Impact of the COVID-19 pandemic on the hospital attendance of patients with primary cervical cancer in Heilongjiang, China.

Information regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on cervical cancer in mainland China is lacking. We explored its impact on the hospital attendance of patients with primary cervical cancer. We included 1918 patients with primary cervical cancer who initially attended Harbin Medical University Cancer Hospital between January 23, 2019, and January 23, 2021. Attendance decreased by 31%, from 1135 in 2019 to 783 in 2020, mainly from January to June (𝜒2 = 73.362, P < .001). The percentage of patients detected by screening decreased from 12.1% in January-June 2019 to 5.8% in January-June 2020 (𝜒2 = 7.187, P = .007). Patients with stage I accounted for 28.4% in 2020 significantly lower than 36.6% in 2019 (𝜒2 = 14.085, P < .001), and patients with stage III accounted for 27.1% in 2020 significantly higher than 20.5% in 2019 (𝜒2 = 11.145, P < .001). Waiting time for treatment was extended from 8 days (median) in January-June and July-December 2019 to 16 days in January-June (𝜒2 = 74.674, P < .001) and 12 days in July-December 2020 (𝜒2 = 37.916, P < .001). Of the 179 patients who delayed treatment, 164 (91.6%) were for the reasons of the healthcare providers. Compared to 2019, the number of patients in Harbin or non-Harbin in Heilongjiang Province and outside the province decreased, and cross-regional medical treatment has been hindered. The COVID-19 pandemic has negatively impacted cervical cancer patient attendance at the initial phase. These results are solid evidence that a strategy and mechanism for the effective attendance of cervical cancer patients in response to public health emergencies is urgently needed.

Quantitative proteomics reveals the effect of Yigu decoction (YGD) on protein expression in bone tissue.

BACKGROUND: Osteoporosis (OP) is a systemic bone disease characterized by decreased bone mass, destruction of the bone tissue microstructure, increased bone brittleness and an increased risk of fracture. OP has a high incidence rate and long disease course and is associated with serious complications. Yigu decoction (YGD) is a compound prescription in traditional Chinese medicine that is used to treat OP. However, its mechanism in OP is not clear. This study used a tandem mass tag (TMT)quantitative proteomics method to explore the potential bone-protective mechanism of YGD in an osteoporotic rat model. MATERIALS AND METHODS: A rat model of OP was established by ovariectomy. Eighteen 12-week-old specific-pathogen-free female Wistar rats weighing 220 ± 10 g were selected. The eighteen rats were randomly divided into 3 groups (n = 6 in each group): the normal, model and YGD groups. The right femurs from each group were subjected to quantitative biological analysis. TMT quantitative proteomics was used to analyze the proteins extracted from the bone tissue of rats in the model and YGD groups, and the differentially expressed proteins after intervention with YGD were identified as biologically relevant proteins of interest. Functional annotation correlation analysis was also performed to explore the biological function and mechanism of YGD. RESULT: Compared with the model group, the YGD group showed significant upregulation of 26 proteins (FC > 1.2, P < 0.05) and significant downregulation of 39 proteins (FC < 0.833, P < 0.05). Four important targets involved in OP and 5 important signaling pathways involved in bone metabolism were identified. CONCLUSIONS: YGD can significantly increase the bone mineral density (BMD) of osteoporotic rats and may play a therapeutic role by regulating target proteins involved in multiple signaling pathways. Therefore, these results improve the understanding of the OP mechanism and provide an experimental basis for the clinical application of YGD in OP treatment.

Scan Time Reduction in Intravoxel Incoherent Motion Diffusion-Weighted Imaging and Diffusion Kurtosis Imaging of the Abdominal Organs: Using a Simultaneous Multislice Technique With Different Acceleration Factors.

