Immunocompetent mouse models revealed that S100A4+ monocytes/macrophages facilitate long-term Zika virus infection in the testes.

During its global epidemic, Zika virus (ZIKV) attracted widespread attention due to its link with various severe neurological symptoms and potential harm to male fertility. However, the understanding of how ZIKV invades and persists in the male reproductive system is limited due to the lack of immunocompetent small animal models. In this study, immunocompetent murine models were generated by using anti-IFNAR antibody blocked C57BL/6 male mice and human STAT2 (hSTAT2) knock in (KI) male mice. After infection, viral RNA could persist in the testes even after the disappearance of viremia. We also found a population of ZIKV-susceptible S100A4+ monocytes/macrophages that were recruited into testes from peripheral blood and played a crucial role for ZIKV infection in the testis. By using single-cell RNA sequencing, we also proved that S100A4+ monocytes/macrophages had a great impact on the microenvironment of ZIKV-infected testes, thus promoting ZIKV-induced testicular lesions. In conclusion, this study proposed a novel mechanism of long-term ZIKV infection in the male reproductive system.

Education and Quality of Life: Does the Internet Matter in China?

The internet has influenced human wellbeing through social networking, time-saving, diffusion of knowledge, and access to health information. Health is a key component of human quality of life. This study examines the nexus between education, the internet, and quality of life using data from China spanning the period from 1991 to 2020. The study used ARDL to examine the short and long-term, exploring education and the impact of the internet on quality of life. Education status plays a significant role in promoting quality of life in the short and long term. The empirical findings show the significant positive impact of the internet and ICT on quality of life in the short and long-run. Financial development and FDI improve the quality of life in the long-term in China. Based on these results, policymakers in China should develop the ICT infrastructure and human capital to support increased quality of life.

Do Higher Education and Financial Institutions Improve Health in China? A New Perspective.

The importance of human wellbeing is documented in the literature of development economics because of its intensifying impacts on economic growth and productivity of labor in the long-run. To the best of the authors' knowledge, no empirical study has examined the symmetric association between China's financial institutional development, education, and health outcomes. Thus, our study aims to fill this vacuum by employing an autoregressive distributed lag (ARDL) approach to explore the impact of financial institutional development and education on life expectancy and infant mortality rate from 1990 to 2020. The empirical analysis reveals that financial institutional development and education report a significant increase in life expectancy and meaningful reduction in mortality rate in the long-run. Based on these findings, the study may deliver intuitive policy implications regarding improvement in health conditions that are imperative for promoting economic growth in the long-run.

Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet Therapy After PCI.

Since aspirin and clopidogrel are the widely and conventionally used drugs to treat acute myocardial infarction after percutaneous coronary intervention (PCI), it is important to explore potential risk factors of their resistance. The platelet aggregation rate with arachidonic acid (AA, PAg-AA%) and adenosine diphosphate (ADP, PAg-ADP%) of 219 PCI patients were measured after standard treatment for 24 h. The disease history and laboratory data (before PCI) were obtained. We found 101 (46.12%) patients to be aspirin-resistant, and PAg-ADP% was the most prominent risk factor of aspirin resistance. Clopidogrel resistance was present in 157 of 219 patients. Patients in the clopidogrel-resistant group carried more CYP2C19*3 or *2, which was associated with higher clopidogrel resistance in this group (69.11%, 47/68) than in the control group (64.29%, 36/56). Platelet count (109/L) and hemoglobin (g/L) were the prominent risk factors of clopidogrel resistance. Among the 219 patients, 98 showed dual antiplatelet drug resistance, for which platelet count (109/L) and monocyte count (g/L) were the risk factors. Aspirin resistance was found to usually accompany clopidogrel resistance.

AMP-activated protein kinase re-sensitizes A549 to paclitaxel via up-regulating solute carrier organic anion transporter family member 1B3 expression.

