The current status and expectation of pediatric total facial management / 临床耳鼻咽喉头颈外科杂志

The pediatric total facial management refers to a series of diagnosis and treatment processes to achieve the healthy development of the face through reasonable medical intervention. The main reason for the poor treatment effect is that the first contact doctor is limited to his own disciplinary analysis and treatment. The importance of multidisciplinary cooperation in the diagnosis and treatment of facial dysplasia in children has become increasingly prominent. it is necessary to comprehensively analyze and find the pathogenic factors of patients and formulate a comprehensive treatment plan to restore normal upper airway structure and nasal breathing, and then reshape the healthy craniomaxillofacial tissue structure, and the monitoring of the results of medical intervention should accompany the whole process of children's growth and development. This paper summarizes the current situation of the treatment of children with facial dysplasia and puts forward the concept of orderly individualized multi-disciplinary diagnosis and treatment of pediatric oral maxillofacial management.

Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults / 中华医学杂志(英文版)

BACKGROUND@#Evidence on the relations of the American Heart Association's ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps.@*METHODS@#A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004-2018), Dongfeng-Tongji cohort (2008-2018), and Kailuan study (2006-2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis.@*RESULTS@#During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10-14 vs. 0-6 were 0.52 (0.41-0.67), 0.44 (0.37-0.53), 0.54 (0.45-0.66), and 0.86 (0.64-1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed.@*CONCLUSIONS@#ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.

Association between fresh fruit consumption and the risk of chronic obstructive pulmonary disease-related hospitalization and death in Chinese adults: A prospective cohort study / 中华医学杂志(英文版)

BACKGROUND@#Existing evidence suggests that fruit consumption is a significant influencing factor for chronic obstructive pulmonary disease (COPD), but this is unclear in the Chinese population. We examined the association of fresh fruit consumption with the risk of COPD-related hospitalization and death in a nationwide, population-based prospective cohort from China.@*METHODS@#Between 2004 and 2008, the China Kadoorie Biobank recruited >0.5 million adults aged 30 to 79 years from ten diverse regions across China. After excluding individuals diagnosed with major chronic diseases and prevalent COPD, the prospective analysis included 421,428 participants. Cox regression was used to calculate the hazard ratios (HRs) for the association between fresh fruit consumption and risk of COPD-related hospitalization and death, with adjustment for established and potential confounders.@*RESULTS@#During a mean follow-up of 10.9 years, 11,292 COPD hospitalization events and deaths were documented, with an overall incidence rate of 2.47/1000 person-years. Participants who consumed fresh fruit daily had a 22% lower risk of COPD-related hospitalization and death compared with non-consumers (HR = 0.78, 95% confidence interval [CI]: 0.71-0.87). The inverse association between fresh fruit consumption and COPD-related hospitalization and death was stronger among non-current smokers and participants with normal body mass index (BMI) (18.5 kg/m 2 ≤ BMI < 24.0 kg/m 2 ); the corresponding HRs for daily fresh fruit consumption were 0.78 (95% CI: 0.68-0.89) and 0.69 (95% CI: 0.59-0.79) compared with their counterparts, respectively.@*CONCLUSIONS@#High-frequency fruit consumption was associated with a lower risk of COPD in Chinese adults. Increasing fruit consumption, together with cigarette cessation and weight control, should be considered in the prevention and management of COPD.

Minimal improvement in coronary artery disease risk prediction in Chinese population using polygenic risk scores: evidence from the China Kadoorie Biobank / 中华医学杂志(英文版)

