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Background Exposure to air pollution is an important risk factor for intracerebral hemorrhage (ICH), which is a major cause of death worldwide. However, the relationship between ICH mortality and air quality improvement has been poorly studied. This study aims to evaluate the impact of the air pollution control policies in the Beijing-Tianjin-Hebei region on ICH mortality among Tianjin residents. Methods This study used an interrupted time series analysis. We fitted autoregressive integrated moving average (ARIMA) models to assess the changes in ICH deaths before and after the interventions of air pollution control policies based on the data of ICH deaths in Tianjin collected by the Tianjin Center for Disease Control and Prevention. Results Between 2009 and 2020, there were 63,944 ICH deaths in Tianjin, and there was an overall decreasing trend in ICH mortality. The intervention conducted in June 2014 resulted in a statistically significant (p = 0.03) long-term trend change, reducing the number of deaths from ICH by 0.69 (95% confidence interval [CI]: -1.30 to -0.07) per month. The intervention in October 2017 resulted in a statistically significant (p = 0.04) immediate decrease of 25.74 (95% CI: -50.62 to -0.85) deaths from ICH in that month. The intervention in December 2017 caused a statistically significant (p = 0.04) immediate reduction of 26.58 (95% CI: -52.02 to -1.14) deaths from ICH in that month. The intervention in March 2018 resulted in a statistically significant (p = 0.02) immediate decrease of 30.40 (95% CI: -56.41 to -4.40) deaths from ICH in that month. No significant differences were observed in the changes of male ICH mortality after any of the four interventions. However, female ICH deaths showed statistically significant long-term trend change after the intervention in June 2014 and immediate changes after the interventions in December 2017 and March 2018. Overall, the interventions prevented an estimated 5984.76 deaths due to ICH. Conclusion During the study period, some interventions of air pollution control policies were significantly associated with the reductions in the number of deaths from ICH among residents in Tianjin. ICH survivors and females were more sensitive to the protective effects of the interventions. Interventions for air pollution control can achieve public health gains in cities with high levels of air pollution.

Prostate cancer (PCa) causes significant mortality and morbidity, with advanced metastasis. WNT signaling is a promising therapeutic target for metastatic PCa. GIPC2 is a GIPC1 paralog involved in WNT signaling pathways associated with tumor progression, but its role in PCa metastasis remains unclear. Herein, we demonstrated that high GIPC2 expression in PCa tissues was significantly associated with distant metastasis and poor prognosis. Functional studies demonstrated that high GIPC2 expression due to CpG-island demethylation promoted increased metastatic capabilities of PCa cells. Conversely, silencing GIPC2 expression significantly inhibited PCa metastasis in vitro and in vivo. Furthermore, GIPC2 directly bound the WNT co-receptor Fzd7 through its PDZ domain, which enabled activation of WNT-β-catenin cascades, thereby stimulating PCa metastasis. Interestingly, GIPC2 protein was also identified as a component of exosomes and that it robustly stimulated PCa adhesion, invasion, and migration. The presence of GIPC2 in tumor-derived exosomes and ability to impact the behavior of tumor cells suggest that GIPC2 is a novel epigenetic oncogene involved in PCa metastasis. Our findings identified GIPC2 as a novel exosomal molecule associated with WNT signaling and may represent a potential therapeutic target and biomarker for metastatic PCa.

Blend oils composed by leaf lard (LL) and cottonseed oil stearin (COS) were prepared and the thermal property, microstructure and crystallization of these blends were investigated in the present study. Solid fat content (SFC), thermal behaviors, triacylglycerols composition, crystal structure and morphology of the LL and COS blends were determined by pulsed nuclear magnetic resonance (pNMR), differential scanning calorimetry (DSC), high-performance liquid chromatography (HPLC), X-ray diffractometer (XRD) and polarized light microscope (PLM), respectively. SFC profiles and iso-solid diagrams indicated that SFCs of all blends were almost close to the weighted averages of the fat components at temperatures beyond 20°C; however, below 20°C, SFCs of blends exhibited higher than those of the weighted averages of the fat components. With the content of COS increasing, palmitic acid and linoleic acid in the blends increased, while stearic acid and oleic acid decreased; monounsaturated-disaturated (USS) and triunsaturated (UUU) glycerides in the blends enhanced, while monosaturated-diunsaturated (UUS) glycerides declined. The melting temperature of the blends decreased with the increase of COS content. The crystal forms in LL were β' and β, and the packing pattern was double and triple chain length (2L and 3L). With COS in blends increasing, β' form crystals and 3L pattern reduced. Polarized light micrographs showed that the number of crystal particles in the blends raised with the increase of COS content, meanwhile, the grainsize of the sample gradually decreased. Visual appearances of the blends indicated that blending LL with COS could efficiently reduce the graininess of LL. The addition of COS had a significant effect on the crystallization behavior of LL. LL presented one-step crystallization at 10°C and 20°C, while COS showed two-step crystallization at 10°C and one-step crystallization at 20°C. However, the blends exhibited obvious two-step crystallization at 10°C, one-step or slight two-step crystallization at 20°C.

Trigonal copper(i) complexes comprising cation–π interactions achieve satisfactory photoluminescence properties.

The global distribution and temporal trend of age-related hearing loss (ARHL) are unknown, and we aimed to investigate magnitudes and temporal trends of ARHL burden and its influencing factors at the national, regional, and global levels. Based on the information of Global Burden of Disease Study 2019, we calculated the estimated annual percentage change to quantify the global, regional, and national temporal trends of age-standardized rates (ASRs) of ARHL by gender, age, and severity. The number of prevalent cases and disability-adjusted life years (DALYs) of ARHL increased from 751.50 million and 22.01 million in 1990 to 1456.66 million and 40.24 million in 2019, respectively. Except for a few countries such as Niger and Burkina Faso, the age-standardized prevalence rate and age-standardized DALYs rate showed a downward trend in most countries and regions. Mild ARHL accounted for the largest proportion in all ARHL, and only mild ARHL showed an upward trend in ASRs. In most regions, the proportion of ARHL disease burden attributable to occupational noise showed a downward trend in the past 30 years. In 2019, ARHL disease burden attributable to occupational noise declined with the increase of socio-demographic index in countries. Although the ASR of ARHL in most parts of the world is declining, the absolute disease burden of ARHL is still heavy. Understanding the real-time disease burden of ARHL and its temporal trend is of great significance for formulating more effective preventive measures and reducing the ARHL burden.

