Rationale for issuing neuroimaging requests for patients with primary headaches in China.

OBJECTIVE: To investigate the prevalence of neuroimaging in patients with primary headaches and the clinician-based rationale for requesting neuroimaging in China. DATA SOURCES AND STUDY SETTING: This study included patients with primary headaches admitted to hospitals and clinicians in China. We identified whether neuroimaging was requested and the types of neuroimaging conducted. STUDY DESIGN: This was a cross-sectional study, and convenience sampling was used to recruit patients with primary headaches. Clinicians were interviewed using a combination of personal in-depth and topic-selection group interviews to explore why doctors requested neuroimaging. DATA COLLECTION: We searched for the diagnosis of primary headache in the outpatient and inpatient systems according to the International Classification of Diseases-10 code of patients admitted to six hospitals in three provincial capitals by 2022.We selected three public and three private hospitals with neurology specialties that treated a corresponding number of patients. PRINCIPLE FINDINGS: Among the 2263 patients recruited for this study, 1942 (89.75%) underwent neuroimaging. Of the patients, 1157 (51.13%) underwent magnetic resonance imaging (MRI), 246 (10.87%) underwent both head computed tomography (CT) and MRI, and 628 (27.75%) underwent CT. Fifteen of the 16 interviewed clinicians did not issue a neuroimaging request for patients with primary headaches. Furthermore, we found that doctors issued a neuroimaging request for patients with primary headaches mostly, to exclude the risk of misdiagnosis, reduce uncertainty, avoid medical disputes, meet patients' medical needs, and complete hospital assessment indicators. CONCLUSIONS: For primary headaches, the probability of clinicians requesting neuroimaging was higher in China than in other countries. There is considerable room for improvement in determining appropriate strategies to reduce the use of low-value care for doctors and patients.

Comprehensive analysis of the immune and prognostic implication of MASP1 in stomach adenocarcinoma.

OBJECTIVE: Stomach adenocarcinoma (STAD) is the major cancer worldwide with high morbidity and mortality rate. Late diagnosis and limited treatment options of STAD lead to disease progression, spread, and metastasis. Therefore, finding a new biomarker to diagnosis and treatment is very important for STAD in clinical practice. MATERIALS AND METHODS: The clinical data, transcriptome data and CCLE data were downloaded from TCGA database and CCLE database, respectively. TIMER website, TISIDB website and CIBERSORT methodology were used to analyse immune infiltration. R software and R package were used to analyse gene difference expression, determine co-expression genes, conduct gene enrichment analyses, construct a prognostic signature and establish nomogram. RESULTS: MASP1 was decreased in STAD compared with normal tissue at the mRNA level (p < 0.001). The enrichment analysis showed that mismatch repair (MMR) was related to the MASP1 gene. Up-regulation of MAPS1 expression was positively associated with dendritic cells (p < 0.01), neutrophils (p < 0.05), macrophages (p < 0.001), CD4+ T cells (p < 0.001) and B cells (p < 0.05). A four-gene prognostic signature was determined based on MASP1-related immunomodulators. The prognostic signature was an independent prognostic predictor in STAD. Finally, we established a nomogram to forecast survival and the nomogram has a good prediction accuracy. CONCLUSIONS: In STAD, MASP1 is closely related to immunity. MASP1 has the potential to positively regulate the abundance of immune cells. The MASP1-related prognosis signature and nomogram can accurately predict the survival of patients with STAD. Therefore, MASP1 is likely to be a diagnosis and promising immunotherapy target spot in STAD clinical practice.

Precise tuning of single molecule conductance in an electrochemical environment.

Tuning of molecular conductance in a liquid environment is a hot topic in molecular electronics. In this article, we explore a new concept where the Fermi level positions of the metallic ends are varied simply by modifying the electroactive salt concentration in solution. We rely on the electrochemical scanning tunneling microscope break junction method that allows the construction in solution of copper atomic contacts that can be then bridged by single molecules. The experimental conductance evolution is first confronted with an analytical formulation that allows the deduction of the molecule's LUMO position and electronic coupling factors. These parameters are in close agreement with those obtained by independent DFT calculations.

Relationship between Leukopenia and Intercellular Adhesion Molecules in Graves' Disease.

