New steroidal saponins from the aerial parts of Paris polyphylla var. yunnanensis and their effects on blood coagulation.

Five new steroidal saponins, paripolins D-H (1-5), and 6 known compounds (6-11) were isolated from the aerial parts of Paris polyphylla var. yunnanensis. The structures of 1-5 were determined using spectroscopic analyses in conjunction with acid hydrolysis. It is for the first time to report the 12-hydroxysteroidal saponins from the genus Paris. The effect of all isolated compounds on blood coagulation was determined in vitro using the plasma recalcification time method. Compounds 1 and 2 showed potent procoagulant activity, and 5-11 exhibited significant anticoagulant activity.

Efficacy and safety of angiogenesis inhibitors in melanoma: a meta-analysis of seven randomized controlled trials.

Little is known about the efficacy and safety of angiogenesis inhibitor therapy in patients with melanoma. The objective of this study was to assess the possible benefits and harms of angiogenesis inhibitor therapy in patients with melanoma. Electronic databases of PubMed and Web of Science were searched from inception to January 2020. Randomized controlled trials (RCTs) that investigated the efficacy and safety of angiogenesis inhibitor therapy in patients with melanoma were included. Primary outcomes were overall survival (OS) and progression-free survival (PFS), reported as hazard ratios (HRs). Secondary outcomes were disease control, objective response, and adverse events, reported as odds ratios (ORs), and trial sequential analysis (TSA) was also performed. We identified seven trials with 3185 patients. There was no significant difference in OS [HR, 0.99; 95% confidence interval (CI), 0.90-1.09] or PFS (HR, 0.91; 95% CI, 0.83-1.00) between the treatment groups. No significant effect of angiogenesis inhibitor therapy was identified on disease control (OR, 1.23; 95% CI, 0.97-1.55) or objective response (OR, 1.27; 95% CI, 0.99-1.62). TSA showed that the sample size for analysis of disease control was sufficient. Additionally, angiogenesis inhibitor therapy increased risks of hypertension, neurological symptoms, and diarrhea. Angiogenesis inhibitor therapy makes no significant improvement in OS or PFS in patients with melanoma and even causes an increased risk of important adverse events. Therefore, angiogenesis inhibitor therapy is not recommended for the treatment of melanoma.

Protective Effects of Ferulic Acid on Metabolic Syndrome: A Comprehensive Review.

Metabolic syndrome (MetS) is a complex disease in which protein, fat, carbohydrates and other substances are metabolized in a disorderly way. Ferulic acid (FA) is a phenolic acid found in many vegetables, fruits, cereals and Chinese herbs that has a strong effect on ameliorating MetS. However, no review has summarized the mechanisms of FA in treating MetS. This review collected articles related to the effects of FA on ameliorating the common symptoms of MetS, such as diabetes, hyperlipidemia, hypertension and obesity, from different sources involving Web of Science, PubMed and Google Scholar, etc. This review summarizes the potential mechanisms of FA in improving various metabolic disorders according to the collected articles. FA ameliorates diabetes via the inhibition of the expressions of PEPCK, G6Pase and GP, the upregulation of the expressions of GK and GS, and the activation of the PI3K/Akt/GLUT4 signaling pathway. The decrease of blood pressure is related to the endothelial function of the aortas and RAAS. The improvement of the lipid spectrum is mediated via the suppression of the HMG-Co A reductase, by promoting the ACSL1 expression and by the regulation of the factors associated with lipid metabolism. Furthermore, FA inhibits obesity by upregulating the MEK/ERK pathway, the MAPK pathway and the AMPK signaling pathway and by inhibiting SREBP-1 expression. This review can be helpful for the development of FA as an appreciable agent for MetS treatment.

Relationship Between Smoking and Pressure Injury Risk: A Systematic Review and Meta-Analysis.

