The molecular characteristics could supplement the staging system of pT2/T3N0M0 esophageal squamous cell carcinoma: a translational study based on a cohort with over 20 years of follow-up.

OBJECTIVE: This study aimed to construct a model based on 23 enrolled molecules to evaluate prognoses of pT2/3N0M0 esophageal squamous cell carcinoma (ESCC) patients with up to 20 years of follow-up. METHODS: The lasso-Cox model was used to identify the candidate molecule. A nomogram was conducted to develop the survival model (molecular score, MS) based on the molecular features. Cox regression and Kaplan-Meier analysis were used in this study. The concordance index (C-index) was measured to compare the predicted ability between different models. The primary endpoint was overall survival (OS). RESULTS: A total of 226 patients and 23 proteins were enrolled in this study. Patients were classified into high-risk (MS-H) and low-risk (MS-L) groups based on the MS score of 227. The survival curves showed that the MS-L cohort had better 5-year and 10-year survival rates than the MS-H group (5-year OS: 51.0% vs. 8.0%; 10-year OS: 45.0% vs. 5.0%, all p < 0.001). Furthermore, multivariable analysis confirmed MS as an independent prognostic factor after eliminating the confounding factors (Hazard ratio 3.220, p < 0.001). The pT classification was confirmed to differentiate ESCC patients' prognosis (Log-rank: p = 0.029). However, the combination of pT and MS could classify survival curves evidently (overall p < 0.001), which showed that the prognostic prediction efficiency was improved significantly by the combination of the pT and MS than by the classical pT classification (C-index: 0.656 vs. 0.539, p < 0.001). CONCLUSIONS: Our study suggested an MS for significant clinical stratification of T2/3N0M0 ESCC patients to screen out subgroups with poor prognoses. Besides, the combination of pT staging and MS could predict survival more accurately for this cohort than the pT staging system alone.

Brain amyloid-ß deposition associated functional connectivity changes of ultra-large structural scale in mild cognitive impairment.

In preclinical Alzheimer's disease, neuro-functional changes due to amyloid-ß (Aß) deposition are not synchronized in different brain lobes and subcortical nuclei. This study aimed to explore the correlation between brain Aß burden, connectivity changes in an ultra-large structural scale, and cognitive function in mild cognitive impairment. Participants with mild cognitive impairment were recruited and underwent florbetapir (F18-AV45) PET, resting-state functional MRI, and multidomain neuropsychological tests. AV-45 standardized uptake value ratio (SUVR) and functional connectivity of all participants were calculated. Of the total 144 participants, 72 were put in the low Aß burden group and 72 in the high Aß burden group. In the low Aß burden group, all connectivities between lobes and nuclei had no correlation with SUVR. In the high Aß burden group, SUVR showed negative correlations with the Subcortical-Occipital connectivity (r=-0.36, P = 0.02) and Subcortical-Parietal connectivity (r=-0.26, P = 0.026). Meanwhile, in the high Aß burden group, SUVR showed positive correlations with the Temporal-Prefrontal connectivity (r = 0.27, P = 0.023), Temporal-Occipital connectivity (r = 0.24, P = 0.038), and Temporal-Parietal connectivity (r = 0.32, P = 0.006). Subcortical to Occipital and Parietal connectivities had positive correlations with general cognition, language, memory, and executive function. Temporal to Prefrontal, Occipital, and Parietal connectivities had negative correlations with memory function, executive function, and visuospatial function, and a positive correlation with language function. In conclusion, Individuals with mild cognitive impairment with high Aß burden have Aß-related bidirectional functional connectivity changes between lobes and subcortical nuclei that are associated with cognitive decline in multiple domains. These connectivity changes reflect neurological impairment and failed compensation.

Dual-stage cognitive assessment: a two-stage screening for cognitive impairment in primary care.

BACKGROUND: Aging population has led to an increased proportion of older adults and cognitively impaired. We designed a brief and flexible two-stage cognitive screening scale, the Dual-Stage Cognitive Assessment (DuCA), for cognitive screening in primary care settings. METHOD: In total, 1,772 community-dwelling participants were recruited, including those with normal cognition (NC, n = 1,008), mild cognitive impairment (MCI, n = 633), and Alzheimer's disease (AD, n = 131), and administered a neuropsychological test battery and the DuCA. To improve performance, the DuCA combines visual and auditory memory tests for an enhanced memory function test. RESULTS: The correlation coefficient between DuCA-part 1 and DuCA-total was 0.84 (P < 0.001). The correlation coefficients of DuCA-part 1 with Addenbrooke's Cognitive Examination III (ACE-III) and Montreal Cognitive Assessment Basic (MoCA-B) were 0.66 (P < 0.001) and 0.85 (P < 0.001), respectively. The correlation coefficients of DuCA-total with ACE-III and MoCA-B were 0.78 (P < 0.001) and 0.83 (P < 0.001), respectively. DuCA-Part 1 showed a similar discrimination ability for MCI from NC (area under curve [AUC] = 0.87, 95%CI 0.848-0.883) as ACE III (AUC = 0.86, 95%CI 0.838-0.874) and MoCA-B (AUC = 0.85, 95%CI 0.830-0.868). DuCA-total had a higher AUC (0.93, 95%CI: 0.917-0.942). At different education levels, the AUC was 0.83-0.84 for DuCA-part 1, and 0.89-0.94 for DuCA-total. DuCA-part 1 and DuCA-total's ability to discriminate AD from MCI was 0.84 and 0.93, respectively. CONCLUSION: DuCA-Part 1 would aid rapid screening and supplemented with the second part for a complete assessment. DuCA is suited for large-scale cognitive screening in primary care, saving time and eliminating the need for extensively training assessors.

Current operating situation of water-defluoridation-project in 2010 in Zhangjiakou city Hebei province / 中国地方病学杂志

Objective To master current operating situation of water-defluoridation-project and the level of fluoride in drinking water of Zhangjiakou city and provide a scientific basis for prevention and control of the disease.Methods Itemized survey of current operating situation of water defluoridation projects built in 2010 and before,and the source of fund situation in Zhangjiakou city was carried out.One source water and 2 terminal water samples of the projects in use were collected,respectively.Water fluoride were determined by Sanitary Standard for Drinking Water Testing Method (GB/T 5750.5-2006).Results A total of 386 water improvement projects to reduce fluoride were investigated,310 in good operation,accounting for 80.31％; 6 in intermittent use,accounting for 1.55％; 70 out of use,accounting for 18.14％.Water fluoride was surveyed in 316 water improvement projects to reduce fluoride,175 of the projects provided water with normal fluoride,accounting for 55.38％; 141 of the projects provided water with fluoride exceeded the standard,accounting for 44.62％.The total investment of 386 water defluoridation projects was 21.8682 million yuan,the investment of the state,the collective and the individual were 10.0780 million yuan,6.2104 million yuan and 5.5798 million yuan,accounted for 46.09％,28.40％,25.51％,respectively.Conclusions The current situation of the projects is very worrying in Zhangjiakou city.Further instensify the water improvement project in diseased areas,insist on sustainable water defluoridation strategy.