Paclitaxel (PTX) is a common antineoplastic drug whose functionality is often restricted by drug resistance. Solute carrier organic anion transporter family member 1B3 (SLCO1B3) is a PTX influx transporter and its low expression has been proved to be relevant with PTX resistance. It has been widely reported that AMP-activated protein kinase (AMPK) could re-sensitize tumor cells to PTX. Our gene array result demonstrates AMPK up-regulated SLCO1B3. In this paper, we have tried to explain the relationships between PTX, SLCO1B3 and AMPK. First, we have verified the proliferative inhibition of PTX on A549 and found that PTX could inhibit A549 cells proliferation. Then, we have explored the relationship between SLCO1B3 and PTX: SLCO1B3 expression significantly decreased when A549 cells were treated with PTX or in A549 PTX resistant cells (A549-PTX) and the intracellular PTX concentration in A549-PTX was also lower. When treated with metformin/LKB1, both SLCO1B3 expression and intracellular PTX concentration have increased. Knockdown of AMPK has induced decreased SLCO1B3 expression. Moreover, in vitro and in vivo experiments have showed that metformin not only obviously inhibited A549-PTX tumor xenograft and A549-PTX proliferation alone, but also enhanced PTX efficacy to A549-PTX and this may be relevant to SLCO1B3. To verify it, we have treated A549 cells with AMPK both activators and an inhibitor, and then found that AMPK activators could weaken the PTX effect in inhibiting SLCO1B3 while its inhibitor has opposite effect. With knockdown of SLCO1B3, the effect of AMPK in re-sensitizing A549 to paclitaxel has decreased. To sum up, activation of AMPK can up-regulate SLCO1B3 expression, enhance the sensitivity of A549 cells to PTX, providing a new way to re-sensitize PTX resistance.

A step towards environmental mitigation: Do tourism, renewable energy and institutions really matter? A QARDL approach.

Adverse changes in environmental conditions due to unprecedented industrialization have been attracting the attention of policymakers, researchers, and activists. For developing nations like Pakistan, sustainability issues become even more severe because of unplanned growth and lack of resources. In this study, we have applied the QARDL model to analyze the impact of renewable energy, institutional quality, tourism, and GDP on the ecological footprint in Pakistan from 1995 to 2017. The results of this study suggest that increased utilization of renewable energy and tourism improve the environment in Pakistan, whereas institutional quality and GDP are positive and significant at all quantiles, revealing that upsurge in GDP and institutional quality are directly related to environmental conditions at all the quantiles. These results also validate the presence of the Environmental Kuznets Curve in Pakistan. The government of Pakistan can play a notable part in attaining sustainability by efficient management of the environment through promoting sustainable tourism, utilization of renewable energy, and enhancement of institutional quality.

[Value of Head and Neck CT Angiography in the Clinical Evaluation of Intraoperative Bleeding Volume of Carotid Body Tumours].

Objective To investigate the value of head and neck CT angiography(CTA)in the evaluation of intraoperative hemorrhage of carotid body tumours. Methods Head and neck CTA images of 36 patients with carotid body tumours confirmed by pathology were retrospectively analyzed.Patients were divided into two groups based on the intraoperative bleeding volume:<500 ml and≥500 ml groups.The patient's age,sex,Shamblin classification,size of the lesion,number of blood supply arteries,course of the disease,plain scan,and enhanced CT value between two groups were compared and analyzed.Logistics regression equation was established based on the CTA parameters with significant differences between the two intraoperative bleeding volume groups,and combined parameter was acquired.The receiver operating characteristic curve was established based on CTA single and combined parameters. Results The bleeding volume during the operation of carotid body tumors was significantly correlated with the age of patients(P=0.019),the maximum diameter of tumours on axial images(P=0.003),the maximum upper and lower diameters(P=0.004),Shamblin classification(P=0.012),and number of blood supply arteries(P<0.001).The area under the receiver operating characteristic curve of the number of feeding arteries,the maximum diameter of axial images,maximum upper and lower diameters,Shamblin classification,and combined parameters were 0.865,0.781,0.806,0.766,and 0.927,respectively.When the optimal critical value was 0.408,the Youden index was 0.794,and the corresponding accuracy,sensitivity,and specificity were 0.919,0.909,and 0.923,respectively. Conclusions Preoperative head and neck CTA can be used to evaluate the intraoperative blood loss.Combined parameters has the best diagnostic performance compared with single parameters.

A General Hypoxia-Responsive Molecular Container for Tumor-Targeted Therapy.