IntroductionTraditional Chinese medicine (TCM) has guided generations of practice on disease treatment and health maintenance. The TCM principles include the framework of body constitution (BC). In essence, it represents one of the first attempts at applying the principle of personalized, precision medicine. Major limitations to broad implementation of the body constitution (BC) framework, and perhaps TCM as a whole, include not only a lack of empirical study about its relation to other models of health maintenance but also a poor understanding of its applicability outside of Chinese population.MethodsWe conducted a study using baseline data from the Personalized Prevention of Colorectal Cancer Trial. 191 participants from an almost entirely White population were evaluated for BC type.ResultsFifty-seven (29.8%) were identified as neutral BC, while Blood-stasis (17.3%), Qi-deficient (13.6%), and Special diathesis (10.5%) were the pre-eminent pathologic subtypes. We also found there are substantial differences in proportions of TCM BC types in our study of white Americans conducted in US from previous studies conducted in Chinese populations. Additional analyses investigated the relationship between cardiovascular disease (CVD) risk and BC subtypes. Among them, Yang-deficiency, Yin-deficiency, and Blood stasis carried a lower risk of CVD.ConclusionsIt is important to understand the underlying mechanisms contributing to these differences, which may not only help to understand the underlying mechanism for TCM, but also help to identify novel factors or mechanisms for CVD risk, prevention and treatment.

Background: This research aims to quantitively evaluate the associations between air pollution control policies in Beijing-Tianjin-Hebei region and intracerebral hemorrhage (ICH) deaths in Tianjin and provide scientific evidence for the prevention and control of ICH as well as the management of air pollution. Methods: This study used an interrupted time series analysis. Based on the data of ICH death cases in Tianjin collected by the Tianjin Center for Disease Control and Prevention, Autoregressive integrated moving average models (ARIMA) were fitted to assess the changes in ICH deaths before and after the interventions of air pollution control policies. Results: There were 63,944 ICH deaths in Tianjin from 2009 to 2020, with an overall decreasing trend in ICH mortality. The secular trend change of the intervention in June 2014 was statistically significant (p = 0.03), with 0.69 (1.30 to 0.07) fewer ICH deaths per month. The immediate change of the intervention in October 2017 was statistically significant (p = 0.04), with 25.74 (50.62 to 0.85) fewer deaths from ICH in the month. A statistically significant immediate change in the intervention in December 2017 (p = 0.04), with 26.58 (-52.02 to -1.14) fewer deaths from ICH in the month. Moreover, a statistically significant immediate change in the intervention in March 2018 (p = 0.02), the number of ICH deaths decreased by 30.40 (56.41 to 4.40) in the month. After the interventions, an estimated 5984.76 ICH deaths (8.56%) were prevented. Conclusion: The interventions of air pollution control policies during the study period were significantly associated with the reductions in ICH deaths in Tianjin. Surviving ICH patients and women were more sensitive to the protective effects of the interventions. Public health gains can be achieved by implementing interventions of air pollution control policy in cities with high levels of air pollution.

In many reversible data hiding (RDH) methods for halftone images, the traditional embedding process embeds a 1-bit secret message into each embeddable pixel or pattern. To improve the embedding efficiency and payload, we propose an RDH method used in halftone images based on the dynamic embedding states group (DESG), which can embed at least 1 bit of secret messages per embeddable pixel or pattern. First, by exploiting the statistical features of $4 \times 4$ patterns and the state sequences in each image, the DESG is constructed dynamically, including $n$ embedding states with their state patterns and state sequences. Then, secret messages are encoded by matching the longest common subsequence according to the DESG, which are split into several state sequences. The state sequences are embedded by Markov transitions between these $n$ changing state patterns. Finally, reversibility is achieved by recording the DESG as the overhead information in RDH. Experiments show that the construction of DESG can improve the embedding efficiency under the same number of embeddable pixels or patterns, and the visual distortion is also significantly reduced by flipping fewer pixels.

Objectives Understanding the global trend of lung cancer deaths attributable to smoking is crucial for prioritizing global lung cancer prevention, as well as tobacco control. We assessed patterns of smoking-induced lung cancer deaths at global, regional, and national levels from 1990 to 2017. Materials and methods We extracted detailed data on lung cancer deaths attributable to smoking from the Global Burden of Disease 2017 Study. The estimated annual percentage change (EAPC) was used to quantify temporal trends in the age-standardized mortality rate (ASMR) of smoking-induced lung cancer. Results In 2017, estimated 1.19 million lung cancer deaths were attributable to smoking, accounting for 63.17 % of all lung cancer deaths. The corresponding ASMR decreased by 13.36 % from 17.29/100,000 in 1990 to 14.98/100,000 in 2017, with an EAPC of −0.59 (95 % confidence interval: −0.66, −0.53). The ASMR of lung cancer in most geographic regions has significantly decreased since 1990; however, the EAPC of ASMR in 20 countries exceeded 1 during the same period. The reductions in the ASMR were pronounced in areas with high Socio-demographic Index and high disease burden, and kept pace with the decrease of smoking prevalence at least 10 years ago. Conclusion Despite the decline in lung cancer ASMR attributable to smoking over the past 28 years, the corresponding number of lung cancer deaths increased steadily due to population aging and growth. Tobacco prevention needs to be strengthened, especially in countries with high smoking prevalence and countries where the ASMR of smoking-induced lung cancer is increasing.

Objective China is one of the countries with the heaviest burden of gastric cancer (GC) in the world. Understanding the epidemiological trends and patterns of GC in China can contribute to formulating effective prevention strategies. Methods The data on incidence, mortality, and disability-adjusted life-years (DALYs) of GC in China from 1990 to 2019 were obtained from the Global Burden of Disease Study (2019). The estimated annual percentage change (EAPC) was calculated to evaluate the temporal trends of disease burden of GC, and the package Nordpred in the R program was used to perform an age-period-cohort analysis to predict the numbers and rates of incidence and mortality in the next 25 years. Results The number of incident cases of GC increased from 317.34 thousand in 1990 to 612.82 thousand in 2019, while the age-standardized incidence rate (ASIR) of GC decreased from 37.56 per 100,000 in 1990 to 30.64 per 100,000 in 2019, with an EAPC of -0.41 [95% confidence interval (95% CI): -0.77, -0.06]. Pronounced temporal trends in mortality and DALYs of GC were observed. In the next 25 years, the numbers of new GC cases and deaths are expected to increase to 738.79 thousand and 454.80 thousand, respectively, while the rates of incidence and deaths should steadily decrease. The deaths and DALYs attributable to smoking were different for males and females. Conclusions In China, despite the fact that the rates of GC have decreased during the past three decades, the numbers of new GC cases and deaths increased, and will continue to increase in the next 25 years. Additional strategies are needed to reduce the burden of GC, such as screening and early detection, novel treatments, and the prevention of risk factors.

