Age Factors in Second Language Acquisition:a Case in China

It has long been noticed that age at onset of acquisition(AoA) is relevant to second language acquisition(SLA) and even can be regarded as one of the determinants of success in language learning. Based on the comparison between the author's successful learning experience of Japanese as an adult and the relatively unsuccessful learning experience of English as a child, this essay will discuss some theories of age factors in SLA and give several practical implications of age effects in SLA on classroom practices.

Dietary Behaviors and Influencing Factors among Rural Left-behind Children Aged below 7 Years in China

Left-behind children comprise a special population inChinese rural areas. According to the 2007 China Census,the number ofleft-behind children aged≤14 years was estimated at 58 million which suggested that these childrencon stituted a

Older age at first birth is a risk factor for pancreatic cancer： a meta-analysis

BACKGROUND： Some studies found that age at first birth is associated with pancreatic cancer; others did not. The present meta-analysis was to evaluate the relationship between age at first birth and pancreatic cancer in women.DATA SOURCES： We searched Pub Med, Embase, and the Cochrane Library for relevant publications on age at first birth and pancreatic cancer up to April, 2014. The eligible studies（six cohorts and five case-controls） were independently selected by two authors. Pooled relative risk（RR） estimates and corresponding 95% confidence interval（95% CI） were calculated using the inverse-variance method.RESULTS： The pooled RR of pancreatic cancer risk for the highest versus lowest categories of age at first birth was 1.21（95% CI： 1.01-1.45, P=0.314, I^2=13.7%）. Consistent relationships were also observed within subgroup analyses stratified by study design, geographic region, and whether the studies included adjustment for cigarette smoking, diabetes, or all of the confounders. In this meta-analysis, no publication bias among studies was observed using Egger＇s test（P=0.383） or Begg＇s test（P=0.436）.CONCLUSION： Our findings suggest that older age at first birth is associated with an increased risk of pancreatic cancer in women and the exact functional mechanism needs further investigation.

Characteristic pattern of human prostatic growth with age

Aim: To study the characteristic pattern of the age-related growth of the human prostate gland. Methods: The volume (weight) of the prostate in 1,601 males, aged from newborn to 92 years, was determined by Bultrasonography. Results: Prostatic volume determination by B-ultrasonography in 1601 males (1301 normal subjects and 300 BPH patients) pointed out that the age-stratified growth of human prostate could be categorized into 4 life stages: (1) the first slow growing phase (from newborn to 9 years): the prostate grows slowly at a rate of 0.14g per year; (2) the first rapid growing phase (from 10 to 30 years): the prostate grows at a rate of 0.84 g per year; (3) the second slow growing phase (from 30 to 50 years), the prostate grows at a rate of 0.21 g per year; (4) the second rapid growing phase (from 50 to 90 years): the prostate grows at one of the following rates: in one group the growth rate is of 0.50 g per year and in the other 1.20 g per year, leading to benign prostatic hyperplasia (BPH). Conclusion: The volumes of the prostate are different in different age groups and it grows with age at different rates in four life phases. The prostate growth in phases can be expressed by the following equation: Y=19.36+1.36X'-0.58X'2+0.33X'3, where Y=prostate volume, X=age (up to 70 years), X'=(X-35.5)/10. (Asian JAndrol 2002 Dec; 4: 269-271)

Immunogenicity and reactogenicity of a recombinant hepatitis B vaccine in subjects over age of forty years and response of a booster dose among nonresponders

