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ObjectiveThe glymphatic system regulates cerebral spinal fluid and interstitial fluid transport which might be one of the pathways of central nervous system （CNS） leukemia at the early stage. This study aimed to investigate the alteration of glymphatic system based on diffusion tensor image-analysis along the perivascular space （DTI-ALPS） in pediatric acute lymphoblastic leukemia （ALL） without clinically diagnosed CNS infiltration. MethodsTwenty-five ALL and typically developing （TD） children were prospectively recruited， and all subjects underwent DTI. Group differences in brain water diffusivities and ALPS-index were evaluated using the analysis of covariance. The Spearman correlation analysis was used to evaluate the relationship between biological characteristics and significant parameters in pediatric ALL. ResultsCompared with TDs， decreased Dxassoc value （PFDR-corrected = 0.048） and increased Dzassoc value （PFDR-corrected = 0.033） were found in pediatric ALL. Hence， lower ALPS-index was found in children with ALL （PFDR-corrected < 0.001）. ALPS-index was negatively associated with the risk classification （rs = -0.47， P = 0.018） as well as immunophenotype （rs = -0.40， P = 0.046） in pediatric ALL. ConclusionsOur results show dysfunction of the glymphatic system is presented in pediatric ALL without clinically diagnosed CNS infiltration， which suggests that the glymphatic system might be one of pathway in the early-stage of ALL CNS infiltration. The DTI-ALPS method can be used to evaluate the change of glymphatic system， providing a new method for exploring the underlying mechanisms and early detection of pediatric ALL CNS infiltration.
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ObjectiveCentral nervous system （CNS） infiltration commonly occurs in children with acute lymphoblastic leukemia （ALL）. Early subclinical CNS infiltration in pediatric ALL is hard to detect with conventional methods. This study aimed to investigate the changes of brain structure volume parameters based on Synthetic MRI （SyMRI） in pediatric ALL without clinically diagnosed CNS infiltration. MethodsThirty-six ALL and twenty-nine typically developing （TD） children were prospectively collected and all underwent SyMRI. The Synthetic MR software was used to obtain brain volumetric parameters including total white matter volume （WMV）， gray matter volume （GMV）， cerebrospinal fluid （CSF） volume， etc. and their within-group differences were assessed by analysis of covariance. The Spearman correlation analysis was used to examine the correlation between biological characteristics and statistically significant brain volume parameters. ResultsALL children showed increased CSF volume （PFDR-corrected = 0.009） and decreased GMV （PFDR-corrected = 0.027） when compared to TD children. We also found a moderately negative association between GMV/intracranial volume and risk classification in pediatric ALL （rs = -0.380， P = 0.022）. ConclusionsPediatric ALL without clinically diagnosed CNS infiltration presented with accumulation of CSF and reduction of gray matter. The brain volumetric changes in subclinical CNS infiltration of pediatric ALL provides a new attempt for exploring the underlying mechanism and early detection of CNS infiltration in pediatric ALL.
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Objective:To compare the cost-effectiveness of hospitalized Chinese patients undergoing nucleic acid screening strategies for hepatitis B and hepatitis C, immunological screening strategy, and no screening strategy under different willingness to pay (WTP). The results might aid to decision-making for the optimal strategy.Methods:In this study, nucleic acid screening, immunological screening and no screening were used as screening strategies, and China′s GDP in 2021 (80 976 yuan) was used as the threshold of WTP to construct a Markov model. After introducing parameters related to the diagnosis and treatment of hepatitis B and C in inpatients, a cohort population of 100 000 inpatients was simulated by TreeAge Pro 2021 software, the total cost, total health effects, incremental cost-effectiveness ratio and average cost-effectiveness ratio of different screening strategies were calculated, and cost-effectiveness analysis was conducted. Univariate and probabilistic sensitivity analysis were used to assess the impact of parameter uncertainty on the final results.Results:Compared with the non-screening strategy, the incremental total cost of the hepatitis B immunological screening strategy for cohort patients was 11 049 536 yuan, and the incremental cost-effectiveness ratio was 24 762 yuan/quality-adjusted life years (QALY), while the total incremental cost of nucleic acid screening was 19 208 059 yuan, and the incremental cost-effectiveness ratio was 29 873 yuan/QALY; the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 834 yuan/QALY. Compared with the non-screening strategy, the incremental cost-effectiveness ratio of hepatitis C immunological screening strategy was 5 731 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening strategy was 8 722 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 591 yuan/QALY. The results of probabilistic sensitivity analysis showed that when the cost of nucleic acid testing exceeded 214.53 yuan, it was not cost-effective to perform hepatitis B nucleic acid screening under the WTP as 1 fold GDP. When the cost of nucleic acid testing exceeded 132.18 yuan, it was not cost-effective to conduct hepatitis C screening under the WTP as 1 fold GDP.Conclusions:Nucleic acid screening strategy can achieve more cost-effectiveness and is worthy of vigorous promotion. Compared with no screening, both the nucleic acid and immunological screening strategies are cost-effective, and hepatitis nucleic acid screening is the optimal strategy for hospitalized patients.