BACKGROUND: Smoking is a risk factor for many diseases. PURPOSE: This study explored the relationship between current or past smoking and pressure injury (PI) risk through a systematic review and meta-analysis. METHODS: The databases PubMed, Web of Science, and China National Knowledge Infrastructure were searched for the years between 2001 and 2020. Quality of evidence was estimated by the Newcastle-Ottawa Scale. The random effects model was applied to assess the odds ratios (OR) and 95% confidence intervals (CI); pooled adjusted OR and 95% CI, subgroup analysis, publication bias, sensitivity analyses, and meta-regression analysis were performed. RESULTS: Fifteen (15) studies (12 retrospective and 3 prospective) comprising data on 11 304 patients were eligible for inclusion in the review. The meta-analysis demonstrated that smoking increased the risk of PI (OR = 1.498; 95% CI, 1.058-2.122), and the pooled adjusted OR (1.969) and 95% CI (1.406-2.757) confirmed this finding. Publication bias was not detected by funnel plot, Begg's test (P = .322), or Egger's test (P = .666). Subgroup analyses yielded the same observations in both retrospective (OR = 1.607; 95% CI, 1.043-2.475) and prospective (OR = 1.218; 95% CI, 0.735-2.017) studies. The results were consistent across sensitivity analyses (OR = 1.07; 95% CI, 1.043- 2.475). Relevant heterogeneity moderators were not identified by meta-regression analysis with PI incidence (P = .466), years of patient data included (P = .637), mean patient age (P = .650), and diabetes mellitus diagnosis (P = .509). CONCLUSION: This study found that individuals who are current or formers smokers have an almost 1.5 times higher risk of PI development than do those who do not smoke.

COVID-19 related pressure injuries in patients and personnel: A systematic review.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is causing a rapid and tragic health emergency worldwide. Because of the particularity of COVID-19, people are at a high risk of pressure injuries during the prevention and treatment process of COVID-19. OBJECTIVES: This systematic review aimed to summarize the pressure injuries caused by COVID-19 and the corresponding preventive measures and treatments. METHODS: This systematic review was according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Web of science and CNKI (Chinese) were searched for studies on pressure injuries caused by COVID-19 published up to August 4, 2020. The quality of included studies was assessed by the Newcastle-Ottawa Quality Assessment Scale (NOS) and the CARE guidelines. RESULTS: The data were extracted from 16 studies involving 7,696 participants in 7 countries. All studies were published in 2020. There are two main types of pressure injuries caused by the COVID-19: 1) Pressure injuries that caused by protective equipment (masks, goggles and face shield, etc.) in the prevention process; 2) pressure injuries caused by prolonged prone position in the therapy process. CONCLUSIONS: In this systematic review, the included studies showed that wearing protective equipment for a long time and long-term prone positioning with mechanical ventilation will cause pressure injuries in the oppressed area. Foam dressing may need to be prioritized in the prevention of medical device related pressure injuries. The prevention of pressure injuries should be our particular attention in the course of clinical treatment and nursing.

Migrant adolescents' behavioral problems compared to host adolescents and adolescents in their region of origin: a longitudinal study.

BACKGROUND: Since the 1990s, families from the ecologically hostile mountainous southern areas of Ningxia Province, China, have been migrating to the northern areas of the province. This study compared the prevalence of behavioral problems among migrant adolescents to those among host adolescents (adolescents from the northern areas) and adolescents in the region of origin (adolescents from the southern areas), to determine whether ecological migration is related to adolescent behavioral problems, and possible changes in such problems over time. METHODS: We used the Children and Adolescents Ecological Migration Survey on Mental Health, administered to 4805 students aged 12-16 years and their parents between 2012 and 2014 (W1), of whom 1753 students and their parents completed the follow-up between 2014 and 2017 (W2). Parents answered questions related to adolescent behavioral problems, main source of family income, parents' desire to reverse migrate, improved standard of living, and parents' educational attainment, while children completed the Eysenck Personality Questionnaire and a classroom environment questionnaire. RESULTS: The prevalence of behavioral problems among the migrant adolescents (28.04%) was significantly higher than among host adolescents (21.59%) or adolescents in the region of origin (24.37%; p < 0.001) at W1. After adjusting for gender and age, parents' work outside the home was the main source of family income (OR = 1.42, 95% CI = 1.13-1.78), and adolescents' learning burden (OR = 1.04, 95% CI = 1.01-1.06) in school negatively influenced behavioral problems. Strong student-teacher relationships (OR = 0.97,95% CI = 0.94-0.99) and parents who had no intention to move back to the original residence (OR = 0.70, 95% CI = 0.52-0.94) exerted a protective effect at W1; at W2, a protective effect was associated with improved living conditions (OR = 0.39-0.55, 95% CI = 0.25-0.84). The extent of behavioral problems among migrant adolescents significantly decreased after two years. CONCLUSION: Ecological migration will increase children's behavioral problems in the early stage, with various factors influencing the extent of these problems.