Background: Various studies have indicated that the prognosis of leukemia has been improved in recent years, but the secular trends of incidence and long-term survival of all leukemia have not been thoroughly examined. Methods: We estimated the leukemia incidence and 5-year survival rate along with the temporal trends by sex, race, age, and subtype in the United States over the past four decades using Surveillance, Epidemiology, and End Results (SEER) database. Results: The overall incidence of leukemia steadily increased from 12.39/100 000 in 1975 to 14.65/100 000 in 2011, and then began to decline in recent years (13.73/100 000 in 2017), with average annual percent changes (APC) of 0.350 (P

Aims Autism spectrum disorder (ASD) is a neurodevelopmental condition, with symptoms appearing in the early developmental period. Little is known about its current burden at the global, regional and national levels. This systematic analysis aims to summarise the latest magnitudes and temporal trends of ASD burden, which is essential to facilitate more detailed development of prevention and intervention strategies. Methods The data on ASD incidence, prevalence, disability-adjusted life years (DALYs) in 204 countries and territories between 1990 and 2019 came from the Global Burden of Disease Study 2019. The average annual percentage change was calculated to quantify the secular trends in age-standardised rates (ASRs) of ASD burden by region, sex and age. Results In 2019, there were an estimated 60.38 × 104 [95% uncertainty interval (UI) 50.17–72.01] incident cases of ASD, 283.25 × 105 (95% UI 235.01–338.11) prevalent cases and 43.07 × 105 (95% UI 28.22–62.32) DALYs globally. The ASR of incidence slightly increased by around 0.06% annually over the past three decades, while the ASRs of prevalence and DALYs both remained stable over the past three decades. In 2019, the highest burden of ASD was observed in high-income regions, especially in high-income North America, high-income Asia Pacific and Western Europe, where a significant growth in ASRs was also observed. The ASR of ASD burden in males was around three times that of females, but the gender difference was shrunk with the pronounced increase among females. Of note, among the population aged over 65 years, the burden of ASD presented increasing trends globally. Conclusions The global burden of ASD continues to increase and remains a major mental health concern. These substantial heterogeneities in ASD burden worldwide highlight the need for making suitable mental-related policies and providing special social and health services.

The blast crisis (BC) is the final deadly phase of chronic myeloid leukemia (CML), which remains a major challenge in clinical management. However, the underlying molecular mechanism driving blastic transformation remains unclear. Here, we show that ASF1A, an essential activator, enhanced the transformation to CML-BC by mediating cell differentiation arrest. ASF1A expression was aberrantly increased in bone marrow samples from CML-BC patients compared with newly diagnosed CML-chronic phase (CP) patients. ASF1A inhibited cell differentiation and promoted CML development in vivo. Mechanistically, we identified ASF1A as a coactivator of the Notch transcriptional complex that induces H3K56ac modification in the promoter regions of Notch target genes, and subsequently enhanced RBPJ binding to these promoter regions, thereby enhancing Notch signaling activation to mediate differentiation arrest in CML cells. Thus, our work suggests that targeting ASF1A might represent a promising therapeutic approach and a biomarker to detect disease progression in CML patients.

This study aimed to identify and project the epidemiological trends and the burden of lung cancer in China.We extracted incidence, mortality, disability-adjusted life-years (DALYs) and age-standardized rates of lung cancer in China, between 1990 and 2019, from the Global Burden of Disease Study (2019). The estimated annual percentage change (EAPC) was applied to quantify the trends of lung cancer burden. Furthermore, we used the Bayesian age-period-cohort model to project the incidence and mortality in the next decade.From 1990 to 2019, the estimated national number of lung cancer incident cases increased by 224.0% to 832,920, deaths increased by 195.4% to 757,170 and DALYs increased by 146.1% to 17,128,580, respectively. Meanwhile, the ASIR, ASMR and ASDR showed an upward trend (EAPC of 1.33, 0.94 and 0.42, respectively). The ASIR and ASMR among males were about 2 times more than females, but the increase in ASIR in females (EAPC = 2.24) was more obvious than those in males (EAPC = 0.10) from 2020 to 2030. In China, smoking remained responsible for the highest burden of lung cancer, but the contribution of ambient particulate matter pollution to DALYs increased from 10.6% in 1990 to 22.5% in 2019 in total population. Moreover, we predicted that the number of deaths from lung cancer will increase by 42.7% in China by 2030.In China, the burden of lung cancer has been increasing over the past three decades, which highlights more targeted intervention measures are needed to reduce the burden of lung cancer.

Background To assess the spatiotemporal variation in female breast cancer attributable to low physical activity (LPA) at a global scale from 1990 to 2019, which is essential to promote physical activity, as well as prevent and control breast cancer. Methods The number of deaths and disability-adjusted life years (DALYs), and the corresponding age-standardized rates (ASMR and ASDR) of LPA-related breast cancer in 204 countries and territories from 1990 to 2019 were retrieved from the Global Burden of Disease Study 2019 to measure the related breast cancer burden by age and region. The estimated annual percentage change (EAPC) was calculated to quantify the secular trend in breast cancer burden rates. Results From 1990 to 2019, globally, both breast cancer deaths and DALYs attributable to LPA nearly doubled, although the corresponding ASMR and ASDR decreased slightly, with EAPC of -0.46 (95% confidence interval: -0.52, -0.40) and -0.44 (95% confidence interval: -0.49, -0.39), respectively. The LPA-related breast cancer burden varied considerably across the world, with the highest-burden rates in Oceania, Tropical Latin America and Caribbean, and the fastest growth in North Africa and Middle East. The ASMR and ASDR showed a logarithmic association with the Socio-demographic Index, and a temporally upward trend in most of 204 countries regardless of the Socio-demographic Index or the ASMR in 1990. Conclusions Despite a decline in LPA-related breast cancer burden achieved in many countries during the last 3 decades like Bermuda, Myanmar, USA and China, an increase still occurred in most of 204 countries and territories, such as Solomon Islands, Equatorial Guinea, Japan and India. The findings can bring greater awareness to the importance of promoting physical activity for the local government to control the attributable breast cancer burden.

