Comparison of recurrence and survival between patients with pathological stage I epithelial ovarian cancer after laparoscopic or laparotomic surgery: retrospective analysis of a propensity-matched cohort.

OBJECTIVE: To compare oncologic outcomes after laparoscopic or laparotomic surgery to treat epithelial ovarian carcinoma in FIGO stage I. DESIGN: Retrospective cohort study. SETTING: Gynecological cancer ward in a tertiary hospital. PARTICIPANTS: A total of 85 patients with FIGO stage I epithelial ovarian carcinoma who underwent laparoscopic staging surgery and 206 who underwent laparotomic staging surgery at West China Second Hospital, Sichuan University (Chengdu, China) between January 1, 2013 and December 31, 2019. INTERVENTIONS: laparoscopic surgery or laparotomic staging surgery. RESULTS: Before propensity score-based matching, the laparotomy group showed higher prevalence of preoperative elevated CA125 level (48.5% vs 35.3%, p = .045) and tumors > 15 cm (27.2% vs 5.9%, p < .001). Multivariate analysis associated higher body mass index with better overall survival (adjusted HR 0.83, 95%CI 0.70-0.99, p = .043). Among propensity score-matched patients (82 per group) who were matched to each other according to propensity scoring based on age, body mass index, CA125 level, largest tumor diameter, FIGO stage, history of abdominal surgery, and American Society of Anesthesiologists grade, the rate of progression-free survival at 5 years was similar between the laparoscopy group (87.1%, 95%CI 79.3-95.7%) and the laparotomy group (90.9%, 95%CI 84.7-97.6%, p = .524), as was the rate of overall survival at 5 years (93.9%, 95%CI 88.0-100.0% vs 94.7%, 95%CI 89.8-99.9%, p = .900). Regardless of whether patients were matched, the two groups showed similar rates of recurrence of 9-11% during follow-up lasting a median of 54.9 months. CONCLUSIONS: Rates of recurrence and survival may be similar between laparoscopy or laparotomy to treat stage I epithelial ovarian cancer. Since laparoscopy is associated with less bleeding and faster recovery, it may be a safe, effective alternative to laparotomy for appropriate patients.

Association between fluoride exposure and psychiatric disorders in adults.

To explore the association between fluoride exposure and depression / anxiety in adults, the 1,169 participants were recruited. The demographic information of participants was obtained through questionnaire survey and physical measurements. Morning urine samples were collected, and urinary fluoride (UF) level was determined. Changes in depression and anxiety levels were evaluated using the Patient Health Questionnaire-2 and General Anxiety Disorder-2 scales. The association between psychiatric disorders and UF levels was analyzed. In the total population, the prevalence of depression and anxiety were 3.17% and 4.19%, respectively. These results showed no significant association between depression / anxiety scale scores and UF levels. Logistic regression suggested no significant association between depression / anxiety levels, and UF levels, but there was an interaction between UF and income on depression. Our findings highlighted the interaction between fluoride exposure and monthly income, which may affect depression in adults.

Differences in the evolution of urban and rural surface thermal environment and their responses to urban renewal in Shanghai, China.

The rapid and extensive urbanization has profound impacts on urban thermal environment. It is of great significance to comprehensively understand how urbanization affects the evolution of urban thermal environment for urban ecological safety, environmental quality, and residents' health. Based on daily land surface temperature (LST) products of MODIS Aqua satellite in the summer of 2002-2020, we investigated the evolution of urban-rural differences in surface summer thermal environment in Shanghai during 2002-2020 and its response to urban spatial renewal. We used normalized land surface temperature (NLST) and urban heat island ratio index (URI) as the surface thermal environment measurement indicators, by combining vegetation index and impervious surface cove-rage, and used M-K trend analysis and interpretation analysis. The results showed that the linear growth rate of LST in Shanghai was 0.09 ℃·a-1 (2002-2020), and that URI showed a trend of first increasing (2002-2010) and then decreasing (2010-2020). The mean summer LST was generally in the order of urban core>suburban>rural. 1.6% of the areas showed a significant cooling trend, of which 54.0% were distributed in the urban core. 39.5% of the regions showed a significant warming trend, of which 77.6% were distributed in the suburban. In general, there were concentrated significant cooling areas in the highly urbanized urban areas, while there was a significant warming trend in the suburban. The transformation from urban expansion to urban renewal was the main reason for the emergence of concentrated and significant cooling areas in the urban. Nearly 20% of the urban area showed a signi-ficant increase of vegetation coverage. Urban renewal projects such as gathering vegetation or dispersing impervious surfaces in highly urbanized areas are important ways to effectively improve the urban residential thermal environment.

Impacts of HBV rtH55R polymerase substitution on viral replication and rtM204I/V resistance to nucleoside/nucleotide antiviral drugs.