Two pairs of bisabolane sesquiterpenoid stereoisomers, bisacurone D-G, from the rhizome of Curcuma longa L.

Phytochemical investigation of an extract of the rhizome of Curcuma longa L., resulted in the identification of four undescribed bisabolane sesquiterpenoids, namely as bisacurone D-G (1-4). With the aid of comprehensive spectroscopic techniques (NMR, IR, UV, MS), the structures of all isolated compounds were elucidated and subsequently screened for both anti-inflammatory and cytotoxic biological activities, Compounds 1 and 2 showed moderate inhibitory activity toward LPS-induced NO production on RAW 264.7 macrophages.

Fate and removal of antibiotic resistance genes in heavy metals and dye co-contaminated wastewater treatment system amended with ß-cyclodextrin functionalized biochar.

Biochar has been received increasing concerns regarding its environmental effect, which is promising in wastewater treatment. In this study, the performance of ß-cyclodextrin functionalized biochar (ß-BC) on the removal of antibiotic resistance genes (ARGs) in wastewater treatment under the co-stresses of heavy metals and dye is evaluated. Results show that when 20 mg/L heavy metals (HMs) and 150 mg/L methyl orange (MO) are present in daily fed influent, only 0.05 mg/L HMs residual and 96.79%-98.84% MO removal efficiency achieved in ß-BC additive group, compare to 0.16 mg/L and 87.92%-94.11% of that in control, respectively, indicating that ß-BC can benefits the performance of contaminants removal. To evaluate the role of ß-BC plays on ARGs in multi-contaminants stressed system, tet W, tet M, sul-1, sul-2, blaTEM, oxa-1, qnr-S, erm-B and intI-1 are identified. The relative abundance of all identified ARGs are decreased when ß-BC presence compared to the corresponding groups without ß-BC additive. The diversity and composition of microbial community are explored and the reduction of potential antibiotic-resistant bacteria is speculated as a driver of ARGs removal. In conclusion, our study demonstrates that ß-BC possesses the ability to promote the removal of ARGs during continuous wastewater treatment under HMs-MO co-contaminant.

Removal of antibiotic resistant bacteria and antibiotic resistance genes in wastewater effluent by UV-activated persulfate.

The emerging antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) are increasingly appreciated to be as important as microbial contaminants. This paper focused on UV-activated persulfate (UV/PS), an advanced oxidation process, in removing ARB and ARGs from secondary wastewater effluent. Results showed that the inactivation efficiency of macrolides-resistant bacteria (MRB), sulfonamides-resistant bacteria (SRB), tetracyclines-resistant bacteria (TRB) and quinolones-resistant bacteria (QRB) by UV/PS reached 96.6 %, 94.7 %, 98.0 % and 99.9 % in 10 min, respectively. UV/PS also showed significant removal efficiency on ARGs. The reduction of total ARGs reached 3.84 orders of magnitude in UV/PS which is more than that in UV by 0.56 log. Particularly, the removal of mobile genetic elements (MGE) which might favor the horizontal gene transfer of ARGs among different microbial achieved 76.09 % by UV/PS. High-throughput sequencing revealed that UV/PS changed the microbial community. The proportions of Proteobacteria and Actinobacteria that pose human health risks were 4.25 % and 1.6 % less than UV, respectively. Co-occurrence analyzes indicated that ARGs were differentially contributed by bacterial taxa. In UV/PS system, hydroxyl radical and sulfate radical contributed to the removal of bacteria and ARGs. Our study provided a new method of UV/PS to remove ARGs and ARB for wastewater treatment.

