The mediating role of diabetes stigma and self-efficacy in relieving diabetes distress among patients with type 2 diabetes mellitus: a multicenter cross-sectional study.

Background: Patients with diabetes mellitus often suffer from diabetes distress. Social support and certain psychological factors potentially influence diabetes distress, but studies exploring the mechanisms underlying these relationships are scarce. Objectives: To reveal the associations between social support, diabetes stigma, diabetes self-efficacy, and diabetes distress among patients with type 2 diabetes and the underlying mechanisms linking these variables. Design and methods: A multicenter cross-sectional study was adopted and a sample of 431 patients with type 2 diabetes was investigated. Social support, diabetes stigma, diabetes self-efficacy, and diabetes distress were surveyed with the Perceived Social Support Scale, Type 2 Diabetes Stigma Assessment Scale, Self-Efficacy for Diabetes Scale, and Diabetes Distress Scale, respectively. The hypothesized model was verified using structural equation modeling. Results: Social support and diabetes stigma had direct associations with diabetes distress. Diabetes stigma mediated the association between social support and diabetes distress, and the association between diabetes self-efficacy and diabetes distress. Diabetes stigma and self-efficacy exerted a chain mediation effect on the association between social support and diabetes distress. Conclusion: Social support and diabetes stigma were significant predictors of diabetes distress. Diabetes stigma and self-efficacy play essential mediating roles in relieving diabetes distress. This can provide guidance for the development of evidence- and theory-based interventions. Culturally sensitive interventions that aim to provide ongoing social support, decrease diabetes stigma, and enhance self-efficacy have the potential to relieve diabetes distress.

Mechanistic investigation of the influence of defects on armchair unburned carbon for PbCl2 adsorption.

As the largest consumer of coal energy, coal-fired power plants emit large amounts of PbCl2 each year, which is of wide concern due to its high toxicity, global migration, and accumulation. Unburned carbon is considered a promising adsorbent for effective PbCl2 removal. However, there is a problem that the current unburned carbon model cannot show the structure of carbon defects on the actual unburned carbon surface. Therefore, it is important to construct defective unburned carbon models with practical significance. In addition, the adsorption mechanism of PbCl2 by an unburned model is not studied deeply enough and the reaction mechanism is not clear yet. This has seriously affected the development of effective adsorbents. To reveal the adsorption mechanism of PbCl2 on unburned carbon, the adsorption mechanism of PbCl2 on defective unburned carbon surfaces was analyzed by using the density flooding theory to investigate the adsorption process of PbCl2 on different unburned carbon models. This will provide theoretical guidance for the design and development of adsorbents for the removal of PbCl2 from coal-fired power plants.

The association of self-control, self-efficacy, and demographic characteristics with home-based E-learning behavior in nursing and midwifery undergraduates: A cross-sectional study under the COVID-19 epidemic.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, nursing and midwifery undergraduate students' time spent in home isolation and being engaged in home-based e-learning was extended. Limited research has been conducted on home-based e-learning behavior during home isolation, and the relationships between individual factors, such as self-control, self-efficacy, and other demographic characteristics, and home-based e-learning behavior are unclear. OBJECTIVES: This study aimed to explore the associations between self-control, self-efficacy, and demographic information with home-based e-learning behavior among nursing and midwifery undergraduates during the COVID-19 pandemic. DESIGN AND METHODS: A cross-sectional study was employed, and an online survey was conducted with 3733 nursing and midwifery undergraduates across seven provinces and cities in mainland China. Data were collected using the Brief Self-control Scale, General Self-efficacy Scale, Undergraduate Home-based E-learning Behavior Questionnaire, and Demographic Information Questionnaire. A multiple linear regression analysis using the stepwise method was conducted to identify predictors of home-based e-learning behavior. RESULTS: Undergraduates achieved an overall mean score of 26.02 (SD = 4.20) for home-based e-learning behavior and an overall mean score of 42.54 (SD = 6.22) and 27.59 (SD = 3.89) for self-control and self-efficacy, respectively. Better self-control (ß = 0.250, P < 0.001), higher self-efficacy (ß = 0.169, P < 0.001), universities being located in non-Hainan provinces (ß = 0.249, P < 0.001), being a sophomore or freshman (ß = -0.255, P < 0.001), and good perceived health status (ß = -0.044, P = 0.003) were identified as the predictors of better home-based e-learning behavior among nursing and midwifery undergraduates. CONCLUSION: Self-control, self-efficacy, and demographic characteristics including the province of the university, grade level, and personal perceived health status were associated with home-based e-learning behavior. Universities should help nursing and midwifery undergraduates improve self-control and enhance self-efficacy while taking measures to decrease the impact caused by demographic characteristic differences.

