Assessment of TUFT1 and Rac1-GTP levels in triple-negative breast cancer patients: clinical and pathological correlations.

OBJECTIVE: The primary goal of this study was to investigate the expressions of TUFT1 (Tuftelin) and Rac1-GTP in the cancerous tissues of individuals with triple-negative breast cancer (TNBC). Additionally, we aimed to explore the correlation between TUFT1 and Rac1-GTP expressions and examine the associations of TUFT1 and Rac1-GTP expressions with the clinical and pathological indicators of the patients. METHODS: Ninety-six patients diagnosed with TNBC, scheduled for surgery between May 2022 and November 2022, were enrolled in this study. Cancerous tissue specimens were collected from these patients, and immunohistochemistry was employed to evaluate the levels of TUFT1 and Rac1-GTP expressions in the cancerous tissues. Subsequent to data collection, a comprehensive analysis was conducted to examine the correlation between TUFT1 and Rac1-GTP expressions. Furthermore, we sought to assess the associations of TUFT1 and Rac1-GTP expressions with the clinical and pathological indicators of the patients. RESULTS: The TUFT1 protein was expressed in both the membrane and cytoplasm of TNBC cancer cells, with notably higher expression observed in the cytoplasm. Rac1-GTP was primarily expressed in the cytoplasm. There was a positive correlation between the levels of TUFT1 and Rac1-GTP expressions (χ2 = 9.816, P < 0.05). The levels of TUFT1 and Rac1-GTP protein expressions showed no correlation with patient age (χ2 = 2.590, 2.565, P > 0.05); however, they demonstrated a positive correlation with tumor size (χ2 = 5.592,5.118), histological grading (χ2 = 6.730, 5.443), and lymph node metastasis (χ2 = 8.221, 5.180) (all with a significance level of P < 0.05). CONCLUSION: A significant correlation was identified between the levels of TUFT1 and Rac1-GTP expressions in the cancerous tissues of patients with TNBC, suggesting a close association with the progression of TNBC. The two molecules play significant roles in facilitating an early diagnosis and treatment of TNBC.

Comparative study of stretched-exponential and kurtosis models of diffusion-weighted imaging in renal assessment to distinguish patients with primary aldosteronism from healthy controls.

PURPOSE: To compare the ability of diffusion parameters obtained by stretched-exponential and kurtosis models of diffusion-weighted imaging (DWI) to distinguish between patients with primary aldosteronism (PA) and healthy controls (HCs) in renal assessment. MATERIALS AND METHODS: A total of 44 participants (22 patients and 22 HCs) underwent renal MRI with an 11 b-value DWI sequence and a 3 b-value diffusion kurtosis imaging (DKI) sequence from June 2021 to April 2022. Binary logistic regression was used to construct regression models combining different diffusion parameters. Receiver-operating characteristic (ROC) curve analysis and comparisons were used to evaluate the ability of single diffusion parameters and combined diffusion models to distinguish between the two groups. RESULTS: A total of six diffusion parameters (including the cortical anomalous exponent term [α_Cortex], medullary fractional anisotropy [FA_Medulla], cortical FA [FA_Cortex], cortical axial diffusivity [Da_Cortex], medullary mean diffusivity [MD_Medulla] and medullary radial diffusivity [Dr_Medulla]) were included, and 10 regression models were studied. The area under the curve (AUC) of Dr_Medulla was 0.855, comparable to that of FA_Cortex and FA_Medulla and significantly higher than that of α_Cortex, Da_Cortex and MD_Medulla. The AUC of the Model_all parameters was 0.967, comparable to that of Model_FA (0.946) and Model_DKI (0.966) and significantly higher than that of the other models. The sensitivity and specificity of Model_all parameters were 87.2% and 95%, respectively. CONCLUSION: The Model_all parameters, Model_FA and Model_DKI were valid for differentiating between PA patients and HCs with similar differentiation efficacy and were superior to single diffusion parameters and other models.

Animal-and mineral-based medicines in Gansu-Ningxia-inner Mongolia region, P.R. China: a cross-cultural ethnobiological assessment.

