Publications by authors named "Weiqing Chen"

90 Publications

Association of healthy lifestyle with risk of obstructive sleep apnea: a cross-sectional study.

BMC Pulm Med 2022 Jan 11;22(1):33. Epub 2022 Jan 11.

School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China.

Background: No studies investigated the whole effect of modifiable lifestyle factors on OSA risk. This study aimed to examine the individual and combined effects of lifestyle factors on OSA risk among Chinese adults.

Methods: This cross-sectional study included 9733 participants aged 35 to 74 years from the baseline survey of Guangzhou Heart Study. OSA was evaluated by Berlin Questionnaire. The healthy lifestyle score (HLS), representing the overall effect of lifestyles, was derived from seven lifestyle factors: active smoking, passive smoking, alcohol, diet, waist-hip ratio, leisure-time physical activity, and mental status. Odds ratio (OR) with 95% confidence interval (CI) was calculated using the multivariate logistic regression model.

Results: 8107 participants were divided into the non-OSA group and 1626 participants into the OSA group. No passive smoking (OR 0.83, 95% CI 0.74-0.94), healthy waist-hip ratio (OR 0.67, 95% CI 0.58-0.77) and healthy mental status (OR 0.45, 95% CI 0. 29-0.73) were associated with a reduced risk of OSA after adjusting for confounders, while others not. Participants with higher HLS were negatively associated with OSA risk (P < 0.001). In comparison to the participants with 0-3 HLS, the OR for participants with 4, 5, 6, and 7 HLS was 0.68 (95% CI 0.56-0.84), 0.71 (95% CI 0.59-0.86), 0.62 (95% CI 0.51-0.76) and 0.49 (95% CI 0.37-0.65) after adjusting for confounders. Every 1-score increment of HLS was associated with a 13% lower risk of OSA.

Conclusions: The results suggest that HLS reflecting the combined effect of multiple-dimensional lifestyle factors was inversely associated with OSA risk. Preventive strategies integrating multiple lifestyle factors may provide a more feasible approach for OSA prevention.
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http://dx.doi.org/10.1186/s12890-021-01818-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751297PMC
January 2022

Numb inhibits migration and promotes proliferation of colon cancer cells via RhoA/ROCK signaling pathway repression.

Exp Cell Res 2022 Feb 3;411(2):113004. Epub 2022 Jan 3.

Department of Gastroenterology, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, 400030, People's Republic of China. Electronic address:

Numb regulates cell proliferation and differentiation through endocytosis and ubiquitination of signaling molecules. Besides, Numb controls the migration of epithelial cells by regulating intercellular junctions. Studies have shown that Numb promotes or inhibits tumor progression in different tumors. However, its role and mechanism in colorectal cancer remain unclear. We found that the expression level of Numb in colon tumor tissues has a great variety in different patients. Numb expression was negatively correlated with TNM stage and lymph node metastasis but positively correlated with tumor size. Elevated expression of Numb was associated with a good prognosis. Inhibiting Numb expression promoted the migration and invasion of colon cancer cells induced by TGF-β, up-regulated the expression of EMT-related molecule Snail, and prevented the expression of E-cadherin. We also found that Numb promoted the proliferation and clones formation while inhibiting colon cancer cells' late apoptosis. In addition, Numb inhibited the RhoA activation and ROCK inhibitor Y-27632 or interfered with ROCK expression, partially inhibiting Numb-regulated cell proliferation and migration. In vivo tumorigenesis assay in nude mice also found that Numb promoted the proliferation of colon cancer cells, inhibited the expression of E-cadherin, and strengthened the expression of Snail. In conclusion, our study found that Numb plays multiple roles in the occurrence and progression of colon cancer by regulating the RhoA/ROCK signaling pathway, which provides a new theoretical molecular basis for the pathogenesis of colon cancer.
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http://dx.doi.org/10.1016/j.yexcr.2021.113004DOI Listing
February 2022

Nighttime sleep duration, restlessness and risk of multimorbidity - A longitudinal study among middle-aged and older adults in China.

Arch Gerontol Geriatr 2021 Nov 15;99:104580. Epub 2021 Nov 15.

Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China. Electronic address:

Purpose: To assess the associations of nighttime sleep duration and restlessness with the risk of multimorbidity in Chinese middle-aged and older adults.

Methods: We used the 2011 and 2015 surveys of the China Health and Retirement Longitudinal Study (CHARLS). Sleep duration was grouped into ≤ 5, (5-6], (6-8], (8-9], and > 9 h/night. Restlessness days in the past week were categorized into < 1, 1-2, 3-4, and 5-7 days/week. Multimorbidity was defined as the co-existence of two or more of 14 chronic conditions (hypertension, dyslipidemia, diabetes mellitus, cancer, chronic lung disease, liver disease, heart problems, stroke, kidney disease, digestive disease, psychiatric problems, memory-related disease, arthritis, and asthma). Log-binomial regression models were used to estimate the associations.

Results: A total of 6,037 participants free of multimorbidity at baseline were included. During four-years of follow-up, 2,203 (36.5%) participants developed multimorbidity. Compared to participants who slept 6-8 h/night, those with short sleep duration ≤ 5 h/night and 5-6 h/night were associated with 33.3% (95% CI: 14.8%-54.7%) and 24.2% (95% CI: 5.9%-45.6%) increased risk of multimorbidity, respectively. Long sleep duration was not significantly associated with incident multimorbidity. Compared to those who rarely or never had a restless sleep in the past week, participants with 5-7 days of restless sleep had increased risk of multimorbidity (RR: 1.750, 95% CI: 1.476-2.076). Similar findings were confirmed in subgroups by age, gender, and baseline chronic condition status.

