A study on the mode choice of large-scale households' farmland transfer-in in rural China: Based on the economic analysis paradigm of transaction costs.

Regarding the mode choice of farmland transfer, the existing literature have more examined the choices between market-based transfer (spontaneous transfer) and government or village committee-led transfer, and between formal contract and informal contract. However, the question that how the two parties choose among various specific transfer modes has not attracted extensive attention of scholars. Based on contract theory and transaction cost economics, this paper uses the public samples of the third national agricultural census data to investigate how large-scale households choose among the specific transfer modes when transferring into farmland, like the transfer of the contracted management right (TCMR), lease and shareholding. The findings of this paper are as follows. Firstly, with the increase in the transfer-in area and the education level of the household head, the probability of choosing lease and shareholding increases relatively, but the latter rises faster. Secondly, compared with large-scale farmers whose aim is to plant crop, the probability of those who transfer into farmland for gardening and forestry operation choosing shareholding has increased significantly. Thirdly, the age of the household head and the number of household laborers have an interactive effect on the mode choice of transferring into farmland. In addition, the mode choice of large-scale households' transferring into farmland is also significantly affected by environmental factors such as local topography, irrigation, traffic conditions, industrial structure, and social security development. Therefore, adhering to the parties to choose the mode of farmland transfer independently is crucial. The government and rural grassroots organizations should help the parties to understand the characteristics, adaptability and supply and demand of different modes, and help the parties to explore the most economical mode. The contribution of this paper is that it expands the study of the transfer of rural land rights to the choices of specific transfer modes, and partially reveals the rule of choices, which provides a reference for the parties to choose the most efficient transfer mode under different conditions and for the government and rural grassroots organizations to play a role.

Prevalence and factors influencing cognitive impairment among the older adult stroke survivors: a cross-sectional study.

Background: Cognitive impairment as a complication in post-stroke patients has high prevalence throughout the world. However, few studies have focused on the older adult stroke survivors and explored their prevalence and factors of post-stroke cognitive impairment (PSCI). The study aims to evaluate the cognitive status of stroke patients in Hunan Province, China and to determine the potential risk factors associated with PSCI in order to identify the older adult population in advance and promote healthy aging. Methods: This cross-sectional study was carried out from August to December, 2021. A total of 520 stroke survivors from 6 tertiary hospitals were randomly selected. The information was collected using the general questionnaire, the Barthel Index Rating Scale and the Mini-mental State Examination (MMSE). Analysis was based on descriptive statistics, chi-square test and the significant variables were included in multivariate logistic regression. The reporting of this cross-sectional study followed the STROBE checklist. Results: A total of 195 older adults (40.37%) were screened for cognitive impairment based on the results of the MMSE score. Patients in the PSCI group had a higher proportion of individuals aged 70 or older (35.90% vs. 24.65%, p<0.001). The potential risk factors for post-stroke cognitive impairment in older adults were being aged between 70 and 79 years old (OR = 3.973, 95% CI, 2.346-6.729, p<0.001), being aged 80 years or older (OR = 3.590, 95% CI, 1.373-9.387, p = 0.009), having a low level of education (OR = 9.183, 95% CI, 5.341-15.789, p<0.001), having hypertension (OR = 1.756, 95% CI, 1.121-2.753, p = 0.014), and having a dominant hemisphere lesion (OR = 1.880, 95% CI, 1.193-2.962, p<0.001). Conclusion: The prevalence of PSCI was high among Chinese older adults, particularly those aged 80 years or older. The factors identified in our study could assist in the early identification of older adults at risk, develop personalized management plans, and promote healthy aging.

Clinical utility of expanded NIPT for chromosomal abnormalities and etiology analysis of cytogenetic discrepancies cases.

