The combined effect of non-alcoholic fatty liver disease and metabolic syndrome on colorectal carcinoma mortality: a retrospective in Chinese females.

BACKGROUND: This research aimed to investigate whether metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD) had both individual and synergistic effects on the prognosis for female colorectal carcinoma (CRC) patients. METHODS: The relationship between CRC prognosis and NAFLD as well as MetS was evaluated in 764 female participants. Based on the NAFLD level, patients were divided into significant NAFLD (SNAFLD), "moderate" and "severe" level, and non-SNAFLD, "non" and "mild" level. All the patients were categorized into four subgroups according to the status of SNAFLD and MetS and then a comparison of CRC prognosis among those four groups was performed. RESULTS: NAFLD, SNAFLD, and MetS were independent factors for CRC-specific mortality with the adjustment of age and other confounders. The hazard ratio (HR) of CRC-specific mortality in MetS (+) SNAFLD (+) group was significantly higher than that in other three groups. Relative excess risk of interaction (RERI) was 2.203 with 95% CI ranged from 0.197 to 4.210, attributable proportion (AP) was 0.444 with range from 0.222 to 0.667, and synergy index (SI) of 2.256 with 95% CI from 1.252 to 4.065, indicating SNAFLD and MetS had a significant synergic effect on CRC-specific mortality. CONCLUSIONS: SNAFLD and MetS are independent risk factors for CRC-specific mortality in females. Moreover, those two diseases have a synergistic effect on promoting CRC-specific mortality.

Guidelines and treatment patterns for primary rhegmatogenous retinal detachments: Expert consensus and survey in Taiwan Retina Society.

Rhegmatogenous retinal detachment (RRD) is a significant cause of vision loss and requires appropriate surgical intervention. There are several approaches available, including observation, laser demarcation, pneumatic retinopexy, scleral buckling, and pars plana vitrectomy, which are chosen based on patient condition, surgeon experience, and national health insurance policies. Despite the various options, there is still no consensus on the optimal intervention. To address this, the Taiwan Retina Society assembled an expert committee with 11 experienced retina specialists to review the current evidence and develop a guideline with seven recommendations for managing RRD patients. Additionally, a survey was conducted with six questions to assess treatment patterns in Taiwan, which included input from the expert committee and an open poll at the 2023 Congress of the Taiwan Retina Society. This report provides a comprehensive summary of the current knowledge and expert consensus on the treatment of RRD, discussing the characteristics of current approaches and providing an overview of current treatment patterns in Taiwan. These findings aim to provide ophthalmologists with the best possible treatment for RRD.

[Effects of intraperitoneal injection of marrow mesenchymal stem cells on intestinal barrier in acute pancreatitis].

OBJECTIVE: To explore the effects of intraperitoneal injection of mesenchymal stem cells (MSC) on intestinal barrier in serve acute pancreatitis (SAP) rats. METHODS: MSC were harvested and cultured from femurs of one male SD rat. And 30 female SD rats were divided into 3 groups: control group (n = 6), SAP group (n = 12) and MSC transplantation group (n = 12). SAP was induced by intraperitoneal injection of L-arginine (2 g/kg) twice in SAP and MSC groups. In MSC group, the third-generation MSC (5×10(6)) were injected intraperitoneally once daily for 3 days. All rats were sacrificed after 72 h. The histomorphologic alternations of small intestine were measured to evaluate the therapeutic effect of MSC transplantation. Reverse transcription (RT)-PCR were used to identify the expression of TNF-α mRNA and IL-1ß mRNA in small intestine and pancreas. Small intestine and pancreatic samples were examined for the engraftment of donor-derived MSC by Y chromosome in situ hybridization analysis. RESULTS: Compared with SAP group, histomorphologic alternations of small intestine significantly lower in MSC group (4.17 ± 0.28 vs 3.00 ± 0.33, P < 0.05). The relative expression quantity of TNF-α mRNA and IL-1ß mRNA in pancreas were both significant higher in SAP and MSC groups than those in control group (3.10 ± 0.73 and 1.92 ± 0.37 vs 0.51 ± 0.24, 4.60 ± 0.59 and 2.43 ± 0.39 vs 1.15 ± 0.18, all P < 0.05). Compared with SAP group, the expression quantity of TNF-α mRNA and IL-1ß mRNA in pancreas significantly lower in MSC group (both P < 0.05). The relative expression quantity of TNF-α mRNA and IL-1ß mRNA in small intestine were both significant higher in SAP and MSC groups than those in control group (2.73 ± 0.91 and 1.55 ± 0.48 vs 0.62 ± 0.20, 5.20 ± 0.94 and 2.10 ± 0.34 vs 0.99 ± 0.10, all P < 0.05). The expressions of TNF-α mRNA and IL-1ß mRNA in MSC group were lower than those in SAP group (both P < 0.05). Sry gene was not detected in pancreatic and intestinal tissue of MSC-treated rats. CONCLUSIONS: Syngraft MSC exert protective effects on pancreas and small intestine injury. And their beneficial effects are primarily mediated via indirect actions but not by their differentiation into target cells.

