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To explore the effects of propaganda and education on the prevention and control of AIDS infection, a model of AIDS transmission in MSM population is proposed and theoretically analyzed by introducing media impact factors. The basic reproduction number of AIDS transmission in MSM group without media intervention R0 = 1.5447 is obtained. Based on the comparison of the implementation of three different detection and treatment measures, it can be concluded that the promotion of condom use is more effective than other strategies, and using condoms with a fixed partner can reduce the value of R0 more quickly.

Purpose Epithelial-mesenchymal transition (EMT) of retinal pigment epithelial (RPE) cells is a key pathological event in proliferative retinal diseases such as proliferative vitreoretinopathy (PVR). This study aimed to explore a new method to reverse EMT in RPE cells to develop an improved therapy for proliferative retinal diseases. Methods In vitro, human embryonic stem cell-derived RPE cells were passaged and cultured at low density for an extended period of time to establish an EMT model. At different stages of EMT after treatment with known molecules or combinations of molecules, the morphology was examined, transepithelial electrical resistance (TER) was measured, and expression of RPE- and EMT-related genes were examined with RT-PCR, Western blotting, and immunofluorescence. In vivo, a rat model of EMT in RPE cells was established via subretinal injection of dispase. Retinal function was examined by electroretinography (ERG), and retinal morphology was examined. Results EMT of RPE cells was effectively induced by prolonged low-density culture. After EMT occurred, only the combination of the Rho-associated coiled-coil containing protein kinase (ROCK) inhibitor Y27632 and the TGF-β receptor inhibitor RepSox (RY treatment) effectively suppressed and reversed the EMT process, even in cells in an intermediate state of EMT. In dispase-treated Sprague-Dawley rats, RY treatment maintained the morphology of RPE cells and the retina and preserved retinal function. Conclusions RY treatment might promote mesenchymal-epithelial transition (MET), the inverse process of EMT, to maintain the epithelial-like morphology and function of RPE cells. This combined RY therapy could be a new strategy for treating proliferative retinal diseases, especially those involving EMT of RPE cells.

Neuromyelitis optica spectrum disorder (NMOSD) is an acute or subacute demyelinating disease that affects mainly the optic nerve and spinal cord. A major proportion of NMOSD cases have a relationship with autoimmunity to aquaporin 4 (AQP4) found on the central nervous system. NMOSD can occur repeatedly, causing symptoms such as decreased vision and weakness of limbs. The main goal of current therapy is to relieve acute symptoms and prevent recurrence of the disease. Without timely and appropriate treatment, the recurrence and disability rates are high. In the present work, we review recent advances in the diagnosis and treatment of patients with NMOSD, as well as the pathogenesis and mechanisms of AQP4-IgG-seropositive NMOSD.

Aim: This present study aims to investigate the prognostic value of FGD genes for predicting the overall survival in head and neck squamous cell carcinoma (HNSC) patients. Materials & methods: Clinical information and FGD gene expressions of 513 HNSC patients were obtained from The Cancer Genome Atlas dataset. Kaplan–Meier survival, Pearson correlation coefficient analyses and enrichment analyses were performed based on The Cancer Genome Atlas dataset, as well as FGD gene expressions analysis in normal tissues. Results: The survival analyses showed that high levels of FGD2 and FGD3 mRNA expressions, and the combination of high levels of FGD2 and FGD3 mRNAs were associated with the favorable overall survival in HNSC patients (p < 0.01). Oppositely, no significant correlations (p > 0.05) were observed between gender and race and OS. Conclusion: Our findings suggest that the expression levels of FGD2 and FGD3 mRNAs in HNSC are associated with favorable prognosis and may be regarded as potential prognostic biomarkers.

