Search

Introduction: The rapid spread of plasmid-mediated tet(X4) conferring high tigecycline resistance poses a significant threat to public health. Escherichia coli as the most common pathogen which carries tet(X4) has been widely disseminated in China. Thus, comprehensive investigations are required to understand the mechanism of transmission of tet(X4)-positive E. coli. Methods: In this study, a total of 775 nonduplicate samples were collected in Guangdong, China from 2019 to 2020. We screened for tet(X4)-positive E. coli by PCR amplification and species identification. Furthermore, we analyzed the phylogenetics and genetic context of tet(X4)-positive E. coli through wholegenome sequencing and long-reads sequencing. Results: Overall, 146 (18.84%) tet(X4)-positive E. coli were isolated, comprising 2 isolates from humans and 144 isolates from pigs. The majority of tet(X4)-positive E. coli exhibited resistance to multiple antibiotics but all of them were susceptible to amikacin and colistin. Phylogenetic analysis showed that ST877, ST871, and ST195 emerged as the predominant sequence types in tet(X4)-positive E. coli. Further analysis revealed various genetic environments associated with the horizontal transfer of tet(X4). Notably, a 100-kbp large fragment insertion was discovered downstream of tet(X4), containing a replicon and a 40-kbp gene cluster for the bacterial type IV secretion system. Discussion: The high colonization rate of tet(X4)-positive E. coli in animals suggests that colonization as a key factor in its dissemination to humans. Diverse genetic context may contribute to the transfer of tet(X4). Our findings underline the urgent need for controlling the spread of plasmid-mediated tigecycline resistance. [ABSTRACT FROM AUTHOR]

More attention has been paid to environmental regulation of greenhouse gas emissions in the energy industry under the transformation of industrial structure. This paper takes microdata of Chinese energy enterprises from 1998 to 2012 as a sample to build a duty-sharing model, analyzes the effect of environmental regulations on the industrial chain, and explains the "double growth" phenomenon that occurred in China, which is nothing short of miraculous in terms of the environment and economy. In the industrial chain, the environmental obligations and responsibilities will be shared between upstream and downstream enterprises due to trade linkages. This paper finds that environmental responsibilities will move forward through the industrial chain when environmental regulations are strengthened. Downstream companies will loosen "relative" control constraints, thereby expanding output but increasing demand for upstream products. Different from the existing research, we claim that, since environmental regulation has a differential effect on the industrial chain, it will promote the growth of output in the entire chain, in contrast to the theory of "cost compliance", which claims that environmental regulation will inevitably lead to the output. Based on this research, this paper puts forward some suggestions and insights on how the government implements environmental regulations. [ABSTRACT FROM AUTHOR]

Introduction: An appropriate supply of ammonium (NH4+) in addition to nitrate (NO3-) can greatly improve plant growth and promote maize productivity. However, knowledge gaps exist regarding the mechanisms by which different nitrogen (N) fertilizer sources affect the enzymatic activity of nitrogen metabolism and non-structural carbohydrates during the post-anthesis period. Methods: A field experiment across 3-year was carried out to explore the effects of four nitrateammonium ratio (NO3-/NH4+ = 1:0 (N1), 1:1 (N2), 1:3 (N3), and 3:1 (N4)) on postanthesis dry matter (DM) and N accumulation, partitioning, transportation, and grain yield in maize. Results: NO3-/NH4+ ratio with 3:1 improved the enzymatic activity of N metabolism and non-structural carbohydrate accumulation, which strongly promoted the transfer of DM and N in vegetative organs to reproductive organs and improved the pre-anthesis DM and nitrogen translocation efficiency. The enzymatic activities of nitrate reductase, nitrite reductase, glutamine synthetase, glutamine oxoglutarate aminotransferase, and nonstructural carbohydrate accumulation under N4 treatment were increased by 9.30%-32.82%, 13.19%-37.94%, 4.11%-16.00%, 11.19%-30.82%, and 14.89%-31.71% compared with the other treatments. Mixed NO3--N and NH4+-N increased the total DM accumulation at the anthesis and maturity stages, simultaneously decreasing the DM partitioning of stem, increasing total DM, DM translocation efficiency (DMtE), and contribution of pre-anthesis assimilates to the grain (CAPG) in 2015 and 2017, promoting the transfer of DM from stem to grain. Furthermore, the grain yield increased by 3.31%-9.94% (2015), 68.6%-26.30% (2016), and 8.292%-36.08% (2017) under the N4 treatment compared to the N1, N2, and N3 treatments. Conclusion: The study showed that a NO3-/NH4+ ratio of 3:1 is recommended for high-yield and sustainable maize management strategies in Northwestern China. [ABSTRACT FROM AUTHOR]