Visual change as the presenting symptom of a suspected metastatic brain lesion in esophageal cancer: A case report.

INTRODUCTION: Esophageal cancer is the seventh most common malignancy worldwide and the sixth leading cause of cancer mortality with an overall survival rate of <20%. Esophageal cancer frequently metastasizes to distant lymph nodes, lungs, liver, and bones. Cerebral metastases originating from esophageal cancer are rare and often carry a poor prognosis as do most all metastatic lesions in esophageal cancer. CASE PRESENTATION: In this report, we describe a 55-year-old patient with past history of esophageal carcinoma who presented with blurred vision after taking ethambutol for tuberculosis. Ethambutol-induced optic neuropathy was the lead diagnosis. Initial vision testing was normal so additional testing with visual field examination was warranted. The visual field examination revealed homonymous hemianopsia. Subsequent magnetic resonance imaging of his brain, demonstrated a focal lesion, consistent with but not diagnostic of a brain metastasis likely from his primary esophageal malignancy. CONCLUSION: We conclude that a careful review of the medical history and comprehensive assessment are essential in establishing an obscure clinical diagnosis especially in the event that an uncommon metastatic lesion is encountered.

Clinical features of macular telangiectasia type 2 and comparison of staging system in Taiwanese patients.

PURPOSE: The purpose of this study is to report the clinical characteristics of macular telangiectasia type 2 (MacTel 2) in Taiwan. MATERIALS AND METHODS: Retrospective analysis of patients diagnosed with MacTel 2 over a 7-year period in Changhua Christian Hospital. Best-corrected visual acuity (BCVA), fundus photography, fluorescein angiography, optical coherence tomography (OCT), and OCT angiography (OCTA) images were reviewed. Differences in BCVA and central macular thickness (CMT) were compared between the initial/baseline and final visits. The staging was performed according to the Gass and Blodi classification and OCTA. RESULTS: There were 38 eyes in 19 patients were collected (Male: Female = 5:14). The mean age at diagnosis was 65.90 ± 8.26 years and the follow-up duration was 39.26 ± 28.31 months. All patients had both eyes affected, and eight of the 19 patients had a history of diabetes mellitus (DM). The mean initial logarithm of the minimum angle of resolution (logMAR) BCVA was 0.40 ± 0.31 and the mean final logMAR BCVA was 0.61 ± 0.53. Difference of BCVA equal or more than two lines between both eyes was noted in 63.1% (12 of 19) of patients at the initial visit and in 78.9% (15 of 19) of patients at the final follow-up. The mean CMT was 224.42 ± 38.50 µm at baseline and 222.05 ± 40.27 µm at the final visit. OCT illustrated macular hole in three eyes of three patients. At the final follow-up, retinal-choroidal anastomosis was noted in 17 eyes. Subretinal neovascularization (SRNV) was not present in any eye. CONCLUSION: Bilateral involvement, asymmetrical BCVA in both eyes, low incidence of SRNV, and high prevalence of DM were characteristics of patients of MacTel 2 in Taiwan.

Modified early intensive and treat-and-extend regimen of anti-vascular endothelial growth factor for diabetic macular edema in Taiwan.