AIM:The study was initiated to evaluate the reactogenicity and immunogenicity of a recombinant hepatitis B vaccine in age group >40 years and to study the response of a single booster dose in primary non-responders to the hepatitis B vaccination. METHODS:A total of 102 volunteers without markers of hepatitis B infection (negative for HBsAg,anti-HBc antibody, HBeAg and anti-HBs antibody) received 20μg of recombinant HB vaccine intramuscularly at 0,1,and 6 months.Anti HBs titers were evaluated by a quantitative Elisa kit at 90 and 210 days.A booster dose of 20μg HB vaccine was given after 6 months of the 3^(rd) vaccine dose to the 15 non- responders and anti-HBs titers were measured after i month. RESULTS:Seroprotection (anti-HBs GMT^3 10 IU/L) was achieved in 85.3 % (87/102) volunteers.The mean GMT titers of the vaccine responders was 136.1 IU/L.Of the seroprotected individuals,there were 32.4% (33/102) hyporesponders (anti- HBs titers <10-99 mIU/ml) and 52.9% (54/102) were responders (anti-HBs titers >100 IU/L).All the non-responders (15/15) responded to a single dose of the booster dose of recombinant HB vaccine and their mean anti-HBs antibody titers were more than 100.5 mIU/ml after the booster dose. CONCLUSION:Recombinant hepatitis B vaccine offers good seroprotection in the age group >40 years and has a good safety profile.A single booster dose after 6 months in primary non-responders leads to good seroprotective anti-HBs antibody titers.However,larger population based studies are needed to evaluate the role of a booster dose in selected group of non-responders and whether such an approach will be cost effective.

Comparison of presentation and impact on quality of life of gastroesophageal reflux disease between young and old adults in a Chinese population

AIM:To compare the presentation and impact on qual-ity of life of gastroesophageal reflux disease(GERD)in old and young age groups.METHODS:Data from adult patients with GERD di-agnosed by endoscopic and symptomic characteristics were collected between January and November 2009.Exclusion criteria included combined peptic ulcers,ma-lignancy,prior surgery,antacid medication for more than 2 mo,and pregnancy.Enrolled patients were assigned to the elderly group if they were 65 years or older,or the younger group if they were under 65 years.They had completed the GERD impact scale,the Chinese GERD questionnaire,and the SF-36 question-naire.Data from other cases without endoscopic f ind-ings or symptoms were collected and these subjects comprised the control group in our study.RESULTS:There were 111 patients with GERD and 44 normal cases:78(70.3%)and 33 patients(29.7%)were in the younger and elderly groups,respectively.There were more female patients(60.3%)in the younger group,and more males(72.7%)in the elderly group.The younger cases had more severe and fre-quent typical symptoms than the elderly patients.Sig-nif icantly more impairment of daily activities was noted in the younger patients compared with the elderly group,except for physical functioning.CONCLUSION:Elderly patients with GERD were pre-dominantly male with rare presentation of typical symp-toms,and had less impaired quality of life compared with younger patients in a Chinese population.

Impact of old age on clinical and angiographic characteristics of coronary artery spasm as assessed by acetylcholine provocation test

Background Smoking and other risk factors have been well known as important factors of variant angina or coronary artery spasm （CAS）. However, clinical features related to age on coronary artery spasm have been rarely evaluated. Methods We evaluated 3155 consecutive patients with insignificant coronary artery lesion. Patients underwent Acetylcholine （Ach） provocation test for induction of CAS. CAS was defined as 〉 70% luminal narrowing of coronary arteries during Ach provocation test. The results of Ach provocation test were compared among age groups; 〈 45 years （Group 1）, 45-54 years （Group 2）, 55-64 years （Group 3）, and 〉_ 65 years （Group 4）. Results Older patients had higher incidence of hypertension, diabetes, but lower incidence rate of current smoking, male sex compared with younger patients. Positive Ach provocation test finding was frequently showed with aging （47.36% vs. 58.3% vs. 62.6% vs. 61.5%; P 〈 0.001）. Multivariate logistic analysis showed that age, male, and myocardial bridge were independent predictors of CAS induced by Ach provocation test. Conclusion Our present study showed that old age was independent predictor for Ach-induced significant coronary artery spasm.

Can Adults Attain a Native-Like Accent in Their Second Language？

Second Language Acquisition （SLA） is influenced by many different factors. This paper attempts to discuss the age factor in SLA, particularly explores the learners＇ acquisition of accent. The author firstly introduces the topic and reviews the literature on Critical Period Hypothesis （CPH）. Then, the optimal age to attain the native-like accent is discussed. Finally, the author describes some other elements that influence the acquisition of accent and draws a natural conclusion that the topic in this paper needs more profound research.

