[Effectiveness of minimally invasive surgery in the treatment of pancreatic acinar cell carcinoma].

Objective: To explore the effectiveness of minimally invasive surgical treatment for pancreatic acinar cell carcinoma (PACC). Methods: Six patients with PACC diagnosed in Peking University Third Hospital from January 2010 to September 2022 were retrospectively selected. Preoperative evaluation was performed on whether the lesions were eligible for surgery, including whether radical resection of liver metastases could be performed. Laparoscopic or Da Vinci robot-assisted resection was performed on six patients, and spleen retention was determined according to the original lesions and the relationship with peripheral blood vessels and tissues, while simultaneous resection was performed on cases of peripheral organ tissue invasion. The patients' basic information, preoperative general conditions, preoperative diagnosis and tumor stage, minimally invasive surgery methods, postoperative complications, pathological results, tumor stage and follow-up data were collected and analyzed to explore the effectiveness of minimally invasive surgery. Results: Among the six patients, four were males and two were females, with the age of 25-69 years. Five patients had abdominal pain and distension before surgery, five patients had tumors located at the tail of the pancreatic body, and one patient had tumors located at the head of the pancreas. Preoperative imaging (enhanced CT and MRI) was performed to measure the tumor diameter (2.8-10.0 cm). Tumor markers were elevated in two patients before surgery, and six patients underwent surgery through laparoscopy or robotic platform. No complications such as postoperative pancreatic fistula and bleeding were clinically relevant during and after surgery. There were two cases with concurrent or heterochronous liver metastasis, two cases with lymph node metastasis and nodular metastasis, four cases with tumor invasion of surrounding organs (stomach, spleen or duodenum), and three cases with vascular cancer thrombi. The follow-up time of the six patients was 12 to 165 months, and one patient underwent three operations due to postoperative liver metastasis and residual pancreatic recurrence, and the results were satisfactory. All the six patients survived at the last follow-up. Conclusions: PACC is prone to invade the surrounding organs, and has a large tumor diameter. Radical surgery for PACC can be completed through minimally invasive surgery, and satisfactory oncology prognosis can be obtained. In addition, some PACC patients with recurrence and metastasis can still be treated by surgery.

[Epidemiological characteristics and spatiotemporal clustering of hepatitis A in Zhejiang Province from 2010 to 2019].

Objective: To analyze the epidemiological characteristics and spatiotemporal clustering of hepatitis A in Zhejiang Province from 2010 to 2019. Methods: The data of hepatitis A incidence in Zhejiang Province from 2010 to 2019 were collected from the infectious disease surveillance system of China Information System for Disease Control and Prevention. ArcGIS 10.7 software was used for spatial autocorrelation analysis. SaTScan 9.6 software was used for spatiotemporal scanning analysis. SPSS 25.0 software was used for additional analysis. Results: Zhejiang Province has reported 5 465 cases of hepatitis A in 2010-2019 years, with an average annual incidence rate of 1.00/100 000, and periodicity and seasonality are not obvious. The incidence of male was higher than that of female (P=0.023), and the highest incidence rate was 50-59 years old. Spatial autocorrelation analysis showed that there was a positive spatial correlation between the incidence of hepatitis A in Zhejiang Province from 2010 to 2017, with the weakest correlation in 2010 (Moran's I =0.103, Z=1.769, P=0.049), and the strongest correlation in 2016 (Moran's I=0.328, Z=4.979, P=0.001). Spatiotemporal scanning analysis showed that there was spatial aggregation of hepatitis A in Zhejiang Province from 2010 to 2019, with a total of three aggregation areas identified. Among them, the mostly aggregation area was concentrated in Xiangshan county of Ningbo city, which covered 10 counties (cities and districts), including Ninghai county and Yinzhou district, and appeared from January 1 to June 30, 2012. Conclusion: The incidence level of hepatitis A in Zhejiang Province shows a stable fluctuation trend from 2010 to 2019, and the seasonal regularity is not obvious. The population group aged 50-59 years old is the key population. There is spatial aggregation in the epidemic situation of hepatitis A. Targeted prevention and control measures of hepatitis A should be done based on the law of spatiotemporal aggregation and local incidence.

