Near Infrared Responsive Gold Nanorods Attenuate Osteoarthritis Progression by Targeting TRPV1.

Osteoarthritis (OA) is the most common degenerative joint disease worldwide, with the main pathological manifestation of articular cartilage degeneration. It have been investigated that pharmacological activation of transient receptor potential vanilloid 1 (TRPV1) significantly alleviated cartilage degeneration by abolishing chondrocyte ferroptosis. In this work, in view of the thermal activated feature of TRPV1, Citrate-stabilized gold nanorods (Cit-AuNRs) is conjugated to TRPV1 monoclonal antibody (Cit-AuNRs@Anti-TRPV1) as a photothermal switch for TRPV1 activation in chondrocytes under near infrared (NIR) irradiation. The conjugation of TRPV1 monoclonal antibody barely affect the morphology and physicochemical properties of Cit-AuNRs. Under NIR irradiation, Cit-AuNRs@Anti-TRPV1 exhibited good biocompatibility and flexible photothermal responsiveness. Intra-articular injection of Cit-AuNRs@Anti-TRPV1 followed by NIR irradiation significantly activated TRPV1 and attenuated cartilage degradation by suppressing chondrocytes ferroptosis. The osteophyte formation and subchondral bone sclerosis are remarkably alleviated by NIR-inspired Cit-AuNRs@Anti-TRPV1. Furthermore, the activation of TRPV1 by Cit-AuNRs@Anti-TRPV1 evidently improved physical activities and alleviated pain of destabilization of the medial meniscus (DMM)-induced OA mice. The study reveals Cit-AuNRs@Anti-TRPV1 under NIR irradiation protects chondrocytes from ferroptosis and attenuates OA progression, providing a potential therapeutic strategy for the treatment of OA.

XJB-5-131 protects chondrocytes from ferroptosis to alleviate osteoarthritis progression via restoring Pebp1 expression.

Background: Osteoarthritis (OA) is the most common age-related musculoskeletal disease. However, there is still a lack of therapy that can modify OA progression due to the complex pathogenic mechanisms. The aim of the study was to explore the role and mechanism of XJB-5-131 inhibiting chondrocytes ferroptosis to alleviate OA progression. Methods: We treated tert-butyl hydroperoxide (TBHP)-induced ferroptosis of mouse primary chondrocytes with XJB-5-131 in vitro. The intracellular ferroptotic hallmarks, cartilage anabolic and catabolic markers, ferroptosis regulatory genes and proteins were detected. Then we established a mouse OA model via destabilization of the medial meniscus (DMM) surgery. The OA mice were treated with intra-articular injection of XJB-5-131 regularly (2 µM, 3 times per week). After 4 and 8 weeks, we performed micro-CT and histological examination to evaluate the protection role of XJB-5-131 in mouse OA subjects. RNA sequencing analysis was performed to unveil the key downstream gene of XJB-5-131 exerting the anti-ferroptotic effect in OA. Results: XJB-5-131 significantly suppressed TBHP-induced increases of ferroptotic hallmarks (ROS, lipid peroxidation, and Fe2+ accumulation), ferroptotic drivers (Ptgs2, Pgd, Tfrc, Atf3, Cdo1), while restored the expression of ferroptotic suppressors (Gpx4, Fth1). XJB-5-131 evidently promoted the expression of cartilage anabolic and decreased the expression of cartilage catabolic markers. Moreover, intra-articular injection of XJB-5-131 significantly inhibited the expression of Cox2 and Mmp13, while promoted the expression of Col2a1, Gpx4 and Fth1 in DMM-induced mouse articular cartilage. Further, we identified Pebp1 as a potential target of XJB-5-131 by RNA sequencing analysis. The anti-ferroptosis and chondroprotective effects of XJB-5-131 were significantly diminished by Locostatin, a specific antagonist of Pebp1. Conclusion: XJB-5-131 significantly protects chondrocytes from ferroptosis in TBHP-induced mouse primary chondrocytes and DMM surgery-induced OA mice model via restoring the expression of Pebp1. XJB-5-131 is a potential therapeutic drug in the management of OA progression.