The prognostic significance of clinical and pathological features in hepatocellular carcinoma

The prognosis of patients with HCC still remains dismal. The life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, such as patient's general conditions, macroscopic tumor morphology, as well as tumor histopathology features, have been proven of prognostic significance. Female HCC patient often has a better prognosis than male patient, which might be due to the receptor of sex hormones. Younger patients often have tumors with higher invasiveness and metastatic potentials, and their survival and prognosis are worse than the older ones. Co-existing hepatitis status and hepatic functional reserve have been confirmed as risk factors for recurrence. Serum alpha-fetoprotein (AFP) is useful not only for diagnosis, but also as a prognostic indicator for HCC patients. AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence. Many pathologic features, such as tumor size, number, capsule state, cell differentiation, venous invasion, intrahepatic spreading, and advanced pTNM stage, are the best-established risk factors for recurrence and important aspects affecting the prognosis of patients with HCC. Marked inflammatory cell infiltration in the tumor could predict a better prognosis. Clinical stage is still the most important factor influencing on the prognosis. Extratumor spreading and lymph nodal metastasis are independent predictors for poor outcome. Some new predictive systems have recently been proposed. Different strategies of treatment might have significant different effects on the patients' prognosis. To date, surgical resection is still the only potentially curative treatment for HCC, including localized postoperative recurrences. Extent of resection, blood transfusion, occlusion of porta hepatis, and blood loss affect the survival and prognosis of HCC patients. Regional therapies provide alternative ways to improve the prognosis of HCC patients who have no opportunity to receive surgical treatment or postoperative recurrence. The combination of these treatment modalities is hopeful to further improve the prognosis. The efficacies of neoadjuvant (preoperative) or adjuvant (postoperative) chemotherapy or chemoembolization in preventing recurrence and on the HCC prognosis still remain great controversy, and deserve further evaluation. Biotherapy, including IFN-alpha therapy, will play more important role in preventing recurrence and metastasis of HCC after operation.

Graft-versus-host disease after liver transplantation:A comprehensive literature review

AIM： To determine the factors affecting mortality in pa- tients who developed graft-versus-host disease （GvHD） after liver transplantation （LT）. METHODS： We performed a review of studies of GvHD following LT published in the English literature and ac- cessed the PubMed, Medline, EBSCO, EMBASE, and Google Scholar databases. Using relevant search phras- es, 88 articles were identified. Of these, 62 articles con- raining most of the study parameters were considered eligible for the study. Risk factors were first examined using a univariate Kaplan-Meier model, and variables with a significant association （P 〈 0.05） were then sub- jected to multivariate analyses using a Cox proportional- hazards model. RESULTS： The 61 articles reported 87 patients, 58 male and 29 female, mean age, 40.4 ± 15.5 years （range： 8 mo to 74 years）, who met the inclusion criteria for the present study. Deaths occurred in 59 （67.8%） patients, whereas 28 （32.2%） survived after a mean follow-up period of 280.8 ± 316.2 d （range： 27-2285 d）. Among the most frequent symptoms were rash （94.2%）, fever （66.6%）, diarrhea （54%）, and pancytopenia （54%）. The average time period between LT and first symptom on- set was 60.6 ± 190.1 d （range： 2-1865 d）. The Kaplan- Meier analysis revealed that pancytopenia （42.8% vs 59.3%, P = 0.03）, diarrhea （39.2% vs 61.0%, P = 0.04）, age difference between the recipient and the donor （14.6 ± 3.1 years vs 22.6 ± 2.7 years, P 〈 0.0001）, and time From first symptom occurrence to diagnosis or treatment （13.3 ± 2.6 mo vs 15.0 ± 2.3 mo, P 〈 0.0001） were significant factors affecting mortality, whereas age, sex, presence of rash and fever, use of immunosuppressive agents, acute rejection before GvHD, etiological causes, time of onset, and donor type were not associated with mortality risk. The Cox proportional-hazards model, de- termined that an age difference between the recipient and donor was an independent risk Factor （P = 0.03; hazard ratio, 7.395, 95% confidence interval, 1.2-46.7）. CONCLUSION： This study showed that an age differ- ence between the recipient and donor is an independent risk factor for mortality in patients who develop GvHD after LT.

