[Efficacy of stent placement in treatment of malignant tracheoesophageal fistula and relevant factors of fistula closure].

Objective: To investigate the efficacy of stent placement in the treatment of malignant tracheoesophageal fistula (MTEF) and the factors affecting the closure of the fistula. Methods: Clinical, pathological, laboratory, and imaging data of 288 patients with MTEF admitted to Zhongda Hospital, Southeast University from 2015 to 2021were retrospectively analyzed. Among them, there were 208 males; the age was (63.6±10.5) years. A total of 94 patients received conservative treatment (conservative group), and 194 in the stent group (170 cases with esophageal stents and 24 cases with tracheal stents). Patients were followed-up at 2 weeks, 1 month, 3 months, and 6 months to evaluate the effect of stent implantation. Multivariable logistic regression was used to analyze factors affecting fistula closure. Results: Age, fistula size, leukocyte count before treatment, and fistula location were significantly different between the conservative group and the stent group (P<0.05). The Karnofsky functional status (KPS) score before treatment in the conservative group was lower than the stent group, (45.1±1.0) vs (51.8±0.7) scores, respectively (P<0.001). After 2 weeks and 1 month of treatment, improvement in KPS scores was significantly better in the stent group than in the conservative group (P<0.05). At 1 month, the pulmonary infection rate in the stent group was 33.5% (58/173), significantly lower than that in the conservative group [77.0% (47/61); P<0.001]. Among the 288 patients, the fistula was closed in 196 patients and unclosed in 92 patients. Fistula size (OR=3.429, 95%CI: 1.623-7.829, P=0.001), leukocyte count before treatment (OR=1.160, 95%CI: 1.027-1.317, P=0.018), KPS score before treatment (OR=0.898, 95%CI: 0.848-0.945, P<0.001) and the treatment method (conservative treatment as reference, esophageal stent OR=0.010, 95%CI: 0.004-0.030, P<0.001; tracheal stent OR=0.003, 95%CI: 0.000-0.042, P<0.001) were factors affecting fistula closure. In the 170 patients in the esophageal stent group, early complications (≤24 h) occurred in 71 patients, and late (>24 h) complications occurred in 11 patients. While in the 24 patients in the tracheal stent group, 9 had early complications and 2 had late complications. Conclusions: Stent placement is an effective treatment for MTEF compared to conservative treatment. Stent treatment, small fistula size, low pre-treatment leukocyte count, and high pre-treatment KPS score are beneficial to fistula closure.

[Effectiveness of the "14 plus 7 day quarantine" and "nucleic acid plus total antibody testing" strategy for screening imported patients with COVID-19 in Xiamen].

Objective: To analysis effectiveness of the "14 plus 7 day quarantine" and "nucleic acid plus total antibody testing" strategy (combined screening strategy) for screenin the imported patients with COVID-19 in Xiamen. Methods: The study populations were overseas travelers arriving in Xiamen from March 17 to December 31, 2020, and overseas travelers who had quarantine outside Xiamen for less than 21 days from July 18 to December 31, 2020. Data were collected and analyzed on the timing of detection, pathways, and test results of the imported patients with COVID-19 after implementing combined screening strategy. Results: A total of 304 imported patients with COVID-19 were found from 174 628 overseas travelers and 943 overseas travelers from other cities. A total of 163 cases (53.6%) were diagnosed by multitime, multisite intensive nucleic acid testing after positive finding in total antibody testing. Among them, 27 (8.9%) were first positive for nucleic acid in 14 plus 7 day quarantine and 136 were first positive for nucleic acid in 14-day quarantine. Only 8 of these individuals were tested positive for nucleic acid after positive total antibody testing. The other 128 individuals were tested positive for nucleic acid after being negative for average 2.3 times (maximum of 6 times). Aditional 155 cases might be detected by using the combined "14 plus 7 day quarantine" and " nucleic acid plus total antibody testing" strategy compared with "14-day quarantine and nucleic acid testing" strategy, accounting for 51.0% of the total inbound infections. So the combined screening strategy doubled the detection rate for imported patients with COVID-19. No second-generation case caused by overseas travelers had been reported in Xiamen as of February 26, 2021. Conclusions: Xiamen's combined screening strategy can effectively screen the imported patients with COVID-19 who were first positive for nucleic acid after 14 day quarantine. Compared with "14 day quarantine and nucleic acid testing", the combined screening strategy improved detection rate and further reduced the risk of the secondary transmission caused by the imported patients with COVID-19.

Synthesis and characterization of an anti-caries and remineralizing fluorine-containing cationic polymer PHMB-F.

