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Background We have limited information about neuroendocrine carcinoma (NEC) of the gallbladder. The purpose of this paper is to compare clinical and pathological features between different age groups and prognostic factors for gallbladder NEC and how it differs from adenocarcinoma (ADC) of the gallbladder. Patients and methods This study included 28 gallbladder NEC patients and 137 ADC patients whose clinical characteristics and pathological findings were retrospectively collected. Propensity score matching and Cox regression analysis were used for the analysis of prognostic factors. Results We divided NEC patients into two groups based on the age more than or less than 60 years. Most of the NEC patients less than 60 years old complained of abdominal pain or discomfort (p = 0.038), and more younger patients accepted adjuvant therapy (p = 0.020) than older patients did. CD56 was positive in all patients more than 60 years old, which is significantly higher than that of younger patients (p = 0.039). The mean age was similar between NEC and ADC patients. After eliminating confounding factors between NEC and ADC patients, the overall survival rates were still lower in NEC patients. Univariate analysis extracted six possible risk factors. Multivariate analysis indicated that surgery type, tumor size, and existence of gallstones were independent prognostic factors. Conclusion The overall survival of gallbladder NEC is not associated with age. In this study, surgical method and tumor size were found to be independent risk factors for NECs. In addition, NEC patients have a worse prognosis than ADC patients with similar clinical and pathological features.

Indium phosphide/zinc sulfate (InP/ZnS) quantum dots (QDs) are presumed to be less hazardous than those that contain cadmium. However, the toxicological profile has not been established. The present study investigated the acute toxicity of InP/ZnS QDs with different surface modifications (COOH, NH2, and OH) in mice after pulmonary aerosol inhalation. InP/ZnS QDs were able to pass through the blood-gas barrier and enter the circulation, and subsequently accumulated in major organs. No obvious changes were observed in the body weight or major organ coefficients. Red blood cell counts and platelet-related indicators were in the normal range, but the proportion of white blood cells was altered. The InP/ZnS QDs caused varying degrees of changes in some serum markers, but no histopathological abnormalities related to InP/ZnS QDs treatment was observed in major organs except that hyperemia in alveolar septa was found in lung sections. These results suggested that the effects of respiratory exposure to InP/ZnS QDs on the lungs need to be fully considered in future biomedical application although the overall toxicity of quantum dots is relatively low. Published version

Introduction The optimal treatment of choledocholithiasis combined with cholecystolithiasis remains controversial. Common surgical methods vary among endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC), laparoscopic transcystic common bile duct exploration (LTCBDE), laparoscopic transductal common bile duct exploration (LCBDE) with or without T-tube drainage. The purpose of this study is to evaluate the safety and effectiveness of surgical methods and to determine the appropriate procedure for patients with cholecystolithiasis combined with choledocholithiasis. Methods From January 2013 to January 2019, a total of 1555 consecutive patients diagnosed with cholecystolithiasis combined with choledocholithiasis who underwent surgical treatment in Tongji Hospital were retrospectively analyzed. Total 521 patients with intrahepatic bile duct stones underwent LC + LCBDE + T-Tube were excluded from the analysis. At last, 1034 patients who met the inclusion criteria were divided into three groups according to their surgical methods: preoperative ERCP + subsequent LC (ERCP + LC group, n = 275), LC + LCBDE + intraoperative endoscopic nasobiliary drainage (ENBD) + primary duct closure (Tri-scope group, n = 479) and LC + laparoscopic transcystic CBD exploration (LTCBDE group, n = 280). Clinical records, operative findings and postoperative follow-up were collected and analyzed. Results There was no mortality in three groups. Common bile duct (CBD) stone clearance rate was 97.5% in ERCP + LC group, 98.7% in Tri-scope group, and 99.3% in LTCBDE group. There were no difference in terms of demographic characteristics, biochemistry findings and presentations, but the Tri-scope group had the biggest diameter and amount of stones and diameter of CBD, the LTCBDE group had the least CBD stones and the biggest diameter of cystic gall duct (CGD). ERCP + LC group have the longest hospital stay (14.16 ± 3.88 days vs 6.92 ± 1.71 days vs 10.74 ± 5.30 days, P P P Conclusion All the three surgical methods are safe and effective. Tri-scope approach and LTCBDE approach have superiority to preoperative ERCP + LC. LC + LTCBDE shows priority over Tri-scope approach, but should be performed in selected patients. LC + LCBDE + T-Tube can be an alternative management if the other three procedures were failed. The surgeons should choose the most appropriate surgical procedure according to the preoperative examination results and intraoperative situation.