Bacterial and Protistan Community Variation across the Changjiang Estuary to the Ocean with Multiple Environmental Gradients.

Plankton microorganisms play central roles in the marine food web and global biogeochemical cycles, while their distribution and abundance are affected by environmental variables. The determinants of microbial community composition and diversity in estuaries and surrounding waters with multiple environmental gradients at a fine scale remain largely unclear. Here, we investigated bacterial and protistan community assembly in surface waters from 27 stations across the Changjiang Estuary to the ocean, with salinity ranging from 0 to 32.1, using 16S rRNA and 18S rRNA gene amplicon sequencing. Statistical analyses revealed that salinity is the major factor structuring both bacterial and protistan communities. Salinity also acted as a significant environmental determinant influencing alpha-diversity patterns. Alpha diversity indices for bacterial and protistan communities revealed a species minimum in higher-salinity waters (22.1-32.1). Contrary to the protistan community, the highest bacterial diversity was identified in medium-salinity waters (2.8-18.8), contrasting Remane's Artenminimum concept. The distribution of major planktonic taxa followed the expected pattern, and the salinity boundary for Syndiniales was specifically identified. These findings revealed the significant effects of salinity on the microbial community across an estuary to ocean transect and the distinct response to salinity between bacterial and protistan communities.

Enhancing deep-UV emission at 234 nm by introducing a truncated pyramid AlN/GaN nanostructure with fine-tuned multiple facets.

The external quantum efficiency of a high-Al content (>0.6) AlGaN deep-ultraviolet (DUV) light-emitting diode is typically below 1% in the sub-250 nm wavelength range. One of the main reasons for this low efficiency is the fundamental properties of high-Al content AlGaN comprising the transverse-magnetic (TM)-dominant emission and low light extraction due to the total internal reflection (TIR). This work demonstrates a truncated pyramid nanostructure with fine-tuned multiple facets in an (AlN)8/(GaN)2 digital alloy to achieve highly efficient DUV emission at 234 nm. By applying nanoimprint lithography, dry and wet etching, a hexagonal truncated pyramid nanohole structure is fabricated featuring multiple crystal facets of (0001), (10-13), and (20-21) planes. These fine-tuned multiple facets act as reflecting mirrors that can effectively modulate the light propagation and extraction patterns to overcome the TIR via multiple reflections and enhanced scattering. Consequently, significant light extraction enhancements of 5.6 times and 1.1 times for TM and transverse-electric emissions are achieved in the truncated pyramid nanohole structure, respectively. The total luminous intensity of this unique nanostructure is greatly increased by 191% compared to that of a conventional planar structure. The truncated pyramid AlN/GaN nanostructure with fine-tuned multiple facets used in this work provides a promising approach for realizing highly efficient sub-250 nm DUV light-emitting devices.

The Cost-Effectiveness Analysis of Self-Efficacy-Focused Structured Education Program for Patients With Type 2 Diabetes Mellitus in Mainland China Setting.

