Effects of pay-for-performance based antimicrobial stewardship on antimicrobial consumption and expenditure: An interrupted time series analysis.

Objectives: To evaluate the impact of pay-for-performance on antimicrobial consumption and antimicrobial expenditure in a large teaching hospital in Guangzhou, China. Methods: We collected data from hospital information system from January 2018 through September 2022 in the inpatient wards. Antimicrobial consumption was evaluated using antibiotic use density (AUD) and antibiotic use rate (AUR). The economic impact of intervention was assessed by antimicrobial expenditure percentage. The data was analyzed using interrupted time series (ITS) analysis. Results: Following the implementation of the intervention, immediate decreases in the level of AUD were observed in Department of Hematology Unit 3 (ß = -66.93 DDDs/100PD, P = 0.002), Urology (ß = -32.80 DDDs/100PD, P < 0.001), Gastrointestinal Surgery Unit 3 (ß = -11.44 DDDs/100PD, P = 0.03), Cardiac Surgery (ß = -14.30 DDDs/100PD, P = 0.01), ICU, Unit 2 (ß = -81.91 DDDs/100PD, P = 0.02) and Cardiothoracic Surgery ICU (ß = -41.52 DDDs/100PD, P = 0.05). Long-term downward trends in AUD were also identified in Organ Transplant Unit (ß = -1.64 DDDs/100PD, P = 0.02). However, only Urology (ß = -6.56 DDDs/100PD, P = 0.02) and Gastrointestinal Surgery Unit 3 (ß = -8.50 %, P = 0.01) showed an immediate decrease in AUR, and long-term downward trends in AUR were observed in Pediatric ICU (ß = -1.88 %, P = 0.05) and ICU Unit 1 (ß = -0.55 %, P = 0.02). Conclusion: This study demonstrates that the adoption of pay-for-performance effectively reduces antibiotic consumption in specific departments of a hospital in Guangzhou in the short term. However, it is important to recognize that the long-term impact of such interventions is often limited. Additionally, it should be noted that the overall effectiveness of the intervention across the entire hospital was not significant.

Morusin inhibits breast cancer-induced osteolysis by decreasing phosphatidylinositol 3-kinase (PI3K)-mTOR signalling.

Bone metastases caused by breast cancer pose a major challenge to the successful treatment of breast cancer patients. Many researchers have suggested that herbal medicines are extremely effective at preventing and treating cancer-associated osteolysis. Previous studies have revealed that Morusin (MOR) is cytotoxic to many cancer cells ex vivo. Nevertheless, how MOR contributes to osteolysis induced by breast cancer is still unknown, and the potential mechanism of action against osteolysis is worthy of further study. The protective effect and molecular mechanism of MOR in inhibiting breast cancer cell-induced osteolysis were verified by experiments and network pharmacology. Cell function was assessed by cell proliferation, osteoclast (OC) formation, bone resorption, and phalloidin staining. Tumour growth was examined by micro-CT scanning in vivo. To identify potential MOR treatments, the active ingredient-target pathway of breast cancer was screened using network pharmacology and molecular docking approaches. This study is the first to report that MOR can prevent osteolysis induced by breast cancer cells. Specifically, our results revealed that MOR inhibits RANKL-induced osteoclastogenesis and restrains the proliferation, invasion and migration of MDA-MB-231 breast cells through restraining the PI3K/AKT/MTOR signalling pathway. Notably, MOR prevented bone loss caused by breast cancer cell-induced osteolysis in vivo, indicating that MOR inhibited the development of OCs and the resorption of bone, which are essential for cancer cell-associated bone distraction. This study showed that MOR treatment inhibited osteolysis induced by breast cancer in vivo. MOR inhibited OC differentiation and bone resorption ex vivo and in vivo and might be a potential drug candidate for treating breast cancer-induced osteolysis.

Expression of CKS2 in Hepatocellular Carcinoma: Correlation with Survival Outcomes and Immune Microenvironment.