Given the rising prevalence of patients with diabetes and increasing treatment burden for patients with vision-threatening diabetic macular edema (DME), we aimed to explore the efficacy of modified early intensive and treat-and-extend regimen of anti-vascular endothelial growth factor (VEGF) therapy under the Taiwan National Insurance Bureau reimbursement policy. We obtained data on 69 eyes treated with initial 4-monthly intravitreal injections of aflibercept or ranibizumab, plus individualized treat-and-extend regimen. At 12 months, the mean (SD) change in LogMAR best corrected visual acuity from baseline was - 0.28 (0.31) in all eyes, while that in the aflibercept and ranibizumab groups were - 0.30 (0.34) and - 0.25 (0.28), respectively. Central retinal thickness decreased by 137.2 (122.4) in all eyes, 138.1 (134.2) in the aflibercept group, and 136.2 (110.9) in the ranibizumab group. Additionally, the aflibercept group had a lower mean number of injections than the ranibizumab group (8.5 vs. 8.7). The last extended dosing interval of > 12 weeks was 31.0% and 16.7% of the eyes in the aflibercept and ranibizumab groups, respectively. The modified anti-VEGF regimens effectively managed DME in terms of functional and anatomical outcomes, and efficiently reduced the healthcare burden by reducing the number of injections and extending treatment intervals within 12 months.

[Analysis of Carbon Emissions and Influencing Factors in China Based on City Scale].

Assessing regional carbon emissions and their relationship with socio-economic conditions is very important for developing strategies for carbon emission reduction. This study explored the impact of the proportion of non-fossil energy, the land development degree, the urbanization rate of permanent residents, the proportion of secondary industry, per capita GDP, and per capita construction land area on per capita CO2 emissions in 339 prefecture-level and above cities in China (excluding some cities in Xinjiang, Hong Kong, Macao, and Taiwan). A Bayesian belief network modeling carbon emissions was constructed to identify the global effects of various factors on per capita CO2 emissions, and multiscale geographically weighted regression was used to analyze their local effects. The results showed that first, per capita CO2 emissions of cities in China increased from the south to the north and decreased from the eastern coast to the inland region. Second, globally, the sensitivity of per capita CO2 emissions to various factors from high to low was in the order of per capita construction land area>per capita GDP>urbanization rate of permanent residents>land development degree>proportion of secondary industry>proportion of non-fossil energy. Third, locally, the direction of the spatial relationship between each factor and per capita CO2 emissions was consistent with the global relationship, and there was spatial heterogeneity in the strength of the relationship. Finally, clean energy, decarbonization technologies, saving and intensive use of land, and green living were effective ways to achieve the dual-carbon goal.

[Sludge Biochar Modified by B-doped and Its Adsorption Behavior and Mechanism of 1,2-DCA in Water].

Sludge biochar (BC600) and B-doped sludge biochar (BBC600) were prepared with the boric acid doping modified co-pyrolysis method using municipal sludge as precursors, and the materials were structurally characterized by SEM, BET, FTIR, and Zeta potential and static contact angle to investigate the adsorption behavior, mechanism of BC600 and BBC600 on 1,2-DCA in water, and the influencing factors. The results of structural characterization showed that the B element content, specific surface area, and pore volume of biochar increased by 76%, 48%, and 30%, respectively, after the B doping modification; the effect of B doping modification on the surface charge and hydrophobicity of biochar was not significant. The results of adsorption experiments showed that the adsorption of 1,2-DCA by BBC600 was better than that by BC600 due to the larger specific surface area and higher strength of oxygen-containing functional groups of BBC600; the pseudo-first-order kinetic equation could better describe the adsorption of 1,2-DCA by BC600, and the pseudo-second-order kinetic equation could better fit the adsorption of 1,2-DCA by BBC600. The intraparticle diffusion was not the only rate-limiting step affecting the adsorption rate; the biochar material was more dispersed and stable under alkaline conditions, and its oxygen-containing functional groups were deprotonated and had enhanced electron-donating ability, which was beneficial to the adsorption of 1,2-DCA. Humic acid (HA) showed a low concentration-promoting and high concentration-inhibiting effect on the adsorption of 1,2-DCA by BC600, whereas both low and high concentrations of HA showed an inhibitory effect on the adsorption of 1,2-DCA by BBC600. The adsorption of 1,2-DCA by BC600 was inhibited by both low and high concentrations of HA, and HA competed with 1,2-DCA for adsorption; Cl-, SO42-, and NO3- all inhibited the adsorption of 1,2-DCA by biochar, and the degree of inhibition ordered from small to large was Cl-

Caveolin-1, E-cadherin and ß-catenin in Gastric Carcinoma, Precancerous Tissues and Chronic Non-atrophic Gastritis.

