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Figure S1, Schematic diagrams of the esophageal wall after submucosal saline injection (SSI); Figure S2, Receiver operating characteristic curves of submucosal saline injection followed by endoscopic ultrasound and endoscopic ultrasound only for distinguishing T1a and T1b esophageal squamous cell carcinoma; Table S1, The diagnostic performance of submucosal saline injection followed by EUS (SSI+EUS) and endoscopic ultrasound (EUS) in sub-staging T1 stage esophageal squamous cell carcinoma; Table S2, The diagnostic performance of submucosal saline injection followed by EUS (SSI+EUS) and endoscopic ultrasound (EUS) in sub-staging T1 stage esophageal squamous cell carcinoma among patients without postoperative atypical hyperplasia.

The aim of this study was to evaluate the association between prenatal and neonatal period exposures and the risk of childhood and adolescent nasopharyngeal carcinoma (NPC). From January 2009 to January 2016, a total of 46 patients with childhood and adolescent NPC (i.e., less than 18 years of age) who were treated at Sun Yat-sen University Cancer Center were screened as cases, and a total of 45 cancer-free patients who were treated at Sun Yat-sen University Zhongshan Ophthalmic Center were selected as controls. The association between maternal exposures during pregnancy and obstetric variables and the risk of childhood and adolescent NPC was evaluated using logistic regression analysis. Univariate analysis revealed that compared to children and adolescents without a family history of cancer, those with a family history of cancer had a significantly higher risk of childhood and adolescent NPC [odds ratios (OR) = 3.15, 95% confidence interval (CI) = 1.02–9.75, P = 0.046], and the maternal use of folic acid and/or multivitamins during pregnancy was associated with a reduced risk of childhood and adolescent NPC in the offspring (OR = 0.07, 95% CI = 0.02–0.25, P < 0.001). After multivariate analysis, only the maternal use of folic acid and/or multivitamins during pregnancy remained statistically significant. These findings suggest that maternal consumption of folic acid and/or multivitamins during pregnancy is associated with a decreased risk of childhood and adolescent NPC in the offspring.

We identified fermitin family member 2 (FERMT2, also known as kindlin-2) as a potential target in A375 cell line by siRNA library screening. Drugs that target mutant BRAF kinase lack durable efficacy in the treatment of melanoma because of acquired resistance, thus the identification of novel therapeutic targets is needed. Immunohistochemistry was used to identify kindlin-2 expression in melanoma samples. The interaction between kindlin-2 and Rac1 or p-Rac/Cdc42 guanine nucleotide exchange factor 6 (α-Pix) was investigated. Finally, the tumor suppressive role of kindlin-2 was validated in vitro and in vivo. Analysis of clinical samples and Oncomine data showed that higher levels of kindlin-2 predicted a more advanced T stage and M stage and facilitated metastasis and recurrence. Kindlin-2 knockdown significantly inhibited melanoma growth and migration, whereas kindlin-2 overexpression had the inverse effects. Further study showed that kindlin-2 could specifically bind to p-α-Pix(S13) and Rac1 to induce a switch from the inactive Rac1-GDP conformation to the active Rac1-GTP conformation and then stimulate the downstream MAPK pathway. Moreover, we revealed that a Rac1 inhibitor suppressed melanoma growth and metastasis and the combination of the Rac1 inhibitor and vemurafenib resulted in a better therapeutic outcome than monotherapy in melanoma with high kindlin-2 expression and BRAF mutation. Our results demonstrated that kindlin-2 promoted melanoma progression, which was attributed to specific binding to p-α-Pix(S13) and Rac1 to stimulate the downstream MAPK pathway. Thus, kindlin-2 could be a potential therapeutic target for treating melanoma.

