Age-related secretion of grancalcin by macrophages induces skeletal stem/progenitor cell senescence during fracture healing

Skeletal stem/progenitor cell(SSPC)senescence is a major cause of decreased bone regenerative potential with aging,but the causes of SSPC senescence remain unclear.In this study,we revealed that macrophages in calluses secrete prosenescent factors,including grancalcin(GCA),during aging,which triggers SSPC senescence and impairs fracture healing.Local injection of human rGCA in young mice induced SSPC senescence and delayed fracture repair.Genetic deletion of Gca in monocytes/macrophages was sufficient to rejuvenate fracture repair in aged mice and alleviate SSPC senescence.Mechanistically,GCA binds to the plexin-B2 receptor and activates Arg2-mediated mitochondrial dysfunction,resulting in cellular senescence.Depletion of Plxnb2 in SSPCs impaired fracture healing.Administration of GCA-neutralizing antibody enhanced fracture healing in aged mice.Thus,our study revealed that senescent macrophages within calluses secrete GCA to trigger SSPC secondary senescence,and GCA neutralization represents a promising therapy for nonunion or delayed union in elderly individuals.

The experiences of menstrual symptom changes among international students studying in China during the acculturation period: A phenomenology study

Objectives Menstruation is a normal physiological phenomenon among female which could be influenced by the process of acculturation.Few studies have explored the experience of menstrual symptom changes among international female students studying in China.Therefore,this paper aims to summarize international female students’experiences of menstrual symptom changes when they were studying in China and interpret these changes through considering the influence of acculturation on their social and academic lives.Methods We used a descriptive phenomenology approach.Structured in-depth face-to-face interviews were conducted between May and November 2019 among ten international female students studying in one Province located in south central China.Participants were those who reported having experienced menstrual symptom changes during the acculturation period,which was defined as the first six months of living in China.All interviews were audio-recorded,transcribed verbatim,and analyzed using NVivo 11.0 with the guidance of Colaizzi's seven-step method.Results The international female students’experiences of menstrual symptom changes were summarized and grouped into five main categories and 13 subcategories.The main categories include:1)demonstration of menstrual symptom changes,2)challenges of maintaining menstrual function in the new setting,3)coping styles to take care of menstrual health,4)consequences of the menstrual symptom changes,and 5)culture-based attitude toward menstruation.Conclusions International female students reported experiences of menstrual symptom changes,including somatic and psychological symptoms during the acculturation period.Culture barriers,academic stress,and sleep patterns are common factors influencing their menstrual symptom changes.More culturally-tailored interventions should be explored to improve the menstrual health of international female students in China.

Influencing Factors for Social Acceptance of Noma (Cancrum Oris) Patients in Niger: A Hospital-Based Cross-Sectional Study

Background: Noma, mostly identified in malnourished young children in the world’s low-income countries, causes severe orofacial disfigurement and significant mortality and morbidity. The majority of noma patients surviving with aesthetical effects are exposed to stigmatization and social rejection. Studies focusing on the socio-psychological impact of noma survivors have rarely been done. Our study aimed to identify the differences in social acceptance/rejection and the influencing factors associated with social acceptance in noma patients. Methods: A cross-sectional study was conducted at the NGO-Sentinelles (Niger) reception center on patients with noma from Zinder, Maradi, and Tahoua regions between 9th May 2017 and 2nd June 2017. The survey was conducted through a face-to-face interview on patients admitted to the center and those discharged from the centre after the treatment. The interview questionnaire comprised 45 questions (Cronbach’s alpha coefficient = 0.812) with pathological information, sociodemographic characteristics, and socio-psychological qualitative information. Findings: We recorded 50 noma patients (43 from Zinder and 7 from Maradi and Tahoua). The younger patients (1 - 5 years old), noma patients who stayed in school during follow-up treatment, patients who were referred by a health structure, patients enrolled into the centre in a short time (<30 days), and patients in the acute phase of noma had a significantly high social acceptance rate with 60.0%, 82.9%, 60.0%, 57.1% and 94.3% respectively;whereas single adults and cheek lesion site had the highest social rejection rate when compared to their corresponding factors with 60.0% and 86.7% respectively. There were significant differences in victims’ perception of noma [χ2 = 45.536, (P < 0.001)] and acceptance of their new faces [P = 0.023], between the social acceptance and social rejection rate, therefore all patients who accepted their new faces felt social acceptance. Social acceptance was significantly highly correlated with pathological history (admission method, phase of noma, care, and treatment received at center) with rs ranging from 0.609 to 0.810, moderately correlated with patient’s sociodemographic characteristics (age, marital status, and region) with rs ranging from 0.381 to 0.474. Lowly correlated with clinical evolution after treatment (rs = 0.293). Logistic regression results showed that the likelihood of social acceptance increased when the patient’s age was young (≤15 years), their marital status was minor, they were enrolled at the school before noma appearance, they were referred to the centre after diagnosis, the admission time to the centre was short (≤30 days), acute phase of noma, and care received at the centre was non-surgery. The location of the lesion on the cheek was a risk factor for social acceptance, indicating cheek lesions from noma increased the likelihood of social rejection in our study. Conclusion: The sociodemographic characteristics, pathological history, and psychological aspects of noma patients were correlated and were found to be important factors influencing their social acceptance/rejection rate.