BackgroundLead exposure is an important risk factor for stroke. However, the latest global spatiotemporal patterns of lead exposure-related stroke burden were unclear. In this study, we assessed this topic.MethodsThe data were obtained from the Global Burden of Disease Study (2019). The estimated annual percentage change (EAPC) was estimated to evaluate the temporal trends of the age-standardized mortality and disability-adjusted life years (DALYs) rates (ASMR and ASDR) of stroke attributable to lead exposure.ResultsIn 2019, the numbers of global stroke deaths and DALYs attributable to lead exposure were 305.27 and 6738.78 thousand, respectively. The corresponding ASMR and ASDR were highest in males, the elderly population, low and middle-income countries, and the intracerebral hemorrhage subtype. From 1990 to 2019, the ASMR and ASDR of global stroke attributable to lead exposure decreased [ASMR: EAPC = −1.34, 95% confidence interval (CI): (−1.57, −1.10); ASDR: EAPC = −1.74, 95% CI: (−1.95, −1.52)], especially in females, the high-income countries, and the subarachnoid hemorrhage subtype.ConclusionThis study emphasizes the importance of continued implementation of lead exposure prevention strategies and improved high-efficiency treatment and stroke acute health care, especially in low and middle-income countries.

IVS-II-5 GC (The clinical phenotypes associated with compound heterozygosity for the IVS-II-5 GC mutation and other β-thalassemia mutations, together with the genetic modifiers' potential effect of the genetic modifiers α-thalassemia, were studied in 13 patients. In addition, analyses of red cell indices, hemoglobin component, iron status, and α-globin genes were carried out in 19 heterozygotes.Next-generation sequencing of 24 undiagnosed patients with transfusion-dependent thalassemia (TDT) or non-transfusion-dependent thalassemia (NTDT) identified 13 carriers of the IVS-II-5 GC mutation. There was a wide spectrum of phenotypic severity in compound heterozygotes and 6 (46.2%) of 13 were transfusion dependent. Analysis of 19 heterozygotes indicated that most were hematologically normal without appreciable microcytosis or hypochromia, and approximately half had normal hemoglobin ACompound heterozygotes for IVS-II-5 GC and other severe β-thalassemia mutations are phenotypically severe enough to necessitate appropriate therapy and counselling. Co-inheritance of this nucleotide substitution with other β-thalassemia mutations may account for a considerable portion of the incidence of undiagnosed patients with NTDT and TDT in Guangxi. Therefore, the IVS-II-5 GC mutation can pose serious difficulties in screening and counselling.

Uterine cancer is one of the most common female cancers worldwide, with huge heterogeneity in morbidity and mortality. Although a high body-mass index (BMI) has been linked to uterine cancer, systematic reports about the influence of high BMI and its temporal trends are scarce.The annual morbidity, mortality, and disability-adjusted life years (DALYs) of uterine cancer in 204 countries or territories were retrieved from the GBD 2019 study. To reflect trends in disease burden, we also calculated the estimated annual percentage change (EAPC) based on the age-standardized rates of uterine cancer from 1990 to 2019.The global incident cases of uterine cancer increased 2.3 times from 187,190 in 1990 to 435,040 in 2019. Although the age-standardized incidence rate (ASIR) of uterine cancer increased worldwide from 8.67/100,000 in 1990 to 9.99/100,000 in 2019, the age-standardized death rate (ASDR) and DALY rate decreased during the same period. High socio-demographic index (SDI) countries tended to have a higher ASIR than developing regions, and their increasing trend in ASIR was also more pronounced. The disease was rare before 40 years old, but its risk rose sharply among women aged 50-70. A high BMI was linked to more than one-third of deaths from uterine cancer in 2019.The incidence in developed areas was significantly higher than in developing areas and also increased much more rapidly. Elderly females, especially those with a high BMI, have a higher risk of uterine cancer. Therefore, more health resources may be needed to curb the rising burden in specific populations.

As an important environmental pollutant, lead exposure can result in idiopathic developmental intellectual disability (IDII). However, the latest spatiotemporal patterns across the world are unclear. Therefore, in this study, the global burden of lead exposure-related IDII was assessed using the Global Burden of Disease (GBD) study (2019). The data were downloaded from the Institute for Health Metrics and Evaluation (IHME), and the estimated annual percentage change (EAPC) was calculated to assess the changing trend of the age-standardized disability-adjusted life-years (DALYs) rates (ASDR) of global IDII attributed to lead exposure. In 2019, the number of global DALYs of IDII attributed to lead exposure was 2.72 million, the corresponding ASDR was 35.70 per 100,000. The ASDR was highest in children and adolescents, and low- and middle-income countries. From 1990 to 2019, the global number of DALYs of IDII attributable to lead exposure increased by 7.89%, while the ASDR of IDII decreased by 19.19% [EAPC = -0.78, 95% confidence interval (CI): (-0.90, -0.66)]. The downward trends were seen in most GBD regions and countries, especially in high-income countries, but 11 countries presented an upward trend. Therefore, it is important to continue to improve primary mental healthcare globally, especially in low- and middle-income countries. Meanwhile, the implementation of effective strategies to reduce lead exposure should be continually strengthened.

Understanding epidemiology trends and patterns of pancreatic cancer in China from 1990 to 2019 and predicting the burden to 2030 will provide foundations for future policies development.We collected incidence, mortality, and disability-adjusted life-years (DALYs) data of pancreatic cancer in China from 1990 to 2019 based on the Global Burden of Disease Study 2019. We calculated the estimated annual percentage change (EAPC) to depict the trends of pancreatic cancer burden and predicted the incidence and mortality in the next decade by using a Bayesian age-period-cohort analysis.The number of incident cases sharply increased from 26.77 thousand in 1990 to 114.96 thousand in 2019, the age-standardized incidence rate (ASIR) nearly doubled from 3.17 per 100,000 in 1990 to 5.78 per 100,000 in 2019, with an EAPC of 2.32 (95% confidence interval [CI]: 2.12, 2.51). The mortality and DALYs presented a similar pattern with incidence. The dominant risk factor for pancreatic cancer was smoking, but the contribution of high body-mass index increased from 1990 to 2019. We projected that the incident cases and deaths of pancreatic cancer would increase to 218.79 thousand and 222.97 thousand, respectively, in 2030 with around 2 times growth.During the past three decades, the incidence, mortality and DALYs of pancreatic cancer gradually increased in China, and the absolute number and rate of pancreatic cancer burden would continue to rise over the next decade. Comprehensive policies and strategies need to be implemented to reduce the incidence and mortality.