Conclusions: Short nighttime sleep duration and restlessness were associated with increased risk of multimorbidity in China.
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http://dx.doi.org/10.1016/j.archger.2021.104580DOI Listing
November 2021

Adverse Childhood Experiences and Subsequent Chronic Diseases Among Middle-aged or Older Adults in China and Associations With Demographic and Socioeconomic Characteristics.

JAMA Netw Open 2021 10 1;4(10):e2130143. Epub 2021 Oct 1.

School of Public Health, Sun Yat-sen University, Guangzhou, China.

Importance: Associations between adverse childhood experiences (ACEs) and chronic diseases among middle-aged or older Chinese individuals have not been well documented. In addition, whether demographic and socioeconomic characteristics modify any such associations has been underexplored.

Objectives: To examine associations between ACEs and subsequent chronic diseases and to assess whether age, sex, educational level, annual per capita household expenditure level, and childhood economic hardship modify these associations.

Design, Setting, And Participants: This population-based cross-sectional study used data from the China Health and Retirement Longitudinal Study (CHARLS), a survey of residents aged 45 years or older in 28 provinces across China; specifically, the study used data from the CHARLS life history survey conducted from June 1 to December 31, 2014, and a CHARLS follow-up health survey conducted from July 1 to September 30, 2015. The study population included 11 972 respondents aged 45 years or older who had data on at least 1 of 14 specified chronic diseases and information on all 12 of the ACE indicators included in this study. Data analysis was performed from December 1 to 30, 2020.

Exposures: Any of 12 ACEs (physical abuse, emotional neglect, household substance abuse, household mental illness, domestic violence, incarcerated household member, parental separation or divorce, unsafe neighborhood, bullying, parental death, sibling death, and parental disability), measured by indicators on a questionnaire. The number of ACEs per participant was summed and categorized into 1 of 5 cumulative-score groups: 0, 1, 2, 3, and 4 or more.

Main Outcomes And Measures: Hypertension, dyslipidemia, diabetes, heart disease, stroke, chronic lung disease, asthma, liver disease, cancer, digestive disease, kidney disease, arthritis, psychiatric disease, and memory-related disease were defined by self-reported physician diagnoses or in combination with health assessment and medication data. Multimorbidity was defined as the presence of 2 or more of these 14 chronic diseases. Logistic regression models were used to assess associations of the 12 ACEs with the 14 chronic diseases and with multimorbidity. Modification of the associations by demographic and socioeconomic characteristics was assessed by stratified analyses and tests for interaction.

Results: Of the 11 972 individuals included (mean [SD] age, 59.85 [9.56] years; 6181 [51.6%] were females), 80.9% had been exposed to at least 1 ACE and 18.0% reported exposure to 4 or more ACEs. Compared with those without ACE exposure, participants who experienced 4 or more ACEs had increased risks of dyslipidemia, chronic lung disease, asthma, liver disease, digestive disease, kidney disease, arthritis, psychiatric disease, memory-related disease, and multimorbidity. The estimated odds ratios (ORs) ranged from 1.27 (95% CI, 1.02-1.59) for dyslipidemia to 2.59 (95% CI, 2.16-3.11) for digestive disease. A dose-response association was also observed between the number of ACEs and the risk of most of the chronic diseases (excluding hypertension, diabetes, and cancer) (eg, chronic lung disease for ≥4 ACEs vs none: OR, 2.01; 95% CI, 1.59-2.55; P < .001 for trend) and of multimorbidity (for individuals among the overall study population with ≥4 ACEs vs none: OR, 2.03; 95% CI, 1.70-2.41; P < .001 for trend). The demographic or socioeconomic characteristics of age, sex, educational level, annual per capita household expenditure level, or childhood economic hardship were not shown to significantly modify the associations between ACEs and multimorbidity.

Conclusions And Relevance: In this population-based, cross-sectional study of adults in China, exposure to ACEs was associated with higher risks of chronic diseases regardless of demographic and socioeconomic characteristics during childhood or adulthood. These findings suggest a need to prevent ACEs and a need for a universal life-course public health strategy to reduce potential adverse health outcomes later in life among individuals who experience them.
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http://dx.doi.org/10.1001/jamanetworkopen.2021.30143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546496PMC
October 2021

Association between systemic inflammation and activities of daily living disability among Chinese elderly individuals: the mediating role of handgrip strength.

Aging Clin Exp Res 2021 Oct 16. Epub 2021 Oct 16.

Department of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China.

Background: Aging is accompanied by chronic low-grade inflammation (inflammaging), which is a risk factor for low handgrip strength (HGS) and activities of daily living (ADL) disability.

Aims: To explore the association between C-reactive protein (CRP) and ADL disability in Chinese elderly individuals and to further evaluate the mediating role of HGS in this association.

Methods: We used data from the China Health and Retirement Longitudinal Study (CHARLS) that were collected in 2015. A total of 3601 elderly individuals aged ≥ 60 years were included. Baron and Kenny's causal steps method was used to explore the possible mediating role of HGS in the associations between CRP and ADL disability. Karlson-Holm-Breen method was further applied to decompose total effect into direct effect and indirect effect via HGS. Subgroup analysis was conducted by sex and age.

Results: A high level of CRP (≥ 3 mg/L) was significantly associated with ADL disability after adjustment for covariates (OR = 1.50, 95% CI = 1.17-1.94). After introducing HGS into the model, the risk estimate was reduced but still significant (OR = 1.40, 95% CI = 1.08-1.81). The proportional mediation through HGS was 14.71%. Similar results were observed in both sexes and in participants aged < 70 years.