OBJECTIVE: To investigate the feasibility of quantitative intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) analyses in the upper abdominal organs by simultaneous multislice diffusion-weighted imaging (SMS-DWI). SUBJECTS AND METHODS: In this prospective study, a total of 32 participants underwent conventional DWI (C-DWI) and SMS-DWI sequences with acceleration factors of 2 and 3 (SMS2-DWI and SMS3-DWI, respectively) in the upper abdomen with multiple b-values (0, 10, 20, 50, 80, 100, 150, 200, 500, 800, 1000, 1500, and 2000 seconds/mm2) on a 3 T system (MAGNETOM Prisma; Siemens Healthcare, Erlangen, Germany). Image quality and quantitatively measurements of apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), mean kurtosis (MK), and mean apparent diffusivity (MD) for the liver, pancreas, kidney cortex and medulla, spleen, and erector spine muscle were compared between the 3 sequences. RESULTS: The acquisition times for C-DWI, SMS2-DWI, and SMS3-DWI were 10 minutes 57 seconds, 5 minutes 9 seconds, and 3 minutes 54 seconds. For image quality parameters, C-DWI and SMS2-DWI yielded better results than SMS3-DWI (P < 0.05). SMS2-DWI had equivalent IVIM and DKI parameters compared with that of C-DWI (P > 0.05). No statistically significant differences in the ADC, D, f, and MD values between the 3 sequences (P > 0.05) were observed. The D* and MK values of the liver (P = 0.005 and P = 0.012) and pancreas (P = 0.019) between SMS3-DWI and C-DWI were significantly different. CONCLUSIONS: SMS2-DWI can substantially reduce the scan time while maintaining equivalent IVIM and DKI parameters in the abdominal organs compared with C-DWI.

Feasibility study of simultaneous multislice diffusion kurtosis imaging with different acceleration factors in the liver.

BACKGROUND: Simultaneous multislice diffusion-weighted imaging (SMS-DWI) has been used to reduce image acquisition time. The purpose of this study was to investigate the feasibility of diffusion kurtosis imaging (DKI) based on the SMS technique in the liver and the influence of this method compared with that of conventional DWI sequences on image quality and DKI-derived quantitative parameters. METHODS: Forty volunteers underwent SMS-DWI sequences with acceleration factors of 2 and 3 (SMS2-DWI, SMS3-DWI) and conventional DWI (C-DWI) of the liver with three b-values (50, 800, 2000 s/mm2) in a 3T system. Qualitative image quality parameters and quantitative measurements of the signal-to-noise ratio (SNR), mean kurtosis (MK), mean apparent diffusivity (MD) and apparent diffusion coefficient (ADC) for the liver were compared between the three sequences. RESULTS: The scan times of C-DWI, SMS2-DWI, and SMS3-DWI were 4 min 11 s, 2 min 2 s, and 1 min 34 s, respectively. For all image quality parameters, there were no significant differences observed between C-DWI and SMS2-DWI (all p > 0.05) in the images with b-values of 800 and 2000 s/mm2. C-DWI and SMS2-DWI exhibited better scores than SMS3-DWI (all p < 0.01) in the images with b-values of 2000 s/mm2. In the images with b-values of 800 s/mm2, C-DWI and SMS2-DWI exhibited better scores than SMS3-DWI for artefacts and overall image quality (all p < 0.01), and C-DWI exhibited better scores than SMS3-DWI for the visibility of intrahepatic vessels (p < 0.001). There were no significant differences in the sharpness of the right lobe edge (p = 0.144), conspicuity of the left lobe (p = 0.370) or visibility of intrahepatic vessels (p = 0.109) between SMS2-DWI and SMS3-DWI. There were no significant differences in the sharpness of the right lobe edge (p = 0.066) or conspicuity of the left lobe (p = 0.131) between C-DWI and SMS3-DWI. For the b-value of 800 s/mm2, there were no statistically significant differences between SMS2-DWI and C-DWI (p = 1.000) or between SMS2-DWI and SMS3-DWI (p = 0.059), whereas SMS3-DWI had a significantly lower SNR than C-DWI (p = 0.024). For the DKI-derived parameters (MK and MD) and ADC values, there were no significant differences between the three sequences (MK, p = 0.606; MD, p = 0.831; ADC, p = 0.264). CONCLUSIONS: SMS-DWI with an acceleration factor of 2 is feasible for the liver, resulting in considerable reductions in scan time while maintaining similar image quality, comparable DKI parameters and ADC values compared with those of C-DWI.

Properties of the surface electromyogram following traumatic spinal cord injury: a scoping review.