Bifunctional TRPV1 Targeted Magnetothermal Switch to Attenuate Osteoarthritis Progression.

Transient receptor potential vanilloid family member 1 (TRPV1) has been revealed as a therapeutic target of osteoarthritis (OA), the most common deteriorating whole joint disease, by impeding macrophagic inflammation and chondrocytes ferroptosis. However, the clinical application for capsaicin as the TRPV1 agonist is largely limited by its chronic toxicity. To address this issue, we developed a bifunctional controllable magnetothermal switch targeting TRPV1 for the alleviation of OA progression by coupling of magnetic nanoparticles (MNPs) to TRPV1 monoclonal antibodies (MNPs-TRPV1). Under the alternating magnetic field (AMF) stimulation, MNPs-TRPV1 locally dissipated heat, which was sufficient to trigger the opening and activation of TRPV1, and effectively impeded macrophagic inflammation and chondrocyte ferroptosis. This magnetothermal modulation of TRPV1 simultaneously attenuated synovitis and cartilage degeneration in mice incurred by destabilization of medial meniscus surgery, indicating the delayed OA progression. Furthermore, MNPs-TRPV1 with AMF exposure remarkably reduced knee pain sensitivity, alleviated the crippled gait, and improved spontaneous ambulatory activity performance in the mice OA model. Overall, this work provides a potential pathogenesis-based precise OA therapy with temporally and spatially magnetothermal modulation of TRPV1 in a controllable manner.

K-CapsNet: K-Nearest Neighbor Based Convolution Capsule Network for Cerenkov Luminescence Tomography Reconstruction.

Cerenkov luminescence tomography (CLT) has received significant attention as a promising imaging modality that can display the three-dimensional (3D) distribution of radioactive probes. However, the reconstruction of CLT suffers from severe ill-posed problem. It is difficult for traditional model-based method to obtain satisfactory result. Recently, deep learning-based method have shown great potential for accurate and efficient CLT reconstruction. In this study, a KNN-based convolution capsule network, named K-CapsNet, is proposed for cerenkov luminescence tomography. In K-CapsNet, the surface photon intensity is encoded in capsule form. The KNN-based convolution and K-means clustering are proposed for efficient encoding. Numerical simulation experiments have been carried out to verify the performance of K-CapsNet, and the results show that it performs superior in source localization and morphological restoration compared with existing methods.

FISTA-NET: Deep Algorithm Unrolling for Cerenkov luminescence tomography.

Cerenkov luminescence tomography (CLT) is a highly sensitive and promising imaging technique that can be used to reconstruct the three-dimensional distribution of radioactive probes in living animals. However, the accuracy of CLT reconstruction is limited by the simplified radiative transfer equation and ill-conditioned inverse problem. To address this issue, we propose a model-based deep learning network that combines the neural network with a model-based approach to enhance the performance of CLT reconstruction. The Fast Iterative Shrinkage Thresholding Algorithm (FISTA), a traditional model-based approach, is expanded into a deep network (known as FISTA-NET). Each layer in the network represents an iteration of the algorithm steps, and connecting these layers can form a deep neural network. In addition, different from the traditional FISTA, the key parameters in FISTA, such as gradient step size and threshold value, can be learned through training data without manual production. To evaluate the performance of FISTA-NET, numerical simulation experiments were conducted, which demonstrate its excellent positioning and shape recovery abilities.Clinical Relevance-This indicates that FISTA-NET strategy can significantly improve the quality of CLT reconstruction, which is further beneficial to the assessment of disease activity and treatment effect based on CLT.

The Mechanism of Peach Gum Polysaccharide Preventing UVB-Induced Skin Photoaging by Regulating Matrix Metalloproteinanse and Oxidative Factors.