Conclusion: CRP was positively associated with the risk of ADL disability in Chinese elderly individuals, and this association was mediated by HGS. Improving muscle strength in combination with anti-inflammatory treatment may have a beneficial effect to maintain ADL ability. Further randomized controlled trials on this topic are necessary.
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http://dx.doi.org/10.1007/s40520-021-02003-wDOI Listing
October 2021

Association between Hypertriglyceridemic-Waist Phenotype and Risk of Type 2 Diabetes Mellitus in Middle-Aged and Older Chinese Population: A Longitudinal Cohort Study.

Int J Environ Res Public Health 2021 09 12;18(18). Epub 2021 Sep 12.

School of Public Health, Sun Yat-Sen University, 74 Zhongshan Second Road, Guangzhou 510080, China.

Current evidence remains inconsistent with regard to the association between different triglyceridemic-waist phenotypes and the risks for type 2 diabetes mellitus (T2DM). We aimed to investigate this association among a retrospective cohort analysis of 6918 participants aged ≥ 45 years in the China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized into four triglyceridemic-waist phenotypes consisting of NWNT (normal waist circumference and normal triglycerides), NWHT (normal waist circumference and high triglycerides), EWNT (enlarged waist circumference and normal triglycerides), and EWHT (enlarged waist circumference and high triglycerides) based on participants' baseline information. Multivariate log-binomial regression was used to assess the T2DM risk in different phenotypes. Subgroup analysis was conducted to test the robustness of the findings. After 4-years of follow-up, participants with EWHT (Relative Risk [RR]: 1.909, 95% Confidence Interval [CI]: 1.499 to 2.447) or EWNT (RR: 1.580, 95%CI: 1.265 to 1.972) phenotypes had significantly higher likelihood of incident T2DM compared to the NWNT phenotype, whereas the association was not significant for the NWHT phenotype (RR: 1.063, 95%CI: 0.793 to 1.425). The subgroup analyses generally revealed similar associations across all subgroups. Among middle-aged and older adults, we suggested a combined use of waist circumference and triglycerides measures in identifying participants who are at high risk of developing T2DM.
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http://dx.doi.org/10.3390/ijerph18189618DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466002PMC
September 2021

The association of nighttime sleep duration and quality with chronic kidney disease in middle-aged and older Chinese: a cohort study.

Sleep Med 2021 10 13;86:25-31. Epub 2021 Aug 13.

School of Public Health, Sun Yat-sen University, Guangzhou, China. Electronic address:

Objective: This cohort study aimed to assess the associations between sleep duration and quality with the risk of incident chronic kidney disease (CKD) in middle-aged and older Chinese.

Methods: We used the 2011 and 2015 surveys of the China Health and Retirement Longitudinal Study (CHARLS). Nighttime sleep duration was categorized into five groups: ≤4, (4-6], (6-8], (8-10], and >10 h/night. Sleep quality was assessed by restless days in the past week (<1, 1-2, 3-4, and 5-7 days/week). Multivariate logistic regression was used to assess the association between sleep duration and quality with incident CKD.

Results: A total of 11,339 participants free of CKD at baseline were included in this study. After four years follow-up, the incidence of CKD was 7.8%. There was a "U-shaped" association between sleep duration and risk of CKD. Compared to 6-8 h of nighttime sleep duration, those who slept ≤4 h/night (RR: 1.639, 95% CI: 1.287-2.087) or >10 h/night (RR: 2.342, 95% CI: 1.007-5.451) had increased risk of developing CKD after adjustment for confounders. Participants with 5-7 restless days per week had significantly increased risk of CKD (adjusted RR: 1.686, 95% CI: 1.352-2.102), compared to those who rarely or never had a restless sleep.

Conclusions: Extreme nighttime sleep duration and poor sleep quality were associated with increased risk of CKD in middle-aged and older Chinese. Obtaining an optimal nighttime sleep duration and better sleep quality might reduce the risk of CKD.
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http://dx.doi.org/10.1016/j.sleep.2021.08.007DOI Listing
October 2021

Towards the development of cavitation technology for gas hydrate prevention.

R Soc Open Sci 2021 Aug 4;8(8):202054. Epub 2021 Aug 4.

College of Petroleum Engineering and Geosciences, King Fahd University of Petroleum and Minerals, Dhahran 31261, Kingdom of Saudi Arabia.

In offshore gas well drilling and production, methane hydrate may block the tubing, resulting in the stoppage of gas production. Conventional methods such as injection of thermal hydrate inhibitors, thermal insulating or heating, gas dehydration and reducing pressure are time-consuming and expensive, and sometimes, they are not realistic in production conditions. New methods are needed to lower the cost of gas hydrate prevention and to overcome these limitations. The thermal effect of cavitation was applied to the prevention of gas hydrate in this study. The thermal impact of cavitation, supposed to heat the fluids and prevent the formation of gas hydrate, was evaluated. Numerical simulation was performed to study the thermal performance of cavitation. Furthermore, experimental studies of the influence of initial temperature, flow rate, fluid volume and fluid viscosity on the thermal effect of cavitation were performed, and the results were analysed.
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http://dx.doi.org/10.1098/rsos.202054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8334838PMC
August 2021

Metabolic signatures in the conversion from gestational diabetes mellitus to postpartum abnormal glucose metabolism: a pilot study in Asian women.

Sci Rep 2021 08 12;11(1):16435. Epub 2021 Aug 12.

Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.