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Objective:This multi-centre study was conducted to assess the efficacy of various preoperative/pre-transfusion screening methods for blood transmitted disease.Methods:From July 2021 to December 2021, plasma samples of patients admitted to 10 hospitals were collected for screening preoperative/pre-transfusion blood transmitted disease. Nucleic acid detection technology was used to detect hepatitis B virus (HBV) DNA, hepatitis C virus (HCV) RNA and human immunodeficiency virus (HIV)(1+2) RNA, and the results were compared with the immuno-serological methods. χ 2 test and Kappa test were used to analyze the efficacy of these two methods. Results:A total of 8 655 valid specimens were collected from 10 hospitals. There was a statistically significant difference in the positive detection rate of HCV between the two methods ( P<0.001). There was no significant difference in the positive detection rate of HBV and HIV assessed by the two methods ( P>0.05), but the number of positive cases detected by HBV DNA and HIV RNA (218 and 4 cases) was significantly higher than the corresponding serological results (216 and 2 cases). At the same time, there were HBV, HCV and HIV immuno-serological omissions by the immuno-serological methods, among which 28 cases were HBsAg negative and HBV DNA positive, 2 cases were HCV antibody negative and HCV RNA positive, and 2 cases were HIV antigen/antibody negative and HIV RNA positive. In addition, in the 66 samples with inconsistent results from the two detection methods, 83.3% (55/66), 68.2% (45/66), 63.6% (42/66) and 62.1% (41/66) of patients aged was>45 years, tumor, surgery and male, respectively. Conclusions:Compared with immuno-serological tests, nucleic acid tests have the advantage in terms of sensitivity on detecting HBV, HCV and HIV infection and could reduce missed detection. The risk of transmission can be reduced by adding HBV, HCV, and HIV nucleic acid tests to preoperative/pre-transfusion immuno-serological tests screening for patients over 45 years of age and tumor patients.
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Objective:To explore clinical value of nucleic acid detection for hepatitis B virus (HBV) screening in hospitalized patients.Methods:This cross-sectional study collected and analyzed plasma samples from patients admitted to 10 domestic medical institutions from July 2021 to December 2021. Serological immunoassay and nucleic acid screening were used to simultaneously detect hepatitis B markers such as hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B e Antigen (HBeAg), hepatitis B e antibody (HBeAb), hepatitis B core antibody (HBcAb),and HBV DNA. Statistical analysis was performed on the serology, nucleic acid test results and clinical information of the patients.Results:Of the 8 655 collected samples, HBsAg was positive in 216 (2.50%) samples,HBV DNA was positive in 238 (2.75%) samples ( P>0.05); 210 (2.43%) samples were positive for both HBsAg and HBV DNA, 28 (0.32%) were HBsAg negative and HBV DNA positive, 6 cases (0.07%) were HBsAg positive and HBV DNA negative. Conclusion:These results indicate that the HBV DNA testing is equally effective as hepatitis B virus serological detection for hepatitis B virus screening in hospitalized patients.
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Objective:To investigate the feasibility of real-time screening and diagnosing fundus diseases with Wild Field Imaging System (WFIS SW-8000) in the eyes with dense cataract patients.Methods:A series of case-observational study was carried out.Ninety-six dense cataractous eyes of 90 patients with suspected fundus diseases were included in Affiliated Hospital of Nantong University from April to July 2019.Lens phacoemulsification combined with intraocular lens implantation was performed after the opacity lens was removed, and fundus examination was performed with WFIS SW-8000.Super field lens, optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) was used to verify the fundus findings after surgery, which were compared with WFIS SW-8000.This study protocol was approved by Ethics Committee of Affiliated Hospital of Nantong University and followed the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination.Results:Among 96 eyes, fundus diseases were detected in 40 eyes with the detection rate of 41.67% by WFIS SW-8000 examination, including dry age-related macular degeneration (AMD) in 2 eyes, wet AMD in 3 eyes, polypoidal choroidal vasculopathy (PCV) in 1 eye, high myopia retinopathy (HMR) in 7 eyes, central retinal vein occlusion (CRVO) with macular edema (ME) in 1 eye, mild non-proliferative diabetic retinopathy (NPDR) in 12 eyes, moderate NPDR in 7 eyes, severe NPDR in 4 eyes and proliferative diabetic retinopathy (PDR) in 3 eyes.Fundus diseases were detected in 45 eyes with detection rate of 46.88% after surgery by a super field lens, OCT and FFA.The detectable rate of digital retinal camera examination and super field lens, OCT and FFA showed no significant difference between intraoperation and postoperation (χ 2=0.528, P=0.468). Twenty-two eyes with fundus neovascular disease or macular edema requiring drug intervention were identified intraoperatively, and intravitreal anti-inflammatory and/or anti-vascular endothelial growth factor (VEGF) drugs were injected in 11 eyes during the operation. Conclusions:WFIS SW-8000 is a useful tool for the accurate and convenient method in real-time fundus examination during phacoemulsification, which is feasible and helpful for timely intervention in and treatment of fundus diseases.