Integration of Theory and Practice in Medical Morphology Curriculum in Postgraduate Training:A Flipped Classroom and Case-based Learning Exercise

Objective:The integration of training in theory and practice across the medical education spectrum is being encouraged to increase student understanding and skills in the sciences.This study aimed to determine the deciding factors that drive students'perceived advantages in class to improve precision education and the teaching model.Methods:A mixed strategy of an existing flipped classroom(FC)and a case-based learning(CBL)model was conducted in a medical morphology curriculum for 575 postgraduate students.The subjective learning evaluation of the individuals(learning time,engagement,study interest and concentration,and professional integration)was collected and analyzed after FC-CBL model learning.Results:The results from the general evaluation showed promising results of the medical morphology in the FC-CBL model.Students felt more engaged by instructors in person and benefited in terms of time-saving,flexible arrangements,and professional improvement.Our study contributed to the FC-CBL model in Research Design in postgraduate training in 4 categories:1)advancing a guideline of precision teaching according to individual characteristics;2)revealing whether a learning background is needed for a Research Design course to guide setting up a preliminary course;3)understanding the perceived advantages and their interfaces;and 4)barriers and/or improvement to implement the FC-CBL model in the Research Design class,such as a richer description of e-learning and hands-on practice.Conclusion:Undertaking a FC-CBL combined model could be a useful addition to pedagogy for medical morphology learning in postgraduate training.

Exploring the potential mechanisms of luteolin against ulcerative colitis and colorectal cancer via network pharmacology and molecular docking

Background:Patients diagnosed with ulcerative colitis(UC)are known to have an increased susceptibility to colorectal cancer(CRC).However,the shared underlying mechanisms between UC and CRC remain unclear.Given the therapeutic potential of luteolin in both UC and CRC,this study aims to elucidate the molecular targets and mechanisms through which luteolin exerts its effects against these diseases.Methods:The GeneCards database,DisGENet database,and Gene Expression Omnibus database were utilized to analyze the targets associated with UC and CRC.Subsequently,the Traditional Chinese Medicine Systems Pharmacology and SwissTargetPrediction databases were employed to identify luteolin-related targets.The identified luteolin-related targets were then mapped to official gene symbols using the UniProt database.The Cytoscape 3.9.0 software was utilized to construct a network of luteolin-associated targets.Venn diagram analysis was performed to identify common targets among UC,CRC,and luteolin.The common targets were further analyzed using the STRING database to construct a protein-protein interaction network.The“cytoHubba”plugin in Cytoscape 3.9.0 was employed to identify hub targets within the PPI network.Gene Ontology functional analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were conducted on the hub targets.Finally,molecular docking using AutoDock and PyMOL software was performed to assess the binding affinity between luteolin and the hub targets.Results:Luteolin was found to interact with a total of 149 pharmacological targets,while UC and CRC were associated with 1232 and 3278 targets,respectively.Forty-six common targets were identified among luteolin,UC,and CRC.Through the application of seven different algorithms,seven hub targets were identified,TP53,AKT1,TNF,SRC,EGFR,and MMP9.Bioinformatics enrichment analysis revealed 49 enriched pathways through Kyoto Encyclopedia of Genes and Genomes analysis,while Gene Ontology analysis yielded a total of 245 biological processes,4 cellular components,and 7 molecular functions.Molecular docking simulations demonstrated a good binding affinity between luteolin and the hub targets.Conclusion:This study identified multiple potential pharmacological targets and elucidated various biological pathways through which luteolin may exert its therapeutic effects in the treatment of UC and CRC.These findings provide a solid theoretical foundation for further experimental investigations in the treatment of UC and CRC.