BACKGROUND@#Several studies have reported that polygenic risk scores (PRSs) can enhance risk prediction of coronary artery disease (CAD) in European populations. However, research on this topic is far from sufficient in non-European countries, including China. We aimed to evaluate the potential of PRS for predicting CAD for primary prevention in the Chinese population.@*METHODS@#Participants with genome-wide genotypic data from the China Kadoorie Biobank were divided into training ( n = 28,490) and testing sets ( n = 72,150). Ten previously developed PRSs were evaluated, and new ones were developed using clumping and thresholding or LDpred method. The PRS showing the strongest association with CAD in the training set was selected to further evaluate its effects on improving the traditional CAD risk-prediction model in the testing set. Genetic risk was computed by summing the product of the weights and allele dosages across genome-wide single-nucleotide polymorphisms. Prediction of the 10-year first CAD events was assessed using hazard ratios (HRs) and measures of model discrimination, calibration, and net reclassification improvement (NRI). Hard CAD (nonfatal I21-I23 and fatal I20-I25) and soft CAD (all fatal or nonfatal I20-I25) were analyzed separately.@*RESULTS@#In the testing set, 1214 hard and 7201 soft CAD cases were documented during a mean follow-up of 11.2 years. The HR per standard deviation of the optimal PRS was 1.26 (95% CI:1.19-1.33) for hard CAD. Based on a traditional CAD risk prediction model containing only non-laboratory-based information, the addition of PRS for hard CAD increased Harrell's C index by 0.001 (-0.001 to 0.003) in women and 0.003 (0.001 to 0.005) in men. Among the different high-risk thresholds ranging from 1% to 10%, the highest categorical NRI was 3.2% (95% CI: 0.4-6.0%) at a high-risk threshold of 10.0% in women. The association of the PRS with soft CAD was much weaker than with hard CAD, leading to minimal or no improvement in the soft CAD model.@*CONCLUSIONS@#In this Chinese population sample, the current PRSs minimally changed risk discrimination and offered little improvement in risk stratification for soft CAD. Therefore, this may not be suitable for promoting genetic screening in the general Chinese population to improve CAD risk prediction.

Genetic and healthy lifestyle factors in relation to the incidence and prognosis of severe liver disease in the Chinese population / 中华医学杂志(英文版)

BACKGROUND@#Severe liver disease (SLD), including cirrhosis and liver cancer, constitutes a major disease burden in China. We aimed to examine the association of genetic and healthy lifestyle factors with the incidence and prognosis of SLD.@*METHODS@#The study population included 504,009 participants from the prospective China Kadoorie Biobank aged 30-79 years. The individuals were from 10 diverse areas in China without a history of cancer or liver disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HRs) for incident SLD and death after SLD diagnosis associated with healthy lifestyle factors (smoking, alcohol, physical activity, and central adiposity). Additionally, the contribution of genetic risk for hepatitis B virus (HBV, assessed by genetic variants in major histocompatibility complex, class II, DP/DQ [ HLA - DP / DQ ] genes) was also estimated.@*RESULTS@#Compared with those with 0-1 healthy lifestyle factor, participants with 2, 3, and 4 factors had 12% (HR 0.88 [95% confidence interval [CI] 0.85, 0.92]), 26% (HR 0.74 [95%CI: 0.69, 0.79]), and 44% (HR 0.56 [95%CI: 0.48, 0.65]) lower risks of SLD, respectively. Inverse associations were observed among participants with both low and high genetic risks (HR per 1-point increase 0.83 [95%CI: 0.74, 0.94] and 0.91 [95%CI: 0.82, 1.02], respectively; Pinteraction = 0.51), although with a non-significant trend among those with a high genetic risk. Inverse associations were also observed between healthy lifestyle factors and liver biomarkers regardless of the genetic risk. Despite the limited power, healthy lifestyle factors were associated with a lower risk of death after incident SLD among participants with a low genetic risk (HR 0.59 [95%CI: 0.37, 0.96]).@*CONCLUSIONS@#Lifestyle modification may be beneficial in terms of lowering the risk of SLD regardless of the genetic risk. Moreover, it is also important for improving the prognosis of SLD in individuals with a low genetic risk. Future studies are warranted to examine the impact of healthy lifestyles on SLD prognosis, particularly among individuals with a high genetic risk.

Heritability of tea drinking and its relationship with cigarette smoking in the Chinese male adult twins.