Despite the rapid development of numerous types of treatment, including radiotherapy (RT) as the main strategy, esophageal squamous cell carcinoma (ESCC) has a poor prognosis. Recent studies demonstrated that immunotherapy can improve the survival of patients with locally advanced and metastatic ESCC. Furthermore, previous studies reported that the expression of programmed death-ligand 1 is significantly associated with esophageal cancer prognosis. At present, several ongoing clinical trials have extended the use of immunotherapy from palliative and salvage treatments to neoadjuvant treatment with concurrent chemoradiation. The first- or second-line treatments were used to explore antitumor efficacy with reduced adverse events. The combination of RT and immunotherapy can exert a local therapeutic effect and improve the function of the immune system, enhancing antitumor efficacy. This review investigated the role of immunotherapy and radiotherapy in ESCC and described the potential efficacy of combining immunotherapy with radiotherapy in ESCC.

Purpose To investigate the effect of Gypenosides (Gyps) on the inflammation and fibrosis in orbital fibroblasts (OFs) in Graves ophthalmopathy (GO). Methods Bioinformatics analyses were performed to identify the enriched genes and signaling pathways related to Gyps function. For ex vivo experiments, OFs were cultured from orbital connective tissues from patients with GO. OF proliferation was estimated by Cell Counting Kit-8 assay. Effects of Gyps treatment on interleukin (IL)-1β-induced inflammation and transforming growth factor-β1 (TGF-β1)-induced fibrosis were evaluated by real-time quantitative PCR (RT-qPCR), enzyme-linked immunosorbent assay (ELISA), and Western blotting. OFs were treated with IL-1β or TGF-β1 in the absence or presence of Gyps pretreatment, and the levels of related mRNA or proteins were evaluated by RT-qPCR or ELISA. Results Eight inflammation-related target genes and nine fibrosis-related target genes were screened out. These genes were mainly enriched in pathways corresponding to inflammation and fibrosis, respectively. IL-1β-induced upregulation of inflammatory cytokines, and TGF-β-induced upregulation of fibrotic mediators in OFs were downregulated by Gyps. Moreover, Gyps reduced the activation of Toll like receptors 4/nuclear factor-κ B signaling and TGF-β1/SMAD2/SMAD4 signaling in GO OFs. Conclusions Gyps could protect GO-derived OFs against IL-1β-induced inflammation and TGF-β1-induced fibrosis. Thus Gyps might have therapeutic potential on inflammation and fibrosis in GO.

Rationale: Myiasis is a parasitic disease caused by fly larvae of the Diptera order that infest human and other vertebrate animal tissues. Orbital myiasis is a potentially destructive infestation of the orbital tissues, which may affect individuals with previous ocular diseases or disorders of consciousness. Patient concerns: A 72-year-old man presented with a complaint of repeated pain for two years after trauma to his right eyelid and aggravated symptoms with larvae wriggling out for 2 days. An orbital computed tomography scan revealed right eyeball protrusion and periocular soft tissue edema. Two days later, magnetic resonance imaging showed that the shape of the right eyeball was changed and that the normal structure of the eyeball could not be identified. Diagnoses: Due to the patient's symptoms and imaging examination results, the diagnosis of orbital myiasis was made. Interventions: The patient was treated by exenteration of the right orbit, and all necrotic tissues and larvae were removed. The defect was repaired via reconstruction with a pedicled musculocutaneous flap from the forehead region. Antibiotics and tetanus toxoid therapy were utilized to prevent potential bacterial infection. Outcomes: The patient recovered well postoperatively and was discharged uneventfully. During the 6-month follow-up period, the wound healed well. Lessons: Advanced age and untreated eye trauma are risk factors for orbital myiasis. Timely removal of larvae and elimination of infections are important measures for protecting the eyeball.