PURPOSE: This study is to assess the performance of expanded noninvasive prenatal testing (NIPT) in detecting chromosome aneuploidies and chromosome copy number variants (CNVs), and elucidate the discordant cases between NIPT and fetal karyotype. METHODS: A total of 2139 single pregnancies have been recruited and sequenced with expanded NIPT. Karyotype analysis and CNV sequencing (CNV-seq) of amniotic fluid were performed in 22 of 23 high-risk, three low-risk NIPT pregnant women with abnormal ultrasound findings in the follow-up, and three non-reportable NIPT pregnant women. The genetic investigation of discordant results between NIPT and amniocytes in three cases was proceeded. Placental samples, fetal samples from the limb, hip, umbilical cord, and maternal peripheral blood leukocytes were collected for CNV-Seq. RESULTS: Expanded NIPT revealed a total of 23 positive pregnancies and yielded the overall positive predictive value (PPV) 65.2%. For T21, T18, and XXY, all the PPV was 100% respectively. For CNVs > 10 Mb and 5-10 Mb, the PPV was 42.8% and 16.7%, respectively. The genetic investigation of placental and fetal samples indicated different levels of placental and fetal mosaicism contributing to two of three verified discordant results. CONCLUSIONS: The results showed that screening for CNVs with expanded NIPT is promising although the accuracy rate remains insufficient. The different occurring time of mitotic non-disjunction of different chromosome in early development of embryo results in varying levels of chromosomal mosaicism in different placental and fetal tissues. The result highlights the significance of comprehensive cytogenetic validation of placental and fetal specimens with an inconsistent NIPT results.

Evaluation of dietary zinc on antioxidant-related gene expression, antioxidant capability and immunity of soft-shelled turtles Pelodiscussinensis.

Zinc (Zn) plays a role in the antioxidant capacity and immunity of aquatic animals. A twelve-week feeding experiment was performed to estimate the impact of dietary zinc on antioxidant enzyme-related gene expression, antioxidant enzyme activity and non-specific immune functions of soft-shelled turtles, Pelodiscus sinensis. Six fishmeal-based experimental diets with 32.45% protein were formulated, which contained 35.43, 46.23, 55.38, 66.74, 75.06 and 85.24 mg/kg Zn, respectively. Catalase (CAT), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) levels improved with an elevation in dietary Zn from 35.43 to 55.38 mg/kg and then reduced when dietary Zn was further elevated. The expression levels of Nrf2 and antioxidant-related genes CuZnSOD, MnSOD, CAT, GPX1, GPX2, GPX3 and GPX4 escalated with elevating Zn concentration up to 55.38 mg/kg in diets and then reduced as dietary Zn elevated. The expression levels of Kelch-like ECH-associating protein 1 (keap1) showed a reverse trend with that of Nrf2. The contents of malondialdehyde (MDA) in the 55.38 and 66.74 mg/kg Zn diet-fed groups were the lowest. Alkaline phosphatase activity (AKP), superoxide anion (O2-), lysozyme activity and total antioxidant capacity (T-AOC) improved with an escalation in dietary Zn concentration up to 66.74 mg/kg. Optimal dietary Zn improved antioxidant capability, immunity, and antioxidant enzyme-related gene expression. The dietary Zn demand for soft-shelled turtles were 60.93 and 61.63 mg/kg, based on second regression analysis of SOD and T-AOC activity, respectively.

Application of Copy Number Variation Detection to Fetal Diagnosis of Echogenic Intracardiac Focus During Pregnancy.

Echogenic intracardiac focus (EIF) is one of the most common ultrasound soft markers (USMs) in prenatal screening. However, the association of EIF with chromosomal abnormalities is still controversial. From January 2018 to April 2020, a total of 571 fetuses with USMs in our center were enrolled, among which 150 (26.27%) presented EIFs. We analyzed the karyotype anomalies and copy number variations (CNVs) in fetuses who presented EIFs by comparing their ultrasound indications, maternal ages and gestational stages. There were no statistically significant differences in the incidence of chromosomal abnormalities between fetuses with EIFs and the fetuses with USMs (4.00 vs. 7.71%, p = 0.112). Additionally, the incidence of chromosomal abnormalities was not related to maternal age (4.10% in maternal age below 35 yeas vs. 3.57% in maternal age above 35, p = 1.000). Interestingly, after 28 weeks of gestation, fetuses with EIFs showed more chromosomal abnormalities (20.00%) than that in the group before 28 weeks of gestation (2.22%, p = 0.014), and this result was attributed to the detection of pathogenic CNVs. After birth, 25 of children conducted cardiac development re-examination. Among them, 9 (36%, 9/25) were diagnosed with congenital heart disease, primarily patent foramen oval and ventricular septal defects (7/9, 77.77%). We concluded that the appearance of EIFs in early or mid-trimester would not indicate an increased risk of fetal chromosomal abnormalities. However, the persistence of EIFs in late trimester was associated with a higher risk of pathology-related CNVs and its persistent appearance may indicate heart development defects after birth. Thus, our results suggest that CNV detection has its advantages in prenatal diagnosis, especially for those with EIFs that persist in the third trimester.