Trend in gastric cancer:35 years of surgical experience in Japan

AIM:To investigate the trend in gastric cancer surgery in the context of rapid therapeutic advancement in Japan and East Asia.METHODS:A retrospective analysis was performed on 4163 patients who underwent gastric resection for gastric cancer with histological confirmation between 1971 and 2007 at the surgical unit in Kitasato University Hospital,to determine the trend in gastric cancer requiring surgery.RESULTS:Gastric cancer requiring surgical resection increased in our hospital,but the incidence adjusted for population was constant during the observed pe-riod.Interestingly,the ratio of diffuse type/intestinal type gastric cancer was unexpectedly unchanged,and that of advanced/early gastric cancer(EGC)was,however,markedly reduced,while the actual incidence of potentially curative advanced gastric cancer tended to decrease.The incidence of EGC requiring surgery tended to increase as a whole,which is consistent with increased prevalence of endoscopic surveillance.As a result,overall survival and mortality of gastric cancer requiring gastric resection has recently markedly improved.CONCLUSION:In Japan,planned interventions may improve surgical gastric cancer mortality,but an unexpected trend of persistent existence of intestinal type cancer suggests the need for more robust medical intervention.

Androgen receptors expressed by prostatic stromal cells obtained from younger versus older males exhibit opposite roles in prostate cancer progression

Aging is a major risk factor for prostate cancer （PCa）, and prostatic stromal cells may also promote PCa progression. Accordingly, stromal cells do not equally promote PCa in older males and younger males. Therefore, it is also possible that the expression of androgen receptors （ARs） by prostatic stromal cells in older versus younger males plays different roles in PCa progression. Using a gene knockdown technique and coculture system, we found that the knockdown of the AR in prostatic stromal cells obtained from younger males could promote the invasiveness and metastasis of cocultured PC3/LNCaP cells in vitro. By contrast, the invasiveness and metastasis of LNCaP cells was inhibited when cocultured with prostatic stromal cells from older males that when AR expression was knocked down. Moreover, after targeting AR expression with small hairpin RNA （shRNA）, matrix metalloproteinase （MMP） expression in stromal cells was observed to increase in the younger group, but decreased or remained unchanged in the older group. One exception, however, was observed with MMP9. In vivo, after knocking down AR expression in prostatic stromal cells, the incidence of metastatic lymph nodes was observed to increase in the younger age group, but decreased in the older age group. Together, these data suggest that the AR in prostatic stromal cells played opposite roles in PCa metastasis for older versus younger males. Therefore, collectively, the function of the AR in prostatic stromal cells appears to change with age, and this may account for the increased incidence of PCa in older males.

Younger patients have poorer biochemical outcome after radical prostatectomy in high-risk prostate cancer

The aim of this study was to investigate the prognostic significance of patient age with respect to tumour aggressiveness in men who underwent radical prostatectomy （RP） for prostate cancer. In this study, we reviewed the records of 743 patients who received RP without neoadjuvant or adjuvant therapy at our institution and were followed up for 〉2 years postoperatively. For our analyses, the patients were divided into two groups according to age： younger （〈60 years） and older （≥ 60 years）. Through uni- and multivariate analyses, associations of various clinicopathological parameters, including biochemical recurrence-free survival, with patient age, were evaluated among all patients, and the patients were stratified according to their D＇Amico risk classification. Among all subjects, younger （n= 126） and older （n=617） patients showed no significant differences regarding pathological parameters and biochemical recurrence-free survival （P=0.288）. For the high-risk group （n= 206）, younger patients had a lower rate of biochemical recurrence-free survival following surgery than older patients （P=0.017）, despite the fact that no significant differences were observed regarding various known prognostic parameters between the two age groups. In addition, multivariate analysis revealed that age was an independent predictor of biochemical recurrence-free survival among the high-risk group （P=O.O03）. Our results showed that relatively younger patients have a comparable biochemical outcome compared with their older counterparts following RP performed for prostate cancer. However, among patients with high-risk disease, younger patients have a worse biochemical outcome following RP compared with older patients.

