Distress and its influencing factors among Chinese patients with incidental pulmonary nodules: a cross-sectional study.

The study aims to investigate the distress level and its influencing factors in Chinese pulmonary nodules patients. A total of 163 outpatients in a tertiary hospital in Xi'an, China, were recruited and investigated by using the Impact of Event Scale, Decision Conflict Scale, Consultation Care Measure, Lung Cancer Worry Scale and a demographic questionnaire. The logistic regression model was used to identify the factors of distress. The mean IES score was 37.35 ± 16.65, which was a moderate level. Patients aged 50-60 years, with higher decision conflicts scores, lower physician-patient communication quality score, and who are anxious about the results of future tests or treatments had higher distress score. Distress levels were moderate in patients with pulmonary nodules. Communication between medical staff and patients is extremely important for the management of pulmonary nodules, which affects the quality of the patient's decision-making and his level of distress.

TMPRSS11D/ALR-mediated ER stress regulates the function of myeloid-derived suppressor cells in the cervical cancer microenvironment.

Myeloid-derived suppressor cells (MDSCs) contribute to tumor immune evasion, and have been identified as immunosuppressive cells in cervical cancer. The effect of TMPRSS11D (transmembrane serine protease 11D) in some cancers has been reported, but its role in immune escape of cervical cancer is still unclear. This study aims to elucidate the regulatory mechanism of TMPRSS11D on the immunosuppressive function of MDSCs in cervical cancer. Our data showed that the proportion of polymorphonucleoid MDSCs (PMN-MDSCs), the contents of immunosuppressive factors (including INOS, IDO, and ARG-1) secreted by MDSCs, and TMPRSS11D mRNA level in peripheral blood mononuclear cells (PBMCs) of malignant cervical cancer patients was significantly higher than that of benign tumor patients. Next, CD3+ T cells from PBMCs of cervical cancer patients were stimulated with anti-CD3 and anti-CD28, and then co-cultured with PMN-MDSCs from the same donors at a ratio of 1:2 for 3 days. PMN-MDSCs from malignant tumors produced more ROS, while TMPRSS11D knockdown blocked ROS production. PMN-MDSCs inhibited T cell proliferation and IFN-γ production, while silencing TMPRSS11D in PMN-MDSCs hindered the immunosuppressive effect of PMN-MDSCs. Mechanistically, TMPRSS11D bound to ALR (Augmenter of liver regeneration) and negatively regulated ALR expression, inducing ER stress in PMN-MDSCs, thereby enhancing the immunosuppressive effect of PMN-MDSCs on T cells. Additionally, mouse xenograft tumor assay was conducted to assess the role of TMPRSS11D in tumor growth and MDSC accumulation in vivo. Silencing TMPRSS11D impeded the growth of cervical cancer xenografts and reduced the accumulation of MDSCs in tumor tissues. In conclusion, TMPRSS11D induced ER stress in MDSCs through negative regulation of ALR, thus enhancing the immunosuppressive effect of MDSCs on T cells, so as to promote the growth of cervical cancer tumors.

Effect of Self-Determination Theory on Knowledge, Treatment Adherence, and Self-Management of Patients with Maintenance Hemodialysis.

Our aim of this study was to investigate the effect of self-determination theory on awareness of relevant knowledge, treatment compliance, and self-management level in maintenance hemodialysis (MHD) patients. A total of 90 patients who received MHD treatment in our hospital from April 2018 to June 2020 were selected and randomly divided into the intervention group and the routine group with 45 cases in each group. Both groups were given basic hemodialysis patient management measures, and the intervention group was given self-determination theory to manage patients on this basis. The awareness rate of hemodialysis patient-related knowledge, patient treatment compliance, patient self-management scores, and quality of life scores were compared between the two groups before intervention and 6 months after intervention. After intervention, the awareness rate of dialysis principle, reasonable diet, internal fistula protection, and complication prevention knowledge in the intervention group was higher t (P < 0.05); before intervention, there was no significant difference in the scores of all dimensions of compliance between the two groups (P > 0.05); after intervention, the dietary compliance, fluid intake compliance, dialysis regimen compliance, and total score of compliance in the intervention group were higher than those in the conventional group (P < 0.05). After intervention, the total scores of problem solving, partnership, emotional processing, self-care activities, and self-management in the intervention group were higher than those in the conventional group, (P < 0.05). After intervention, the physical domain, psychological domain, social relationship domain, and total scores of quality of life in the intervention group were higher than those in the conventional group (P < 0.05). Self-determination theory management is effective in improving the awareness of hemodialysis-related knowledge, treatment compliance, self-management level, and quality of life in MHD patients.