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@#【Objective】To assess the value of 18F-FDG PET/CT for imaging liver fibrosis.【Methods】12 male SD rats （170±10 g）were divided into model group（TAA group）and control group. In the model group，200 mg/kg thioacetamide dissolved in sterile saline was administered to rats by means of intraperitoneal injection twice a week for a total of 6 weeks. In the control group，rats were treated with the same volume of saline. At week 6 after injection，18F- FDG PET/CT imaging was performed on two groups and measurement of the liver 18F-FDG uptake in two groups was taken. After PET/ CT scans， all rats were sacrificed to observe anatomical morphological changes. Liver tissues were harvested for hematoxylin and eosin （H&E） staining，Masson staining and measurement of hydroxyproline levels. 【Results】 Liver anatomical morphology of the TAA-induced rats was roughness with brunt margins and coarse surfaces ，while control rats showed sharp margins and smooth surfaces. HE staining showed visible histological changes that hepatocyte and liver sinus area surrounded by plentiful recruited hepatocyte neutrophils in the model group. Masson staining showed that obvious proliferation of fibroblasts and deposition of collagen in liver tissues in the model group. Model group showed higher hydroxyproline content than that in the control group（P<0.001）. The results of 18F- FDG imaging indicated that apparent liver radioactivity concentration in the model group. 18F-FDG uptake value of liver tissues in the model group was higher than that in the control group（P<0.001）.【Conclusion】18F- FDG PET/CT imaging could be used for diagnosis of liver fibrosis noninvasively.
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Objective To explore the correlation between psychological health service demand and loneliness and anxiety depression in rural left-behind women.Methods 260 left-behind wo nen in Hebei province were surveyed by psychological health service demand scale,UCLA loneliness scale,trait anxiety scale and the center for epidemiologic studies depression scale (CES-D).Results There were statistically significant differences between the only child and non-only child left-behind women in mental health service demand ((131.72±13.91) vs (122.94±14.76)),loneliness ((52.94±5.65) vs (49.864±5.90)) and anxiety ((50.97±6.38) vs (47.16±4.80)) (t=3.313,2.899,4.151,P＜0.01).The mental health service demand,loneliness,anxiety and depression of left-behind women were different in the age of marriage (F=6.196,9.441,5.257,4.221,all P＜0.01),husband go out time (F=2.761,27.020,4.550,2.830,all P＜0.05) and degree of farm work (F=12.142,6.403,4.115,5.366,all P＜0.001).The anxiety of left-behind women was positively correlated with service content,service demand and depression (r=0.138-0.221,P＜0.01).Depression was negatively correlated with mental health service demand and service teams (r=-0.352--0.223,P＜ 0.01).Loneliness was positively correlated with service content,anxiety and depression (r=0.177-0.262,P＜ 0.01).Multiple linear regression showed that husbands go out time (β=0.326),farm work in very heavy degree (β=-0.376) and relatively heavy degree (β=-0.281),depression (β=-0.194) had a predictive effect on mental health services.Conclusion The mental health service demand of left-behind women are affected by their age,whether the only child,the age of marriage,their husbands' go out time and the degree of heavy farm work.
