Safety and feasibility of modified duct-to-mucosa pancreaticojejunostomy during pancreatoduodenectomy: A retrospective cohort study.

BACKGROUND: Pancreatoduodenectomy (PD) is the most effective surgical procedure to remove a pancreatic tumor, but the prevalent postoperative complications, including postoperative pancreatic fistula (POPF), can be life-threatening. Thus far, there is no consensus about the prevention of POPF. AIM: To determine possible prognostic factors and investigate the clinical effects of modified duct-to-mucosa pancreaticojejunostomy (PJ) on POPF development. METHODS: We retrospectively collected and analyzed the data of 215 patients who underwent PD between January 2017 and February 2022 in our surgery center. The risk factors for POPF were analyzed by univariate analysis and multivariate logistic regression analysis. Then, we stratified patients by anastomotic technique (end-to-side invagination PJ vs modified duct-to-mucosa PJ) to conduct a comparative study. RESULTS: A total of 108 patients received traditional end-to-side invagination PJ, and 107 received modified duct-to-mucosa PJ. Overall, 58.6% of patients had various complications, and 0.9% of patients died after PD. Univariate and multivariate logistic regression analyses showed that anastomotic approaches, main pancreatic duct (MPD) diameter and pancreatic texture were significantly associated with the incidence of POPF. Additionally, the POPF incidence and operation time in patients receiving modified duct-to-mucosa PJ were 11.2% and 283.4 min, respectively, which were significantly lower than those in patients receiving traditional end-to-side invagination PJ (27.8% and 333.2 minutes). CONCLUSION: Anastomotic approach, MPD diameter and pancreatic texture are major risk factors for POPF development. Compared with traditional end-to-side invagination PJ, modified duct-to-mucosa PJ is a simpler and more efficient technique that results in a lower incidence of POPF. Further studies are needed to validate our findings and explore the clinical applicability of our technique for laparoscopic and robotic PD.

Pharmacokinetics, bioavailability, and excretion of ponazuril in piglets.

Ponazuril is a triazine anticoccidial drug which is the main metabolite of toltrazuril in animals, it has excellent activity against many protozoa, including Cystoisospora suis, and has broad application prospects in the control of swine coccidiosis. To evaluate the pharmacokinetic and excretion characteristics of ponazuril, 12 healthy piglets aged 10-14 days were divided into 2 groups for pharmacokinetic studies, which were given 20 mg/kg body weight ponazuril orally and intravenously, respectively. And 6 other piglets were housed individually in metabolic cages and given the same oral dose of ponazuril. After administration, the concentration of ponazuril in plasma, fecal, and urine samples collected was determined using high-performance liquid chromatography (HPLC). The plasma concentration profiles of ponazuril obtained after intravenous and oral administration were analyzed simultaneously by the nonlinear mixed-effects (NLME) model. Following the results, the pharmacokinetics of ponazuril exhibited a Michaelis-Menten elimination with Michaelis-Menten constant Km and maximum metabolic rate Vm of 10.8 µg/mL and 0.083 mg/kg/h. The apparent volume of distribution was calculated to be 735 mL/kg, and the final estimated oral bioavailability was 81%. Besides, cumulatively 86.42 ± 2.96% of ponazuril was recovered from feces and 0.31% ± 0.08% from urine during 0-1,020 h after oral administration. These findings indicated a good oral absorption of ponazuril in piglets with nonlinear disposition and slow excretion largely via feces, implying sustained drug concentration in vivo and long-lasting anticoccidial effects.

Tre2 (USP6NL) promotes colorectal cancer cell proliferation via Wnt/ß-catenin pathway.