Comparing nanoparticle polymeric micellar paclitaxel and solvent-based paclitaxel as first-line treatment of advanced non-small-cell lung cancer: an open-label, randomized, multicenter, phase III trial.

BACKGROUND: Polymeric micellar paclitaxel (pm-Pac) is a novel Cremophor EL-free, nanoparticle micellar formulation of paclitaxel. We aimed to compare the efficacy and safety between pm-Pac plus cisplatin and solvent-based paclitaxel (sb-Pac) plus cisplatin in advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: A total of 448 stage IIIB to IV NSCLC patients were randomly assigned (2:1) to receive six 3-week cycles of either pm-Pac (230 mg/m2) plus cisplatin (70 mg/m2; n = 300), followed by dose escalation of pm-Pac to 300 mg/m2 from the second 3-week cycle if prespecified toxic effects were not observed after the first cycle, or sb-Pac (175 mg/m2) plus cisplatin (70 mg/m2; n = 148). The primary end point was objective response rate (ORR) assessed by independent review committees (IRCs). The secondary end points included IRC-assessed progression-free survival (PFS), overall survival (OS), and safety. RESULTS: Patients in the pm-Pac-plus-cisplatin group showed significant improvements in IRC-assessed ORR compared with those in the sb-Pac-plus-cisplatin group (50% versus 26%; rate ratio 1.91; P < 0.0001). Additionally, subgroup analysis showed that a higher ORR was consistently observed in both squamous and nonsquamous histological types. IRC-assessed median PFS was significantly higher in the pm-Pac-plus-cisplatin group than in the sb-Pac-plus-cisplatin group (6.4-month versus 5.3-month; hazard ratio 0.63; P = 0.0001). Median OS was not significantly different between the two groups. The incidence of treatment-related serious adverse events (9% versus 18%; P = 0.0090) was significantly lower in the pm-Pac-plus-cisplatin group than in the sb-Pac-plus-cisplatin group. CONCLUSION: Pm-Pac plus cisplatin yielded superior ORR and PFS along with a favorable safety profile and should become an option for patients with advanced NSCLC. CLINICAL TRIAL IDENTIFIER: ClinicalTrials.gov NCT02667743; https://clinicaltrials.gov/ct2/show/NCT02667743.

[The prevalence of retinopathy of prematurity in the mainland of China from 2008 to 2018].

With improved neonatal care, the survival rate of premature infants has been greatly increased, and retinopathy of prematurity (ROP) has already been the leading cause of blindness in children. Thereupon screening and treatment of ROP have been deeply performed in China. However, the implementation and the detection rate vary greatly in different regions. In this article, based on the 20-year prevalence data of ROP in all parts of the country before 2010, we review and summarize the literatures from 2008 to 2018, in order to track and update the screening data of ROP in the mainland of China and to find the incidence trend during the decade. The evidence of the changing prevalence of ROP would benefit further prevention of this serious eye disease. (Chin J Ophthalmol, 2021, 57: 379-385).

Relationship between serum homocysteine and different menopausal stage.

Objective: This study aimed to investigate the serum level of homocysteine in menopausal women and to explore the association between menopausal status, blood lipids, and homocysteine concentrations.Methods: The study recruited females aged 40-60 years who were not receiving menopausal hormone therapy. The demographic characteristics and menopausal status of the women were collected in the form of questionnaires. The study analyzed the association between hyperhomocysteinemia and variables using binary logistic stepwise regression.Results: Among 366 enrolled subjects, menopausal status was divided into four stages: premenopause stage (n = 135), menopausal transition stage (n = 91), early postmenopause stage (n = 87), and late postmenopause stage (n = 53). The proportion of hyperhomocysteinemia in the premenopausal stage, menopausal transition stage, and postmenopausal stage was 43%, 26.4%, and 45%, respectively (χ2 = 8.999, p = 0.011). The mean concentration of homocysteine was 9.75 µmol/l. The level of homocysteine was higher in the postmenopause stage than in the other stages (p = 0.043), and the difference between postmenopause and menopausal transition was statistically significant (p < 0.01). In the binary logic analysis, menopausal transition compared with postmenopause (odds ratio = 2.027, 95% confidence interval = 1.117-3.679, p = 0.005).Conclusions: Serum homocysteine levels are associated with menopausal status. Homocysteine concentrations were progressively higher across menopausal stages. The transformation in the female body across the menopause transition stages may cause elevations in the homocysteine level in postmenopausal women.