We aimed to identify serum metabolites related to abnormal glucose metabolism (AGM) among women with gestational diabetes mellitus (GDM). The study recruited 50 women diagnosed with GDM during mid-late pregnancy and 50 non-GDM matchees in a Singapore birth cohort. At the 5-year post-partum follow-up, we applied an untargeted approach to investigate the profiles of serum metabolites among all participants. We first employed OPLS-DA and logistic regression to discriminate women with and without follow-up AGM, and then applied area under the curve (AUC) to assess the incremental indicative value of metabolic signatures on AGM. We identified 23 candidate metabolites that were associated with postpartum AGM among all participants. We then narrowed down to five metabolites [p-cresol sulfate, linoleic acid, glycocholic acid, lysoPC(16:1) and lysoPC(20:3)] specifically associating with both GDM and postpartum AGM. The combined metabolites in addition to traditional risks showed a higher indicative value in AUC (0.92-0.94 vs. 0.74 of traditional risks and 0.77 of baseline diagnostic biomarkers) and R (0.67-0.70 vs. 0.25 of traditional risks and 0.32 of baseline diagnostic biomarkers) in terms of AGM indication, compared with the traditional risks model and traditional risks and diagnostic biomarkers combined model. These metabolic signatures significantly increased the AUC value of AGM indication in addition to traditional risks, and might shed light on the pathophysiology underlying the transition from GDM to AGM.
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http://dx.doi.org/10.1038/s41598-021-95903-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361021PMC
August 2021

Preparation of Bis[(3-ethyl-3-methoxyoxetane)propyl]diphenylsilane and Investigation of Its Cationic UV-Curing Material Properties.

Polymers (Basel) 2021 Aug 2;13(15). Epub 2021 Aug 2.

School of Materials Science and Engineering, Nanchang University, Nanchang 330031, China.

Precusor EHO(3-ethyl-3-hydroxymethyloxetane) was synthesized with diethyl carbonate and trihydroxypropane as the main raw materials. Intermediate AllyEHO(3-ethyl-3-allylmethoxyoxetane) was synthesized with 3-ethyl-3-hydroxymethyloxetane and allyl bromide as the main raw materials. Prepolymer bis[(3-ethyl-3-methoxyoxetane)propyl]diphenylsilane was synthesized with 3-ethyl-3-methoxyoxetane)propyl and diphenylsilane. Photoinitiator triarylsulfonium hexafluoroantimonate of 3% was added to the prepolymer, and a novel kind of the photosensitive resin was prepared. They were analyzed and characterized with FTIR and H-NMR. Photo-DSC examination revealed that the bis[(3-ethyl-3-methoxyoxetane)propyl]diphenylsilane has great photosensitivity. The thermal properties and mechanical properties of the photosensitive resin were examined by TGA and a microcomputer-controlled universal material testing machine, with thermal stabilities of up to 446 °C. The tensile strength was 75.5 MPa and the bending strength was 49.5 MPa. The light transmittance remained above 98%.
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http://dx.doi.org/10.3390/polym13152573DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347805PMC
August 2021

Indoor solid fuel use for heating and cooking with blood pressure and hypertension: A cross-sectional study among middle-aged and older adults in China.

Indoor Air 2021 11 12;31(6):2158-2166. Epub 2021 Jun 12.

School of Public Health, Sun Yat-sen University, Guangzhou, China.

A cross-sectional study was conducted to investigate the impact of solid fuel use for heating and cooking on blood pressure (BP) and hypertension, using data from the China Health and Retirement Longitudinal Study (CHARLS). The primary fuels used for indoor heating and cooking were collected by questionnaires, respectively. Hypertension was defined based on self-report of physician's diagnosis, and/or measured BP, and/or anti-hypertensive medication use. Multivariate logistic regression models were constructed to assess the associations. Among 10 450 eligible participants, 68.2% and 57.2% used indoor solid fuel for heating and cooking, respectively. Compared with none/clean fuel users, solid fuel for heating was associated with elevated BP (adjusted β: 2.02, 95% CI: 1.04-3.01 for systolic BP; adjusted β: 1.36, 95% CI: 0.78-1.94 for diastolic BP) and increased risk of hypertension (adjusted odds ratio: 1.15, 95% CI: 1.03-1.29). The impact of indoor solid fuel for heating on BP was more evident in rural and north residents, and hypertensive patients. We did not detect any significant associations between solid fuel use for cooking and BP/hypertension. Indoor solid fuel use is prevalent in China, especially in the rural areas. Its negative impact on BP suggested that modernization of household fuel use may help to reduce the burden of hypertension in China.
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http://dx.doi.org/10.1111/ina.12872DOI Listing
November 2021

A Highly Stable Photodetector Based on a Lead-Free Double Perovskite Operating at Different Temperatures.

J Phys Chem Lett 2021 Jun 11;12(24):5682-5688. Epub 2021 Jun 11.

College of Materials Science and Engineering, Key Laboratory of Advanced Materials of Yunnan Province, Kunming University of Science and Technology, Kunming 650093, Yunnan, China.

In recent years, considerable breakthroughs have been achieved in the explored photodetectors with improved performance and stability. However, such devices suffer from the drifting parameters (photoresponsivity, response time, and specific detectivity) in the case of evident operating temperature changes. Here, a double perovskite CsNaBiCl-based ultraviolet (UV) photodetector is developed free from thermal disturbance, exhibiting a steady photoresponsivity (≈ 67.98 mA/W) and response time (≈ 16.42 ms) within a wide temperature range (from 273 to 333 K). Further studies demonstrate that the stability of the crystal structure endows the superior photodetection capability. This result unambiguously highlights the great potential of such double perovskite CsNaBiCl compound as an environmentally friendly alternative for UV photodetectors.
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http://dx.doi.org/10.1021/acs.jpclett.1c01416DOI Listing
June 2021

Systematic review and meta-analysis of the association between paediatric obesity and telomere length.

Acta Paediatr 2021 Oct 21;110(10):2695-2703. Epub 2021 Jun 21.

Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.

Aim: This systematic review and meta-analysis aimed to assess the association between paediatric obesity and telomere length.

Methods: We conducted a comprehensive literature search for original studies assessing the associations between obesity and telomere length in children. Fixed or random effects with inverse-variance meta-analysis were used to estimate the standardised mean difference (SMD) and its 95% confidence interval (95% CI) between overweight or obese and normal-weight children. Heterogeneity was assessed using the I statistic, and meta-regression analyses were used to evaluate the potential source of heterogeneity. Subgroup analysis was further conducted by sex.