Cuihua Zou,1,2,* Xiaohua Huang,1,2,* Xuequn Lan,1 Xiaorui Huang,1 Yun Feng,1 Jianmin Huang,1 Lanqing Meng,1 Chongdong Jian,1 Donghua Zou,3 Jie Wang,4 Xuebin Li1,2 1Department of Neurology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, 533000, People’s Republic of China; 2Department of Neurology, Youjiang Medical University for Nationalities, Baise, Guangxi, 533000, People’s Republic of China; 3Department of Neurology, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530022, People’s Republic of China; 4Department of Nephrology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, 533000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jie Wang; Xuebin LiThe Affiliated Hospital of Youjiang Medical University for Nationalities, 18 Zhongshan er Road, Baise, Guangxi, 533000, People’s Republic of ChinaEmail yyfywj@126.com; yyfylxb@163.comPurpose: The purpose of this study was to investigate the potential pathogenic mechanisms of post-intracerebral hemorrhage depression.Methods: Profiles of gene expression in brain tissue of patients with intracerebral hemorrhage (ICH) or depression were downloaded from the Gene Expression Omnibus (GEO) database. We analyzed differentially expressed genes (DEGs) for the two diseases separately. With these DEGs, we conducted an enrichment analysis based on Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) as well as cross-talk analysis, then we identified hub bridge genes using integrated bridge landscape analysis.Results: We found 131 DEGs for interaction between ICH and depression. In the enrichment analysis, we found 55 GO terms and KEGG pathways involving interacting genes of ICH and depression, and 10 GO terms and 10 KEGG pathways most significantly related to cross-talk between ICH and depression. In the integrated bridge landscape analysis, we identified 20 hub bridge genes. In further analysis, we found that hub bridge genes HLA-A, HMOX1, and JUN related to endocytosis, cell adhesion, and phagosomes may exert their effects through the dopamine (DA) system and the serotonergic pathway post-ICH depression. HLA-A may play a role in the occurrence and development of ICH and depression through immune mediation and cell adhesion. HMOX1 and JUN may participate in the mechanism by interacting with HLA-A.Conclusion: Through bioinformatics analysis, we identified potential hub bridge genes and pathways related to post-ICH depression. Our study provides references for further research on mechanisms on the pathogenesis of post-ICH depression.Keywords: intracerebral hemorrhage, depression, differentially expressed genes, hub bridge genes

This study contributes to interdisciplinary research on the social and environmental determinants of population health, with a focus on the interaction between working hours and fine particulate matter (PM2.5) concentration. The authors estimate longitudinal models of the relationship between US state-level average life expectancy and both average working hours and PM2.5 concentration for the 2005-2014 period. Results obtained from two-way fixed effects models indicate that average life expectancy is negatively associated with both average working hours and fine particulate matter concentration. Findings also indicate clear moderating relationships: the negative association between life expectancy and working hours is amplified as PM2.5 concentration increases, and the negative relationship between life expectancy and fine particulate matter concentration is amplified when average working hours increase. The results of this study underscore the need for additional research on the multiplicative impacts of socioeconomic factors and environmental factors in the modeling of population health.

Cranberry growers in New England are increasingly pressured by negative effects associated with global climate change, some of which are familiar to this group (such as precipitation fluctuations and pest pressures), others that are rather new (such as warmer winters that threaten needed chill hours for the plants to bloom). The first study of this population of its kind, we use a survey, supplemented with observations and interviews, to assess Massachusetts cranberry grower attitudes towards climate change, and whether certain conditions of production might be associated with their attitudes. Our findings suggest that certain personal and ecological conditions are associated with greater worry of climate change effects, and that communal conditions of the cranberry grower social network provide some ways to cope with a warming climate. While the cranberry growing community has created a strong social network that has allowed it to sustain production, a warming planet will likely require significant change in order to overcome general attitudes of climate skepticism so that cranberry production may continue in the future.

Background: Largely due to methodological problems in existing studies, issues concerning causal directions and confounding factors, such as the stability effect, remain to be clarified in the relations among aggression, peer relationships, and psychological adjustment. The purpose of this longitudinal study was to examine (a) reciprocal direct and indirect effects among aggression, peer relationships, and depression based on a full cross-lagged model with the stability effect controlled, and (b) moderating effects of initial status on the growth of the variables. Method: A sample of Chinese children (N = 1,162) participated in the study. Four waves of longitudinal panel data were collected from the participants in ages 9-12 years from multiple sources including peer assessments, teacher ratings, sociometric nominations, and self-reports. Results: Aggression negatively contributed, in both direct and indirect manners, to later peer relationships, and positively contributed to depression in late childhood. Peer relationships had negative direct and indirect effects on later aggression and depression. In addition, the initial level of aggression moderated the growth pattern of peer relationships. Conclusions: Early social and behavioral problems have proximal as well as long-term cross-domain effects on individual development. Moreover, children's early behavioral characteristics may serve to facilitate the development of social competence and exacerbate the development of social problems. The study provided valuable information about how the important aspects of socioemotional functioning were associated with each other in Chinese children from a developmental perspective. Language: en

The primary purpose of this longitudinal study was to examine, in a sample of Chinese children (initialMage = 8 years,N= 1,140), contributions of aggression to the development of social competence and academic achievement. Five waves of panel data on aggression and social and school performance were collected from peer evaluations, teacher ratings, and school records in Grades 2 to 5. Structural equation modeling revealed that aggression had unique effects on later social competence and academic achievement after their stabilities were controlled, particularly in the junior grades. Aggression also had significant indirect effects on social and academic outcomes through multiple pathways. Social competence and academic achievement contributed to the development of each other, but not aggression. The results indicate cascade effects of aggression in Chinese children from a developmental perspective.

The purpose of the study was to examine the relations of authoritative parenting and corporal punishment to Chinese first and second graders' effortful control (EC), impulsivity, ego resilience, and maladjustment, as well as mediating relations. A parent and teacher reported on children's EC, impulsivity, and ego resilience; parents reported on children's internalizing symptoms and their own parenting, and teachers and peers reported on children's externalizing symptoms. Authoritative parenting and low corporal punishment predicted high EC, and EC mediated the relation between parenting and externalizing problems. In addition, impulsivity mediated the relation of corporal punishment to externalizing problems. The relation of parenting to children's ego resilience was mediated by EC and/or impulsivity, and ego resilience mediated the relations of EC and impulsivity to internalizing problems.