Exposure to ultraviolet light can cause oxidative damage and accelerate skin aging and is one of the main causes of skin aging. Peach gum polysaccharide (PG) is a natural edible plant component that has many biological activities, such as regulating blood glucose and blood lipids and improving colitis, as well as antioxidant and anticancer properties. However, there are few reports on the antiphotoaging effect of peach gum polysaccharide. Therefore, in this paper, we study the basic composition of the raw material peach gum polysaccharide and its ability to improve UVB-induced skin photoaging damage in vivo and in vitro. The results show that peach gum polysaccharide is mainly composed of mannose, glucuronic acid, galactose, xylose, and arabinose, and its molecular weight (Mw) is 4.10 × 106 g/mol. The results of the in vitro cell experiments show that PG could significantly alleviate UVB-induced apoptosis of human skin keratinocytes, promote cell growth repair, reduce the expression of intracellular oxidative factors and matrix metal collagenase, and improve the extent of oxidative stress repair. Moreover, the results from the in vivo animal experiments showed that PG could not only effectively improve the phenotype of UVB-induced photoaged skin in model mice but also significantly improve their oxidative stress status, regulate the contents of ROS and the levels of SOD and CAT, and repair the oxidative skin damage induced by UVB in vivo. In addition, PG improved UVB-induced photoaging-mediated collagen degradation in mice by inhibiting the secretion of matrix metalloproteinases. The above results indicate that peach gum polysaccharide has the ability to repair UVB-induced photoaging and may be used as a potential drug and antioxidant functional food to resist photoaging in the future.

Evaluating the Risk of Social Isolation in Older People: AHP-Fuzzy Comprehensive Evaluation.

Background: Social isolation is a serious and pervasive health issue among older people, and it is difficult to identify and assess effectively. Based on a thorough and scientific evaluation index system, AHP-Fuzzy comprehensive evaluation could be a valuable technique. Objective: It is crucial to establish interventions that focus on risk factors for the prevention of social isolation in order to give a strong scientific foundation for enhancing older people's health habits. This can be achieved by using a fuzzy comprehensive evaluation method to assess the risk of social isolation in older people. Methods: A hundred community members over 60 from Nanjing were selected as the evaluation subjects in China. After the element layer was split into three categories of "social risk, economic risk, and cultural risk" using the analytic hierarchy process approach, a total of 22 assessment indicators were picked to develop a risk evaluation index system. Results: The risk level of social isolation belonging to the "low risk, relatively low risk, medium risk, relatively high risk, high risk" of membership degree are respectively "0.3392, 0.2632, 0.2257, 0.1069, 0.0650". Fuzzy comprehensive evaluation analysis showed that social relations (0.4934), monthly income (0.4654), health status (0.5960) were significant factors of social isolation risk in older people. The results showed that factors related to social risk had the most significant impact on social isolation. Conclusion: It is scientific and feasible to construct the risk evaluation index model of social isolation risk for the elderly by using AHP-Fuzzy comprehensive evaluation method. In preventing social isolation of older people in the future, we should pay attention to the impact of social and cultural factors on them, and provide practical intervention programs and references from the government, community, family.

Rational design, synthesis, antifungal evaluation and docking studies of antifungal peptide CGA-N12 analogues based on the target CtKRE9.

Candida tropicalis is a major non-albicans species that causes invasive candidiasis. CGA-N12, an anti-Candida peptide found by our group, disrupted cell wall architecture by inhibiting the activity of the protein killer-resistant 9 (KRE9), a ß-1,6-glucan synthase specific to Candida spp. and plants. Herein, a set of CGA-N12 analogues were rationally designed based on the interaction networks between CGA-N12 and C. tropicalis KRE9 (CtKRE9). Seven CGA-N12 analogues with significantly improved antifungal activity against C. tropicalis were screened by reducing the docking energy of CGA-N12 and CtKRE9 and increasing the number of positive charges on CGA-N12 based on a stable three-dimensional model of CtKRE9. CGA-N12 and its analogues exhibited antifungal activity against C. tropicalis and its persist cells; they also inhibited biofilm formation and eradicated preformed biofilms. Compared with fluconazole, they displayed higher activities against the growth of persister cells and more effective preformed biofilm eradication. Among them, CGA-N12-0801, CGA-N12-0902 and CGA-N12-1002 displayed much higher activity and anti-proteinase digestion stability than CGA-N12. Specifically, CGA-N12-0801 was the optimal analogue, with a minimum inhibitory concentration of 3.46 µg/mL and a therapeutic index of 158.07. The results of electronic microscopy observations and KRE9 activity inhibition assays showed that CGA-N12 and its analogues killed C. tropicalis by disrupting the architecture of the cell wall and the integrity of the cell membrane. In conclusion, for the first time, we provide a simple and reliable method for the rational design of antimicrobial peptides and ideal candidates for treating Candida infections that not effectively eliminated by azole drugs.