OBJECTIVE: To investigate the expressions of caveolin-1, E-cadherin and ß-catenin in gastric carcinoma, precancerous gastric and chronic non-atrophic gastritis tissues, and evaluate the correlation of these expressions with the development of gastric cancer. METHODS: The expressions of caveolin-1, E-cadherin and ß-catenin were detected by biotin-streptavidin- peroxidase (SP) immunohistochemistry on 58 gastric cancer tissues, 40 precancerous gastric tissues and 42 chronic non-atrophic gastritis tissues. The correlation between the expressions of caveolin-1, E-cadherin and ß-catenin, and the clinicopathologic parameters of gastric cancer was analyzed retrospectively. RESULTS: The positive rates of caveolin-1 and E-cadherin expressions in gastric carcinoma were significantly lower than precancerous gastric and chronic non-atrophic gastritis tissues (P<0.01). An abnormal rate of ß-catenin expression in gastric carcinoma was higher than precancerous gastric and chronic non-atrophic gastritis tissues (P<0.01). Moreover, low expressions of caveolin-1, E-cadherin and ß-catenin correlated with tumor size, depth of invasion, lymph node metastasis and TNM stage (P<0.05). The positive rates of caveolin-1 and E-cadherin expressions decreased (P<0.01), while an abnormal rate of ß-catenin expression increased inversely, with the degree of atypical hyperplasia (P<0.01). Caveolin-1 expression correlated positively with E-cadherin (r=0.41, P<0.05). Caveolin-1 (r=-0.36, P<0.05) and E-cadherin (r=-0.45, P<0.05) expressions negatively correlated with abnormal ß-catenin expression. CONCLUSION: These results suggested that dysregulated expressions of caveolin-1, E-cadherin and ß-catenin correlated with the development of gastric cancer and its biological behavior.

Age, alcohol, sex, and metabolic factors as risk factors for colonic diverticulosis.

BACKGROUND: The pathogenesis of colonic diverticulosis is not well understood. Moreover, only a few studies on colonic diverticulosis have been reported in mainland China. AIM: To evaluate the prevalence of and risk factors for asymptomatic colorectal diverticulosis in Eastern China. METHODS: From August 2016 to July 2020, 6180 asymptomatic individuals were enrolled in this cross-sectional study. These individuals had undergone physical examinations, laboratory testing, and colonoscopy. Data regarding the baseline characteristics and their general health status were obtained through interviews. RESULTS: The prevalence of colonic diverticulosis was 7.3% (449/6180). Colonic diverticulosis was detected predominantly on the right side of the colon (88.4%). Logistic regression analysis revealed that an age ≥ 60 years (adjusted odds ratio [OR] 2.149, 95% confidence interval [CI] 1.511-3.057, P < 0.001), male sex (adjusted OR: 1.878, 95%CI: 1.373-2.568, P < 0.001), obesity (adjusted OR: 1.446, 95%CI: 1.100-1.902, P = 0.008), alcohol intake (adjusted OR: 1.518, 95%CI: 1.213-1.901, P < 0.001), hypertension (adjusted OR: 1.454, 95%CI: 1.181-1.789, P < 0.001), hypertriglyceridemia (adjusted OR: 1.287, 95%CI: 1.032-1.607, P = 0.025), and hyperuricemia (adjusted OR: 1.570, 95%CI: 1.257-1.961, P < 0.001) significantly increased the risk of colonic diverticulosis. CONCLUSION: Advanced age, male sex, alcohol intake, obesity, and other metabolic-related factors, such as hypertension, hypertriglyceridemia, and hyperuricemia, were independent risk factors for colonic diverticulosis. Understanding the true prevalence of colonic diverticulosis and its associated risk factors will aid in its prevention and treatment.

CMV Retinitis with Panretinal Occlusive Vasculitis.

PURPOSE: To report the clinical features of cytomegalovirus (CMV) retinitis with panretinal occlusive vasculitis. METHODS: Retrospective case series. RESULTS: Four eyes in 3 non-HIV patients (male: female = 3:0) were included. Previous medical history included diabetes mellitus (n = 2), age-related macular degeneration (n = 1), and Multiple myeloma under chemotherapy (n = 1). All patients were treated with oral valganciclovir and intravitreal ganciclovir. Slow resolution of retinitis related retinal opacification was noted in all 4 eyes. Two eyes had anti-viral agents discontinued despite the persistent retinitis related opacification and the lesions slowly resolved in the following months. The final decimal visual acuity was equal to or worse than 0.02 in 3 of the 4 eyes. CONCLUSION: In eyes of CMV retinitis with panretinal occlusive vasculitis, rapid resolution of retinitis lesions is an unreliable sign evaluating the therapeutic efficacy of anti-viral agents. Besides, despite treatment of anti-viral agents, deteriorating vascular occlusion may further endanger macular function.

