Developmental trajectories of health-promoting behaviours among pregnant women: A longitudinal study.

AIMS AND OBJECTIVES: The aim of this study is to estimate differences in health-promoting behaviour levels throughout the pregnancy trimesters, to identify distinct patterns of health-promoting behaviour trajectories during pregnancy and to evaluate predictors of these trajectory group memberships. BACKGROUND: Promoting healthy lifestyle behaviours during pregnancy could decrease devastating outcomes for the mother and foetus. However, there is currently limited insight into the dynamics of health-promoting behaviours during pregnancy. DESIGN: An observational longitudinal study. METHODS: 158 pregnant women were recruited from June 2020 to June 2021 in Qingdao, China. The Health-Promoting Lifestyle Profile was used to assess health-promoting behaviours. Latent growth model was performed to compare health-promoting behaviours at different time points. Group-based trajectory model was applied to identify health-promoting behaviour trajectories. Multinomial logistic regression was adopted to determine the predictors of trajectory group memberships. We used the STROBE checklist to report this study. RESULTS: The entire sample of pregnant women experienced a significant increase in health-promoting behaviours during pregnancy. Three trajectories were identified including a 'low-increase behaviour trajectory (20.1% of sample)', a 'moderate-increase behaviour trajectory (58.0% of sample)' and a 'stable then increased behaviour trajectory (21.9% of sample)'. Low maternal sense of coherence, lack of pre-pregnancy exercise habit, artificial insemination and low monthly family income were significantly associated with the low-increase behaviour trajectory. High self-efficacy and pre-pregnancy exercise habit were significantly associated with the stable then increased behaviour trajectory. CONCLUSIONS: Pregnant women exhibit different health-promoting behaviours throughout the pregnancy trimesters. Meanwhile, three trajectories were identified among pregnant women. Thus, more attentions should be paid on early identification and targeted intervention in a future study. RELEVANCE OF CLINICAL PRACTICE: Healthcare providers should pay closer and earlier attention to identify women in the low-increase trajectory subgroup at the outset of pregnancy. Similarly, increased efforts should be made to improve maternal self-efficacy and develop good pre-pregnancy exercise habit in future study.

Effects of e-health interventions on health outcomes in patients with rheumatoid arthritis: a systematic review and meta-analysis.

AIMS AND OBJECTIVES: To evaluate the effects of e-health interventions on disease activity, self-efficacy, pain and quality of life among patients with rheumatoid arthritis (RA). BACKGROUND: Prior systematic reviews have only reported the quality and features of e-health interventions in patients with RA. However, the effect of e-health interventions in patients with RA is unclear. DESIGN: Systematic review and meta-analysis. METHODS: This review was conducted following the PRISMA guideline. We searched 5 databases, including PubMed, EMBASE, CINAHL, Scopus and the Cochrane library. The risk of bias was assessed using the Cochrane risk of bias tool. The quality of the evidence was assessed via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. Using a random-effects model adopted the standardised mean difference (SMD) with a 95% confidence interval (CI). A chi-squared test and an I2 test were used to assess heterogeneity. Subgroup analyses were conducted based on different controls. RESULTS: A total of 9 randomised control trials were included in this study. Compared with the control group, disease activity of the e-health group significantly decreased (SMD with 95% CI: -.17 [-.30, -.04], p = .01, I2  = 1%). Meanwhile, trials with usual care control had a larger effect on disease activity (SMD with 95% CI: -.21 [-.40, -.02], p = .03, I2  = 38%). The effect of e-health interventions on self-efficacy was controversial; pain and quality of life were negative in the currently included studies. The quality of evidence was rated as low for disease activity and very low for pain, self-efficacy and quality of life. CONCLUSIONS: The effect of e-health interventions on disease activity was statistically significant. More well-designed randomised controlled trials are still needed to verify the effects in the future. RELEVANCE TO CLINICAL PRACTICE: This study shows the potential value of e-health in improving health outcomes in patients with RA.

Association between pregnancy intention and smoking or alcohol consumption in the preconception and pregnancy periods: A systematic review and meta-analysis.