Traumatic spinal cord injury (SCI) disrupts spinal and supraspinal pathways, and this process is reflected in changes in surface electromyography (sEMG). sEMG is an informative complement to current clinical testing and can capture the residual motor command in great detail-including in muscles below the level of injury with seemingly absent motor activities. In this comprehensive review, we sought to describe how the sEMG properties are changed after SCI. We conducted a systematic literature search followed by a narrative review focusing on sEMG analysis techniques and signal properties post-SCI. We found that early reports were mostly focused on the qualitative analysis of sEMG patterns and evolved to semi-quantitative scores and a more detailed amplitude-based quantification. Nonetheless, recent studies are still constrained to an amplitude-based analysis of the sEMG, and there are opportunities to more broadly characterize the time- and frequency-domain properties of the signal as well as to take fuller advantage of high-density EMG techniques. We recommend the incorporation of a broader range of signal properties into the neurophysiological assessment post-SCI and the development of a greater understanding of the relation between these sEMG properties and underlying physiology. Enhanced sEMG analysis could contribute to a more complete description of the effects of SCI on upper and lower motor neuron function and their interactions, and also assist in understanding the mechanisms of change following neuromodulation or exercise therapy.

Three-Dimensional Breath-Hold MRCP Using SPACE Pulse Sequence at 3 T: Comparison With Conventional Navigator-Triggered Technique.

OBJECTIVE. The purpose of this study was to evaluate the clinical feasibility of breath-hold (BH) MRCP with multichannel receiver coils in comparison with conventional navigator-triggered (NT) MRCP at 3 T. SUBJECTS AND METHODS. We prospectively studied 53 consecutive patients who underwent MRCP with BH sampling perfection with application-optimized contrasts using different flip-angle evolutions (SPACE) and NT SPACE. The acquisition time for each MRCP image was noted. The contrast ratio, the signal-to-noise ratio (SNR), and the contrast-to-noise ratio (CNR) between the common bile duct (CBD) and periductal tissues on 3D MRCP images were evaluated quantitatively. The overall image quality, motion artifacts, and CBD visibility were scored on a 4-point scale by two blinded radiologists. A paired t test was used to analyze the differences in the qualitative and quantitative evaluations between the two MRCP acquisition methods. RESULTS. Both MRCP methods were successfully performed for all subjects without any complications. The mean acquisition time of BH MRCP was significantly shorter than that of NT MRCP (18 seconds vs 264.64 ± 89.66 [SD] seconds; p < 0.001). The mean SNR, the contrast ratio, and the CNR of the CBD were significantly higher on NT MRCP images than on BH MRCP images (11.58 ± 6.24 vs 8.71 ± 4.21, 0.93 ± 0.04 vs 0.92 ± 0.03, and 15.42 ± 8.04 vs 12.00 ± 5.76, respectively; p < 0.05). All visual scores were significantly higher with BH MRCP than with conventional NT MRCP (p < 0.001). CONCLUSION. Using 3D BH MRCP with a SPACE sequence at 3 T is feasible in clinical patients, yielding significantly better perceived image quality of the pancreaticobiliary tree in a single BH (mean acquisition time, 18 seconds) without losing image quality compared with the conventional NT MRCP.

A computational model of surface electromyography signal alterations after spinal cord injury.

Objective. Spinal cord injury (SCI) can cause significant impairment and disability with an impact on the quality of life for individuals with SCI and their caregivers. Surface electromyography (sEMG) is a sensitive and non-invasive technique to measure muscle activity and has demonstrated great potential in capturing neuromuscular changes resulting from SCI. The mechanisms of the sEMG signal characteristic changes due to SCI are multi-faceted and difficult to studyin vivo. In this study, we utilized well-established computational models to characterize changes in sEMG signal after SCI and identify sEMG features that are sensitive and specific to different aspects of the SCI.Approach. Starting from existing models for motor neuron pool organization and motor unit action potential generation for healthy neuromuscular systems, we implemented scenarios to model damages to upper motor neurons, lower motor neurons, and the number of muscle fibers within each motor unit. After simulating sEMG signals from each scenario, we extracted time and frequency domain features and investigated the impact of SCI disruptions on sEMG features using the Kendall Rank Correlation analysis.Main results. The commonly used amplitude-based sEMG features (such as mean absolute values and root mean square) cannot differentiate between injury scenarios, but a broader set of features (including autoregression and cepstrum coefficients) provides greater specificity to the type of damage present.Significance. We introduce a novel approach to mechanistically relate sEMG features (often underused in SCI research) to different types of neuromuscular alterations that may occur after SCI. This work contributes to the further understanding and utilization of sEMG in clinical applications, which will ultimately improve patient outcomes after SCI.

Endoplasmic reticulum stress involves the high glucose-induced nucleus pulposus cell pyroptosis.