To evaluate how prevertebral space involvement (PSI) and degree of tumor extension within the space affects prognosis in nasopharyngeal carcinoma (NPC).Data of patients with newly-diagnosed nonmetastatic NPC (n = 757) were retrospectively analyzed. Patients were separated into groups according to presence or absence of PSI and degree of tumor spread. Overall survival (OS), failure-free survival (FFS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared between the groups.Prevalence of PSI, simple prevertebral muscle involvement (PMI), and behind prevertebral muscle involvement (BPMI) were 44.9% (340/757), 22.5% (170/757), and 22.5% (170/757), respectively. OS, FFS, LRFS, and DMFS for patients with and without PSI were 64% vs. 84.8%, 68% vs. 85.6%, 85.8% vs. 94.4%, and 78.5% vs. 92.8%, respectively (all P 0.001). PSI was an independent predictor of OS, FFS, LRFS, and DMFS. OS, FFS, and DMFS for patients with simple PMI and with BPMI were 72.7% vs. 54.8% (P = 0.002), 75.8% vs. 59.8% (P = 0.003), and 85.5% vs. 71.2% (P = 0.002), respectively. Degree of PSI extension was related to OS, FFS, and DMFS. OS, FFS, LRFS, and DMFS were significantly poorer in patients with PSI in T2-3 stage than in patients without PSI in T3 stage (P 0.05), but comparable to those in patients with T4 stage (P 0.05).PSI predicts poor prognosis in NPC. Survival is poorer in patients with BPMI than in those with simple PMI. NPC with PSI should be classified as T4 stage.

Objectives We aimed to reconstitute T2 and T3 stage classification in nasopharyngeal carcinoma (NPC) cases and verify its utility in clinical settings. Materials and Methods We enrolled 792 NPC patients. Cox proportional hazards model was used to compare the effect sizes (hazard ratio [HR]) of the cranial structure invasion on survival and select the structures for up‐staging or downstaging T2 and T3 NPC. The samples were reclassified and the survival curves for T2 and T3 stages were analyzed. The proposed new staging system was validated on an external sample (n = 433). Results Thirteen cranial structures were examined. American Joint Committee on Cancer (AJCC) T3 stage patients with the invasion of the base of the sphenoid (HR = 2.58, 95% CI = 1.16‐5.77) or base of the pterygoid (HR = 2.00, 95% CI = 0.84‐4.77) had significantly lower hazard ratios than T2 stage patients with the invasion of soft tissues in the bilateral parapharyngeal space (HR = 5.26, 95% CI = 2.02‐13.68) and single/bilateral carotid sheath (HR = 7.78, 95% CI = 3.06‐19.76). T3 stage with the invasion of the above‐mentioned bones was reclassified as T2, and T2 stage with the invasion of the above‐mentioned soft‐tissue structures was reclassified as T3. Survival analysis showed a significant difference between the reclassified T2 and T3 stages (P, Hazard ratio was lower for AJCC T3 with bone than AJCC T2 with soft tissue invasion ·The 5‐year OS and PFS were higher for re‐classified T2 than T3 stage NPC patients·Modified staging system for T2 and T3 NPC may result in better management.

Cervical cancer is an aggressive cutaneous malignancy, illuminating the molecular mechanisms of tumorigenesis and discovering novel therapeutic targets are urgently needed. KMT2A is a transcriptional co-activator regulating gene expression during early development and hematopoiesis, but the role of KMT2A in cervical cancer remains unknown. Here, we demonstrated that KMT2A regulated cervical cancer growth via targeting VADC1. Knockdown of KMT2A significantly suppressed cell proliferation and migration and induced apoptosis in cervical cancer cells, accompanying with activation of PARP/caspase pathway and inhibition of VADC1. Overexpression of VDAC1 reversed the KMT2A knockdown-mediated regulation of cell proliferation, migration and apoptosis. The in vivo results from a cervical cancer xenograft mouse model also validated that KMT2A knockdown suppressed tumor growth by inhibiting VDAC1, whereas KMT2A overexpression promoted cervical cancer growth. Moreover, analyses of Biewenga cervix database and clinical samples showed that both KMT2A and VDAC1 were upregulated in cervix squamous cell carcinoma compared with cervix uteri tissues, and their expression was negatively correlated with the differentiation grade of cervical cancer. Our results therefore indicated that the KMT2A/VDAC1 signaling axis may be a potential new mechanism of cervical carcinogenesis.