In utero exposure to per-/polyfluoroalkyl substances (PFASs): Preeclampsia in pregnancy and low birth weight for neonates.

Per-/polyfluoroalkyl substances (PFASs) have been linked to preeclampsia with inconsistent directions for outcomes. However, information regarding the joint effects of PFASs mixtures on preeclampsia as well as their associations with the low birth weight (LBW) and small for gestational age (SGA) is nascent. The present study included 82 women with preeclampsia and 169 healthy participants from Hangzhou, China. Fifteen PFASs were analyzed in maternal serum before delivery. PFOA and 6:2Cl-PFESA were associated with higher incidence of preeclampsia both linearly and by tertile. Each log-unit increase in serum PFOA (OR:5.29, 95% CI: 1.05, 26.7, p = 0.044) and 6:2 Cl-PFESA (OR:1.02, 95%CI: 1.00, 1.48, p = 0.045) concentrations were associated with increased risks of preeclampsia. These effects were more profound among primiparous women carrying female fetuses. Both PFOA and PFUnDA concentrations were significantly associated with higher odds of early-onset preeclampsia, but the associations tended to be null for late-onset. In addition, each logarithmic increment in PFOA concentrations were significantly associated with a 0.262 and 0.224 mmHg increase in systolic (95% CI: 0.147, 0.377) and diastolic (95% CI: 0.133, 0.314) blood pressures. Using Bayesian kernel machine regressions (BKMR), the overall effects of PFASs mixture concentrations on preeclampsia showed an increasing trend, with PFOA being the largest contributor. With regard to birth weight, the Cox proportional hazards model indicated that significantly higher risks of the LBW were associated with preeclampsia than normal pregnancy (OR: 4.56, 95% CI: 2.44, 6.68, p = 0.000). Increased LBW risks were found for the higher PFOA exposure both linearly and by tertile. Besides, serum PFOA and PFUnDA concentrations were significantly associated with higher odds of SGA development. Nevertheless 4:2 FTS and ADONA were inversely associated with LBW and SGA incidences. Further adverse birth outcomes should be explored to elucidate the health implications of PFASs exposure and preeclampsia development.

Current situation and factors influencing elderly care in community day care centers: a cross-sectional study.

Background: The latest census data show that people over 60 years of age account for about 18.7% of the total population in China, and the aging of the population has become an irreversible trend in the 21st century. This study aimed to investigate the current status and factors influencing the care of the elderly in community day care centers in order to lay the foundation for the development of better services in community day care centers. Methods: This study was a cross-sectional survey using convenience sampling in Nanjing, China. The survey instrument was the Day care and Elderly Care Service Needs Questionnaire, which included the Ability of Daily Living Assessment (ADL), the Xiao Shuiyuan Social Support Rating Scale (SSRS) and the Day care Elderly Care Service Needs Survey Form, and a general information survey. Results: A total of 450 elderly people in day care centers were surveyed. The elderly had different levels of demand for day care services, especially regarding daily care. Correlation analyses indicated that age (r = 0.619), education level (r = 0.616), source of income (r = 0.582), caregiver (r = 0.557), satisfaction with care service (r = 0.603), and degree of ADL (r = 0.629) were correlated with the need for elderly day care services (all p < 0.05). The factors influencing the demand for day care services encompassed age, education level, income source, caregiver, satisfaction with service, and ADL (all p < 0.05). Conclusion: Elderly care services in community day care centers are mainly based on daily and spiritual comfort, and the needs of the elderly are influenced by many factors. Timely nursing care policies and measures that target these factors are needed to improve elderly care.

