Relationship between health literacy and COVID-19 knowledge: A cross-sectional study.

Background: Health literacy (HL) is a protective factor for some chronic diseases. However, its role in the Coronavirus Disease 2019 (COVID-19) pandemic has not been clarified. This study aims to explore the association between HL and COVID-19 knowledge among residents in Ningbo. Methods: A total of 6,336 residents aged 15-69 years in Ningbo were selected by multi-stage stratified random sampling method. The "Health Literacy Questionnaire of Chinese Citizens (2020)" was used to evaluate the relationship between COVID-19 knowledge and HL. Chi-square test, Mann-Whitney U test and logistic regression were used to analyze the data. Results: The HL and COVID-19 knowledge levels of Ningbo residents were 24.8% and 15.7%, respectively. After adjusting for confounding factors, people with adequate HL were the more likely to have adequate COVID-19 knowledge compared with those with limited HL (OR = 3.473, 95% CI = 2.974-4.057, P <0.001). Compared with the limited HL group, the adequate HL group had a higher rate of COVID-19 knowledge, a more positive attitude, and a more active behavior. Conclusion: COVID-19 knowledge is significantly associated with HL. Improving HL may influence people's knowledge about COVID-19, thereby changing people's behaviors, and finally combating the pandemic.

Trends in mortality of malignant tumors in Ningbo City from 2002 to 2022 / 预防医学

Objective@#To investigate the trends in mortality of malignant tumors in Ningbo City, Zhejiang Province from 2002 to 2022, so as to provide the evidence for formulating malignant tumor control strategies in Ningbo City. Methods The data regarding the mortality of malignant tumors in Ningbo City from 2002 to 2022 were collected through the Ningbo Municipal Death Cause Monitoring System, and the crude mortality and age-specific mortality of malignant tumors were calculated in Ningbo City. The mortality of malignant tumors was standardized by the population of the sixth National Population Census in China in 2010 (Chinese-standardized mortality) and the world standard population in 1960 (world-standardized mortality). The trends in mortality of malignant tumors were evaluated with annual percent change (APC) and average annual percent change (AAPC). @*Methods@#The data regarding the mortality of malignant tumors in Ningbo City from 2002 to 2022 were collected through the Ningbo Municipal Death Cause Monitoring System, and the crude mortality and age-specific mortality of malignant tumors were calculated in Ningbo City. The mortality of malignant tumors was standardized by the population of the sixth National Population Census in China in 2010 (Chinese-standardized mortality) and the world standard population in 1960 (world-standardized mortality). The trends in mortality of malignant tumors were evaluated with annual percent change (APC) and average annual percent change (AAPC). @*Results@#The crude mortality of malignant tumors was 186.43/105 to 221.24/105 in Ningbo City from 2002 to 2022, which showed a tendency towards a rise (AAPC=0.76%), and both the Chinese- (AAPC=-2.64%) and world-standardized mortality (AAPC=-2.74%) appeared a tendency towards a decline (all P<0.05). The world-standardized mortality of malignant tumors presented three changes in Ningbo City from 2002 to 2022, with a more remarkable decline from 2011 to 2018 (APC=-3.53%) than from 2002 to 2011 (APC=-2.10%) and from 2018 to 2022 (APC=-2.00%) (all P<0.05). The annual decline in mortality of malignant tumors was higher in men (Chinese-standardized mortality: AAPC=-2.68%; world-standardized mortality: AAPC=-2.75%) than in women (Chinese-standardized mortality: AAPC=-2.45%; world-standardized mortality: AAPC=-2.57%), and higher in urban areas (Chinese-standardized mortality: AAPC=-2.85%; world-standardized mortality: AAPC=-2.92%) than in rural areas (Chinese-standardized mortality: AAPC=-2.45%; world-standardized mortality: AAPC=-2.57%) (all P<0.05). The mortality of malignant tumors appeared a tendency towards a rise with age in Ningbo City, with the highest mortality in residents at ages of 85 years and older (1 447.13/105). Death from malignant tumors were responsible for 31.86% of all causes of death in Ningbo City, and the five most common causes of cancer death included lung cancer, liver cancer, gastric cancer, colorectal cancer and esophageal cancer. In addition, the world-standardized mortality of pancreatic cancer (AAPC=3.92%), prostate cancer (AAPC=4.71%), and cervical cancer (AAPC=1.60%) appeared a tendency towards a rise in Ningbo City (all P<0.05). @*Conclusions@#The crude mortality of malignant tumors appeared a tendency towards a rise in Ningbo City from 2002 to 2022, while the standardized mortality showed a tendency towards a decline. Management of malignant tumors should be given a high priority among men and rural residents, and lung cancer, liver cancer, gastric cancer, colorectal cancer and esophageal cancer should be emphasized.