Purpose: To examine whether submucosal saline injection (SSI) can improve traditional endoscopic ultrasound (EUS) accuracy in distinguishing between T1a and T1b stage esophageal squamous cell carcinoma (ESCC). Experimental Design: Patients with T1N0M0 stage ESCC (n = 180) ages 18 to 85 years were enrolled between February 14, 2012 to June 4, 2018 at Sun Yat-sen University Cancer Center (Guangdong, China). They were randomly assigned (1:1) to receive either EUS examination after 3–5 mL SSI or EUS only examination. All the patients were referred to thoracic surgeons to receive endoscopic resection (ER) or esophagectomy 5 to 10 days after EUS examination. Standard EUS criteria were used to preoperatively stage the ESCC cases, and surgical pathology reports after referral were used to postoperatively stage the cases. The primary endpoint was the diagnostic accuracy of T1b staging [defined as the sum of the true positive (T1b) and true negative (T1a) cases divided by the total number of cases]. Results: Among the per-protocol population, the SSI+EUS group (n = 81) was superior to the EUS-only group (n = 85) in terms of the diagnostic accuracy for T1b staging [93.8% (95% confidence interval (CI), 88.6–99.1) vs. 65.9% (95% CI, 55.8–76.0); P < 0.001]. The positive predictive value of SSI+EUS for diagnosing T1b ESCC reached 90.9% (95% CI, 81.1–100), which was significantly superior to that of EUS only [0.576 (0.450-0.702), P = 0.001]. Conclusions: SSI significantly improves the diagnostic accuracy of EUS in distinguishing between T1a and T1b ESCC, which might help avoid unnecessary esophagectomy and diagnostic ER.

Fine particulate matter (PMA total of 298,069 participants from the UK Biobank study without lung cancer at baseline were included in this study. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were estimated using multivariable Cox proportional models for the association of lung cancer and its subtypes with PMDuring 10.4 years of follow-up, 1683 incident lung cancer cases were identified. Our analysis found that genetic variants, smoking, and PMGenetic susceptibility, smoking, and PM

Objective: The study aimed to examine how the phonological loop influences reading ability and processing in Chinese children with developmental dyslexia (DD).Methods: This study included 30 children with DD and 37 children without DD. Two types of articles (i.e., scenery prose and narrative story) and two conditions (under the conditions of articulatory-suppression and silent reading) were applied. An eye-link II High-Speed Eye Tracker was used to track a series of eye-movement parameters. The data were analyzed by the linear Mixed-Effects model.Results: Compared with children without DD, Children with DD had lower reading achievement (RA), frequency of saccades (FS) and frequency of fixations (FF), longer reading time (RT) and average fixation duration (AFD), slower reading speed (RS), shorter average saccade amplitude (ASA) and fixation distance (FD), more number of fixations (NF), and number of saccades (NS). There were significant interactions between participant group and articulatory suppression on RT and FD. We also observed interaction effects between article types and articulatory suppression on RA, AFD, ASA, and FS.Conclusion: Children DD exhibit abnormal phonological loop and eye movements while reading. The role of articulatory suppression on reading varies with the presentation of DD and the article type.

A complete characterization of genetic variation is a fundamental goal of human genome research. Long-read sequencing has improved the sensitivity of structural variant discovery. Here, we conduct the long-read sequencing-based structural variant analysis for 405 unrelated Chinese individuals, with 68 phenotypic and clinical measurements. We discover a landscape of 132,312 nonredundant structural variants, of which 45.2% are novel. The identified structural variants are of high-quality, with an estimated false discovery rate of 3.2%. The concatenated length of all the structural variants is approximately 13.2% of the human reference genome. We annotate 1,929 loss-of-function structural variants affecting the coding sequence of 1,681 genes. We discover rare deletions in HBA1/HBA2/HBB associated with anemia. Furthermore, we identify structural variants related to immunity which differentiate the northern and southern Chinese populations. Our study describes the landscape of structural variants in the Chinese population and their contribution to phenotypes and disease., Although many studies have characterized genetic variation in human populations, few have investigated structural variation and few have been in non-European populations. Here, the authors have performed long read sequencing on 405 Chinese individuals to identify structural variants and link them to phenotypes.