Enhanced drug delivery can improve the therapeutic efficacy of drugs and help overcome side effects. However, many reported drug-delivery systems are too complex and irreproducible for practical use. In this work, the design of a hypoxia-responsive molecular container based on calixarene, called CAC4A, which presents a significant advance in practical, hypoxia-targeted drug-delivery, is reported. CAC4A enables a wide variety of clinical drugs to be quantitatively loaded to improve their solubility and stability, as well as enable the administration of reduced doses. Furthermore, as a result of its azo functional groups, which are sensitive to reduction within a hypoxic environment, it is possible to achieve tumor-targeted drug-release with reduced side effects. CAC4A fulfils all essential requirements for a drug-delivery system in addition to multiple advantages, including facile preparation, well-defined molecular weight, and structure, and universal applicability. Such features collectively enable supramolecular prodrugs to be formulated simply and reproducibly, with potential for bench-to-bedside translation. Moreover, CAC4A is amenable to other therapy modalities and can be facilely decorated with functional groups and hybridized with nanomaterials, providing ample possibilities for its role in future drug-delivery systems.

Value of Head and Neck CT Angiography in the Clinical Evaluation of Intraoperative Bleeding Volume of Carotid Body Tumours / 中国医学科学院学报

To investigate the value of head and neck CT angiography(CTA)in the evaluation of intraoperative hemorrhage of carotid body tumours. Head and neck CTA images of 36 patients with carotid body tumours confirmed by pathology were retrospectively analyzed.Patients were divided into two groups based on the intraoperative bleeding volume:<500 ml and≥500 ml groups.The patient's age,sex,Shamblin classification,size of the lesion,number of blood supply arteries,course of the disease,plain scan,and enhanced CT value between two groups were compared and analyzed.Logistics regression equation was established based on the CTA parameters with significant differences between the two intraoperative bleeding volume groups,and combined parameter was acquired.The receiver operating characteristic curve was established based on CTA single and combined parameters. The bleeding volume during the operation of carotid body tumors was significantly correlated with the age of patients(=0.019),the maximum diameter of tumours on axial images(=0.003),the maximum upper and lower diameters(=0.004),Shamblin classification(=0.012),and number of blood supply arteries(<0.001).The area under the receiver operating characteristic curve of the number of feeding arteries,the maximum diameter of axial images,maximum upper and lower diameters,Shamblin classification,and combined parameters were 0.865,0.781,0.806,0.766,and 0.927,respectively.When the optimal critical value was 0.408,the Youden index was 0.794,and the corresponding accuracy,sensitivity,and specificity were 0.919,0.909,and 0.923,respectively. Preoperative head and neck CTA can be used to evaluate the intraoperative blood loss.Combined parameters has the best diagnostic performance compared with single parameters.

Design, synthesis and biological evaluation of 3,5-dimethylisoxazole and pyridone derivatives as BRD4 inhibitors.

Bromodomain-containing protein 4 (BRD4), a member of the bromodomain and extra-terminal (BET) family, has been recognized as an attractive candidate target for the treatment targeting gene transcription in several types of cancers. In this study, two types of novel compounds were designed, synthesized and evaluated as BRD4 inhibitors. Therein, pyridone derivatives were more effective against BRD4 protein and human leukemia cell lines MV4-11. Among them, compounds 11d, 11e and 11f were the most potential ones with IC50 values of 0.55 µM, 0.86 µM and 0.80 µM against BRD4, and exhibited remarkable antiproliferative activities against MV4-11 cells with IC50 values of 0.19 µM, 0.32 µM and 0.12 µM, respectively. Moreover, in western blot assay, compound 11e induced down-regulation of C-Myc, which is a significant downstream gene of BRD4. Cell cycle analysis assay also showed that compound 11e could block MV4-11 cells at G0/G1 phase. Taken together, our results suggested that compound 11e and its derivatives were a class of novel structural potential BRD4 inhibitors and could serve as lead compounds for further exploration.

AMP-activated protein kinase regulates cancer cell growth and metabolism via nuclear and mitochondria events.