Objective: To assess the long-term (50 years) cost-effectiveness of the self-efficacy-focused structured education program (SSEP) as opposed to routine education among patients with type 2 diabetes mellitus (T2DM) in mainland China from a healthcare service perspective. Methods: A cost-effectiveness analysis method was used. The IQVIA CORE Diabetes Model (version 9.0) was adopted to estimate the outcomes. The baseline cohort characteristics, variations of physiological parameters, costs of intervention and other treatments, and management-related diabetes were derived from a randomized controlled trial. Moreover, the complications costs and utilities were extracted from published sources. Furthermore, the univariate sensitivity analysis and the probabilistic sensitivity analysis were conducted. Results: As compared with the control group, the life expectancy and quality-adjusted life-year in the intervention group were increased. Besides, the intervention group achieved lower cumulative incidences of complications and saved more direct medical costs compared with the control group. The sensitivity analysis revealed that the SSEP had 100% probability to be cost-effective. Conclusion: The SSEP is recognized as a highly cost-effective option for managing patients with T2DM, which are projected to both improve clinical outcomes and reduce costs.

Bacterial Composition Associated With Giant Colonies of the Harmful Algal Species Phaeocystis globosa.

The cosmopolitan algae Phaeocystis globosa forms harmful algal blooms frequently in a number of tropical and subtropical coastal regions in the past two decades. During the bloom, the giant colony, which is formed by P. globosa, is the dominant morphotype. However, the microenvironment and the microbial composition in the intracolonial fluid are poorly understood. Here, we used high-throughput 16S rRNA amplicon sequencing to examine the bacterial composition and predicted functions in intracolonial fluid. Compared with the bacterial consortia in ambient seawater, intracolonial fluids possessed the lower levels of microbial richness and diversity, implying selectivity of bacteria by the unique intracolonial microenvironment enclosed within the P. globosa polysaccharide envelope. The bacterial consortia in intracolonial fluid were dominated by Balneola (48.6% of total abundance) and Labrezia (28.5%). The bacteria and microbial function enriched in intracolonial fluid were involved in aromatic benzenoid compounds degradation, DMSP and DMS production and consumption, and antibacterial compounds synthesis. We suggest that the P. globosa colonial envelope allows for the formation of a specific microenvironment; thus, the unique microbial consortia inhabiting intracolonial fluid has close interaction with P. globosa cells, which may benefit colony development.

The Effectiveness of a Self-Efficacy-Focused Structured Education Program (SSEP) in Improving Metabolic Control and Psychological Outcomes of Type 2 Diabetes Patients: A 12-Month Follow-Up of a Multicenter Randomized Controlled Trial.

BACKGROUND AND OBJECTIVE: The 12-month follow-up effect of the self-efficacy-focused structured education program (SSEP) requires in-depth confirmation. This study aims to verify whether the benefits of SSEP can be maintained in 12 months. MATERIALS AND METHODS: A multicenter randomized controlled trial with 12-month follow-up conducted among 265 type 2 diabetes patients not on insulin from 4 hospitals in mainland China. The intervention group (n = 133) was administrated with SSEP, and the control group (n = 132) received the routine education. The indicators of metabolic and psychosocial aspects of the patients were assessed at baseline and 12 months. RESULTS: As opposed to the control group, the primary outcomes of HbA1c in the intervention group were improved obviously in the 12th month during the 12-month follow-up (-1.13%, P < 0.001). The secondary outcomes (ie, waist circumference, total cholesterol, low-density lipoprotein cholesterol, diabetes self-efficacy, diabetes self-management behaviors, diabetes knowledge and diabetes distress) were improved significantly in the intervention group as compared with the control group in the 12th month during the 12-month follow-up (-3.14 cm, P = 0.001; -0.30 mmol/L, P = 0.032; -0.25 mmol/L, P = 0.008; 0.87, P < 0.001; 10.67, P < 0.001; 3.42, P < 0.001; -4.97, P < 0.001). The non-significant difference in the secondary outcomes (ie, systolic pressure, diastolic pressure, triglycerides and high-density lipoprotein cholesterol) was identified between the two groups in the 12th month during the 12-month follow-up (P > 0.05). CONCLUSION: The SSEP provided sustainable benefits in outcomes of HbA1c, waist circumference, total cholesterol, low-density lipoprotein cholesterol, diabetes knowledge, diabetes distress, diabetes self-efficacy and diabetes self-management behaviors for type 2 diabetes patients not on insulin in the 12th month during the 12-month follow-up. Thus, it will be an effective education model capable of being generalized nationwide, and it can be referenced for the nations and regions under consistent conditions. CLINICAL TRIAL REGISTRY: Chinese Clinical Trial Registry (ChiCTR-IOR-17011007).