Three new species of the leafhopper genus Arboridia Zachvatkin 1946, Arboridia (Arboridia) furcata Han, sp. nov., Arboridia (Arboridia) rubrovittata Han, sp. nov., and Arboridia (Arboridia) robustipenis Han, sp. nov., are described and illustrated from fruit trees in Southwest China. A key and checklist to known species from China are provided. [ABSTRACT FROM AUTHOR]

The dikraneurine leafhopper genus Anaka is reviewed based on a comparative morphological study. Five new species, Anaka auricula sp. nov., Anaka cruciata sp. nov., Anaka curvata sp. nov., Anaka rosacea sp. nov., and Anaka spiralis sp. nov. from China are described and illustrated in detail. Additionally, a key to known Anaka species is provided along with a checklist of all species and their distributions. [ABSTRACT FROM AUTHOR]

River and reservoir bacterial communities are the most basic part of river biomes and ecosystem structure, and play an important role in river biological processes. Yet, it remains unclear how highly regulated dam reservoirs affect both soil and sediment bacterial communities. A temporal distribution pattern of bacterial communities was investigated using Illumina MiSeq sequencing in a transition section of the Three Gorges Reservoir (TGR). In total, 106,682 features belong to the bacteria kingdom, encompassing 95 phyla, 228 classes, 514 orders, 871 families, 1959 genera, and 3,053 species. With water level regulation, Shannon diversity index, and observed species differed significantly, with no significant difference in Simpson evenness. Both in the high water level period (October) and the low water level period (June), Proteobacteria, Acidobacteri, and Chloroflexi were the most abundant phyla. Whereas, based on PCA plots and Circos plot, the microbial community structure has changed significantly. LEfSe method was used to identify the classified bacterial taxa with significant abundance differences between the low water level and high water level periods. KOs (KEGG Orthology) pathway enrichment analysis were conducted to investigate functional and related metabolic pathways in groups. To some extent, it can be inferred that water level regulation affects community growth by affecting the metabolism of the microbial community. [ABSTRACT FROM AUTHOR]

Objectives: Tigecycline is recognized as one of the last-line antibiotics to treat serious bacterial infection caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). The plasmid-borne gene tet(X4) mediates high resistance to tigecycline. However, the prevalence and genetic context of tet(X4) in K. pneumoniae from various sources are not fully understood. Here, we investigated the prevalence of tet(X4)-positive K. pneumoniae and characterized the genetic context of tet(X4)- bearing plasmids in K. pneumoniae isolates. Methods: Polymerase chain reaction (PCR) was used to detect the tet(X4) gene. The transferability of the tet(X4)-carrying plasmids was tested by conjugation assays. The Galleria mellonella infection model was used to test virulence of tet(X4)-positive strains. Whole-genome sequencing and genome-wide analysis were performed to identify the antimicrobial resistance and the virulence genes, and to clarify the genetic characteristics of the tet(X4)-positive isolates. Results: Among 921 samples, we identified two tet(X4)-positive K. pneumoniae strains collected from nasal swabs of two pigs (0.22%, 2/921). The two tet(X4)- positive isolates exhibited high minimum inhibitory concentrations to tigecycline (32–256 mg/L) and tetracycline (256 mg/L). The plasmids carrying the tet(X4) gene can transfer from the donor strain K. pneumoniae to the recipient strain Escherichia coli J53. Genetic analysis of the complete sequence of two tet(X4)- carrying plasmids pTKPN_3-186k-tetX4 and pTKPN_8-216k-tetX4 disclosed that the tet(X4) gene was flanked by delta ISCR2 and IS1R, which may mediate the transmission of the tet(X4) gene. Conclusion: The prevalence of tet(X4)-positive K. pneumoniae among different sources was low. ISCR2 and IS1R may contribute to the horizontal transfer of tet(X4) gene. Effective measures should be taken to prevent the transmission of tet(X4)-producing K. pneumoniae in humans or animals. [ABSTRACT FROM AUTHOR]

This paper examines the impact of executive resume information disclosure on corporate innovation in China. Text analysis is used to measure executive resume information disclosure by constructing three indicators of completeness, readability, and detail from the form and content. The results show that executive resume information disclosure promotes corporate innovation. Moreover, executive resume information disclosure is incrementally informative on corporate innovation by attracting high‐educated employees or alleviating financing constraints. Further analyses show that the innovation motivation of executive resume information disclosure is enhanced when firms have a better information environment as represented by greater media coverage and higher audit quality. [ABSTRACT FROM AUTHOR]

In Chinese higher environmental education, undergraduate education of environmental engineering starts earliest and develops fastest. The undergraduate has been playing an important role in controlling pollution for more than twenty years. The setting and distribution of the environmental engineering major was analyzed, the conditions of the major, for example teachers, research, experiments, instruments, books, and data, are studied and talent demand and ideas for reformation and development are discussed in this article. (Contains 6 figures and 3 tables.)