Background: There are some reports on association between maternal prenatal cooking oil fume (COF) exposure and preterm birth (PTB), but its mechanism remains poorly understood. Therefore, this study aims to assess whether placental weight mediates their associations.Method: We enrolled 619 pregnant women delivering PTB newborns as cases and 1701 delivering full-term appropriate for gestational age newborns as controls. They were inquired with a self-reported questionnaire about prenatal COF exposure, socio-demographics and obstetric characteristics at Women and Children's Hospitals of Shenzhen and Foshan. After controlling for the potential confounders, a series of logistic and linear regressions were conducted to assess associations among COF exposure, placental weight and PTB, and the mediation of placental weight in the association between COF exposure and PTB.Results: Maternal prenatal COF exposure was significantly associated with PTB and the frequency of prenatal COF exposure was negatively associated with placental weight. Compared with mother who never cooked, those cooking occasionally, sometimes or often increased the risk of PTB, and similarly, those cooking between half to an hour was also showed a higher risk of PTB. Typical Chinese cooking methods including stir-frying, pan-frying and deep-frying were also associated with PTB. Different oil types mainly used, including peanut oil, corn oil and animal oil were associated with PTB as well. Mediation analysis illustrated that placental weight partially mediated 13.60% (95% CI = 10.62-33.20%) of the effects on the association between the frequency of maternal prenatal COF exposure and PTB.Conclusion: Maternal cooking during pregnancy and the frequency of prenatal COF exposure might increase the risk of PTB, in which placenta might play mediation role.

Nan Shao,1,* Chuanbo Xie,2,* Yawei Shi,1 Runyi Ye,1 Jianting Long,3 Huijuan Shi,4 Zhen Shan,1 Alastair M Thompson,5 Ying Lin1 1Department of Breast Surgery, Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; 2Department of Cancer Prevention Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; 3Department of Medicinal Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; 4Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; 5Department of Breast Surgery, Division of Surgical Oncology, Dan L Duncan Comprehensive Cancer, Baylor College of Medicine, Houston, TX, USA *These authors contributed equally to this work Background: The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for breast cancer has incorporated tumor grade, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status as staging biologic factors reflecting prognosis. The purpose of this study was to compare the 7th and 8th edition of AJCC staging system for prognostic impact.Materials and methods: Primary breast cancer patients diagnosed from 2010 to 2014 were identified using the Surveillance, Epidemiology and End Results 18 registries research database. Breast cancer-specific survival (BCSS) and overall survival (OS) between stages were estimated using the Kaplan–Meier method and compared using the log-rank test. Multivariable analysis was performed using Cox proportional hazards regression analysis to identify factors independently associated with outcome. Akaike’s information criterion (AIC) was calculated to estimate how well the staging system fitted the data and the complexity of the model. Results: A total of 184,221 primary breast cancer patients were identified in the 7th AJCC staging system; 16,145 (8.8%) patients could not be categorized according to 8th AJCC prognostic staging system leaving 168,076 patients included for final analyses. The 8th AJCC performed well with the BCSS and OS concordant with stage. A total of 89,494 (53.2%) of patients were restaged to a different stage group in the 8th AJCC; stage IIIA in the 7th AJCC migrated to stage IB with a worse prognosis than IIA and IIB in the 8th AJCC. Nevertheless, the 8th AJCC had a better AIC than the 7th staging system.Conclusion: The prognostic accuracy of the 8th AJCC staging system was generally superior to the 7th AJCC, although subtle differences between the two systems should be noted in comparative studies. Keywords: breast cancer, prognosis, AJCC

SummaryA complete characterization of genetic variation is a fundamental goal of human genome research. Long-read sequencing (LRS) improves the sensitivity for structural variant (SV) discovery and facilitates a better understanding of the SV spectrum in human genomes. Here, we conduct the first LRS-based SV analysis in Chinese population. We perform whole-genome LRS for 405 unrelated Chinese, with 68 phenotypic and clinical measurements. We discover a complex landscape of 132,312 non-redundant SVs, of which 53.3% are novel. The identified SVs are of high-quality validated by the PacBio high-fidelity sequencing and PCR experiments. The total length of SVs represents approximately 13.2% of the human reference genome. We annotate 1,929 loss-of-function SVs affecting the coding sequences of 1,681 genes. We discover new associations of SVs with phenotypes and diseases, such as rare deletions in HBA1/HBA2/HBB associated with anemia and common deletions in GHR associated with body height. Furthermore, we identify SV candidates related to human immunity that differentiate sub-populations of Chinese. Our study reveals the complex landscape of human SVs in unprecedented detail and provides new insights into their roles contributing to phenotypes, diseases and evolution. The genotypic and phenotypic resource is freely available to the scientific community.