Introduction: Traditional animal- and mineral-based medicines are widely used in the Gansu-Ningxia-Inner Mongolia junction zone, a region with diverse ethnic groups and cultures. This study aims to document, conserve, and explore the potential of these medicines for further research and sustainable development of ethnic medicine. Methods: We interviewed 56 informants from different ethnic backgrounds and analyzed their responses quantitatively. Additionally, a comparative analysis with adjacent regions was conducted, providing invaluable contextual insights. Results: The study unveiled a diverse array of traditional medicines in the Gansu-Ningxia-Inner Mongolia junction zone. A total of 47 animal-based medicines were identified, ranging from insects and scorpios to distinctive animal organs. Of notable significance was Moschus, emerging as a pivotal traditional Chinese medicine resource. In parallel, 12 mineral-based medicines were cataloged, procured both locally and from "pharmacies". Female informants, frequently local herbal practitioners, demonstrated broader knowledge of medicines. The analysis of 13 villages revealed varying perceptions of medicine importance, underscoring the wealth of traditional knowledge. Specific medicines, such as Feng-Mi and Xie-Zi, were widely used and valued in local healthcare practices for their cultural and medicinal benefits. Conclusion: This study provides a comprehensive overview of traditional animal- and mineral-based medicines in the Gansu-Ningxia-Inner Mongolia junction zone. It highlights the need for preserving and applying these practices in a sustainable manner. It also lays a solid foundation for future research on ethnic medicine, which can contribute to the holistic wellbeing of local communities.

Assessment of Differentiated Thyroid Carcinomas in French Polynesia After Atmospheric Nuclear Tests Performed by France.

Importance: Due to the amount of iodine 131 released in nuclear tests and its active uptake by the thyroid, differentiated thyroid carcinoma (DTC) is the most serious health risk for the population living near sites of nuclear tests. Whether low doses to the thyroid from nuclear fallout are associated with increased risk of thyroid cancer remains a controversial issue in medicine and public health, and a misunderstanding of this issue may be associated with overdiagnosis of DTCs. Design, Setting, and Participants: This case-control study was conducted by extending a case-control study published in 2010 that included DTCs diagnosed between 1984 and 2003 by adding DTCs diagnosed between 2004 and 2016 and improving the dose assessment methodology. Data on 41 atmospheric nuclear tests conducted by France between 1966 and 1974 in French Polynesia (FP) were assessed from original internal radiation-protection reports, which the French military declassified in 2013 and which included measurements in soil, air, water, milk, and food in all FP archipelagos. These original reports led to an upward reassessment of the nuclear fallout from the tests and a doubling of estimates of the mean thyroid radiation dose received by inhabitants from 2 mGy to nearly 5 mGy. Included patients were diagnosed from 1984 to 2016 with DTC at age 55 years or younger and were born in and resided in FP at diagnosis; 395 of 457 eligible cases were included, and up to 2 controls per case nearest by birthdate and matched on sex were identified from the FP birth registry. Data were analyzed from March 2019 through October 2021. Exposure: The radiation dose to the thyroid gland was estimated using recently declassified original radiation-protection service reports, meteorological reports, self-reported lifestyle information, and group interviews of key informants and female individuals who had children at the time of these tests. Main Outcomes and Measures: The lifetime risk of DTC based on Biological Effects of Ionizing Radiation (BEIR) VII models was estimated. Results: A total of 395 DTC cases (336 females [85.1%]; mean [SD] age at end of follow-up, 43.6 [12.9] years) and 555 controls (473 females [85.2%]; mean [SD] age at end of follow-up, 42.3 [12.5] years) were included. No association was found between thyroid radiation dose received before age 15 years and risk of DTC (excess relative risk [ERR] per milligray, 0.04; 95% CI, -0.09 to 0.17; P = .27). When excluding unifocal noninvasive microcarcinomas, the dose response was significant (ERR per milligray, 0.09; 95% CI, -0.03 to 0.02; P = .02), but several incoherencies with the results of the initial study reduce the credibility of this result. The lifetime risk for the entire FP population was 29 cases of DTC (95% CI, 8-97 cases), or 2.3% (95% CI, 0.6%-7.7%) of 1524 sporadic DTC cases in this population. Conclusions and Relevance: This case-control study found that French nuclear tests were associated with an increase in lifetime risk of PTC in FP residents of 29 cases of PTC. This finding suggests that the number of thyroid cancer cases and the true order of magnitude of health outcomes associated with these nuclear tests were small, which may reassure populations of this Pacific territory.

