, highly nicotine dependence and positive change of tobacco related knowledge and attitudes (smoking can cause heart disease, all kinds of tobacco advertisements should be prohibited, smoking waste money and restaurant should be smoking free) with OR (95% CI): 2.85 (2.00-4.07), 3.34 (1.23-9.07), 2.78 (1.64-4.72), 2.30 (1.03-5.15), 5.33 (1.47-19.32), 6.32 (1.56-25.62) and 10.47 (2.25-48.84), respectively. CONCLUSION: The awareness rate of tobacco related harm was high among the smokers seeking counsel at smoking cessation clinic. Systematic smoking cessation intervention can improve smokers' tobacco related knowledge and attitudes and increase smoking cessation rate.