The aims of this study are to estimate the contributions of genetic factors to the variation of tea drinking and cigarette smoking, to examine the roles of genetic factors in their correlation and further to investigate underlying causation between them. We included 11 625 male twin pairs from the Chinese National Twin Registry (CNTR). Bivariate genetic modelling was fitted to explore the genetic influences on tea drinking, cigarette smoking and their correlation. Inference about Causation through Examination of FAmiliaL CONfounding (ICE FALCON) was further used to explore the causal relationship between them. We found that genetic factors explained 17% and 23% of the variation in tea drinking and cigarette smoking, respectively. A low phenotypic association between them was reported (rph = 0.21, 95% confidence interval [CI]: [0.19, 0.24]), which was partly attributed to common genetic factors (rA = 0.45, 95% CI [0.19, 1.00]). In the ICE FALCON analysis with current smoking as the exposure, tea drinking was associated with his own (ßself = 0.39, 95% CI [0.23, 0.55]) and his co-twin's smoking status (ßco-twin = 0.25, 95% CI [0.10, 0.41]). Their association attenuated with borderline significance conditioning on his own smoking status (p = 0.045), indicating a suggestive causal effect of smoking status on tea drinking. On the contrary, when we used tea drinking as the predictor, we found familial confounding between them only. In conclusion, both tea drinking and cigarette smoking were influenced by genetic factors, and their correlation was partly explained by common genetic factors. In addition, our finding suggests that familial confounders account for the relationship between tea drinking and cigarette smoking. And current smoking might have a causal effect on weekly tea drinking, but not vice versa.

Establishment and identification of human immortalized keratinocytes stably expressing human papillomavirus type 16 E6/E7 gene / 中华皮肤科杂志

Objective:To construct human immortalized keratinocytes stably expressing human papillomavirus type 16 (HPV16) E6/E7 gene, and provide a cell model for studying mechanisms underlying HPV16 E6/E7-induced cell immortalization and malignant transformation.Methods:Primary human foreskin keratinocytes (HFKs) were isolated by sequential two-step enzymatic digestion. Cultured HFKs were stably transfected with a HPV16 E6/E7 gene-overexpressing lentiviral vector LV5-HPV16 E6/E7, and consecutively cultured for more than 30 passages. Then, immortalized keratinocytes were screened out and divided into 3 groups: (1) blank control group: second-passage primary HFKs; (2) experimental group: HFKs transfected with LV5-HPV16 E6/E7 at different passages, and the second-passage primary HFKs transfected with LV5-HPV16 E6/E7 were referred to as A0 cells, thereafter, the transfected HFKs were named according to their passage number, such as A1, A2, ... A30; (3) positive control group: the HPV16-positive cervical cancer cell line SiHa. Real-time fluorescence-based quantitative PCR (qRT-PCR) and Western blot analysis were performed to determine the mRNA expression of HPV16 E6/E7 and protein expression of HPV16 E6/E7 and CK14, respectively, in the blank control group, experimental group and positive control group. Cell counting kit-8 (CCK8) assay and Transwell insert invasion assay were conducted to assess the cellular proliferative and invasive activity. In vivo tumor formation experiment in nude mice was conducted to investigate the tumorigenicity of A30 cells in the experimental group and SiHa cells in the positive control group. Results:Primary HFKs were successfully isolated. After the primary HFKs were transfected with the recombinant plasmid LV5-HPV16 E6/E7, the blank control group showed no fluorescence in the cells, but showed senescent phenotypes after serial passages, while in the experimental group, the volume and morphology of A30 cells were similar to those of the primary HFKs with the proportion of fluorescence-positive cells being 100%. Compared with the blank control group, the experimental group showed significantly increased mRNA expression levels of HPV16 E6 and E7 in A1, A10, A20 and A30 cells (HPV16 E6: t = 7.12, 8.07, 6.53, 5.66, P < 0.001, < 0.001, = 0.001, = 0.005, respectively; HPV16 E7: t = 3.20, 4.29, 3.75, 4.22; P = 0.024, 0.008, 0.013, 0.014, respectively) . The protein expression of HPV16 E6/E7 was absent in the blank control group, but was observed in A30 and SiHa cells. CCK8 assay showed that the proliferative activity of A10, A20 and A30 cells was significantly higher than that of the blank control group ( t = 6.49, 7.55, 9.43, P = 0.003, 0.002, 0.001, respectively) , while there was no significant difference in the proliferative activity between A1 cells and the blank control group ( t = 2.40, P = 0.074) . Transwell insert invasion assay showed that A30 cells could not cross the basement membrane, but SiHa cells could pass through the basement membrane and were stained blue. Two months after the inoculation with A30 cells in the nude mice, no visible tumors were found, which was confirmed by a histological study. Subcutaneous tumors were formed in the nude mice after the inoculation with SiHa cells. Conclusion:Human immortalized keratinocytes were successfully established by lentivirus-mediated transfection with HPV16 E6/E7 gene, and can serve as an ideal cell model for HPV-related research.