Purpose: Cyclin-dependent kinase regulatory subunit 2 (CKS2) has an important function in regulating cancer progression and cell cycle. This research aims to ascertain how CKS2 plays its part through multi-omics analyses, to reveal its relationship with the immune microenvironment in hepatocellular carcinoma (HCC). Material and Methods: Multiple databases were used to determine the transcriptional data of CKS2, epigenetic changes, and effects thereof upon the prognosis of HCC patients. The biological functions of CKS2 in HCC were expounded by functional enrichment analysis. TIMER, GSEA, TIP, and online single-cell sequencing databases were adopted for revealing correlations of CKS2 expression with infiltration of immune cells, immunomodulators, immunity cycle, and immune markers in the immune microenvironment of HCC. In addition, qRT-PCR and Western blot were used to validate gene expression in tissues from HCC patients. Results: Open database analysis confirmed that CKS2 is highly expressed in HCC and that it is related to poor prognosis in HCC patients. Aberrant methylation levels of the two methylation sites of CKS2 in HCC contributed to its high expression and were correlated significantly with survival. The CKS2 expression was positively correlated with most immunomodulators and infiltration levels for B and CD8+T cells, dendritic cells, and macrophages, especially exhausted CD8+T cells. Besides, the CKS2 expression was also found to have significant correlations with immunity cycle steps and diverse immune markers in HCC. The high CKS2 expression was confirmed in HCC at both mRNA and protein levels, showing a significant increase compared to normal tissue. Conclusion: CKS2 is a potential prognostic biomarker of HCC and can promote the progression of HCC via its influences on the immune environment. Additionally, a positive correlation between CKS2 and immune markers was observed, highlighting its potential as an immunotherapeutic target.

Prediction of axillary lymph node metastasis in early breast cancer patients with ultrasonic videos based deep learning.

Objective: To develop a deep learning (DL) model for predicting axillary lymph node (ALN) metastasis using dynamic ultrasound (US) videos in breast cancer patients. Methods: A total of 271 US videos from 271 early breast cancer patients collected from Xiang'an Hospital of Xiamen University andShantou Central Hospitabetween September 2019 and June 2021 were used as the training, validation, and internal testing set (testing set A). Additionally, an independent dataset of 49 US videos from 49 patients with breast cancer, collected from Shanghai 10th Hospital of Tongji University from July 2021 to May 2022, was used as an external testing set (testing set B). All ALN metastases were confirmed using pathological examination. Three different convolutional neural networks (CNNs) with R2 + 1D, TIN, and ResNet-3D architectures were used to build the models. The performance of the US video DL models was compared with that of US static image DL models and axillary US examination performed by ultra-sonographers. The performances of the DL models and ultra-sonographers were evaluated based on accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Additionally, gradient class activation mapping (Grad-CAM) technology was also used to enhance the interpretability of the models. Results: Among the three US video DL models, TIN showed the best performance, achieving an AUC of 0.914 (95% CI: 0.843-0.985) in predicting ALN metastasis in testing set A. The model achieved an accuracy of 85.25% (52/61), with a sensitivity of 76.19% (16/21) and a specificity of 90.00% (36/40). The AUC of the US video DL model was superior to that of the US static image DL model (0.856, 95% CI: 0.753-0.959, P<0.05). The Grad-CAM technology confirmed the heatmap of the model, which highlighted important subregions of the keyframe for ultra-sonographers' review. Conclusion: A feasible and improved DL model to predict ALN metastasis from breast cancer US video images was developed. The DL model in this study with reliable interpretability would provide an early diagnostic strategy for the appropriate management of axillary in the early breast cancer patients.

Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation.

Lumbar disc herniation (LDH) is a type of serious sinus or sciatic nerve dysfunction caused by nucleus pulposus protrusion and annulus fibrosus tears. Its clinical symptoms often include severe low back pain, limited lumbar movement, sciatic nerve pain in the lower limbs, and even cauda equina syndrome. The common treatment for LDH is a conservative treatment scheme involving medicine, rest, and physical therapy. However, if the conservative treatment scheme is ineffective, a surgical treatment approach is adopted. Traditional open lumbar surgery has some disadvantages, including the potential for severe surgical trauma, severe blood loss during the operation, instability of the lumbar spine, and loss of the lumbar motor unit. Among the minimally invasive surgical schemes, full-endoscopic spine surgery (FESS) is undoubtedly the most appropriate and has the advantages of minimal trauma, high safety, quick postoperative recovery, and the retention of the stable structure and the motor unit of the lumbar spine. However, simultaneously, incomplete removal of the nucleus pulposus and residual nerve dysfunction after surgery can occur. To avoid these shortcomings, we studied a specific spinal endoscopy technique, the "isolation zone" surgical strategy, which can effectively block the pain from the nerve conduction pathway by completely relieving the nerve compression and nerve dysfunction through the orderly treatment of the protruding nucleus pulposus, the fissure of the annulus fibrosus, the sinus nerve, and the surrounding inflammatory soft tissues.