Preterm birth (PTB) has become a major public health concern as the leading cause of neonatal death, but little is understood about its etiology. Children born preterm are also at increased risk of long-term consequences such as neurodevelopmental disorders, adulthood hypertension and diabetes. Recent studies have indicated that DNA methylation may be involved in the occurrence of PTB as well as related adverse outcomes. The latest Infinium EPIC BeadChip extends the coverage of the genome and provides a better tool to help investigate the involvement of DNA methylation in these conditions.We conducted this case-control study in three Women and Children's hospitals in South China, and enrolled 32 spontaneous preterm births and 16 term births. We assessed placental DNA methylation profiling of these participants with the Infinium EPIC BeadChip. We identified PTB and gestational age (GA)-associated CpG sites with limma regression model, and appliedWe identified a total of 8 differentially methylated positions (DMPs) that were significantly associated with PTB (FDR0.1) and a total of 15 DMPs that were associated with GA (FDR0.1). In the regional analysis, one differentially methylated region in theOur findings suggested that preterm placenta have distinct DNA methylation alterations, and these alteration patterns established at birth provide insight into the long-term consequences of preterm birth.

Background Vascular endothelial growth factor (VEGF)-targeted therapy is effective in patients with ovarian cancer. Whether adipose tissue (AT) could predict the efficacy of VEGF receptor (VEGFR) inhibitors in ovarian cancer is unknown. We aimed to evaluate the ability of distinct AT depots to predict the efficacy of apatinib, a VEGFR inhibitor, in recurrent ovarian cancers included in the AEROC trial. Methods The AEROC was a single-arm phase 2 trial of apatinib and oral etoposide in patients with platinum-resistant or platinum-refractory ovarian cancer. Apatinib was administered continuously, and oral etoposide was administered every 21 days for a maximum of six cycles. This was a post hoc study based on the AEROC trial. Areas of visceral AT (VAT), subcutaneous AT (SAT), and intermuscular AT (IMAT) were measured using computed tomography scan at baseline to assess their association with the objective response rate, progression-free survival, and overall survival. Results Of the 35 treated patients, 31 patients with at least one post-baseline efficacy assessment by computed tomography scan were included in this study. After adjusting for apatinib exposure, high VAT (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.03–0.90, P = 0.037) and SAT (OR, 0.16; 95% CI, 0.03–0.87, P = 0.034) were significantly associated with a higher objective response rate. Further, decreased risks of disease progression and death were associated with high VAT (hazard ratio [HR], 0.39; 95% CI, 0.17–0.92, P = 0.031, and HR, 0.12; 95% CI, 0.04–0.40, P P = 0.027, and HR, 0.24; 95% CI, 0.08–0.67, P = 0.007, respectively), and IMAT (HR, 0.20; 95% CI, 0.06–0.74, P = 0.016, and HR, 0.13; 95% CI, 0.03–0.62, P = 0.011, respectively). Conclusions High areas of VAT, SAT, and IMAT were significantly associated with better outcomes in patients with platinum-resistant or platinum-refractory ovarian cancer who received VEGFR inhibitors. AT assessments may be valuable as patient-specific imaging biomarkers for predicting response to VEGFR inhibitors. Trial registration ClinicalTrials.gov identifier: NCT02867956.

Background We aimed to develop and validate a nomogram incorporating CA125 levels after three cycles of chemotherapy for predicting progression-free survival (PFS) in patients with ovarian cancer.Methods The nomogram was developed in a primary cohort of 491 patients with stage II-IV ovarian cancer. Performance was assessed by concordance index (C-index), calibration curve, and decision curve analysis, and compared with the International Federation of Gynecology and Obstetrics (FIGO) staging system. The predictive value of CA125 levels after three cycles of chemotherapy was evaluated. The model was subjected to bootstrap internal validation. An independent cohort of 81 patients was used for external validation.Results CA125 levels after three cycles of chemotherapy were significantly associated with PFS. Five variables, including CA125 levels were selected to develop the nomogram. The nomogram demonstrated adequate discrimination, with a bootstrap-corrected C-index of 0.708, and good calibration. External validation of the nomogram achieved excellent discrimination (C-index, 0.724) and calibration. CA125 levels after three adjuvant chemotherapy cycles showed a marginally significant increment of discrimination to the nomogram in the primary cohort (C-index, 0.708 vs 0.668; P = 0.097). Superior discriminative ability was observed in the nomogram when compared with the FIGO staging system only in the primary cohort (C-index, 0.708 vs 0.578; P < 0.001). Decision curve analysis demonstrated that our nomogram was clinically useful.Conclusion We developed and validated a nomogram incorporating CA125 levels after three chemotherapy cycles for PFS prediction in ovarian cancer. This nomogram showed well-predictive performance and easy clinical application.