Results: A total of 11 studies were included. The meta-analysis showed that children who were overweight or obese had shorter telomere length than normal-weight children (SMD: -0.85; 95% CI: -1.42 to -0.28; p < 0.01). However, significant heterogeneity was present (I  = 97%; p < 0.01). Study design, methods used for measuring telomere length, tissue types, mean age, and percentage of boys were not the source of heterogeneity revealed by meta-regression analysis. The inverse trend was significant only in boys, but not in girls.

Conclusion: There was a negative association between paediatric obesity and telomere length. Weight control in children might have beneficial effect on telomere length.
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http://dx.doi.org/10.1111/apa.15971DOI Listing
October 2021

Daytime Napping and Nighttime Sleep Duration with Incident Diabetes Mellitus: A Cohort Study in Chinese Older Adults.

Int J Environ Res Public Health 2021 05 9;18(9). Epub 2021 May 9.

Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.

Background: We aimed to examine the longitudinal associations between daytime napping and nighttime sleep duration with the risk of diabetes mellitus (DM) among Chinese elderly using data from the China Health and Retirement Longitudinal Study (CHARLS).

Methods: A cohort study was conducted among 2620 participants aged 60 years or above. Information on daytime napping and nighttime sleep duration was self-reported during the 2011 baseline survey. DM status during the 2015 follow-up survey was confirmed according to the American Diabetes Association criteria.

Results: Individuals with long daytime napping (>1 h/day) had increased risk of developing DM than non-nappers (adjusted RR = 1.52, 95%CI: 1.10, 2.10). In addition, we observed a U-shaped association between nighttime sleep duration and incident DM risk. We further found that nappers with <4 h of nighttime sleep, and those with >1 h of daytime napping and >6 h nighttime sleep had approximately two-fold elevated risk of DM, compared to non-nappers with 6-8 h of nighttime sleep.

Conclusion: Long daytime napping and extreme nighttime sleep duration were associated with increased DM risk among Chinese elderly. There was a joint effect of long daytime napping and nighttime sleep duration on the risk of DM.
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http://dx.doi.org/10.3390/ijerph18095012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8125963PMC
May 2021

Parity and the risks of adverse birth outcomes: a retrospective study among Chinese.

BMC Pregnancy Childbirth 2021 Mar 26;21(1):257. Epub 2021 Mar 26.

Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.

Background: Nulliparity is considered to be a risk factor of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). With the new two-child policy launched in 2016, more Chinese women have delivered their 2nd baby. Yet few studies have assessed the impact of parity on adverse birth outcomes in China. This study aimed to examine the association between parity and risks of PTB, LBW and SGA in a Chinese population. The combined effects of maternal age and parity on adverse birth outcomes were also assessed.

Methods: This retrospective study included all non-malformed live births born during January 1, 2014 and December 31, 2018 in Chengdu, China. A total of 746,410 eligible live singletons with complete information were included in the analysis. Parity was classified into nulliparity (i.e. has never delivered a newborn before) and multiparity (i.e. has delivered at least one newborn before). Log-binomial regression analyses were applied to evaluate the association between parity and PTB, LBW and SGA. We further divided maternal age into different groups (< 25 years, 25-29 years, 30-34 years and ≥ 35 years) to assess the combined effects of maternal age and parity on adverse birth outcomes.

Results: Multiparity was associated with reduced risks of PTB (aRR = 0.91, 95% CI: 0.89-0.93), LBW (aRR = 0.74, 95% CI: 0.72-0.77) and SGA (aRR = 0.67, 95% CI: 0.66-0.69) compared with nulliparity. In each age group, we observed that multiparity was associated with lower risks of adverse birth outcomes. Compared to nulliparous women aged between 25 and 29 years, women aged ≥35 years had greater risks of PTB and LBW, regardless of their parity status. In contrast, multiparous women aged ≥35 years (aRR = 0.73, 95% CI: 0.70-0.77) and those aged < 25 years (aRR = 0.88, 95% CI: 0.84-0.93) were at lower risk of SGA compared with nulliparous women aged between 25 and 29 years.

Conclusion: Multiparity was associated with lower risks of all adverse birth outcomes. Special attention should be paid to nulliparous mothers and those with advanced age during antenatal care, in order to reduce the risks of adverse birth outcomes.
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http://dx.doi.org/10.1186/s12884-021-03718-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8004392PMC
March 2021

Low-dose PPI to prevent bleeding after ESD: A multicenter randomized controlled study.

Biomed Pharmacother 2021 Apr 12;136:111251. Epub 2021 Jan 12.

Department of Gastroenterology, Xinqiao Hospital of Army Medical University, Chongqing, China. Electronic address:

Background: Although proton pump inhibitors (PPIs) are widely used in the prevention of gastric bleeding caused by endoscopic submucosal dissection (ESD), there is no consensus on the optimal regimen for these patients. Therefore, we aim to investigate whether intermittent use of low-dose PPI is sufficient to prevent post-ESD bleeding.

Methods: This multicenter, non-inferiority, randomized controlled trial was conducted at 9 hospitals in China. Consecutive eligible patients with a diagnosis of gastric mucosal lesions after ESD treatment were randomly assigned (1:1) to receive either intermittent low-dose or continuous high-dose PPIs treatment. After three days, all patients administered orally esomeprazole 40 mg once a day for 8 weeks. The primary endpoint was post-ESD bleeding within 7 days. Analysis was done according to the intention-to-treat principle with the non-inferiority margin (Δ) of 5%.