Genetic Variations and Nonalcoholic Fatty Liver Disease:Field Synopsis,Systematic Meta-Analysis,and Epidemiological Evidence

Objective To systematically summarize the published literature on the genetic variants associated with nonalcoholic fatty liver disease(NAFLD).Methods Literature from Web of Science,PubMed,and Embase between January 1980 and September 2022 was systematically searched.Meta-analyses of the genetic variants were conducted using at least five data sources.The epidemiologic credibility of the significant associations was graded using the Venice criteria.Results Based on literature screening,399 eligible studies were included,comprising 381 candidate gene association,16 genome-wide association,and 2 whole-exome sequencing studies.We identified 465 genetic variants in 173 genes in candidate gene association studies,and 25 genetic variants in 17 genes were included in the meta-analysis.The meta-analysis identified 11 variants in 10 genes that were significantly associated with NAFLD,with cumulative epidemiological evidence of an association graded as strong for two variants in two genes(HFE,TNF),moderate for four variants in three genes(TM6SF2,GCKR,and ADIPOQ),and weak for five variants in five genes(MBOAT7,PEMT,PNPLA3,LEPR,and MTHFR).Conclusion This study identified six variants in five genes that had moderate to strong evidence of an association with NAFLD,which may help understand the genetic architecture of NAFLD risk.

Predicting Purchasing Behavior on E-Commerce Platforms: A Regression Model Approach for Understanding User Features that Lead to Purchasing

This research introduces a novel approach to improve and optimize the predictive capacity of consumer purchase behaviors on e-commerce platforms. This study presented an introduction to the fundamental concepts of the logistic regression algorithm. In addition, it analyzed user data obtained from an e-commerce platform. The original data were preprocessed, and a consumer purchase prediction model was developed for the e-commerce platform using the logistic regression method. The comparison study used the classic random forest approach, further enhanced by including the K-fold cross-validation method. Evaluation of the accuracy of the model’s classification was conducted using performance indicators that included the accuracy rate, the precision rate, the recall rate, and the F1 score. A visual examination determined the significance of the findings. The findings suggest that employing the logistic regression algorithm to forecast customer purchase behaviors on e-commerce platforms can improve the efficacy of the approach and yield more accurate predictions. This study serves as a valuable resource for improving the precision of forecasting customers’ purchase behaviors on e-commerce platforms. It has significant practical implications for optimizing the operational efficiency of e-commerce platforms.

Epidemiological Survey of the Prevalence of Non-fatal Injury among Children Aged 5-14 Years in China

Objective To determine the prevalence of non-fatal injuries among children aged 5-14 years in China. Methods Data of 21 973 children aged 5-14 years were extracted from the Fourth National Health Service Survey of China carried out between June 15 and July 10, 2008. Injury-related indicators included： history of ever having had an injury, and injury frequency, cause, location and severity. Results The overall prevalence of non-fatal injuries among the children in the previous 12 months was 17.0 per 1000 subjects. The leading causes of non-fatal injuries were falls, animal bites, traffic accidents, falling objects and burns. The majority of children sustained only one injury. The main place of injury was at home in 40% and 54% of urban boys and girls, respectively, at school in 48% of rural boys, and at home and at school each in 33% of rural girls. Medical treatment for one day was the main option for 80% of urban boys and girls, 84% of rural boys, and 72% of rural girls. Conclusion Nonfatal injuries among children aged 5-14 years are a serious public health concern in China.