AIMS: To investigate the association between pregnancy intention and smoking or alcohol consumption in preconception and pregnancy periods. BACKGROUND: Suboptimal lifestyle such as smoking and alcohol consumption can lead to devastating outcomes on the maternal and foetus. Pregnancy intention exerts a significant effect on promoting healthy lifestyle behaviours. However, no reliable evidences confirmed pregnancy intention was associated with smoking and alcohol consumption before and during pregnancy. DESIGN: Systematic review and meta-analysis. METHODS: We performed a comprehensive search from databases including PubMed, Cochrane, Web of Science, IEEE Xplore, MEDLINE, ProQuest and Scopus from the inception of these databases up to November, 2020. All eligible studies exploring the association between pregnancy intention and smoking or alcohol consumption were included. The fixed- or random effect pooled measure was used to estimate the odds ratio (OR) or risk ratio (RR) and 95% CI. In addition, the PRISMA checklist was used in this meta-analysis. RESULTS: A total of 23 studies were included in this systematic review and meta-analysis. During pregnancy, the findings suggested that women with unplanned pregnancy were 68% more likely to consume cigarettes (OR = 1.68, 95% CI = 1.44-1.95) and 44% more likely to consume alcohol (OR = 1.44, 95% CI = 1.15-1.81) than those women with planned pregnancy. Meanwhile, during preconception, women with unplanned pregnancy were 30% more likely to consume cigarettes (OR = 1.30, 95% CI = 1.10-1.53) and 20% more likely to consume alcohol (OR = 1.20, 95% CI = 1.01-1.42) than those women with planned pregnancy. CONCLUSION: The findings suggested that women with unplanned pregnancy were more likely to follow unhealthy behaviours such as smoking and alcohol consumption before and during pregnancy. Health professionals should consider the women's desire for pregnancy to decrease preconception and pregnancy smoking or alcohol consumption in future studies. RELEVANCE OF CLINICAL PRACTICE: Pregnancy intention is the key determinant of smoking and alcohol consumption during preconception and pregnancy periods. Offering effective contraception in primary healthcare setting could prevent unplanned pregnancy. Meanwhile, popularising minimal alcohol consumption and comprehensive smoke-free legislation would be beneficial to improve reproductive outcomes.

Amorphous Ni(OH)2 -Ni3 S2 /NF nano-flower heterostructure catalyst promotes efficient urea assisted overall water splitting.

Urea assisted overall water splitting represents a cost-effective and efficient technology for hydrogen production, which not only obviates the generation of explosive H2 and O2 gas mixture but also minimizes the energy cost for the water splitting. In this study, we employed a one-pot hydrothermal method to directly synthesize Ni(OH)2 -Ni3 S2 /NF hybrid nanoflowers on a nickel foam (NF) substrate, resulting in efficient and stable bi-functional electrocatalysts for urea oxidation reaction (UOR) and hydrogen evolution reaction (HER). Under alkaline conditions, the Ni(OH)2 -Ni3 S2 /NF catalyst exhibits low voltage requirements of 1.346 V and -0.014 V vs. RHE with a current density of 10 mA cm-2 for UOR and HER, respectively. Furthermore, when employing the Ni(OH)2 -Ni3 S2 /NF catalyst as both anode and cathode for urea-assisted overall water splitting, it requires a cell voltage of merely 1.396 V with a current density of 10 mA cm-2 , which is notably lower than the voltage required for complete water decomposition at the same current density (1.568 V vs. RHE). The one-step synthesis of the Ni(OH)2 -Ni3 S2 /NF catalyst lays a foundation for further exploration of other transition metal complexes as dual-function electrocatalysts, enabling energy-efficient electrolytic hydrogen production and the treatment of urea-rich wastewater.