[Relationship between serum brain-derived neurotrophic factor and clinical stage and dysmenorrhoea of enodmetriosis].

Objective: To explore the association between serum brain-derived neurotrophic factor and clinical stage and dysmenorrhoea of endometriosis. Methods: A total of 82 patients were studied with laparoscopically diagnosed endometriosis between June 2017 and June 2019, and 75 healthy women with reproductive age were selected as the control group during the same period. The endometriosis patients were scored by visual analogue scale(VAS)according to their preoperative dysmenorrhoea.And endometriosis was staged and scored according to the score of Revised American Fertility Society(r-AFS).Enzyme-linked immunosorbent assay (ELISA) was used to determine preoperative BDNF level in serum, and the correlation between BDNF level with clinical stage as well as dysmenorrhea of endometriosis were analysed. Results: The serum BDNF level in endometriosis patients was (1 082±43) ng/L, significantly higher than that in the normal control [(649±30) ng/L], there was statistical difference between the two groups(P<0.001). The BDNF expression in patients with r-AFS stage Ⅲ-Ⅳ was higher than that in patients with Ⅰ-Ⅱ stage [(1 164±389) ng/L vs (791±218)ng/L, P<0.001]. BDNF level in serum was closely correlated with the degree of dysmenorrhea (r=0.682), and the BDNF level in patients with moderate or severe dysmenorrhea was significantly higher than that in patients without dysmenorrhea and patients with mild dysmenorrhea [(1 292±43) ng/L vs(718±36) ng/L, P<0.001]. Conclusions: The serum BDNF level in endometriosis patients is positively correlated with clinical stage and dysmenorrhea.

[Distributions of time, place, and population of novel coronavirus disease 2019 (COVID-19) from January 20 to February 10, 2020, in China]. / Distribución temporal, geográfica y por población de la nueva enfermedad por coronavirus (COVID-19) desde el 20 de enero hasta el 10 de febrero del 2020, en China.

Background and objective: Since December 2019, increasing cases of novel coronavirus disease 2019 (COVID-19) are being detected worldwide. The purpose of this paper is to provide a scientific reference for the global prevention and control of COVID-19. Methods: General demographic characteristics, epidemiological history, and clinical symptoms of COVID-19 were collected that had been reported on the websites of multiple Municipal Health Commissions in China. We herein describe distributions in time, place, and population of COVID-19. Results: As of midnight on February 10, 2020, the number of confirmed cases of COVID-19 in China was 42,638, and the province with the largest number of confirmed cases was Hubei (31728), followed by Guangdong (1177), Zhejiang (1117), and Henan (1105) province. The number of cases and the speed of confirmed cases in provinces other than Hubei were more moderate than those of the Hubei province. The median (interquartile range) age of patients with COVID-19 was 44 (33, 54) years, with a range of 10 months to 89 years. Conclusions: The COVID-19 epidemic should be considered a global threat and the steps for control include early diagnosis and treatment, as well as isolation.

Miconazole triggers various forms of cell death in human breast cancer MDA-MB-231 cells.