Scoring systems for prediction of mortality in decompensated liver cirrhosis: A meta-analysis of test accuracy

AIM To compare the accuracy of the scoring systems ChildTurcotte-Pugh(CTP), Model for End-stage Liver Disease score(MELD), MELD-Na, and MELD to Serum Sodium ratio(MESO) to predict the mortality in decompensated liver cirrhosis.METHODS The PubMed, Web of Science, Cochrane Library, EMBASE, and Ovid databases were systematically searched from inception to September 2018 for relevant articles, and we evaluated the quality of the included studies. The accuracy of scoring systems was analyzed with Stata 12 and MetaDiSc 1.4.RESULTS Sixteen studies involving 2337 patients were included. The pooled areas under the summary receiver operating characteristic curves(AUROCs) of CTP, MELD, MELD-Na, and MESO to predict mortality were 0.81,0.78, 0.85, and 0.86, respectively. Within 3 mo, the AUROCs of CTP, MELD, and MELD-Na in predicting mortality were 0.78, 0.76, and 0.89, respectively. The AUROCs of CTP, MELD, and MELD-Na at 3 mo were 0.86, 0.78, and 0.86, respectively. The AUROCs of CTP, MELD, and MELD-Na at 6 mo were 0.91, 0.83, and 0.90, respectively. The AUROCs of CTP, MELD, and MELDNa at 12 mo were 0.72, 0.75 and 0.84, respectively. In cirrhotic patients with bleeding, the AUROCs of CTP and MELD were 0.76 and 0.88, respectively.CONCLUSION MESO has the highest AUROC in all assessed scoring systems. Considering the different time points, MELDNa has good accuracy in predicting the mortality of decompensated liver cirrhosis. Compared to CTP, MELD is better in predicting variceal bleeding.

Validity of Different Methods to Prenatal Screening for Down’s Syndrom During First and Second Trimester Pregnancy of Chinese Women

Objective To identify and determine the optimal method to screening for fetal Down＇s syndrome （DS）. Methods Three large cohorts with 17 118, 39 903, 16 646 subjects were enrolled for the first trimester double marker （pregnancy-associated plasma protein A and free [B-human chorionic gonadotropin） screening （FTDMS）, second trimester double marker （c{-fetoprotein and free B-human chorionic gonadotropin） screening （STDMS）, and second trimester triple marker （a-fetoprotein, free 13-human chorionic gonadotropin and unconjugated estriol 3） screening （STTMS）, respectively. The sensitivity, specificity, false positive rate （FPR）, false negative rate （FNR） and the areas under ROC curves （AUCs） were estimated in order to determine the optimal screening method in women under or above 35 years old. Results For women under 35 years old, STTMS was the best method with a detection rate of 68.8% and FPR of 4.3% followed by the STDMS with a detection rate （sensitivity） of 66.7% and FPR of 4.9%. The FTDMS had a lower detection rate of 61.1% and FPR of 6.3%. For women above 35 years old, the detection rate of all the methods was similar, but STTMS method had a lowest FPR of 15.9%. For women under 35 years old AUCs were 0.77 （95% CI, 0.64 to 0.91）, 0.81 （95% CI, 0.71 to 0.91）, and 0.82 （95% CI, 0.69 to 0.96） for FTDMS, STDMS, and STTMS methods, respectively; for those above 35 years old, AUCs were 0.70 （95% CI, 0.56 to 0.83）, 0.70 （95% CI, 0.59 to 0.82）, 0.78 （95% Cl, 0.58 to 0.97） for FTDMS, STDMS and SITMS, respectively. Conclusion Findings from our study revealed that STDMS is optimal for the detection of fetal DS in pregnant women aged under 35. For individual women, if economic condition permits, STFMS is the best choice, while for women aged above 35, STTMS is the best choice in this regard.