Effect of health coaching on blood pressure control and behavioral modification among patients with hypertension: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Health coaching has emerged as a potential supporting tool for improving hypertension health behavior. However, health coaching efficacy on hypertension has not been reviewed systematically. OBJECTIVE: To evaluate the effects of health coaching on blood pressure and behavioral changes among patients with hypertension in randomized controlled trials. DESIGN: A systematic review and meta-analysis. METHODS: We searched Medline (via PubMed), Web of Science, Embase, Cochrane Central Register of Controlled Trials, Proquest, and Scopus from inception to November 30, 2021. All randomized controlled trials that estimated the effects of health coaching on blood pressure and behavioral changes in adults with hypertension were included. The Cochrane risk-of-bias tool was used to evaluate the quality of the included studies. Standardized mean differences (SMD) and 95 % confidence intervals (CIs) were calculated using random-effects or fixed-effects meta-analysis. Sensitivity analysis and subgroup analysis were also conducted. RESULTS: A total of 1655 studies were screened and 12 randomized controlled trials were selected for inclusion, with 2497 participants were included. Most of the studies were at low risk of bias and the quality of evidence was high. The meta-analysis demonstrated that health coaching could significantly reduce systolic blood pressure (SMD: -0.26, 95 % CI: -0.39, -0.13, p < 0.001) and diastolic blood pressure in hypertension (SMD: -0.13, 95 % CI: -0.22, -0.03, p = 0.009). In addition, health coaching showed statistically significant positive effects on dietary behaviors (SMD: 0.76, 95 % CI: 0.08, 1.44, p = 0.02) and self-efficacy (SMD: 0.39, 95 % CI: 0.05, 0.73, p = 0.02). Subgroup analysis indicated that the most common and effective type of health coaching was the phone-based interventions (systolic blood pressure: SMD: -0.27, 95 % CI: -0.44, -0.10, p = 0.002; diastolic blood pressure: SMD: -0.14, 95 % CI: -0.25, -0.03, p = 0.02). The effects of nurse-delivered interventions were larger than other health care professionals (systolic blood pressure: SMD: -0.42, 95 % CI: -0.68, -0.16, p = 0.002; diastolic blood pressure: SMD: -0.19, 95 % CI: -0.35, -0.04, p = 0.02). CONCLUSION: Current evidence suggested that health coaching could reduce blood pressure, improve dietary behaviors, and increase self-efficacy among patients with hypertension and thus could be an effective and alternative method in the management of hypertension. The most common and effective types of health coaching were phone-based and nurse-delivered interventions. Thus, more strategies and policies may be needed to implement these types of interventions to more patients with hypertension.

Nanoengineering Metal-Organic Frameworks and Derivatives for Electrosynthesis of Ammonia.

Electrocatalytic synthesis under mild conditions has become increasingly important as one of the practical alternatives for industrial applications, especially for the green ammonia (NH3) industry. A properly engineered electrocatalyst plays a vital role in the realization of superior catalytic performance. Among various types of promising nanomaterials, metal-organic frameworks (MOFs) are competitive candidates for developing efficient electrocatalytic NH3 synthesis from simple nitrogen-containing molecules or ions, such as N2 and NO3-. In this review, recent advances in the development of electrocatalysts derived from MOFs for the electrosynthesis of NH3 are collected, categorized, and discussed, including their application in the N2 reduction reaction (NRR) and the NO3- reduction reaction (NO3RR). Firstly, the fundamental principles are illustrated, such as plausible mechanisms of NH3 generation from N2 and NO3-, the apparatus of corresponding electrocatalysis, parameters for evaluation of reaction efficiency, and detection methods of yielding NH3. Then, the electrocatalysts for NRR processes are discussed in detail, including pristine MOFs, MOF-hybrids, MOF-derived N-doped porous carbons, single atomic catalysts from pyrolysis of MOFs, and other MOF-related materials. Subsequently, MOF-related NO3RR processes are also listed and discussed. Finally, the existing challenges and prospects for the rational design and fabrication of electrocatalysts from MOFs for electrochemical NH3 synthesis are presented, such as the evolution of investigation methods with artificial intelligence, innovation in synthetic methods of MOF-related catalysts, advancement of characterization techniques, and extended electrocatalytic reactions.

Autonomic nervous function and baroreflex sensitivity in hypertensive diabetic patients.