Background Poor oral health may be a significant risk factor for gastric cancer (GC), however, previous results are not consistent. Here, we investigated the effect of oral health on GC and effect modification by other factors. Methods We conducted a population-based case-control study in Taixing, China. Participants aged between 40 and 85 years and who had lived in Taixing for at least 5 years were included. The GC cases were confirmed by endoscopy and pathological diagnosis, and the controls were randomly selected using the frequency-matching method. Unconditional logistic regression models were used to derive odds ratios (ORs) and 95% confidence intervals (CIs) of oral health for GC risk after adjusting for confounders and risk factors. Results Overall, 901 GC cases and 1972 controls were included. Tooth loss was not significantly associated with an increased risk of GC (yes vs. no, OR = 1.08, 95% CI 0.88-1.33). Compared with toothbrushing at least twice per day, toothbrushing once per day or less was associated with an increased risk of GC (OR = 2.39, 95% CI 1.94-2.94), and was more pronounced in esophagogastric junction cancer and intestinal-type GC. There was no significant interaction between the indicators of oral health and age, sex, tobacco smoking, alcohol drinking, and Helicobacter pylori seropositivity. Conclusion Poor oral hygiene behavior is associated with an increased risk of GC, and this positive association is consistent across all GC subgroups classified by anatomy and histology. Further studies are needed to explore the possible mechanisms behind this association. This article is protected by copyright. All rights reserved.

The relationship between risk of esophageal squamous cell carcinoma (ESCC) and adult height, changes in individual body mass index (BMI) and body shape is not established. We performed a large population‐based case‐control study, which enrolled a total of 1414 ESCC cases and 1989 controls in a high‐incidence area in China. Using face‐to‐face interview with a structured questionnaire, information on participants' heights, weights, and perceived body shapes at 20 years of age was collected. Additionally, data on weight and perceived body shape among the same participants 10 years prior to ascertainment were collected using the same method. Odd ratios (ORs) of ESCC risk in relation to BMI and body shape were estimated using unconditional logistic regression models. The adjusted results indicated that ESCC risk in adults rapidly rose as height increased, plateauing at 170 cm among men and 157 cm among women. Among participants who were underweight, normal weight, or thinner than body shape 4, body weight loss was associated with increased risk of ESCC, and body weight gain was associated with decreased incidence of ESCC (ORs ranging from 0.40 to 0.76). Notably, however, changes in body weight did not significantly affect ESCC risk among participants who were overweight, obese, or larger than body shape 3. Maintaining a fit body shape and a reasonable BMI is advisable and of vital importance to reduce the risk of ESCC, especially in high‐risk areas.

The future trend of water and sediment variation is closely related to the governance of the Yellow River. The increasingly frequent occurrence of extreme rainfall events has rendered the future water and sediment situation of the Yellow River uncertain. Understanding the characteristics of flood and sediment yield of the river basin under extreme rainfall conditions at different times is a prerequisite and foundation for accurate prediction of water and sediment situation in the Yellow River in the future period. We here used the July 26 extraordinary rainstorm event in 2017 in the Wuding River as a starting point for revealing the law of flood and sediment yields changes under extreme rainfall conditions around the year 2000. The results indicated that, during the period from 1960 to 2016, the average proportion of extreme rainfall depth in the middle Yellow River region over the total precipitation depth increased by 5.1%. Areas where extreme rainfall events frequently occur showed a trend of developing from localized regions in the Toudaoguai–Longmen reach to the majority of the middle reaches. There were obvious changes in the rainfall-flood and rainfall-sediment relations under extreme rainfall conditions. Compared with historical extreme rainfall events, the decline in flood and sediment yield in the river basin after 2000 under similar rainfall and intensity conditions was obvious. Among these results, flood decreased by 30.4–78.2%, sediment yield was decreased by 53.0–88.2% and sediment content in flood was decreased by >47.2% on average when compared with the same rainfall conditions in the previous century. Comparative watershed studies showed that, during extreme rainfall events, areas under soil and water loss management programs suffer 57.2% and 75.7% less flood runoff modulus and sediment transport modulus, respectively, than non-managed areas. This indicates that soil and water loss management is the major driving factor for changes in rainfall-flood and rainfall-sediment relations under extreme rainfall conditions. This study highlights the importance of soil and water loss management in the flood control and sediment reduction. We concluded that, with the implementation of soil and water conservation measures, the probability of large flood and sediment events will greatly decrease and the amount of sediment entering the Yellow River under extreme rainfall will further decrease in the next 30 years.

The dose-response relationship between folate and the risk of esophageal cancer (EC) is not clear. To further elucidate their relationships, we carried out a dose-response meta-analysis of folate intake, serum folate, and the risk of EC. PubMed, Embase, Web of Science, and China National Knowledge Infrastructure were searched for observational studies until September 2016. Then, we carried out a systematic review and dose-response meta-analysis using Stata 14.0 software. Subgroup analyses were further carried out according to study characteristics and adjustment confounders. A total of 23 studies with a total of 3886 patients were enrolled in this study. The pooled odds ratios for EC in the highest versus the lowest levels of folate intake and serum folate were 0.64 (0.54-0.76, P

We report a rare case of hereditary spherocytosis (HS) and hereditary persistence of fetal hemoglobin (Hb) (HPFH) complicated with a β-thalassemia (β-thal) trait and a Kruppel-like factor 1 (KLF1) gene mutation misdiagnosed as β-thal intermedia (β-TI) due to a high percentage of Hb F. The proband presented with pale skin, jaundice and splenomegaly. Analysis of the thalassemia gene indicated βcodon 17/βA (HBB: c.52A>T), while Hb analysis showed significantly increased Hb F levels. The proband was diagnosed to carry β-TI, and a blood transfusion regimen together with iron chelation treatment was recommended. Due to the difference between the phenotype and genotype, next generation sequencing (NGS) was performed and the proband was found to carry a homozygous mutation on the SPTB gene combined with a heterozygous mutation in KLF1. An eosin-5-maleimide binding test (EMA-BT) showed that the mean fluorescence intensity decreased by 47.1%. The proband was finally diagnosed with HS and HPFH complicated with a β-thal trait and the high percentage of Hb F was believed to be ascribed to the KLF1 gene mutation, which is frequent in areas where thalassemia is prevalent. For patients with a β gene mutation accompanying significantly high percentage of Hb F, the diagnosis of β-TI could be warranted, and the influence of the KLF1 gene mutation should be carefully excluded to avoid misdiagnosis of other types of hereditary hemolytic diseases.