Modulation of Spike Count Correlations Between Macaque Primary Visual Cortex Neurons by Difficulty of Attentional Task / 神经科学通报·英文版

Studies have shown that spatial attention remarkably affects the trial-to-trial response variability shared between neurons. Difficulty in the attentional task adjusts how much concentration we maintain on what is currently important and what is filtered as irrelevant sensory information. However, how task difficulty mediates the interactions between neurons with separated receptive fields (RFs) that are attended to or attended away is still not clear. We examined spike count correlations between single-unit activities recorded simultaneously in the primary visual cortex (V1) while monkeys performed a spatial attention task with two levels of difficulty. Moreover, the RFs of the two neurons recorded were non-overlapping to allow us to study fluctuations in the correlated responses between competing visual inputs when the focus of attention was allocated to the RF of one neuron. While increasing difficulty in the spatial attention task, spike count correlations were either decreased to become negative between neuronal pairs, implying competition among them, with one neuron (or none) exhibiting attentional enhancement of firing rate, or increased to become positive, suggesting inter-neuronal cooperation, with one of the pair showing attentional suppression of spiking responses. Besides, the modulation of spike count correlations by task difficulty was independent of the attended locations. These findings provide evidence that task difficulty affects the functional interactions between different neuronal pools in V1 when selective attention resolves the spatial competition.

Multimorbidity patterns and association with mortality in 0.5 million Chinese adults / 中华医学杂志(英文版)

BACKGROUND@#Few studies have assessed the relationship between multimorbidity patterns and mortality risk in the Chinese population. We aimed to identify multimorbidity patterns and examined the associations of multimorbidity patterns and the number of chronic diseases with the risk of mortality among Chinese middle-aged and older adults.@*METHODS@#We used data from the China Kadoorie Biobank and included 512,723 participants aged 30 to 79 years. Multimorbidity was defined as the presence of two or more of the 15 chronic diseases collected by self-report or physical examination at baseline. Multimorbidity patterns were identified using hierarchical cluster analysis. Cox regression was used to estimate the associations of multimorbidity patterns and the number of chronic diseases with all-cause and cause-specific mortality.@*RESULTS@#Overall, 15.8% of participants had multimorbidity. The prevalence of multimorbidity increased with age and was higher in urban than rural participants. Four multimorbidity patterns were identified, including cardiometabolic multimorbidity (diabetes, coronary heart disease, stroke, and hypertension), respiratory multimorbidity (tuberculosis, asthma, and chronic obstructive pulmonary disease), gastrointestinal and hepatorenal multimorbidity (gallstone disease, chronic kidney disease, cirrhosis, peptic ulcer, and cancer), and mental and arthritis multimorbidity (neurasthenia, psychiatric disorder, and rheumatoid arthritis). During a median of 10.8 years of follow-up, 49,371 deaths occurred. Compared with participants without multimorbidity, cardiometabolic multimorbidity (hazard ratios [HR] = 2.20, 95% confidence intervals [CI]: 2.14 - 2.26) and respiratory multimorbidity (HR = 2.13, 95% CI:1.97 - 2.31) demonstrated relatively higher risks of mortality, followed by gastrointestinal and hepatorenal multimorbidity (HR = 1.33, 95% CI:1.22 - 1.46). The mortality risk increased by 36% (HR = 1.36, 95% CI: 1.35 - 1.37) with every additional disease.@*CONCLUSION@#Cardiometabolic multimorbidity and respiratory multimorbidity posed the highest threat on mortality risk and deserved particular attention in Chinese adults.