Antifibrotic Mechanism of Piceatannol in Bleomycin-Induced Pulmonary Fibrosis in Mice.

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease characterized by myofibroblast accumulation and extracellular matrix deposition, which lead to irreversible damage of the lung's architecture and the formation of fibrotic lesions. IPF is also a sequela in serious patients with the coronavirus disease 2019 (COVID-19). The molecular mechanisms under pulmonary fibrosis remain unclear, and there is no satisfactory treatment currently available. Piceatannol (PIC) is a naturally occurring resveratrol analog found in a variety of dietary sources such as grapes, passion fruit, and white tea. It has been reported to inhibit liver fibroblast growth and exhibited various antitumor activities, although its role in pulmonary fibrosis has not been established yet. In the present study, we evaluated the anti-fibrotic role of PIC in bleomycin (BLM)-induced pulmonary fibrosis in mice. Methods: Mice with BLM-induced pulmonary fibrosis were treated with PIC, and fibrotic changes were measured by hematoxylin-eosin (H&E) staining and hydroxyproline assay. Luciferase assay, Western blot assay, histological analysis, and immunofluorescence staining were used to evaluate the effect of PIC on fibroblast activation and autophagy in mouse embryonic fibroblast cells (NIH-3T3) and human lung fibroblast cells (HFL1). The anti-fibrotic mechanisms of PIC were either confirmed in vivo. Results: Our results showed that PIC significantly alleviated the bleomycin-induced collagen deposition and myofibroblast accumulation. In vitro and in vivo studies indicated that PIC plays a role in activating autophagy in the process of anti-fibroblast activation. Further mechanism studies demonstrated that PIC can promote autophagy via inhibiting the TGF-ß1-Smad3/ERK/P38 signaling pathway, which leads to a decreased number of activated myofibroblasts. Conclusion: Our study demonstrated for the first time that PIC possesses the protective effects against bleomycin-induced pulmonary fibrosis due to the direct pulmonary protective effects which enhance the effect of autophagy in vitro and in vivo and finally leads to the decreased number of activated myofibroblasts. PIC may serve as a candidate compound for pulmonary fibrosis therapy and attenuates the sequelae of SARS-COV-2 pulmonary fibrosis.

Chrysin Protects Against Titanium Particle-Induced Osteolysis by Attenuating Osteoclast Formation and Function by Inhibiting NF-κB and MAPK Signaling.

Bone homeostasis only exists when the physical function of osteoblast and osteoclast stays in the balance between bone formation and resorption. Bone resorption occurs when the two processes are uncoupled, shifting the balance in favour of bone resorption. Excessive activation of osteoclasts leads to a range of osteolytic bone diseases including osteoporosis, aseptic prosthesis loosening, rheumatoid arthritis, and osteoarthritis. Receptor activator of nuclear factor kappa-B ligand (RANKL) and its downstream signaling pathways are recognized as key mediators that drive the formation and activation of osteoclastic function. Hence, osteoclast formation and/or its function remain as dominant targets for research and development of agents reaching the treatment towards osteolytic diseases. Chrysin (CHR) is a flavonoid with a wide range of anti-inflammatory and anti-tumor effects. However, its effect on osteoclasts remains unknown. In this study, we found the effects of CHR on inhibiting osteoclast differentiation which were assessed in terms of the number and size of TRAcP positive multinucleated osteoclasts (OCs). Further, the inhibitory effects of CHR on bone resorption and osteoclast fusion of pre-OC were assessed by hydroxyapatite resorption pit assay and F-actin belts staining; respectively. Western blotting analysis of RANKL-induced signaling pathways and immunofluorescence analysis for p65 nuclear translocation in response to RANKL-induced osteoclasts were used to analyze the mechanism of action of CHR affecting osteoclasts. Lastly, the murine calvarial osteolysis model revealed that CHR could protect against particle-induced bone destruction in vivo. Collectively, our data strongly suggested that CHR with its promising anti-tumor effects would also be a potential therapeutic agent for osteolytic diseases.