Aim To investigate the positive rate and types of cells that express Epstein-Barr virus-encoded small RNAs (EBERs) and to determine the distribution of EBER-expressing cells in idiopathic orbital inflammatory pseudotumor (IOIP) tissues. Methods We retrospectively examined 40 archived paraffin specimens from two teaching hospitals in Southern China between January 2007 and January 2015 that were pathologically determined to exhibit IOIP. Eleven concurrent paraffin specimens of thyroid-associated ophthalmopathy (TAO) composed the control group. In situ hybridization was performed to detect EBERs. Immunohistochemistry was employed to detect CD3, CD20, Vimentin, and smooth muscle actin (SMA), and the positive rate, types of positive cells, and distribution and location of EBERs were evaluated. Results The positive expression rate of EBERs was 47.5% (19/40) in the IOIP group, which was significantly higher than that in the TAO group [0 (0/11), P=0.011]. In the IOIP group, the lymphocyte infiltrative subtype, fibrotic subtype, and mixed subtype exhibited EBER-positive rates of 57.1% (12/21), 12.5% (1/8), and 54.5% (6/11), respectively, and no significant differences were found between these subtypes (P=0.085). Positive signals of EBERs were mainly present in medium-small lymphocytes between or around follicles and in the nuclei of activated immunoblasts (14/19). Conclusion The positive rate, types, and distribution of EBER-expressing cells in IOIP have been documented. These findings are conducive for a better understanding of the underlying mechanisms of Epstein-Barr virus infection in IOIP pathogenesis.

This systematic review aimed to evaluate the effectiveness and safety of intravitreal dexamethasone (DEX) implant and intravitreal anti-vascular endothelial growth factor (VEGF) treatments for macular edema (ME) secondary to retinal vein occlusion (RVO), central retinal vein occlusion (CRVO), and branch retinal vein occlusion (BRVO). The electronic databases comprehensively searched for the studies that compared DEX with anti-VEGF treatments in patients suffering from RVO-related ME. The effectiveness was estimated using best-corrected visual acuity (BCVA), central retinal thickness (CRT), and intraocular pressure (IOP). All data were analyzed by Review Manager (RevMan) 5.3. According to the meta-analysis from five randomized control trials, both DEX implant and anti-VEGF agent treatments were effective, but no significant differences in BCVA and CRT were observed between these two treatments. Novartis’ two studies indicated that anti-VEGF agents significantly reduced the CRT compared with DEX implant at 6 months [weighted mean difference: 158.53 μm, 95% confidence interval (CI): (71.09, 245.96), P = 0.0004]. Furthermore, anti-VEGF agents showed some advantages on cataract formation [risk ratio (RR): 3.43, 95% CI: (1.35, 8.71), P = 0.009] and other adverse events [RR: 1.19, 95% CI: (1.09, 1.31), P = 0.0002] without heterogeneity (P = 0.20, I2 = 35%). Anti-VEGF agents were also effective treatments for cataract formation or less adverse events for RVO-related ME. In contrast, DEX implant had higher risk for IOP elevation and lower cataract incidence than anti-VEGF agents. Hence, complementary and alternative treatments are expected.

In this study, we try to explore the effect of orbital decompression treatment on severe dysthyroid optic neuropathy. We retrospectively collected demographic and clinical characteristics of thyroid eye disease patients who performed orbital decompression. Then we analyzed the change of best-corrected visual acuity and exophthalmometry after surgery and the correlations among clinical parameters. A total of 22 cases (30 eyes) were included in the study. After orbital decompression, visual acuities improved in 16 eyes, declined in 8 eyes, and had no change in 5 eyes. Best-corrected visual acuity was significantly improved (0.1 vs 0.4, P = .039) and exophthalmometry was significantly declined (22.0 mm vs 16.5 mm, P = .001) after orbital decompression. Better postoperative best-corrected visual acuity was significantly correlated with better preoperative best-corrected visual acuity (r = 0.718, P

The aim of this study is to compare the clinical features between nonarteritic anterior ischemic optic neuropathy (NAION) and optic neuritis (ON) in Chinese patients. The clinical features of 23 cases (23 eyes) of NAION and 62 cases (80 eyes) of ON, including their general conditions, manifestations, auxiliary examinations were retrospectively compared. Simultaneous onset of bilateral eye (29.03% vs. 0%, p=0.009) and pain on movement of the eyes (23.75% vs. 0%, p=0.022) were more common in ON patients in comparison to NAION patients. Ocular pain (32.5% vs. 4.35%, p=0.007) was higher in ON patients than that in NAION patients. Optic disc edema (100% vs. 62.5%, p