Background Studies on the relationship between lifetime body mass index (BMI) trajectory and colorectal premalignant precursor lesions are limited. This study aimed to assess the relationship between prediagnostic adulthood BMI trajectory and the risk of colorectal adenomas using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial. Methods In total, 39,824 participants in the intervention arm of the prospective PLCO cohort, who have undergone at least one colonoscopy or sigmoidoscopy examination with a confirmed diagnosis of colorectal adenomas, were enrolled and divided into four groups (underweight, normal weight, overweight, and obese) according to BMI during each age period. SAS Proc Traj was used to establish the BMI trajectory model. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results Compared with normal weight, overweight or obesity significantly increased colorectal adenomas risk in each age period after 30 years. Specifically, obesity in the 50s was most closely related to colorectal adenomas risk [HR: 1.32, 95% CI: (1.22, 1.43)]. BMI gain from the age of 40 to 50 [HR: 1.25, 95% CI: (1.11, 1.42)] showed the strongest correlation with an increased incidence of colorectal adenomas, followed by that from the age of 30 to 50 [HR: 1.19, 95% CI: (1.10, 1.29)], the age of 20 to 50 [HR: 1.16, 95% CI: (1.10, 1.24)], the age of 20 to 40 [HR: 1.14, 95% CI: (1.05, 1.23)], and the age of 20 to 30 [HR: 1.13, 95% CI: (1.02, 1.26)]. Additionally, compared with those who maintained normal weight throughout adulthood, those who progressed from normal weight to obesity [HR: 1.15, 95% CI: (1.06, 1.25)], or from overweight to obesity [HR: 1.33, 95% CI: (1.11, 1.61)], had a higher risk of colorectal adenomas. Conclusions Overweight and obesity increased the risk of colorectal adenomas, and this risk increased with advancing age.

Purpose To assess the impact of tumor necrosis on treatment sensitivity and long-term survival in patients with nasopharyngeal carcinoma (NPC) treated using intensity-modulated radiation therapy (IMRT). Participants and methods In total, 757 patients with non-metastatic, histologically confirmed NPC were retrospectively examined. All patients were treated using IMRT; 93.7% patients with stage T3-T4/N1-N3 disease also received cisplatin-based chemotherapy. Results The incidence rates of tumor necrosis in primary tumor, retropharyngeal lymph nodes, neck lymph nodes, and total tumor were 2%, 17.7%, 21.5%, and 31.4%. Overall, 40.8% patients with necrosis of the total tumor achieved complete response (CR) and 54.7% patients without tumor necrosis achieved CR at the end of treatment (χ2 = 12.728, P Conclusions Tumor necrosis served as a predictor of treatment sensitivity and poor prognosis for patients with NPC. Lymph node necrosis significantly improved the prognostic value of the current N classification criteria for NPC.

Background: In Western countries, phonological processing deficit was regard as a core deficit in developmental dyslexia (DD). As Chinese is a logographic language, it’s still controversial whether and how the articulatory suppression influences reading ability and processing of Chinese children with DD. The study aimed to examine how the phonological loop influences reading ability and processing in Chinese children with DD.Methods: This study included 30 children with DD and 37 children without DD. Two types of articles (i.e., scenery prose and narrative story) and two conditions (under the conditions of articulatory-suppression and silent reading) were applied. An eye-link II High-Speed Eye Tracker was used to track a series of eye-movement parameters. The data was analyzed by the linear Mixed-Effects model. Results: Compared with children without DD, Children with DD had lower reading achievement (RA), frequency of saccades (FS) and frequency of fixations (FF), longer reading time (RT) and average fixation duration (AFD), slower reading speed (RS), shorter average saccade amplitude (ASA) and fixation distance (FD), more number of fixations (NF) and number of saccades (NS). There were significant interactions between participant group and articulatory suppression on RT and FD. We also observed interaction effects between article types and articulatory suppression on RA, AFD, ASA, and FS.Conclusion: Children DD exhibit abnormal phonological loop and eye movements while reading. The role of the articulatory suppression on reading varies with the presentation of DD and the article type.