Taxifolin improves inflammatory injury of human bronchial epithelial cells by inhibiting matrix metalloproteinase (MMP) 10 via Wnt/ß-catenin pathway.

Taxifolin (TXL), also known as dihydroquercetin, is one of the most important flavonoids prevalent across the plant kingdom. Increasing evidence has demonstrated its critical role in respiratory diseases. The present study aims to reveal the detailed mechanism in TNF-α-stimulated BEAS-2B cells by which TXL might exert effects on the development of asthma. Cell viability detection of BEAS-2B treated with TXL before and after TNF-α induction employed MMT. The expressions of inflammatory cytokines, MUC5AC and ICAM-1 were determined by quantitative reverse transcription PCR (RT-qPCR), enzyme-linked immunosorbent assay (ELISA) and Western blot after TXL was exposed to an in vitro asthma model. Then, light transmittance and apoptosis were then measured employing fluorescein transmittance, TUNEL and Western blot. After overexpressing MMP10, the abovementioned assays were performed again. Finally, the association between Wnt/ß-catenin pathway and MMP10 was confirmed by detecting the proteins in this pathway. TXL increases the cell viability of TNF-induced BEAS-2B cells. TXL suppressed the inflammation, mucus formation, and apoptosis in TNF-α-induced BEAS-2B cells. Furthermore, after the prediction of binding sites between TXL and MMP10, it was found that overexpression of MMP10 reversed the effects of TXL on suppressing the progression of TNF-α-induced BEAS-2B cells. Finally, TXL blocked Wnt/ß-catenin pathway by inhibiting MMP10 expression.TXL can be a promising drug for the treatment of asthma due to its inhibition of MMP10 expression by blocking Wnt/ß-catenin pathway. Future experimental in vivo studies of asthma on this commonly used bioactive flavonoid could open new avenues for the therapies of asthma.

Chemokine CXCL1 as a potential marker of disease activity in systemic lupus erythematosus.

OBJECTIVES: The chemokine CXCL1, known as growth-related oncogene α (GRO-α), is a potent chemoattractant and regulator of neutrophils. The purpose of our study was to evaluate the regulatory response of CXCL1 in the serum of patients with systemic lupus erythematosus (SLE) in the active stage of disease and to assess whether it was implicated in the pathogenesis/inflammatory process in lupus. METHODS: CXCL1 serum concentrations were examined in 90 SLE patients, 56 other autoimmune diseases (OADs) patients and 100 healthy controls using enzyme-linked immunosorbent methodology. RESULTS: SLE patients exhibited significant increases in serum CXCL1 concentrations [1492.86 (735.47-2887.34) pg/ml] compared with OADs patients [155.88 (10.77-366.78) pg/ml] and healthy controls [13.58 (8.46-37.22) pg/ml] (p < 0.001). Moreover, the level of CXCL1 decreased as the level of anti-dsDNA IgG decreased after treatment between the anti-dsDNA-positive SLE patients and the anti-dsDNA-negative SLE patients. Additionly, serum CXCL1 concentrations were related to different disease activity levels in SLE and lupus nephritis (LN) and high avidity of IgG ANAs (HA IgG ANAs) (p < 0.05). Furthermore, CXCL1 serum concentrations were significantly correlated with the SLE Disease Activity Index(SLEDAI) score, relative avidity index (RAI) of HA IgG ANAs and the levels of anti-dsDNA IgG, CRP, ESR, albumin, C3 and C4.Additionally, Statistical analysis revealed that positivity for IgG ANA (p < 0.001), the presence of HA IgG ANAs (p = 0.001) and the logarithmic level of anti-dsDNA IgG (p = 0.021) were significantly associated with the logarithmic level of CXCL1 with standard partial regression coefficients (95% CI) of 2.371 (1.734-3.009), 1.231 (0.52-1.937) and 0.409 (0.062-0.755), respectively. Finally, using cutoff points of 1182.17 pg/mL and 1500.31 pg/mL, serum CXCL1 levels had a similar sensitivity of 76% and specificity of 100% and 75% for the diagnosis of active SLE and LN, respectively. CONCLUSIONS: Serum CXCL13 concentrations might represent a potential marker of disease activity in systemic lupus erythematosus.

