Prevalence and Risk Factors of Stroke in Inpatients with Type 2 Diabetes Mellitus in China

Objective The prevalence and the cluster characteristics of risk factors of stroke were assessed in a Chinese diabetic population.Methods Clinical data of 30693 inpatients who were diagnosed with type 2 diabetes mellitus(T2DM)and admitted between 2013 and 2018 were retrospectively analyzed.The age-standardized prevalence of stroke was estimated using the 2010 Chinese population census data,and risk factors were analyzed by multiple imputation and regression.Results The crude and standardized prevalence rates of stroke in patients with T2DM were 34.4%and 21.5%,respectively,and 85.2%of the stroke patients had ischemic stroke.Nearly half of the patients who experienced stroke had clusters of more than 4 risk factors.Compared with no-risk-factor clustering,the risk of stroke significantly increased 3-4 times in the presence of more than 4 risk-factor clusters(P<0.001).Hypertension was the most common major risk factor for ischemic stroke[odds ratio(OR),2.34;95%confidence interval(CI),2.18-2.50]and hemorrhagic stroke(OR,3.68;95%CI 2.95-4.59;P<0.001).Moreover,a 1-standard-deviation increase in fasting blood glucose(FBG)was significantly negatively correlated with ischemic stroke risk,and the same change in FBG was significantly associated with an 8%increased risk of hemorrhagic stroke.Conclusion The prevalence of stroke in patients with T2DM is rather high,and the clustering of risk factors is associated with the development of stroke in T2DM patients.Risk factors differ in different stroke subtypes.Identifying risk factors for a specific high-risk group is necessary.

Influence of matrix physical properties on flow characteristics in dual network model

The tight oil formation develops with microfractures and matrix pores,it is important to study the influence of matrix physical properties on flow characteristics.At first,the representative fracture and matrix samples are selected respectively in the dual media,the fracture and matrix digital rocks are constructed with micro-CT scanning at different resolutions,and the corresponding fracture and matrix pore networks are extracted,respectively.Then,the modified integration method is proposed to build the dual network model containing both fracture and matrix pore-throat elements,while the geometric-topological structure equivalent matrix pores are generated to fill in the skeleton domain of fracture network,the constructed dual network could describe the geometric-topological structure characteristics of fracture and matrix pore-throat simultaneously.At last,by adjusting the matrix pore density and the matrix filling domain factor,a series of dual network models are obtained to analyze the influence of matrix physical properties on flow characteristics in dual-media.It can be seen that the matrix system contributes more to the porosity of the dual media and less to the permeability.With the decrease in matrix pore density,the porosity/permeability contributions of matrix system to dual media keep decreasing,but the decrease is not significant,the oil-water co-flow zone decreases and the irreducible water saturation increases,and the saturation interval dominated by the fluid flow in the fracture keeps increasing.With the decrease in matrix filling domain factor,the porosity/permeability contributions of matrix system to dual media decreases,the oil-water co-flow zone increases and the irreducible water saturation decreases,and the saturation interval dominated by the fluid flow in the fracture keeps increasing.The results can be used to explain the dual-media flow pattern under different matrix types and different fracture control volumes during tight oil production.

Artificial intelligence-aided diagnosis and treatment in the field of optometry

With the rapid development of computer technology,the application of artificial intelligence(AI)to ophthalmology has gained prominence in modern medicine.As modern optometry is closely related to ophthalmology,AI research on optometry has also increased.This review summarizes current AI research and technologies used for diagnosis in optometry,related to myopia,strabismus,amblyopia,optical glasses,contact lenses,and other aspects.The aim is to identify mature AI models that are suitable for research on optometry and potential algorithms that may be used in future clinical practice.

An update on chemotherapy of colorectal liver metastases

Surgical resection of liver metastases of colorectal cancer greatly improves the clinical outcome of patients with advanced disease. Developments in chemotherapeutic agents and strategies bring hope of a cure to patients with initially unresectable colorectal liver metastases (CLM). Perioperative chemotherapy signif icantly improves the survival time of patients who receive curative-intent hepatectomy. Even for unresectable CLM, recent studies demonstrated that active preoperative chemotherapy could achieve shrinkage of liver metastasis and thus render some for resection. Furthermore, an increase in tumor resection rate and prolonged survival time among patients with CLM has been observed following the application of monoclonal antibodies in recent years. However, the value of chemotherapy via hepatic arterial infusion is still unclear. More trials should be conducted in patients with CLM in order to improve survival.