OBJECTIVE: Diabetes has been identified as a risk factor for intervertebral disc degeneration (IDD). The aim of this study is to investigate the potential mechanism underlying diabetes-related pyroptosis in nucleus pulposus (NP) cells. METHODS: We used a high-glucose environment to mimic diabetes in vitro and examined the endoplasmic reticulum stress (ERS) and pyroptotic response. Furthermore, we utilized activators and inducers of ERS to explore the role of ERS in high-glucose-induced pyroptosis in NP cells. We evaluated the ERS and pyroptosis levels using immunofluorescence (IF) or RT-PCR and measured the expression of collagen II, aggrecan, and MMPs. Additionally, we used ELISA to determine the levels of IL-1ß and IL-18 in the culture medium, and CCK8 assay to test cell viability. RESULTS: High-glucose conditions promoted the degeneration of NP cells and triggered ERS and pyroptosis. A high level of ERS aggravated pyroptosis, and partially suppressing ERS resisted high-glucose-induced pyroptosis and alleviated the degeneration of NP cells. Inhibiting caspase-1-based pyroptosis under high-glucose conditions helped relieve the degeneration of NP cells but did not affect ERS levels. CONCLUSIONS: High-glucose induces pyroptosis in NP cells via the mediation of ERS, and suppressing ERS or pyroptosis protects NP cells under high-glucose conditions.

Functional electrical stimulation therapy for upper extremity rehabilitation following spinal cord injury: a pilot study.

STUDY DESIGN: Pilot study. OBJECTIVES: To examine if functional electrical stimulation therapy (FEST) improves neuromuscular factors underlying upper limb function in individuals with SCI. SETTING: A tertiary spinal cord rehabilitation center specialized in spinal cord injury care in Canada. METHODS: We examined 29 muscles from 4 individuals living with chronic, cervical, and incomplete SCI. The analysis was focused on the changes in muscle activation, as well as on how the treatment could change the ability to control a given muscle or on how multiple muscles would be coordinated during volitional efforts. RESULTS: There was evidence of gains in muscle strength, activation, and median frequency after the FEST. Gains in muscle activation indicated the activation of a greater number of motor units and gains in muscle median frequency the involvement of higher threshold, faster motor units. In some individuals, these changes were smaller but accompanied by increased control over muscle contraction, evident in a greater ability to sustain a volitional contraction, reduce the co-contraction of antagonist muscles, and provide cortical drive. CONCLUSIONS: FEST increases muscle strength and activation. Enhanced control of muscle contraction, reduced co-contraction of antagonist muscles, and a greater presence of cortical drive were some of the findings supporting the effects of FEST at the sensory-motor integration level.

Segmental motor recovery after cervical spinal cord injury relates to density and integrity of corticospinal tract projections.

Cervical spinal cord injury (SCI) causes extensive impairments for individuals which may include dextrous hand function. Although prior work has focused on the recovery at the person-level, the factors determining the recovery of individual muscles are poorly understood. Here, we investigate the muscle-specific recovery after cervical spinal cord injury in a retrospective analysis of 748 individuals from the European Multicenter Study about Spinal Cord Injury (NCT01571531). We show associations between corticospinal tract (CST) sparing and upper extremity recovery in SCI, which improves the prediction of hand muscle strength recovery. Our findings suggest that assessment strategies for muscle-specific motor recovery in acute spinal cord injury are improved by accounting for CST sparing, and complement person-level predictions.

Development and validation of a point-based scoring system for predicting axillary lymph node metastasis and disease outcome in breast cancer using clinicopathological and multiparametric MRI features.