OBJECTIVE: Little is known about how the cardiac autonomic nervous function (CAN) changes with gradually increasing systolic blood pressure (SBP). This study investigated cardiac autonomic nervous function in diabetic patients and controls with different grades of SBP. METHODS AND RESULTS: We measured heart rate variability (HRV) and spontaneous baroreflex sensitivity (BRS) by power spectral analysis in 118 Chinese type-2 diabetic patients and 137 age-matched controls. Subjects were further subdivided into 4 SBP groups. Results showed total HRV and BRS values were significantly lower in several diabetic SBP groups. Total HRV and BRS decreased with increasing SBP, with significant differences in the 140-159 mm Hg or 160-179 mm Hg groups compared with other groups of diabetic and control subjects. CONCLUSIONS: We found that HRV and BRS can reflect cardiovascular autonomic dysfunction of diabetes when accompanied by hypertension. In our selected Chinese diabetic and control subjects, HRV and BRS parameters were influenced by gradually increasing SBP.

[Clinical significance of counting follicles in diagnosis of polycystic ovary syndrome by the three-dimensional ultrasound imaging with sonography based automated volume calculation method].

OBJECTIVE: To investigate clinical significance of counting follicles classification by three-dimensional imaging with sonography based automated volume calculation (SonoAVC) in the diagnosis of polycystic ovary syndrome (PCOS). METHODS: Eighty cases with PCOS were counted classified follicles and determined ovarian volume by three-dimensional (3D) imaging with SonoAVC method matched with 60 infertile women with fallopian tube or male factors as control. Main clinical, biological and other ultrasonographic markers were assessed during the early follicular phase, and the relationship between the follicle number range per ovary or the volume per ovary and the major hormonal features of PCOS was studied. RESULTS: Three-dimensional ultrasound imaging with SonoAVC method provides a new path for objective quantitative assessment of follicle count, ovarian volume, total follicle numbers. The volume of (11 ± 8) ml, total numbers of 27 ± 14 follicle and number of 22 ± 19 follicle with diameter of ≥ 2 - < 6 mm in PCOS patients were significantly higher than (6 ± 4) ml in ovarian volume, 6 ± 4 in total follicles and 2 ± 3 in follicle with diameter of ≥ 2 - < 6 mm in controls (P < 0.05), while follicles were similar for the ≥ 6 - ≤ 9 mm range (P > 0.05). Total follicle numbers and follicles ≥ 2 - < 6 mm had significantly positive relationships with ovarian volume (r = 0.600, 0.618, P < 0.01) and level of testosterones (r = 0.364, 0.291, P < 0.05), follicles ≥ 2 - < mm also had significantly positive relationships with total follicle number (r = 0.916, P < 0.01). The follicles within the ≥ 6 - ≤ 9 mm range was significantly and negatively related to ovarian volume and total follicle numbers (r = -0.618, -0.263, all P = 0.001), but no significantly related to the major hormonal features of PCOS. The ovarian volume was significantly positively related with luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio (r = 0.282, P = 0.010) but negatively related to FSH level (r = -0.226, P = 0.042). CONCLUSIONS: Ovarian volume, total follicle numbers and follicles ≥ 2 - < 6 mm in PCOS patients were significantly higher than those in controls. The larger ovarian volume might produce more total follicle and follicles ≥ 2 - < 6 mm. The higher level of testosterone might produce more total follicle probably, which mainly result in more follicles ≥ 2 - < 6 mm. These morphologically ultrasonographic characteristics could reflect pathophysiological changes in PCOS. Obviously, it has important clinical significance to count follicles in patients with PCOS by the three-dimensional ultrasound imaging with SonoAVC method.

miR-660-5p-loaded M2 macrophages-derived exosomes augment hepatocellular carcinoma development through regulating KLF3.