Most state-of-the-art binary image steganography methods depend on the content of the image to determine where to embed secret messages, which is capacity-limited and indicates that their distortion measurement may be not precise enough. In this paper, we propose a kind of distortion measurement that is not only based on the discrimination effects after flipping the pixels but also depends on the visual effects of flipping corresponding pixels, which is called joint distortion measurement. Instead of selecting suitable position to embed secret messages, we then employ the syndrome-trellis code to minimize the embedding distortion and get messages embedded. And experimental results have demonstrated that the proposed distortion measurement has higher performance and the steganography scheme can achieve stronger statistical security with high capacity and image quality.

Molecular mechanisms and observational studies have found that diet-derived antioxidants are associated with digestive system cancers, whereas there is a lack of causal evidence from randomized clinical trials. In this study, we aimed to assess the causality of these associations through a Mendelian randomization (MR) study. Single nucleotide polymorphisms of diet-derived circulating antioxidants (i.e., α- and γ-tocopherol, ascorbate, retinol, β-carotene, lycopene, and urate), accessed by absolute levels and relative metabolite concentrations, were used as genetic instruments. Summary statistics for digestive system cancers were obtained from the UK Biobank and FinnGen studies. Two-sample MR analyses were performed in each of the two outcome databases, followed by a meta-analysis. The inverse-variance weighted MR was adopted as the primary analysis. Five additional MR methods (likelihood-based MR, MR-Egger, weighted median, penalized weighted median, and MR-PRESSO) and replicate MR analyses for outcomes from different sources were used as sensitivity analyses. Genetically determined antioxidants were not significantly associated with five digestive system cancers, after correcting for multiple tests. However, we found suggestive evidence that absolute ascorbate levels were negatively associated with colon cancer in UK Biobank—the odds ratio (OR) per unit increase in ascorbate was 0.774 (95% confidence interval [CI] 0.608–0.985, p = 0.037), which was consistent with the results in FinnGen, and the combined OR was 0.764 (95% CI 0.623–0.936, p = 0.010). Likewise, higher absolute retinol levels suggestively reduced the pancreatic cancer risk in FinnGen—the OR per 10% unit increase in ln-transformed retinol was 0.705 (95% CI 0.529–0.940, p = 0.017), which was consistent with the results in UK Biobank and the combined OR was 0.747 (95% CI, 0.584–0.955, p = 0.020). Sensitivity analyses verified the above suggestive evidence. Our findings suggest that higher levels of antioxidants are unlikely to be a causal protective factor for most digestive system cancers, except for the suggestive protective effects of ascorbate on colon cancer and of retinol on pancreatic cancer.

Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia (AML), which is characterized by the reciprocal t (15;17) (q24; q21) translocation, resulting in PML-RARA gene fusion. Therapy-related AML (t-AML) is a serious complication after cytotoxic and/or radiation therapy in many malignant diseases. In this report, MLL/KMT2A-MON2, with balanced chromosomal translocation t (11;12) (q23; q14), was identified as a novel fusion in a child transformed to t-AML after successful treatment of APL. This study emphasized that clinical monitoring with an integrated laboratory approach is essential for the diagnosis and treatment of t-AML.

To map the magnitudes and temporal trends of blindness and vision loss (BVL) due to common eye diseases along with its attributable risk factors at the national, regional, and global levels. The annual burden of BVL in 204 countries and territories was extracted from the Global Burden of Disease Study 2019. The estimated annual percentage change (EAPC) and causes composition change were calculated to quantify the temporal trends of BVL-related disease burden by sex, region, and eye disease. The global disability-adjusted life years (DALYs) of BVL increased from 12.44 million in 1990 to 22.56 million in 2019, with a slightly decreased rate from 3.03 to 2.78 per 1000 population (EAPC = -0.30). About 29.6% of BVL-related DALYs worldwide were caused by cataract, followed by refraction disorders (29.1%), near vision loss (21.7%), other vision loss (13.7%), glaucoma (3.3%), and age-related macular degeneration (2.5%) in 2019. The age-standardized DALYs rates due to each eye disease type in most regions were decreased, especially in countries with high burden and high-middle socio-demographic index. Moreover, the contribution of smoking and air pollution from solid fuels to BVL burden decreased, however, the age-standardized burden of BVL attributed to high body-mass index and high fasting plasma glucose elevated gradually across almost all regions. The temporal trend of BVL burden due to specific eye diseases varies remarkably by region, sex and age. Understanding the real-time patterns of BVL burden is crucial for formulating more effective and targeted prevention and healthcare strategies to decrease the BVL burden.

Background: The global disease burden of gastric cancer (GC) is still heavy. Understanding the patterns and trends of the global GC burden is important for developing precise prevention strategies. Materials and Methods: The data of GC burden were retrieved from the Global Burden of Disease Study (2019). The estimated annual percentage change (EAPC) was calculated to estimate the temporal trends of the age-standardized incidence and mortality rates (ASIR and ASMR) of global GC by age-specific groups (15-49, 50-69, and ≥70 years), sexes, socio-demographic indexes (SDIs), regions, and countries. Results: In 2019, the ASIR and ASMR of global GC increased with age in both sexes, and reached a peak in the older 70 age group. The ASIR and ASMR in males were higher than those in females. From 1990 to 2019, the global number of GC incident cases increased in both sexes in all age-specific groups; while the ASIR of GC decreased, and the most significant decrease was observed in the 50-69 age group [males: EAPC=-1.34, 95% CI: (-1.49, -1.18); females: EAPC= -2.09, 95% CI: (-2.22, -1.96)]. During the study period, downward trends in ASIR of GC were observed in both sexes in most SDI regions, GBD regions, and countries. Similar trends in ASMR of GC were also observed. Conclusion: The global GC incidence and mortality rates decreased from 1990 to 2019 in both sexes, most GBD regions, and most countries. However, the GC burden was still heavy in some GBD regions and countries in special age-specific groups. It is important to formulate and implement tertiary prevention strategies based on the GC burden of age-specific groups in different regions and countries.