Expression of IL-26 predicts prognosis of patients with hepatocellular carcinoma after surgical resection

Background: There is no data regarding prognostic impact of interleukin(IL)-26 on outcomes of patients with hepatocellular carcinoma(HCC). The present study aimed to evaluate the prognostic impact of IL-26 on HCC patients undergoing liver resection. Methods: From 2003 to 2008, 122 patients with HCC who received surgical curative resection were enrolled. Patients were stratified into IL-26-upper and-lower groups according to the median expression level from immunohistochemical staining of resected specimens. Prognostic impact of IL-26 was estimated using Kaplan–Meier curves. Univariate and multivariate analyses were performed to evaluate timedependent prognostic impact and independency of IL-26. Demographic and clinical factors that were associated with IL-26 were comprehensively identified. Results: Prognosis of the patients with high level of IL-26 revealed to be significantly unfavorable in both cumulative recurrence-free survival( P < 0.001) and overall survival( P = 0.002). Upper expression of IL-26(HR: 1.643;95% CI: 1.021 to 2.644;P = 0.041) and microvascular invasion(HR: 3.303;95% CI: 1.255 to 8.696;P = 0.016) were identified as significant independent prognostic factors for overall survival in the multivariable analysis. Conclusions: IL-26 is a novel prognostic factor for HCC after resection. Evaluation of IL-26 expression may be potentially valuable in clinical therapy when planning individualized follow-up schedule and evaluating candidates for prophylactic adjuvant treatment to prevent recurrence.

Empathetic nursing with mindful cognitive therapy for fatigue,depression,and negative emotions in leukemia patients undergoing long-term chemotherapy

BACKGROUND Leukemia is a broad term for blood cell cancer.Leukemia is divided into acute or chronic,depending on cell differentiation.Leukemia patients are prone to adverse reactions during chemotherapy,such as anxiety,depression,and even suicide,affecting prognosis.As a nursing model developed by three well-known cognitive psychologists,empathetic nursing with mindfulness cognitive therapy(ENMCT)can effectively reduce anxiety and depression and improve the quality of life in patients with chronic disease.AIM To explore the effect of ENMCT on cancer-induced fatigue,hope level,and negative emotions in patients with long-term leukemia chemotherapy.METHODS A total of 103 patients with long-term leukemia chemotherapy diagnosed and treated in our hospital from July 2017 to October 2019 were enrolled and randomly assigned to observation and control groups using the random number table approach.Fifty-one patients in the control group received routine nursing,while 52 patients in the observation group received empathic nursing with mindfulness cognitive therapy.After three months of nursing care,cancerinduced fatigue was measured with the Piper Fatigue Scale(PFS),hope level with the Herth Hope Index(HHI),and negative emotion with the Hamilton Anxiety Scale(HAMA)/Hamilton Depression Scale(HAMD).Self-management(Chinese Strategies Used by People to Promote Health)was also recorded.RESULTS The observation group’s total scores in behavior,cognition,emotion,feeling,and PFS were lower than the control group after the intervention(P<0.05).Keeping close contact with others,the attitude of taking positive actions,the attitude toward reality and future,and the total HHI score were higher in the observation group than the control group(P<0.05).The observation group’s HAMA and HAMD scores were lower than the control group(P<0.05).The observation group’s positive attitude,self-decision,and self-relief scores were greater than the control group(P<0.05).CONCLUSION Empathetic nursing with cognitive mindfulness therapy is beneficial in improving cancer-related fatigue,negative emotions,expectation level,and self-management ability in patients with longterm leukemia chemotherapy.