Purpose: Dysthyroid optic neuropathy (DON) is the most severe condition in thyroid eye disease (TED); however, no study has been conducted to assess quality of life in these patients to date. The aim of this study was to evaluate vision-related quality of life in TED patients with DON using a Chinese version of the 25-item National Eye Institute Visual Function Questionnaire (CHI-VFQ-25). Methods: The CHI-VFQ-25 scores were compared for 23 TED patients with DON and 13 TED patients without DON. The correlations between the clinical characteristics and subscale scores on the CHI-VFQ-25 and the floor and ceiling effects of the CHI-VFQ-25 were also assessed. Results: Patients with DON scored significantly lower than patients without DON on the CHI-VFQ-25 (composite score: 54 versus 77, respectively, p = 0.001). Many subscales were significantly correlated with the severity and activity of the disease (p50.05). In patients with DON, no floor effects were found, and ceiling effects were only observed for Color vision, Peripheral vision and Social function. Role limitations and Mental health were the lowest scores in all the subscales. Conclusions: The current study showed that vision-related quality of life tended to be more severely impaired in TED patients with DON than in patients without DON. The CHI-VFQ-25 may be a promising tool to estimate the benefits of interventions in patients with DON.

Multiple sclerosis (MS) is a chronic disease that affects the central nervous system and impacts substantially on patients. MS lesions are visible in conventional magnetic resonance imaging (cMRI) and the automatic segmentation of MS lesions enables the efficient processing of images for research studies and in clinical trials. A new method for the segmentation of MS white matter lesions (WML) on cMRI is presented in this paper. Firstly the Kernel Fuzzy C-Means Clustering (KFCM) is applied to the preprocessed T1-weight (T1-w) image for extracting the white matter (WM) region. Then region growing algorithm is applied to the WM region image to make a binary mask which is then superimposed on the corresponding T2-weight (T2-w) image to yield a masked image only containing WM structures and lesions. The KFCM is then reapplied to the masked image to obtain MS lesions. The testing results show that the proposed method is able to segment WML on cMRI automatically and effectively.

Aim To determine whether gypenosides have protective effects in experimental autoimmune optic neuritis (EAON). Methods Mice were randomly divided into seven groups: control group, model group, three different density gypenosides monotherapy, methylprednisolone monotherapy, combination of gypenosides and methylprednisolone group. The control group was subcutaneously injected with oil emulsion adjuvant and all other groups were subcutaneously immunized with an emulsified mixture of myelin oligodendrocyte glycoprotein (MOG) 35-55 peptide to induce EAON. Mice in the gypenosides groups were administered injections daily with three concentrations (15 mg/kg, 30 mg/kg, 45 mg/kg) of gypenosides respectively. Mice in the methylprednisolone group and the combination treatment group were injected daily with methylprednisolone (20 mg/kg) or methylprednisolone (20 mg/kg) + gypenosides (30 mg/kg), respectively. After MOG immunization, visual evoked potential (VEP), optical coherence tomography (OCT), and histopathologic examination were performed at 14, 20, 30, and 40d post-inoculation (p.i.). All results were expressed as mean±SEM. The data were evaluated by one-way ANOVA followed by Tukey or Games-Howell test. Results Compared with the control group, p2 latency was prolonged in the model group (P=0.041). Combination treatment can alleviated the change in VEP at 20d p.i. (P=0.012). Average peripapillary retinal nerve fiber layer (RNFL) thickness was reduced in the model group (P=0.000, 30d; P=0.000, 40d) and gypenosides treatment remarkably diminished the degree of RNFL degeneration at 30d and 40d p.i (P=0.000, 30d; P=0.000, 40d). The pathomorphological results showed a decrease in demye-lination (P=0.020) and inflammatory reactions in the combination group compared with the model group (20d p.i.). Gypenosides treatment also alleviated the degree of axonal loss (40d p.i.) (P=0.003). Conclusion Treatment with gypenosides exerts protective effects on retinal nerve fibers and axons in EAON. When combined with gypenosides, methylprednisolone reduces demyelination in the acute stage of EAON.