Thermal Bistability of an Ultrathin Film of Iron(II) Spin-Crossover Molecules Directly Adsorbed on a Metal Surface.

Spin-crossover molecules are very attractive compounds to realize multifunctional spintronic devices. Understanding their properties when deposited on metals is therefore crucial for their future rational implementation as ultrathin films in such devices. Using X-ray absorption spectroscopy, we study the thermal transition of the spin-crossover compound FeII((3,5-(CH3)2Pz)3BH)2 from submonolayer to multilayers on a Cu(111) substrate. We determine how the residual fraction of high spin molecules at low temperature, as well as the bistability range and the temperature of switching, depends on the layer thickness. The most spectacular effect is the clear opening of a 35 ± 9 K thermal hysteresis loop for a 3.0 ± 0.7 monolayers thick film. To better understand the role played by the substrate and the dimensionality on the thermal bistability, we have performed Monte Carlo Arrhenius simulations in the framework of a mechanoelastic model that include a molecule-substrate interaction. This model reproduces well the main features observed experimentally and can predict how the spin-crossover transition is modified by the thickness and the substrate interaction.

α-Tomatine, a novel early-stage autophagy inhibitor, inhibits autophagy to enhance apoptosis via Beclin-1 in Skov3 cells.

Targeting the autophagy process is considered to be a promising new strategy for drug treatment of ovarian cancer. α-Tomatine, a steroidal alkaloid extracted, is mainly isolated from leaves, roots and immature green tomatoes. α-Tomatine has biological activities such as anticancer, antioxidative and anti-inflammatory. The study aimed to explore the effects of α-tomatine on proliferation, apoptosis and autophagy and the underlying mechanisms in ovarian cancer Skov3 cells. After treatment with different concentrations of α-tomatine (0, 0.75, 1 and 1.5 µM) in Skov3 cells for 24 h, proliferation was determined by the CCK-8 assay, and apoptosis was detected by flow cytometric analysis. Autophagy in cells was determined by the number of fluorescent spots using confocal fluorescence microscopy after mRFP-GFP-LC3 transfection. The relationship between autophagy and apoptosis was proved by Beclin-1 overexpression. The protein expression levels were tested by western blotting. The results demonstrated that α-tomatine effectively repressed proliferation, exerted a proapoptotic effect and inhibited early-stage autophagy in Skov3 cells in a dose- and time-dependent manner. Additionally, Beclin-1 overexpression significantly suppressed α-tomatine-treated apoptosis in Skov3 cells, indicating that α-tomatine inhibits autophagy to induce apoptosis. We also found α-tomatine inhibited the protein expression levels of PI3K/Akt/mTOR signaling pathway. However, the autophagy inhibition of α-tomatine could be reversed obviously by Beclin-1 overexpression. Taken together, α-tomatine inhibited autophagy through Beclin-1. Our study suggests that α-tomatine, as a novel early-stage autophagy inhibitor, might be a potential drug for further treatment of ovarian cancer by inhibiting proliferation and promoting apoptosis.

Responses of functional traits to seven-year nitrogen addition in two tree species: coordination of hydraulics, gas exchange and carbon reserves.