Predictive value of visceral adipose tissue in occult peritoneal metastasis of gastric cancer / 中华放射学杂志

Objective:To investigate the predictive value of visceral adipose tissue (VAT) in occult peritoneal metastasis (OPM) of gastric cancer.Methods:A total of 93 patients with gastric cancer admitted to the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2021 were retrospectively collected. None of the patients had typical peritoneal metastasis on CT. Patients were divided into OPM group (31 cases) and non-OPM group (62 cases) according to laparoscopic exploration. The clinical, pathological and CT features were recorded. The parameters related to adipose tissue (VAT and subcutaneous adipose tissue) within the range of 15 mm and 25 mm below the largest layer of gastric cancer lesions in preoperative CT images were measured, including the volume, average CT attenuation and standard deviation. The independent-sample t test, Wilcoxon rank-sum test, χ 2 test or Fisher′s exact probability were used to compare the clinical, pathological and CT imaging parameters between OPM and non-OPM groups. Multivariate logistic regression analysis was used to explore the independent risk factors for OPM of gastric cancer and establish a combined model. The receiver operating characteristic curve was used to evaluate the efficacy of each indicator and the combined model in predicting OPM of gastric cancer. Results:There were statistically significant differences in age, pathological type, CA125, ascites, cT stage, the thickest diameter of lesion, average CT attenuation of 15 mm VAT and 25 mm VAT between the OPM group and the non-OPM group ( P<0.05). Multivariate analysis showed that ascites, cT stage and average CT attenuation of 25 mm VAT were independent risk factors for OPM of gastric cancer, with the OR (95%CI) of 4.940 (1.287-18.967), 4.284 (1.270-14.455), and 1.149 (1.013-1.303), respectively. A combined model was established. The area under the curve (AUC) of ascites, cT stage, average CT attenuation of 25 mm VAT, average CT attenuation of 15 mm VAT and combined model were 0.685, 0.718, 0.703, 0.674 and 0.813, respectively. There were statistically significant differences in AUC between the combined model and each four single indicators above ( Z=2.98, 2.63, 2.09, 2.54, P=0.003, 0.009, 0.037, 0.011). Conclusions:The ascites, cT stage and average CT attenuation of 25 mm VAT are independent risk factors for OPM in gastric cancer. The combined model based on the above three indicators has the best performance in predicting OPM in gastric cancer.

Glomus tumor located in trachea: two cases reports / 中国医师杂志

Objective:To investigate the clinicopathological features and computed tomography (CT) findings of tracheal glomus tumor (GT) in order to improve the understanding and diagnosis of tracheal GT.Methods:The clinical and CT imaging data of 2 patients with tracheal GT diagnosed in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively. The image characteristics based on previous reports were analyzed.Results:The clinical manifestations of trachea GT were dyspnea, chest tightness, hemoptysis, etc., which were easy to be misdiagnosed. The CT manifestations were spherical or nodular protrusions in the trachea cavity, with uneven edges, which can be lobulated. Cystic changes can be seen in the focus. After enhancement, it showed progressive filling and obvious enhancement, without deep infiltration and distant metastasis.Conclusions:Chest CT can accurately localize tracheal GT, provide its morphological size, blood supply, growth characteristics and other characteristics, accurately display the overall morphology of the lesion, and provide some help for the development of the surgical plan, and its definitive diagnosis still relies on pathological examination.