Monoexponential, biexponential, stretched-exponential and kurtosis models of diffusion-weighted imaging in kidney assessment: comparison between patients with primary aldosteronism and healthy controls.

PURPOSE: This study used various diffusion-weighted imaging (DWI) models (including monoexponential, biexponential, stretched-exponential and kurtosis models) in renal magnetic resonance imaging (MRI) to compare whether there were differences in each diffusion parameter between patients with primary aldosteronism (PA) and healthy volunteers. MATERIALS AND METHODS: Twenty-two (female:male, 14:8; age, 48 ± 10 years) patients with PA and 22 age- and sex-matched healthy controls (HCs) underwent MRI examinations of the kidneys. The independent-sample t test or the Mann‒Whitney U test was used to detect differences in the diffusion metrics of the kidneys between the two groups. Univariable and multivariable linear regression were applied to analyze the correlations between diffusion parameters and the clinical indicators. RESULTS: The mean diffusivity (MD, p < 0.001) and radial diffusivity (Dr, p < 0.001) values in the medulla were lower in the PA group than in the HC group. The medullary fractional anisotropy (FA, p < 0.001) was higher than that of HCs. The FA (p < 0.001) and axial diffusivity (Da, p < 0.001) values in the cortex were lower in the PA group. The cortical α (anomalous exponent term, p = 0.016) was higher in the PA patients than in the HCs. Linear regression analysis showed that log(plasma aldosterone concentration) and the estimated glomerular filtration rate (eGFR) were correlated with medullary FA. CONCLUSION: The stretched-exponential model (cortical α) and the kurtosis model (FA, MD and Dr in the medulla and FA and Da in the cortex) showed significant differences between PA patients and healthy volunteers and may have potential for noninvasive renal assessment in PA patients.

Quality Evaluation of Traditional Chinese Medicine Mylabris Based on Heavy Metal Risk Assessment and Analysis of Pharmacological Component Contents.

As a highly representative traditional Chinese anti-tumor medicinal material, the biomass of Mylabris is collected from the wild. However, the living environments of Mylabris is differ, so Mylabris may be contaminated by heavy metal pollution depending on the environment. These environments may also affect the amount of biosynthesis of its medicinal ingredient, cantharidin, there by affecting the quality of Mylabris. In this study, we determined the heavy metal content in Mylabris from different origins by using ICP-MS, evaluated the risk posed by these heavy metals, and recommended theoretical maximum limits of heavy metals in medicinal Mylabris. The results show that the Cu content in Mylabris is substantially higher than that in Cr, As, Pb, Cd, and Hg. A quantitative risk assessment showed that Mylabris poses no noncarcinogenic risks. The results of the total carcinogenic risk value showed that origins S12 and S13 pose carcinogenic risk by Cr and As, and the rest of the origins were in the human-tolerable carcinogenic risk range. We found large differences in the cantharidin content in Mylabris from different origins. In general, the Mylabris from origins S2, S3 and S4 had a higher in vivo cantharidin content, which proved that the quality of the medicinal materials was higher here than in other production areas. Finally, we providing a reference for the quality evaluation of medicinal Mylabris materials.

Projected burden of stroke in China through 2050.