A culturally sensitive nurse-led structured education programme in patients with type 2 diabetes.

AIM: To assess the feasibility, acceptability, and preliminary efficacy of a culturally sensitive nurse-led structured education programme for patients with type 2 diabetes. BACKGROUND: A nurse-led satisfactory diabetes education programme might be feasible. The structured education programme is considered a potential model that helps patients manage diabetes. DESIGN: A mixed-method design. METHODS: A convenience sample of 44 participants received the programme. Feasibility was assessed using the recruitment rate and the retention rate. Acceptability was assessed by interviews to obtain the perception and experience of participants. Also, preliminary efficacy on diabetes knowledge, self-efficacy, self-management behaviours, and clinical outcomes was assessed. Finally, data were collected from April to December 2015. RESULTS: The recruitment rate and the retention rate were acceptable. Participants thought that the programme contributed to their positive changes. They enjoyed and accepted the programme, and they wanted to gain the ongoing support. Significant improvements in diabetes knowledge, self-efficacy, self-management behaviours, A1C , fasting blood glucose, low-density lipoprotein cholesterol, weight, body mass index, and waist circumference were reported in 12-week follow-up. CONCLUSIONS: This programme is feasible and acceptable, and its preliminary efficacy is promising. Ongoing support, a control group, and long-term follow-up are required in future studies to assess its effectiveness.

The effectiveness of a self-efficacy-focused structured education programme on adults with type 2 diabetes: A multicentre randomised controlled trial.

AIMS AND OBJECTIVES: To evaluate the effectiveness of a self-efficacy-focused structured education programme on outcomes in adults with type 2 diabetes (T2DM) without insulin therapy. BACKGROUND: Structured education regarding metabolic control in T2DM adults without insulin therapy has not always been effective, and this lack of effectiveness might be due to overlooking self-efficacy. Whether a self-efficacy-focused structured education programme could improve metabolic and psychosocial outcomes for T2DM adults more effectively remains unknown. DESIGN: A multicentre parallel randomised controlled concealed label trial. METHODS: The study conducted in outpatients of four hospitals in China. A total of 265 T2DM adults without insulin therapy were randomly assigned to an intervention group of a self-efficacy-focused structured education programme (n = 133), or to a control group of routine education (n = 132). The differences in metabolic and psychosocial outcomes were investigated at baseline, three- and 6-month follow-ups. RESULTS: The primary outcome of A1C and the secondary outcomes of weight, body mass index, waist circumference, diastolic pressure, self-efficacy, self-management behaviours and knowledge improved significantly in the intervention group compared with the control group at 6-month follow-up. The differences in A1C between groups for patients with a low educational background at 6-month follow-up were significant. No significant differences were found in other secondary outcomes of systolic pressure, the blood lipid profile and diabetes distress between groups at 6-month follow-up. CONCLUSIONS: This programme can improve glycaemic control, weight control, diastolic pressure, self-efficacy, self-management behaviours and diabetes knowledge for T2DM adults. RELEVANCE TO CLINICAL PRACTICE: This self-efficacy-focused structured education programme is effective and can be incorporated into regular clinical care and led by trained staff (e.g. nurses), and it can be implemented in patients with low educational backgrounds.

The Mediating Role of Self-Efficacy in Shaping Self-Management Behaviors Among Adults With Type 2 Diabetes.