Effect of autologous platelet-rich plasma combined with sodium hyaluronate on clinical efficacy and serum inflammatory factors in patients with knee osteoarthritis.

OBJECTIVE: To observe the effect of autologous platelet-rich plasma combined with sodium hyaluronate on clinical efficacy and serum inflammatory factor levels in patients with knee osteoarthritis. METHODS: A retrospective study was conducted on a total of 99 knee osteoarthritis patients who underwent arthroscopic surgery after failed conservative treatment in No. 215 Hospital of Shaanxi Nuclear Industry from January 2019 to January 2022. Among them, 45 patients treated with only sodium hyaluronate injection after arthroscopic debridement were grouped as the control group (CG), and 54 patients treated with platelet-rich plasma combined with intra-articular injection of sodium hyaluronate after arthroscopic debridement were the observation group (OG). Visual analogue scale/score (VAS) and Lysholm knee scale (LKS) were used to evaluate the clinical therapeutic effect before and 5 weeks after treatment, and ELISA was to detect the changes of matrix metalloproteinase-3 (MMP-3), interleukin-1ß (IL-1ß), high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) levels in the serum of patients before and 5 weeks after treatment. Risk factors affecting patient outcomes were analyzed by logistic regression. RESULTS: Compared to theCG, the improvement of clinical efficacy in the OG was higher (P < 0.05), as well as its LKS score, while the VAS score after treatment in OG was markedly lower (P < 0.05). After treatment, MMP-3, IL-1ß, hs-CRP, and TNF-α in the OG were significantly lower than those in the CG (P < 0.05). There was nodifference in the incidence rate of adverse reactions between the two groups (P > 0.05). Logistic regression analysis showed that younger age and lower BMI were protective factors for efficacy in the patients, while higher LKS and TNF-α were risk factors affecting the efficacy in the patients. CONCLUSION: Intra-articular injection of platelet-rich plasma combined with sodium hyaluronate in the treatment of knee osteoarthritis can significantly reduce the symptoms of knee joint pain, improving knee joint function and in vivo inflammatory response.

Low-molecular-weight heparin reduces the formation of lower limb deep venous thrombosis in patients with hypertensive intracerebral hemorrhage.

OBJECTIVE: To demonstrate that low-molecular-weight heparin (LMWH) can reduce the formation of lower limb deep venous thrombosis (DVT) and improve the quality of life (QOL) of patients with hypertensive intracerebral hemorrhage (HICH). METHODS: Totally, 98 patients with HICH were selected according to different treatment and intervention schemes. Patients receiving routine intracranial pressure reduction and blood pressure regulation intervention were included in group A (n=46) and those receiving LMWH calcium on the basis of treatment in group A were included in group B (n=52). The total effective rate of patients was compared between the two groups, and the prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen degradation product (FDP), D-dimer, and inflammatory factor levels as well as complications and QOL scores before and after treatment were recorded and compared. RESULTS: The FDP and D-dimer showed an increasing trend in both groups after treatment, with the increase being significantly lower in group B than in group A (P<0.001). Serum tumor necrosis factor-α and interleukin-1ß levels increased significantly in the two groups after treatment, with the increase being significantly lower in group B than in group A (P<0.05). Complications of pulmonary embolism, DVT, intracranial hemorrhage, and gastrointestinal hemorrhage were better in group B than in group A (P<0.05). In terms of QOL, physical and mental health, material life, and social functioning were significantly higher in patients of group B than for those in group A (P<0.001). CONCLUSIONS: The application of LMWH in patients with HICH can reduce the formation of lower limb DVT.

[Thoracic Intraspinal Ganglioneuroma with Cough as Its Main Symptom:Report of One Case].

The ganglioneuroma is a benign tumor originating from sympathetic ganglion cells.It often locates in the posterior mediastinum,retroperitoneum,and adrenal medulla.The intraspinal ganglioneuromas is relatively rare in clinical practice,which mainly locates in the cervical and thoracolumbar segments.A patient with main symptom of cough was examined by magnetic resonance imaging before operation in our center.Intraspinal ganglioneuromas was confirmed in the left intervertebral cavity area.Total resection of the tumor via the posterior median approach was performed.HE staining showed the mature ganglion cells were scattered.The patient was followed up for three months and no tumor recurrence occured.

MDU-Net: A Convolutional Network for Clavicle and Rib Segmentation from a Chest Radiograph.