ABPO-TVSCAD: alternating Bregman proximity operators approach based on TVSCAD regularization for bioluminescence tomography.

Objective.Bioluminescence tomography (BLT) is a promising non-invasive optical medical imaging technique, which can visualize and quantitatively analyze the distribution of tumor cells in living tissues. However, due to the influence of photon scattering effect and ill-conditioned inverse problem, the reconstruction result is unsatisfactory. The purpose of this study is to improve the reconstruction performance of BLT.Approach.An alternating Bregman proximity operators (ABPO) method based on TVSCAD regularization is proposed for BLT reconstruction. TVSCAD combines the anisotropic total variation (TV) regularization constraints and the non-convex smoothly clipped absolute deviation (SCAD) penalty constraints, to make a trade-off between the sparsity and edge preservation of the source. ABPO approach is used to solve the TVSCAD model (ABPO-TVSCAD for short). In addition, to accelerate the convergence speed of the ABPO, we adapt the strategy of shrinking the permission source region, which further improves the performance of ABPO-TVSCAD.Main results.The results of numerical simulations andin vivoxenograft mouse experiment show that our proposed method achieved superior accuracy in spatial localization and morphological reconstruction of bioluminescent source.Significance.ABPO-TVSCAD is an effective and robust reconstruction method for BLT, and we hope that this method can promote the development of optical molecular tomography.

Elastic net-based non-negative iterative three-operator splitting strategy for Cerenkov luminescence tomography.

Cerenkov luminescence tomography (CLT) provides a powerful optical molecular imaging technique for non-invasive detection and visualization of radiopharmaceuticals in living objects. However, the severe photon scattering effect causes ill-posedness of the inverse problem, and the location accuracy and shape recovery of CLT reconstruction results are unsatisfactory for clinical application. Here, to improve the reconstruction spatial location accuracy and shape recovery ability, a non-negative iterative three operator splitting (NNITOS) strategy based on elastic net (EN) regularization was proposed. NNITOS formalizes the CLT reconstruction as a non-convex optimization problem and splits it into three operators, the least square, L1/2-norm regularization, and adaptive grouping manifold learning, then iteratively solved them. After stepwise iterations, the result of NNITOS converged progressively. Meanwhile, to speed up the convergence and ensure the sparsity of the solution, shrinking the region of interest was utilized in this strategy. To verify the effectiveness of the method, numerical simulations and in vivo experiments were performed. The result of these experiments demonstrated that, compared to several methods, NNITOS can achieve superior performance in terms of location accuracy, shape recovery capability, and robustness. We hope this work can accelerate the clinical application of CLT in the future.

Single cell RNA-seq analysis identifies ferroptotic chondrocyte cluster and reveals TRPV1 as an anti-ferroptotic target in osteoarthritis.

BACKGROUND: Osteoarthritis (OA) is the most common degenerative joint disease primarily characterized by cartilage destruction. The aim of this study was to investigate the role, molecular characteristics and potential therapeutic target of chondrocyte ferroptosis in the pathogenesis of OA. METHODS: The expression of ferroptotic hallmarks (iron and lipid peroxidation accumulation, glutathione deletion) were analyzed in paired intact and damaged cartilages from OA patients. Single cell RNA sequencing (scRNA-seq) analysis was performed on 17,638 chondrocytes to verify the presence, investigate the molecular signatures and unveil the potential therapeutic target of ferroptotic chondrocyte cluster in human OA cartilages. Destabilization of medial meniscus (DMM)-induced OA model and tert-butyl hydroperoxide (TBHP)-treated primary mouse chondrocytes and human cartilage explants were used to evaluate the protective effect of pharmacologically activated transient receptor potential vanilloid 1 (TRPV1). The downstream molecular mechanisms of TRPV1 was further investigated in glutathione peroxidase 4 (Gpx4) heterozygous genetic deletion mice (Gpx4+/-). FINDINGS: The concentrations of iron and lipid peroxidation and the expression of ferroptotic drivers in the damaged areas of human OA cartilages were significantly higher than those in the intact cartilage. scRNA-seq analysis revealed a chondrocyte cluster characterized by preferentially expressed ferroptotic hallmarks and genes, namely ferroptotic chondrocyte cluster. Comprehensive gene set variation analysis revealed TRPV1 as an anti-ferroptotic target in human OA cartilage. Pharmacological activation of TRPV1 significantly abrogated cartilage degeneration by protecting chondrocytes from ferroptosis. Mechanistically, TRPV1 promoted the expression of GPX4, and its anti-ferroptotic role was largely mitigated in the OA model of Gpx4+/- mice. INTERPRETATION: TRPV1 activation protects chondrocytes from ferroptosis and ameliorates OA progression by upregulating GPX4. FUNDING: National Key R&D Program of China (2018YFC1105904), Key Program of NSFC (81730067), National Science Foundation of China (81772335, 81941009, 81802196), Natural Science Foundation of Jiangsu Province, China (BK20180127), Jiangsu Provincial Key Medical Talent Foundation, Six Talent Peaks Project of Jiangsu Province (WSW-079).