BACKGROUND: Stroke is the leading cause of death in China, and predicting the stroke burden could provide essential information guiding the setting of medium- and long-term health policies and priorities. The study aimed to project trends associated with stroke burden in China through 2050, not only in terms of incidence and mortality but also for prevalence and disability-adjusted life years (DALYs). METHODS: Data on stroke rates in incidence, prevalence, deaths, and DALYs in China between 1990 and 2019 were obtained from a recent Global Burden of Disease study. Demographic-specific trends in rates over time were estimated using three models: the loglinear model, the Lee-Carter model, and a functional time series model. The mean absolute percentage error and the root mean squared error were used for model selection. Projections up to 2050 were estimated using the best fitting model. United Nations population data were used to project the absolute numbers through 2050. RESULTS: From 2019 to 2050, the crude rates for all measures of the stroke burden are projected to increase continuously among both men and women. We project that compared with those in 2019, the incidence, prevalence, deaths, and DALYs because of stroke in China in 2050 will increase by 55.58%, 119.16%, 72.15%, and 20.04%, respectively; the corresponding increases in number were 2.19, 34.27, 1.58, and 9.21 million. The age-standardized rate is projected to substantially decline for incidence (8.94%), death (40.37%), and DALYs (43.47%), but the age-standardized prevalence rate is predicted to increase by 10.82%. By 2050, the burden of stroke among the population aged ≥65 years will increase significantly: by 104.70% for incidence, by 218.48% for prevalence, by 100.00% for death, and by 58.93% for DALYs. CONCLUSIONS: With the aging population in China increasing over the next three decades, the burden of stroke will be markedly increased. Continuous efforts are needed to improve stroke health care and secondary prevention, especially for older adults.

The impact of national centralized drug procurement on health expenditures for lung cancer inpatients: A difference-in-differences analysis in a large tertiary hospital in China.

The availability and affordability of medicines remain major health challenges around the world. In March 2019, the Chinese government introduced a pilot National Centralized Drug Procurement (NCDP) program in order to reduce drug prices and improve the affordability of effective and safe medicines. This study aimed to assess the impact of NCDP policy on health expenditures of cancer patients. Using inpatient discharge records from a large hospital in the pilot city, we performed a difference-in-differences design to estimate the change in health expenditures before and after the policy. We found that the implementation of NCDP was associated with a significant decrease in total expenditures (14.13%) and drug expenditures (20.75%) per inpatient admission. There were also significant reductions in non-drug-related expenditures, including a 7.65% decrease in health service expenditures, a 38.28% decrease in diagnosis expenditures, and a 25.31% decrease in consumable material expenditures per inpatient admission. However, the NCDP implementation was associated with a 107.97% increase in the traditional Chinese medicine expenditures. Overall, the study provided evidence that the NCDP policy has achieved its goals of high-quality and affordable healthcare. The drug expenditures of lung cancer patients revealed a continuous decline, and the policy may have spillover effects on other healthcare expenditures. Further studies are needed to evaluate the long-term effects of NCDP on policy-related expenditures and health outcomes.

Quantifying the contribution of 18F-FDG PET to the diagnostic assessment of pediatric patients with fever of unknown origin: a systematic review and meta-analysis.

BACKGROUND: The value of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in the diagnostic assessment of pediatric fever of unknown origin is not known, and evidence from adults is not applicable. OBJECTIVE: To quantify the contribution of 18F-FDG PET to pediatric fever of unknown origin, considering its diagnostic limitations. MATERIALS AND METHODS: We searched PubMed, EMBASE and Cochrane Central Register of Controlled Trials up to Feb. 18, 2021. We included studies on patients with pediatric fever of unknown origin presenting sufficient data to calculate the likelihood of achieving definite diagnosis (based on pathology or clinical follow-up) between those with abnormal PET findings versus those with normal PET findings. We assessed the risk of bias using a modified Newcastle-Ottawa quality assessment scale and quantified the value of PET by pooling the likelihood of achieving definite diagnosis using a random-effects model. RESULTS: We included 6 studies and found that pediatric patients with abnormal PET findings were about 17 times more likely to achieve definite diagnoses than those with normal PET findings (odds ratio [OR]: 16.75, 95% confidence interval [CI] 8.0-35, P < 0.00001). Sensitivity analyses using a fixed-effect model (OR 16.91, 95% CI 8.1-35, P < 0.0001) or removing one study at a time (OR 12-20, 95% CI lower bound 3.8-8.6, 95% CI upper bound 33-45, P < 0.0001) did not significantly alter the results. Sample size (interaction P = 0.75), imaging modality (interaction P = 0.29), length of follow-up (interaction P = 0.37), fever of unknown origin subclasses (interaction P = 0.89) and geographical areas (interaction P = 0.74) of studies showed no statistically significant influence on the results. CONCLUSION: 18F-FDG PET is a promising approach in the diagnostic work-up of pediatric fever of unknown origin. Further studies are warranted to support routine use in clinical care.