[Constructing an ecological security pattern in Shenzhen, China, by matching the supply and demand of ecosystem services]. / åŸºäºŽç”Ÿæ€ç³»ç»ŸæœåŠ¡ä¾›éœ€åŒ¹é çš„æ·±åœ³å¸‚ç”Ÿæ€å®‰å ¨æ ¼å±€æž„å»º.

Constructing an ecological security pattern by matching the supply and demand of ecosystem services is of great significance for Shenzhen, China. To determine the strategic positioning of sustainable development pioneers and benchmarks for human well-being in a pilot demonstration area of socialism with Chinese characteristics, we selected water yield, carbon sequestration, and recreational services to identifiy the integrated supply and demand status of ecosystem services in Shenzhen using the InVEST model, ecological supply-demand ratio, cell phone signalling data analysis, and circuit theory. An ecological security pattern based on the matching of supply and demand of ecosystem services was constructed. We further examined the impacts of different delimitation boundaries on the area and number of ecological sources. The results showed that the comprehensive ecological supply-demand ratio in Shenzhen generally showed a distribution pattern of abundant in the east and scarce in the west. Among them, water yield services met the demand in terms of quantity and spatial distribution, but carbon sequestration services can not. Recreational services met the demand in terms of quantity, but their spatial distribution was extremely uneven. We identified 25 ecological sources covering a total area of 347.62 km2 and 34 ecological corridors with a total length of 346.06 km. The ecological source area was large in the east and small in the west, while the length of the corridors showed the opposite distribution pattern. Different delineation boundaries had different effects on the area and number of ecological sources. Primary, secondary, and tertiary ecological source areas cover 347.62, 520.84, and 557.58 km2, respectively, showing a gradual increasing trend, the numbers of ecological sources were 25, 35, and 32, showing an increasing then decreasing trend. In Shenzhen, there were important ecological patches that were not included in the ecological control line, and some patches within the ecological control line had poor ecological sustainability. Targeted protection and management policies could be formulated based on such pattern. The results could provide spatial guidance for the delimitation of ecological management and control units in Shenzhen.

Diabetic macular edema and proliferative diabetic retinopathy treated with anti-vascular endothelial growth factor under the reimbursement policy in Taiwan.

The purpose of this retrospective interventional case series is to compare the functional and anatomical outcomes in eyes with diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) treated intravitreally with aflibercept or ranibizumab under the Taiwan National Insurance Bureau reimbursement policy. 84 eyes were collected and all eyes were imaged with spectral-domain optical coherence tomography (SD-OCT), color fundus photographs (CFPs), and fluorescein angiography (FA). At 24 months after therapy initiation, the logMAR BCVA improved from 0.58 ± 0.33 to 0.47 ± 0.38 (p < 0.01), the CRT decreased from 423.92 ± 135.84 to 316.36 ± 90.02 (p < 0.01), and the number of microaneurysms decreased from 142.14 ± 57.23 to 75.32 ± 43.86 (p < 0.01). The mean injection count was 11.74 ± 5.44. There was no intergroup difference in logMAR BCVA (p = 0.96), CRT (p = 0.69), or injection count (p = 0.81). However, the mean number of microaneurysms was marginally reduced (p = 0.06) in eyes treated with aflibercept at the end of the follow-up, and the incidence rates of supplementary panretinal photocoagulation (PRP) (p = 0.04) and subthreshold micropulse laser (SMPL) therapy sessions (p = 0.01) were also reduced. Multivariate analysis revealed that only initial logMAR BCVA influenced the final VA improvements (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.21 ~ 0.93, p < 0.01); in contrast, age (OR - 0.38, 95% CI - 6.97 ~ - 1.85, p < 0.01) and initial CRT (OR 0.56, 95% CI 0.34 ~ 0.84, p < 0.01) both influenced the final CRT reduction at 24 months. To sum up, both aflibercept and ranibizumab are effective in managing DME with PDR in terms of VA, CRT and MA count. Eyes receiving aflibercept required less supplementary PRP and SMPL treatment than those receiving ranibizumab. The initial VA influenced the final VA improvements at 24 months, while age and initial CRT were prognostic predictors of 24-month CRT reduction.