Influential factors of internal fixation for closed posterior ankle fractures / 中国基层医药

Objective:To investigate the influential factors of internal fixation for closed posterior ankle fractures.Methods:The clinical data of 352 patients with closed ankle fractures who received treatment in Yeda Hospital from January 2016 to June 2020 were retrospectively analyzed. Among the 352 patients, 232 patients had posterior ankle fractures. These patients were grouped according to whether they had undergone internal fixation. The factors that affect internal fixation for closed posterior ankle fractures were analyzed by univariate and multivariate analyses.Results:232 patients out of 352 patients with closed ankle fractures had closed posterior ankle fractures, accounting for 65.91%. A total of 102 (43.97%) patients with posterior ankle fractures underwent internal fixation. There were significant differences in Bartonicek classification, the proportion of the posterior subluxation of the talus, the proportion of posterior ankle bone area, the proportion of posterior ankle bone area ≥ 25% displayed on X-ray image, the proportion of posterior ankle bone area ≥ 15% displayed on CT scan, the proportion of outward displacement of bone mass (92.31% vs. 41.82%) and the proportion of die-punch bone mass (94.23% vs. 40.00%) between patients receiving and not receiving internal fixation ( χ2 = 3.89, 0.26, 1.51, 0.31, 9.27, 8.67, 1.68, 5.84, 10.33, 12.47, 11.48, 10.69, 1.39, all P < 0.05). Multivariate analysis of a logistic regression model showed that posterior subluxation of the talus and the proportion of posterior ankle bone area ≥ 15% displayed on CT scan were independent influential factors of internal fixation for closed posterior ankle fracture ( OR = 5.47, 9.29, 95% CI:1.62-9.75, 3.24-27.01, all P < 0.05). Conclusion:In patients with closed ankle fractures, posterior ankle fractures and internal fixation are more common. At the same time, the posterior subluxation of the talus and the proportion of posterior ankle bone area ≥ 15% displayed on CT scan are closely related to receiving internal fixation.

Multiphasic enhanced CT-based radiomics signature for preoperatively predicting the invasive behavior of pancreatic solid pseudopapillary neoplasm / 中华放射学杂志

Objective:To explore the value of multiphasic CT-based radiomics signature in predicting the invasive behavior of pancreatic solid pseudopapillary neoplasm (pSPN).Methods:The multiphasic CT images of patients with pSPN confirmed by postoperative pathology in the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2021 were analyzed retrospectively. There were 23 cases of invasiveness and 59 cases of non-invasiveness. The region of interest(ROI) was artificially delineated layer by layer in the plain scan, arterial-phase and venous-phase images, respectively. The 1 316 image features were extracted from each ROI. The data set was divided into training and validation sets with a ratio of 7∶3 by stratified random sampling, and synthetic minority oversampling technique (SMOTE) algorithm was used for oversampling in the training set to generate invasive and non-invasive balanced data for building the training model. The constructed model was validated in the validation set. The receiver operating characteristic(ROC) analysis was used to evaluate model performance and the Delong′s test was applied to compare the area under the ROC curve (AUC) of different predict models. The improvement for classification efficiency of each independent model or their combinations were also assessed by net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indices.Results:After feature extraction, 2, 6 and 3 features were retained to construct plain-scanned model, arterial-phase and venous-phase models, respectively. Seven independent-phase and combined-phase models were established. Except the plain-scanned model, the AUC values of other models were greater than 0.800. The arterial-phase model had the best efficiency for classification among all independent-phase models. The AUC values of arterial-phase model in the SMOTE training and validation sets were 0.913 and 0.873, respectively. By combining the radiomics signature of the arterial-phase and venous-phase models, the AUC values of training and validation sets increased to 0.934 and 0.913 respectively. There were no significant differences of the AUC values between the scan-arterial venous-phase model and arterial venous-phase model in both training and validation sets (both P>0.05). The NRI and IDI indexes showed that the combined form of plain-scan model and arterial-venous-phase model could not significantly improve the classification efficiency in the validation set (both NRI and IDI<0). Conclusions:The arterial-phase CT-based radiomics model has a good predictive performance in the invasive behavior of pSPN, and the combination with a venous-phase radiomics model can further improve the model performance.