Maternal serum level of resistin is associated with risk for gestational diabetes mellitus:A meta-analysis

BACKGROUND Resistin is most likely involved in the pathogenesis of gestational diabetes mellitus(GDM), but the existing findings are inconsistent.AIM To review the literature investigating the associations of the risk of GDM with serum level of resistin.METHODS A systematic literature search was performed using MEDLINE, EMBASE, and Web of Science(all databases). This meta-analysis included eligible studies that:(1) investigated the relationship between the risk of GDM and serum resistin;(2)included GDM cases and controls without GDM;(3) diagnosed GDM according to the oral glucose-tolerance test;(4) were performed in humans;(5) were published as full text articles in English; and(6) provided data with median and quartile range, median and minimum and maximum values, or mean and standard deviation. The pooled standardized mean difference(SMD) and 95%confidence interval(CI) were calculated to estimate the association between the risk of GDM and serum resistin. To analyze the potential influences of need for insulin in GDM patients and gestational age at blood sampling, we performed a subgroup analysis. Meta-regression with restricted maximum likelihood estimation was performed to assess the potentially important covariate exerting substantial impact on between-study heterogeneity.RESULTS The meta-analysis for the association between serum resistin level and GDM risk included 18 studies(22 comparisons) with 1041 cases and 1292 controls. The total results showed that the risk of GDM was associated with higher serum resistin level(SMD = 0.250, 95%CI: 0.116, 0.384). The "after 28 wk" subgroup, "no need for insulin" subgroup, and "need for insulin" subgroup indicated that higher serum resistin level was related to GDM risk("after 28 wk" subgroup: SMD =0.394, 95%CI: 0.108, 0.680; "no need for insulin" subgroup: SMD = 0.177, 95%CI:0.018, 0.336; "need for insulin" subgroup: SMD = 0.403, 95%CI: 0.119, 0.687). The"before 14 wk" subgroup, "14-28 wk" subgroup, and "no information of need for insulin" subgroup showed a nonsignificant association between serum resistin level and GDM risk("before 14 wk" subgroup: SMD = 0.087, 95%CI:-0.055, 0.230;"14-28 wk" subgroup: SMD = 0.217, 95%CI:-0.003, 0.436; "no information of need for insulin" subgroup: SMD = 0.356, 95%CI:-0.143, 0.855). The postpartum subgroup included only one study and showed that higher serum resistin level was related to GDM risk(SMD = 0.571, 95%CI: 0.054, 1.087) The meta-regression revealed that no need for insulin in GDM patients, age distribution similar between cases and controls, and ELISA all had a significant impact on between-study heterogeneity.CONCLUSION This meta-analysis supports that the maternal serum resistin level is associated with GDM risk.

Detection of HBsAg, HBcAg, and HBV DNA in ovarian tissues from patients with HBV infection

AIM: To investigate the presence of HBsAg, HBcAg, and HBV DNA in ovarian tissues from patients with HBV infection.METHODS: HBsAg and HBcAg were examined in ovarian biopsy tissues from 26 patients with HBV infection by immunocytochemistry, and HBV DNA was detected in ovarian tissues by PCR.RESULTS: HBsAg and HBcAg were present with the same positive rate of 34.6% (9/26). The total positive rate was 46.2% (12/26). HBsAg and HBcAg were positive in 6 (23.1%) of the 26 patients. Brown positive particles were diffusely distributed in ovarian cells. The positive rate of HBV DNA was 58.3% (7/12).CONCLUSION: HBsAg, HBcAg, and HBV DNA can be detected in ovarian tissues from patients with HBV infection. The presence of HBsAg and HBcAg in ovarian tissues does not correlate with the HBV markers in serum.

Prognostic value and predictive threshold of tumor volume for patients with locally advanced nasopharyngeal carcinoma receiving intensity-modulated radiotherapy

Background: Gross target volume of primary tumor(GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma(NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity?modulated radiotherapy(IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to ind a suitable cut?of value of GTV?P for prognosis prediction.Methods: Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver oper?ating characteristic(ROC) curves were used to identify the cut?of values of GTV?P for the prediction of diferent end?points [overall survival(OS), local relapse?free survival(LRFS), distant metastasis?free survival(DMFS), and disease?free survival(DFS)] and to test the prognostic value of GTV?P when compared with that of the American Joint Committee on Cancer T staging system.Results: The 358 patients with locally advanced NPC were divided into two groups by the cut?of value of GTV?P as determined using ROC curves: 219(61.2%) patients with GTV?P ≤46.4 mL and 139(38.8%) with GTV?P >46.4 mL. The 3?year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV?P ≤46.4 mL than in those with GTV?P > 46.4 mL(all P < 0.05). Multivariate analysis indicated that GTV?P >46.4 mL was an independent unfavorable prognostic factor for patient survival. The ROC curve veriied that the predictive ability of GTV?P was superior to that of T category(P < 0.001). The cut?of values of GTV?P for the prediction of OS, LRFS, DMFS, and DFS were 46.4, 57.9, 75.4 and 46.4 mL, respectively.Conclusion: In patients with locally advanced NPC, GTV?P >46.4 mL is an independent unfavorable prognostic indi?cator for survival after IMRT, with a prognostic value superior to that of T category.