Diabetes mellitus (DM) is a global disease, the number of patients of which is predicted to rise to about 380 million by 2025 by the World Health Organization (WHO)[1]. Diabetic retinopathy (DR) is one of the most sigificant complications in DM[1], and the first cause of irreversible blindness of adults in the world[2]. It occurs in 90% of patients after 20-30y from the diagnosis of DM[1], and about 5 million individuals have DR, which is responsible for approximately 5% of blindness worldwide[3]. There are two main stages of DR: proliferative DR (PDR) and non-PDR (NPDR) [2]. The hallmark of the presence of PDR is neovascularization, while no neovascularization means NPDR[4]. About 60% of diabetic patients suffer from PDR, which is the advanced form of DR[1]. Oxidative stress is defined as the increased generation of free radicals and impaired antioxidant defense which induces imbalance[5]. Because it activates other pathway (e.g. polyol pathway flux, and activation of diacylglyceol-protein kinase C pathway, etc.) and leads to other structural and functional changes, it plays a leading role in the progression of DM and its complications[6]. Oxidative stress can be measured by many indicative parameters, such as lipoperoxidation, protein oxidation, and changes in antioxidant defence system status[7]. Lipid peroxidation biomarkers included malondialdehyde, lipoperoxides and lipid hydroperoxides[7]. However, 8-iso-prostaglandin-F2α (8-iso-PGF2α), as one of the stable products of non-cyclooxygenase peroxidation of arachidonic acid, has proved to be the most available and reliable marker of lipid peroxidation in vivo[8]–[9], and it appears more sensitive and specific than other markers of oxidative stress[8]. Furthermore, 8-iso-PGF2α induces vasoconstriction, mitogenesis and persistent platelet activation[9]–[10], which can contribute to the progression of diabetes and/or its complications. Some previous studies showed that the concentration of 8-iso-PGF2α is associated with the level of acute and chronic glucose fluctuation[11]–[12], the level of hemoglobin A1c (HbA1c), and fasting glucose[13], which might lead to the onset and/or progression of DR. To the best of our knowledge, however, there has been no studies about the relationship between the level of plasma 8-iso-PGF2α and the onset and/or progression of DR so far.

Optic neuritis is a common disease in young adults, inducing apoptosis of retinal ganglion cells, which leads to varying degree of visual function damages, even blindness. As the standard treatment, methylprednisolone pulse therapy can only promote the recovery of visual acuity but not prevent retinal ganglion cell degeneration. It cannot help improve the ultimate visual outcome. Both inflammatory response and endogenous oxidative stress play crucial roles in the progression of optic neuritis. The combination of immunomodulatory and antioxidant is expected to improve the prognosis of the disease by preventing the apoptosis of retinal ganglion cells. Triterpenoids (oleanolic acid derived) were reported to have the dual capacity of simultaneously repressing production of pro-inflammatory mediators and exerting neuroprotective effects through induction of anti-oxidant genes in experimental optic neuritis. Gypenosides with an aglycone mainly of dammarane-type tetracyclic triterpenoids, also has the dual capacity of immune regulation and antioxidation. Both gypenosides and oleanolic acid were reported to have similar roles in hepatoprotection. Beside, gypenosides were reported to have the capacity of modulating the activation of immune cells and the expression of cytokines. In addition, gypenosides showed neuroprotective effect against oxidative injury in dopaminergic neurons and mouse model of Parkinson's disease. Accordingly, we propose that gypenosides have potential neuroprotective and immunomodulatory effects on optic neuritis through antioxidation and immune regulation. The application of gypenosides might prevent the apoptosis of retinal ganglion cells and improve the ultimate visual outcome in patients with optic neuritis.

Background: To compare clinical features in young (18–44 years) and older patients (>44 years) with optic neuritis (ON). Methods: This is a retrospective case series study. One hundred thirty-three young cases and 51 older cases diagnosed with ON were reviewed. Results: The older patients had lower proportion of disc swelling (37.3% vs . 57.1%, P=0.016), but higher proportion of brain plaques (21.6% vs . 7.5%, P=0.007) compared with the young patients. The proportion of patients suffered from hypertension or hyperglycemia was nearly 6 times higher in the older patients than in the young patients (29.4% vs . 5.3%, P Conclusions: There are some distinct differences between young patients (18–44 years) and older patients (>44 years). Physicians should pay attention to the side effects of corticosteroids in elderly patients in clinical practice, although they are generally safe.