Dental caries have become a major global public health problem. Plaque control and remineralization of initial enamel lesions are paramount for the prevention and control of caries. Polyhexamethylene biguanide (PHMB) is a type of cationic amphipathic antibacterial agent with broad-spectrum antibacterial properties and good biological safety. Fluoride delays demineralization and promotes the remineralization of hard dental tissues. However, a high concentration is needed for it to function as an antibacterial agent. In order to create a PHMB with the benefits associated with fluoride, we synthesized a fluorine-containing cationic polymer, PHMB-F. Fourier transform-infrared spectroscopy and solid state nuclear magnetic resonance characterization confirmed the successful synthesis of PHMB-F. Antibacterial tests showed that PHMB-F had better antiseptic efficacy for Streptococcus mutans compared with just PHMB. Moreover, positively-charged PHMB-F allows fluoride ions to exist closer to the enamel surface with negative potential, which markedly lowers the ion concentrations in the microenvironment adjacent to hard dental tissues needed to maintain equilibrium. Thus, only low concentrations of PHMB-F are required for enamel remineralization.

A field test of a model for the stability of androdioecy in the freshwater shrimp, Eulimnadia texana.

The evolution of hermaphroditism from dioecy is a poorly studied transition. Androdioecy (the coexistence of males and hermaphrodites) has been suggested as an intermediate step in this evolutionary transition or could be a stable reproductive mode. Freshwater crustaceans in the genus Eulimnadia have reproduced via androdioecy for 24+ million years and thus are excellent organisms to test models of the stability of androdioecy. Two related models that allow for the stable maintenance of males and hermaphrodites rely on the counterbalancing of three life history parameters. We tested these models in the field over three field seasons and compared the results to previous laboratory estimates of these three parameters. Male and hermaphroditic ratios within years were not well predicted using either the simpler original model or a version of this model updated to account for differences between hermaphroditic types ('monogenic' and 'amphigenic' hermaphrodites). Using parameter estimates of the previous year to predict the next year's sex ratios revealed a much better fit to the original relative to the updated version of the model. Therefore, counter to expectations, accounting for differences between the two hermaphroditic types did not improve the fit of these models. At the moment, we lack strong evidence that the long-term maintenance of androdioecy in these crustaceans is the result of a balancing of life history parameters; other factors, such as metapopulation dynamics or evolutionary constraints, may better explain the 24+ million year maintenance of androdioecy in clam shrimp.

Serum levels of IL-33 and its receptor ST2 are elevated in patients with ankylosing spondylitis.

OBJECTIVES: The aims of this study were to measure the levels of interleukin (IL)-33 and ST2 and T-helper (Th)2-associated cytokines (IL-13, IL-4, IL-5) in patients with ankylosing spondylitis (AS), and examine the correlation of serum cytokine levels with disease activity and laboratory parameters. METHOD: Serum IL-33, IL-13, IL-4, and IL-5 levels were assessed by sandwich enzyme-linked immunosorbent assay (ELISA), and the mRNA levels of IL-33 and ST2 were quantified by real-time quantitative polymerase chain reaction (RT-qPCR), in 43 AS samples and compared with 27 age- and sex-matched healthy controls. RESULTS: Serum IL-33, IL-13, and IL-4 levels were increased significantly in AS patients compared with controls (p < 0.01); moreover, serum IL-33 and IL-13 levels were significantly higher in patients with active AS than in those with inactive AS (p < 0.05). The serum levels of IL-5 showed no significant difference between AS patients and controls (p > 0.05). Serum IL-33 levels were positively correlated with both IL-13 (r = 0.306, p < 0.01) and IL-4 levels (r = 0.432, p < 0.01). The mRNA levels of IL-33 and ST2 were significantly different between AS patients and controls (p < 0.01) but not between active and inactive AS patients. CONCLUSIONS: Serum levels of IL-33 could partially reflect AS disease activity and indicate that IL-33/ST2 signalling plays an important role in the pathogenesis of AS.

Epidemiological features of traumatic spinal cord injury in Anhui Province, China.

STUDY DESIGN: A retrospective hospital-based study. OBJECTIVES: To describe the epidemiologic features of traumatic spinal cord injury (TSCI) in Anhui Province. SETTING: Two hospitals within Anhui Province, China. METHODS: We retrospectively reviewed the hospital records on all patients with TSCI, admitted between 1 January 2007 and 31 December 2010 (n=761). Variables included age, gender, occupation, neurological level, severity of injury, cause and treatment. RESULTS: Seven hundred and sixty-one cases of TSCI were identified. Five hundred and eighty eight were males (77.3%) and 173 were females (22.7%), with a mean age of 45 years (s.d.=13, range from 5 to 87). Fall from height was the leading cause of injury (52.6%), followed by transport (21.2%). The neurological lesion levels were cervical (46.3%), lumbosacral (33.3%) and thoracic (20.4%). CONCLUSION: Prevention strategies for TSCI should target 30-60 age group, males, farmers and fall from height. The results of this study will serve as a basis for further studies on TSCI. The prevention strategies and treatment should be designed according to the injury features.

Lack of association between CTLA-4 +49A/G and -318C/T polymorphisms and Behçet's disease risk: a meta-analysis.