Penicillium polonicum MCCC3A00951 is a fungus with influenza neuraminidase (NA) inhibition activity derived from a sediment of the mangrove forest of Zhangjiangkou in Fujian province, China. Chemical investigation on an ethyl acetate extract of its fermentation led to the isolation of a new compound, 7-hydroxy-3,10-dehydrocyclopeptine (1), and 13 known compounds (2–14). The new compound was comprehensively characterised by high-resolution electrospray ionisation-mass spectrometry, and 1D, 2D nuclear magnetic resonance (NMR) spectra. The anti-influenza NA assay was performed to evaluate the potential biological activity. Surprisingly, Cyclopenin (2) showed potent influenza NA inhibition with an IC50 value of 5.02 μM. Besides, molecular docking simulation was performed to investigate the binding model of cyclopenin (2) with influenza NA. Consequently, cyclopenin (2) could be further optimised to be a potential anti-influenza NA candidate. [ABSTRACT FROM AUTHOR]

Purpose: Given that the novel coronavirus disease (COVID-19) pandemic has disrupted operations globally, an institution's ability to repeat transarterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC) has also been affected. The aim of this study was to evaluate the impact of the COVID-19 on the intervals and outcomes of TACE in HCC patients. Materials and Methods: This retrospective study included 154 HCC patients who underwent follow-up after TACE treatment from January 2020 to March 2020 (n = 71, study group) and January 2019 to March 2019 (n = 83, control group) at two institutions in China. The endpoints included the follow-up interval and overall response rate (ORR). Multivariate logistic regression analyses were performed to identify independent risk factors for a worse ORR. The cut-off point was determined to divide follow-up durations into long- and short-intervals. Results: The median follow-up interval was 82.0 days (IQR, 61–109) in the study group, which was significantly longer than 66.0 days (IQR, 51–94) in the control group (P = 0.004). The ORR was 23.9 and 39.8% in the study and control group, respectively (P = 0.037). The cut-off value was 95 days. The grouping (OR, 2.402; 95% CI, 1.040–5.546; P = 0.040), long interval (OR, 2.573; 95% CI, 1.022–6.478; P = 0.045), and China liver cancer staging system (OR, 2.500; 95% CI, 1.797–3.480; P < 0.001) were independent predictors for the efficacy of TACE treatment. Conclusions: The COVID-19 pandemic causes a longer follow-up interval in general, which may further lead to a lower ORR in HCC patients. Those with a follow-up interval of >95 days tend to have a worse prognosis. [ABSTRACT FROM AUTHOR]

A new leafhopper genus and species, Anzihelus bistriatus Yan & Yang, gen. nov. sp. nov. (Cicadellidae, Mileewinae, Mileewini) is described from Sichuan Province, China. Habitus images and figures of the male and female genitalia are provided together with a key to the genera of Mileewini from China. [ABSTRACT FROM AUTHOR]