Primary mediastinal giant malignant synovial sarcoma: two cases reports / 中国医师杂志

Objective:To understand the clinical features and computed tomography (CT) imaging performance of mediastinal giant malignant synovial sarcoma (SS) and to improve the clinicians′ diagnosis and treatment of this disease.Methods:We report the clinical data of 2 cases of primary mediastinal giant malignant SS, and reviews the literature for CT presentation and differential diagnosis.Results:Primary giant malignant SS of mediastinum is rare in clinic. CT showed irregular cystic and solid mass with mural nodules, adjacent osteolytic destruction, unclear boundary with adjacent tissues. The enhancement showed that the solid components of the tumor and mural nodules were enhanced, while the cystic necrosis area had no enhanced uneven enhancement. The two cases in this paper showed " borehole-like" growth above the clavicle and growth into the left thoracic cavity, with pulmonary metastasis and lymphatic metastasis respectively.Conclusions:Mediastinal malignant SS is a rare disease with high malignancy and easy to metastasize, which emphasizes " early detection, early diagnosis and early treatment" . It should be taken into account in the differential diagnosis of mediastinal tumors, but the confirmation of diagnosis needs to be combined with pathological and immunohistochemical findings. Clinicians need to take advantage of imaging examinations to provide auxiliary guidance on the diagnosis, metastasis assessment and surgical treatment options of SS.

Genome-wide associations between alcohol consumption and blood DNA methylation: evidence from twin study.

Aim: Alcohol intake alters DNA methylation profiles and methylation might mediate the association between alcohol and disease, but limited number of positive CpG sites repeatedly replicated. Materials & methods: In total, 57 monozygotic (MZ) twin pairs discordant for alcohol drinking from the Chinese National Twin Registry and 158 MZ and dizygotic twin pairs in the Swedish Adoption/Twin Study of Aging were evaluated. DNA methylation was detected using the Infinium HumanMethylation450 BeadChip. Results: Among candidate CpG sites, cg07326074 was significantly correlated with drinking after adjusting for covariates in MZ twins in both datasets but not in the entire sample or dizygotic twins. Conclusion: The hypermethylation of cg07326074, located in the tumor-promoting gene C16orf59, was associated with alcohol consumption.

A population-based seroprevalence survey of severe acute respiratory syndrome coronavirus 2 infection in Beijing, China

BACKGOUNDThe spread of Coronavirus Disease 2019 (COVID-19) had been controlled in China. The seroprevalence of COVID-19 in Beijing has not been evaluated. METHODSIn April, residents in Beijing were randomly enrolled. Blood samples were collected and antibodies to SARS- CoV-2 were tested by two colloidal gold kits. All colloidal gold positive serums were then tested by Micro- neutralization assay. RESULTSNone of 2,184 residents participated was tested positive by micro-neutralization assay. The seroprevalence of COVID-19 in Beijing was estimated < 0.17%. CONCLUSIONSThe seroprevalence of COVID-19 was low in April suggesting that community-wide spread was prevented in Beijing.

Estimating the scale of COVID-19 Epidemic in the United States: Simulations Based on Air Traffic directly from Wuhan, China

IntroductionCoronavirus Disease 2019 (COVID-19) infection has been characterized by rapid spread and unusually large case clusters. It is important to have an estimate of the current state of COVID-19 epidemic in the U.S. to help develop informed public health strategies. MethodsWe estimated the potential scale of the COVID-19 epidemic (as of 03/01/2020) in the U.S. from cases imported directly from Wuhan area. We used simulations based on transmission dynamics parameters estimated from previous studies and air traffic data from Wuhan to the U.S and deliberately built our model based on conservative assumptions. Detection and quarantine of individual COVID-19 cases in the U.S before 03/01/2020 were also taken into account. A SEIR model was used to simulate the growth of the number of infected individuals in Wuhan area and in the U.S. ResultsWith the most likely model, we estimated that there would be 9,484 infected cases (90%CI 2,054-24,241) as of 03/01/2020 if no successful intervention procedure had been taken to reduce the transmissibility in unidentified cases. Assuming current preventive procedures have reduced 25% of the transmissibility in unidentified cases, the number of infected cases would be 1,043 (90%CI 107-2,474). ConclusionOur research indicates that, as of 03/01/2020., it is likely that there are already thousands of individuals in the US infected with SARS-CoV-2. Our model is dynamic and is available to the research community to further evaluate as the situation becomes clearer.