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The dynamic simulation of cucumber growth and development in sunlight greenhouse can provide technical support for the intelligent management of cucumber production. According to the cucumber response characteristics to light and temperature, the cucumber development module based on the algorithm of clock model was established by using data from four-stage experiment with 'Jinyou 35' as experiment variety in two years. Based on the relationship between the leaf growth and key meteorological factors (temperature and radiation), leaf area index (LAI) module was established with the accumulated product of thermal effectiveness and photosynthetically active radiation (TEP) as independent variables. The simulation module of cucumber dry matter production was established by taking into consideration the double integral of LAI and daily length in photosynthesis per unit leaf area as well as the respiratory expenditure of different organs. Combined with water content of organs, fresh weight simulation module of cucumber organs was constructed. The whole cucumber development and growth simulation model in greenhouse was built based on each sub-module. The model parameters were calibrated and determined. The results showed that root mean square error (RMSE) of simulated values and observed values of four deve-lopment stages (from transplanting date to stretch tendril, to initial flowering, to early harvested and to uprooting), was 3.9-10.5 d. The normalized root mean square error (nRMSE) was 6.5%-28.6%. The coincidence index (D) was 0.79-0.97. The relationship between LAI and TEP was the regression of 'S' type curve. The RMSE of simulated and observed LAI values was 0.19. The nRMSE was 17.2%. The D value was 0.90. The RMSE of dry weight of root, stem, leaf, flower and fruit of the simulated values and observed values were 0.39-8.94 g·m-2. The nRMSE were 10.9%-17.7%. The D values were all above 0.98. The growth and development model of cucumber could accurately simulate the key development period of cucumber, leaf area and the dry and fresh weight of various organs and quantify the growth and development of cucumber in sunlight greenhouse.

Preterm Birth in China Between 2015 and 2016.

Objectives. To describe the incidence, risk factors, and potential causes of preterm birth (PTB) in China between 2015 and 2016.Methods. The China Labor and Delivery Survey was a population-based multicenter study conducted from 2015 to 2016. We assigned each birth a weight based on the sampling frame. We calculated the incidence of PTB and the multivariable logistic regression, and we used 2-step cluster analysis to examine the relationships between PTB and maternal, fetal, and placental conditions.Results. The weighted nationwide incidence of PTB was 7.3% of all births and 6.7% of live births at 24 or more weeks of gestation. Of the PTBs, 70.5% were born after 34 weeks and 42.7% were iatrogenic. Nearly two thirds of all preterm births were attributable to maternal, fetal, or placental conditions, and one third had unknown etiology.Conclusions. This study provided information on the incidence of PTB in China and identified several factors associated with PTB. The high frequency of iatrogenic PTB calls for a careful assessment and prudent management of such pregnancies, as PTB has short- and long-term health consequences.

Active Sites in Single-Layer BiOX (X = Cl, Br, and I) Catalysts for the Hydrogen Evolution Reaction.

Although few-layer bismuth oxyhalides (BiOX, X = Cl, Br, and I) have been shown to be appropriate for photocatalytic hydrogen production, the hydrogen evolution reaction (HER) activity of BiOX is unrevealed. Herein, the origins of catalytic activity on single-layer BiOX are investigated by using the density functional theory. The grand potential calculations show that the Bi- and BiO-terminations of single-layer BiOX are stable in O-poor and O-rich environments, respectively. The Bi- and BiO-terminations of single-layer BiOX are found to have obviously active sites for HER, whereas the (001) basal planes are inert. The Gibbs free energies for the adsorption of hydrogen atoms on the Bi- and BiO-terminations are close to the optimal value of 0 eV, indicating that single-layer BiOX possess favorable HER performances. The enhanced HER activities on the Bi- and BiO-terminations are attributed to the localized edge states around the Fermi level, which are caused by the Bi 6p-orbital density of the fringe bismuth atoms and O 2p-orbital density of the fringe oxygen atoms, respectively. The results of this work suggest that single-layer BiOX are a family of promising catalysts for water splitting.

Promising Approach for High-Performance MoS2 Nanodevice: Doping the BN Buffer Layer to Eliminate the Schottky Barriers.

Reducing the Schottky barrier height (SBH) of metal-MoS2 interface with no deteriorating the intrinsic properties of MoS2 channel layer is crucial to realize the high-performance MoS2 nanodevice. To realize this expectation, a promising approach is present in this study by doping the boron nitride (BN) buffer layer between metal electrode and MoS2 channel layer. Results demonstrate that no matter the types of concentrations and dopants the intrinsic electronic structure, low electron effective mass of MoS2 channel layer, and the weak Fermi level pinning effects of metal/BN-MoS2 interfaces are preserved and not deteriorated. More importantly, the n- and p-type SBHs of metal/BN-MoS2 interfaces are significantly reduced by the electron-poor and -rich dopants, respectively, when the doped BN buffer layer spreads all over the nanodevice, which is in contrast to the traditional doping rule. Moreover, both the n- and p-type SBHs are further decreased and even eliminated when the concentrations of dopants increase. The n-type SBH of doped Au/BxN-MoS2 interface and the p-type SBH of doped Pt/BNx-MoS2 interface can be reduced to -0.21 and -0.61 eV by doping with high concentrations of Li and O, respectively. This theoretical work provides an effective and promising method to realize high-performance MoS2 nanodevices with negligible SBHs.