BACKGROUND: Axillary lymph node (ALN) metastasis is used to select treatment strategies and define the prognosis in breast cancer (BC) patients and is typically assessed using an invasive procedure. Noninvasive, simple, and reliable tools to accurately predict ALN status are desirable. We aimed to develop and validate a point-based scoring system (PSS) for stratifying the ALN metastasis risk of BC based on clinicopathological and quantitative MRI features and to explore its prognostic significance. METHODS: A total of 219 BC patients were evaluated. The clinicopathological and quantitative MRI features of the tumors were collected. A multivariate logistic regression analysis was used to create the PSS. The performance of the models was evaluated using receiver operating characteristic curves, and the area under the curve (AUC) of the models was calculated. Kaplan-Meier curves were used to analyze the survival outcomes. RESULTS: Clinical features, including the American Joint Committee on Cancer (AJCC) stage, T stage, human epidermal growth factor receptor-2, estrogen receptor, and quantitative MRI features, including maximum tumor diameter, Kep, Ve, and TTP, were identified as risk factors for ALN metastasis and were assigned scores for the PSS. The PSS achieved an AUC of 0.799 in the primary cohort and 0.713 in the validation cohort. The recurrence-free survival (RFS) and overall survival (OS) of the high-risk (> 19.5 points) groups were significantly shorter than those of the low-risk (≤ 19.5 points) groups in the PSS. CONCLUSION: PSS could predict the ALN metastasis risk of BC. A PSS greater than 19.5 was demonstrated to be a predictor of short RFS and OS.

Hair Selenium of Residents in Keshan Disease Endemic and Non-endemic Regions in China.

Few nationwide investigations on hair selenium (Se) and Keshan disease (KD) have been conducted. KD is closely associated with Se deficiency. Hair Se is an important biomarker for selenium nutrition. This research aimed to provide evidence for assessment of KD prevention, control, and elimination at the molecular level from the etiological perspective of selenium nutrition. The hair Se of the residents living in the KD endemic and non-endemic areas were determined through atomic fluorescence spectrometer. The median of the hair Se levels of the inhabitants living in KD endemic counties was significantly lower than that in KD non-endemic counties (0.34 vs 0.39 mg/kg, U = -10.03, P < 0.0001). The proportion of Se-deficient or Se-marginal residents in KD endemic counties was significantly higher than that in KD non-endemic counties (56.9% vs 36.6%, U = -9.57, P < 0.0001). The medians of the hair Se levels in KD endemic provinces of Shannxi, Heilongjiang, and Gansu were the lowest (0.35mg/kg), and in the category of Se-marginal status. The hair Se level featured a positive Spearman correlation with per capita disposable income (rs = 0.20, P < 0.0001). In conclusion, the median of the hair Se contents of residents living in KD endemic counties was significantly lower than that in KD non-endemic counties. The hair Se contents of nearly 57% of inhabitants living in KD endemic regions were in Se-deficient or Se-marginal status. The KD endemic provinces of Shannxi, Heilongjiang, and Gansu should be given high priority in KD prevention and control.

Anti-osteoporotic drugs affect the pathogenesis of gut microbiota and its metabolites: a clinical study.

Background: Disordered gut microbiota (GM) structure and function may contribute to osteoporosis (OP). This study explores how traditional Chinese medicine (TCM) intervention affects the structure and function of the GM in patients with OP. Method: In a 3-month clinical study, 43 patients were randomly divided into two groups receiving conventional treatment and combined TCM (Yigu decoction, YGD) treatment. The correlation between the intestinal flora and its metabolites was analyzed using 16S rDNA and untargeted metabolomics and the combination of the two. Results: After three months of treatment, patients in the treatment group had better bone mineral density (BMD) than those in the control group (P < 0.05). Patients in the treatment group had obvious abundance changes in GM microbes, such as Bacteroides, Escherichia-Shigella, Faecalibacterium, Megamonas, Blautia, Klebsiella, Romboutsia, Akkermansia, and Prevotella_9. The functional changes observed in the GM mainly involved changes in metabolic function, genetic information processing and cellular processes. The metabolites for which major changes were observed were capsazepine, Phe-Tyr, dichlorprop, D-pyroglutamic acid and tamsulosin. These metabolites may act through metabolic pathways, the citrate cycle (TCA cycle) and beta alanine metabolism. Combined analysis showed that the main acting metabolites were dichlorprop, capsazepine, D-pyroglutamic acid and tamsulosin. Conclusion: This study showed that TCM influenced the structure and function of the GM in patients with OP, which may be one mechanism by which TCM promotes the rehabilitation of patients with OP through the GM.

The use of surface EMG in neurorehabilitation following traumatic spinal cord injury: A scoping review.