Atmospheric nitrogen (N) deposition has been observed to impact plant structure and functional traits in terrestrial ecosystems. Although the effect of N deposition on plant water use has been well-evaluated in laboratories and in experimental forests, the linkages between water and carbon relations under N deposition are unclear. Here, we report on hydraulics, gas exchange and carbon reserves of two broad-leaved tree species (Quercus mongolica and Fraxinus mandshurica) in mature temperate forests after a seven-year experiment with different levels of N addition (control (CK), low (23 kg N ha-1 yr-1), medium (46 kg N ha-1 yr-1) and high (69 kg N ha-1 yr-1)). We investigated variation in hydraulic traits (xylem-specific hydraulic conductivity (Ks), native percentage loss of conductivity (PLC) and leaf water potential), xylem anatomy (vessel diameter and density), gas exchange (maximum net photosynthesis rate and stomatal conductance) and carbon reserves (soluble sugars, starch and total nonstructural carbohydrates (NSC)) with different N addition levels. We found that medium N addition significantly increased Ks and vessel diameter compared to control, but accompanied increasing PLC and decreasing leaf water potential, suggesting that N addition results in a greater hydraulic efficiency and higher risk of embolism. N addition promoted photosynthetic capacity via increasing foliar N concentration but did not change stomatal conductance. In addition, we found increase in foliar soluble sugar concentration and decrease in starch concentration with N addition, and positive correlations between hydraulic traits (vessel diameter and PLC) and soluble sugars. These coupled responses of tree hydraulics and carbon metabolism are consistent with a regulatory role of carbohydrates in maintaining hydraulic integrity. Our study provides an important insight into the relationship of plant water transport and carbon dynamics under increasing N deposition.

Uninfluenced alpha-fetoprotein and treatment of liver primary carcinoma by lobaplatin in combination with 5-fluorouracil and doxorubicin via chemoembolization and transarterial chemoembolization.

Alpha-fetoprotein (AFP) is a protein encoded by the AFP gene and normally produced by the fetus. The purpose of this study is to investigate the efficacy of lobaplatin in combination with 5-fluorouracil (5-FU) and doxorubicin on AFP and treatment of primary carcinoma of the liver by transhepatic arterial chemotherapy and embolization (TACE). Patients with primary carcinoma of the liver who took the TACE for treatment were enrolled in this study and divided randomly into the research group and the control group. Patients in the research group adopted the TACE in combination with lobaplatin, while those in the control group took cisplatin instead in combination with TACE. We compared the baseline data, hepatic indicators before treatment and after 1 month of treatment, efficacy and the incidence rates of adverse events after TACE between two groups. Differences in the baseline data, including Child-pugh grade, type of liver cirrhosis, KPS scores and AFP showed no statistical significance (P >0.05). Before the treatment, we identified no significant differences in the comparison of ALT, AST, TBiL and ALB between two groups (P >0.05), while significant differences emerged after treatment (P <0.05). Also, efficacy comparison revealed the significant difference between the two groups (P <0.05). After TACE, patients in the research group reported 1 case of nausea, 1 of vomiting and 1 of necrotic absorption fever, and those in the control group reported 3 cases of nausea, 5 of vomiting and 4 of necrotic absorption fever, with a significant difference in comparison of the incidence rates (P <0.05). TACE is a promising strategy for the treatment of primary carcinoma of the liver, while lobaplatin, as the 3rd generation of anti-tumor platinum-based drugs, is less toxic than cisplatin, but excels in efficacy.

The status and characteristics of urinary stone composition in China.

OBJECTIVES: To explore characteristics of urinary stone composition in China, and determine the effects of gender, age, body mass index (BMI), stone location, and geographical region on stone composition. PATIENTS AND METHODS: We prospectively used Fourier-transform infrared spectroscopy to analyse stones from consecutive patients presenting with new-onset urolithiasis at 46 hospitals in seven geographical areas of China, between 1 June 2010 and 31 May 2015. Chi-squared tests and logistic regression analyses were used to determine associations between stone composition and gender, age, BMI, stone location, and geographical region. RESULTS: The most common stone constituents were: calcium oxalate (CaOx; 65.9%), carbapatite (15.6%), urate (12.4%), struvite (2.7%), and brushite (1.7%). CaOx and urate stones occurred more frequently in males, whereas carbapatite and struvite were more common in females (P < 0.01). CaOx and carbapatite were more common in those aged 30-50 and 20-40 years than in other groups. Brushite and struvite were most common amongst those aged <20 and >70 years. The detection rate of urate increased with age, whilst cystine decreased with age. Obese patients were more likely to have urate stones than carbapatite or brushite stones (P < 0.01). CaOx, carbapatite, brushite, and cystine stones were more frequently found in the kidney than other types, whereas urate and struvite were more frequent in the bladder (P < 0.01). Stone composition varied by geographical region. CONCLUSIONS: The most common stone composition was CaOx, followed by carbapatite, urate, struvite, and brushite. Stone composition differed significantly in patients grouped by gender, age, BMI, stone location, and geographical region.