Construction of path analysis model on related factors of social isolation in older people.

BACKGROUND: With the gradual acceleration of population ageing, social isolation in older people has increasingly become a hot topic of social concern. The reduction of valid social participation will cause older people to weaken their sense of belonging to the community and social acquisition, negatively impacting on older people's quality of life. This study is aimed to explore the main related factors affecting the social isolation of older people, so as to provide a solid scientific basis for improving the health behaviour of older people in China. METHOD: A cross-sectional study was conducted among 2267 community residents over 60 years old from four cites in Jiangsu Province, China. Perceived social support scale, Geriatric Depression Scale, Connor-Davidson Resilience Scale, Comprehensive Ability of Older People Assessment Scale and other influencing factors scales were used to investigate the current situation. Social isolation was measured with the Lubben Social Network Scale. Demographic data were evaluated using descriptive statistical analyses and relationships among study variables were determined to use a path analysis. All data were analyzed using SPSS version 22 and AMOS version 26 using T-test, analysis of variance, logistic regression analyses, and path analysis method. The test level was set at alpha = 0.05, and the difference was statistically significant at P-value <0.05. RESULTS: The results of the model test analysis indicated that the hypothesised paths were supported by data from our samples and demonstrated significance on the path coefficients (P < 0.05). Related factors in the three dimensions of social risk, economic risk and cultural risk have an impact on the social isolation of older people in the community through direct and indirect pathways, and also indirectly through the partially mediated role of depression. Overall, our hypothesised model was retained, indicating empirical support and adequate model fit indices for the theoretical model. CONCLUSION: The findings demonstrated the predictive role of related factors of social isolation in older people. In the future, we should focus on developing interventions by uniting many forces such as society, family and older people themselves to reduce social isolation among this vulnerable population and improve the quality of life of older people and promote healthy ageing.

Instrument development and validation of the comprehensive ability of older people assessment scale.

AIM: The study is aimed to develop and psychometrically test the Comprehensive Ability of Older People Assessment scale and classify the ability grades. DESIGN: A cross-sectional design was used for instrument development. METHOD: The Comprehensive Ability of Older People Assessment scale was developed by a sample of 971 older people from 4 long-term care institutions in China. The data were collected between April 2018 and March 2020. One-way analysis of variance and multiple regression analysis was used to screen scale items, while focus group interviews were used to integrate the subjective and objective items. Confirmative factor analysis and expert judgment were applied to explore construct validity. Reliability was explored through internal consistency estimation using Cronbach's alpha and homogeneity evaluation using corrected item-total correlations. Cluster analysis and discriminant analysis were used to segment the comprehensive ability assessment scores and discriminant function was established to determine the boundary value of each segment, using correlation analysis to perform reverse verification. RESULTS: Factor analysis yielded 40 items with six dimensions, including "mentation and cognitive," "perception and communication," "emotional problems," "mental and behavioural problems," "daily life and social participation," and "skin and oral status." The Cronbach's α was 0.951, while the dimensions showed Cronbach's α values ranging from 0.760-0.946. The rationality and scientificity of this scale were proved by the correlation analysis of reverse validation. CONCLUSION: The 4-grade Comprehensive Ability of Older People Assessment scale is proved to be with good validity and reliability and should be considered for institutional assessors. IMPACT: Assessors can accurately evaluate older people's health status and nursing needs through this scale in long-term care institutions, communities and hospitals, so as to provide accurate and high-quality nursing services. It will become a scientific basis for the government to offer accurate pension subsidies, purchase pension services scientifically for older people and establish third-party objective evaluation and supervision.