OBJECTIVE: M2 macrophages (M2) can affect tumor development by secreting various cytokines, including exosomes (Exo). Herein, we intended to explore how microRNA (miR)-660-5p-modified M2-Exo affected hepatocellular carcinoma (HCC) development through regulating Kruppel-like factor 3 (KLF3). METHODS: miR-660-5p and KLF3 levels were first measured in clinical HCC tissues. A miR-targeted relation was explored between miR-660-5p and KLF3. M2-Exo were modified by miR-660-5p-related oligonucleotides and co-cultured with HepG2 cells to determine their effects on cell proliferation, colony formation, invasion, migration, apoptosis and epithelial-mesenchymal transition (EMT). Xenografted tumors were collected from mice to further verify the in vitro results. RESULTS: Higher miR-660-5p and lower KLF3 levels were examined in HCC. KLF3 was targeted by miR-660-5p. Up-regulated miR-660-5p-modified M2-Exo boosted the grwoth and EMT of HepG2 cells, but this effect was impaired by overexpression of KLF3. miR-660-5p-loaded M2-Exo enhanced tumorigenic ability of HCC cells in mice. On the contrary, down-regulated miR-660-5p reduced M2-Exo-mediated promotion of growth of HCC cells in vitro and in vivo. CONCLUSION: Our study summarizes that miR-660-5p-loaded M2-Exo augment HCC development through down-regulating KLF3.

Does CSR affect the cost of equity capital: Empirical evidence from the targeted poverty alleviation of listed companies in China.

Social responsibility fulfillment helps modern enterprises achieve sustainable development. Based on empirical data on China's A-share listed companies in 2013-2016, this paper examines the impact of corporate social responsibility performance on a company's financing costs from the perspective of targeted poverty alleviation. Specifically, we find that enterprises' engagement in poverty alleviation social responsibility helps to reduce the cost of equity capital. The result is robust to using alternative indicators of the cost of equity capital, propensity score matching method, change model and sample removed financial sector. Furthermore, we find that the negative relationship between enterprises' engagement in poverty relief and the cost of equity capital is mainly concentrated in private enterprises and in the central and eastern regions of China. Moreover, the negative relationship mainly exists after China's listed companies were forced to disclose information on poverty alleviation. This paper also finds that institutional investors' shareholding plays a partial mediating role in this reduction effect and that enterprises' poverty alleviation efforts help companies improve their financial performance and firm value. This study enriches the relevant literature on corporate social responsibility and the cost of equity capital and has reference value for corporate sustainable development. It also provides a theoretical basis for corporate poverty alleviation work in developing countries and the economic results of CSR.

MicroRNA-183-5p contributes to malignant progression through targeting PDCD4 in human hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) remains one of the most common malignant tumors worldwide. The present study aimed to investigate the biological role of microRNA-183-5p (miR-183-5p), a novel tumor-related microRNA (miRNA), in HCC and illuminate the possible molecular mechanisms. The expression patterns of miR-183-5p in clinical samples were characterized using qPCR analysis. Kaplan-Meier survival curve was applied to evaluate the correlation between miR-183-5p expression and overall survival of HCC patients. Effects of miR-183-5p knockdown on HCC cell proliferation, apoptosis, migration and invasion capabilities were determined via Cell Counting Kit-8 (CCK8) assays, flow cytometry, scratch wound healing assays and Transwell invasion assays, respectively. Mouse neoplasm transplantation models were established to assess the effects of miR-183-5p knockdown on tumor growth in vivo. Bioinformatics analysis, dual-luciferase reporter assays and rescue assays were performed for mechanistic researches. Results showed that miR-183-5p was highly expressed in tumorous tissues compared with adjacent normal tissues. Elevated miR-183-5p expression correlated with shorter overall survival of HCC patients. Moreover, miR-183-5p knockdown significantly suppressed proliferation, survival, migration and invasion of HCC cells compared with negative control treatment. Consistently, miR-183-5p knockdown restrained tumor growth in vivo. Furthermore, programmed cell death factor 4 (PDCD4) was identified as a direct target of miR-183-5p. Additionally, PDCD4 down-regulation was observed to abrogate the inhibitory effects of miR-183-5p knockdown on malignant phenotypes of HCC cells. Collectively, our data suggest that miR-183-5p may exert an oncogenic role in HCC through directly targeting PDCD4. The current study may offer some new insights into understanding the role of miR-183-5p in HCC.

FOXP3 inhibits MYC expression via regulating miR-198 and influences cell viability, proliferation and cell apoptosis in HepG2.