Results: 526 consecutive patients were assessed for eligibility from 30 September 2017 to 30 July 2019, of whom 414 were randomly assigned to low-dose (n = 209) or high-dose (n = 205) esomeprazole treatment group without dropouts within7 days. The total post-ESD bleeding is occurred in 13 (6.2 %, 95 % CI 3.3-9.6) of 209 within 7 days in the intermittent low-dose group, and 12 (5.9 %, 95 % CI 2.9-9.3) of 205 in the continuous high-dose group. The absolute risk reduction (ARR) was 0.4 % (-4.2, 4.9). One month after ESD, There are 44 patients (21.1 %, 95 % CI 15.8, 26.8) and 39 patients (19.0 % 95 % CI 13.7, 24.4) in scar stage respectively in low-dose group and high-dose group (P = 0.875).The hospital costs in the low-dose PPI group was lower than high -dose group (P = 0.005).

Conclusion: The intermittent use of low-dose PPIs is sufficient to prevent post-ESD bleeding. It might be applied in clinical practice to prevent post-ESD bleeding and reduce the costs related to PPIs.
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http://dx.doi.org/10.1016/j.biopha.2021.111251DOI Listing
April 2021

High-Stable X-ray Imaging from All-Inorganic Perovskite Nanocrystals under a High Dose Radiation.

J Phys Chem Lett 2020 Nov 15;11(21):9203-9209. Epub 2020 Oct 15.

Faculty of Materials Science and Engineering, Kunming University of Science and Technology, Kunming 650093, P. R. China.

All-inorganic perovskites of CsPbBr nanocrystals (NCs) exhibit strong X-ray absorption and have been demonstrated to be highly efficient scintillators for X-ray detection and imaging. However, the long-term stability of the perovskite remains a major hurdle in practical applications, especially under a commercial dose of X-ray irradiation (0.5-5.5 mGy·s). Herein, with a solution-protected annealing approach reconstructing the CsPbBr NCs free from undesired defects, the perovskite scintillators provide a long-term (∼3600 s) stable visualization tool for X-ray radiography (1.44 × 10 captured images for the exposure time of 2.5 ms per image) under the irradiation dose of 1 mGy·s. This work opens a window for the stability of perovskite scintillators and demonstrates their robust and long-term efficient radioluminescence (RL) for low-cost radiography and X-ray imaging application.
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http://dx.doi.org/10.1021/acs.jpclett.0c02570DOI Listing
November 2020

Aggressive diffuse large B-cell lymphoma with hemophagocytic lymphohistiocytosis: report of one case.

Int J Clin Exp Pathol 2020 1;13(9):2392-2396. Epub 2020 Sep 1.

Department of Gastroenterology, Chongqing University Cancer Hospital Chongqing, P. R. China.

Hemophagocytic lymphohistiocytosis (HLH) is a rare fatal hyperinflammatory syndrome resulting in cytokine storm and secondary multi-organ impairment. The natural killer (NK)/T-cell lymphoma is the predominant subtype in patients with lymphoma-associated hemophagocytic syndrome (LAHS) in Asia. Yet the non-Hodgkin's B-cell lymphoma is a relatively uncommon trigger of HLH. We report a case of a 64-year-old woman who had a bone marrow-spleen type of diffuse large B-cell lymphoma (DLBCL) associated with HLH. The patient presented with EBV-positive infection, significantly increased inflammatory cytokines (IL-6, IL-8, IL-10), and dramatically increased aspartate aminotransferase (AST) and total bilirubin (TB), resulting the patient's aggressive clinical course and early death. This case may not only illustrate the nonspecific manifestation and rapidly progressive characteristics of HLH but also highlight the necessity of anti-inflammatory therapy for the treatment of lymphoma-associated HLH.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539858PMC
September 2020

Analysis of the economic burden of diagnosis and treatment on patients with tuberculosis in Bao'an district of Shenzhen City, China.

PLoS One 2020 31;15(8):e0237865. Epub 2020 Aug 31.

Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts, Boston, United States of America.

Background: Illness-related costs experienced by tuberculosis patients produce a severe economic impact on households, especially poor families. Few studies have investigated the full costs, including direct and indirect costs, at the patient and household levels in south-east China.

Methods: A case follow-up study was conducted in the Bao'an district of Shenzhen City, China. Eligible new and previously treated individuals with pulmonary tuberculosis (TB) during January 1st 2013 to June 30th 2013 were enrolled. Medical and non-medical costs as well as income loss were calculated in diagnosis and treatment periods, respectively. Factors associated with costs due to TB diagnosis, treatment and TB care (diagnosis + treatment) were explored respectively with a linear regression model.

Results: Of the total 514 TB patients enrolled, 95% were from the migrant population, and 65% were males, with a mean age of 32.25 (±10.11). The median costs due to TB diagnosis and TB treatment were 79 United States dollar (USD), 748USD (6.2897 China Yuan (CNY) = 1USD, 2013) per patient, respectively. The median costs due to TB care (diagnosis and treatment) per patient was 1218USD, corresponding to 26% of patients' annual income pre-illness. Those who visited more times to health facilities, hospitalized, received higher education, or occupied in national civil servant/services/retired staff might expense more before diagnosis. Costs due to TB treatment was significantly higher among migrant patients, sputum smear positive patients, and widowed/divorced population. Factors associated with less total costs were native patients, fewer times of visiting to health-care facilities and those with no hospitalization history due to TB.

Conclusions: Although a free TB control policy is in force, patients with TB are still facing a heavy economic burden. More available interventions to reduce the financial burden on tuberculosis patients are urgently needed.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237865PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458315PMC
October 2020

Impact of honey on radiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis.

Ann Palliat Med 2020 Jul 14;9(4):1431-1441. Epub 2020 Jul 14.

Department of Gastroenterology, Chongqing University Cancer Hospital, Chongqing, China.