Prognosis of lung cancer associated with cystic airspaces: A propensity score matching analysis.

OBJECTIVE: The association between the morphological characteristics and survival outcome of lung cancer associated with cystic airspaces (LCCAs) is unclear due to rarity of this disease. The current study attempted to compare the survival outcome between LCCAs and non-LCCAs and investigate the correlation between imaging features and prognosis of LCCA. METHOD: Of 10,835 patients diagnosed with non-small cell lung carcinoma (NSCLC) between January 2015 and December 2016, 123 patients with LCCA were included. The non-LCCA group comprised 3136 patients with primary solitary adenocarcinoma or squamous cell lung cancer. Propensity score matching (PSM) was performed for age, sex, tumor size, tumor stage, and lymph node involvement in a 1:1 ratio between the LCCAs and non-LCCAs, and the correlation between radiological features and recurrence-free survival (RFS) was analyzed. RESULT: The computed tomography (CT) lesion size was found to be higher in all LCCA subtypes, particularly in Type III (a cystic airspace with a mural nodule) and Type IV (mixed) LCCAs (3.09 and 3.65 cm, respectively), than in non-LCCAs (2 cm) after PSM. Three-year RFS in the LCCA group was higher than in the non-LCCA group (Type I- IV LCCAs: 100%, 84%, 77% and 83%, respectively vs. non-LCCAs: 77%). However, statistically significant difference was only found in comparison between LCCA Type I (thin-walled) and non-LCCA groups (P = 0.026). Type III lung cancer exhibited the worst survival among all four LCCA subtypes. CONCLUSIONS: The CT lesion size and pathologic tumor size varied significantly across LCCAs. Type I LCCAs exhibited better survival than non-LCCAs, whereas Type III LCCAs exhibited the worst survival rate among the four LCCA subtypes.

Chinese Herbal Medicine for Chemotherapy-Induced Leukopenia: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials.

Aim: We conducted a systematic review of high-quality randomized controlled trials (RCTs) to assess the efficacy and safety of Chinese herbal medicine (CHM) for the treatment of chemotherapy-induced leukopenia (CIL). Methods: Eight electronic databases were searched from the date of inception to November 4, 2020 for high-quality RCTs that met the requirements of at least four key domains of the Cochrane risk of bias (RoB) tool. RevMan 5.3 was applied for the meta-analysis. Results: Fourteen RCTs involving 1,053 patients were included. The pooled results showed that CHM + chemotherapy exerted greater beneficial effects on white blood cell (WBC), neutrophil (NEU), hemoglobin (Hb), and platelet (PLT) counts in addition to the Karnofsky performance scale (KPS) score, but showed no significant difference on granulocyte colony-stimulating factor (G-CSF) dosage compared with chemotherapy alone. Placebo (PBO) + chemotherapy and CHM + chemotherapy groups showed no significant differences in terms of reduction of the incidence of neutropenia. CHM + chemotherapy was superior to Western medicine (WM) + chemotherapy in improving the WBC count, KPS, infection amount, G-CSF use rate, and incidence of leukopenia. In addition, no severe adverse events were observed in the 14 RCTs. Conclusion: CHM in combination with chemotherapy could effectively improve the clinical symptoms of CIL when compared with chemotherapy alone or Western medicine + chemotherapy, except when comparing with PBO + chemotherapy. While CHMs were generally safe for clinical use and exerted no severe side effects in the 14 RCTs, high-quality RCTs with larger sample sizes are essential to reduce study heterogeneity.

Acupuncture for mild cognitive impairment in elderly people: Systematic review and meta-analyses.