Automatic bone segmentation from a chest radiograph is an important and challenging task in medical image analysis. However, a chest radiograph contains numerous artifacts and tissue shadows, such as trachea, blood vessels, and lung veins, which limit the accuracy of traditional segmentation methods, such as thresholding and contour-related techniques. Deep learning has recently achieved excellent segmentation of some organs, such as the pancreas and the hippocampus. However, the insufficiency of annotated datasets impedes clavicle and rib segmentation from chest X-rays. We have constructed a dataset of chest X-rays with a raw chest radiograph and four annotated images showing the clavicles, anterior ribs, posterior ribs, and all bones (the complete set of ribs and clavicle). On the basis of a sufficient dataset, a multitask dense connection U-Net (MDU-Net) is proposed to address the challenge of bone segmentation from a chest radiograph. We first combine the U-Net multiscale feature fusion method, DenseNet dense connection, and multitasking mechanism to construct the proposed network referred to as MDU-Net. We then present a mask encoding mechanism that can force the network to learn the background features. Transfer learning is ultimately introduced to help the network extract sufficient features. We evaluate the proposed network by fourfold cross validation on 88 chest radiography images. The proposed method achieves the average DSC (Dice similarity coefficient) values of 93.78%, 80.95%, 89.06%, and 88.38% in clavicle segmentation, anterior rib segmentation, posterior rib segmentation, and segmentation of all bones, respectively.

A knowledge-driven feature learning and integration method for breast cancer diagnosis on multi-sequence MRI.

BACKGROUND: The classification of benign versus malignant breast lesions on multi-sequence Magnetic Resonance Imaging (MRI) is a challenging task since breast lesions are heterogeneous and complex. Recently, deep learning methods have been used for breast lesion diagnosis with raw image input. However, without the guidance of domain knowledge, these data-driven methods cannot ensure that the features extracted from images are comprehensive for breast cancer diagnosis. Specifically, these features are difficult to relate to clinically relevant phenomena. PURPOSE: Inspired by the cognition process of radiologists, we propose a Knowledge-driven Feature Learning and Integration (KFLI) framework, to discriminate between benign and malignant breast lesions using Multi-sequences MRI. METHODS: Starting from sequence division based on characteristics, we use domain knowledge to guide the feature learning process so that the feature vectors of sub-sequence are constrained to lie in characteristic-related semantic space. Then, different deep networks are designed to extract various sub-sequence features. Furthermore, a weighting module is employed for the integration of the features extracted from different sub-sequence images adaptively. RESULTS: The KFLI is a domain knowledge and deep network ensemble, which can extract sufficient and effective features from each sub-sequence for a comprehensive diagnosis of breast cancer. Experiments on 100 MRI studies have demonstrated that the KFLI achieves sensitivity, specificity, and accuracy of 84.6%, 85.7% and 85.0%, respectively, which outperforms other state-of-the-art algorithms.

Knowledge, attitude and practice of coronavirus disease 2019 in Ningbo residents / 预防医学

Objective@#To understand the levels of knowledge,attitude and practice (KAP) of coronavirus disease 2019 (COVID-19) in Ningbo residents during the epidemic,so as to provide evidence for further health education and promotion. @*Methods@#Participants,aged 18 years or over and resided in Ningbo from December 1,2019 to February 26,2020,were recruited by snowball sampling method to respond a questionnaire through WeChat, including the status of KAP of COVID-19 and the approaches to acquire the information.@*Results@#Totally 967 questionnaires were collected and 917 of them were valid (94.83%). The awareness rate of COVID-19 was 56.49%, with 96.51%,64.78% and 88.00% for the clinical symptoms,source of infection and transmission route,respectively. Among the participants,163 felt anxious,accounting for 17.78%;101 felt panic,accounting for 11.01%. About 96.40%,11.67% and 95.97% of the participants considered COVID-19 severe,susceptible and controllable. About 99.89% of the participants tried to purchase the protective equipment,99.45% wore masks when they went out,98.91% washed hands after they were back,and 95.53% covered the mouth and nose when coughing or sneezing. Compared to the situation before,668 (72.85%) participants used electronic products (such as cellphone and computer) more,while 481 (52.45%) participants exercised less. About 899 (98.04%),712 (77.64%) and 603 (65.76%) participants obtained the information through cellphone,internet and TV,respectively.@*Conclusions@#Ningbo residents have acquired some knowledgeof COVID-19 through cellphones, internet and television,and can consciously take protective practice. A few residents feel anxious and panic,so further health education and mental health intervention should be strengthened.

Long noncoding RNA UCA1 promotes osteosarcoma metastasis through CREB1-mediated epithelial-mesenchymal transition and activating PI3K/AKT/mTOR pathway.