We describe a 10-year-old Chinese girl with blurred vision in her left eye over a month and an optic nerve “mass” of her left orbit shown on computed tomography. The patient was initially misdiagnosed as having a retrobulbar tumour. However, detailed fundus examination showed a very deep excavation surrounding the disc and magnetic resonance imaging revealed excavation of the posterior wall connected to the vitreous cavity. These findings suggested a diagnosis of peripapillary staphyloma. The reasons for the misdiagnosis are discussed.

Runt-related transcription factor-3 (RUNX3), being a tumor suppressor gene in gastric cancer, plays an important role in inhibiting cellular growth by participating in the transforming growth factor-β-dependent apoptosis. The aim of this study was to determine the expression of RUNX3 in normal salivary glands and adenoid cystic carcinomas (ACCs), comparing the results with clinicopathological factors and patient survival. The quantitative reverse transcription–polymerase chain reaction (RT-PCR) analysis and Western blot analysis revealed the expression of RUNX3 both in normal salivary glands and ACCs. Nuclear and cytoplasmic immunoreactivities against RUNX3 in ductal luminal cells and acinous cells, but immunonegative in myoepithelial cells, were detected in normal salivary glands. In ACC, the RUNX3 immunostaining was shown in the cytoplasm of tumor cells; however, no nuclear location of RUNX3 was found. Lower RUNX3 expression showed significant correlation to distant metastasis and histological growth pattern (P = 0.009 and P = 0.025, respectively). On univariate analysis, low level of RUNX3 immunolabeling (P = 0.012), stage T4 (P = 0.017), lymph node involvement (P = 0.007), and distant metastasis (P

Bilateral acute optic neuritis (AON) is rare in adults in Western countries, but is relatively common in Asian populations. We aimed to document clinical features in Chinese patients with bilateral AON, and to identify factors that are predictive of visual acuity outcome. We reviewed 41 patients (23 males, 18 females; age 18-74 years) diagnosed with bilateral AON from three centers between 2003 and 2009. Demographic and clinical data were compared to a group of patients with unilateral AON. Univariate analysis and multivariate linear regression were used to identify prognostic factors. We found that the median visual acuity (expressed as the logarithm of the minimal angle of resolution [LogMAR] scores) in our patients was 1.55 at presentation and 0.72 at discharge (p

To describe the clinical profile of unilateral optic neuritis (ON) in a Chinese population, we reviewed retrospectively the records of 100 patients (66% female; age 18-74 years) diagnosed with unilateral ON between 2003 and 2009 at three hospitals in Guangxi Province, China. Ocular pain was noted in 40% and disc swelling in 48%. Periventricular plaques were found in 8% and multiple sclerosis in 6%. Visual loss varied at presentation, being mild (≥ 0.5) in 15%, moderate (0.1-0.4) in 26%, and severe (0.1) in 59%. Visual acuity improved after a mean (± standard deviation) hospitalization of 12.5 ± 5.3 days, with visual loss eing mild in 52%, moderate in 14% and severe in 34%. Our findings suggest that the characteristics and severity of initial visual loss of patients in our study are more similar to those of patients in Japan than to those of patients in the United States of America. It seems that visual recovery in our patients is relatively good.