Analysis of Xinjiang HPV16 L1 gene polymorphisms: a newly developed, low-cost enzyme-linked immunosorbent assay.

BACKGROUND: Xinjiang, China shows the world's highest incidence and mortality rates of cervical cancer. Due to limited conditions available for medical examination, hybrid capture 2 (HC2) and other detection methods are used rarely, and early screening for human papillomavirus (HPV) cannot be carried out. Therefore, we established a double-antibody sandwich (DAS)-enzyme-linked immunosorbent assay (ELISA) based on a polymorphism of the Xinjiang HPV16 L1 strain (KU721788). METHODS: According to the conserved sequence and specific epitope of Xinjiang strain HPV16 L1, we prepared two anti-HPV16 L1 monoclonal antibodies and combined them to construct a DAS-ELISA. Detection conditions for the DAS-ELISA were optimized, and HC2 was used as the control to verify the specificity, repeatability and coincidence detection of the DAS-ELISA. RESULTS: The optimized conditions for the DAS-ELISA were: dilution of the capture antibody was 1:100; the enzyme-labelled antibody was 1:10; the sample reaction time was 45 min; the enzyme-labelled antibody was applied for 40 min, and the substrate color development time was 15 min. The quality of the DAS-ELISA for the detection of HPV 16 was very high, and there was no significant difference when compared with HC2. CONCLUSION: The DAS-ELISA developed on the basis of the Xinjiang strain (KU721788) polymorphism possesses the advantages of a detection rate similar to that for the HC2 assay currently used clinically, but it is more convenient operationally and at lower cost. DAS-ELISA is thus easier to implement for cervical cancer screening in economically depressed areas.

Heavy Metal Pollution Analysis and Health Risk Assessment of Two Medicinal Insects of Mylabris.

Mylabris is the dried body of the Chinese blister beetle (Mylabris sp.), which has been used in traditional Chinese medicine and achieved significant positive effects in the treatment of cancer including liver cancer, lung cancer, and rectal cancer. However, heavy metal pollution and accumulation of Mylabris insects could pose threat to human health. This study was carried out to assess levels of different heavy metals like Cu, As, Cd, Hg, and Pb, along with soil-plant-insect system and health risks using two representative Mylabris insects from the Hasi Mountains of Gansu Province, China. The results showed that the heavy metal concentration of plants and insects followed the order Cu > Pb > As > Hg > Cd. Compared with soil and plants, the content of Cu in insects was the highest, reaching 45.65 mg/kg. Cu was the main element that caused insects to absorb and accumulate. The quantitative risk analysis implied the two Mylabris insects had carcinogenic risks, with the contribution of As providing 63% and 60.7%, respectively. This kind of carcinogenic risk that the human body could bear was not easy to cause side effects to normal people, but it was difficult and dangerous for cancer patients. Thus, the evaluation of health risk lays the foundation for pollutant risk monitoring.

Global burden of acute viral hepatitis and its association with socioeconomic development status, 1990-2019.