Characteristics of lateral and hybrid heterostructures based on monolayer MoS2: a computational study.

Novel MoS2/(MX2)n lateral and (MoS2)/(MX2)n-BN hybrid heterostructures have been designed on monolayer MoS2 to extend its applications. The electronic, interfacial and optical properties of the lateral and hybrid heterostructures have been investigated comparatively using first-principles calculations. It was found that the charge distributions, band gaps, band levels, electrostatic potentials, and optical absorption of the MoS2/(MX2)n lateral heterostructures depend greatly on the width n of MX2, irrespective of the size of the lateral heterostructures. The CBM states of the MoS2/(MX2)n lateral heterostructures dominated by the dz2 orbitals are localized around MoS2, whereas the VBM states of the MoS2/(MX2)n lateral heterostructures are dominated by the MX2 region. Through regulating the width n of the MX2 region in the MoS2/(MX2)n lateral heterostructures, the optical absorption of the lateral heterostructures under visible light can be increased, and the CBM and VBM states of the lateral heterostructures can be located above the hydrogen reduction potential and below the water oxidation potential, respectively. The similar characteristics were observed in the MoS2/(MX2)n-BN hybrid heterostructures, indicating that BN is a good substrate for the MoS2/(MX2)n lateral heterostructures. The analysis implies that forming the lateral and hybrid heterostructures is an effective way to extend the applications of monolayer MoS2 in photocatalytic water and photovoltaic devices.

A new nomogram score for predicting surgery-related pressure ulcers in cardiovascular surgical patients.

The aim of this study was to build a new nomogram score for predicting surgery-related pressure ulcers (SRPU) in cardiovascular surgical patients. We performed a prospective cohort study among consecutive patients with cardiovascular surgery between January 2015 and December 2015. Univariate and multivariate logistic regression was used to analyse the risk factors for SRPU. A nomogram-predicting model was built based on the logistic regression model. Then, calibration and discrimination were tested. A total of 149 patients with cardiovascular surgery were included in the study. Thirty-seven patients developed SRPUs, with an incidence rate of 24·8% (95%CI: 18·1-32·6%). The logistic regression model for predicting SRPU with four risk factors was Logit(P) = (1·861 × VDH, OR 2·174 × CAD, OR 1·747 × TAA) - 0·029 × weight + 0·005 × surgery duration + 1·241 × perioperative corticosteroids administration (P = 0·003, R2 = 0·1181). The goodness-of-fit test (Pearson χ2 = 150·69, P = 0·217) indicated acceptable calibration, and the C-index (0·725) indicated moderate discrimination. When the probability cut-off is 0·25 (total score 12), the nomogram model has the best sensitivity and specificity in predicting SRPU. We established a new nomogram model that can provide an individual prediction of SRPU in cardiovascular surgical patients. When the probability is more than 0·25 (total score 12), the cardiovascular surgery patients should be considered at high-risk.

Maternal obesity and the risk of neural tube defects in offspring: A meta-analysis.

OBJECTIVES: The aim of this was to access maternal obesity and the risk of neural tube defects (NTDs) in offspring, and establishes a nonlinear dose-response relationship between maternal body mass index (BMI) and risk of NTDs in offspring. METHODS: PubMed and Web of Science were systematically searched. We compared NTDs risk difference in maternal obesity group vs. normal weight group+overweight group, and maternal obesity group vs. normal weight group. We also examined the dose-response relationship between maternal body mass index and the risk of NTDs in offspring. RESULTS: A total of 22 studies with 1,758,832 patients included in the meta-analysis. The results showed obesity maternal obesity is an important risk factor for NTDs in offspring. When maternal obesity group compared with normal weight group+overweight group, the summary OR of NTDs was 1.632 (95% CI 1.473-1.808; Z=9.37, P<0.00001); when maternal obesity group compared with normal weight group, the summary OR was 1.682 (95% CI 1.510-1.873; Z=9.44, P<0.00001). No publication biases were found. Dose-response meta-analysis showed statistically significant association between maternal BMI and risk of NTDs in offspring (model χ2=41.49, <0.00001). In linear model, the OR of NTDs in offspring was 1.040 (95% CI 1.027-1.051) for every 1kg/m2 BMI increase in mother. In spline model, the OR of NTDs in offspring risk increased rapidly along with maternal BMI, especially when BMI >30kg/m2. Sensitivity analyses by only included the studies reported adjusted OR showed the result was robust. CONCLUSION: Our meta-analysis indicated that maternal obesity is an important risk factor for neural tube defects in offspring.