OBJECTIVE: Changes in soluble intercellular adhesion molecule-1 (sICAM-1) and E-selectin levels as well as leukocyte count were examined in this study to explore the relationship between leukopenia and ICAMs in Graves' disease (GD). METHODS: Fasting blood samples were obtained from 37 GD patients with normal leukocytes and 32 GD patients with leukopenia. Enzyme-linked immunosorbent assay (ELISA) was performed to determine serum sICAM-1 and E-selectin levels for comparison. The same analyses were repeated for the GD patients with leukopenia after glucocorticoid treatment (15 mg/day to 30 mg/day prednisone). RESULTS: The ELISA results showed that E-selectin levels were higher in GD patients with leukopenia than those with normal leukocytes (p < 0.05), but these levels decreased after glucocorticoid (prednisone) treatment (p < 0.05). No significant change in sICAM-1 levels was observed (p = 0.12). Correlation analysis showed that leukocyte count and E-selectin were negatively correlated (r = -0.778; p < 0.05). CONCLUSION: E-selectin may have an important function in GD with leukopenia, and glucocorticoids (prednisone) could decrease E-selectin level, which may be a new therapy target for GD with leukopenia.

Periodontal health of Singapore school children over two decades from 1970 to 1994.

Dental health surveys of school children in Singapore from the past two decades were reviewed to document changes in prevalence and severity of periodontal disease. In 1970, 1979, 1984, 1989 and 1994 a sample of 12,801, 10,232, 4,203, 4,733 and 5,005 school children aged 6-18 years respectively, were examined in schools by the Dental Division, Ministry of Health. Parameters examined were oral hygiene, calculus, gingival inflammation/bleeding and periodontal pockets. Oral hygiene was assessed by the Oral Hygiene Index of Greene and Vermillion. Periodontal condition was assessed by observation of presence or absence of gingival inflammation and periodontal pockets in the early surveys, and the Community Periodontal Index of Treatment Needs in 1989 and 1994. Findings demonstrated oral hygiene among children in Singapore was good. The mean Debris Scores for 6-11 year old were 0.74, 0.78 and 0.72 respectively in 1979, 1984 and 1989 while those of 12-18 year old were 0.43, 0.80 and 0.56 respectively for the corresponding years. Proportions of younger children with no periodontal disease were 32.2%, 60.0%, 59.0%, 31.0% and 34.4% in 1970, 1979, 1984, 1989 and 1994 respectively. For children aged twelve and above, proportions with no periodontal disease were 24.5%, 55.8%, 29%, 12% and 30% respectively in 1970, 1979, 1984, 1989 and 1994. Prevalence of gingivitis remained relatively high. However, a decrease in gingivitis from 1970 to 1979 in both age groups was noted. The period from 1984 to 1994, trends were dealt with cautiously due to changes in indices used. Severity of periodontal disease declined in terms of reduced mean number of diseased units/sextants and decrease in prevalence of periodontal pockets. Comparison of survey data for 1970, 1979, 1984, 1989 and 1994 shows improvement in periodontal health among children in Singapore over the past 2 decades. There is a continuing need for greater effort to promote better oral hygiene practices in view that only one third of children in 1994 had no periodontal disease.

Determination of nicotine and cotinine in human plasma by liquid chromatography-tandem mass spectrometry with atmospheric-pressure chemical ionization interface.

Here we report a sensitive liquid chromatographic-tandem mass spectrometric (LC-MS-MS) method capable of quantifying nicotine down to 1 ng/ml and cotinine to 10 ng/ml from 1.0 ml of human plasma. The method was validated over linear ranges of 1.0-50.0 ng/ml for nicotine and 10.0-500.0 ng/ml for cotinine, using deuterated internal standards. Compounds were simply extracted from alkalinized human heparinized plasma with methylene chloride, reconstituted into a solution of acetonitrile, methanol and 10 mM ammonium acetate (53:32:15, v/v) after the organic phase was dried down, and analyzed on the LC-MS-MS, which is a PE Sciex API III system equipped with a Keystone BDS Hypersil CI8 column and atmospheric pressure chemical ionization (APCI) interface. The between-run precision and accuracy of the calibration standards were < or = 6.42% relative standard deviation (R.S.D.) and < or = 11.8% relative error (R.E.) for both nicotine and cotinine. The between-run and within-run precision and accuracy of quality controls, (2.5, 15.0, 37.5 ng/ml for nicotine and 25.0, 150.0, 375.0 ng/ml for cotinine), were < or = 6.34% R.S.D. and < or = 7.62% R.E. for both analytes. Sample stabilities in chromatography, in processing and in biological matrix were also investigated. This method has been applied to pharmacokinetic analysis of nicotine and cotinine in human plasma.