Graves’ ophthalmopathy is an inflammatory autoimmune disease of the orbit, characterized by inflammation and proliferation of the orbital tissue caused by CD4+T cells and orbital fibroblasts. Despite recent substantial findings regarding its cellular and molecular foundations, the pathogenesis of Graves’ ophthalmopathy remains unclear. Accumulating data suggest that microRNAs play important roles in the pathophysiology of autoimmunity and proliferation. Specifically, microRNA-155 (miR-155) can promote autoimmune inflammation by enhancing inflammatory T cell development. In contrast to miR-155, microRNA-146a (miR-146a) can inhibit the immune response by suppressing T cell activation. Furthermore, miR-155 and miR-146a are involved in cell proliferation, differentiation, and many other life processes. Thus, miR-155 and miR-146a, with opposite impacts on inflammatory responses carried out by T lymphocytes, appear to have multiple targets in the pathogenesis of Graves’ ophthalmopathy. Our previous work showed that the expression of miR-146a was significantly decreased in peripheral blood mononuclear cells from Graves’ ophthalmopathy patients compared with normal subjects. Accordingly, we proposed that the expression of miR-155 increased and the expression of miR-146a decreased in the target cells (CD4+T cells and orbital fibroblasts), thus promoting ocular inflammation and proliferation in Graves’ ophthalmopathy. The proposed hypothesis warrants further investigation of the function of the differentially expressed microRNAs, which may shed new light on the pathogenesis of Graves’ ophthalmopathy and lead to new strategies for its management.

EDITOR: We read with great interest the article by Hsu and colleagues2013 describing a 28‐year‐old Chinese man with gradual bilateral visual loss treated with methylprednisolone pulse therapy. The ...

The purpose of this study was to explore the factors associated with the recurrence of adenoid cystic carcinomas (ACCs). We examined the recurrence values of clinicopathological variables and GLUT-1, p-Akt and PI3K expression in 42 patients with ACC. Of the 42 patients, 17 developed recurrence following initial surgery. The positive rates of GLUT-1, PI3K and p-Akt protein expression in ACC were 38.1, 38.1 and 50.0%, respectively. The expression of GLUT-1, p-Akt or PI3K protein in ACC was higher than that in inflammatory lesions or benign tumors. Our study demonstrated that T stage, a positive resection margin, perineural invasion, surgery without postoperative radiotherapy and the expression of GLUT-1, PI3K and p-Akt were factors predictive of recurrence by univariate analyses. In multivariate analyses, perineural invasion, a positive resection margin and p-Akt were significant predictors of recurrence. Initial surgery is very significant in the recurrence of ACC. Overexpression of GLUT-1, PI3K and p-Akt may also play a role in its development and recurrence.

Background Dengue, a mosquito-borne febrile viral disease, is found in tropical and sub-tropical regions around the world. Since the first occurrence of dengue was confirmed in Guangdong, China in 1978, dengue outbreaks have been reported sequentially in different provinces in South China transmitted by.peridomestic Ae. albopictus mosquitoes, diplaying Ae. aegypti, a fully domestic vector that transmits dengue worldwide. Rapid and uncontrolled urbanization is a characteristic change in developing countries, which impacts greatly on vector habitat, human lifestyle and transmission dynamics on dengue epidemics. In September 2010, an outbreak of dengue was detected in Dongguan, a city in Guangdong province characterized by its fast urbanization. An investigation was initiated to identify the cause, to describe the epidemical characteristics of the outbreak, and to implement control measures to stop the outbreak. This is the first report of dengue outbreak in Dongguan, even though dengue cases were documented before in this city. Methods Epidemiological data were obtained from local Center of Disease Control and prevention (CDC). Laboratory tests such as real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR), the virus cDNA sequencing, and Enzyme-Linked immunosorbent assay (ELISA) were employed to identify the virus infection and molecular phylogenetic analysis was performed with MEGA5. The febrile cases were reported every day by the fever surveillance system. Vector control measures including insecticidal fogging and elimination of habitats of Ae. albopictus were used to control the dengue outbreak. Results The epidemiological studies results showed that this dengue outbreak was initiated by an imported case from Southeast Asia. The outbreak was characterized by 31 cases reported with an attack rate of 50.63 out of a population of 100,000. Ae. albopictus was the only vector species responsible for the outbreak. The virus cDNA sequencing analysis showed that the virus responsible for the outbreak was Dengue Virus serotype-1 (DENV-1). Conclusions Several characterized points of urbanization contributed to this outbreak of dengue in Dongguan: the residents are highly concentrated; the residents' life habits helped to form the habitats of Ae. albopictus and contributed to the high Breteau Index; the self-constructed houses lacks of mosquito prevention facilities. This report has reaffirmed the importance of a surveillance system for infectious diseases control and aroused the awareness of an imported case causing the epidemic of an infectious disease in urbanized region.