BACKGROUND: Self-efficacy, diabetes distress, knowledge, and education level are likely the important factors affecting diabetes self-management (DSM) behaviors. However, the theoretical mechanisms underlying these variables remain unclear. AIMS: The study aimed to test a model including variables of self-efficacy, diabetes distress, knowledge, and education level and DSM behaviors that were informed by social cognitive theory and the literature review among adults with type 2 diabetes. METHODS: A cross-sectional study design was employed. Among a convenience sample of 320 adults with type 2 diabetes, 265 eligible participants (response rate = 82.81%) were investigated, using the demographic information questionnaire, the Summary of Diabetes Self-Care Activities, the Self-Efficacy for Diabetes Scale, the Diabetes-Related Knowledge Questionnaire, and the Diabetes Distress Scale. Structural equation modeling was performed with 10,000 bootstrap samples using AMOS 23.0. RESULTS: The final model provided a good fit to the data (χ2 [22, N = 265] = 9.192, df = 5, p = .102, NFI = 0.972, RMSEA = 0.056). Self-efficacy had the strongest direct effect on DSM behaviors (ß = 0.550, p = .000). Knowledge (ß = 0.167, p = .004) and employment status (ß = -0.130, p = .009) had a direct effect on DSM behaviors. The association between knowledge and DSM behaviors was partially mediated by self-efficacy (bootstrap mean = 0.160, 95% CI: 0.088, 0.237), explaining 49.08% of the total effect of knowledge on DSM behaviors. The association between diabetes distress and DSM behaviors (bootstrap mean = -0.113, 95% CI: -0.192, -0.043) and education level and DSM behaviors (bootstrap mean = 0.102, 95% CI: 0.047, 0.165) were completely mediated by self-efficacy. CONCLUSIONS: Self-efficacy plays an important role in the mediation of the association between knowledge and DSM behaviors, diabetes distress and DSM behaviors, and education level and DSM behaviors, as well as a direct contributing role in the predication of DSM behaviors. LINKING EVIDENCE TO ACTION: Self-efficacy plays a direct contributing and mediating role in shaping DSM behaviors. The results of the model can help to develop evidence- and theory-based and culturally sensitive interventions. Strategies including goal setting, practicing, recording, peer models, persuasion, positive feedback, and encouragement can be used to address self-efficacy of patients. Interventions led by nurses that increase knowledge, reduce diabetes distress, and emphasize self-efficacy have the potential to promote changes in DSM behaviors.

Self-efficacy-focused education in persons with diabetes: a systematic review and meta-analysis.

AIMS: The aims of this study were to assess the effectiveness of self-efficacy-focused education on health outcomes in persons with diabetes and review the strategies employed in the interventions. BACKGROUND: The traditional educational interventions for persons with diabetes were insufficient to achieve the desired outcomes. Self-efficacy-focused education has been used to regulate the blood sugar level, behaviors, and psychosocial indicators for persons with diabetes. DESIGN: This study is a systematic review and meta-analysis. METHODS: Studies on the effectiveness of self-efficacy-focused education in persons with diabetes were searched in six databases from inception until January 2018. The data were extracted and the quality of literature was assessed independently. Review Manager 5.3 was applied for the meta-analysis. Besides, the findings were summarized for narrative synthesis. RESULTS: Sixteen trials with 1,745 participants were included in the systematic review and ten trails with 1,308 participants in the meta-analysis. The meta-analysis for A1C, self-efficacy, self-management behaviors, knowledge, and quality of life (QOL) were represented in four, six, six, three, and three studies, respectively. The findings indicated that self-efficacy-focused education would probably reduce A1C, enhance self-efficacy, regulate self-management behaviors, increase knowledge, and improve the QOL for patients with diabetes. Weak quality studies, limited participants, and heterogeneity hindered the results pooled of the other secondary outcomes of fasting blood glucose, 2-hour plasma glucose, weight, weight circumference, body mass index, plasma lipid profile, and other psychological indicators. Goal setting, self-management skills practicing and recording, peer models, demonstration, persuasion by health providers, and positive feedback were the most commonly used strategies in the interventions. However, physiological/emotion arousal strategies were relatively less applied and varied significantly. CONCLUSION: Individuals with diabetes may benefit a lot from the self-efficacy-focused education. However, insufficient high-quality studies, short-term follow-up period, relatively deficient physiological/emotion strategies, and incomplete outcome assessments were the drawbacks in most studies. Establishing satisfactory self-efficacy-focused education and better evaluating the effects were required in further studies.