Adiponectin gene polymorphisms and risk of gestational diabetes mellitus:A meta-analysis

BACKGROUND Adiponectin(ADIPOQ) is an important factor involved in the regulation of both carbohydrate and lipid metabolism. Polymorphisms in the ADIPOQ gene are known to influence an individual's predisposition to metabolic syndrome and type 2 diabetes. Moreover, women with gestational diabetes mellitus(GDM) are at an increased risk of developing type 2 diabetes. Several studies have been conducted previously to assess the association between ADIPOQ polymorphisms and GDM; however, the results of the association are inconclusive.AIM To quantitatively evaluate the association between ADIPOQ +45 T/G, +276 G/T,and-11377 C/G polymorphisms and the risk of GDM.METHODS A systematic search of EMBASE, PubMed, CNKI, Web of Science, and WANFANG DATA was conducted up to October 20, 2018. We calculated merged odds ratios(ORs) with 95% confidence intervals(CIs) using a fixed-effects or random-effects model depending on the between-study heterogeneity to evaluate the association between AIDPOQ +45 T/G, +276 G/T, and-11377 C/G polymorphisms and the risk of GDM. Subgroup analysis was performed by ethnicity. Publication and sensitivity bias analyses were performed to test the robustness of the association. All statistical analyses were conducted using Stata 12.0.RESULTS Nine studies of +45 T/G included 1024 GDM cases and 1059 controls, five studies of +276 G/T included 590 GDM cases and 595 controls, and five studies of-11377 C/G included 722 GDM cases and 791 controls. Pooled ORs indicated that+45 T/G increased GDM risk in Asians(allelic model: OR = 1.47, 95%CI: 1.27-1.70,P = 0.000; dominant model: OR = 1.54, 95%CI: 1.27-1.85, P = 0.000; recessive model: OR=2.00, 95%CI: 1.43-2.85, P = 0.000), not in South Americans(allelic model: OR = 1.21, 95%CI: 0.68-2.41, P = 0.510; dominant model: OR = 1.13, 95%CI:,0.59-2.15, P = 0.710; recessive model: OR = 2.18, 95%CI: 0.43-11.07, P = 0.350).There were no significant associations between +276 G/T(allelic model: OR = 0.88,95%CI: 0.74-1.05, P = 0.158; dominant model: OR = 0.91, 95%CI: 0.65-1.26, P =0.561; recessive model: OR = 0.82, 95%CI: 0.64-1.05, P = 0.118) or-11377 C/G(allelic model: OR = 0.96, 95%CI: 0.72-1.26, P = 0.750; dominant model: OR = 1.00,95%CI: 0.73-1.37, P = 0.980; recessive model: OR = 0.90, 95%CI: 0.61-1.32, P =0.570) and the risk of GDM.CONCLUSION Our meta-analysis shows the critical role of the ADIPOQ +45 T/G polymorphism in GDM, especially in Asians. Studies focused on delineating ethnicity-specific factors with larger sample sizes are needed.

Demographic Characteristics and Environmental Risk Factors Exposure of Birth Defects in Pregnant Women: A Population-based Study

Worldwide, the incidence of birth defects in low-income countries is 6.42%, while in middle-income and high-income countries it is 5.57% and 4.72%, respectively;approximately 303, 000 newborns die from birth defects each year. In China, the incidence of birth defects is about 5.6%, and around 8.14 million people have congenital disabilities, accounting for 9.6% of total disabled people[1]. Birth defect remains a major clinical and public health challenge because of its high fatality rate and protracted and severe sequela.