OBJECTIVE: Surface electromyography (sEMG) is a common electrophysiological assessment used in clinical trials in individuals with spinal cord injury (SCI). This scoping review summarizes the most common sEMG techniques used to address clinically relevant neurorehabilitation questions. We focused on the role of sEMG assessments in the clinical practice and research studies on neurorehabilitation after SCI, and how sEMG reflects the changes observed with rehabilitation. Additionally, this review emphasizes the limitations and pitfalls of the sEMG assessments in the field of neurorehabilitation after SCI. METHODS: A comprehensive search of Medline (Ovid), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, Emcare, Cumulative Index to Nursing & Allied Health Literature, and PubMed was conducted to find peer-reviewed journal articles that included individuals post-SCI that participated in neurorehabilitation interventions using sEMG assessments. This is a scoping review using a systematic search (hybrid review). RESULTS: Of 4522 references captured in the primary database searches, 100 references were selected and included in the scoping review. The main focus of the studies was on neurorehabilitation using sEMG biofeedback, brain stimulation, locomotor training, neuromuscular electrical stimulation (NMES), paired-pulse stimulation, pharmacology, posture and balance training, spinal cord stimulation, upper limb training, vibration, and photobiomodulation. CONCLUSIONS: Most studies employed sEMG amplitude to understand the effects of neurorehabilitation on muscle activation during volitional efforts or reduction of spontaneous muscle activity (e.g., spasms, spasticity, and hypertonia). Further studies are needed to understand the long-term reliability of sEMG amplitude, to circumvent normalization issues, and to provide a deeper physiological background to the different sEMG analyses. SIGNIFICANCE: This scoping review reveals the potential of sEMG in exploring promising neurorehabilitation strategies following SCI and discusses the barriers limiting its widespread use in the clinic.

Feasibility of 3D Breath-Hold MR Cholangiopancreatography with a Spatially Selective Radiofrequency Excitation Pulse: Prospective Comparison with Parallel Imaging Technique and Compressed Sensing Method.

RATIONALE AND OBJECTIVES: The purpose of the present study was to evaluate the clinical feasibility of the modified 3D breath-hold magnetic resonance cholangiopancreatography with parallel imaging (3D-BH-PI-MRCP) using a spatially selective radiofrequency excitation pulse in patients with suspected pancreaticobiliary diseases. Moreover, we also compared its image quality with those of the original 3D-BH-PI-MRCP with a nonselective exciting pulse and the 3D breath hold compressed sensing magnetic resonance cholangiopancreatography (3D-BH-CS-MRCP). MATERIALS AND METHODS: Between January 2021 and July 2021, 106 patients prospectively underwent modified 3D-BH-PI-MRCP, original 3D-BH-PI-MRCP and 3D-BH-CS-MRCP at 3T in this study. The Friedman test was performed to compare the contrast, signal-to-noise-ratio (SNR), and contrast-noise-ratio, overall image quality, and duct visualization among the three protocols. RESULTS: The contrast ratio, SNR and contrast-to-noise ratio of the common bile duct differed significantly among the three sequences (p < 0.001). Compared to the 3D-BH-CS-MRCP protocol, the overall imaging quality of the two 3D-BH-PI-MRCP was higher but not significantly different. The scores for the anterior and posterior branches visualization were significantly higher in the original 3D-BH-PI-MRCP compared to the 3D-BH-CS-MRCP, but were no significant differences between the modified 3D-BH-PI-MRCP and the 3D-BH-CS-MRCP. CONCLUSION: The modified 3D-BH-PI-MRCP with a spatially selective radiofrequency excitation pulse could provide comparable image quality to the original 3D-BH-PI-MRCP and the 3D-BH-CS-MRCP during a single breath hold (22 seconds), and showed improved SNR and superior visualization of the pancreaticobiliary tree.

Spatial Epidemiological Analysis of Keshan Disease in China.

Objectives: Few researchers have studied the national prevalence of Keshan disease (KD) in China using spatial epidemiological methods. This study aimed to provide geographically precise and visualized evidence for the strategies for KD prevention and control. Methods: We surveyed and analyzed 237,000 people in 280 out of 328 KD-endemic counties (85.4%) in mainland China using a design of key investigation based on case-searching in 2015-2016. ArcGIS version 9.0 was used for spatial autocorrelation analysis, spatial interpolation analysis and spatial regression analysis. Results: Global autocorrelation analysis showed that global clustering of latent Keshan disease (LKD) prevalence was noted (Moran's I = 0.22, Z = 7.06, and P < 0.0001), no global clustering of chronic Keshan disease (CKD) prevalence (Moran's I = 0.03, Z = 1.10, and P = 0.27) was observed. Spatial regression analysis showed that LKD prevalence was negatively correlated with per capita disposable income (t = -4.36, P < 0.0001). Local autocorrelation analysis at the county level effectively identified the cluster areas of LKD prevalence in the provinces of Shaanxi, Gansu, Shanxi, Inner Mongolia, and Jilin. The high-high cluster areas should be given priority for precision prevention and control of Keshan disease. Conclusions: This spatial epidemiological study revealed that LKD prevention and control should be strengthened in areas with high values of clustering. Our findings provided spatially, geographically precise and visualized evidence for prioritizing KD prevention and control.