BACKGROUND: Most colorectal cancer (CRC) patients are diagnosed at an advanced or metastatic stage with poor prognosis. Ubiquitin-specific protease 6 N-terminal-like protein (USP6NL) with high expression in CRC tissues regulates CRC cell proliferation via Wnt/ß-catenin pathway. We hypothesized that USP6NL impacts CRC growth and inhibition of USP6NL may be a novel treatment strategy to improve CRC therapy. METHODS: USP6NL level in human CRC tissues and its association with tumor growth and metastasis were examined. Its roles and potential mechanisms in regulating tumor growth were studied by genetic and pharmacological manipulation of CRC cells in vitro and in vivo. RESULTS: Herein, we found that USP6NL was up-regulated in tumorous tissues of CRC patients. Our data suggested that knockdown of USP6NL in human CRC cell lines (HCT116 and LOVO cells) inhibited cell proliferation, induced G0/G1 cell cycle arrest, and prevented the tumorigenicity of HCT116 cells in nude mice, and which was associated with the prevention of Wnt/ß-catenin pathway. On the contrary, USP6NL overexpression in human CRC cells (SW480) showed the opposite result. Our data suggested that the promoted cell proliferation, G1/S cell cycle progression, and the enhanced expression of ß-catenin Cyclin D1 and C-myc while reduced P27 induced by the overexpression of USP6NL were significantly reversed by additional treatment of XAV939, indicating that activating Wnt/ß-catenin pathway was the mechanism, by which USP6NL exerted carcinogenesis in CRC in vitro. Besides, our data suggested that knockdown of USP6NL increased the ubiquitination of ß-catenin, indicating that USP6NL may serve as a deubiquitinase that regulated ß-catenin accumulation in this process. Furthermore, 10058-F4 down-regulated USP6NL, inhibited CRC cell proliferation and induced cell cycle arrest. The result demonstrated a possible feedback loop between USP6NL, ß-catenin and C-myc in regulating CRC cell growth. CONCLUSION: USP6NL was an oncogene in CRC, and it may be a potential target for the treatment of CRC.

Sleep quality in preschool children in three provinces along the middle and lower reaches of the Yangtze River / 中国学校卫生

Objective@#To analyze the detection rate of sleep problems such as sleep delay and deficiency in preschool children in the middle and lower reaches of the Yangtze River in China,and to provide the reference for the standard of sleeping mode among preschool students.@*Methods@#From October to November 2017, a questionnaire survey was conducted among 27 200 preschool children in 11 cities in Hubei, Anhui and Jiangsu provinces in the middle and lower reaches of the Yangtze River in China. Epidemiology of sleep delays, deficiencies and sleep patterns in preschool children was described.@*Results@#The detection rate of sleep problems in preschool children in the middle and lower reaches of the Yangtze River was 15.3%. Taking the length of sleep and bedtime as the main analysis points, it was found that the average sleeping time point of each age group was 21:31, and the detection rate of bedtime delay was 86.5%. The average length of sleep was (10.60±1.12) hours. The detection rate of sleep deprivation in preschool children was 15.7%. Sleep delay was positively correlated with girls, age increase and parents’ higher educational level (P<0.05), and negatively correlated with living in the city, non-only child and bedroom without TV (P<0.01) .The detection rate of sleep deprivation was positively correlated with children of high age group (4yearold group：OR=1.32，95%CI=1.19-1.46；5-year-old group：OR=2.10，95%CI=1.91-2.32；6-year-old group：OR=2.47，95%CI=2.20-2.77)(P<0.01), and negatively correlated with no TV in bedroom (OR=0.91，95%CI=0.84-0.98) and no light in sleep (OR=0.87，95%CI=0.78-0.97)(P<0.05).@*Conclusion@#Preschool children sleep delay and sleep deprivation and other sleep problems are more prominent, affected by family environment and other factors.

Association of genetic variations in the serotonin and dopamine systems with aggressive behavior in the Chinese adolescent population: Single- and multiple-risk genetic variants.

BACKGROUND: Genetic predisposition is an important factor leading to aggressive behavior. However, the relationship between genetic polymorphisms and aggressive behavior has not been elucidated. METHODS: We identified candidate genes located in the dopaminergic and serotonin system (DRD3, DRD4, and FEV) that had been previously reported to be associated with aggressive behavior. We investigated 14 tag single-nucleotide polymorphisms (SNPs) using a multi-analytic strategy combining logistic regression (LR) and classification and regression tree (CART) to explore higher-order interactions between these SNPs and aggressive behavior in 318 patients and 558 controls. RESULTS: Both LR and CART analyses suggested that the rs16859448 polymorphism is the strongest individual factor associated with aggressive behavior risk. In CART analysis, individuals carrying the combined genotypes of rs16859448TT/GT-rs11246228CT/TT-rs3773679TT had the highest risk, while rs16859448GG-rs2134655CT had the lowest risk (OR = 5.25, 95% CI: 2.53-10.86). CONCLUSION: This study adds to the growing evidence on the association of single- and multiple-risk variants in DRD3, DRD4, and FEV with aggressive behavior in Chinese adolescents. However, the aggressive behavior scale used to diagnose aggression in this study did not account for comorbid conditions; therefore, further studies are needed to confirm our observations.

A comparative analysis of suicide attempts in left-behind children and non-left-behind children in rural China.

