Empirical and quantitative studies of Feng Shui: A systematic review (PRISMA 2009 item 1).

Despite a long period of scholarly interest in Feng Shui, there has been no systematic review of this subject. The objective of this study was, therefore, to conduct a systematic review of empirical and quantitative Feng Shui journal articles written in Chinese or English to shed light on the nature of Feng Shui. This study identifies both existing empirical and quantitative studies of Feng Shui and directions for further research. It is the first to provide a synthesis of empirical and quantitative findings on the specific outcomes of Feng Shui, and more importantly, to explore its reliability and validity. We searched four databases, two in Chinese (Taiwan Periodical Literature and WANFANG DATA) and two in English (Web of Science and SCOPUS), and reviewed 36 articles following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA 2009). The eligibility criteria were: (1) any kind of participants or study samples; (2) any Feng Shui-related intervention; (3) comparators belonging to the same study samples or between different study samples; (4) the outcome of any empirical and quantitative measurement of Feng Shui; and (5) any study design except for qualitative studies. We used the Joanna Briggs Institute's Critical Appraisal Tools to analyze the research quality of the included articles. We found that Feng Shui was associated with housing prices in societies influenced by Chinese culture. Other findings suggested that: (1) Feng Shui was associated with the decisions of house-buyers growing up in societies influenced by Chinese culture; (2) Feng Shui forests had greater habitat diversity than other forests in China; (3) Feng Shui environments in Asia had more comfortable wind fields than non-Feng Shui settings; (4) in Asia, Feng Shui was related to sunlight; (5) Feng Shui had good reliability; and (6) Feng Shui was valid with respect to environmental features but its influence on humans has not been determined. We therefore conclude that Feng Shui is neither a superstition nor a science. Given that the research quality of the included articles was less than ideal and the number of each specific outcome and their samples were also limited, their findings should be interpreted with caution. We look forward to more good quality empirical studies of Feng Shui in the future, particularly those involving de facto field experiments recruiting non-Asian participants to provide further insights into the quasi-science of Feng Shui. (PRISMA 2009 Item 2).

Management and Predictors of Treatment Failure in Patients with Chemo-Resistant/Relapsed Gestational Trophoblastic Neoplasia with Lung Metastasis.

The aim of the study was to assess the effectiveness of a combined treatment modality of salvage chemotherapy and pulmonary resection in chemo-resistant/relapsed gestational trophoblastic neoplasia (GTN) with lung metastasis and identify predictors of treatment failure. Data of patients with chemo-resistant/relapsed GTN with lung metastasis who received salvage chemotherapy combined with pulmonary resection were retrospectively analyzed. Among 134 included patients, the number of preoperative chemotherapy regimens ranged from 2−8 (median, 3), and courses ranged from 4−37 (median, 14). Pulmonary lobectomies, segmentectomies, wedge resections, and lobectomies plus wedge resections were performed in 84, 5, 35, and 10 patients, respectively. After completion of treatment, 130 (97.0%) patients achieved complete remission. In the entire cohort, the 5-year overall survival (OS) rate was 87.6%. OS rates were similar between stage III and stage IV disease cohorts (89.4% vs. 75.0%, p = 0.137). Preoperative ß-human chorionic gonadotropin (ß-hCG) levels > 10 IU/L (p = 0.027) and number of preoperative chemotherapy regimens > 3 (p = 0.018) were predictors of treatment failure. The combined treatment modality of salvage chemotherapy and pulmonary resection is effective in patients with chemo-resistant/relapsed GTN with lung metastasis, improving their prognoses. Patients with preoperative serum ß-hCG >10 IU/L and those with >3 chemotherapy regimens preoperatively may not benefit from this multidisciplinary treatment.

Case Report: TEMPI syndrome: Report of three cases and treatment follow-up.