Changes in Cerebrospinal Fluid Tau and ß-Amyloid Levels in Diabetic and Prediabetic Patients: A Meta-Analysis.

Increased risks for Alzheimer's disease (AD) are a well-recognized consequence of diabetes, insulin resistance (IR), and hyperinsulinemia. Since cerebrospinal fluid (CSF) is surrounding the central nervous system, alterations of ß-amyloid (Aß) and tau protein in the CSF may be indicative of AD-type degenerations in the brain. Current laboratory diagnosis of AD uses three biomarkers in CSF: Aß1-42, total tau (t-Tau), and phosphorylated tau (p-Tau). However, changes in these biomarkers in diabetic and prediabetic patients are scattered and variable in literature. Thus, we attempt to perform a systematical analysis of these available data. MEDLINE, EMBASE, the Cochrane Central database, China National Knowledge Infrastructure (CNKI), and Wanfang Data electronic databases were searched to gather published studies that have evaluated the AD-type biomarkers in the CSF of subjects with diabetes, IR, or hyperinsulinemia in comparison with respective controls. Overall analysis of the published data showed no significant differences in Aß1-42, t-Tau, and p-Tau levels in the CSF between the (pre)diabetic subjects and controls. However, subgroup analysis suggested that (pre)diabetic conditions might accelerate decrease of Aß1-42, but increase of t-Tau levels in the CSF of subjects with cognitive impairment, and the association with p-Tau in the CSF was stronger (P = 0.001) for diabetes than those of prediabetes (P = 0.61). Our analyses reveal that the relationship between (pre)diabetic conditions and AD-type biomarker status in the CSF was subjective to clinical characteristics.

The Effects of Reflective Training on the Disposition of Critical Thinking for Nursing Students in China: A Controlled Trial.

PURPOSE: The aim of this study was to evaluate the effects of reflective trainings for nursing students on their critical thinking disposition. METHODS: A total of 157 senior undergraduate nursing students sampled from Hainan Medical University in China participated in this study in 2014. They were randomly divided into experimental and control groups. The experimental group students were provided the reflective training during their entire 12-month clinical internship, whereas students in the control group were requested to keep their reflective diaries but without a formal training. Before and after the intervention, nursing students' critical thinking disposition was rated using the Chinese version of Critical Thinking Disposition Inventory (CTDI-CV). RESULTS: Before the start of the intervention, the critical thinking disposition scores of the two groups had no significant differences. At the end of the intervention, it was found that the experimental students performed better in each subscale of CTDI-CV. These include the search for truth, open mind, analytical ability, systematic ability, critical thinking, self-confidence, curiosity, and cognitive maturity. By summing the scores of all categories, the results showed that the experimental group had a significantly higher total score than that of the control group (p ≤ .044). Evaluating the score difference in each function indicated that there was a range of improvements on the critical thinking disposition because of the reflective training intervention. CONCLUSION: Reflective training during the internship period improves nursing students' disposition of critical thinking and promotes their readiness for their clinical practices in the rapidly increasing demands of the healthcare field.

Tumstatin transfected into human glioma cell line U251 represses tumor growth by inhibiting angiogenesis.