To estimate the prevalence of suicide attempts and explore the shared and unique factors influencing suicide risk in left-behind children (LBC) and non-left-behind children (NLBC) in rural China, this study collected data using a multi-stage cluster random sampling method from 13,952 children including 6,034 LBC and 7,918 NLBC. Sociodemographic characteristics, suicide attempts, neglect and physical abuse, negative life events, and loneliness were measured by self-reported questionnaires. Data were analyzed using logistic regression models. Gender and mother's education level were unique influential factors for NLBC while family structure type was a unique influential factor for LBC. The study provides two novel findings regarding NLBC specifically: 1. Children with optimal family socioeconomic status are more likely to report suicide attempts (odds ratio OR = 1)than are those in the general children population, OR 0.52 (95% CI: 0.39-0.70), and 2. Children with higher mother's education level are subject to higher suicide rates in high school, OR 1.67 (95% CI: 1.13-2.46), and post-secondary education, OR 2.14 (95% CI: 1.37-3.37). The unique characteristics of LBC and NLBC in China suggest that investigating risk factors and determining the factors that might be targeted in intervention programs are urgently needed currently.

Possible association between SIRT1 single nucleotide polymorphisms and predisposition to antisocial personality traits in Chinese adolescents.

Accumulating evidence suggests an association between the SIRT1 gene and human psychiatric disorders. The aim of the study was to investigate the association between SIRT1 and predisposition to antisocial personality traits (ASP) in Chinese adolescents. Participants consisted of 327 controls and 261 juvenile offenders who were diagnosed with predisposition to ASP according to the Personality Diagnostic Questionnaire. Four tag single nucleotide polymorphisms (tagSNPs) of SIRT1, namely rs12778366, rs7896005, rs10823112, and rs4746720, were genotyped. Association analysis between individual SNPs and ASP risk revealed the CC genotype of rs4746720 to be significantly associated with reduced risk of ASP (OR = 0.51, 95% CI = 0.33-0.77, adjusted P = 0.007). Haplotype analysis showed the TAAC haplotype was associated with reduced susceptibility to ASP (OR = 0.72, 95% CI = 0.57-0.91, P = 0.005). Moreover, rs4746720 variants were found to not only have a direct impact on ASP susceptibility but also modulate the effect of alcohol consumption (Y = 0.022X + 0.431 vs. Y = -0.066X + 0.387). The present study is the first to report a significant association between SIRT1 polymorphisms and ASP in adolescents. This finding is expected to aid in the development of effective interventions for this socially and personally costly disorder.

Factors associated with trait anger level of juvenile offenders in Hubei province: A binary logistic regression analysis.

The risk factors of high trait anger of juvenile offenders were explored through questionnaire study in a youth correctional facility of Hubei province, China. A total of 1090 juvenile offenders in Hubei province were investigated by self-compiled social-demographic questionnaire, Childhood Trauma Questionnaire (CTQ), and State-Trait Anger Expression Inventory-II (STAXI-II). The risk factors were analyzed by chi-square tests, correlation analysis, and binary logistic regression analysis with SPSS 19.0. A total of 1082 copies of valid questionnaires were collected. High trait anger group (n=316) was defined as those who scored in the upper 27th percentile of STAXI-II trait anger scale (TAS), and the rest were defined as low trait anger group (n=766). The risk factors associated with high level of trait anger included: childhood emotional abuse, childhood sexual abuse, step family, frequent drug abuse, and frequent internet using (P<0.05 or P<0.01). Birth sequence, number of sibling, ranking in the family, identity of the main care-taker, the education level of care-taker, educational style of care-taker, family income, relationship between parents, social atmosphere of local area, frequent drinking, and frequent smoking did not predict to high level of trait anger (P>0.05). It was suggested that traumatic experience in childhood and unhealthy life style may significantly increase the level of trait anger in adulthood. The risk factors of high trait anger and their effects should be taken into consideration seriously.

Aggression and related stressful life events among Chinese adolescents living in rural areas: A cross-sectional study.