Stack pattern of the countercation-modulating magnetic property of low-dimensional [Pt(mnt)2]⁻ monoanion spin systems.

Three [1-N-(4'-R-benzyl)-4-aminopyridinium][Pt(mnt)(2)] compounds were structurally and magnetically characterized, where the substituent was attached to the para-position of the phenyl ring (R = CN (1), Cl (2), and H (3); mnt(2-) = maleonitriledithiolate). 1 and 2 crystallized in the monoclinic space group P2(1)/c, with the cations and anions forming segregated columnar stacks. Their structural differences involved two aspects: (1) both anion and cation stacks were regular in 1 and irregular in 2; (2) the neighboring cations were arranged in the boat-type pattern in 1, whereas these cations were in the chair-type pattern in 2 within the cation stack. 3 belonged to the triclinic space group P ̅1, where the anions were assembled into the stack with a tetrameric [Pt(mnt)(2)](-) subunit, but the cations did not form the columnar stack. Magnetic measurements disclosed that a spin-Peierls-type transition occurred around 240 K for 1, whereas a long-range, antiferromagnetic ordering took place at about 5.8 K, and a metamagnetic phenomenon was observed with H(C) ≈ 1000 Oe for 2; 3 showed very strong antiferromagnetic interactions with diamagnetism in the temperature range 5-300 K. Combined with our previous studies, the correlation between the stacking pattern of benzylpyridinium derivatives in a cation stack and the spin-Peierls-type transition is discussed for the series of quasi-1-D [M(mnt)(2)](-) (M = Ni, Pd and Pt) compounds.

Influence of systemic steroids on subretinal fluid after scleral buckle surgery for macula-off retinal detachment.

PURPOSE: To investigate the effect of postoperative systemic steroid therapy on the incidence and duration of the subretinal fluid (SRF) and its correlation with the visual outcome after scleral buckle surgery for macula-off rhegmatogenous retinal detachment. METHODS: Prospective interventional study of sixty patients with macula-off rhegmatogenous retinal detachment who undertook scleral buckle surgery. Those patients who had recurrent retinal detachment, proliferative preretinal membrane, or primary surgical failure were excluded. Patients were assigned to Group 1 (with prescription of oral prednisolone for 3 days postoperatively) and Group 2 (with no such prescription).Furthermore, patients in Group 1 were subdivided into Group 1A (0.5 mg prednisolone/kg)and Group 1B (1 mg prednisolone/kg) according to the dosage of prednisolone. Patients were followed-up initially 1 week and 2 weeks after surgery and then on a monthly basis for at least 1 year. After the operation, all patients had corrected visual acuity and also received examinations of indirect ophthalmoscopy and optical coherence tomography. We compared the incidence, duration of SRF, and the correlation with the visual outcome between the groups. RESULTS: Lower incidence of SRF was noted in Group 1 than in Group 2 (56.7% vs. 80%;P = 0.052), and the duration of SRF was significantly shorter in Group 1 than in Group 2 (218 days vs. 286 days; P = 0.039). There was no significant difference in the final BCVA between the two groups. However, patients in Group 1 had greater improvements of BCVA 1 year after operation (13 lines vs. 7 lines in Groups 1 and 2, respectively; P = 0.026). Statistically,there were no difference between Groups 1A and 1B, in terms of the incidence of SRF,duration of SRF, final BCVA, and improvement of BCVA. CONCLUSION: Postoperative systemic steroid treatment may decrease the incidence of SRF and facilitate the absorption of SRF. Patients treated with steroids had greater improvement of BCVA.

Predicting Conversion from MCI to AD Combining Multi-Modality Data and Based on Molecular Subtype.