BACKGROUND: Angiogenesis is a prerequisite for tumor growth and plays an important role in rapidly growing tumors, such as malignant gliomas. A variety of factors controlling the angiogenic balance have been described, and among these, the endogenous inhibitor of angiogenesis, tumstatin, has drawn considerable attention. The current study investigated whether expression of tumstatin by glioma cells could alter this balance and prevent tumor formation. METHODS: We engineered stable transfectants from human glioma cell line U251 to constitutively secrete a human tumstatin protein with c-myc and polyhistidine tags. Production and secretion of the tumstatin-c-myc-His fusion protein by tumstatin-transfected cells were confirmed by Western blotting analysis. In the present study, we identify the anti-angiogenic capacity of tumstatin using several in vitro and in vivo assays. Student's t-test and one-way analysis of variance (ANOVA) test were used to determine the statistical significance in this study. RESULTS: The tumstatin transfectants and control transfectants (stably transfected with a control plasmid) had similar in vitro growth rates compared to their parental cell lines. However, the conditioned medium from the tumstatin transfected tumor cells significantly inhibits proliferation and causes apoptosis of endothelial cells. It also inhibits tube formation of endothelial cells on Matrigel. Examination of armpit tumors arising from cells overexpressing tumstatin repress the growth of tumor, accompanying the decreased density of CD31 positive vessels in tumors ((5.62 ± 1.32)/HP), compared to the control-transfectants group ((23.84 + 1.71)/HP) and wild type U251 glioma cells group ((29.33 + 4.45)/HP). CONCLUSION: Anti-angiogenic gene therapy using human tumstatin gene may be an effective strategy for the treatment of glioma.

The expression of moesin in astrocytoma: correlation with pathologic grade and poor clinical outcome.

Moesin, a member of the ERM family, acts as a linker between the actin cytoskeleton and the plasma membrane and plays a key role in the control of cell morphology, motility, adhesion and other processes of tumourigenesis. The expression pattern and clinical significance of moesin in astrocytoma remain unknown. In this study, we used RT-PCR to systematically investigate the expression of moesin in 49 astrocytomas of different pathological grade and 6 normal brain tissues. We found that the mRNA expression levels of moesin in astrocytomas were significantly higher in comparison with normal brain tissues. Furthermore, moesin up-regulation was correlated with pathological grade of astrocytomas. Subsequently, we tested 112 astrocytomas and 14 normal brain tissues by immunohistochemistry. Similar results were also confirmed. Univariate and multivariate survival analysis were used to determine the correlations of moesin expression with overall survival and progression-free survival. Our results showed the expression of moesin was strongly negatively correlated with the patient progression-free survival and overall survival. These results suggest moesin protein involved in the genesis and progression of astrocytomas and might be regarded as an independent predictor of poor prognosis.

Large medial sphenoid wing meningiomas: long-term outcome and correlation with tumor size after microsurgical treatment in 127 consecutive cases.

AIM: We present the long-term outcomes as well as their correlation with tumor size in 127 consecutive patients harboring large MSWM after microsurgical treatment. MATERIAL AND METHODS: The retrospective analysis of clinical data and follow-up data of 127 microsurgical treated patients with MSWM was performed. The mean maximum diameter of tumors was 5.2cm (ranged 1.5-10.0cm). RESULTS: 104 cases (81.9%) achieved gross total resection. There was no operative mortality. Detailed follow-up data was available in 120 cases for a mean duration of 81.6 months (12-216 months). The permanent morbidity was 14.2%. The mean KPS score 1 year after surgery was 90.6 (ranged 60-100). Among 74 patients of preoperative visual acuity (VA) impairment, postoperative VA improved in 42 cases (56.8%), unchanged in 30 (40.5%), and deteriorated in 2 (2.7%). MR images revealed tumor recurrence after total resection in 10 cases (10.2%) and tumor progression after subtotal resection in 10 cases (45.5%). CONCLUSION: Tumor recurrence was the major risk in the long run, thus the initial surgery was extremely important and hence should be aggressive. The size of tumor affected the extent of tumor removal determining clinical outcomes including VA improvement and KPS score immediately after surgery; however, it was not correlated with long-term overall outcomes.