BACKGROUND: High genetic variability at the reverse transcriptase (RT) region of HBV could confer resistance to nucleoside/nucleotide analogues (NUCs). The aim of this study was to identify new RT amino acid (AA) substitutions related to NUC resistance. METHODS: HBV RT sequences of genotype C from 501 chronic hepatitis B (CHB) patients were analysed to identify potential RT substitutions related to NUC resistance. In vitro studies without and with NUCs were performed in a HepG2 cell line transfected by clones with RT harbouring wild-type or substituted AA(s) of interest. RESULTS: Among 261 NUC-treated CHB patients, we found a high detection rate of rtM204I/V substitution (30.7% [80/261]). We identified a new substitution of rtH55R, and its detection rate had a significantly increasing trend from 3.8% (9/240) in the untreated group to 7.2% (13/181) or 33.8% (27/80) in the treated group with rtM204 or with rtM204I/V substitutions (P<0.0001). In vitro studies showed that rtH55R had a similar HBV DNA level compared to wild type. The rtH55R+rtM204I clone had a significantly better replication capacity than the rtM204I clone without NUCs (P<0.05). The replication capacity of the rtM204I clone was found to significantly decrease under lamivudine treatment, but this was not found in the rtH55R+rtM204I clone. CONCLUSIONS: We identified a new HBV RT substitution of rtH55R in genotype-C-infected CHB patients. It is frequently found in combination with rtM204I/V substitution under NUC treatment. In vitro studies suggest that it might play some replication compensatory role in rtM204I mutants under lamivudine treatment.

Hepatitis B virus basal core promoter mutations A1762T/G1764A are associated with genotype C and a low serum HBsAg level in chronically-infected HBeAg-positive Chinese patients.

The present study was aimed to obtain baseline information of basal core promoter A1762T/G1764A and precore G1896A mutations of hepatitis B virus (HBV) in 192 HBeAg-positive chronically-infected Chinese patients, who were potential candidates for antiviral treatment. The detection of these mutations (including minor mutant subpopulations) was achieved by direct sequencing, whose sensitivity for minor mutant subpopulations identification was confirmed by clone sequencing. Patients enrolled were infected with either genotype B (46.35%) or C (53.65%) HBV identified by routine tests in our laboratory. The A1762T/G1764A or G1896A mutations were detected in 125specimens (125/192, 65.10%), in which 77 (77/125, 61.60%) existed as subpopulations. The A1762T/G1764A mutations were found to be more prevalent in genotype C than that in genotype B HBV [62.14% (64/103) vs. 20.22% (18/89), P<0.0001]. There is no statistically significant link between G1896A and genotypes. The emergence of A1762T/G1764A mutations was also found to be associated with an older age, an elevated ALT/AST level, and a lower HBsAg level in serum [wild-type vs. mutant: 4.57 (3.46-5.42) vs. 3.93 (2.51-5.36), P<0.0001]. In conclusion, HBV basal core promoter mutations A1762T/G1764A are associated with genotype C and a low serum HBsAg level in chronically-infected HBeAg-positive Chinese patients.

[The value of determination of serum myoglobin in estimation of degree of illness and prognosis of patients with sepsis in Xining area].

OBJECTIVE: To investigate the value of determination of serum myoglobin (MYO) in estimation of the degree of illness and prognosis of patients with sepsis in Xining area. METHODS: Serum MYO was measured and acute physiological and chronic health estimationII (APACHEII) score was evaluated in 30 cases with sepsis within 24 hours of admission to emergency intensive care unit (EICU), and their correlation was analyzed. The patients were divided into two groups, survival group and death group according to the result within 28 days. The MYO and APACHEII score were analyzed in both groups. All cases were divided into three groups: namely <500 (n=10), 500-1 000 (n=14), >1 000 µg/L (n=6) groups, according to serum MYO value, and APACHEII score and dead case were compared among three groups. RESULTS: Sixteen patients survived, and 14 patients died. The level of serum MYO and APACHEII score were significantly lower in survival group than death group [MYO (µg/L): 607.85±499.40 vs. 976.21±370.10, APACHEII score: 15.50±4.43 vs. 18.93±3.63, t(1)=2.28, t(2)=2.29, both P<0.05]. With the elevation of serum MYO, the dead case was increased in sepsis patients (the dead case in MYO<500, 500-1 000, >1 000 µg/L groups was 2, 7, 5 cases, respectively,χ(2)=5.94, P<0.05), but there was no difference in APACHEII score among three groups. There was significant positive correlation between serum MYO and APACHEII score (r=0.407, P<0.05). CONCLUSION: Determination of serum MYO can reflect degree of illness and prognosis of sepsis patients in Xining area.