BACKGROUND: Aggression is a serious problem for both individuals and society. Despite progress in aggression research, its persistence among adolescents living in rural areas remains to be investigated. We evaluate the prevalence of aggression and the association between stressful life events and aggression in a nationwide, school-based sample of adolescents living in rural areas of China. METHODS: A sample of 13,495 Chinese rural students (7065 boys and 6430 girls; 11-20 years old) was selected from 15 representative rural areas from 5 provinces in China using stratified randomized cluster sampling. Aggression, stressful life events, neglect, emotional management, social support, and demographic characteristics were assessed via self-report questionnaires. Multivariate logistic regressions were used to estimate the association of stressful life events and aggression after controlling for confounds. RESULTS: The prevalence of aggressive behavior among Chinese adolescents living in rural areas was 24.3%. Regression analyses indicated that the odds of aggression were negatively influenced by chronic long-term stressors related to interpersonal problems (OR=2.03, 95% CI [1.75-2.36]), health adaptation difficulties (OR=1.21, 95% CI [1.09-1.34]), and other troubles (OR=1.93, 95% CI [1.74-2.14]), even after adjustment for parental neglect, emotional management, social support, and other relevant factors. LIMITATIONS: This study was cross-sectional; thus, it is necessary to validate the causal relationship between stressful life events and aggression via follow-up studies. CONCLUSIONS: Aggression was prevalent among Chinese adolescents living in rural areas, and interpersonal problems, health adaption difficulties, and other troubles were considered potential independent risk factors for aggression.

Factors Associated with Trait Anger Level of Juvenile Offenders in Hubei Province: A Binary Logistic Regression Analysis / 华中科技大学学报（医学）（英德文版）

The risk factors of high trait anger of juvenile offenders were explored through question naire study in a youth correctional facility of Hubei province,China.A total of 1090 juvenile offenders in Hubei province were investigated by self-compiled social-demographic questionnaire,Childhood Trauma Questionnaire (CTQ),and State-Trait Anger Expression Inventory-Ⅱ (STAXI-Ⅱ).The risk factors were analyzed by chi-square tests,correlation analysis,and binary logistic regression analysis with SPSS 19.0.A total of 1082 copies of valid questionnaires were collected.High trait anger group (n=316) was defined as those who scored in the upper 27th percentile of STAXI-Ⅱ trait anger scale (TAS),and the rest were defined as low trait anger group (n=766).The risk factors associated with high level of trait anger included:childhood emotional abuse,childhood sexual abuse,step family,frequent drug abuse,and frequent internet using (P＜0.05 or P＜0.01).Birth sequence,number of sibling,ranking in the family,identity of the main care-taker,the education level of care-taker,educational style of care-taker,family income,relationship between parents,social atmosphere of local area,frequent drinking,and frequent smoking did not predict to high level of trait anger (P＞0.05).It was suggested that traumatic experience in childhood and unhealthy life style may significantly increase the level of trait anger in adulthood.The risk factors of high trait anger and their effects should be taken into consideration seriously.

[Aerobic power of students aged 13-15 years in Wuhan City].

OBJECTIVE: To measure the maximal capacity of students aged 13- 15 years by graded exercise test, and establish a model to indirect predict VO2 max. METHODS: A total of 31 school-aged students in Wuhan participated in the study. Maximal oxygen uptake was obtained from a graded maximal exercise test, the anthropometric variables including height, weight, vital capacity( VC), resting heart rate, fat mass were measured and body mass index( BMI), body fat percentage( FAT%) was calculated. The relationships between maximal oxygen uptake and anthropometric characteristics were investigated in partial correlation analysis and a linear multiple regression model was established. RESULTS: There was a significant difference in mass-relative VO_(2max)[( 48. 00± 5. 80) L / min vs( 39. 79 ± 6. 37) L / min, P < 0. 001], absolute VO_(2max)[( 2. 66 ± 0. 29)m L /( kg·min) vs( 2. 02 ± 0. 36) m L /( kg·min), P < 0. 001], pulse oxygen [( 13. 33 ±1. 28) m L / beat vs( 10. 34 ± 1. 70) m L / beat, P < 0. 001] between the boys and girls respectively. And a statistically significant negative correlation was observed between values of maximal oxygen uptake and weight, BMI, FAT% and resting heart rate( P <0. 05), while lean body mass was positive with VO_(2max)( P < 0. 05). Multiple regression analysis suggested that the best VO_(2max) predictive model of boys was VO_(2max)= 0. 856 +0. 044 × lean body mass- 0. 011 × resting heart rate + 0. 0002 × vital capacity( R =0. 903, R~2= 0. 816), and the prediction equation of girls was follows: VO_(2max)= 4. 769 +0. 044 × lean body mass- 0. 020 × resting heart rate- 0. 254 × age( R = 0. 813, R~2=0. 662). CONCLUSION: The present study suggests that anthropometric characteristics might be closely related with maximal aerobic capacity and can effectively predict the maximal aerobic power.