Sodium selenite inhibits cervical cancer growth via ROS mediated AMPK/FOXO3a /GADD45a axis.

Selenium is a trace element that has been shown to inhibit the growth of various cancer cell types. However, its role in cervical cancer and its underlying mechanisms remains largely unknown. Herein, we explored the anti-cervical cancer effect of selenium and its potential mechanisms through xenograft and in vitro experiments. HeLa cell xenografts in female nude mice showed tumor growth retardation, with no obvious liver and kidney toxicity, after being intraperitoneally injected with 3 mg/kg sodium selenite (SS) for 14 days. Compared to the control group, selenium levels in the tumor tissue increased significantly after SS treatment. In vitro experiments, SS inhibited the viability of HeLa and SiHa cells, blocked the cell cycle at the S phase, and enhanced apoptosis. RNA-sequencing, Kyoto encyclopedia of genes and genomes pathway analysis showed that forkhead box protein O (FOXO) was a key regulatory signaling pathway for SS to exhibit anticancer effects. Gene Ontology analysis filtered multiple terms associated with apoptosis, anti-proliferation, and cell cycle arrest. Further research revealed that SS increased intracellular reactive oxygen species (ROS) and impaired mitochondrial function, which activated adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) via phosphorylation at Thr172, resulting in activation of FOXO3a and its downstream growth arrest and DNA damage-inducible alpha (GADD45a). In summary, SS exhibited anti-cervical cancer effects, and their mechanisms may be that SS is involved in inducing cell cycle arrest and potentiating cell apoptosis caused by ROS-dependent activation of the AMPK/FOXO3a/GADD45a axis.

A county-level spatial epidemiological study of hair selenium and Keshan disease.

Background: No spatial analysis of hair selenium and Keshan disease (KD) on a nationwide county-level has been performed. Selenium deficiency is a recognized environmental risk factor for KD. Hair selenium is one of the recognized biomarkers of selenium nutrition. This study aimed to perform a geographically precise and visualized assessment of the achievement of KD prevention and control at the level of selenium nutrition in terms of etiology. Methods: A spatial ecological study was conducted. The hair selenium content of the residents was assayed using an atomic fluorescence spectrometer. The spatial analysis was performed using ArcGIS. Results: The median of the hair selenium levels of the 3,028 participants in the 1,174 counties was 0.38 mg/kg, and the content of inhabitants in KD endemic counties was significantly lower than that in KD non-endemic counties (0.34 vs. 0.39 mg/kg, z = -10.03, P < 0.0001). The proportion of Se-deficient and Se-marginal counties in KD endemic counties was significantly higher than that in KD non-endemic counties (59.4 vs. 29.0%, z = -7.45, P < 0.0001). The global autocorrelation analysis was not statistically significant (Moran's I = 0.0005, P = 0.68). Local autocorrelation analysis identified 174 low-low clusters of hair selenium levels, 83 (47.7%) of which are KD endemic counties located in KD endemic provinces of Henan, Gansu, Shaanxi, Inner Mongolia, Jilin, and Heilongjiang. The hair selenium featured a positive correlation with per capita GDP (r s = 0.20, P < 0.0001). Conclusion: The median of the hair selenium levels of inhabitants living in KD endemic counties was significantly lower than that in KD non-endemic counties. All the 83 KD endemic counties with low-low clusters of hair selenium levels should be prioritized in KD precision prevention and control. These findings are geographically precise and visualized evidence of the assessment of the effectiveness of KD prevention and control at the level of selenium nutrition in terms of etiology.

Comparing the clinical utility of single-shot echo-planar imaging and readout-segmented echo-planar imaging in diffusion-weighted imaging of the liver at 3 tesla.