Adenine monophosphate-activated protein kinase (AMPK) is a fuel sensing enzyme that is activated in shortage of energy and inhibited in its surplus. Cancer is a metabolic disease characteristic of aerobic glycolysis, namely Warburg effect, and possesses heterogeneity featured by spatiotemporal hypoxia and normoxia, where AMPK is deeply implicated. The present study delineates the regulation of mitochondrial functions by AMPK in cancer cells. On the one hand, AMPKα subunit binds to mitochondria independently of ß subunit and targeting AMPK to mitochondria facilitates oxidative phosphorylation and fatty acid oxidation, and inhibits glycolysis. As such, mitochondrial AMPK inhibits the growth of cancer cells and tumorigenesis. On the other hand, ablation of the ß subunits completely abolishes AMPK activity and simultaneously leads to decreases in mitochondria DNA and protein contents. The effect of the ß deletion is rescued by overexpression of the active mutant of bulky AMPKα1 subunit. In conjunction, the transcriptional factors PGC1α and Nrf-1 are up-regulated by LKB1/AMPK, an event that is abolished in the absence of the ß subunits. Intriguingly, the stimulation of mitochondria biogenesis is not achieved by mitochondria-targeted AMPK. Therefore, our study suggests that AMPK inhibits cancer cell growth and tumorigenesis via regulation of mitochondria-mediated metabolism.

Spontaneous and transient hyperglycemia before sleep in a patient with glaucomatous blindness and diabetes: A case reprt.

RATIONALE: The peak of blood glucose was during 9 PM to 3 AM. There is a stable, spontaneous and short-term abnormal increase of blood glucose. The pathophysiological mechanism is unknown. It is speculated that the cause might be the imbalance of the glucose-regulating hormone that is caused by the disorder of the biological clock system. PATIENT CONCERNS: The case was a 73-year old man with bilateral glaucoma (only mild light perception) and was hospitalized to establish a viable hypoglycemic plan. He received 4 shots of insulin enhancement, oral meditation, pre-mixed insulin treatment during the 22 days. However, his blood glucose had been spontaneously increased from 9 PM to 3 AM which was the highest of the day, and then resumed by itself. Insulin intervention was effective. DIAGNOSIS: Glaucomatous blindness and diabetes, spontaneous and transient hyperglycemia before sleep. INTERVENTIONS: We used insulin aspart 3u when we found hyperglycemia three times at 9 PM and it was effective. Without intervention, blood sugar will automatically improve in the morning. OUTCOMES: During the late night and early morning, there is a stable, spontaneous and short-term transit abnormal increase in blood glucose, which suggests the complexity of blood glucose adjustment. LESSONS: Due to the case specialty, we could not do the systematic review of the study. However, it improves the awareness of the abnormal periodically increase of blood glucose during the special periods, and provides with a reference for clinical research of dawn and dusk phenomenon. Multi-point blood glucose monitoring or dynamic blood glucose monitoring throughout the day is of great significance for the detection of special types of hyperglycemia.

Clinical diagnosis for dusk phenomenon of diabetes.

The diabetes dusk phenomenon (spontaneous and transient pre-dinner hyperglycemia) anecdotally exists but has not been investigated.A total of 80 diabetic patients that received continuous subcutaneous insulin infusions were retrospectively studied. They were grouped into a routine group (R) (consecutive δDG [dusk blood glucose difference] <0 mmol/L) and a classic dusk phenomenon group (CDP, consecutive δDG≥0 mmol/L). δDG represents differences in blood glucose measurements between pre-dinner and post-lunch (δDG: dusk blood glucose difference). Other patients were placed in a suspicious group (S). The suspicious group was further divided into 3 groups based on the frequency at which the δDG occurred: suspicious 1 group (S1), δDG≥0 mmol/L occurred once only; suspicious 3 group (S3), δDG < 0 mmol/L occurred once only, and the remaining patients were grouped in the suspicious 2 group (S2).We identified the CDP and S3 groups as the "clinical dusk phenomenon" group (CLDP). We confirmed that the S1 and R groups to be in the "clinical routine" group. The S2 group was significantly different from the CDP group. In addition, the S2 group had significant differences in δDG measurements and post-lunch blood glucose values compared with the R group, but no differences in other parameters were seen. Multiple comparisons with the other suspicious groups also showed no statistical difference in many parameters. Thus, we placed these patients into the "suspicious clinical dusk phenomenon" group (SDP). The δDG cut-off for the CLDP group was 1.0167 mmol/L. The pre-dinner-pre-lunch blood glucose cut-off for this group was 2.72 mmol/L. The δDG cut-off for the SDP group was -0.95 mmol/L. The pre-dinner-pre-lunch blood glucose cut-off for this group was 0.87 mmol/L. The cut-off points for the post-dinner-post-lunch blood glucose measurements in the CLDP and SDP groups were both 1.2667 mmol/L.A consecutive δDG≥0 or a once only δDG < 0 could be diagnosed as falling into the CLDP group. The CLDP could be excluded when a consecutive δDG < 0 or a once only δDG≥0 was found. Patients falling into other categories were placed into the SDP group.