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Objective To investigate the value of serum IgG4 level for the diagnosis of IgG4-related hepatobiliary diseases and the differentiation from other hepatobiliary diseases.Methods A total of 270 patients with hepatobiliary diseases in the People's Hospital of Hunan Province from August 2015 to April 2017 were enrolled in this study,and 20 healthy subjects were selected as controls.The 270patients were divided into eight groups:liver cirrhosis group (n =17),acute pancreatitis group (n =52),chronic pancreatitis group (n =33),cholecystitis and gallstone group (n =27),bile duct carcinoma group (n =30),cholangitis and biliary calculi group (n =41),pancreatic cancer group (n =47),IgG4-related hepatobiliary disease group (n =23).The levels of serum IgG4 were measured by rate nephelometery assay.The sensitivity and specificity of IgG4 levels for distinguishing IgG4-associated hepatobiliary diseases were evaluated by receiver operating characteristic curve.Results The levels of IgG4 of the cirrhosis group and the IgG4 related hepatobiliary disease group were significantly higher than those of the control group (P ＜ 0.05).The IgG4 level in the hepatobiliary disease group was significantly higher than those of the other seven groups (Z =-5.267,-6.802,-5.921,-6.005,-6.173,-6.513,-6.014,P all ＜ 0.01).The area under curve (AUC) for IgG4 level in distinguishing IgG4 associated hepatobiliary diseases and other hepatobiliary diseases was 0.982.When 4.13 g/L was used as the cut off value of diagnosis,the sensitivity and specificity of IgG4for diagnosis were 95.7％ and 96.0％ respectively.The IgG4 levels in twelve patients with IgG-associated hepatobiliary diseases after 2 months of glucocorticoid therapy were significantly lower than those before glucocorticoid therapy (Z =-2.021,P =0.043).Conclusion The elevated serum IgG4 level may not be specific just for IgG4-related hepatobiliary diseases.The cut off value of 4.13 g/L should be very useful for diagnosing IgG4-related hepatobiliary diseases,differentiating from other hepatobiliary diseases and evaluating the therapeutic effect of glucocorticoid therapy.The further detailed verification for these findings should be necessary in clinical practice by increasing the sample size.
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Objective To examine the association of 18 single nucleotide polymorphisms (SNPs) in 4 DNA repair genes (BLM,WRN,ERCC6 and OGG1) with age-related cataract (ARC) in a Han Chinese population from Jiangsu Eye Study and to determine the possible functional consequence of the SNPs to DNA damage.Methods Together 18 SNPs in 4 DNA repair genes were genotyped in 789 ARC patients and 531 normal controls from Jiangsu Eye Study.The Comet assay was conducted to assess the extent of DNA damage in peripheral lymphocytes of the selected subjects.Results The results showed that WRN-rs11574311 was initially associated with ARC in general,cortical and mixed cataracts (P =0.003,OR =1.49;P =0.001,OR =1.68 and P ＜0.000 1,OR=2.08),BLM-rs1063147 with nuclear cataracts (P =0.03,OR =1.31),WRN-rs2725383 with cortical cataracts (P =0.01,OR =1.49),WRN-rs4733220 and WRN-rs2725338 with mixed cataracts (P =0.04,OR =0.74 and P =0.003,OR =0.60).However,after Bonferroni corrections,WRN-rs11574311 was still associated with cortical and mixed cataracts,as well as WRN-rs2725338 with mixed cataracts.The difference in DNA damage of peripheral lymphocytes with SNP types did not approach statistical significance among groups (all P ＞ 0.05).Conclusion WRN genes may have a vital role in ARC pathogenesis and exert a different action in ARC subtypes,which may be associated with different risk factors and mechanisms.
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Tripterygium hypoglaucum is an endangered species in arid areas of Xiannvshan Chongqing, China. The dynamic characteristics of seed rain and soil seed bank of T. hypoglaucum were studied in this paper．Results showed that T. hypoglaucum years of mature seeds distribution number up to October; the seed rain occurred from the last ten-day of September to in the first ten-day of November and the peak of scattered seed rain concentrated in the October．The numbers of soil seed bank at 2-5 cm soil layer,mainly concentrated in the 1.5-3.5 m range. T. hypoglaucum seeds to the wind as a force for transmission, the transmission ability is strong, but in the process of natural reproduction, full mature seed rate is low, the soil seed bank seeds seed short-lived factors these were unfavorable for the natural reproduction of T. hypoglaucum population.
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To establish a genetic susceptibility assessment model of lung cancer risk potentially associated with polycyclic aromatic hydrocarbon (PAH) inhalation exposure among non-smokers in China, a total of 143 patients with lung adenocarcinoma and 143 cancer-free individuals were recruited. Sixty-eight genetic polymorphisms in 10 pathways related to PAH metabolism and tumorigenesis were selected and examined. It was observed that 3 genetic polymorphisms, along with 10 additional genetic polymorphisms via gene-gene interactions, significantly influenced lung cancer risk potentially associated with PAH inhalation exposure. Most polymorphisms were associated with PAH metabolism. According to the established genetic susceptibility score (GSS), lung cancer risk increased with a rise in the GSS level, thereby indicating a positive dose-response relationship.