The TEMPI syndrome is a novel and rare disease with five distinct clinical features: Telangiectasis, Erythrocytosis, Monoclonal gammopathy, Perinephric fluids collection, and Intrapulmonary shunting. Here, we report three cases of TEMPI syndrome and their treatment response. The three patients were presented to our department with polycythemia, abdominal distension, and dyspnea. On admission, all patients manifested telangiectasis, erythrocytosis, monoclonal gammopathy, and intrapulmonary shunting. Patient 1 and 2 manifested perinephric fluids collection. In addition, all patients had skin pigmentation, patient 1 and 2 had polyserosal effusion, two symptoms that had not been associated with TEMPI syndrome before. The three patients showed various response to plasma cell-directed therapy. We demonstrated their treatment response by measuring erythropoietin, hemoglobin, and M protein levels throughout therapy. This report suggested that TEMPI syndrome is a rare yet treatable disease. The diagnosis and treatment of it remain challenging.

The impact of pulmonary metastases on therapeutic response and prognosis in malignant gestational trophoblastic neoplasia patients: a retrospective cohort study.

AIM: The lung is the most common site of metastasis for gestational trophoblastic neoplasia (GTN). However, the level of influence of lung metastases on the prognosis of GTN and the degree to which lung metastases are considered in assessments of disease treatment options are unclear. Moreover, it is unclear which characteristics of lung metastases impact the disease. In this study, we evaluated the influence of lung metastases on the clinical course of GTN and identified lung imaging characteristics that impact treatment outcomes. METHODS: A retrospective cohort study was conducted on GTN patients treated at Peking Union Medical College Hospital between 2002 and 2018. The baseline characteristics, first-line treatment outcomes and final outcomes of patients with lung metastases (Group 1) and those without lung metastases (Group 2) were compared. RESULTS: The emergence of resistance occurred significantly more frequently in Group 1 (n = 994) than in Group 2 (n = 570) (19.52% versus 14.56%, p = 0.019), and the death rate was higher in Group 1 (0.91% versus 0%, p = 0.031). Among the patients treated with multi-agent chemotherapy, the rate of resistance and the number of treatment courses were significantly higher in Group 1 than in Group 2 (p = 0.002 and < 0.001, respectively). The lung imaging characteristics that impacted prognosis included the number of nodules, whether there were multiple nodules or a single nodule, and the number of nodules sized >1 cm. Multivariate analysis showed that a nodule measuring ≥1.8 cm was an independent risk factor for first-line treatment resistance and recurrence. CONCLUSION: Although pulmonary metastases do not affect overall survival in GTN patients, the presence of lung metastases before treatment is associated with increased risk of disease recurrence and resistance to first-line multidrug chemotherapy, especially when pulmonary nodules are larger than 1.8 cm. CLINICAL TRIAL REGISTRATION: N.A.

Effects of Arginine Deimination and Citrulline Side-Chain Length on Peptide Secondary Structure Formation.

Post-translational modifications expand the chemical functionality of peptides and proteins beyond that originating from the encoded amino acids, but studies on the structural effects of these modifications have been limited. Arginine undergoes deimination to give citrulline (Cit), converting the positively charged guanidinium moiety into a neutral urea group. Herein, we report the effect of Arg deimination on secondary structure formation. To understand the reason for the number of methylene units in Cit, the effect of Cit side-chain length on secondary structure formation was also studied. Ala-based peptides and ß-hairpin peptides were used to study α-helix and ß-sheet formation, respectively. Peptides containing Cit analogues were prepared by an orthogonal protecting group strategy coupled with solid-phase carbamylation. The CD data for the Ala-based peptides were analyzed by using modified Lifson-Roig theory, showing that the helix propensity of Arg decreased upon deimination and that either shortening or lengthening Cit also decreased the helix propensity. The ß-hairpin peptides were analyzed by NMR methods, showing minimal change in strand formation energetics upon Arg deimination. Altering the Cit side-chain length did not affect strand formation energetics either. These results should be useful for the preparation of urea-bearing systems and the design of peptides incorporating urea-bearing residues with varying side-chain length.