OBJECTIVE: Our study aimed to explore the effects of FOXP3 expression on liver neoplasms cells and to further investigate the relationship between FOXP3 and proto-oncogene MYC. METHODS: QRT-PCR was used for assessment of FOXP3 expression in liver neoplasms tissues and para-carcinoma tissues. The effects of FOXP3 on cell viability were determined by CCK8 assay, clone formation experiment, and flow cytometry. For miRNA selection, chips were used to figure out the differentially expressed miRNAs in FOXP3-overexpressing HepG2 cells. The result was followed by bioinformatics prediction to screen the possible MYC-targeted miRNAs, and it was examined by dual luciferase assay and ChIP assay. The expression levels of MYC protein and apoptosis-associated proteins (bcl2 and bax) were measured by Western blot assay. RESULTS: It showed an under-regulated expression of FOXP3 in liver neoplasm tissues from qRT-PCR results. Overexpression of FOXP3 contributed to cell apoptosis as well as suppressed tumor cells' proliferation. MiR-198 was detected to be highly expressed in FOXP3-overexpressing HepG2 cells. FOXP3 regulated the transcription level of miR-198 by binding to its promoter sequence and overexpressed miR-198 could suppress tumor cells' proliferation and promote cell apoptosis. There existed targeted relationship between miR-198 and MYC gene. MiR-198 inhibited cancer by suppressing the expression of MYC in liver neoplasm. CONCLUSION: FOXP3 up-regulated miR-198 expression by binding to its promoter sequence specifically, while miR-198 inhibited proto-oncogene MYC via targeted relationship. High level of miR-198 contributed to the apoptosis of tumor cells and suppressed cell viability meanwhile.

Laparoscopic Pancreaticoduodenectomy: A Single Team Preliminary Experience.

OBJECTIVE: The present study aimed to describe the authors' experience and the perioperative outcome for laparoscopic pancreaticoduodenectomy (LPD). MATERIALS AND METHODS: Perioperative clinical data of 57 consecutive pancreaticoduodenectomy (PD) procedures performed from January 2014 to May 2016 in the Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital were retrospectively analyzed. RESULTS: The median of operative time was 315 minutes (range, 220 to 575 min) and the median of intraoperative estimated blood loss was 200 mL (range, 100 to 550 mL). Conversion to open PD was required in 3 patients (5.3%) as a result of difficult dissection. Hand-assisted LPD was used in 2 patients (3.5%). Mean length of hospital stay was 14.8 days (8 to 29 d). Cumulative surgery-related morbidity was 28.1%, included bleeding (n=4), pancreatic fistula (n=3), biliary fistula (n=1), delayed gastric emptying (n=1), intra-abdominal infection (n=3), pulmonary infection (n=3), and ileus (n=1). Postoperative severe complications (Clavien≥III) were detected in 4 patients (7.0%) including 1 intra-abdominal infection, 2 postoperative bleeding event, and 1 afferent delayed gastric emptying. Three patients required reoperation. There was no 30-day or in-hospital mortality. Pathologic diagnoses were pancreatic ductal adenocarcinoma (n=5), ampullary adenocarcinoma (n=10), duodenal adenocarcinoma (n=24), distal common bile duct cancer (n=13), atypical hyperplasia of bile duct (n=2), and chronic pancreatitis (n=3). No patient had margin positive resection; the number of harvested lymph nodes were (16.7±4.2), the number of positive lymph nodes were (1.3±1.1). CONCLUSIONS: LPD, although complicated and difficult, serve as a safe and effective method for experienced surgeons.

Spatial working memory dysfunction in minimal hepatic encephalopathy: an ethology and BOLD-fMRI study.