Background: Oral mucositis is one of the most frequent, irreversible and distressing complications faced by head and neck cancer (HNC) patients undergoing radiotherapy. Several studies have investigated the role of honey in the prevention and alleviation of radiation-induced oral mucositis in HNC patients, however, a definitive conclusion has not yet been generated. We performed this updated systematic review and metaanalysis to determine whether honey can prevent and alleviate radiation-induced oral mucositis in HNC patients.

Methods: We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) through October 2019. We searched and selected literature, extracted data and assessed risk of bias accordingly, and then conducted statistical analyses with RevMan software version 5.3.

Results: Seven trials involving 412 patients were included in the final analysis. Meta-analyses showed that honey did not decrease the incidence of radiation-induced oral mucositis [(relative risk (RR), 0.69; 95% confidence interval (CI), 0.40-1.18; P=0.18]; however, relieved the severity of oral mucositis (RR, 0.22; 95% CI, 0.13-0.38; P<0.001), maintained or increased weight (RR, 1.92; 95% CI, 1.33-2.77; P<0.001) and reduced the treatment interruption related to oral mucositis (RR, 0.13; 95% CI, 0.02-0.97; P=0.05). Qualitative analysis also revealed a decreased incidence of oral mucositis in the honey group.

Conclusions: Based on limited evidence, honey may have a clinical benefit against radiation-induced oral mucositis in HNC patients. However, future trials with large-scale and rigorous methods are warranted to further establish the role of honey in the management of radiation-induced oral mucositis.
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http://dx.doi.org/10.21037/apm-20-44DOI Listing
July 2020

Linked Color Imaging Can Improve Detection Rate of Early Gastric Cancer in a High-Risk Population: A Multi-Center Randomized Controlled Clinical Trial.

Dig Dis Sci 2021 04 4;66(4):1212-1219. Epub 2020 May 4.

Xi'an Central Hospital, Xi'an, China.

Background: Early diagnosis of gastric cancer is difficult in China due to the lack of a valid method for endoscopic screening. Early gastric cancer, especially flat gastric cancer, lacks specific endoscopic features. Many cases appear to be similar to ordinary gastritis cases under normal white light endoscopy, which can lead to misdiagnosis.

Aims: In order to find a new method to improve detection rate of early gastric cancer in China, we designed a trial to validate linked color imaging (LCI) for screening of early gastric cancer in a high-risk population, as compared to white light imaging (WLI).

Method: Subjects were randomly allocated to either the LCI + WLI or WLI group and then subjected to gastroscopy and all endoscopies were made after special preparation. All endoscopists had knowledge of this experiment. The main indicator was the rate of detection of gastric neoplastic lesions. The difference in the detection rate between the two groups is reported.

Results: The detection rate was 4.31% in the WLI group and 8.01% in the LCI + WLI group. This is a difference of 3.70% with a P value < 0.001 and an OR (95% CI) of 1.934 (1.362, 2.746). The lower limit of the 95% CI was greater than 0, and the superiority margin was 1%.

Conclusion: The detection rate of gastric neoplastic lesions was higher in the LCI + WLI group than in the WLI group, LCI might be an effective method for screening early gastric cancer.
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http://dx.doi.org/10.1007/s10620-020-06289-0DOI Listing
April 2021

Long non coding RNA SLC26A4-AS1 exerts antiangiogenic effects in human glioma by upregulating NPTX1 via NFKB1 transcriptional factor.

FEBS J 2021 01 15;288(1):212-228. Epub 2020 Jul 15.

Infection Medicine, Taizhou Municipal Hospital, China.

Malignant gliomas are a heterogeneous group of brain tumors with a poor prognosis, which is largely due to its aggressive invasiveness and angiogenesis. In recent years, it has been found that multiple long noncoding RNAs (lncRNAs) participate in a wide range of biological functions including angiogenesis through the regulation of gene expression in cancers. In this study, we investigate and report the novel role of lncRNA SLC26A4-AS1 in gliomas, with a novel mechanism involving transcription factors NFKB1 and NPTX1. We determined that SLC26A4-AS1 was downregulated in human glioma tissues and cells. Furthermore, overexpression of SLC26A4-AS1 or NPTX1 restrained the aggressiveness of glioma cells and their pro-angiogenic ability. SLC26A4-AS1 was also found to upregulate NPTX1 by recruiting NFKB1 into the NPTX1 promoter. Moreover, silencing of either NPTX1 or NFKB1 restored the aggressive and pro-angiogenic properties of glioma cells in the presence of SLC26A4-AS1. Taken together, we demonstrate that SLC26A4-AS1 promotes NPTX1 transcriptional activity by recruiting NFKB1 and thus exerting antiangiogenic effects on glioma cells. This study provides an experimental basis for the intervention of SLC26A4-AS1 in the treatment of gliomas.
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http://dx.doi.org/10.1111/febs.15325DOI Listing
January 2021

A retrospective cohort study of open preperitoneal repair versus open suture repair for the treatment of emergency femoral hernia.

Sci Rep 2020 02 28;10(1):3707. Epub 2020 Feb 28.

Department of Vascular & Hernial Surgery, Ganzhou People's Hospital (The Affiliated Ganzhou hospital of Nanchang University), No. 17, Red flag avenue, Ganzhou city, Jiangxi Province, 341000, P.R. China.