In recent years, "drug repurposing" has become an important approach and focus of studies on anti-tumor drug research and development (R&D). As one of the first-generation broad-spectrum imidazole anti-fungal drugs, miconazole (MCZ) exhibits anti-tumor effects in addition to its anti-fungal effect. However, no report has focused on examining the effect of MCZ on the proliferation and cell-death of human breast cancer MDA-MB-231 cells. MCZ significantly inhibited the proliferation of MDA-MB-231 cells in a concentration- and time-dependent manner. We also observed that MCZ induced both apoptosis and necroptosis in MDA-MB-231 cells. Transmission electron microscopy showed submicroscopic structures in these cells, which correspond to necrotic features, in addition to the characteristic features of apoptosis. Pretreatment of cells with z-VAD-fmk, an apoptosis inhibitor or Nec-1, a necroptosis inhibitor, significantly increased their viability compared with MCZ treatment. The initial mechanism of MCZ-mediated cell death in human breast cancer MDA-MB-231 cells involves an increase in the Bax/Bcl-2 ratio, downregulation of apoptosis induced by Akt and p-Akt-473, a simultaneous upregulation of the receptor-interacting protein 3 (RIP3) and mixed lineage kinase domain-like (MLKL) protein expression, and ROS production to induce necroptosis. Our results suggest that MCZ may be a potential lead compound for the development of anti-breast cancer drugs.

[Comparison of etiology and incidence of pulmonary infection in patients with esophageal carcinoma accompanied by esophagotracheal fistula before and after the airway stent implantation].

Objective: To compare the etiology and incidence of pulmonary infection in patients with esophageal carcinoma accompanied by esophagotracheal fistula before and after the airway stent implantation. Methods: The clinical records of patients with esophageal carcinoma accompanied by esophagotracheal fistula in Respiratory Department and Oncology Department of Meitan General Hospital were retrospectively analyzed from March 2008 to January 2018. The demographic data, comorbidities, pathological results and etiology were collected before and after tracheal stents were implanted in all patients. The incidence of pulmonary infection was analyzed, and the classification of etiology was compared before and after tracheal stents implantation. Results: A total of 100 patients were included in the study. The incidence rate of pulmonary infection before stents implantation was 83.0%. A total of 105 bacterial strains were cultured, including 73 strains of gram-negative bacteria (69.5%) and mainly pseudomonas aeruginosa, 5 strains of gram-positive bacteria [all methicillin-resistant staphylococcus aureus (MRSA)] (4.8%), and 27 strains of fungi (25.7%) and mainly candida albicans. The incidence rate of pulmonary infection was lowered to 53.0% after tracheal stents implantation (χ(2)=29.102, P<0.001). A total of 79 bacterial strains were cultured, and the main bacteria were still gram-negative bacteria and fungi, in which pseudomonas aeruginosa and candida albicans accounted for the majority. However, 13 strains of MRSA were cultured (16.5%), significantly higher than those before stents implantation (χ(2)=7.451, P=0.005). Conclusions: The incidence rate of pulmonary infection in patients with esophageal carcinoma accompanied by esophagotracheal fistula is very high. Gram-negative bacteria and fungi are the main etiologies. Tracheal stents implantation can effectively reduce the incidence of pulmonary infection. However, the incidence rate of MRSA is significantly increased after stents implantation.

Oral bisphosphonate use and lung cancer incidence among postmenopausal women.

Background: Bisphosphonates are common medications for the treatment of osteoporosis in older populations. Several studies, including the Women's Health Initiative (WHI), have found inverse associations of bisphosphonate use with risk of breast and endometrial cancer, but little is known about its association with other common malignancies. The objective of this study was to evaluate the association of bisphosphonate use on the incidence of lung cancer in the WHI. Patients and methods: The association between oral bisphosphonate use and lung cancer risk was examined in 151 432 postmenopausal women enrolled into the WHI in 1993-1998. At baseline and during follow-up, participants completed an inventory of regularly used medications including bisphosphonates. Results: After a mean follow-up of 13.3 years, 2511 women were diagnosed with incident lung cancer. There was no evidence of a difference in lung cancer incidence between oral bisphosphonate users and never users (adjusted hazard ratio = 0.91; 95% confidence intervals, 0.80-1.04; P = 0.16). However, an inverse association was observed among those who were never smokers (hazard ratio = 0.57, 95% confidence interval, 0.39-0.84; P < 0.01). Conclusion: In this large prospective cohort of postmenopausal women, oral bisphosphonate use was associated with significantly lower lung cancer risk among never smokers, suggesting bisphosphonates may have a protective effect against lung cancer. Additional studies are needed to confirm our findings.