The professional activities of nurse managers in Chinese hospitals: A cross-sectional survey in hunan province.

OBJECTIVE: To explore nurse managers' perceptions of the frequency and importance of professional activities performed in their daily work in public hospitals in Hunan, China. BACKGROUND: Nurse managers are responsible for the management of almost all nursing activities in Chinese hospitals. Understanding how nurse managers operationalize their role and their perceptions of the importance of each activity is essential for clarification of their role and the competencies required to perform it. METHODS: A cross-sectional questionnaire survey. RESULTS: A total of 1,371 nurse managers in Hunan Province completed the survey. Nursing quality/safety management and patient management were performed most frequently and perceived as most important. Nurse managers performed nursing information management frequently while perceiving it as less important. They seldom performed nursing research management and placed low value on it. CONCLUSIONS: Patient-centred care remains central to nursing management. Nursing managers can create a leadership culture in their hospital settings that includes the effective management of information and facilitation of research knowledge to benefit nurse managers, staff and patients. IMPLICATIONS FOR NURSING MANAGEMENT: The results provide evidence for standardization of roles and job descriptions of nurse managers and for developing their knowledge and skills to ensure quality patient care.

Development and validation of a risk prediction model and scoring system for post-endoscopic retrograde cholangiopancreatography pancreatitis.

BACKGROUND: A few models have been proposed for the prediction of the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP), but many include factors that are not assessed routinely. Herein, we intend to develop and validate a predictive model for the occurrence of PEP. METHODS: Data of patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) from January 01, 2016 to May 16, 2019 (training set and internal test set) and from May 17, 2019 to December 25, 2019 (external test set) were retrospectively collected. The performance of the model was validated in the two validation cohorts. RESULTS: A total of 342 patients were included for the external test set, and 47 (13.7%) developed PEP. The variables included in the scoring system were gastrectomy history, high direct bilirubin (DBIL), high albumin (ALB), villous type of papillary orifice, nodular type of papillary orifice, pancreatic guidewire passages, precut sphincterotomy, and high operator experience. A total score >5 indicated high risk. In the external test set, the area under the curve (AUC) was 0.718, the sensitivity was 0.723, and the specificity was 0.676. In the external test set, the probability of PEP was 6.1%, 17.0%, and 37.5% in patients with low (<0), moderate (0-5), and high (>5) risk scores, respectively. CONCLUSIONS: This study established a scoring system for predicting the risk of PEP using routinely measured clinical variables. Its application in routine work warrants further investigation.

Adversarial active learning for the identification of medical concepts and annotation inconsistency.

OBJECTIVE: Named entity recognition (NER) is a principal task in the biomedical field and deep learning-based algorithms have been widely applied to biomedical NER. However, all of these methods that are applied to biomedical corpora use only annotated samples to maximize their performances. Thus, (1) large numbers of unannotated samples are relinquished and their values are overlooked. (2) Compared with other types of active learning (AL) algorithms, generative adversarial learning (GAN)-based AL methods have developed slowly. Furthermore, current diversity-based AL methods only compute similarities between a pair of sentences and cannot evaluate distribution similarities between groups of sentences. Annotation inconsistency is one of the significant challenges in the biomedical annotation field. Most existing methods for addressing this challenge are statistics-based or rule-based methods. (3) They require sufficient expert knowledge and complex designs. To address challenges (1), (2), and (3) simultaneously, we propose innovative algorithms. METHODS: GAN is introduced in this paper, and we propose the GAN-bidirectional long short-term memory-conditional random field (GAN-BiLSTM-CRF) and the GAN-bidirectional encoder representations from transformers-conditional random field (GAN-BERT-CRF) models, which can be considered an NER model, an AL model, and a model identifying error labels. BiLSTM-CRF or BERT-CRF is defined as the generator and a convolutional neural network (CNN)-based network is considered the discriminator. (1) The generator employs unannotated samples in addition to annotated samples to maximize NER performance. (2) The outputs of the CRF layer and the discriminator are used to select unlabeled samples for the AL task. (3) The discriminator discriminates the distribution of error labels from that of correct labels, identify error labels, and address the annotation inconsistency challenge. RESULTS: The corpus from the 2010 i2b2/VA NLP challenge and the Chinese CCKS-2017 Task 2 dataset are adopted for experiments. Compared to the baseline BiLSTM-CRF and BERT-CRF, the GAN-BiLSTM-CRF and GAN-BERT-CRF models achieved significant improvements on the precision, recall, and F1 scores in terms of NER performance. Learning curves in AL experiments show the comparative results of the proposed models. Furthermore, the trained discriminator can identify samples with incorrect medical labels in both simulation and real-word experimental environments. CONCLUSION: The idea of introducing GAN contributes significant results in terms of NER, active learning, and the ability to identify incorrect annotated samples. The benefits of GAN will be further studied.