BACKGROUND & AIMS: Acute viral hepatitis (AVH) represents an important global health problem; however, the progress in understanding AVH is limited because of the priority of combating persistent HBV and HCV infections. Therefore, an improved understanding of the burden of AVH is required to help design strategies for global intervention. METHODS: Data on 4 major AVH types, including acute hepatitis A, B, C, and E, excluding D, were collected by the Global Burden of Disease (GBD) 2019 database. Age-standardized incidence rates and disability-adjusted life year (DALY) rates for AVH were extracted from GBD 2019 and stratified by sex, level of socio-demographic index (SDI), country, and territory. The association between the burden of AVH and socioeconomic development status, as represented by the SDI, was described. RESULTS: In 2019, there was an age-standardized incidence rate of 3,615.9 (95% CI 3,360.5-3,888.3) and an age-standardized DALY rate of 58.0 (47.3-70.0) per 100,000 person-years for the 4 major types of AVH. Among the major AVH types, acute hepatitis A caused the heaviest burden. There was a significant downward trend in age-standardized DALY rates caused by major incidences of AVH between 1990 and 2019. In 2019, regions or countries located in West and East Africa exhibited the highest age-standardized incidence rates of the 4 major AVH types. These rates were stratified by SDI: high SDI and high-middle SDI locations recorded the lowest incidence and DALY rates of AVH, whereas the low-middle SDI and low SDI locations showed the highest burden of AVH. CONCLUSIONS: The socioeconomic development status and burden of AVH are associated. Therefore, the GBD 2019 data should be used by policymakers to guide cost-effective interventions for AVH. LAY SUMMARY: We identified a negative association between socioeconomic development status and the burden of acute viral hepatitis. The lowest burden of acute viral hepatitis was noted for rich countries, whereas the highest burden of acute viral hepatitis was noted for poor countries.

Neuropeptide S Attenuates the Alarm Pheromone-Evoked Defensive and Risk Assessment Behaviors Through Activation of Cognate Receptor-Expressing Neurons in the Posterior Medial Amygdala.

Neuropeptide S (NPS) acts by activating its cognate receptor (NPSR). High level expression of NPSR in the posterior medial amygdala suggests that NPS-NPSR system should be involved in regulation of social behaviors induced by social pheromones. The present study was undertaken to investigate the effects of central administration of NPS or with NPSR antagonist on the alarm pheromone (AP)-evoked defensive and risk assessment behaviors in mice. Furthermore, H129-H8, a novel high-brightness anterograde multiple trans-synaptic virus, c-Fos and NPSR immunostaining were employed to reveal the involved neurocircuits and targets of NPS action. The mice exposed to AP displayed an enhancement in defensive and risk assessment behaviors. NPS (0.1-1 nmol) intracerebroventricular (i.c.v.) injection significantly attenuated the AP-evoked defensive and risk assessment behaviors. NPSR antagonist [D-Val5]NPS at the dose of 40 nmol completely blocked the effect of 0.5 nmol of NPS which showed the best effective among dose range. The H129-H8-labeled neurons were observed in the bilateral posterodorsal medial amygdala (MePD) and posteroventral medial amygdala (MePV) 72 h after the virus injection into the unilateral olfactory bulb (OB), suggesting that the MePD and MePV receive olfactory information inputs from the OB. The percentage of H129-H8-labeled neurons that also express NPSR were 90.27 ± 3.56% and 91.67 ± 2.46% in the MePD and MePV, respectively. NPS (0.5 nmol, i.c.v.) remarkably increased the number of Fos immunoreactive (-ir) neurons in the MePD and MePV, and the majority of NPS-induced Fos-ir neurons also expressed NPSR. The behavior characteristic of NPS or with [D-Val5]NPS can be better replicated in MePD/MePV local injection within lower dose. The present findings demonstrated that NPS, via selective activation of the neurons bearing NPSR in the posterior medial amygdala, attenuates the AP-evoked defensive and risk assessment behaviors in mice.

Practice and exploration of infection prevention and control measures based on risk management of surgical patients during the epidemic of corona virus disease 2019 (COVID-19).