Background and Aims: The subtropical and tropical regions exhibit a distinct seasonality of influenza incidence from the temperate regions, and the mechanism behind it remains unclear. Environmenta...

Background and Aims: Environmental factors have been identified as an important driving force for influenza seasonality. But the results from previous studies were neither consistent nor conclusive...

Background: Environmental factors have been associated with transmission and survival of influenza viruses but no studies have ever explored the role of environmental factors on severity of influenza infection.Methods: We applied a Poisson regression model to the mortality data of two Chinese metropolitan cities located within the subtropical zone, to calculate the influenza associated excess mortality risks during the periods with different levels of temperature and humidity.Results: The results showed that high absolute humidity (measured by vapor pressure) was significantly (p < 0.05) associated with increased risks of all-cause and cardiorespiratory deaths, but not with increased risks of pneumonia and influenza deaths. The association between absolute humidity and mortality risks was found consistent among the two cities. An increasing pattern of influenza associated mortality risks was also found across the strata of low to high relative humidity, but the results were less consistent for temperature.Conclusions: These findings highlight the need for people with chronic cardiovascular and respiratory diseases to take extra caution against influenza during hot and humid days in the subtropics and tropics. © 2011 Yang et al; licensee BioMed Central Ltd., published_or_final_version

We read with great interest the review article by Dr. Woung and associates.1 They reviewed the recent important studies on optic neuritis in Asia, and compared them with those in Western countries. Their article included the studies addressed in Taiwan, Japan, India, and Singapore. However, several important studies in mainland China had not been included. We would like to review them in this letter. Almost all the studies in Asia that were published in the English language investigated unilateral and bilateral acute optic neuritis (AON) simultaneously. In the Optic Neuritis Treatment Trial (ONTT), however, the investigators only recruited the patients with unilateral AON.2 According to the literature, the proportion of bilateral AON in Asia is 25–33%.3 It is unsuitable to mix bilateral and unilateral AON, and to compare them with ONTT due to the significantly different features of bilateral and unilateral AON. In mainland China, Dr. Du described unilateral and bilateral AON separately,3,4 and found that bilateral AON has some clinical differences from unilateral AON, including a higher prevalence of male cases and disc swelling, and more severe initial visual loss, but quicker visual recovery.3 In our experiences, considerable Chinese patients with AON have a very poor visual prognosis.4,5 Dr. Lai and associates studied this subgroup of Chinese patients, and found that these patients have a high positive rate of anti-aquaporin-4 antibody (neuromyelitis optica immunoglobulin G),6,7 which is a highly sensitive and specific antibody in patients with neuromyelitis optica. For this reason, Dr. Lai’s studies had partly demonstrated the hypotheses proposed by Dr. Du, that a proportion of Chinese patients with AON might develop neuromyelitis optica during long-term follow-up, or might be a forme fruste of neuromyelitis optica.8 Although most knowledge of clinical aspects of optic neuritis is from the Optic Neuritis Treatment Trial, some cases in the Optic Neuritis Treatment Trial also had poor visual recovery, and the reason remains unclear, which is similar to the situation clinicians in China have to face almost every day. We hope our colleagues in the world keep an eye on optic neuritis studies in mainland China.

Background Approximately 30–50% of idiopathic optic neuritis (ION) patients experience one or multiple episodes of recurrence. The aim of this study was to search for risk factors for ION recurrence. Methods Clinical data on hospitalized patients diagnosed with ION between January 2003 and January 2011 at the First Affiliated Hospital of Guangxi Medical University were retrospectively collected. Univariate and multivariate analyses were performed on factors that might cause ION recurrence. In total, 115 ION cases (32 recurrent and 83 non-recurrent cases) with complete data were analyzed. The length of the follow-up period ranged from 12 to 108 months (median: 42 months). Results The univariate analysis showed that the recurrence rate for unilateral ION was higher than that for bilateral ION (40% vs. 12%, p = 0.001). Underlying diseases had a significant impact on recurrence (p