Bats can harbor zoonotic pathogens causing emerging infectious diseases, but their status as hosts for bacteria is limited. We aimed to investigate the distribution, prevalence and genetic diversity of Borrelia in bats and bat ticks in Hubei Province, China, which will give us a better understanding of the risk of Borrelia infection posed by bats and their ticks. During 2018–2020, 403 bats were captured from caves in Hubei Province, China, 2 bats were PCR-positive for Borrelia. Sequence analysis of rrs, flaB and glpQ genes of positive samples showed 99.55%-100% similarity to Candidatus Borrelia fainii, a novel human-pathogenic relapsing fever Borrelia species recently reported in Zambia, Africa and Eastern China, which was clustered together with relapsing fever Borrelia species traditionally reported only in the New World. Multilocus sequence typing (MLST) and pairwise genetic distances further confirmed the Borrelia species in the bats from Central China as Candidatus Borrelia fainii. No Borrelia DNA was detected in ticks collected from bats. The detection of this human-pathogenic relapsing fever Borrelia in bats suggests a wide distribution of this novel relapsing fever Borrelia species in China, which may pose a threat to public health in China. Author summary: Bats have a wide range of species and distribution, these mammals have been proposed as the natural reservoirs of pathogens for many years. Previous research focus mainly on viral agents in bats, while the infection of Borrelia spirochetes in bats is much neglected. Borrelia species causing Lyme disease and relapsing fever have been found in a wide range of ticks. Relapsing fever has long been recognized as major cause of disease and death in Africa, but as more and more cases reported in different continents, relapsing fever has become an emergent disease. There is growing evidence that bats can play a role in carrying Borrelia species. In this study, we captured different species of bats from caves during 2018–2020 in Central China, tested liver tissue for Borrelia by PCR, and applied multilocus sequence typing (MLST) to identify this bacterium. Our study found human pathogenic relapsing fever Candidatus Borrelia fainii in Central China, suggesting bat borne Borrelia spirochetes may pose a threat to public health in China. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical effects of thick-needle therapy (TNT) and acupuncture therapy (AT) on patients with Bell's palsy (BP) at the recovery stage. Methods: A total of 146 eligible participants from 3 hospitals in China were randomized into the TNT group (73 cases) and the AT group (73 cases) using a central randomization. Both groups received Western medicine thrice a day for 4 weeks. Moreover, patients in the TNT group received subcutaneous insertion of a thick needle into Shendao (GV 11) acupoint, while patients in the AT group received AT at acupoints of Cuanzhu (BL 2), Yangbai (GB 14), Dicang (ST 4), Xiaguan (ST 7), Jiache (ST 6), Yingxiang (LI 20) and Hegu (LI 4), 4 times a week, for 4 weeks. Both groups received 2 follow-up visits, which were arranged at 1 month and 3 months after treatment, respectively. The primary outcome measure was House-Brackmann Facial Nerve Grading System (HBFNGS) grade. And the clinical recovery rates of both groups were evaluated according to the HBFNGS grades after treatment. The secondary outcome measures included the facial disability index (FDI) and electroneurogram (EnoG). The adverse events were observed and recorded in both groups. Results: Three cases withdrew from the trial, 2 in the TNT group and 1 in the AT group. There was no signifificant difference in the clinical recovery rates between the TNT and AT groups after 4-week treatment [40.85% (29/71) vs. 34.72% (25/72), P>0.05]. At the 2nd follow-up visit, more patients in the TNT group showed reduced HBFNGS grades than those in the AT group (P<0.01). No significant difference was observed between the two groups in FDI score, EnoG latency and maximum amplitude ratio at all time points (all P>0.05). Conclusion: The clinical effect of TNT was equivalent to that of AT in patients with BP at recovery stage, while the post-treatment effect of TNT was superior to that of AT. (Registration No. ChiCTR-INR-16008409) [ABSTRACT FROM AUTHOR]

The Alataw Pass, near the Ebinur Lake Wetland (northwest of China) and Taldykorgan (east of Kazakhstan), is a natural habitat for wild rodents. To date, little has been done on the surveillance of Bartonella spp. and Wolbachia spp. from fleas in the region. Here we molecularly detected Bartonella spp. and Wolbachia spp. in wild rodent fleas during January and October of 2016 along the Alataw Pass-Kazakhstan border. A total of 1,706 fleas belonging to 10 species were collected from 6 rodent species. Among the 10 flea species, 4 were found to be positive for Wolbachia, and 5 flea species were positive for Bartonella. Molecular analysis indicated that i) B. rochalimae was firstly identified in Xenopsylla gerbilli minax and X. conforms conforms, ii) B. grahamii was firstly identified in X. gerbilli minax, and iii) B. elizabethae was firstly detected in Coptopsylla lamellifer ardua, Paradoxopsyllus repandus, and Nosopsyllus laeviceps laeviceps. Additionally, 3 Wolbachia endosymbionts were firstly found in X. gerbilli minax, X. conforms conforms, P. repandus, and N. laeviceps laeviceps. BLASTn analysis indicated 3 Bartonella species showed genotypic variation. Phylogenetic analysis revealed 3 Wolbachia endosymbionts were clustered into the non-Siphonaptera Wolbachia group. These findings extend our knowledge of the geographical distribution and carriers of B. rochalimae, B. grahamii, B. elizabethae, and Wolbachia spp. In the future, there is a need for China-Kazakhstan cooperation to strengthen the surveillance of flea-borne pathogens in wildlife. [ABSTRACT FROM AUTHOR]