Increasing evidences have demonstrated that Long noncoding RNAs (lncRNAs) are key regulatory RNAs that participate in multiple biological processes. LncRNA urothelial carcinoma-associated 1 (UCA1) is a newly identified lncRNA and functions as a regulator of growth in several cancers. However, the biological function and molecular mechanism of UCA1 in the metastasis of osteosarcoma remain unclear. In this study, we firstly found UCA1 is upregulated in both osteosarcoma tissues and cell lines, and increased UCA1 is associated with higher tumor stage, larger tumor size and poorer prognosis. Then for the first time, we demonstrated that UCA1 promotes the invasion and metastasis of osteosarcoma both in vitro and in vivo. Further mechanistic investigation showed that UCA1 directly interactes with miR-582 and suppresses its expression. Moreover, UCA1 increases CREB1 expression by functioning as a ceRNA against miR-582, thus promoting the EMT process via CREB1-mediated PI3K/AKT/mTOR pathway and finally leading to osteosarcoma metastasis. These findings may extend the function of UCA1 in osteosarcoma progression and provide a promising therapeutic target for osteosarcoma treatment.

A New Phylogenetic Inference Based on Genetic Attribute Reduction for Morphological Data.

To address the instability of phylogenetic trees in morphological datasets caused by missing values, we present a phylogenetic inference method based on a concept decision tree (CDT) in conjunction with attribute reduction. First, a reliable initial phylogenetic seed tree is created using a few species with relatively complete morphological information by using biologists' prior knowledge or by applying existing tools such as MrBayes. Second, using a top-down data processing approach, we construct concept-sample templates by performing attribute reduction at each node in the initial phylogenetic seed tree. In this way, each node is turned into a decision point with multiple concept-sample templates, providing decision-making functions for grafting. Third, we apply a novel matching algorithm to evaluate the degree of similarity between the species' attributes and their concept-sample templates and to determine the location of the species in the initial phylogenetic seed tree. In this manner, the phylogenetic tree is established step by step. We apply our algorithm to several datasets and compare it with the maximum parsimony, maximum likelihood, and Bayesian inference methods using the two evaluation criteria of accuracy and stability. The experimental results indicate that as the proportion of missing data increases, the accuracy of the CDT method remains at 86.5%, outperforming all other methods and producing a reliable phylogenetic tree.

LncRNA-FENDRR mediates VEGFA to promote the apoptosis of brain microvascular endothelial cells via regulating miR-126 in mice with hypertensive intracerebral hemorrhage.

BACKGROUND: LncRNA-FENDRR is a kind of endothelial genes critical for vascular development. Moreover, miR-126 and vascular endothelial growth factor A (VEGFA) are also involved in the physiological process of vascular endothelial cells. This study aimed to the underlying mechanism of FENDRR involving miR-126 and VEGFA in hypertensive intracerebral hemorrhage (HICH). METHODS: C57BL/6 mice were chosen to establish HICH model. The expression of FENDRR, miR-126, and VEGFA at mRNA level was determined by qRT-PCR. The protein expression of VEGFA was assessed using Western blot. RIP assay and RNA pull-down assay were used to the relationship between FENDRR and miR-126. Flow cytometry was used to analyze cell apoptosis. RESULTS: The levels of FENDRR and VEGFA were increased, and miR-126 expression was decreased in vascular endothelial cells (VECs) from the right brain of model mice and human brain microvascular endothelial cells (HBMECs) treated by thrombin. Overexpression of FENDRR promoted the apoptosis of HBMECs. FENDRR regulating VEGFA participated in HBMECs apoptosis through targeting miR-126. Downregulation of FENDRR was indicated to relieve the HICH in mice. CONCLUSIONS: FENDRR could promote the apoptosis of HBMECs via miR-126 regulating VEGFA in HICH.

TeA is a key virulence factor for Alternaria alternata (Fr.) Keissler infection of its host.

A toxin-deficient mutant strain, HP001 mutant of Alternaria alternata, whose mycelium is unable to infect its host, produces little tenuazonic acid (TeA) toxin. How TeA plays a role in initiating host infection by A. alternata remains unclear. In this research we use Imaging-PAM based on chlorophyll fluorescence parameters and transmission electron microscopy to explore the role of TeA toxin during the infection process of A. alternata. Photosystem II damage began even before wild type mycelium infected the leaves of its host, croftonweed (Ageratina adenophora). Compared with the wild type, HP001 mutant produces morphologically different colonies, hyphae with thinner cell walls, has higher reactive oxygen species (ROS) content and lower peroxidase activity, and fails to form appressoria on the host surface. Adding TeA toxin allows the mutant to partially recover these characters and more closely resemble the wild type. Additionally, we found that the mutant is able to elicit disease symptoms when its mycelium is placed on leaves whose epidermis has been manually removed, which indicates that TeA may be determinant in the fungus recognition of its plant host. Lack of TeA toxin appears responsible for the loss of pathogenicity of the HP001 mutant. As a key virulence factor, TeA toxin not only damages the host plant but also is involved in maintaining ROS content, host recognition, inducing appressoria to infect the host and for allowing completion of the infection process.