The prevalence and determinants of genitourinary syndrome of menopause in Chinese mid-life women: a single-center study.

OBJECTIVE: This study aimed to explore the prevalence and determinants of genitourinary syndrome of menopause (GSM) in Chinese mid-life women. METHODS: A cross-sectional single-center study was performed among 40-65-year-old women who participated in physical examinations at Shanghai Jiao Tong University Affiliated Sixth People's Hospital from December 2015 to December 2016. The participating women were questioned about their genitourinary symptoms, and the relationships between these symptoms and the women's demographic characteristics were evaluated. RESULTS: The prevalence of GSM was 30.8%, the most frequent symptom was decreased sexual desire (18.4%), and the frequency of vulvovaginal symptoms and lower urinary tract symptoms was 17.5% and 14.8%, respectively. In addition, most of the symptoms were mild. In postmenopausal women, the prevalences of GSM and the three aforementioned symptoms were higher than those in perimenopausal women (p < 0.05). Based on binary logistic regression analysis, GSM was found to be associated with postmenopause (p = 0.007; odds ratio (OR) 1.52), at least two abortions (p = 0.035; OR 1.42), body mass index (BMI) ≥ 30 kg/m2 (p = 0.032; OR 1.91) and diabetes (p = 0.041; OR 1.94). CONCLUSIONS: GSM is common in Chinese mid-life women, and associations between GSM and postmenopause, abortion, BMI and diabetes were identified. Health-care practitioners should actively discuss urogenital symptoms with middle-aged female patients and take appropriate interventions to improve the health of their urogenital tract and quality of life.

Association of body composition with menopausal symptoms in (peri-)menopausal women.

OBJECTIVE: To explore the correlation of body composition with the severity of menopausal symptoms, as well as each classic menopausal symptom. METHODS: A total of 758 (peri-)menopausal women were recruited (aged from 40 to 67 years) from the Menopause Clinic in the Shanghai Sixth People's Hospital. Different regions of fat mass, lean mass and fat-free mass were measured by bioelectrical impedance analysis, while menopausal symptoms were evaluated by valid modified Kupperman's index (KMI) in the Chinese version. RESULTS: After adjusting for potential confounders, logistic regression revealed that trunk lean mass (odds ratio 0.29, 95% confidence interval 0.09-0.99) was the independent determinant of moderate to severe menopausal symptoms (KMI ≥ 16). In multiple regression analysis, significant relationships were found between body mass index and hot flushes/sweating and diabetes (p < 0.05). There was a significant relationship between lean mass and muscle/joint pain and sexual problems (p < 0.05). We also observed significant relationships between fat mass and hot flushes/sweating and muscle/joint pain. CONCLUSIONS: Our findings indicated that trunk lean mass was an independent protective factor for moderate to severe menopausal symptoms. Strengthening the trunk lean mass may alleviate menopausal symptoms.

Hox genes reveal genomic DNA variation in tetraploid hybrids derived from Carassius auratus red var. (female) × Megalobrama amblycephala (male).

BACKGROUND: Allotetraploid F1 hybrids (4nF1) (AABB, 4n = 148) were generated from the distant hybridization of Carassius auratus red var. (RCC) (AA, 2n = 100) (♀) × Megalobrama amblycephala (BSB) (BB, 2n = 48) (♂). It has been reported that Hox gene clusters are highly conserved among plants and vertebrates. In this study, we investigated the genomic organization of Hox gene clusters in the allotetraploid F1 hybrids and their parents to investigate the polyploidization process. RESULTS: There were three copies of Hox genes in the 4nF1 hybrids, two copies in RCC and one copy in BSB. In addition, obvious variation and pseudogenization were observed in some Hox genes from 4nF1. CONCLUSION: Our results reveal the influence of polyploidization on the organization and evolution of Hox gene clusters in fish and also clarify some aspects of vertebrate genome evolution.