Distant metastasis is among the main reasons for treatment failure in nasopharyngeal carcinoma (NPC) patients. To identify patients with a high risk of distant metastasis is important to guide posttreatment surveillance, appropriate time treatments, and prolonging their long-term survival. In this study, we systematically examined the associations between a series of nodal-related characteristics and distant metastasis-free survival (DMFS) by detailed MRI reading and established a nomogram for DMFS in NPC patients. T-stage, age group, Epstein-Barr virus (EBV) level, central nodal necrosis, and nodal number were identified as independent risk factors for distant metastasis and were included into the final nomogram. The calibration plot showed a high agreement between the prediction by the nomogram and actual observations. Our established nomogram achieved a high C-index in predicting distant metastasis in both of the training cohort (0.737) and the validation cohort (0.718). This nomogram incorporated several readily available nodal features from the MR images, and it might be useful for guiding clinical decision and NPC patients' posttreatment surveillance. It also provides cues for how to redefine N-stage. Additional research is needed to confirm our conclusions.

BACKGROUND Helicobacter pylori (H pylori) immunoglobulin G (IgG) seropositivity is prevalent but its relation with leukocyte telomere length (LTL), a cellular aging biomarker, is unclear. METHODS Among 3,472 participants from the National Health and Nutrition Examination Survey (NHANES) cycle 1999-2000, LTL was measured with the quantitative polymerase chain reaction. H pylori IgG was measured by enzyme-linked immunosorbent assays and defined as seropositivity with an immune status ratio score > 0.9. We used linear regression models to examine the relation of H pylori IgG seropositivity with continuous LTL and logistic regression for the relation with short LTL (

Background and Purpose The number of metastatic lymph nodes (LNs) has been demonstrated to be an important prognosticator in some head and neck cancers. This study aimed to examine its prognostic value in nasopharyngeal carcinoma (NPC). Materials and Methods Patients with newly-diagnosed, non-distant metastatic NPC from two centers were enrolled in this study. According to the radiologic criteria for involved LNs, the number of positive LNs was assessed on MRI. Univariate and multivariate models were constructed to assess the association between the number of positive LNs and clinical outcomes. Exhaustive method was used to determine the cutoff values of the number of positive LNs. Results In 1224 patients, the number of MRI-positive LNs was an independent risk factor for overall survival (OS), distant metastasis-free survival (DMFS), relapse-free survival (RFS), progression-free survival (PFS) and regional relapse-free survival (RRFS), surpassing other nodal factors. All the patients were divided into no, low (1–4 positive LNs), moderate (5–9 positive LNs) and high (>9 positive LNs) risk groups. The HRs of high-risk group exceeded the HRs of N3 classification for OS, DMFS, RFS, PFS and RRFS. On upgrading patients with more than 9 positive LNs from N2 to N3, the revised N-staging system showed a higher C-index compared to current N-staging system for predicting OS (0.747 vs. 0.741, P = 0.002), RFS (0.655 vs. 0.640, P = 0.015) and PFS (0.674 vs. 0.669, P = 0.035). Conclusions The number of MRI-positive LNs was a predominant independent prognostic factor for NPC patients’ survival. It may be incorporated into the future N-staging system to improve its accuracy in predicting outcomes.

Purpose Whether or not young patients with squamous cell carcinoma of oral cavity (OC-SCC) have a difference in prognosis remains a controversy. This study aimed to analyze the clinical characteristics and difference of survival rates between adult patients less than 40 years of age and those 40 years of age and older. Methods A retrospective analysis was conducted using the database of patients diagnosed with OC-SCC between 1990 and 2013 in the Sun Yat-sen University Cancer Center, but patients older than 85 years, younger than 18 years, or died within 6 months of diagnosis were excluded. Patients were categorized into two groups: the young group ( Results A total of 1902 OC-SCC patients were identified. The percentage of female in the young group was significantly higher than that in the older group (40.27% vs 31.03%, p p > 0.05). The young group was more likely to receive adjuvant radiotherapy and/or chemotherapy (42.48% vs 26.91%, p p p Conclusion Our findings suggested that OC-SCC in younger patients did not present at a more advanced stage. In addition, young age is an independent predictor for better survival.

Additional file 1: Table S1. Best cutoffs for the areas of VAT associated with the objective response rate. Table S1 showed the performance of the proposed cutoffs selected by the SAS %cutpoint macro. The cutoff 33 cm2 achieved the highest total score. However, an area of 55.53 cm2 was selected instead of 33 cm2 as the optimal cutoff because it was not only significantly associated with objective response rate but also associated with progression-free survival and overall survival. VAT: visceral adipose tissue; CI, confidence interval.