Acute diverticulitis in younger patients:Any rationale for a different approach?

AIM:To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently. METHODS:This study was a retrospective review of 157 patients treated with acute diverticulitis between January 1,2004 and December 31,2007.Diverticulitis was stratified according to the Hinchey classification. Patients were divided into 2 populations:group A≤ 50 years(n=31) ;group B>50 years(n=126) .Mean patient follow-up was 15 mo. RESULTS:The median age was 60 years.A significantly higher proportion of patients in group B presented with complicated diverticulitis(36.5%vs 12.9%,P=0.01) .Recurrence was more frequent in group A(25.8%vs 11.1%,P=0.03) and the mean time-torecurrence was shorter(12 mo vs 28 mo,P=0.26) . The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stageⅠand none of the patients required emergency surgery.In multivariate analysis,only age(P=0.024) was identified as an independent prognostic factor for recurrence. CONCLUSION:Based on the results of this study,we recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient.

Biochemical and radiological predictors of malignant biliary strictures

AIM: Differentiation of benign biliary strictures (BBS) from malignant biliary strictures (MBS) remains difficult despite improvement in imaging and endoscopic techniques. The aim of this study was to identify the clinical, biochemical and or radiological predictors of malignant biliary strictures.METHODS: We retrospectively reviewed all charts of patients who had biliary strictures (BS) on endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous cholangiography (PTC) in case of unsuccessful ERCP from March 1998 to August 2002. Patient characteristics, clinical features, biochemical, radiological and biopsy results were all recorded. Stricture etiology was determined based on cytology,biopsy or clinical follow-up. A receiver operator characteristic (ROC) curve was constructed to determine the optimal laboratory diagnostic criterion threshold in predicting MBS.RESULTS: One hundred twenty six patients with biliary strictures were enrolled, of which 72 were malignant. The mean age for BBS was 53 years compared to 62.4 years for MBS (P=0.0006). Distal bile duct stricture was mainly due to a malignant process 48.6% vs 9% (P=0.001). Alkaline phosphates and AST levels were more significantly elevated in MBS (P=0.0002). ROC curve showed that a bilirubin level of 84 μmol/L or more was the most predictive of MBS with a sensitivity of 98.6%, specificity of 59.3% and a positive likelihood ratio of 2.42 (95% CI=0.649-0.810). Proximal biliary dilatation was more frequently encountered in MBS compared to BBS, 73.8% vs39.5% (P=0.0001). Majority of BBS (87%) and MBS (78%) were managed endoscopically.CONCLUSION: A serum bilirubin level of 84 μmol/L or greater is the best predictor of MBS. Older age, proximal biliary dilatation, higher levels of bilirubin, alkaline phosphatase, ALT and AST are all associated with MBS. ERCP is necessary to diagnose and treat benign and malignant biliary strictures.

Enlightenment of the Critical Period Hypothesis for the Early English Education

Whether children should learn English as early as possible has been a controversial topic, and one of the focal point is the credibility of the critical period hypothesis.Does critical period hypothesis really exist?How does child's age factor influence English acquisition?Analyzing the problems existing in the early English education based on the critical period hypothesis theory, secondly, investigating child's characteristics and psychological characteristics based on a case study.The research results show that learning English is not the sooner the better; the emphasis is how to ensure the quality.We should Specify children's English education market, and providence environment of language acquisition, attach great importance to the interest, and give full play to children in different stages of learning advantage.Parents and society should correctly treat the early English education, reduce misunderstanding and promote the healthy development of children's English education.