Dosimetric Comparisons of Volumetric Modulated Arc Therapy and Tomotherapy for Early T-Stage Nasopharyngeal Carcinoma.

PURPOSE: To compare the dosimetric differences between volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) in treating early T-stage nasopharyngeal carcinoma (NPC). METHOD: Ten patients with early T-stage NPC who received tomotherapy using simultaneously integrated boost (SIB) strategies were replanned with VMAT (RapidArc of Varian, dual-arc). Dosimetric comparisons between the RapidArc plan and the HT plan included the following: (1) D98, homogeneity, and conformity of PTVs; (2) sparing of organs at risk (OARs); (3) delivery time and monitor units (MUs). RESULTS: (1) Compared with RapidArc, HT achieved better dose conformity (CI of PGTVnx + nd: 0.861 versus 0.818, P = 0.004). (2) In terms of OAR protection, RapidArc exhibited significant superiority in sparing ipsilateral optic nerve (Dmax: 27.5Gy versus 49.1Gy, P < 0.001; D2: 23.5Gy versus 48.2Gy, P < 0.001), contralateral optic nerve (Dmax: 30.4Gy versus 49.2Gy, P < 0.001; D2: 26.2Gy versus 48.1Gy, P < 0.001), and optic chiasm (Dmax: 32.8Gy versus 48.3Gy, P < 0.001; D2: 30Gy versus 47.6Gy, P < 0.001). HT demonstrated a superior ability to protect the brain stem (D1cc: 43.0Gy versus 45.2Gy, P = 0.012), ipsilateral temporal lobe (Dmax 64.5Gy versus 66.4 Gy, P = 0.015), contralateral temporal lobe (Dmax: 62.8Gy versus 65.1Gy, P = 0.001), ipsilateral lens (Dmax: 4.27Gy versus 5.24Gy, P = 0.009; D2: 4.00Gy versus 5.05Gy, P = 0.002; Dmean: 2.99Gy versus 4.31Gy, P < 0.001), contralateral lens (Dmax: 4.25Gy versus 5.09Gy, P = 0.047; D2: 3.91Gy versus 4.92Gy, P = 0.005; Dmean: 2.91Gy versus 4.18Gy, P < 0.001), ipsilateral parotid (Dmean: 36.4Gy versus 41.1Gy, P = 0.002; V30Gy: 54.8% versus 70.4%, P = 0.009), and contralateral parotid (Dmean: 33.4Gy versus 39.1Gy, P < 0.001; V30Gy: 48.2% versus 67.3%, P = 0.005). There were no statistically significant differences in spinal cord or pituitary protection between the RapidArc plan and the HT plan. (3) RapidArc achieved a much shorter delivery time (3.8 min versus 7.5 min, P < 0.001) and a lower MU (618MUs versus 5646MUs, P < 0.001). CONCLUSION: Our results show that RapidArc and HT are comparable in D98, dose homogeneity, and protection of the spinal cord and pituitary gland. RapidArc performs better in shortening delivery time, lowering MUs, and sparing the optic nerve and optic chiasm. HT is superior in dose conformity and protection of the brain stem, temporal lobe, lens, and parotid.