Additional file 4: Table S2. Best cutoffs for the areas of SAT associated with the objective response rate. Table S2 showed the performance of the proposed cutoffs selected by the SAS %cutpoint macro. Although the area of 110 cm2 achieved the highest total score, the area of 129.28 cm2 was selected as the optimal cutoff because it was significantly associated with objective response rate as well as progression-free survival and overall survival. SAT: subcutaneous adipose tissue; CI: confidence interval.

Additional file 7: Table S3. Best cutoffs for the areas of IMAT associated with the objective response rate. Table S3 showed the performance of the proposed cutoffs selected by the SAS %cutpoint macro. The cutoff 5 cm2 had the highest total score. However, an area of 3.28 cm2 was selected instead of 5 cm2 as the optimal cutoff because it was not only significantly associated with objective response rate but also associated with progression-free survival and overall survival. IMAT: intermuscular adipose tissue; CI: confidence interval.

Additional file 3: Fig. S2. Plot of cutoff selection for the area of VAT associated with overall survival. The x-axis represents the area of VAT and the y-axis shows the Wald P value. The horizontal dotted gray line indicates significance. Points above the line have a P > 0.05, and points below the line have a P < 0.05 and are suitable as cutoffs. VAT: visceral adipose tissue.

Additional file 5: Fig. S3. Plot of cutoff selection for the area of SAT associated with progression-free survival. The x-axis represents the area of SAT and the y-axis shows the Wald P value. The horizontal dotted gray line indicates significance. Points above the line have a P > 0.05, and points below the line have a P < 0.05 and are suitable as cutoffs. SAT: subcutaneous adipose tissue.

Additional file 9: Fig. S6. Plot of cutoff selection for the area of IMAT associated with overall survival. The x-axis represents the area of IMAT and the y-axis shows the Wald P value. The horizontal dotted gray line indicates significance. Points above the line have a P > 0.05, and points below the line have a P < 0.05 and are suitable for selection as cutoffs. IMAT: intermuscular adipose tissue.

Additional file 8: Fig. S5. Plot of cutoff selection for the area of IMAT associated with progression-free survival. The x-axis represents the area of IMAT and the y-axis shows the Wald P value. The horizontal dotted gray line indicates significance. Points above the line have a P > 0.05, and points below the line have a P < 0.05 and are suitable as cutoffs. IMAT: intermuscular adipose tissue.

Objective Evidence regarding the association between prenatal exposure to cooking oil fumes (COF) and full-term low birth weight (FTLBW) is still controversial, and the mechanism remains unclear. This study thus aims to explore the association of prenatal COF exposure with off-spring FT-LBW as well as the mediating role of placenta in their association. Methods A case-control study enrolling 266 pregnant women delivering FTLBW newborns (cases) and 1420 delivering normal birth weight (NBW) newborns (controls) was conducted. Information on prenatal COF exposure, socio-demographics, and obstetric conditions were collected at the Women's and Children's Hospitals of Shenzhen and Foshan in Guangdong, China. Linear and hierarchical logistic regression models were undertaken to explore the associations among COF exposure, placenta and birth weight, as well as the mediation effect of placental weight. Results After controlling for potential confounders, prenatal COF exposure was significantly associated with the higher risk of FT-LBW (OR = 1.31, 95% CI= 1.06–1.63) and the lower placental weight (s = −0.12, 95% CI= −0.23 ~ −0.005). Compared with mothers who never cooked, those cooking sometimes (OR= 2.99, 95% CI= 1.48–6.04) or often (OR= 3.41, 95% CI= 1.40–8.34) showed a higher risk of FT-LBW, and likewise, those cooking for less than half an hour (OR= 2.08, 95% CI= 1.14–3.79) or cooking between half to an hour (OR= 2.48, 95% CI= 1.44–4.29) were also more likely to exhibit FT-LBW. Different cooking methods including pan-frying (OR= 2.24, 95% CI= 1.30–3.85) or deep-frying (OR= 1.78, 95% CI= 1.12–2.85) during pregnancy were associated with increased FT-LBW risks as well. The further mediation analysis illustrated that placental weight mediated 15.96% (95% CI: 12.81~28.80%) and 15.90% (95% CI= 14.62%~16.66%) of the associations of cooking during pregnancy and frequency of prenatal COF exposure, respectively, with FT-LBW.