The term "minimal hepatic encephalopathy" (MHE) refers to a population of individuals who have no recognizable clinical symptoms but perform abnormally on neuropsychological and neurophysiological tests. Research shows that MHE patients have impairments in cognition affecting their daily lives that should be treated. This study explored the neural basis of spatial working memory impairment in MHE patients using behavioral test and BOLD-fMRI. Twelve normal controls, twelve cirrhosis patients without MHE and twelve MHE patients took part. The memory quotient of the MHE group (Wechsler Memory Scale-Chinese revised: WMS-CR) was lower than the normal control group and the cirrhosis-without-MHE group, and primarily concerned short-term memory and transient memory. Performance accuracy was lower for the MHE group than the control group and the cirrhosis-without-MHE group, and mean reaction time was prolonged. The fMRI data highlighted a neural network consisting of: bilateral prefrontal cortex (PFC), bilateral premotor area (PreMA), supplementary motor area (SMA) and bilateral parietal areas (PA), which was activated in the n-back task. The load effect of BOLD-fMRI response appeared in all regions of interest (ROI) for the normal control group, but only appeared in PreMA and PA, and did not vary with n-back load in PFC or SMA for the MHE group. Activation intensities for all ROIs were higher for the normal control group than the MHE group, especially in 2-back load. In conclusion, these results demonstrate that MHE patients have debilitated spatial working memory, and that impairments of bilateral PFC, PMA, SMA, and PA commonly lead to spatial working memory dysfunction. Furthermore, PFC impairment may form the neural basis of spatial working memory impairment.

Chromogranin A (CgA) as poor prognostic factor in patients with small cell carcinoma of the cervix: results of a retrospective study of 293 patients.

BACKGROUND: Small cell carcinoma of the cervix (SCCC) is a very rare tumor. Due to its rarity and the long time period, there is a paucity of information pertaining to prognostic factors associated with survival. The objective of this study was to determine whether clinicopathologic finings or immunohistochemical presence of molecular markers predictive of clinical outcome in patients with SCCC. METHODOLOGY AND FINDINGS: We retrospectively reviewed a total of 293 patients with SCCC (47 patients from Cancer Center of Sun Yat-sen University in china, 71 patients from case report of china journal, 175 patients from case report in PubMed database). Of those 293 patients with SCCC, the median survival time is 23 months. The 3-year overall survival rates (OS) and 3-year disease-free survival rates (DFS) for all patients were 34.5% and 31.1%, respectively. Univariate and multivariate analysis showed that FIGO stage (IIb-IV VS I-IIa, Hazard Ratio (HR) = 3.08, 95% confidence interval (CI) of ratio = [2.05, 4.63], P<0.001), tumor mass size (≥ 4 cm VS <4 cm, HR = 2.37, 95% CI = [1.28, 4.36], P = 0.006) and chromogranin A (CgA) (Positive VS Negative, HR = 1.81, 95% CI = [1.12, 2.91], P = 0.015) were predictive of poor prognosis. CgA stained positive was found to be highly predictive of death in early-stage (FIGO I-IIa) patient specifically. CONCLUSIONS: Patients with SCCC have poor prognosis. FIGO stage, tumor mass size and CgA stained positive may act as a surrogate for factors prognostic of survival. CgA may serve as a useful marker in prognostic evaluation for early-stage patients with SCCC.

[Transfection of hBcl-2 gene protects the liver against ischemia/reperfusion injury in rats during liver transplantation].

OBJECTIVE: To study the effect of hBcl-2 gene transfer on rat liver against ischemia-reperfusion injury, and explore the feasibility of this approach to reduce ischemia-reperfusion injury in liver transplantation. METHODS: We constructed the replication-deficient recombinant adenoviruses Adv-EGFP and Adv-Bcl-2 and transfected them into 293 cells and packaged into adenovirus particles for amplification and purification. The empty plasmid vector virus was constructed similarly. Male SD rats were randomized into Adv-Bcl-2-transfected group, Adv-EGFP-transfected group, ischemia-reperfusion group, and sham-operated group, and liver allograft transplantation model was established by sleeve method. In the transfected groups, the recombinant viruses were administered by perfusion through the portal vein, and the ischemia-reperfusion and sham-operated groups received no treatment. Real-time quantitative PCR and Western blotting were used to detect the mRNA and protein expressions of bcl-2 in the liver tissue of each group, and at 0, 60 and 180 min after reperfusion, serum AST, LDH, and MDA levels were measured. Histological changes of the liver cells were evaluated by HE staining. RESULTS: Bcl-2 mRNA and protein expressions in Adv-Bcl-2-transfected group, as compared with those in Adv-EGFP-transfected group and control group, were significantly increased (P<0.01); the serum levels of AST, LDH and MDA in Adv-Bcl-2-transfected group were significantly lower than those of Adv-EGFP-transfected group and ischemia-reperfusion group (P<0.05 or 0.01). Compared with the sham-operated group, Adv-Bcl-2 treatment group showed lessened edema and vacuolar degeneration of the liver cells without patches or spots of necrosis. In ischemia-reperfusion and Adv-EGFP group, HE staining revealed hepatic lobular destruction and extensive liver cell swelling, enlargement, vacuolar degeneration, edema and occasional focal necrosis. CONCLUSION: Adv-Bcl-2 transfection can induce the expression of bcl-2 gene to reduce ischemia-reperfusion injury of the liver graft in rats.