BackgroundChronic myeloid leukemia (CML) is a malignant clonal proliferative disease. Once it progresses into the phase of blast crisis (CML-BP), the curative effect is poor, and the fatality rate is extremely high. Therefore, it is urgent to explore the molecular mechanisms of blast crisis and identify new therapeutic targets.MethodsThe expression levels of miR-181d, RBP2 and NF-κB p65 were assessed in 42 newly diagnosed CML-CP patients and 15 CML-BP patients. Quantitative real-time PCR, Western blots, and cell proliferation assay were used to characterize the changes induced by overexpression or inhibition of miR-181d, RBP2 or p65. Luciferase reporter assay and ChIP assay was conducted to establish functional association between miR-181d, RBP2 and p65. Inhibition of miR-181d expression and its consequences in tumor growth was demonstrated in vivo models.ResultsWe found that miR-181d was overexpressed in CML-BP, which promoted leukemia cell proliferation. Histone demethylase RBP2 was identified as a direct target of miR-181d which downregulated RBP2 expression. Moreover, RBP2 inhibited transcriptional expression of NF-κB subunit, p65 by binding to its promoter and demethylating the tri/dimethylated H3K4 region in the p65 promoter locus. In turn, p65 directly bound to miR-181d promoter and upregulated its expression. Therefore, RBP2 inhibition resulting from miR-181d overexpression led to p65 upregulation which further forwarded miR-181d expression. This miR-181d/RBP2/p65 feedback regulation caused sustained NF-κB activation, which contributed to the development of CML-BP.ConclusionsTaken together, the miR-181d/RBP2/p65 feedback regulation promoted CML-BP and miR-181d may serve as a potential therapeutic target of CML-BP.

Additional file 1: Table S1. 92 proteins from the Olink multiplex Oncology II panel. Table S2. The general information of selected participants, controls and cases based on different cancer stages. Figure S1. The protein interaction of 23 preliminarily authenticated proteins. Each node represents a protein, and the gene name is marked at the top right of the node. Table S3. Gene ontology enrichment analysis of the identified 23 proteins that were differentially expressed between early ESCC and controls, covering three categories, i.e. molecular function, cellular component, and biological process. Top 5 gene ontologies in each enrichment category were selected. Data were obtained from the online ConsensusPathDB- human interaction network database http://cpdb.molgen.mpg.de/ . Table S4. Pathway enrichment analysis of the identified 23 proteins that were differentially expressed between early ESCC and controls. Top 7 enriched pathway were selected. Data were obtained from the online ConsensusPathDB- human interaction network database http://cpdb.molgen.mpg.de/ . Figure S2. An unsupervised hierarchical clustering analysis of 23 preliminarily authenticated proteins for discriminating early esophageal squamous cell carcinoma (ESCC) from healthy controls. Figure S3. The selection feature of least absolute shrinkage and selection operator (LASSO) via tenfold cross-validation based on area under the ROC curve (AUC). Selection of the tuning parameter (λ) in the LASSO model was via tenfold cross-validation based on minimum standard error. The y-axis indicates AUC. The lower x-axis indicates the log(λ). Numbers along the upper x-axis represent the average number of predictors. Red dots indicate average AUC values for each model with a given λ, and vertical bars through the red dots show the upper and lower values of AUC. The vertical black lines define the optimal values of λ, where the model provides its best fit to the data. Figure S4. A nomogram to predict individual ESCC risk based on the identified five-protein panel.

Additional file 1: Supplementary material. The questionnaire of upper gastrointestinal disease in Taixing, China.

Additional file 3: Table S2. OR with 95%CIs and nomogram points of candidate ESCC risk factors.

Additional file 2: Table S1. The age distribution of local residents in Taixing city and the weight of controls in our data analysis.

Steganography focuses on imperceptibility of both the human eyes but also to potential analyzers. Based on the human visual system (HVS) of halftone image, most previous visual quality measurements for multi-tone images can not be adopted to design the steganographic schemes. In this paper, we propose a halftone image steganographic scheme based on the maximizing visual similarity of block units aiming at improving the statistical security but also the image visual quality. First, the halftone HVS model is discussed. The similarity of a pixel and its neighboring regions (which are called block units) is an important factor for human eyes. Then the distortion score is designed based on the visual similarity for each pixel in an image. Several visual similarity scores owned by a pixel are obtained in different block units. In general, the maximal visual similarity score means that this pixel is optimal to embed data. Finally, these visual similarity scores are combined with a weight matrix, and the distortion score that measures the embedding distortion is sent into syndrome-trellis code (STC) to minimize the distortion. Experimental results demonstrate the proposed scheme preserves the visual quality and improves the statistical security.

Background: IVS-II-5 G>C (HBB: c.315+5 G>C) is a rare β-thalassemia mutation. However, there is no clear evidence regarding the effect of this defect or co-inheritance of other β-thalassemia mutations on phenotypes. Methods: The clinical phenotypes associated with compound heterozygosity for the IVS-II-5 G>C mutation with other β-thalassemia mutations, together with the potential effect of the genetic modifiers α-thalassemia were studied in 13 patients. Analyses of red cell indices, hemoglobin component, iron status, and α-globin genes were carried out in 19 heterozygotes. Results: Next-generation sequencing of 24 undiagnosed patients with thalassemia major (TM) or thalassemia intermedia (TI) identified 13 carriers of the IVS-II-5 G>C mutation. There was a wide spectrum of phenotypic severity in compound heterozygotes and 6 (46.2%) of 13 were transfusion dependent. Analysis of 19 heterozygotes indicated that most were hematologically normal without appreciable microcytosis or hypochromia, and approximately half had normal hemoglobin A2 levels at the same time. Conclusion: Compound heterozygotes for IVS-II-5 G>C and other severe β-thalassemia mutations are phenotypically severe enough to necessitate appropriate therapy and counseling. Co-inheritance of this nucleotide substitution with other β-thalassemia mutations may account for a considerable portion of the incidence of undiagnosed patients with TI and TM in Guangxi. The IVS-II-5 G>C mutation can pose serious difficulties in screening and counseling. Keywords: β-thalassemia; IVS-II-5 G>C; genotype; phenotype

Background: Chronic myeloid leukemia (CML) is a malignant clonal proliferative disease. Once it progresses into the phase of blast crisis (CML-BP), the curative effect is poor, and the fatality rate is extremely high. Therefore, it is becoming urgent to explore the molecular mechanisms of blast crisis transition and develop new therapeutic targets.Methods: The expression levels of miR-181d, RBP2 and NF-κB p65 were assessed in 42 newly diagnosed CML-CP patients and 15 CML-BP patients. Quantitative real-time PCR, Western blots, and cell proliferation assay were used to characterize the changes induced by overexpression or inhibition of miR-181d or RBP2 or p65. Luciferase reporter assay and CHIP assay was conducted to establish functional association between miR-181d, RBP2 and p65. Inhibition of miR-181d expression and its consequences in tumor growth was demonstrated in vivo models.Results: We found that the non-coding RNA miR-181d is overexpressed in CML-BP, which promotes leukemia cell proliferation. We identified histone demethylase RBP2 as directly downregulated by miR-181d and found that RBP2 inhibited p65 expression in leukemia cells by its binding to the p65 promoter and demethylating the tri/dimethylated H3K4 region in the p65 promoter locus. Conversely, p65 directly binds to miR-181d promoter and upregulates its expression; thus, forming a positive feedback loop.Conclusions: Taken together, the miR-181d/RBP2/p65 loop promotes CML blast transformation.