Impact of disease management of caregivers on self-management behaviors among patients with chronic heart failure / 上海交通大学学报（医学版）

Objective·To explore the impact and mechanism of disease management of caregivers on self-management behaviors among patients with chronic heart failure.Methods·A total of 231 dyads of outpatient chronic heart failure patients and their caregivers were assessed by caregivers contribution to self-care of heart failure index (CC-SCHFI),self-care of heart failure index (SCHFI) and Atlanta heart failure knowledge test (AHFKT-V2).IBM SPSS 22.0 was used to conduct the paired t test and Pearson correlation analysis.LISREL 8.80 was used to conduct the path analysis.Results·There were significant differences between caregivers and patients in maintenance behavior (P=0.015),management behavior (P=0.023) and self-efficacy (P=0.001).There was no correlation between caregiver self-efficacy and patient heart failure knowledge and skill,but other variables were positively correlated,and r value ranged from 0.129 to 0.575 (P＜0.05).Patient self-management behaviors were directly influenced by caregiver disease management,patient heart failure knowledge and skill and patient self-efficacy,and indirectly influenced in part by caregiver disease management through patient heart failure knowledge and skill and patient self-efficacy.Conclusion·Caregiver disease management not only can directly influence patient self-management behaviors,but also can indirectly influence patient self-management behaviors through patient heart failure knowledge and skill and self-efficacy.Health care workers should carry out family-centered health education,and help caregivers actively participate in disease management of patients with heart failure;for those patients whose caregivers can't change their disease management behaviors,health care workers should also improve their self-management behaviors by improving paticnts' heart failure knowledge and skill and self-efficacy.

Study of Thermal Electrical Modified Etching for Glass and Its Application in Structure Etching.

In this work, an accelerating etching method for glass named thermal electrical modified etching (TEM etching) is investigated. Based on the identification of the effect in anodic bonding, a novel method for glass structure micromachining is proposed using TEM etching. To validate the method, TEM-etched glasses are prepared and their morphology is tested, revealing the feasibility of the new method for micro/nano structure micromachining. Furthermore, two kinds of edge effect in the TEM and etching processes are analyzed. Additionally, a parameter study of TEM etching involving transferred charge, applied pressure, and etching roughness is conducted to evaluate this method. The study shows that TEM etching is a promising manufacture method for glass with low process temperature, three-dimensional self-control ability, and low equipment requirement.

Cardiac fibroblasts of the rat transfected by lenti virus-stromal cell-derived factor-la-green fluorescent protein vector / 解剖学报

Objective To investigate the effect of lentivirus-stromal cell-derived factor-1α-green fluorescent protein(LV-SDF-1α-GFP) on the cardiac fibroblasts, the optimum conditions of infection, the expression and secretion of the target protein. Methods The cardiac fibroblasts of neonatal rats were primarily isolated and cultured by differential adherence methods, and were observed and identifi with immunofluorescence. LV-SDF-1α-GFP with different titers and conditions was transfected into cardiac fibroblasts. The expression of fluorescence and the optimal transfection conditions were observed. LV-SDF-1α-GFP target gene virus and negative control C0N145 virus were transfected into cardiac fibroblasts. The growth curve was drawn, and the effect of transfection on the proliferation of cardiac fibroblasts was explored. The cardiac fibroblasts were transfected with the optimum transfection dose, and the expression of SDF-1α was detected by Dot-blotting. The measurement data underwent statistical analysis. Results There was no statistical difference between the cardiac fibroblasts with SDF-1α transfected lentivirus and without no-transfected SDF-1α lentivirus. The peak of the expression of SDF-1α appeared in culture day 4 and statistical analysis showed significantly difference (P<0.05). Conclusion The LV-SDF-1α-GFP vector is of higher transfection efficiency to cardiac fibroblasts with the both low cytotoxicity and ability of secreting SDF-la protein.

Development and Testing of a Reliable and Valid Patient-Needs Questionnaire for Breast Cancer Inpatients in China.