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Humans , Adenocarcinoma , Epidemiology , Genetics , Air Pollutants , Toxicity , China , Genetic Predisposition to Disease , Inhalation Exposure , Lung Neoplasms , Epidemiology , Genetics , Polycyclic Aromatic Hydrocarbons , ToxicityABSTRACT
Background Age-related cataract is one of the common causes of blindness.Although the pathophysiology of age-related cataract is far from clearly understood,it is well accepted that DNA damage plays an important role in the disease pathogenesis.Objective The purpose of this study was to quantitatively evaluate the DNA damage in peripheral lymphocytes of age-related cataract.Methods A cross-sectional study was carried out.This study complied Declaration of Helsinki and approved by Ethic Committee of Affiliated Hospital of Nantong University.Written informed consent was obtained from each subject.Two hundred and eleven patients with agerelated cataract and 147 normal subjects were enrolled from a “ Jiangsu Eye Study:Funing 2011 Eye Disease Epidemic Survey”.All the subjects aged from 50 through 80 years with matched age and gender between the two groups.The percentage of tail DNA and Olive tail moment (OTM) were detected by comet assay to assess the extent of DNA damage in peripheral lymphocytes.Statistical analyses were performed with SPSS 17.0 software,and the differences of the percentage of tail DNA and OTM were compared between the age-related cataract group and normal control group by independent sample t test as well as among the 50-59 years group,60-69 years group and ≥70 years group by one-way analysis of variance.Results Comet assay showed a round lymph cell with the clear border in the normal group;while in the age-related cataract group,the cell was bigger with a comet-like tail.The percentage of tail DNA and OTM in peripheral lymphocytes were (21.75 ± 3.51) ％ and 6.54 ± 1.65 in the age-related cataract group,and those in the normal control group were (9.31 ±3.60)％ and 2.18 ± 1.10,respectively,with significant differences between them (t =32.67,P =0.00 ; t =28.02,P =O.00).In the 50-59 years subgroup of the age-related cataract group,the percentage of tail DNA and OTM in peripheral lymphocytes were (20.04±2.86) ％ and 5.92± 1.14,and in the 60-69 years subgroup of the age-related cataract group,the percentage of tail DNA and OTM in peripheral lymphocytes were (20.77 ±2.93) ％ and 6.13 ± 1.14,which were significantly reduced in comparison with (22.79 ± 3.67)％ and 6.95±1.91 of the ≥70years subgroup(TailDNA％:q=2.75,P=0.00; q=2.02,P=0.00;OTM:q=1.03,P =0.02 ; q =0.82,P =0.00).Conclusions The pathogenesis and development of age-related cataract probably is associated with DNA damage.
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Objective To evaluate the application of the polymethyl methacrylate (PMMA) artificial eye in acquired ophthalmostewesis. Methods We summarized the experience in the application of PMMA in prosthesis for 8 years. 1155 patients were involved in the artificial eye custom-made program. The artificial eye was individually prepared based on the patient's condition and characters of the healthy eye.Results PMMA artificial eye associated with hydroxyl apatite implantation gave good cosmetic results with good motility, and there was no rejective reaction. The artificial eye was almost same to the real one in color and transparency. Conclusion It is suggested that PMMA is one of the best materials for manufacture of artificial eye at present.
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Objective To evaluate the clinical effect of Medpor ( porous high density polyethylene )as a padding material in correction of sunken eyelid after hydroxyapatite (HA) implantation. Methods We used Medpor in 17 patients ( 10 male and 7 female ), aged from 18 to 43 years (mean 26.6 years ), in which 9 cases had concomitant orbital fractures. The Medpor was implanted after HA sphere implantation ranged from 2 to 19 months ( average 6.7 months ). 17 consecutive patients with implantation of HA sphere were filled with Medpor under the periosteum. All of the cases were examined by CT scanning to distinguish orbital lesions with or without fracture. In the orbital fracture cases, we first repaired orbit bone defects with Medpor. Results There were no secondary infection or implant rejection occurred after following up for 1 to 18 months (average 8.7 months ). All patients' cosmesis was acceptable. 14 of 17 patients gained symmetric appearance. Although 3 patients had slight sunken eyelid, they gained a dramatic improvement of facial appearance nevertheless. Conclusions Sunken eyelid after HA sphere implant is related with orbital fracture as well as relative reduction of orbital content. Medpor presents fine biological compatibility. It is also easy to remodel and fix during operation. Medpor is a good implant for treatment of sunken eyelid after HA sphere orbital implantaion. [