Association between knowledge and risk for cardiovascular disease among older adults: A cross-sectional study in China.

OBJECTIVES: This study aimed to describe cardiovascular risk and cardiovascular disease (CVD) knowledge among older adults, and further explore the association between knowledge and risk. METHODS: In this cross-sectional study, we enrolled 1120 older adults who received physical examination in health centers. The participants were interviewed to obtain their behavioral risk factors related to CVD and clinical characteristics. A risk prediction chart was used to predict participants' cardiovascular risk based on clinical characteristics and behavioral risk factors. Participants' CVD knowledge was collected with a pretested knowledge questionnaire. RESULTS: Among the 1120 participants, 240 (21.4%) had low cardiovascular risk, 353 (31.5%) had moderate cardiovascular risk, 527 (47%) had high and very high cardiovascular risk. The knowledge level about CVD among 0.8% of the 1120 participants was good while that of 56.9% was poor. Lower CVD knowledge level, older age, lower income, and lower educational level were the independent factors of higher cardiovascular risk level. CONCLUSIONS: This study highlights the need to reduce the cardiovascular risk among older adults. CVD knowledge should be considered when developing health interventions.

Effects of personal characteristics, disease uncertainty and knowledge on family caregivers' preparedness of stroke survivors: a cross-sectional study.

Family caregivers play an important role in the rehabilitation of stroke survivors. The aims of this study were to describe preparedness, uncertainty, and knowledge regarding stroke in family caregivers of people who have undergone strokes and to investigate factors influencing preparedness. A total of 306 caregivers completed the questionnaires, including the Caregiver Preparedness Scale, the Mishel Uncertainty in Illness Scale, and Knowledge of Stroke. The result showed that the mean score of the family caregivers' preparedness was 14.42, the mean score of disease uncertainty was 75.62, and the mean score of stroke knowledge was 10.41. Caregiver preparedness was negatively correlated with disease uncertainty and positively correlated with knowledge. Multivariate stepwise regression analysis showed that educational background, profession, caregiving experience and uncertainty degree of the family caregivers, gender, and age of stroke survivor could predict 45.90% of the total variation in preparedness. The findings suggest that demographic characteristics of stroke survivor and family caregiver, as well as caregivers' disease uncertainty, enable predict the level of caregiver preparedness. Medical professionals should pay attention to providing personalized and targeted approaches to maximize caregivers' preparedness.

Mindfulness and Job Satisfaction Among Hospital Nurses: The Mediating Roles of Positive Affect and Resilience.

The current study aimed to explore the relationships between nurses' mindfulness and job satisfaction and the mediating roles of positive affect and resilience. A total of 1,043 Chinese hospital nurses completed self-report questionnaires from March to April 2019. Pearson's correlation analysis was used to identify the relationships among the four variables, and the bias-corrected bootstrap method was used to test the mediation hypotheses. The results revealed that nurses' mindfulness was at a medium-high level, whereas positive affect, resilience, and job satisfaction were at medium levels. The total scores and dimension scores of the four variables showed strong positive correlations, and nurses' mindfulness affected job satisfaction directly and indirectly through the intermediary roles of positive affect and resilience. Nursing managers should recognize the importance of mindfulness and incorporate mindfulness training into health promotion and employee management plans for hospital nurses. In addition, strategies should be implemented to cultivate positive affect and resilience. [Journal of Psychosocial Nursing and Mental Health Services, 58(6), 46-55.].

Feasibility and efficacy of nurse-led team management intervention for improving the self-management of type 2 diabetes patients in a Chinese community: a randomized controlled trial.