Drought propagation under global warming: Characteristics, approaches, processes, and controlling factors.

Drought is a costly natural hazard with far-reaching impacts on agriculture, ecosystem, water supply, and socio-economy. While propagating through the water cycle, drought evolves into different types and affects the natural system and human society. Despite much progress made in recent decades, a synthesis of the characteristics, approaches, processes, and controlling factors of drought propagation is still lacking. We bridge this gap by reviewing the recent progress of drought propagation and discussing challenges and future directions. We first introduce drought propagation characteristics (e.g., response time scale, lag time), followed by different approaches, including statistical analysis and hydrological modeling. The recent progress in the propagation from meteorological drought to different types of drought (agricultural drought, hydrological drought, and ecological drought) is then synthesized, including the basic process, commonly used indicators, data sources, and main findings of drought propagation characteristics. Different controlling factors of drought propagations, including climate (e.g., aridity, seasonality, and anomalies of meteorological variables), catchment properties (e.g., slope, elevation, land cover, aquifer, baseflow), and human activities (e.g., reservoir operation and water diversion, irrigation, and groundwater abstraction), are then summarized. Challenges in drought propagation include the discrepancy in drought indicators (and approaches) and difficulty in characterizing the full propagation process and isolating influencing factors. Future analysis of drought propagation should shift from single indicators to multiple indicators, from individual drivers to combined drivers, from uni-directional analysis to feedbacks, from hazards to impacts, and from stationary to nonstationary assumptions. This review is expected to be useful for drought prediction and management across different regions under global warming.

Quantifying likelihoods of extreme occurrences causing maize yield reduction at the global scale.

A variety of weather and climate extremes (e.g., droughts, heatwaves) can lead to negative impacts on crop yields and food security. It is thus important to understand likelihoods of extreme occurrences causing crop yield reduction for enhanced resilience of the food system. Here, we investigate the likelihood of occurrences of dry, hot, and compound dry-hot conditions causing crop yield reduction for ten maize-producing countries based on climate observations and country-level maize yields for the period 1961-2016. The likelihood of occurrences of different extremes causing maize yield reduction is quantified using a multivariate statistical model. Results show that the multivariate model performs well in quantifying the likelihood of extreme occurrences (i.e., dry, hot and compound dry-hot conditions) causing maize yield reduction. Overall, the likelihood of occurrences of the above three conditions leading to yield reduction varies among ten maize-producing countries and that of compound dry-hot condition is the highest for most countries, which is shown to be closely related to the precipitation-temperature dependence of each country. Moreover, the likelihood of compound dry-hot occurrences becomes higher as the severity of crop yield reduction increases. These findings highlight significant impacts of compound dry-hot conditions on maize yield reduction and provide valuable information for formulating effective agricultural measures under global warming.

Probabilistic evaluation of the impact of compound dry-hot events on global maize yields.

Weather and climate extremes, such as droughts and hot extremes, may result in marked damages to crop yields and threaten regional and global food security. Understanding the relationship between climate extremes and crop yields is of critical importance for food security under a changing climate. The objective of this study is to investigate the probabilistic variability of maize yields with respect to compound dry-hot events, which has been shown to be more stressful to crops compared with individual dry or hot events. A multivariate model is first constructed to model the joint behavior of the dry condition, hot condition, and crop yields. The response of crop yields under different dry, hot, and compound dry-hot conditions at national and global scales is then investigated based on the conditional distribution. For the major maize producing countries (top 5), the probability of maize yield reduction could increase by from 0.07 to 0.31 (from 0.04 to 0.31) when the individual extreme drought (extreme hot) conditions changed to compound dry-hot conditions. The probabilistic evaluation of compound dry-hot events' impacts on maize yields is expected to provide useful insights for the mitigation of compound events and their impacts under a changing climate.

Epidemiology and risk factors for nosocomial infection in the respiratory intensive care unit of a teaching hospital in China: A prospective surveillance during 2013 and 2015.