Background: Hundreds of studies have found that the microbiota contributes to the development of gastric cancer in the past two decades. This study aimed to access the research trends of microbiota and gastric cancer. Materials and Methods: Publications from January 1, 2000 to December 31, 2019 were retrieved from the Web of Science Core Collection database and screened according to inclusion criteria. Different kinds of software, SPSS21.0, HistCite, VOSviewer, CiteSpace, and the online bibliometric analysis platform were used to evaluate and visualize the results. Results: A total of 196 publications were finally identified, and the annual number of publications showed an increasing trend. These publications were from 44 countries and the USA showed its dominant position in publication outputs, H-index, total citations, and international collaborations. The journal of Helicobacter was the most productive journal. Correa P and Peek RM published the most papers, and the most productive institution was Vanderbilt University. The keyword of "Helicobacter pylori" ranked first in research frontiers and appeared earlier, and the keyword of "microbiota" began to appear in the past 3 to 5 years. Conclusion: The annual number of publications would continue to grow. Besides the traditional Helicobacter pylori related researches, future research hotspots will focus on microbiota and its mechanism of action.

Background: Early diagnosis of esophageal squamous cell carcinoma (ESCC) remains a challenge due to the lack of specific blood biomarkers. We aimed to develop a serum multi-protein signature for early detection of ESCC. Methods: We selected 70 healthy controls, 30 precancerous patients, 60 stage I patients, 70 stage II patients and 70 stage III/IV ESCC patients from a completed ESCC case-control study in a high-risk area of China. Olink Multiplex Oncology II targeted proteomics panel was used to simultaneously detect the levels of 92 cancer-related proteins in serum using proximity extension assay. Findings: We found that 10 upregulated and 13 downregulated protein biomarkers in serum could distinguish the early ESCC from healthy controls and their serum levels had significant dose-response relationships with ESCC progression. Applying least absolute shrinkage and selection operator (LASSO) regression and backward elimination algorithm, ANXA1 (annexin A1), hK8 (kallikrein-8), hK14(kallikrein-14), VIM (vimentin), and RSPO3 (R-spondin-3) were kept in final model to discriminate early ESCC cases from healthy controls with an area under curve (AUC) of 0.936 (95% confidence interval: 0.899~0.973). The average accuracy rates of the five-protein classifier were 0.861 and 0.825 in training and test data by five-fold cross-validation. Interpretation: Our study suggested that a combination of ANXA1, hK8, hK14, VIM and RSPO3 serum proteins could be considered as a potential tool for screening and early diagnosis of ESCC. Our results, however, need be confirmed in external case-control studies and prospective studies. Funding Statement: This work was supported by National Natural Science Foundation of China (81973116, 91846302, 81573229 and 81502870), National Key Research and Development program of China (2017YFC0907002 and 2017YFC0907003), International S&T Cooperation Program of China (2015DFE32790), European Research Council (682663), Medical and Health Technology Development Plan of Shandong Province (2018WS331). The funding sources had no role in the study design, interpretation of results, writing the manuscript or decision to submit the manuscript for the publication. The corresponding author has full access to all the data and assumes final responsibility for the decision to submit for publication. Declaration of Interests: The authors declare no potential conflicts of interest. Ethics Approval Statement: The study protocol was approved by the Institutional Review Boards of the School of Life Sciences, Fudan University (date: February 19, 2009), Qilu Hospital, Shandong University (date: March 8, 2010), and Stockholm Ethical Vetting Board (2018/357-31). The study was carried out in accordance with the approved protocol, and all participants provided written informed consent.

For halftone image data hiding, it is difficult to achieve good visual quality and statistical security when high embedding capacity is demanded. In this paper, a secure steganographic scheme for halftone image is proposed, which aims to minimize the embedding distortion on structural similarity. Structural distortions are the ones that affect the most the perception of degradation of a halftone image. To evaluate the structural distortions caused by flipping pixels, halftone image structural similarity (HSSIM) is introduced based on a human visual filter, which is trained by Least-Mean-Square (LMS) approach. Utilizing the HSSIM, a distortion measurement is proposed to evaluate the embedding distortions on both vision and statistics. To minimize the embedding distortions, syndrome-trellis code (STC) is employed in the embedding process. The experimental results have demonstrated that the proposed steganographic scheme can achieve high statistical security with good visual quality without degrading the embedding capacity.

Cotton fabrics dyed with Reactive Black 5 (RB5) was electrochemically stripped using Ti/TiO2-RuO2-IrO2 anode in water, pyridine and phenol solution. The results showed that RB5 dye could be easily stripped from the surface of cotton fabrics through the cleavage of chromophoric group (NN) under the attack of hydroxyl radicals (OH) and active chlorines generated in situ. Efficient stripping performance could be obtained in water and pyridine solution, whilst the stripping percent was not obviously affected by pyridine concentration and layers of dyed cotton fabrics. Whereas, phenol existing in water slowed the stripping rate due to the competition between the stripping of RB5 dye and the degradation of phenol. In the case of multi-layer dyed cotton fabrics, the stripping performance of the inner layer is superior to that of the outer layer owing to that the cotton fabrics hinder the diffusion of active chlorines and OH. The FTIR analysis of stripped cotton fabrics showed that the effect of electrochemical process and the existence of pollutant in water on the stripped cotton fabrics could be negligible. Electrochemical oxidation could also successfully strip various dyes from waste cotton fabrics in the investigated stripping solutions. Therefore, electrochemical oxidation provides an environmentally friendly alternative for color stripping of dyed cotton fabrics. The removal of dye from cotton fabrics and the degradation of pollutant in water could occur simultaneously, implying that wastewater containing chloride ions may replace the fresh water as stripping solution.