Genetic polymorphisms and pancreatic cancer risk: A PRISMA-compliant systematic review and meta-analysis.

BACKGROUNDS: Previous investigations yielded inconsistent results for the associations between pancreatic cancer (PC) risk and genetic polymorphisms. The study aimed to perform a systematic review and meta-analysis of studies exploring association of some genetic polymorphisms and PC risk. METHODS: We systematically searched on PubMed and Web of Science for association of genetic polymorphisms and PC risk published from 1969 to January 2019. We computed the multivariate odd ratio (OR) and 95% confidence intervals (CI), comparing different genetic types. RESULTS: The present meta-analysis showed significant associations between deoxyribonucleic acid (DNA) repair gene (X-ray repair cross-complementing group 1 (XRCC1) Arg399GIn and Arg194Trp, excision repair cross complementation 1 (ERCC1) rs11615 and rs3212986, ERCC2 rs13181) polymorphisms and PC risk. CONCLUSIONS: Because of the limited sample size and ethnicity enrolled in the present meta-analysis, further larger scaled studies should be performed to demonstrate the association.

Responses of Woody Plant Functional Traits to Nitrogen Addition: A Meta-Analysis of Leaf Economics, Gas Exchange, and Hydraulic Traits.

Atmospheric nitrogen (N) deposition has been found to significantly affect plant growth and physiological performance in terrestrial ecosystems. Many individual studies have investigated how N addition influences plant functional traits, however these investigations have usually been limited to a single species, and thereby do not allow derivation of general patterns or underlying mechanisms. We synthesized data from 56 papers and conducted a meta-analysis to assess the general responses of 15 variables related to leaf economics, gas exchange, and hydraulic traits to N addition among 61 woody plant species, primarily from temperate and subtropical regions. Results showed that under N addition, leaf area index (+10.3%), foliar N content (+7.3%), intrinsic water-use efficiency (+3.1%) and net photosynthetic rate (+16.1%) significantly increased, while specific leaf area, stomatal conductance, and transpiration rate did not change. For plant hydraulics, N addition significantly increased vessel diameter (+7.0%), hydraulic conductance in stems/shoots (+6.7%), and water potential corresponding to 50% loss of hydraulic conductivity (P50, +21.5%; i.e., P50 became less negative), while water potential in leaves (-6.7%) decreased (became more negative). N addition had little effect on vessel density, hydraulic conductance in leaves and roots, or water potential in stems/shoots. N addition had greater effects on gymnosperms than angiosperms and ammonium nitrate fertilization had larger effects than fertilization with urea, and high levels of N addition affected more traits than low levels. Our results demonstrate that N addition has coupled effects on both carbon and water dynamics of woody plants. Increased leaf N, likely fixed in photosynthetic enzymes and pigments leads to higher photosynthesis and water use efficiency, which may increase leaf growth, as reflected in LAI results. These changes appear to have downstream effects on hydraulic function through increases in vessel diameter, which leads to higher hydraulic conductance, but lower water potential and increased vulnerability to embolism. Overall, our results suggest that N addition will shift plant function along a tradeoff between C and hydraulic economies by enhancing C uptake while simultaneously increasing the risk of hydraulic dysfunction.

[Clinical features and mutational analysis of a case with Sensenbrenner syndrome].

OBJECTIVE: To explore the clinical characteristics of a patient with Sensenbrenner syndrome (also called cranioectodermal dysplasia type 3) caused by mutation of intraflagellar transport (IFT) 43 gene. METHODS: The clinical data of the patient was retrospectively analyzed. The target genes was the patient were captured and subjected to next generation sequencing. Suspected mutations were verified through Sanger sequencing. RESULTS: The patient, a-13 year-and-5-month-old girl, was admitted for anemia and renal dysfunction for 8 months. Clinically, she has featured short stature, short limbs, brachydactylia, tooth agenesis, and retinal dystrophy, high-degree myopia, and chronic renal failure. Gene sequencing showed that she has carried a homozygous c.1A>G (p.M1V) mutation of the IFT43 gene, for which both of her parents were heterozygous carriers. CONCLUSION: c.1A>G (p.M1V) mutation of the C14ORF179/IFT43 gene is the cause for praecox chronic renal failure in children. Genetic testing can facilitate the diagnosis of this rare disorder. For affected families, prenatal diagnosis should be provided.