BACKGROUND: An outbreak of corona virus disease 2019 (COVID-19) in Wuhan, China has spread quickly across the world, the World Health Organization (WHO) has declared this a pandemic. COVID-19 can be transmitted from human to human and cause nosocomial infection that has brought great challenges to infection control in medical institutions. Due to the professional characteristics, the research hospital still received a large number of trauma emergency tasks during the outbreak. It is urgent to establish a graded prevention and control guidance of surgery. METHODS: Review the implementation of surgical grading control measures in this hospital during the epidemic of COVID-19. RESULTS: The surgical prevention measures based on patients with different risks included prescreening and preoperative risk assessment, preparation of operating room, medical staff protection and environmental disinfection measures, etc. From January 20 to March 5, 2020, a total of 4,720 operations had been performed in this hospital, of which 1,565 were emergency operations and 22 for medium-risk and high-risk patients who may have the 2019 severe acute respiratory syndrome coronavirus 2 infection. And there is no medical staff exposed during the implementation of protective measures. CONCLUSIONS: Through the risk assessment of surgical patients and adopting surgical grading control measures, the risk of severe acute respiratory syndrome coronavirus 2 spread during the surgical process can be reduced greatly.

Assessment of left ventricular deformation in patients with type 2 diabetes mellitus by cardiac magnetic resonance tissue tracking.

To quantify the global and regional left ventricular (LV) myocardial strain in type 2 diabetes mellitus (T2DM) patients using cardiac magnetic resonance (CMR) tissue-tracking techniques and to determine the ability of myocardial strain parameters to assessment the LV deformation. Our study included 98 adult T2DM patients (preserved LV ejection fraction [LVEF], 72; reduced LVEF, 26) and 35 healthy controls. Conventional LV function, volume-time curve parameters and LV remodeling index were measured using CMR. Global and regional LV myocardial strain parameters were measured using CMR tissue tracking and compared between the different sub-groups. Receiver operating characteristic analysis was used to assess the diagnostic accuracy. Regression analyses were conducted to determine the relationship between strain parameters and the LV remodeling index. The results show that global radial peak strain (PS) and circumferential PS were not significantly different between the preserved-LVEF group and control group (P > 0.05). However, longitudinal PS was significantly lower in the preserved-LVEF group than in the control group (P = 0.005). Multivariate linear and logistic regression analyses showed that global longitudinal PS was independently associated (ß = 0.385, P < 0.001) with the LV remodeling index. In conclusion, early quantitative evaluation of cardiac deformation can be successfully performed using CMR tissue tracking in T2DM patients. In addition, global longitudinal PS can complement LVEF in the assessment of cardiac function.

The reporting of safety among drug systematic reviews was poor before the implementation of the PRISMA harms checklist.

OBJECTIVES: To examine, through a cross-sectional survey, how well safety information was reported among drug systematic reviews predating PRISMA harms checklist and explore factors associated with better reporting. STUDY DESIGN AND SETTING: We searched PubMed to identify all systematic reviews published in the Cochrane Database of Systematic Review or the core clinical journals in 2015, one year before the PRISMA harms checklist was published. We randomly selected, in a 1:1 ratio, Cochrane and non-Cochrane systematic reviews assessing drug effects (including both efficacy and safety). We used the PRISMA harms checklist published in 2016 to assess the quality of reporting of drug safety information. Multivariable linear regression analyses were used to explore the association of six prespecified variables with more complete reporting of PRISMA harms items. RESULTS: We included 120 systematic reviews, including 60 Cochrane and 60 non-Cochrane reviews. Scores on the PRISMA harms checklist (23 items) were low (median 4, [first, third quartile: 2, 6]), with no difference between Cochrane and non-Cochrane reviews (4.5 [2, 7] vs. 4 [2.5, 5]; P = 0.29). Among all eligible reviews, only one item (i.e., state conclusions in coherence with the review findings) was reported adequately (proportion of adherence 81.6%); proportion of reporting for other items ranged from 1.7% to 68.3%. The four essential reporting items from PRISMA harms checklist were also poorly complied (proportion of adherence ranged from 1.7% to 9.2%). Multivariable linear regression analyses found no significant associations between any study characteristic and reporting on the PRISMA harms, likely because of limited variability in scores across studies. CONCLUSIONS: The reporting of safety information was poor both for Cochrane and non-Cochrane drug systematic reviews predating PRISMA harms checklist. The findings suggested a strong need to use the PRISMA harms checklist for reporting safety among drug systematic reviews.

Disparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western China.

BACKGROUND: The maternal mortality rate (MMR) markedly decreased in China, but there has been a significant imbalance among different geographic regions (east, central and west regions), and the mortality in the western region remains high. This study aims to examine how much disparity in the health system and MMR between ethnic minority and non-minority counties exists in Sichuan province of western China and measures conceivable commitments of the health system determinants of the disparity in MMR. METHODS: The MMR and health system data of 67 minority and 116 non-minority counties were taken from Sichuan provincial official sources. The 2-level Poisson regression model was used to identify health system determinants. A series of nested models with different health system factors were fitted to decide contribution of each factor to the disparity in MMR. RESULTS: The MMR decreased over the last decade, with the fastest declining rate from 2006 to 2010. The minority counties experienced higher raw MMR in 2002 than non-minority counties (94.4 VS. 58.2), which still remained higher in 2014 (35.7 VS. 14.3), but the disparity of raw MMR between minority and non-minority counties decreased from 36.2 to 21.4. The better socio-economic condition, more health human resources and higher maternal health care services rate were associated with lower MMR. Hospital delivery rate alone explained 74.5% of the difference in MMR between minority and non-minority counties. All health system indicators together explained 97.6% of the ethnic difference in MMR, 59.8% in the change trend, and 66.3% county level variation respectively. CONCLUSIONS: Hospital delivery rate mainly determined disparity in MMR between minority and non-minority counties in Sichuan province. Increasing hospital birth rates among ethnic minority counties may narrow the disparity in MMR by more than two-thirds of the current level.

Pharmacodynamic and pharmacokinetic assessment of pulmonary rehabilitation mixture for the treatment of pulmonary fibrosis.

Pulmonary rehabilitation mixture (PRM), a Chinese herbal medicine formula, has been used to treat pulmonary fibrosis for decades. In this study, we systematically evaluated the pharmacodynamic and pharmacokinetic performance of PRM. The pharmacodynamic results showed that PRM could improve the condition of CoCl2-stimulated human type II alveolar epithelial cells, human pulmonary microvascular endothelial cells, human lung fibroblasts and pulmonary fibrosis rats induced by bleomycin, PRM treatment reduced the expression of platelet-derived growth factor, fibroblast growth factor, toll-like receptor 4, high-mobility group box protein 1 and hypoxia-inducible factor 1α. In the pharmacokinetic study, an accurate and sensitive ultra-high performance liquid chromatography tandem mass spectrometry method was developed and validated for the simultaneous determination of calycosin, calycosin-7-O-glucoside, formononetin, ononin and mangiferin of PRM in the rat plasma for the first time. The method was then successfully applied to the comparative pharmacokinetic study of PRM in normal and pulmonary fibrosis rats. The five constituents could be absorbed in the blood after the oral administration of PRM and exhibited different pharmacokinetic behaviors in normal and pulmonary fibrosis rats. In summary, PRM exhibited a satisfactory pharmacodynamic and pharmacokinetic performance, which highlights PRM as a potential multi-target oral drug for the treatment of pulmonary fibrosis.

[Landscape ecological risk assessment and its spatio-temporal variations in Ebinur Lake region of inland arid area].

The typical region of the Ebinur Lake Basin was chosen as study area. Landsat TM/OLI images for 1998, 2011 and 2013 were obtained. In the study area, landscape was classified into six types, including cropland, woodland, grassland, water body, bare lake bed, salinized land and unutilized land. Landscape indices and ecological risk index were calculated and spatially interpolated for the whole region, which was divided into five different risk zones: extremely low, low, moderate, high and extremely high ecological risk. They were carried out for assessing the spatio-temporal changes in ecological risk for each landscape pattern. The results showed that the regional landscape patterns had experienced significant changes, and the increase in the area of croplands was the main trend in landscape evolution from 1998-2013. The main part of the regional ecosystem faced extremely high risk in 1998, high risk in 2011 and low risk in 2013. The ecological risk level of the study area was significantly decreased in the overall period, and the total area of change from high to low risk was much greater than those from low to high risk.