Rapid genomic DNA changes in allotetraploid fish hybrids.

Rapid genomic change has been demonstrated in several allopolyploid plant systems; however, few studies focused on animals. We addressed this issue using an allotetraploid lineage (4nAT) of freshwater fish originally derived from the interspecific hybridization of red crucian carp (Carassius auratus red var., ♀, 2n=100) × common carp (Cyprinus carpio L., ♂, 2n=100). We constructed a bacterial artificial chromosome (BAC) library from allotetraploid hybrids in the 20th generation (F20) and sequenced 14 BAC clones representing a total of 592.126 kb, identified 11 functional genes and estimated the guanine-cytosine content (37.10%) and the proportion of repetitive elements (17.46%). The analysis of intron evolution using nine orthologous genes across a number of selected fish species detected a gain of 39 introns and a loss of 30 introns in the 4nAT lineage. A comparative study based on seven functional genes among 4nAT, diploid F1 hybrids (2nF1) (first generation of hybrids) and their original parents revealed that both hybrid types (2nF1 and 4nAT) not only inherited genomic DNA from their parents, but also demonstrated rapid genomic DNA changes (homoeologous recombination, parental DNA fragments loss and formation of novel genes). However, 4nAT presented more genomic variations compared with their parents than 2nF1. Interestingly, novel gene fragments were found for the iqca1 gene in both hybrid types. This study provided a preliminary genomic characterization of allotetraploid F20 hybrids and revealed evolutionary and functional genomic significance of allopolyploid animals.

Comprehensive transcriptome analysis of mesenchymal stem cells in elderly patients with osteoporosis.

OBJECTIVE: To explore the role of aging in the pathogenesis of osteoporosis, several differentially expressed genes (DEGs) and altered biological pathways were identified in mesenchymal stem cells (MSCs) in elderly patients with osteoporosis. METHODS: Raw data were downloaded from Gene Expression Omnibus database. A total of 14 human MSC samples were available, including five samples from elderly patients suffering from osteoporosis, five controls from young non-osteoporotic donors and five controls from old non-osteoporotic donors. The DEGs were identified using LIMMA package among the three groups. Gene ontology and KEGG pathway analysis were carried out using DAVID. A protein-protein interaction (PPI) network of DEGs was constructed with STRING and then visualized with Cytoscape. RESULTS: A total of 3179 DEGs were screened, including 1071 up- and 2108 down-regulated genes. Compared with young and old controls, 271 and 781 genes were up-regulated in osteoporosis, respectively, and 17 genes were shared. Function and pathway enrichment showed that the up-regulated genes in osteoporosis were involved in extracellular matrix (ECM)-receptor interaction, focal adhesion and mammalian target of rapamycin signaling pathway. Moreover, a range of genes linked to cell adhesion, ECM-receptor interaction and cell cycle were revealed in the PPI network, such as transforming growth factor beta 1, insulin-like growth factor 2 and integrin beta 2. CONCLUSION: A number of DEGs and altered pathways were screened in osteoporosis. Our study provided insights into the role of aging in the pathogenesis of osteoporosis and some DEGs might be potential biomarkers for osteoporosis.

Involvement of the mitfa gene in the development of pigment cell in Japanese ornamental (Koi) carp (Cyprinus carpio L.).