Hopf Bifurcation of an Epidemic Model with Delay.

A spatiotemporal epidemic model with nonlinear incidence rate and Neumann boundary conditions is investigated. On the basis of the analysis of eigenvalues of the eigenpolynomial, we derive the conditions of the existence of Hopf bifurcation in one dimension space. By utilizing the normal form theory and the center manifold theorem of partial functional differential equations (PFDs), the properties of bifurcating periodic solutions are analyzed. Moreover, according to numerical simulations, it is found that the periodic solutions can emerge in delayed epidemic model with spatial diffusion, which is consistent with our theoretical results. The obtained results may provide a new viewpoint for the recurrent outbreak of disease.

Performance of field-effect transistors based on Nb(x)W(1-x)S2 monolayers.

The Schottky barrier has been detected in many field-effect transistors (FETs) based on transition metal dichalcogenide (TMD) semiconductors and has seriously affected the electronic properties of the devices. In order to decrease the Schottky barrier in WS2 FETs, novel Nb doping in WS2 monolayers has been performed and p-FETs based on Nb-doped WS2 (Nb(x)W(1-x)S2) monolayers as the active channel have been fabricated for the first time. The monolayer Nb0.15W0.85S2 p-FET has a drain current of 330 µA µm(-1), an impressive I(ON)/I(OFF) of 10(7), and a high effective hole mobility of ∼146 cm(2) V(-1) s(-1). The novel Nb doping in monolayer WS2 has eliminated the ambipolar behavior and reduced the Schottky barrier in WS2 FETs. The reduction of the Schottky barrier is ascribed to the hybridization between W 5d, Nb 4d and S 3p states near the EF and to the enhancement of the metallization of the contact between the Pd metal and monolayer Nb(x)W(1-x)S2 after Nb doping.

Annexin A3 Is a Potential Predictor of Platinum Resistance in Epithelial Ovarian Cancer Patients in a Prospective Cohort.

Epithelial ovarian cancer (EOC) is the leading cause of death among gynecological malignancies and is rarely cured in the recurrent setting, mainly because of progressive chemoresistance, especially platinum resistance. In our previous studies, the platinum-resistance-related protein, annexin A3, was selected by comparative proteomics. In this study, we detected serum annexin A3 levels using a self-developed chemiluminescence immunoassay kit in a prospective EOC patient cohort. We also evaluated the capacity of serum annexin A3 levels to predict platinum resistance. Serum annexin A3 levels in healthy women exhibited a similar normal distribution (Z=0.723, P=0.673), allowing determination of a normal cutoff level of 0.11-1.45 ng/mL. Of the 89 EOC patients, 21 were platinum resistant and 68 were platinum sensitive. Residual disease after primary surgery (p=0.004) and serum annexin A3 levels (p=0.036) were both independent factors associated with platinum resistance. The AUC was 0.733 (95% confidence interval (CI), 0.627-0.823). The optimal cutoff value for serum annexin A3 levels was 2.05 ng/mL. Multivariate logistic analysis showed that expression of annexin A3 as assessed by immunohistochemistry (P=0.005) and residual tumor size (P=0.000) had a significant influence on platinum resistance. The AUC of ROC curve of annexin A3 expression by immunohistochemistry was 0.664 (95% CI, 0.554-0.763) and the cut off value was ">=moderate scores". In conclusion, we demonstrate that annexin A3 is a secreted protein that may be measured in the peripheral blood using a self-developed, chemiluminescence immunoassay kit. Serum annexin A3 levels may be a potential predictor of platinum resistance in epithelial ovarian cancer patients.