Prevalence, incidence and risk factors of chronic heart failure in the type 2 diabetic population: systematic review.

OBJECTIVES: The aim of this review was to examine the prevalence, incidence and risk factors of chronic heart failure in the type 2 diabetic population. METHODS: A systematic search of studies related to chronic heart failure (CHF) in the diabetic population was performed using medical databases. RESULTS: 1) The prevalence of CHF in the diabetic population was approximately 10-23% in the large previously studied cohort. This was about three times higher than in non-diabetic control groups. 2) The incidence of CHF in diabetes varied greatly. It was influenced by the time of follow-up, the mean age of patients, the state of metabolic control and the complications of diabetes. The incidence of CHF in patients with diabetes was approximately two-fold greater than in the non-diabetic population. 3) The main risk factors of CHF in the type 2 diabetic population were age, hemoglobin A1c (HbA1c), coronary heart disease, hypertension, microalbuminuria and obesity. CONCLUSIONS: The prevalence and incidence of CHF were found to be high in the diabetic population, and the risk factors of CHF were somewhat different from those in the general population.

[Impact of instantaneous uniformity of SonoVue microbubbles on binding characteristics of a new contrast agent targeted to choriocarcinoma cells in vitro].

BACKGROUND & OBJECTIVE: At present, the investigation of microbubble contrast agents is a hot spot. Although these contrast agents can increase the ultrasound detection rate of tumor vessels, they lack tissue specificity. This study was to evaluate the impact of instantaneous uniformity of SonoVue microbubbles on binding characteristics, including the adhesion rate and stability, of a new contrast agent targeted to choriocarcinoma cells (JARs) in vitro, in order to establish a foundation to explore targeted ultrasound imaging for localization of tumor cell antigens and increase the early diagnostic rate for tumors. METHODS: The objects were divided into three groups: the uneven microbubble group (n=10), the uniform microbubble group (n=10) and the tiny microbubble group (n=10). The rosette formation rate was counted. JARs were calculated by flow cytometry (FCM). The shape of the rosette was recorded. The targeted contrast agent was prepared by mixing SonoVue microbubbles of different uniformity with rabbit anti-human chorionic gonadotrophin (HCG) antibody. The binding rates of the contrast agent to JARs before and after PBS rinse were analyzed. RESULTS: The binding rate was significantlylower in the uneven microbubble group (60.4+/-1.5)% than in the uniform microbubble group (84.3+/-5.5)% and the tiny microbubble group (90.6+/-6.8)% (P<0.05). The binding rates of different microbubbles to JARs before and after PBS rinse were different. The uniform microbubbles were the most stable ones, with the binding rate of (84.3+/-5.5)% and (82.4+/-3.7)% before and after PBS rinse (P>0.05). The binding rates of the targeted microbubbles labeled with fluorescence to JARs were 72.9%, 81.03% and 88.5% in the uneven microbubble group, the uniform microbubble group and the tiny microbubble group, respectively (P<0.05). CONCLUSIONS: The binding capacity of the targeted SonoVue microbubbles to JARs is related to instantaneous uniformity of the microbubble, which is determined by the shaking method before preparation. Improving instantaneous uniformity of SonoVue microbubbles may increase the binding rate and stability of targeted microbubbles to JARs, thus to improve the image of JARs.