BACKGROUND: To determine the epidemiology and risk factors for nosocomial infection (NI) in the Respiratory Intensive Care Unit (RICU) of a teaching hospital in Northwest China. METHODS: An observational, prospective surveillance was conducted in the RICU from 2013 to 2015. The overall infection rate, distribution of infection sites, device-associated infections and pathogen in the RICU were investigated. Then, the logistic regression analysis was used to test the risk factors for RICU infection. RESULTS: In this study, 102 out of 1347 patients experienced NI. Among them, 87 were device-associated infection. The overall prevalence of NI was 7.57% with varied rates from 7.19 to 7.73% over the 3 years. The lower respiratory tract (43.1%), urinary tract (26.5%) and bloodstream (20.6%) infections accounted for the majority of infections. The device-associated infection rates of urinary catheter, central catheter and ventilator were 9.8, 7.4 and 7.4 per 1000 days, respectively.The most frequently isolated pathogens were Staphylococcus aureus (20.9%), Klebsiella pneumoniae (16.4%) and Pseudomonas aeruginosa (10.7%). Multivariate analysis showed that the categories D or E of Average Severity of Illness Score (ASIS), length of stay (10-30, 30-60, ≥60 days), immunosuppressive therapy and ventilator use are the independent risk factors for RICU infection with an adjusted odds ratio (OR) of 1.65 (95% CI: 1.15~2.37), 5.22 (95% CI: 2.63~10.38)), 2.32 (95% CI: 1.19~4.65), 8.93 (95% CI: 3.17~21.23), 31.25 (95% CI: 11.80~63.65)) and 2.70 (95% CI: 1.33~5.35), respectively. CONCLUSION: A relatively low and stable rate of NI was observed in our RICU through year 2013-2015. The ASIS-D、E, stay ≥10 days, immunosuppressive therapy and ventilator use are the independent risk factors for RICU infection.

MicroRNA-134 regulates lung cancer cell H69 growth and apoptosis by targeting WWOX gene and suppressing the ERK1/2 signaling pathway.

MicroRNAs have been shown to act as crucial modulators during carcinogenesis. Recent studies have implied that miR-134 expression associated with epithelial-to-mesenchymal transition phenotype and invasive potential of NSCLC cells. Our study investigated the pathogenic implications of miR-134 in small cell lung cancer (SCLC). Overexpression or inhibition MiR-134 expression by miR-134 mimics or miR-134 inhibitors (anti-miR-134) in SCLC cell lines was detected using qRT-PCR. Lactate dehydrogenase (LDH) assay, MTT assays and flow cytometry were performed in order to clarify the growth and apoptosis of SCLC cells which had been transfected with miR-134 mimics or anti-miR-134. WWOX expression in H69 cells was detected by qRT-PCR and western blot, respectively. The results showed that overexpression miR-134 was significantly promoting SCLC cells growth and inhibit its apoptosis. In addition, reduced miR-134 expression was significantly correlated with cell growth inhibition and apoptosis promotion. Furthermore, transfection of miR-134 mimics into the SCLC cells markedly down-regulated the level of WWOX, whereas, anti-miR-134 up-regulated WWOX expression. We also found that overexpression WWOX attenuate miR-134 induced H69 cells growth, and promote cell apoptosis. Moreover, miR-134 promoted cell proliferation and inhibit apoptosis via the activation of ERK1/2 pathway. These findings suggest that miR-134 may be an ideal diagnostic and prognostic marker, and may be attributed to the molecular therapy of SCLC.

MicroRNA-370 inhibits the progression of non-small cell lung cancer by downregulating oncogene TRAF4.

Lung cancer is the leading cause of cancer-related deaths, of which most can be attributed to non-small cell lung cancer (NSCLC). microRNAs (miRNAs) are a group of small non-coding RNAs that focus on post-transcriptional modification. The present study aimed to investigate the role and function of microRNA-370 (miR-370) in NSCLC and explore the underlying functional mechanisms. We found that miR-370 was significantly downregulated in the tumor tissues of NSCLC patients as well as in NSCLC cell lines. Overexpression of miR-370 by infection of recombinant lentivirus markedly inhibited cell proliferation and promoted cell apoptosis of NSCLC cells. In addition, in vivo tumor formation of NSCLC cells was decreased by miR-370 overexpression. Through bioinformatic analysis, we found that tumor necrosis factor receptor-associated factor 4 (TRAF4), an oncogene as previously reported, was predicted as a putative target gene of miR-370. The direct targeting relationship between miR-370 and the 3'-untranslated region was validated by dual-luciferase reporter assay. Furthermore, overexpression of miR-370 downregulated the protein expression of TRAF4 in the NSCLC cells. Moreover, the growth inhibitory effect of miR-370 overexpression on NSCLC cells was abrogated by TRAF4 overexpression. In conclusion, our results suggest that miR-370 plays an important role in NSCLC by regulating TRAF4 and may be a potential target for the treatment of NSCLC.