INTRODUCTION: Breast cancer patients are demanding more active roles in their care, especially in the initial diagnosis and treatment stages. At present, there is no suitable patient questionnaire that appropriately incorporates Chinese language, habits, and cultural differences. AIM: To develop and validate a patient-needs questionnaire for female breast cancer inpatients in China. MATERIALS AND METHODS: The questionnaire structure was based on Maslow's model and a modern medical model. In the first step, a focus group was used to design 125 questions, of which 64 constituted the initial questionnaire for item screening with a group of 115 hospitalized patients with breast cancer. Items were included or excluded based on the evaluation of eight statistical analysis. Ultimately, 38 items were selected and validated. The reliability and validity of the 38-item questionnaire were determined in a cohort of 323 patients. RESULTS: The scale was set up with the 38 selected items. The four primary areas were disease knowledge, medical environment, psychosocial parameters and sexual attitudes. Cronbach's coefficient was 0.959. The split-half reliability value was 0.935. Principal component factor analysis extracted four common factors. CONCLUSION: Our new questionnaire, designed to assess the care needs of Chinese inpatients with breast cancer is reliable, sensitive, effective, independent and representative. It can be used in medical practice as a tool for a more complete assessment of patients' needs.

Spontaneous and transient predinner hyperglycemia in some patients with diabetes: Dusk phenomenon.

Blood glucose fluctuations have higher risk than absolute blood glucose level in diabetic chronic complications. At present, "dawn phenomenon" is well known by clinicians, but "dusk phenomenon" has not been recognized. This study explored the objective existence of "dusk phenomenon" (spontaneous and transient predinner hyperglycemia) and its clinical significance.The data of 54 patients with diabetes, who received routine insulin pump therapy between December 2010 and October 2012 in our hospital, were retrospectively analyzed. These patients included 4 patients with type 1 diabetes mellitus (DM) (T1DM) and 50 patients with type 2 DM (T2DM). According to the difference between predinner and postlunch blood glucose levels, the 50 patients with T2DM were divided into dusk phenomenon group (4 patients, all the differences ≥0 mmol/L during insulin pump therapy), nondusk phenomenon group (12 patients, all the differences <0 mmol/L during insulin pump therapy), and suspicious group (34 patients, the differences were uncertain during insulin pump therapy). In the 4 patients with T1DM of this study, the differences all were more than 0 mmol/L during insulin pump therapy. The changes in blood glucose levels were observed, and the correlations of blood glucose level with other factors were analyzed in T1DM and T2DM patients, respectively.In T1DM patients, blood glucose level was significantly higher in predinner than in prebreakfast and prelunch (all P < 0.01), and in postdinner 2 hour than in postlunch 2 hour (P = 0.021). The predinner blood level had no significant correlations with the blood glucose level at other time points and insulin dosages (all P > 0.05). In T2DM patients, the predinner blood glucose level was significantly higher in dusk phenomenon group than in suspicious group and nondusk phenomenon group (all P < 0.05). In dusk phenomenon group, the blood glucose level remained rising from predinner to prebed, and the predinner blood glucose level was only significantly correlated with postdinner 2-hour blood glucose level (P < 0.05).The "dusk phenomenon" (spontaneous and transient predinner hyperglycemia) is an objective existence in some patients with diabetes. The predinner hyperglycemia can affect blood glucose control between postdinner and prebed. Awareness of the "dusk phenomenon" has important clinical significance.

Clinical utility of microRNA-378 as early diagnostic biomarker of human cancers: a meta-analysis of diagnostic test.

A meta-analysis was performed to evaluate the diagnostic value of miR-378 for detecting human cancers. Systematic electronic searches were conducted in PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and Wanfang from the inception to January 15, 2016. We used the bivariate mixed effects models to estimate the combined sensitivity, specificity, PLRs (positive likelihood ratios), NLR (negative likelihood ratios), DORs (diagnostic odds ratios) and their 95% CI (confidence intervals) for assessing the diagnostic performance of miR-378 for cancers. Twelve studies were included in the meta-analysis, with a total number of 1172 cancer patients and 809 health controls. The overall estimated sensitivity and specificity were 0.75 and 0.74. The pooled PLR was 2.91, NLR was 0.34, DOR was 8.50, and AUC (Area Under the Curve) was 0.81. The subgroup analyses suggested that AUC for plasma-based is higher than serum-based. The overall diagnostic values of miR-378 in the present meta-analyses are moderate accurate for human cancers; The source of specimen has an effect on the diagnostic accuracy. The diagnostic value of serum-based was higher than that of plasma-based.