Advances on the Asymptomatic Infection of COVID-19 / 中华流行病学杂志

The COVID-19 outbreak in China has been gradually controlled. At present, the management and risk assessment of asymptomatic infected cases has become an urgent problem to be addressed. Asymptomatic case is mainly detected by close contact screening, cluster epidemic investigation, infection source tracking investigation, and active detection of target population. Currently, research on the spread risk from asymptomatic cases was limited, and lacking the data relates to the distribution of asymptomatic cases in large community population. Pathogen detection using PCR is suitable for screening in close contacts of confirmed cases and should be started as early as possible. The antibody test is more suitable for screening in general population where the source of infection is unclear. The management of asymptomatic cases now in China focuses on isolation and medical observation according to the guideline of 'early detection, early report, early isolation and early treatment' .

Suggestions on reforming and improving the prevention and treatment system for major epidemic diseases in China / 中华流行病学杂志

Based on systematic review of the role of clinical treatment, disease control and scientific research, and combining with the problems exposed by the COVID-19 epidemic, suggestions were proposed to reform and improve the prevention and treatment system for major epidemics diseases in China. In clinical treatment, it is necessary to enhance clinical staff's awareness of law-based reporting, capabilities of syndromic surveillance, the use of infectious diseases reporting systems, and to improve national or local monitoring platforms for emerging infectious diseases detection. In terms of disease control, it is important to provide authorities to disease control departments through laws and regulations, improve the quantity and quality of related human resources, and strengthen the applied research and technical readiness targeted infections disease prevention, control and emergency preparedness. As for scientific research in major epidemic response, it is essential to strengthen research projects guided by national requests, build research institutions that can 'make a final decision', establish national and regional key laboratories, and strengthen strategic technical reserve for emergency disease control and treatment.

CT findings of gastritis cystica profunda / 中华放射学杂志

Objective:To explore the CT imaging and clinical features of gastritis cystica profunda (GCP) and improve the level of diagnosis.Methods:From June 2015 to August 2019, the clinical and CT imaging data of 9 GCP patients confirmed by pathology in the First Affiliated Hospital of Zhengzhou University were retrospectively collected. These 9 GCP patients included 3 male and 6 female, aged from 44 to 66 years, with an avereage age of (59±7) years. All the 9 patients underwent plain and enhanced abdominal CT scan. The location, shape, size, margin, density, enhancement pattern and enhancement degree of the lesions were analyzed and summarized.Results:The lesions are more common in gastric antrum (3 cases) and gastric fundus (3 cases). CT imaging showed thickening gastric wall thickening in 3 cases, circular ovoid or circular mass shadow protruding into the gastric cavity in 6 cases. Solid components were dominant in 2 cases and cystic components were dominant in 7 cases. In arterial phase, solid components showed significantly enhancement in 6 cases and moderate enhancement in 3 cases, while muscle layer of lesions were characterized by mild enhancement in 5 cases and moderate enhancement in 4 cases. In venous phase, solid components illustrated as significantly enhancement in 6 cases with progressive pattern and moderate enhancement in 3 cases, while the muscle layer of lesions were featured as progressive moderate enhancement in 4 cases and there is no significant enhancement in the rest 5 cases whose enhancement degree were similar to that of normal gastric wall. Additionally, the surface of the cyst covered with intact mucosa in 7 cases and in other 2 cases without complete mucosa.Conclusion:On the basis of accurate localization, CT scan could provide rich information including size, shape, internal structure and state around the lesion, which is of great value for the diagnosis of GCP.