Prognostic factors for community-acquired pneumonia in middle-aged and elderly patients treated with integrated medicine

OBJECTIVE:To identify prognostic factors in middle-aged and elderly patients with community-acquired pneumonia(CAP) who underwent integrated interventions involving traditional Chinese medicine(TCM) and modern medicine.METHODS:Patients aged ≥45 years and diagnosed with CAP were divided into a middle-aged cohort(45-59 years) and an elderly cohort(≥60 years),and clinical data comprising 75 predictor variables in seven classes were collected.After replacing missing data,calibrating multicenter differences and classifYing quantitative data,univariate and multivariate analysis were performed.RESULTS:On multivariate analysis,eight independent risk factors-respiration rate,C reactive protein(CRP),cost of hospitalization,anemia,gasping,confusion,moist rales and pneumonia severity index(PSI)-were correlated with the outcome "not cured" in the elderly cohort.Nine factors-neutrophil percentage(Neu%),blood urea nitrogen(BUN),time to clinical stability,appetite,anemia,confusion,being retired or unemployed,Gram-negative bacterial infection and educational level-were correlated with not cured in the middle-aged cohort.CONCLUSION:Independent predictive risk factors correlated with adverse outcomes in elderly patients were higher respiration rate,CRP≥four times the mean or median for the patient's center,cost of hospitalization>11,323 RMB and PSI>II,plus anemia,gasping,confusion and moist rales;those in middle-aged patients were higher Neu%,BUN≥mean or median,loss of appetite,anemia,confusion,being retired or unemployed and lower educational level.Gram-negative bacterial infection and time to clinical stability>9 days were protective factors.

The Optimization of Preventive Maintenance Scheduling for Production Machine of Production System in Finite Time Horizon

The recursion relation of preventive maintenance (PM) cycle is built up concerning the concept of effective age and age setback factor proposed in this paper, which illustrates the dynamic relationship between failure rate and preventive maintenance activity. And the nonlinear optimal PM policy model satisfying the reliability constraints in finite time horizon following Weibull distribution is proposed. The model built in this paper avoids the shortcoming of steady analytical PM model in infinite time horizon and can be used to aid scheduling the maintenance plan and providing decision supporting for job shop scheduling.

SVEAT score outperforms HEART score in patients admitted to a chest pain observation unit

BACKGROUND Timely and accurate identification of subgroup at risk for major adverse cardiovascular events among patients presenting with acute chest pain remains a challenge.Currently available risk stratification scores are suboptimal.Recently,a new scoring system called the Symptoms,history of Vascular disease,Electrocardiography,Age,and Troponin(SVEAT)score has been shown to outperform the History,Electrocardiography,Age,Risk factors and Troponin(HEART)score,one of the most used risk scores in the United States.AIM To assess the potential usefulness of the SVEAT score as a risk stratification tool by comparing its performance to HEART score in chest pain patients with low suspicion for acute coronary syndrome and admitted for overnight observation.METHODS We retrospectively reviewed medical records of 330 consecutive patients admitted to our clinical decision unit for acute chest pain between January 1st to April 17th,2019.To avoid potential biases,investigators assigned to calculate the SVEAT,and HEART scores were blinded to the results of 30-d combined endpoint of death,acute myocardial infarction or confirmed coronary artery disease requiring revascularization or medical therapy[30-d major adverse cardiovascular event(MACE)].An area under receiving-operator characteristic curve(AUC)for each score was then calculated.C-statistic and logistic model were used to compare RESULTS A 30-d MACE was observed in 11 patients(3.33%of the subjects).The AUC of SVEAT score(0.8876,95%CI:0.82-0.96)was significantly higher than the AUC of HEART score(0.7962,95%CI:0.71-0.88),P=0.03.Using logistic model,SVEAT score with cut-off of 4 or less significantly predicts 30-d MACE(odd ratio 1.52,95%CI:1.19-1.95,P=0.001)but not the HEART score(odd ratio 1.29,95%CI:0.78-2.14,P=0.32).CONCLUSION The SVEAT score is superior to the HEART score as a risk stratification tool for acute chest pain in low to intermediate risk patients.