Alzheimer's disease (AD) is a neurodegenerative brain disease in the elderly. Identifying patients with mild cognitive impairment (MCI) who are more likely to progress to AD is a key step in AD prevention. Recent studies have shown that AD is a heterogeneous disease. In this study, we propose a subtyping-based prediction strategy to predict the conversion from MCI to AD in three years according to MCI patient subtypes. Structural magnetic resonance imaging (sMRI) data and multi-omics data, including genotype data and gene expression profiling derived from peripheral blood samples, from 125 MCI patients were used in the Alzheimer's Disease Neuroimaging Initiative (ADNI)-1 dataset and from 98 MCI patients in the ADNI-GO/2 dataset. A variational Bayes approximation model based on the multiple kernel learning method was constructed to predict whether an MCI patient will progress to AD within three years. In internal fivefold cross-validation within ADNI-1, we achieved an overall AUC of 0.83 (79.20% accuracy, 81.25% sensitivity, 77.92% specificity) compared to the model without subtyping, which achieved an AUC of 0.78 (76.00% accuracy, 77.08% sensitivity, 75.32% specificity). In external validation using ADNI-1 as a training set and ADNI-GO/2 as an independent test set, we attained an AUC of 0.78 (74.49% accuracy, 74.19% sensitivity, 74.63% specificity). Identifying MCI patient subtypes with omics data would improve the accuracy of predicting the conversion from MCI to AD. In addition to evaluating statistics, obtaining the significant sMRI, single nucleotide polymorphism (SNP) and mRNA expression data from peripheral blood of MCI patients is noninvasive and cost-effective for predicting conversion from MCI to AD.

[The expression of melatonin MT1 receptor in acute necrotizing pancreatitis rats and the protective effects of melatonin].

OBJECTIVE: To investigate the expression of melatonin MT1 receptor in rats with acute necrotizing pancreatitis (ANP) and the protective effects of melatonin (MT) pre-intervention for the pancreas. METHODS: Fifty-four male Sprague-Dawley (SD) rats were randomly divided into three groups: sham-operation group, ANP group and MT-pretreated group. The models of ANP were induced by retrograde injection sodium taurocholate into the bili-pancreatic duct. MT group undergoing intraperitoneal injection 50 mg/kg 30 minutes before the establishment of ANP models. Four, 8 and 12 hours after the onset of operation, the levels of serum amylase and pathological changes of the pancreas were observed. The contents of malondialdehyde (MDA), superoxide dismutase (SOD) and tumor necrosis factor-alpha (TNFα) in the pancreas were measured. The expression of MT1 protein and MT1 mRNA in pancreas were separately analyzed by immunohistochemistry and real-time PCR. RESULTS: (1) Pancreatic pathological damage in ANP groups was progressive exacerbated. It was obviously ameliorated in MT group as compared with ANP group (P < 0.05); (2) Compared with SO group, the levels of serum amylase, MDA and TNFα in the pancreas were significantly increased in ANP group (P < 0.05 or P < 0.01). They were markedly decreased in MT group as compared with ANP group [12 h, (2348.00 ± 278.90) U/L vs (3194.83 ± 538.10) U/L, (2.255 ± 0.472) µmol/L vs (2.960 ± 0.722) µmol/L, (102.929 ± 29.399) ng/L vs (378.544 ± 183.454) ng/L, P < 0.05]. The level of SOD was decreased in ANP group compared with SO group (P < 0.05) and increased in MT group [12 h, (11.448 ± 1.594) U/L vs (8.427 ± 1.950) U/L, P < 0.05]; (3) Compared with SO group, the expression of MT1 protein and MT1 mRNA in ANP group were down-regulated as the severity of the disease increased (P < 0.05). They were significantly higher in MT group than ANP group. CONCLUSIONS: Melatonin pre-intervention is able to increase SOD level and decrease MDA, TNFα levels, thereby reducing pancreatic injury. The MT1 might play an important role in the pathogenesis of ANP. MT might exert protective effects for the pancreas in ANP rats through increase the expression of MT1.

Clinicomicrobiological profile, visual outcome and mortality of culture-proven endogenous endophthalmitis in Taiwan.

This is a retrospective study in consecutive cases with cultured-proven endogenous endophthalmitis (EE) treated at the largest tertiary medical center in middle Taiwan in the past 10 years. 83 eyes of 70 patients were enrolled. The mean interval between systemic diseases to the diagnosis of EE was 8.84 ± 6.94 days. The mean initial visual acuity (VA) in the logarithm of minimal angle of resolution (logMAR) was 1.63 ± 0.87. Type 2 diabetes mellitus was the most common predisposing medical illness (N = 53, 63.86%). The most common infectious sources were intra-abdominal abscess (N = 36, 43.37%), and the second most reason was urinary tract infection. The causative pathogen was Gram-negative predominant (N = 64, 77.11%). After aggressive treatment, 34.94% of eyes regain useful vision, and only six eyes underwent enucleation or evisceration. The binary multivariate logistic regression model revealed that female gender (95% CI 1.002-19.036, p = 0.05, OR 4.37), initial VA logMAR (95% CI 0.089-0.550, p = 0.01, OR 0.22), and more intravitreal injections (95% CI 0.368-0.927, p = 0.023, OR 0.58) were independent risk factors influencing final outcomes. Based on the results mentioned above, early diagnosis is recommended to gain better outcomes. The mean interval between systemic diseases to the diagnosis of EE was 8.84 ± 6.94 days in our sample population, clinicians should maintain a higher index of suspicion during this period when encountering patients with bacteremia or fungemia.

Helicobacter pylori infection with atrophic gastritis: An independent risk factor for colorectal adenomas.

BACKGROUND: The significance of Helicobacter pylori (H. pylori) infection and atrophic gastritis (AG) in the prevalence of colorectal adenomas has been examined in a limited number of studies. However, these studies reported disputed conclusions. AIM: To investigate whether H. pylori infection, AG, and H. pylori-related AG increase the risk of colorectal adenomas. METHODS: This retrospective cross-sectional study included 6018 health-check individuals. The relevant data for physical examination, laboratory testing, 13C-urea breath testing, gastroscopy, colonoscopy and histopathological examination of gastric and colorectal biopsies were recorded. Univariate and multivariate logistic regression analyses were performed to determine the association between H. pylori-related AG and colorectal adenomas. RESULTS: Overall, 1012 subjects (16.8%) were diagnosed with colorectal adenomas, of whom 143 (2.4%) had advanced adenomas. Among the enrolled patients, the prevalence of H. pylori infection and AG was observed as 49.5% (2981/6018) and 10.0% (602/6018), respectively. Subjects with H. pylori infection had an elevated risk of colorectal adenomas (adjusted odds ratio [OR] of 1.220, 95% confidence interval (CI): 1.053-1.413, P = 0.008) but no increased risk of advance adenomas (adjusted OR = 1.303, 95%CI: 0.922-1.842, P = 0.134). AG was significantly correlated to an increased risk of colorectal adenomas (unadjusted OR = 1.668, 95%CI: 1.352-2.059, P < 0.001; adjusted OR = 1.237, 95%CI: 0.988-1.549, P = 0.064). H. pylori infection accompanied by AG was significantly associated with an increased risk of adenomas (adjusted OR = 1.491, 95%CI: 1.103-2.015, P = 0.009) and advanced adenomas (adjusted OR = 1.910, 95%CI: 1.022-3.572, P = 0.043). CONCLUSION: H. pylori-related AG was associated with a high risk of colorectal adenomas and advanced adenomas in Chinese individuals.

Optical Coherence Tomography Angiography for Diagnosis of Choroidal Neovascularization in Chronic Central Serous Chorioretinopathy after Photodynamic Therapy.

The authors evaluated the proportion of choroidal neovascularization (CNV) detected by spectral-domain optical coherence tomography angiography (OCTA) in eyes with chronic central serous chorioretinopathy (CSC) (more than 3 months) with previous treatment via half-dose photodynamic therapy (PDT). All patients were followed up with at least twelve months. Macular angiograms were obtained using spectral-domain OCT (SD-OCT, RTVue XR; Optovue). CNV was defined as flow in the outer retinal slab between the outer plexiform layer and Bruch's membrane. Clinical characteristics were compared between CNV and non-CNV groups. Seventy eyes of 61 patients (51 male and 10 female) were included. The average age was 46.2 years old. The average duration of symptom was 32.9 months. All patients were treated with half-dose PDT initially. Eleven eyes (15.7%) received more than one session of PDT. CNV was diagnosed in 32 of 70 eyes (45.7%) based on OCTA. Only 6 of the 32 eyes (18.8%) needed intravitreal anti- vascular endothelial growth factor (VEGF) therapy for the exudative activity of CNV. Older age (p = 0.059), larger PDT spot size (p = 0.024), and thinner subfoveal choroidal thickness (p = 0.008) were noted in CNV group. The authors conclude that OCTA reveals high rates of CNV associated with chronic CSC after PDT. Patients in the CNV group had older age, larger PDT spot size, and thinner subfoveal choroidal thickness. OCTA may be considered as a first step in identifying CNV in chronic CSC following PDT.