AIM: The aim of this study was to examine the feasibility and efficacy of nurse-led team management (NLTM) intervention at improving the self-management of patients with type 2 diabetes (T2D) at community settings in Changsha, Hunan, China. BACKGROUND: China has become the country with the largest number of patients with diabetes, and that number is growing, causing increasing pressure on the health care system. At present, the main diabetes management model in China is teamwork guided by general practitioners. However, the number of general practitioners is insufficient, and their work is overloaded, which leads to poor outcomes of diabetes management. Therefore, it is important to explore alternative methods of diabetes management, such as NLTM. PATIENTS AND METHODS: In a randomized controlled trial, 171 T2D patients were randomized into the control or intervention arm. Participants in the control group received routine management from the community health service center, whereas the intervention group received 12 months NLTM intervention in addition to the standard care. The diabetes self-management scale, fasting blood sugar, and glycosylated hemoglobin A1c (HbA1c) were assessed at baseline and at 6 and 12 months after the start of the intervention. RESULTS: Baseline data were comparable between arms. Repeated-measurement analysis showed that self-management of the intervention group improved compared with the control group after the intervention (P<0.05). There were no significant differences in HbA1c at 6 months, whereas after 12 months of intervention, there was a significant difference in HbA1c between the two groups (F=10.114, P<0.05). The intervention had no significant effect on fasting blood sugar. CONCLUSION: The NLTM intervention has resulted in an impact of practical significance on T2D self-management, and was beneficial for controlling the level of HbA1c. The study has demonstrated the feasibility and efficacy of using NLTM in the management of T2D in a Chinese community.

Awareness of risk factors and warning symptoms and attitude towards gastric cancer screening among the general public in China: a cross-sectional study.

OBJECTIVES: This study aimed to assess the knowledge of risk factors and warning symptoms and attitude towards gastric cancer screening among the general population in China. SETTING: Hunan province, China PARTICIPANTS: Individuals aged older than 18 years were recruited using a cluster sampling method. DESIGN: A cross-sectional study, and a pretested structured questionnaire was used to assess participants' awareness of gastric cancer. PRIMARY AND SECONDARY OUTCOME MEASURES: Knowledge level of risk factors and warning symptoms of gastric cancer, gastric cancer screening attitude, sociodemographic factors associated with gastric cancer knowledge and screening behaviour. RESULTS: This study comprised 1200 participants with a mean age of 40.31 (SD 16.73) years, of whom 622 (51.8%) were women. The mean score for gastric cancer knowledge was 8.85/22 (SD 6.48). There were 47.0% of the participants who had a low knowledge level about the risk factors and warning symptoms of gastric cancer. In total, 83.8% believed screening is helpful for early detection of gastric cancer, and 15.2% had undergone gastric cancer screening. The most common reason for not undergoing screening was having 'no symptoms' (63.0%), followed by 'fear of undergoing gastroscopy' (38.1%). Independent factors related to lower knowledge levels included male sex, living in rural areas, lower educational level, working as a farmer and without a family history of gastric cancer (p<0.05). Factors independently associated with screening behaviour included white-collar employment, higher income and having upper gastrointestinal tract diseases (p<0.05). CONCLUSIONS: In China, people have poor knowledge about risk factors and warning symptoms of gastric cancer, but a majority have a positive attitude towards the benefits of gastric cancer screening. Being asymptomatic and having a fear of gastroscopy were the main self-reported reasons for not undergoing screening. These results highlight the urgent need for educational campaigns to improve gastric cancer awareness.

A randomized study on the effect of modified behavioral activation treatment for depressive symptoms in rural left-behind elderly.

OBJECTIVE: To evaluate the effectiveness of a modified behavioral activation treatment (MBAT) intervention on reducing depressive symptoms in rural left-behind elderly. METHOD: This is a randomized study registered in Chinese Clinical Trial Registry (ChiCTR-IOR-17011289). Eighty rural left-behind elderly people who had a Geriatric Depression Scale (GDS) score between 11 and 25 were randomly assigned to the intervention (n = 40) and control group (n = 40). The intervention group received both MBAT and regular treatment for 8 weeks while the control group received regular treatment. Both groups were assessed with the GDS, Beck Anxiety Inventory (BAI), and Oxford Happiness Questionnaire (OHQ) at baseline, immediately post-intervention, and at 3 months post-intervention. RESULTS: There were a total of 73 participants that completed the intervention. The scores of GDS and BAI decreased significantly, but the scores of OHQ increased significantly in the intervention group after 8 sessions of MBAT (P < .01). The reduction in depression symptoms after the intervention was maintained at the 3-month follow-up. Significant differences in GDS, BAI, and OHQ scores were observed between the intervention group and the control group (P < .01). CONCLUSION: MBAT produced a significantly greater reduction in depressive symptoms than regular care in rural left-behind elderly. Clinical or methodological significance of this article: A modified behavioral activation (BA) psychotherapy can significantly reduce the recurrence and seriousness of depression symptoms in the left-behind elderly with mild to moderate depression. This study also suggests that further study of the MBAT as an intervention will provide a direction for the management of mental health in rural left-behind elders.