The plateau vole, Neodon fuscus is endemic to China and is distributed mainly in Qinghai Province. It is of public health interest, as it is, a potential reservoir of Toxoplasma gondii and the intermediate host of Echinococcus multilocularis. However, genetic data of this species are lacking, and its name and taxonomy are still a controversy. In the present study, we determined the nucleotide sequence of the entire mitochondrial (mt) genome of N. fuscus and analyzed its evolutionary relationship. The mitogenome was 16328 bp in length and contained 13 protein-coding genes, 22 genes for transfer RNAs (tRNA), two ribosomal RNA genes and two major noncoding regions (OL region and D-loop region). Most genes were located on the heavy strand. All tRNA genes had typical cloverleaf structures except for tRNASer (GCU). The mt genome of N. fuscus was rich in A+T (58.45%). Maximum likelihood (ML) and Bayesian methods yielded phylogenetic trees from 33 mt genomes of Arvicolinae, in which N. fuscus formed a sister group with Neodon irene and Neodon sikimensis to the exclusion of species of Microtus and other members of the Arvicolinae. Further phylogenetic analyses (ML only) based on the cytb gene sequences also demonstrated that N. fuscus had a close relationship with N. irene. The complete mitochondrial genome was successfully assembled and annotated, providing the necessary information for the phylogenetic analyses. Although the name Lasiopodomys fuscus was used in the book 'Wilson & Reeder's Mammal Species of the World', we have confirmed here that its appropriate name is N. fuscus through an analysis of the evolutionary relationships. [ABSTRACT FROM AUTHOR]

The construction of twin cable-stayed railway bridges was undertaken near Changsha station of the Shanghai- Kunming high-speed railway (HSR) in China. Because of the inevitability of crossing the existing Wuhan- Guangzhou HSR line, the swing method was chosen so that the construction process does not interrupt the operation of the existing line. The objective of this study is to highlight the features of two cable-stayed bridges. Key structural components along with structural dimensions are discussed. Key issues associated with the structural design are analyzed, including the pylon-girder joint behavior, solar radiation temperature mode of through girder, track-bridge behavior, and the aerodynamic effects induced by high-speed trains. Finally, a brief account of the construction is given. The use of the swing method proved to be an effective solution to span existing HSR lines. [ABSTRACT FROM AUTHOR]

The complete mitochondrial genomes of Bothrogonia tongmaiana and Bothrogonia yunana are sequenced and annotated, which are 15,539 and 15,585 bp in length, respectively. Bothrogonia tongmaiana has an A + T content of 79.4% (A 55.7%; C 13.5%; G 7.1%, and T 23.7%), while B. yunana has an A + T content of 80.6% (A 37.5%; C 5.6%; G 13.8%, and T 43.1%). Every mitogenome encodes 13 proteins, 2 ribosomal RNAs, 22 tRNAs, and a control region. The phylogenetic tree was reconstructed based on them and 27 reference species, which could further confirm the status of these two species. [ABSTRACT FROM AUTHOR]

The complete mitochondrial genome of Zyginella minuta was sequenced and annotated in this study. The closed-loop mitogenome is 15,544 bp in length, has an AþT content of 76.3% (A=43.0%, T=33.3%, G=10.2%, and C=13.5%), containing 37 typical genes and a control region. All proteincoding genes (PCGs) started with ATN and stopped with TAA, except for ATP8 used TTG as initiation codon, Cytb ended with TAG, ND5, and ND4 used incomplete T as stop codon. The resultant phylogeny using 13 PCGs and 2 rRNAs showed these species in Typhlocybinae including Z. minuta formed a cluster indicating closer relationship than others. [ABSTRACT FROM AUTHOR]

Abstract: Infrastructure construction is a necessary precondition to rapid and continues growth for local economy. Many cities have conspicuous contradiction of expansion of investment and lack of capital or unsmooth financial channel. Lack of capital effects the quantity and quality of public product which provided by local government, and causes social welfare loss. How to utilize and integrate present resources is studied in this paper. Foreign regulation is referenced to explore new financing channel in China. Some countermeasures and suggestions are put forward to solve present financing problems of local government. [Copyright &y& Elsevier]

Objective To explore the association of brain-derived neurotrophic-factor (BDNF) Val66Met polymorphism with both baseline health related quality of life (HRQOL) scores and improvement in HRQOL scores in Chinese major depressive patients treated with fluoxetine. Methods Patients with major depressive disorder (MDD) took fluoxetine (20 mg/day) for 6 weeks. The HRQOL was measured with the Medical Outcomes Study Short Form-36 (SF-36) at baseline and at 6th week. Patients were genotyped for Val66Met polymorphism of BDNF gene. Results There was a significant association between social function (SF) and BDNF Val66Met polymorphism, and patients with Met/Met genotype had better SF (compared with Val/Val P = 0.004; compared with Val/Met P = 0.005). A significant association was found between improvement in SF and BDNF Val66Met polymorphism, and patients with Met/Met genotype had poorer improvement in SF (compared with Val/Val P = 0.010; compared with Val/Met P = 0.001). Similar association was found between improvement in mental component summary (MCS) and BDNF Val66Met polymorphism, and patients with Met/Met genotype had poorer improvement in MCS (compared with Val/Val P = 0.066; compared with Val/Met P = 0.006). Conclusions These results indicate that there may be association between BDNF Val66Met polymorphism and both baseline HRQOL (SF) scores and improvement in HRQOL (SF, MCS) scores in Chinese major depressive patients treated with fluoxetine. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article presents a study on the effects of methadone maintenance treatment on heroin abusers in China. The scope of the study is discussed along with the methods used for analysis. Results are described showing reduction of opioid use and improvement of health status including dependence, depression and criminal activity. Conclusion is drawn showing broad beneficial effects.