Flow simulation considering adsorption boundary layer based on digital rock and finite element method

Due to the low permeability of tight reservoirs,throats play a significant role in controlling fluid flow.Although many studies have been conducted to investigate fluid flow in throats in the microscale domain,comparatively fewer works have been devoted to study the effect of adsorption boundary layer(ABL)in throats based on the digital rock method.By considering an ABL,we investigate its effects on fluid flow.We build digital rock model based on computed tomography technology.Then,microscopic pore structures are extracted with watershed segmentation and pore geometries are meshed through Delaunay triangulation approach.Finally,using the meshed digital simulation model and finite element method,we investigate the effects of viscosity and thickness of ABL on microscale flow.Our results demonstrate that viscosity and thickness of ABL are major factors that significantly hinder fluid flow in throats.

LRP5 polymorphism—A potential predictor of the clinical outcome in advanced gastric cancer patients treated with EOF regimen

Purpose： Wnt pathways control key biological processes that potentially impact on tumor progression and patient survival. The present study analyzed the polymorphism of lipoprotein-related receptor 5 （LRPS） （gene with key functions in Wnt signaling） and its impact on the response to chemotherapy and survival of patients with advanced gastric cancer （AGC）. Methods： A total of 107 consecutive patients with AGC treated with first-line chemotherapy of EOF regimen were enrolled in the present retrospective study. The association between single nucleotide polymorphism （SNP） of rs3736228 in LRP5 and the clinical outcomes of the patients was studied. Results： The CC genotype of rs3736228 was significantly correlated with a higher disease control rate when compared to the CT and TT genotypes （89.3% and 61.8%, respectively, P〈0.001）. A univariate survival analysis also showed that the progression free survival （PFS） and overall survival （OS） for the patients with the TC and TF genotypes of rs3736228 were worse than for the patients with the CC genotype （PFS： 3.3 and 6.7 months, respectively, HR =0.454, P〈0.001; OS： 8.1 months and 18.8 months, respectively, HR =3.056, P〈0.001）. A multivariate Cox model incorporates rs3736228 and clinical features, also identified rs3736228 was significantly associated with the PFS and OS. Conclusions： Our results firstly highlight the importance of LRPY gene of Wnt pathway in the treatment of AGC and identify polymorphism of rs3736228 as independent predictor of disease control rate, PFS and OS in AGC patients treated with first-line chemotherapy of EOF regimen in the Chinese Han population.

Increased systemic RNA oxidative damage and diagnostic value of RNA oxidative metabolites during Shigella flexneri-induced intestinal infection

BACKGROUND Shigella flexneri(S.flexneri)is a major pathogen causing acute intestinal infection,but the systematic oxidative damage incurred during the course of infection has not been investigated.AIM To investigate the incurred systemic RNA oxidative damage and the diagnostic value of RNA oxidative metabolites during S.flexneri-induced intestinal infection.METHODS In this study,a Sprague-Dawley rat model of acute intestinal infection was established by oral gavage with S.flexneri strains.The changes in white blood cells(WBCs)and cytokine levels in blood and the inflammatory response in the colon were investigated.We also detected the RNA and DNA oxidation in urine and tissues.RESULTS S.flexneri infection induced an increase in WBCs,C-reactive protein,interleukin(IL)-6,IL-10,IL-1β,IL-4,IL-17a,IL-10,and tumor necrosis factorα(TNF-α)in blood.Of note,a significant increase in urinary 8-oxo-7,8-dihydroguanosine(8-oxo-Gsn),an important marker of total RNA oxidation,was detected after intestinal infection(P=0.03).The urinary 8-oxo-Gsn level returned to the baseline level after recovery from infection.In addition,the results of a correlation analysis showed that urinary 8-oxo-Gsn was positively correlated with the WBC count and the cytokines IL-6,TNF-α,IL-10,IL-1β,and IL-17α.Further detection of the oxidation in different tissues showed that S.flexneri infection induced RNA oxidative damage in the colon,ileum,liver,spleen,and brain.CONCLUSION Acute infection induced by S.flexneri causes increased RNA oxidative damage in various tissues(liver,spleen,and brain)and an increase of 8-oxo-Gsn,a urinary metabolite.Urinary 8-oxo-Gsn may be useful as a biomarker for evaluating the severity and prognosis of infection.