The Effects of a Modified Mindfulness-Based Stress Reduction Program for Nurses: A Randomized Controlled Trial.

The purpose of the study was to evaluate the effects of a modified mindfulness-based stress reduction (MBSR) program on the levels of stress, affect, and resilience among nurses in general hospitals in mainland China. In addition, the study attempted to determine the impact of the program on job satisfaction. A total of 110 nurses were randomly assigned to the intervention versus control groups. The intervention group participated in a modified 8-week MBSR program. All participants were evaluated with questionnaires at baseline, immediately after the intervention, and 3 months later. The intervention group showed decreases in stress and negative affect and increases in positive affect and resilience after the intervention. No improvement in job satisfaction was observed, but the trends of the data were in the hypothesized direction that job satisfaction would improve. The modified MBSR program is an effective approach for nurses to decrease stress and negative affect and improve positive affect and resilience. In addition, the program has the potential to improve job satisfaction.

Evaluation of a school entry immunization record check strategy in 4 counties of Ningxia and Hubei provinces, China.

China has a national requirement that children's vaccination status is to be checked upon entry to kindergarten and school; children who have missed vaccine doses are to be referred to vaccination clinics to receive the necessary vaccinations. Most provinces have Immunization Information Systems (IIS) that contain and manage vaccination records of children served by immunization clinics. We conducted an evaluation in Hubei and Ningxia provinces using IIS data to determine the effect of their school entry immunization record checking strategy (SECS) on vaccination coverage and rate of catch-up for selected vaccines. We selected two counties with well-functioning IISs from each province. Names and demographic information of children enrolled in 185 kindergartens and 125 primary school in 2016 were used to identify children in the IIS and obtain their vaccination records. We calculated vaccination coverage before and after implementation of the SECS and determined catch-up rates for 5 vaccines, of which 3 are given before 2 years of age and 2 are given after 2 years of age. Among the 20,215 newly-enrolled children, 75% were able to be matched with IIS records. Few children who had missed one or more doses of the 3 vaccines recommended in the first two years of life received catch-up doses after SECS. For vaccines scheduled after 2 years of age, there was a statistically significant (p < 0.05) coverage increase in both provinces following the school-entry record check. Among children who were age-eligible for the selected vaccines before SCES, the catch-up rate was <50%. SECS provides opportunities to identify incompletely vaccinated children, improve coverage, and remind families of school-age children about up-coming vaccinations; SECS has potential to improve completeness of IIS data and enrollment of children in immunization clinics. Evidence-based policy with implementation guidance and routine monitoring are necessary to improve China's school entry checking strategy.

Correlation between miR-200 Family Overexpression and Cancer Prognosis.

The correlation between miR-200 family overexpression and cancer prognosis remains controversial. Therefore, we conducted a systematic review and meta-analysis by searching PubMed, Embase, Cochrane Library, China Biology Medicine disc (CBM), and China National Knowledge Infrastructure (CNKI) to identify eligible studies. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to evaluate the strength of the correlations. Additionally, different subgroup analyses and publication bias test were performed. Eventually, we analyzed 23 articles that included five tumor types and 3038 patients. Consequently, high expression of miR-200 family in various tumors was associated with unfavorable overall survival (OS) in both univariate (HR = 1.32, 95% CI: 1.14-1.54, P < 0.001) and multivariate (HR = 1.32, 95% CI: 1.16-1.49, P < 0.001) analyses. Likewise, a similar result was found in different subgroups of the patient source, cancer type, test method, sample source, miR-200 component, and sample size. However, no association of miR-200 family was detected with recurrence- or relapse-free survival (RFS) (univariate: HR = 1.02, 95% CI: 0.96-1.09, P = 0.47; multivariate: HR = 1.07, 95% CI: 1.00-1.14, P = 0.07), progression-free survival (PFS) (univariate: HR = 0.96, 95% CI: 0.54-1.70, P = 0.88; multivariate: HR = 1.17, 95% CI: 0.86-1.61, P = 0.32), and disease-free survival (DFS) (univariate: HR = 0.90, 95% CI: 0.74-1.09, P = 0.29; multivariate: HR = 0.98, 95% CI: 0.68-1.41, P = 0.90). Our findings have provided convincing evidence that miR-200 family overexpression suggested poor prognosis of various cancer types, which efforts may raise the potential use of miR-200 family for cancer prognosis in clinical practice.