A colored phenotype is an important feature of ornamental fish. In mammals, microphthalmia-associated transcription factor (MITF) was found to regulate the development of melanocytes. In this study, the mitfa cDNA was first cloned from the Japanese ornamental (Koi) carp (Cyprinus carpio L.), an important ornamental freshwater fish. The full-length cDNA of the mitfa gene contains 1634 bp, coding for 412 amino acids in Koi. The identity degree of mitfa amino acid sequences between the Koi carp and zebrafish is 92.9%. We tested the expression of the mitfa gene in several varieties of Koi using reverse transcription-polymerase chain reaction and found that the mitfa gene is highly expressed in the skin tissues of the Taisho sanke and the Procypris merus. Interestingly, the mitfa gene was also expressed in the Kohaku and Yamabaki ogon, although melanocytes were not observed in the skin. Koi carp embryos were transparent and colorless, while after hatching, different types of pigment cells successively emerged in a fixed order. In Taisho sanke, melanocytes first appeared in the trunk at approximately 12 days of age. Subsequently, there was a large area of melanocytes by 30 days of age. The expression level of the mitfa mRNA was low in early embryos and newly hatched larvae, and increased to high levels in 30-day-old fry. The results show that the mitfa gene is involved in regulating fish body color in the development of both melanocytes and pigment cells.

An analysis of the main reasons that perimenopausal and postmenopausal women in China have for seeking outpatient treatment and factors influencing their symptoms: a single-center survey.

OBJECTIVE: To explore the main reasons that perimenopausal and postmenopausal women have for seeking treatment and factors influencing their symptoms in order to provide (peri-) menopausal women with better healthcare treatments. MATERIALS AND METHODS: Interviews were conducted with 357 (peri-) menopausal women who sought outpatient treatment at The Sixth People's Hospital, Shanghai Jiaotong University from July 1, 2010 to March 31, 2012. The survey includes general questions and an evaluation of (peri-) menopausal symptoms using the modified Kupperman index score. RESULTS: The average age of the women who took part in the study was 51.47 years old (standard deviation = 5.18). Of the women, 47.6% were perimenopausal, 34.7% were early postmenopausal, and 17.7% were late postmenopausal. The age of natural menopause was between 39 and 56 years, and the average natural menopause age was 49.3 years (standard deviation = 4.0). The incidence of (peri-) menopausal symptoms was 91%. Age, education level, and chronic diseases were associated with menopausal symptoms. The main reasons for seeking treatment were hot flushes, insomnia, bone and joint pains, mood swings, and palpitations. CONCLUSIONS: The main reasons for Chinese (peri-) menopausal women seeking treatment were hot flushes, insomnia, bone and joint pains, mood swings, and palpitations; age, education level, and chronic diseases are the main factors that influencing the (peri-) menopausal symptoms.

Innate immunity drives xenobiotic-induced murine autoimmune cholangitis.

Although primary biliary cirrhosis (PBC) is considered a model autoimmune disease, it has not responded therapeutically to traditional immunosuppressive agents. In addition, PBC may recur following liver transplantation, despite the absence of major histocompatibility complex (MHC) matching, in sharp contrast to the well-known paradigm of MHC restriction. We have suggested previously that invariant natural killer T (iNK T) cells are critical to the initiation of PBC. In this study we have taken advantage of our ability to induce autoimmune cholangitis with 2-octynoic acid, a common component of cosmetics, conjugated to bovine serum albumin (2-OA-BSA), and studied the natural history of pathology in mice genetically deleted for CD4 or CD8 following immunization with 2-OA-BSA in the presence or absence of α-galactosylceramide (α-GalCer). In particular, we address whether autoimmune cholangitis can be induced in the absence of traditional CD4 and CD8 responses. We report herein that CD4 and CD8 knock-out mice immunized with 2-OA-BSA/PBS or 2-OA-BSA/α-GalCer develop anti-mitochondrial antibodies (AMAs), portal infiltrates and fibrosis. Indeed, our data suggest that the innate immunity is critical for immunopathology and that the pathology is exacerbated in the presence of α-GalCer. In conclusion, these data provide not only an explanation for the recurrence of PBC following liver transplantation in the absence of MHC compatibility, but also suggest that effective therapies for PBC must include blocking of both innate and adaptive pathways.

The structure of the symptoms of major depression: exploratory and confirmatory factor analysis in depressed Han Chinese women.

BACKGROUND: The symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome? METHOD: Symptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples. RESULTS: The preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety. CONCLUSIONS: MD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome.