A Nomogram for Predicting Cancer-Specific Survival in Young Patients With Advanced Lung Cancer Based on Competing Risk Model.

BACKGROUND: Young lung cancer is a rare subgroup accounting for 5% of lung cancer. The aim of this study was to compare the causes of death (COD) among lung cancer patients of different age groups and construct a nomogram to predict cancer-specific survival (CSS) in young patients with advanced stage. METHODS: Lung cancer patients diagnosed between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and stratified into the young (18-45 years) and old (> 45 years) groups to compare their COD. Young patients diagnosed with advanced stage (IVa and IVb) from 2010 to 2015 were reselected and divided into training and validation cohorts (7:3). Independent prognostic factors were identified through the Fine-Gray's test and further integrated to the competing risk model. The area under the receiver operating characteristic curve (AUC), consistency index (C-index), and calibration curve were applied for validation. RESULTS: The proportion of cancer-specific death (CSD) in young patients was higher than that in old patients with early-stage lung cancer (p < 0.001), while there was no difference in the advanced stage (p = 0.999). Through univariate and multivariate analysis, 10 variables were identified as independent prognostic factors for CSS. The AUC of the 1-, 3-, and 5-year prediction of CSS was 0.688, 0.706, and 0.791 in the training cohort and 0.747, 0.752, and 0.719 in the validation cohort. The calibration curves demonstrated great accuracy. The C-index of the competing risk model was 0.692 (95% CI: 0.636-0.747) in the young patient cohort. CONCLUSION: Young lung cancer is a distinct entity with a different spectrum of competing risk events. The construction of our nomogram can provide new insights into the management of young patients with lung cancer.

Genome-Wide Association Study of Egg-Laying Traits and Egg Quality in LingKun Chickens.

Egg production is the most important trait of laying hens. To identify molecular markers and candidate genes associated with egg production and quality, such as body weight at first oviposition (BWF), the number of eggs produced in 500 days (EN500), egg weight (EW), egg shell thickness (EST), egg shell strength (ESS), and Haugh unit (HU), a genome-wide analysis was performed in 266 LingKun Chickens. The results showed that thirty-seven single nucleotide polymorphisms (SNPs) were associated with all traits (p < 9.47 × 10-8, Bonferroni correction). These SNPs were located in close proximity to or within the sequence of the thirteen candidate genes, such as Galanin And GMAP Prepropeptide (GAL), Centromere Protein (CENPF), Glypican 2 (GPC2), Phosphatidylethanolamine N-Methyltransferase (PEMT), Transcription Factor AP-2 Delta (TFAP2D), and Carboxypeptidase Q (CPQ) gene related to egg-laying and Solute Carrier Family 5 Member 7 (SLC5A7), Neurocalcin Delta (NCALD), Proteasome 20S Subunit Beta 2 (PSMB2), Slit Guidance Ligand 3 (SLIT3), and Tubulin Tyrosine Ligase Like 7 (TTLL7) genes related to egg quality. Interestingly, one of the genes involved in bone formation (SLIT3) was identified as a candidate gene for ESS. Our candidate genes and SNPs associated with egg-laying traits were significant for molecular breeding of egg-laying traits and egg quality in LingKun chickens.

Ageism, resilience, coping, family support, and quality of life among older people living with HIV/AIDS in Nanning, China.

Although the HIV epidemic continues to spread among older adults over 50 years old in China, little empirical research has investigated the interrelationships among ageism, adaptability, family support, and quality of life among older people living with HIV/AIDS (PLWHAs). In this cross-sectional study, among 197 older PLWHAs over 50 years old, path analytic modelling was used to assess the interrelationships among ageism, resilience, coping, family support, and quality of life. Compared with female PLWHAs, male PLWHAs had a higher level of resilience and coping. There were no significant differences in the scores of quality of life, ageism, family support, HIV knowledge, and duration since HIV diagnosis between males and females. The following relationships were statistically significant in the path analysis: (1) family support → resilience [ß (standardised coefficient) = 0.18], (2) resilience → ageism (ß = -0.29), (3) resilience → coping (ß = 0.48), and (4) coping → quality of life (ß = 0.24). In addition, male PLWHAs were more resilient than female PLWHAs (ß = 0.16). The findings indicate that older PLWHAs do not only negatively accept adversity, but build their adaptability to positively manage the challenges. Family-based interventions need take this adaptability to adversity into consideration.

Bias in Self-Reported Condom Use: Association Between Over-Reported Condom Use and Syphilis in a Three-Site Study in China.

This study examined over-reporting bias in self-reported condom use and assessed its association with syphilis. A survey was conducted among 1245 female sex workers (FSWs) in three cities in China. Respondent's over-reported condom use was defined as reporting no unprotected sex for the past 24 h but testing positive for prostate specific antigen. The proportion of prevalent syphilis and active syphilis was 23 and 10 % respectively among FSWs. The proportion of over-reported condom use with sex clients only was 27-45 % among the three study sites. The proportion of over-reported condom use with all sex partners (clients, husbands, or boyfriends) was 26-46 %. FSWs who had active or prevalent syphilis were more likely to over report condom use. Self-reported condom use may not be a valid tool to measure the efficacy of HIV/STI intervention because the bias is associated with the outcome measure, i.e., syphilis.

Sex and Age Differences in Mortality in Southern China, 2004-2010.

The purpose of this study was to describe the mortality patterns in the southern provinces of China, and to provide epidemiologic data on sex and age differences of death outcomes. Reliable mortality and population data from January 2004 to December 2010 were obtained from 12 Disease Surveillance Point (DSP) sites in four provinces of China. Death data from all causes and respiratory disease, chronic obstructive pulmonary disease (COPD), pneumonia and influenza, circulatory disease, and ischemic heart disease, were stratified by year, month of death occurrence and sex, seven age groups, and summarized by descriptive statistics. The mean annual mortality rates of the selected 12 DSP sites in the southernmost provinces of China were 543.9 (range: 423.9-593.6) deaths per 100,000 population. The death rates show that noted sex differences were higher in the male population for all-cause, COPD and circulatory diseases. Pneumonia and influenza death rates present a different sex- and age-related distribution, with higher rates in male aged 65-74 years; whereas the death rates were opposite in elderly aged ≥75 years, and relatively higher in young children. This study had practical implications for recommending target groups for public health interventions.

[Investigation of a family clustering of human infection with avian influenza A (H7N9) virus in Nanning, Guangxi].

OBJECTIVE: To understand the transmission mode of human infection with avian influenza A (H7N9) virus. METHODS: Field epidemiological investigation was conducted for a family clustering of human infection with H7N9 virus in Hengxian county, Guangxi Zhuang Autonomous Region in February 2014. Two patients and their 82 close contacts were surveyed. The samples collected from the patients, environments and poultry were tested by using real time reverse transcriptase-polymerase chain reaction (rRT-PCR), and the samples from patients were used for virus isolation. The samples from 5 close contacts were tested with RT-PCR. The clinical data, exposure histories of the patients and the detection results of the isolates and their homology were analyzed. RESULTS: Patient A became ill 4 days after her last exposure to poultry in Zhongshan, Guangdong province, and returned to her hometown in Hengxian 2 days after onset. Patient B was patient A's 5 years old son, who had no known exposure to poultry but slept with patient A for 4 days. He developed symptoms 4 days after last contact with his mother. Two strains of H7N9 virus were isolated from the two patients. The 2 isolates were highly homogenous (almost 100%) indicated by gene sequencing and phylogenetic tree. None of the other 81 close contacts developed symptoms of H7N9 virus infection. CONCLUSION: Patients B was infected through close contact with patient A, indicating that avian H7N9 virus can spread from person to person, but the transmissibility is limited and non-sustainable.

Psychological Impacts among Older and Younger People Living with HIV/AIDS in Nanning, China.

Objectives. The HIV epidemic has drastically increased among older adults in China, yet little research has examined the psychological impacts among older and younger people living with HIV/AIDS (PLWHAs). This study examined and compared self-efficacy, depression, well-being, and quality of life among older and younger PLWHAs in China. Method. A two-stage sampling procedure was used to recruit a final sample of 148 participants. Older adults were defined as age 50 and older. Result. Compared to younger PLWHAs aged 18-49 years old, older PLWHAs reported lower levels of well-being (7.6 versus 11.4), higher levels of depression (18.6 versus 15.8), and poorer quality of life. Self-efficacy was similar among older (23.9) and younger (24.6) PLWHAs. A higher level of depression among older PLWHAs was associated with much lower levels of subjective well-being and quality of life (physical health and psychological health). Conclusion. The findings suggest that older PLWHAs face psychological problems and mental health challenges beyond those experienced by younger PLWHAs. Intervention programs dedicated to improving mental health and quality of life are greatly needed for HIV infected older adults.

HIV pre-exposure prophylaxis interest among female sex workers in Guangxi, China.

OBJECTIVES: Acceptability of pre-exposure prophylaxis (PrEP) and willingness to participate in a clinical trial for both safety and efficacy of PrEP were investigated among female sex workers (FSWs) in Guangxi, China. METHODS: A cross-sectional study was performed in three cities in Guangxi. Structured, self-administered questionnaires were used to assess the acceptability of PrEP and the willingness to participate in a clinical trial. Multivariable logistic regression models were fitted to identify predictors. RESULTS: Among 405 participants, 15.1% had heard of PrEP. If PrEP was deemed to be effective, safe and provided for free, 85.9% reported that they would accept it, and 54.3% of those who accepted PrEP said that they would participate in a clinical trial. The increased acceptability of PrEP was associated with working in male dominated venues, higher income, a poor family relationship, better HIV/AIDS knowledge, not realizing HIV risk from unfamiliar clients, not being forced to use condoms by the gatekeepers, consistent use of condoms, and use of drugs to prevent STD infection. The increased willingness to participate in a clinical trial was associated with a poor family relationship, better HIV/AIDS knowledge, not realizing HIV risk from unfamiliar clients, a willingness to adhere to daily PreP use, and not being concerned about discrimination by others. The main reason for rejecting PrEP or participating in a clinical trial was the concern about the side effects of PrEP. CONCLUSIONS: Acceptability of PrEP among Guangxi FSWs is relatively high, indicating that PrEP intervention programs may be feasible for Chinese FSWs. Given the fact that most of the participants had never heard of PrEP before, and that family, gatekeepers, and social discrimination could significantly affect its acceptability, a comprehensive mix of multiple interventions is necessary for the successful implementation of a PrEP program among this population in Guangxi.

Methamphetamine inhibits Toll-like receptor 9-mediated anti-HIV activity in macrophages.

Toll-like receptor 9 (TLR9) is one of the key sensors that recognize viral infection/replication in the host cells. Studies have demonstrated that methamphetamine (METH) dysregulated host cell innate immunity and facilitated HIV infection of macrophages. In this study, we present new evidence that METH suppressed TLR9-mediated anti-HIV activity in macrophages. Activation of TLR9 by its agonist CpG-ODN 2216 inhibits HIV replication, which was demonstrated by increased expression of TLR9, interferon (IFN)-α, IFN regulatory factor-7 (IRF-7), myeloid differentiation factor 88 (MyD88), and myxovirus resistance gene A (MxA) in macrophages. However, METH treatment of macrophages greatly compromised the TLR9 signaling-mediated anti-HIV effect and inhibited the expression of TLR9 downstream signaling factors. Dopamine D1 receptor (D1R) antagonists (SCH23390) could block METH-mediated inhibition of anti-HIV activity of TLR9 signaling. Investigation of the underlying mechanisms of the METH action showed that METH treatment selectively down-regulated the expression of TLR9 on macrophages, whereas it had little effect on the expression of other TLRs. Collectively, our results provide further evidence that METH suppresses host cell innate immunity against HIV infection by down-regulating TLR9 expression and its signaling-mediated antiviral effect in macrophages.

Emerging HIV epidemic among older adults in Nanning, China.

The HIV/AIDS surveillance data indicates that the proportion of people living with HIV/AIDS (PLWHAs) who were 50 years old or older increased to 42.7% in 2011 from 16.5% in 2007 in Nanning, the capital city of Guangxi Province. A greater number of newly diagnosed HIV cases compared to clinical AIDS cases were identified from older adults. The dominant HIV transmission mode among older PLWHAs was heterosexual although approximately 30% of all PLWHAs acquired HIV through heterosexual contacts.

[Acceptability and influencing factors on pre-exposure prophylaxis programs among female sex workers in Guangxi, China].

OBJECTIVE: To study the acceptability of pre-exposure prophylaxis (PrEP) program on prevention of human immunodeficiency virus (HIV) infection among female sex workers (FSWs) in Guangxi of China. METHODS: A cross-sectional survey using convenience sampling was administered among 405 FSWs in Nanning, Liuzhou and Beihai cities of Guangxi, China. Self-designed questionnaire, face to face interviews were used to collect HIV-related risk behaviors, knowledge and acceptability of PrEP. RESULTS: After an introduction on PrEP, presuming that it was effective, safe and free of charge, 85.9% of the 405 FSWs said they would use it. Data from logistic regression analysis showed that significant factors of intent to use PrEP would include the followings: workplace (OR = 2.256, P = 0.009), monthly income (OR = 0.257, P = 0.004), family closeness (OR = 0.338, P = 0.012), knowledge on HIV/AIDS (OR = 2.802, P = 0.028), HIV/AIDS risk was introduced from a strange client (OR = 0.363, P = 0.049), whether the gatekeeper ordering the use of condom (OR = 0.432, P = 0.010), whether consistent using condom with clients (OR = 3.010, P = 0.002), whether ever using drugs to prevent STD infection (OR = 3.570, P = 0.049) etc. CONCLUSION: Awareness on HIV/AIDS knowledge and self-protection seemed the main influential factors while health education might promote the acceptability of PrEP.

[The correlation analysis between environmental factors, bone morphogenetic protein-4 and transforming growth factor beta-3 polymorphisms in nonsyndromic cleft lip with or without cleft palate].

OBJECTIVE: To investigate the effects of interactions among environmental factors, bone morphogenetic protein-4 (BMP4) and transforming growth factor beta-3 (TGF-ß(3)) polymorphisms on nonsyndromic cleft lip and cleft palate (NSCLP). METHODS: The data of environmental exposures were collected with questionnaires. Genotypes were determined with techniques of polymerase chain reaction-restriction fragment length polymorphism. Interactions between genes, environmental factors and NSCLP were analyzed using multifactor dimensionality reduction (MDR) method. The interactions were validated by logistic regression analysis. RESULTS: There was no correlation between three single nucleotide polymorphism (SNP) associated with NSCLP. The developmental accident of NSCLP had higher risk in the interaction between BMP4 T538C, maternal passive smoking and infection in first trimester pregnancy, as well as in the interaction of six factors between TGF-ß(3) G15572-, maternal passive smoking, infections, multivitamin supplement in the first trimester pregnancy, paternal smoking and high risk drinking before realizing pregnancy than in other interactions of environmental factors. The results could be validated by logistic regression analysis. CONCLUSIONS: The NSCLP is induced by the interactions between genes and environmental risk factors.