A nested case-control study of maternal-neonatal transmission of hepatitis B virus in a Chinese population

AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to September 31,2006 To avoid potential maternal blood contamination,we collected vein blood of newborns immediately after birth and before initial hepatitis B vaccination to determine the HBV infection status of the newborn For each HBsAg-positive infant,one HBsAg-negative infant born to an HBsAg-positive mother was matched by hospital at birth(same),gender(same),and date of birth(within 1 mo) A faceto-face interview was conducted to collect clinical and epidemiological data Conditional logistic regression analysis was used to estimate the independent effects of various determinants on maternal-neonatal transmission of HBV RESULTS:A total of 141 HBsAg-positive infants and 141 individually matched HBsAg-negative infants were included in the final analysis Maternal first-degree family history of HBV infection,intrahepatic cholestasis,and premature rupture of membranes were risk factors for perinatal transmission of HBV,whereas systematic treatment and HBV immunoglobulin injections for mothers with HBV infection were protective factors for maternal-neonatal transmission of HBV,after adjustment for potential confounding factors CONCLUSION:For HBsAg-positive mothers,systematic treatment,HBV immunoglobulin administration,and controlling intrahepatic cholestasis and pregnancy complications may reduce the incidence of perinatal transmission of HBV.

PBX1 attributes as a determinant of connexin 32 downregulation in Helicobacter pylori-related gastric carcinogenesis

AIM To clarify the mechanisms of connexin 32 (Cx32) downregulation by potential transcriptional factors (TFs) in Helicobacter pylori (H. pylori)-associated gastric carcinogenesis. METHODS Approximately 25 specimens at each developmental stage of gastric carcinogenesis [non-atrophic gastritis, chronic atrophic gastritis, intestinal metaplasia, dysplasia and gastric carcinoma (GC)] with H. pylori infection [H. pylori (+)] and 25 normal gastric mucosa (NGM) without H. pylori infection [H. pylori (-)] were collected. After transcriptional factor array analysis, the Cx32 and PBX1 expression levels of H. pylori-infected tissues from the developmental stages of GC and NGM with no H. pylori infection were measured by real-time polymerase chain reaction (RT-PCR) and Western blot analysis. Regarding H. pylori-infected animal models, the Cx32 and PBX1 mRNA expression levels and correlation between the gastric mucosa from 10 Mongolian gerbils with long-term H. pylori colonization and 10 controls were analyzed. PBX1 and Cx32 mRNA and protein levels were further studied under the H. pylori-infected condition as well as PBX1 overexpression and knockdown conditions in vitro. RESULTS Incremental PBX1 was first detected by TF microarray in H. pylori-related gastric carcinogenesis. The identical trend of PBX1 and Cx32 expression was confirmed in the developmental stages of H. pylori-related clinical specimens. The negative correlation of PBX1 and Cx32 was confirmed in H. pylori-infected Mongolian gerbils. Furthermore, decreased PBX1 expression was detected in the normal gastric epithelial cell line GES-1 with H. pylori infection. Enforced overexpression or RNAi-mediated knockdown of PBX1 contributed to the diminished or restored Cx32 expression in GES-1 and the gastric carcinoma cell line BGC823, respectively. Finally, dual-luciferase reporter assay in HEK293T cells showed that Cx32 promoter activity decreased by 30% after PBX1 vector co-transfection, indicating PBX1 as a transcriptional downregulator of Cx32 by directly binding to its promoters. ONCLUSION PBX1 is one of the determinants in the Cx32 promoter targeting site, preventing further damage of gap junction protein in H. pylori-associated gastric carcinogenesis.

Factors influencing the diagnosis and treatment of chronic prostatitis among urologists in China