Maternal deprivation promotes hippocampal neuronal apoptosis via ERK1/2 signaling.

Neonatal maternal deprivation (MD) leads to depressive-like behaviors by promoting hippocampal neuronal apoptosis, but whether and how ERK1/2 signaling participates in MD-induced hippocampal neuronal apoptosis remains unclear. We therefore explored the role of ERK1/2 signaling pathway in neonatal MD-induced depression. Neonatal rats were divided into control group, PD group given intraperitoneal injections of MAPKK inhibitor (PD98059), MD group, and MD+PD group. The neonatal MD model was confirmed by behavioral tests. Compared with controls, MD group showed increased hippocampal neuronal apoptosis, higher mRNA expressions of Bax, caspase-3 and caspase-9mRNAs, and lower expression of Bcl-2 and BDNF. Similarly, compared with controls, MD group showed higher protein expression and wider distribution of Bax, caspase-3, caspase-9 and Cytochrome C but lower protein expression of Bcl-2, p-CREB, BDNF and p-ERK1/2. The changes in the MD group were reversed in the MD+PD group, except that p-ERK1/2 expression was decreased. In conclusion, MD-induced depression is associated with hippocampal neuronal apoptosis, which may be mediated by the ERK1/2 signaling pathway. These findings may provide novel avenues for depression therapy.

Plasma concentrations of neurotransmitters and postpartum depression.

OBJECTIVE: To determine associations between postpartum depression (PPD) and plasma neurotransmitters.
 Methods: We conducted a case-control study nested to a prospective cohort established in 3 comprehensive tertiary hospitals in Changsha, Hunan, China from February to September 2007. The Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was used at 2 weeks postpartum to screen PPD, with a score of 13 or higher as the cut-off for PPD. The women with matched age but without PPD and delivery within 5 years were selected as controls. The levels of plasma monoamine neurotransmitters including serotonin (5-hydroxytryptamine, 5-HT), dopamine (DA), and norepinephrine (NE), and peptide neurotransmitters including neuropeptide Y (NPY) and substance P (SP) in maternal blood samples taken at 2 weeks postpartum were measured and compared between PPD women (n=42) and controls (n=42).
 Results: Plasma levels of 5-HT and NPY were significantly lower while plasma levels of NE and SP were significantly higher in PPD women than those in the controls. For women with PPD, a negative correlation between NPY and NE (r=-0.36, P﹤0.05) was observed.
 Conclusion: There are changes in plasma levels of neurotransmitters in women with PPD, and there are potential interactions between different neurotransmitters.

Examination of a Nurse-led Community-based Education and Coaching Intervention for Coronary Heart Disease High-risk Individuals in China.

PURPOSE: Early detection and management of coronary heart disease (CHD) are embedded into many community health service and primary care practices in western countries. The Framingham CHD risk score has been used to predict CHD and mortality for nearly 20 years, and it has predicted CHD event risk accurately in multiethnic populations. The aim of this study was to access the effect of a 6-month community-based intervention on CHD risk in individuals at high risk. METHODS: A randomized controlled trial of individuals with a high 10-year CHD risk were recruited from two communities in China. Individuals in the intervention group (n = 53) received a 3-month group education and a 3-month coaching session. Physical examination and self-report questionnaires were used to collect both pre- and postintervention data on blood pressure, glucose, cholesterol, body mass index, smoking, depression, and health-related quality of life (HRQoL). RESULTS: A total of 102 participants (85.0%) completed the 6-month study. Compared with the usual care group, the intervention group had a 5 mmHg greater reduction in systolic blood pressure (t = 2.01, p = .047), larger declines in glucose (t = -2.49, p = .015), cholesterol (t = -2.44, p = .017), body mass index (t = -2.58, p = .011), and depression (t = -2.05, p = .043), and better reports of HRQoL (t = 3.36, p = .001). No significant group differences in smoking behaviors were reported. CONCLUSION: A 6-month community-based intervention in a CHD high-risk population improved disease-related risk factors, depression, and HRQoL. Results provide preliminary evidence for primary prevention of cardiovascular disease risk in a community high-risk population.