The ocean is hypothesized to have been anoxic throughout the Marinoan "Snowball Earth" event, from ca. 649 to 635 Ma, with potentially catastrophic implications for the survival of eukaryotic life. However, the precise nature of ocean redox chemistry across this critical interval, and hence the factors that governed the persistence of eukaryotes, remains unknown. We report records of pyrite iron and sulfur isotopes, combined with Fe speciation, for glaciogenic diamictites from the Nantuo Formation of South China. These data provide constraints on seawater redox state across the Marinoan glaciation, and they reveal that the redox state of the ocean fluctuated in concert with waxing and waning extents of glaciation, to include intervals of expanded oxygenation. The input of meltwater-derived oxygen provides a potential explanation for the persistence of eukaryotes through the Cryogenian "Snowball Earth" events, which ultimately paved the way for subsequent intervals of rapid biological innovation. [ABSTRACT FROM AUTHOR]

In this article, the updated status of interventional radiology (IR) in China is reported and compared vs that a decade ago based on a poll carried out in 2017 in Jiangsu Province, where the economy and overall health level are among the best of the 31 provinces in China. All 98 polled centers responded, and 56 IR departments (57%) had become independent departments separate from the radiology department; 74 (76%) had inpatient wards. In 2017, there were 538 interventional radiologists performing IR procedures in Jiangsu Province, with a total of 69,277 procedures performed, with interventional oncologic procedures accounting for the largest proportion (58%)., (Copyright © 2020 SIR. Published by Elsevier Inc. All rights reserved.)

Purpose: To establish a nomogram for predicting the occurrence of early biliary infection (EBI) after percutaneous transhepatic biliary stent (PTBS) placement in malignant biliary obstruction (MBO)., Materials and Methods: In this multicenter study, patients treated with PTBS for MBO were allocated to a training cohort or a validation cohort. The independent risk factors for EBI selected by multivariate analyses in the training cohort were used to develop a predictive nomogram. An artificial neural network was applied to assess the importance of these factors in predicting EBI. The predictive accuracy of this nomogram was determined by concordance index (c-index) and a calibration plot, both internally and externally., Results: A total of 243 patients (training cohort: n = 182; validation cohort: n = 61) were included in this study. The independent risk factors were length of obstruction (odds ratio [OR], 1.061; 95% confidence interval [CI], 1.013-1.111; P = .012), diabetes (OR, 5.070; 95% CI, 1.917-13.412; P = .001), location of obstruction (OR, 2.283; 95% CI, 1.012-5.149; P = .047), and previous surgical or endoscopic intervention (OR, 3.968; 95% CI, 1.709-9.217; P = .001), which were selected into the nomogram. The c-index values showed good predictive performance in the training and validation cohorts (0.792 and 0.802, respectively). The optimum cutoff value of risk was 0.25., Conclusions: The nomogram can facilitate the early and accurate prediction of EBI in patients with MBO who underwent PTBS. Patients with high risk (> 0.25) should be administered more effective prophylactic antibiotics and undergo closer monitoring., (Copyright © 2019 SIR. Published by Elsevier Inc. All rights reserved.)

Purpose: To construct the albumin-bilirubin (ALBI) grade and the Child-Turcotte-Pugh (CTP) score based on nomograms, as well as to develop an artificial neural network (ANN) to compare the prognostic performance of the 2 scores for hepatocellular carcinoma (HCC) that has undergone transarterial chemoembolization., Materials and Methods: This multicentric retrospective study included patients with HCC who underwent transarterial chemoembolization monotherapy as an initial treatment at 4 institutions between January 2008 and December 2016. In the training cohort, significant risk factors associated with overall survival (OS) were identified by univariate and multivariate analyses. The prognostic nomograms and ANN were established and then validated in 2 validation cohorts., Results: A total of 838 patients (548, 115, and 175 in the training cohort and validation cohorts 1 and 2, respectively) were included. The median OS was 10.4, 15.7, and 9.2 months in the training cohort and validation cohorts 1 and 2, respectively. In the training cohort, both ALBI grade and CTP score were identified as significant risk factors. The ALBI grade and CTP score based on nomograms were established separately and showed similar prognostic performance when assessed externally in validation cohorts (C-index in validation cohort 1: 0.823 vs 0.802, P = .417; in validation cohort 2: 0.716 vs 0.729, P = .793). ANN showed that ALBI grade had higher importance on survival prediction than CTP score., Conclusions: ALBI grade performs at least no worse than CTP score regarding survival prediction for HCC receiving transarterial chemoembolization. Considering the easy application, ALBI grade has the potential to be regarded as an alternative to CTP score., (Copyright © 2019. Published by Elsevier Inc.)