OBJECTIVES: To more precisely determine whether there is a significant association of cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) gene polymorphisms with the susceptibility for Behçet's disease. METHODS: Eight studies that included data from 7 articles were identified using PubMed, Embase, Chinese Biomedical Literature Database (CBM), and Chinese National Knowledge Infrastructure (CNKI) published before March 2012. Meta-analysis was performed for two CTLA-4 gene polymorphisms, +49A/G (rs231775) and -318C/T (rs5742909). Statistical analyses were performed using software Review Manager (version 5.1) and Stata (version 11.0). The pooled odds ratio (OR) with 95% confidence interval (95%CI) were presented. RESULTS: Overall, no significant association was detected in all genetic models when all studies were pooled into the meta-analysis (for +49A/G polymorphism: A vs. G, OR=1.173, 95% CI=0.790-1.743; A/A vs. A/G+G/G, OR=1.422, 95% CI=0.718-2.814; A/A+A/G vs. G/G, OR=1.421, 95% CI=0.729-2.767; and for -318C/T polymorphism: C vs. T, OR=1.051, 95% CI=0.844-1.307; C/C vs. T/T+C/T, OR=1.154 95% CI=0.891-1.495, C/C+C/T vs. T/T, OR=1.044, 95% CI=0.301-3.617). Furthermore, in the subgroup analysis by ethnicity, there was also lack of evidence for the association in Turkish patients. CONCLUSIONS: Our study failed to provide evidence for the genetic association between CTLA-4 +49A/G and -318C/T polymorphisms with Behçet's disease based on currently available evidence from literature. Further confirmations in large and well-designed studies including other CTLA-4 gene polymorphisms are needed.

The FCGR2B rs10917661 polymorphism may confer susceptibility to ankylosing spondylitis in Han Chinese: a case-control study.

OBJECTIVE: Single-nucleotide polymorphisms (SNPs) in the Fc gamma receptor IIB (FCGR2B) gene have recently been found to be associated with several human autoimmune diseases. We undertook the current study to investigate the influence of these polymorphisms on the risk of ankylosing spondylitis (AS). METHOD: A total of 306 patients with AS from Anhui, China, fulfilling the modified New York Criteria, and 300 matched healthy controls were analysed. All subjects were genotyped for two SNPs (rs1050501, rs10917661) in the FCGR2B gene, and the SNaPshot Assay was used for genotyping. RESULTS: SNP rs10917661 was significantly associated with AS [C vs. T: odds ratio (OR) 1.723, 95% confidence interval (CI) 1.086-2.733, p = 0.020; genotype: p = 0.026] whereas no association was found for rs1050501. Furthermore, no haplotype was found to be associated with AS. CONCLUSION: These findings indicated that rs10917661 may be a novel SNP involved in AS genetic predisposition in the Han Chinese population.

A meta-analysis of the relation of polymorphism at sites -1082 and -592 of the IL-10 gene promoter with susceptibility and clearance to persistent hepatitis B virus infection in the Chinese population.

BACKGROUND: Up to now, many publications about the Chinese population have evaluated the correlation between interleukin-10 (IL-10) -1082 and -592 polymorphisms and persistent hepatitis B virus (HBV) infection. However, the results remain inconclusive. In order to resolve this conflict, a meta-analysis was performed. METHODS: Seven studies were included and dichotomous data are presented as the odds ratio (OR) with a 95% confidence interval (CI). RESULTS: The results of our study suggest that carriers of the IL-10 -592A allele were more likely to clear HBV spontaneously in the Chinese pooled population (A vs. C: OR = 0.799, 95% CI = 0.678-0.941, P = 0.007; AC vs. AA: OR = 1.343, 95% CI = 1.017-1.684, P = 0.011; AA vs. AC + CC: OR = 0.736, 95% CI = 0.594-0.912; AA + AC vs. CC: OR = 0.588, 95% CI = 0.408-0.848, P = 0.004) and the IL-10 -1082A allele was associated with significantly reduced persistent HBV infection risk in Chinese (A vs. G: OR = 0.701, 95% CI = 0.494-0.996, P = 0.047; AA vs. GG + GA: OR = 0.684, 95% CI = 0.476-0.982, P = 0.040). CONCLUSIONS: Persistent HBV infection susceptibility is associated with the gene polymorphism IL-10 -1082GA in the Chinese population and the clearance of HBV is associated with the gene polymorphism IL-10 -592CA in the Chinese population.

A modified gambler's ruin model of polyethylene chains in the amorphous region.

Polyethylene chains in the amorphous region between two crystalline lamellae M unit apart are modeled as random walks with one-step memory on a cubic lattice between two absorbing boundaries. These walks avoid the two preceding steps, though they are not true self-avoiding walks. Systems of difference equations are introduced to calculate the statistics of the restricted random walks. They yield that the fraction of loops is (2M - 2)/(2M + 1), the fraction of ties 3/(2M + 1), the average length of loops 2M - 0.5, the average length of ties 2/3M2 + 2/3M - 4/3, the average length of walks equals 3M - 3, the variance of the loop length 16/15M3 + O(M2), the variance of the tie length 28/45M4 + O(M3), and the variance of the walk length 2M3 + O(M2).