BACKGROUND: Acupuncture has an unique role in preventing and managing mild cognitive impairment (MCI) in nonpharmaceutical therapies because of its small wound, mild pain, and high security for many years. However, there is no systematic review evaluating safety and efficacy of acupuncture for MCI in elderly people. Therefore, this study will provide a protocol to explore the effectiveness and safety of acupuncture for MCI in the elderly. METHODS: Retrieval from 8 electronic databases was conducted to determine eligible trials published until May, 2019. Homogeneity qualified studies were included for data were extracted such as study country location, demographic characteristics, and measure outcomes, and were analyzed by a random effect model and sensitivity analyses to identify heterogeneity. Review Manager (Revman Version 5.3) software will be used for data synthesis, sensitivity analysis, meta regression, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias. RESULTS: A total of 15 randomized control trials involving 1051 subjects were included. The results were as follows: Compared with the control group, the clinical efficacy rates of acupuncture was better, odds ratio = 2.52, 95% confidence interval (CI) (1.86, 3.42), P < .00001, mini-mental state examination scores (mean difference [MD] = 1.53, 95% CI [1.04, 2.01], P < .00001), Montreal cognitive assessment scores (MD = 2.05, 95% CI [1.17, 1.92], P < .00001), activity of daily living scale (MD = 1.71, 95% CI [-1.38, 4.79], P > .05), and clock drawing task scores (MD = 1.91, 95% CI [1.74, 2.08], P < .00001). CONCLUSION: This study shows that acupuncture is beneficial for improving aspects of cognitive function in elderly people with MCI, which suggests that acupuncture may be an effective alternative and complementary approach to existing therapies for elderly people. More rigorous experimental studies and longer follow-up studies should be conducted in the future.

Effects of meteorological factors on the incidence of mumps and models for prediction, China.

BACKGROUND: Mumps is an acute respiratory infectious disease with obvious regional and seasonal differences. Exploring the impact of climate factors on the incidence of mumps and predicting its incidence trend on this basis could effectively control the outbreak and epidemic of mumps. METHODS: Considering the great differences of climate in the vast territory of China, this study divided the Chinese mainland into seven regions according to the administrative planning criteria, data of Mumps were collected from the China Disease Prevention and Control Information System, ARIMA model and ARIMAX model with meteorological factors were established to predict the incidence of mumps. RESULTS: In this study, we found that precipitation, air pressure, temperature, and wind speed had an impact on the incidence of mumps in most regions of China and the incidence of mumps in the north and southwest China was more susceptible to climate factors. Considering meteorological factors, the average relative error of ARIMAX model was 10.87%, which was lower than ARIMA model (15.57%). CONCLUSIONS: Meteorology factors were the important factors which can affect the incidence of mumps, ARIMAX model with meteorological factors could better simulate and predict the incidence of mumps in China, which has certain reference value for the prevention and control of mumps.

Spatial-temporal analysis and visualization of scarlet fever in mainland China from 2004 to 2017.

This study retrospectively analyzed the spatio-temporal distribution and spatial clustering of scarlet fever in mainland China from 2004 to 2017. In recent years, the incidence of scarlet fever is increasing. Previous studies on the spatial distribution of scarlet fever in China are mainly focused at the provincial and municipal levels, and there is few systematic report on the spatial and temporal distribution characteristics of scarlet fever on the national level. Based on the incidence information of scarlet fever in mainland China between 2004 and 2017 collected from the China Center for Disease Control, this paper systematically explored the Spatio-temporal distribution of scarlet fever by three methods, contains spatial autocorrelation analysis, Spatio-temporal scanning analysis, and trend surface analysis. The results demonstrate that the incidence of scarlet fever varies by seasons, which is in line with double-peak distribution.The first peak generally occurs from May to June and the second one from November to December, while February and August is the lowest period of incidence. Trend surface analysis indicates that the incidence of scarlet fever in northern China is higher than the south, slightly higher in western compared to the east, and lower in the central part. Additionally, the results show that the clustering regions of scarlet fever centrally distributed in the northeast, northwest, north china and some provinces in the east, such as Zhejiang, Shanghai, Shandong, and Jiangsu.