Background: This study aimed to elucidate the relationship between body mass index (BMI) and the presence of arterial stiffness in rural-dwelling Chinese adults with primary hypertension., Methods: Primary hypertension patients (n = 19,375) receiving an average of 4.5 years of antihypertension therapy were selected from the Chinese Stroke Primary Prevention Trial (mean age: 64.7 ± 7.4 years, male: 37.8%). Anthropometric, demographic, hemodynamic, and biochemical data were obtained. Arterial stiffness was assessed using brachial-ankle pulse wave velocity (baPWV)., Results: BMI was inversely associated with baPWV after adjusting for gender, age, smoking, alcohol consumption, center, pulse, SBP, DBP, FBG, TC, TG, HDL-C, BUN, Scr, UA, HCY, antidiabetes treatment, lipid-lowing treatment, and antihypertensive treatment (β (SE): -10.72 (0.69), P < 0.0001). Quintile1 (Q1) was used as a reference; Q2, Q3, Q4, and Q5 groups were all inversely associated with baPWV. The β increased with increasing BMI, β (SE) was -20.29 (6.74), -30.66 (7.01), -51.82 (7.27), and -103.1 (7.62), respectively, for Q2 - Q5, P < 0.05. BMI remained inversely correlated with baPWV across differences in gender, center, blood pressure, lipid levels, and the presence or absence of diabetes subgroups., Conclusion: Increased BMI is a positive factor against the development of arterial stiffness in Chinese rural-dwelling adults with primary hypertension undergoing antihypertension treatments, after adjusting for confounding factors.

Purpose: To develop a modified assessment for retreatment with transarterial chemoembolization (mART) score that may be more suitable for Chinese patients with hepatocellular carcinoma (HCC)., Materials and Methods: Chinese patients with HCC who were treated with transarterial chemoembolization in four hospitals were included. A univariate analysis and a multivariate forward Cox regression analysis were used to identify significant prognostic factors of overall survival (OS). A point scoring model was subsequently developed from the training cohort, and the validation process was performed in the validation cohort., Results: The study included 259 patients (124 patients in the training cohort and 135 patients in the validation cohort). Increase in Child-Pugh scores relative to the baseline (P < .001), Barcelona Clinic Liver Cancer (BCLC) stage B before first transarterial chemoembolization (P = .001), and absence of radiologic tumor response (P < .001) were identified as negative prognostic factors for OS and were used to create the mART scores. BCLC staging was substituted for aspartate aminotransferase increase in the mART scores. The mART scores differentiated two groups with distinct prognosis by a cutoff score of 2.5 points (22.9 mo [95% confidence interval (CI), 17.4-28.4] vs 8.9 mo [95% CI, 7.5-10.3] in median survival; P < .001). In the validation cohort, the C index in assessment for retreatment with transarterial chemoembolization (ART) criteria was 0.64, whereas it was 0.82 in mART criteria., Conclusions: In Chinese patients with HCC, mART score of > 2.5 before second transarterial chemoembolization was associated with poor prognosis. The mART score was probably better validated compared with the ART score., (Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.)

The association between elevated body mass index (BMI) and risk of death has been reported in many studies. However, the association between BMI and all-cause mortality for hypertensive Chinese adults remains unclear. We conducted a post-hoc analysis using data from the China Stroke Primary Prevention Trial (CSPPT). Cox regression analysis was performed to determine the significance of the association of BMI with all-cause mortality. During a mean follow-up duration of 4.5 years, 622 deaths (3.0%) occurred among the 20,694 participants aged 45-75 years. A reversed J-shaped relationship was observed between BMI and all-cause mortality. The hazard ratios (HRs) for underweight (<18.5 kg/m²), overweight (24.0-27.9 kg/m²), and obesity (≥28.0 kg/m²) were calculated relative to normal weight (18.5-23.9 kg/m²). The summary HRs were 1.56 (95% CI, 1.11-2.18) for underweight, 0.78 (95% CI 0.64-0.95) for overweight and 0.64 (95% CI, 0.48-0.85) for obesity. In sex-age-specific analyses, participants over 60 years of age had optimal BMI in the obesity classification and the results were consistent in both males and females. Relative to normal weight, underweight was associated with significantly higher mortality. Excessive weight was not associated with increased risk of mortality. Chinese hypertensive adults had the lowest mortality in grade 1 obesity.