[Applicability of daytime downward longwave radiation parameterized models in Changbai Mountains, Northeast China].

A total of eight clear-sky and eight cloudy-sky parameterized models for estimating daytime downward longwave radiation were evaluated by using the meteorological data measured in the Changbai Mountains region, Northeast China. The results indicated that the Satterlund model performed better in estimating clear-sky downward longwave radiation, and the bias (BIAS) and root mean square error (RMSE) were -23.34 and 28.55 W· m(-2), respectively. Although the coefficients were not significantly changed, the performance of Satterlund model was significantly improved after the locally calibrated, and the BIAS and RMSE decreased to -6.33 and 18.08 W · m(-2), respectively. Jacobs model was found to be best for modeling cloudy-sky downward long-wave radiation and the BIAS and RMSE were 0.38 and 29.29 W · m(-2), respectively. Sensitivity analysis showed that the vapor pressure was the most sensitive variable to the atmospheric emissivity and the temperature was not sensitive to it. The predicted results of the optimal model (clear- and cloudy-sky) were consistent with the measured data, while the performance of these models was affected by a sudden change of cloudy cover.

Aptamer Oligonucleotides: Novel Potential Therapeutic Agents in Autoimmune Disease.

Aptamers are single-stranded deoxyribonucleic acid or ribonucleic acid oligonucleotides generated in vitro based on affinity for certain target molecules by a process known as Systematic Evolution of Ligands by Exponential Enrichment. Aptamers can bind their target molecules with high specificity and selectivity by means of structure compatibility, stacking of aromatic rings, electrostatic and van der Waals interactions, and hydrogen bonding. With several advantages over monoclonal antibodies and other conventional small-molecule therapeutics, such as high specificity and affinity, negligible batch to batch variation, flexible modification and stability, lack of toxicity and low immunogenicity, aptamers are becoming promising novel diagnostic and therapeutic agents. This review focuses on the development of aptamers as potential therapeutics for autoimmune diseases, including diabetes mellitus, multiple sclerosis, rheumatoid arthritis, myasthenia gravis, and systemic lupus erythematosus.

Factors associated with primary transmission of multidrug-resistant tuberculosis compared with healthy controls in Henan Province, China.

BACKGROUND: It is estimated that there are about 74,000 primary multidrug-resistant tuberculosis (MDR-TB) patients per year according to the prevalence of MDR-TB of 5.7% among new TB patients in China. Thus, the risks of primary transmission of MDR-TB require further attention. This study aimed to identify the factors associated with primary transmission of MDR-TB in Henan province, where the number of new TB patients is ranked second highest in China. METHODS: A 1:1 matched case-control study was conducted in Henan, China. Cases were primary MDR-TB patients who were individually matched with a healthy control without TB from the same neighborhood. The study was conducted from July 2013 to June 2014. Both case and control were matched by age (±5 years) and sex. Conditional logistic regression was used to compute adjusted odds ratios (AORs) with corresponding 95% confidence intervals (CIs) for risk factors associated with primary MDR-TB. RESULTS: For the study, 146 pairs of participants were recruited. The final multivariable logistic regression model disclosed that after adjusting for age and sex, primary MDR-TB cases were more likely to be single (AOR, 5.4; 95% CI, 1.4-20.7), earn an annual income of ≤ 12,000 yuan (RMB) (AOR, 9.9; 95% CI, 2.0-48.1), experience more life pressure/stress (AOR, 10.8; 95% CI, 2.8-41.5), not be medically insured (AOR, 50.1; 95% CI, 8.2-306.8), and suffer from diabetes, cardiovascular disease or other respiratory diseases, or cancer (AOR, 57.1; 95% CI, 8.6-424.2). CONCLUSIONS: In order to control primary transmission of MDR-TB in China, we recommend that improving the social support, living standards and medical security of the lower social class become a priority.