Correlation of renal peroxidative damage with apoptosis and autophagy in rats with chronic fluorosis

Objective:To study the correlation of renal peroxidative damage with apoptosis and autophagy in rats with chronic fluorosis.Methods:Male SD rats were selected as experimental animals and randomly divided into model group and control group. After chronic fluorosis model rats were established, renal injury marker contents in serum as well as oxidative stress injury marker contents, apoptosis gene expression and autophagy gene expression in kidney tissue were determined.Results:1 month, 2 months and 3 months after model establishment, serum BUN and Scr contents of model group were significantly higher than those of control group, and ROS contents, calpain-1, caspase-3, Notch1, Hes1, mTOR and Beclin-1 mRNA expression as well as LC3-Ⅱ/LC3-Ⅰ ratio in kidney tissue of model group were significantly higher than those of control group. Pearson test showed that ROS content in kidney tissue was positively correlated with BUN and Scr contents in serum as well as calpain-1, caspase-3, Notch1, Hes1, mTOR and Beclin-1 mRNA expression and LC3-Ⅱ/LC3-Ⅰ ratio in kidney tissue.Conclusion:The renal injury induced by peroxidation in rats with chronic fluorosis is closely related to the excessive activation of apoptosis and autophagy.

XELOX doublet regimen versus EOX triplet regimen as first-line treatment for advanced gastric cancer:An open-labeled,multicenter,randomized,prospective phase III trial(EXELOX)

Background:There is no consensus on whether triplet regimen is better than doublet regimen in the first-line treatment of advanced gastric cancer(AGC).We aimed to compare the efficacy and safety of oxaliplatin plus capecitabine(XELOX)and epirubicin,oxaliplatin,plus capecitabine(EOX)regimens in treating AGC.Methods:This phase III trial enrolled previously untreated patients with AGC whowere randomly assigned to receive the XELOXor EOXregimen.The primary endpoint was non-inferiority in progression-free survival(PFS)for XELOX as compared with EOX on an intention-to-treat basis.Results:Between April 10,2015 andAugust 20,2020,448AGCpatientswere randomized to receive XELOX(n=222)or EOX(n=226).The median PFS(mPFS)was 5.0 months(95%confidence interval[CI]=4.5-6.0 months)in the XELOX arm and 5.5 months(95%CI=5.0-6.0 months)in the EOX arm(hazard ratio[HR]=0.989,95%CI=0.812-1.203;P_(non-inferiority)=0.003).There was no significant difference inmedian overall survival(mOS)(12.0 vs.12.0months,P=0.384)or objective response rate(37.4%vs.45.1%,P=0.291)between the two groups.In patients with poorly differentiated adenocarcinoma and liver metastasis,the EOX arm had a significantly longer mOS(P=0.021)and a trend of longer mPFS(P=0.073)than the XELOX arm.The rate of grade 3/4 adverse events(AEs)was 42.2%(90/213)in the XELOX arm and 72.5%(156/215)in the EOX arm(P=0.001).The global health-related quality of life(QoL)score was significantly higher in the XELOX arm than in the EOX arm during chemotherapy.Conclusions:This non-inferiority trial demonstrated that the doublet regimen was as effective as the triplet regimen and had a better safety profile and QoL as a first-line treatment for AGC patients.However,the triplet regimen might have a survival advantage in patients with poorly differentiated adenocarcinoma and liver metastasis.

Study on heavy metal concentrations in river sediments through the total amount evaluation method

A quantitative method to evaluate the amounts of heavy metals in river sediments is established. Using the BT Drainage River in North China as a study object, six representative cross sections were selected for measurement of heavy metal indicators in sediments, and then the main contamination indicators were determined by performing a potential ecological risk assessment. Using a section of this river as an example, the total amounts of the main pollution indicators and those of their harmful forms are estimated by the Surfer software, which simulates the pollution status within the downstream sediments of the outfall at this section. The calculation results could provide a theoretical guideline and data support for pollution treatment of the BT Drainage River.