Objective: To explore the association of brain-derived neurotrophic-factor (BDNF) Val66Met polymorphism with both baseline health related quality of life (HRQOL) scores and improvement in HRQOL scores in Chinese major depressive patients treated with fluoxetine., Methods: Patients with major depressive disorder (MDD) took fluoxetine (20 mg/day) for 6 weeks. The HRQOL was measured with the Medical Outcomes Study Short Form-36 (SF-36) at baseline and at 6th week. Patients were genotyped for Val66Met polymorphism of BDNF gene., Results: There was a significant association between social function (SF) and BDNF Val66Met polymorphism, and patients with Met/Met genotype had better SF (compared with Val/Val P = 0.004; compared with Val/Met P = 0.005). A significant association was found between improvement in SF and BDNF Val66Met polymorphism, and patients with Met/Met genotype had poorer improvement in SF (compared with Val/Val P = 0.010; compared with Val/Met P = 0.001). Similar association was found between improvement in mental component summary (MCS) and BDNF Val66Met polymorphism, and patients with Met/Met genotype had poorer improvement in MCS (compared with Val/Val P = 0.066; compared with Val/Met P = 0.006)., Conclusions: These results indicate that there may be association between BDNF Val66Met polymorphism and both baseline HRQOL (SF) scores and improvement in HRQOL (SF, MCS) scores in Chinese major depressive patients treated with fluoxetine., (Copyright 2010 John Wiley & Sons, Ltd.)

Purpose: The study was to reflect and forecast the evolutive tendency and influence factors of secondary failure of sulphonylurea (SFS) changing with time by using a Markov (MKV) model in the elderly diabetic population in Shanghai., Methods: A total of 549 patients with elderly diabetes mellitus (DM) were enrolled and grouped in the study. A door-to-door retrospective epidemiological survey was used to collect data. The MKV model was used to assess the process and influence factors of SFS and the MKV process decision support system was adopted to calculate state probability of the MKV process., Results: The rate of SFS in the group of all cases, FPG < or = 10 mmol . L(-1) before treatment and FPG > 10 mmol . L(-1) before treatment, taking single type of sulphonylurea (SU) and taking two types of SU and over respectively was 9.11%, 3.55%, 11.03%, 8.54% and 11.21%. The years of changing into the state of secondary failure in half patients was 5 years, 11-12 years, 4 years, 5 years, 4 years, respectively in the following groups: all cases, FPG < or = 10 mmol . L(-1) before treatment and FPG > 10 mmol . L(-1) before treatment, taking single type of SU and taking two types of SU and over., Conclusions: A MKV model could predict the long-term evolutive process of SFS by a short-term observation; the speed of SFS was related to the degree of DM patients' condition, patients with higher glucose levels prior to treatment would develop SFS faster; but we cannot postpone the development of secondary failure by exchanging SU types.

Purpose: The study was to assess the quality of life (QOL) of the elderly diabetes mellitus (DM) in Shanghai community and to screen the possible risk factors., Methods: A total of 951 patients with elderly DM and 1007 elderly subjects with normal glucose tolerance from the same community as control group were enrolled in the study. A door-to-door retrospectively epidemiological survey was used to collect data of QOL, demographic, and diabetic information. The SF-36 instrument (Chinese edition) was used to assess QOL. Multiple stepwise linear regression analysis was also used to identify possible risk factors of QOL in elder DM., Results: In subjects with elderly DM, the general assessment of perceived health was worse, compared with the normal elderly people; the mean score of multi-item dimensions assessment had been decreased, the lowest and highest scores of which on SF-36, respectively, were general health and body pain (ranged from 42.08 to 77.00). Based on the multiple stepwise regression analysis, 23 risk factors entered 9 multiple regressive models (9 dependent variables of which stand for the scores of 8 dimensions and the total score on SF-36) with different amount ultimately. Within the 13 risk factors that affect QOL of the elderly diabetic patients, the negative correlated factors were gender, age, payment ability of medical treatment, tumor, level of fasting plasma glucose (FPG), medicines purchasing channels, diabetic microvascular complications, diabetic macrovascular complications, acute complications, while the positive correlated factors were occupation, income, exercises, knowledge of DM. The multiple correlation coefficient square (R2) represented the above 13 risk factors had a totally 30.5% impact on the entire QOL., Conclusions: QOL of elderly DM population had significantly been decreased; QOL of the elderly patients in Shanghai community had many risk factors, which on one hand stated the complexity of elderly DM, and on the other hand gave us many useful and practical methods to improve QOL of elderly DM., (Copyright 2005 John Wiley & Sons, Ltd.)