PURPOSE: To compare the clinical utility of single-shot echo-planar imaging (SS-EPI) using different breathing schemes and readout-segmented EPI (RS-EPI) in the repeatability of apparent diffusion coefficient (ADC) measurements, signal-to-noise ratio (SNR) and image quality. METHODS: In this institutional review board-approved prospective study, hepatic DWIs (b = 50, 300, 600 s/mm2) were performed in 22 volunteers on 3.0 T MRI using SS-EPI with free-breathing diffusion-weighted imaging (FB-DWI), breath-hold (BH-DWI), respiratory-triggered (RT-DWI) and navigator-triggered (NT-DWI), and readout-segmented EPI (RS-DWI). ADC and surrogate SNR (sSNR) were measured in nine anatomic locations in the right lobe, and image quality was assessed on all FB-DWI, BH-DWI, RT-DWI, NT-DWI, and RS-DWI sequences. The sequence with the optimal clinical utility was decided by systematically comparing the ADC repeatability, sSNR and image quality of the above DWIs. RESULTS: In all the five sequences, NT-DWI had the most reliable intra-observer agreement (intraclass correlation coefficient (ICC): 0.900-0.922; all P > 0.05), and a better interobserver agreement (ICC: 0.853-0.960; all p > 0.05) than RS-DWI (ICC:0.881-0.916; some P < 0.05). NT-DWI had the best ADC repeatability in the nine locations (mean ADC absolute differences: 38.47-56.38 × 10-6 mm2/s, limits of agreement (LOA): 17.33-22.52 × 10-6 mm2/s). Also, NT-DWI had the highest sSNR (Reader 1: 50.58 ±â€¯20.11 (Superior), 74.06 ±â€¯28.37 (Central), 80.99 ±â€¯38.11(Inferior)); Reader 2: 48.07 ±â€¯23.92 (Superior), 68.23 ±â€¯32.91 (Central), 76.78 ±â€¯33.07 (Inferior)) in three representative sections except for RS-DWI. Furthermore, NT-DWI had a better image quality than RS-DWI (P < 0.05) and was superior to FB-DWI and BH-DWI in sharpness of the liver (at b = 300 s/mm2) (P < 0.05) CONCLUSION: RS-DWI has the best SNR. However, NT-DWI can provide sufficient SNR, excellent image quality, and the best ADC repeatability on 3.0 T MRI. It is thus the recommended sequence for the clinical application of hepatic DWI.

Comparing compressed sensing breath-hold 3D MR cholangiopancreatography with two parallel imaging MRCP strategies in main pancreatic duct and common bile duct.

PURPOSE: To evaluate the image quality and image consistency between 3D Breath-hold (BH)-MRCP with parallel imaging (3D-BH-PI-MRCP) and 3D-BH compressed sensing (CS)-MRCP (3D-BH-CS-MRCP) in patients with suspected pancreaticobiliary diseases, compared with 3D navigator-triggered (NT)-MRCP. MATERIALS AND METHODS: The A total number of 109 patients who underwent 3D-NT-MRCP, 3D-BH-PI-MRCP and 3D-BH-CS-MRCP were prospectively enrolled in this study. The Friedman test was performed to compare quantitative values, image acquisition time, the presence of artifacts, overall image quality, and duct visualization among the three protocols. Additionally, we compared 3D-BH-PI-MRCP and 3D-BH-CS-MRCP with 3D-NT-MRCP in morphological consistency of main pancreatic duct and common bile duct (CBD) based on overall image quality score of = 4. RESULTS: Three MRCP methods were successfully performed in all the patients. The contrast ratio, SNR and CNR of the CBD were significantly higher for 3D-BH-CS-MRCP than those for 3D-NT-MRCP and 3D-BH-PI-MRCP images. Overall image quality did differ significantly across the three sequences. Visualization of the CBD, RHD, LHD, anterior branch, posterior branch and cystic duct was similar with the 3D-BH-CS-MRCP and 3D-BH-PI-MRCP sequences. In contrast, segment 2 or 3 branch and main pancreatic duct visualization were significantly better with 3D-BH-PI-MRCP than with 3D-BH-CS-MRCP and 3D-NT-MRCP (p < 0.001). CONCLUSIONS: Both the two breath-hold approaches were considering the time-saving advantages without deterioration of image quality. Compared with 3D-BH-CS-MRCP, 3D-BH-PI-MRCP yielded significantly better visualization of the segment 2 and 3 branch of the intrahepatic duct and performed better consistency in main pancreatic duct and common bile duct morphology.