Aim. To identify the factors influencing diagnosis and treatment of chronic prostatitis （CP） among Chinese urologists. Methods： A sample of 656 urologists from 29 provinces of China were asked to complete a questionnaire that explored attitudes towards CP as well as diagnosis and treatment patterns in the management of CP. Both univariate and multivariate logistic regression analysis schemes were used to determine the factors that influence the diagnosis and treatment of CP. Results： A total of 656 questionnaires were given out. All were returned and 410 of those were included in the final univariate and multivariate analysis. Multivariate logistic regression analysis indicated that belief of bacterial infection in the etiology of CP （odds ratio [OR], 2.544; 95% confidence interval [CI], 1.650-3.923; P 〈 0.001） was the most significant factor influencing the routine performance of bacterial culture test. Using the same model, the type of hospital （OR, 2.799; 95% CI, 1.719-4.559; P 〈 0.001） and the routine use of the 4- or the 2-glass test （OR, 3.194; 95% CI, 2.069-4.931; P 〈 0.001） were determined to be significant factors influencing the use of the National Institutes of Health （NIH） new classification system. According to the same model, belief of bacterial infection in the etiology of CP （OR, 3.415; 95% CI, 2.024-5.762; P 〈 0.001） and the routine use of bacterial culture test （OR, 2.261; 95% CI, 1.364-3.749; P 〈 0.01） were important factors influencing the routine prescription of antibiotics. Conclusion： Our findings suggest that attitudes towards CP, and the characteristics of individual urologists＇ practices may influence the diagnosis and treatment of CP among Chinese urologists.

Prevalence and Related Factors of Falls among the Elderly in an Urban Community of Beijing

Objective To understand the prevalence, consequences and risk factors of falls among urban community-dwelling elderly in Beijing. Methods A cross-sectional study was conducted in Longtan Community, Beijing. A total of 1512 individuals aged 60 years or over were selected by stratified cluster sampling. Data regarding the frequency of falls in the previous year, as well as circumstances, consequence and related factors of falls were collected from the elderly through face-to-face interviews with questionnaires in their home. Results The prevalence of falls was 18.0% on the average among 1512 participants, higher in women （20.1%） than in men （14.9%） （P=0.006）, and increased with age （Х^2 for trend=10.37, P=0.001）. The total rate of falls-induced injuries among the fallers was 37.7%. Falls usually resulted in soft-tissues bruises （58.7%）, fear of repeated episodes of falls （58.8%）, loss of independence and confidence in movement （35.7%） and even in hip fracture. In addition to the burden of medical care, falls also generated a big economic burden. Occurrence of falls was significantly associated with both intrinsic and extrinsic factors. The related factors of falls in the elderly included age≥60-70 years, femininity, less physical activities, fear of future falls, living alone, severely impaired vision, health problem-impacted activities of daily living, chronic diseases （diabetes, hypertension, postural hypotension, stroke sequela, cataract, arthritis, dementia and depression）, medications （psychoactive, anti-diabetic）, gait imbalance, high bed and faintly-lighted stairway. Conclusion The prevalence of falls among urban community-dwelling elderly in Beijing is closely associated with significant associated with intrinsic and extrinsic factors. Efforts to prevent falls in the elderly should be made at community level.

Incidence and Associated Factors for Single and Recurrent Falls among the Elderly in an Urban Community of Beijing

Objective To investigate the incidence of falls and recurrent falls, and explore associated factors for single and recurrent falls among urban community-dwelling elderly in Beijing. Methods A cross-sectional study was conducted in 472 elderly in the Longtan community of Dongcheng district, Beijing in 2009. Data regarding the incidence of fall and recurrent falls in the previous year, as well as associated factors were collected from the elderly through face-to-face interviews. Results The incidence of falls and recurrent falls was 17.8% and 6.1%, respectively, and it increased with age （X^2for trend=21.06, 19.20, P=0.001, 0.002）. Binary logistic stepwise regression analysis showed that age （OR=2.20）, living alone （OR=4.67） and gait disturbance （OR=1.27） were risk factors, while housing with elevators （OR=0.35）, appropriate width/height of stair steps （0R=0.78）, sufficient lighting for stairway （OR=0.45） and regular exercise （OR=0.12） could lower the risk for single fall; factors such as low monthly family income （OR=1.39）, poor vision （OR=1.83）, low physical ability （OR=4.47）, abnormal static balance （OR=2.48）, and fear of falls（OR=2.23） were risk factors, while appropriate width/height of stair steps （OR=0.49） and easiness of access to daily supplies （OR=0.41） were protective factors for recurrent falls. Conclusion The incidence of falls in commun and their related injuries have been associated ty-dwelling elderly people in Beijing is common, and falls with both intrinsic and extrinsic factors.