To compare the outcomes of open preperitoneal repair (OPR) with the use of mesh and open suture repair (OSR) without mesh via inguinal approach for the treatment of emergency femoral hernia (FH). The primary outcome was the postoperative complication and the secondary outcomes were the recurrence rate of FH and the postoperative comfort level at the surgical site. 104 patients with emergency FHs were included, of whom 51 patients were treated with OPR, 53 patients were treated with OSR. Between the two groups, no significant difference was found in surgical site infection (SSI) (P = 0.801) or seroma (P = 0.843), while there was significant difference in the improvement of comfort at the surgical site (P = 0.013). The results of the 2-year follow-up demonstrated 1 and 8 cases of recurrence in the OPR and OSR group respectively, which was statistically significant (HR, 8.193 [95% CI, 1.024 to 65.547], P = 0.047). Compared with OSR, OPR with the use of mesh did not increase the risk of SSI and was safe to apply even under the condition of an emergency FH operation with intestine resection; OPR could reduce the recurrence rate of FH and improve the comfort at the surgical site.
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http://dx.doi.org/10.1038/s41598-020-60722-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048755PMC
February 2020

A retrospective cohort study comparing two treatments for active venous leg ulcers.

Medicine (Baltimore) 2020 Feb;99(8):e19317

The Department of Vascular and Hernial Surgery, The Ganzhou People's Hospital (The Affiliated Ganzhou Hospital of Nanchang University), Ganzhou, PR China.

Endovenous laser ablation (EVLA) and ultrasound-guided foam sclerotherapy (UGFS) have largely replaced traditional surgery for treatment of varicose veins (VVs) with active venous leg ulcers (VLUs), and multiple combined modes have emerged. A retrospective cohort study was performed to compare the effect of traditional surgery (high ligation and stripping followed with compression [compression plus HL-S]) to high ligation-endovenous laser ablation-foam sclerotherapy followed with compression (compression plus HL-EVLA-FS) on the treatment of active VLUs.Data of active VLUs treated in our center from 2008 to 2017 and followed up for 1 year were analyzed. The intervention measures in the first 5 years were compression plus HL-S, and in the following 5 years were compression plus HL-EVLA-FS. The primary outcome was ulcer healing time. The secondary outcomes were the VVs occlusion and clinical success as assessed by a change in venous clinical severity score (VCSS) and complications.The study included 120 patients and 200 patients treated with HL-S and HL-EVLA-FS, respectively, during 2008 to 2017. The average ulcer healing time were 2.3 ± 2.4 and 1.7 ± 1.7 months, respectively. Significant difference was found in the cumulative ulcers healing rate between the two groups (Hazard ratio [HR] and 95% confidence interval [CI] was respectively 1.458 and 1.140-1.865, P = .0002), but no difference was found in the VVs occlusion (HR and 95% CI was respectively 1.005 and 0.774-1.3071, P = .967). Significant difference occurred in 6 months and 12 months post-operatively in the VCSS change and in the procedure data and some complications between the 2 groups.In conclusion, the treatment of HL-EVLA-FS can accelerate the healing of VLUs, improve the VCSS and present superior procedure data. However, no advantage could be found in the VVs occlusion compared with control group.
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http://dx.doi.org/10.1097/MD.0000000000019317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034671PMC
February 2020

The comparative efficacy of supervised- versus home-based exercise programs in patients with ankylosing spondylitis: A meta-analysis.

Medicine (Baltimore) 2020 Feb;99(8):e19229

Department of Nursing, Chongqing University Cancer Hospital.

Objectives: The aim of this meta-analysis is to investigate the comparative efficacy between supervised- and home-based programs in patients with ankylosing spondylitis (AS).

Method: A systematic search in PubMed, Web of Science, EMBASE, and the Cochrane Library was electronically performed by 2 independent investigators in order to capture all potential studies comparing supervised- with home-based in patients with AS from inception to April 2018. After extracted essential information, apprised risk of bias, statistical analysis was performed with Review Manager (RevMan) software (version 5.3.0). The protocol was registered at PROSPERO platform with an identifier of CRD42018097046.

Results: A total of 7 studies comprising 271 patients were included finally. Meta-analyses showed that, compared to home-based program, supervised-based program was associated with reduced bath ankylosing spondylitis metrology index (BASMI) scores (mean difference [MD], -0.45; 95% confidence interval [CI], -0.73, -0.17), bath ankylosing spondylitis disease activity index (BASDAI) scores (MD, -0.48; 95% CI, -0.88, -0.08), and bath ankylosing spondylitis functional index (BASFI) scores (MD, -0.78; 95% CI, -1.19, -0.37). However, depression scores (standard mean difference, -0.22; 95% CI, -0.58, 0.14) between the 2 groups showed no significant defference.

Conclusions: Both supervised- and home-based programs can benefit to reduce BASMI, BASDAI, and BASFI scores in AS patients. However, short-term, supervised exercise program may be more effective than home-based exercises at decreasing disease activity with AS.
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http://dx.doi.org/10.1097/MD.0000000000019229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034711PMC
February 2020

Chronic mesh infection complicated by an enterocutaneous fistula successfully treated by infected mesh removal and negative pressure wound therapy: A case report.

Medicine (Baltimore) 2019 Dec;98(49):e18192

The Department of General Surgery, Ganzhou People's Hospital (The Affiliated Ganzhou Hospital of Nanchang University), Ganzhou, China.

Rationale: Tension-free repair of inguinal hernia with prosthetic materials in adults has become a routine surgical procedure. However, serious complications may arise such as mesh displacement, infection, and even enterocutaneous fistula (EF). The management of chronic mesh infection (CMI) complicated by an EF is very challenging. A simple treatment of infected mesh removal and negative pressure wound therapy (NPWT) may cure the patients with EF with CMI.

Patient Concerns: A 75-year-old male patient underwent tension-free treatment for a bilateral inguinal hernia at a county hospital 10 years ago. Three months before admission, the right groin gradually formed a skin sinus with outflow of fetid thin pus, and it could not heal.

Diagnoses: The patient was diagnosed preoperatively with mesh plug adhesion to the intestine, which resulted in low-flow EF combined with CMI.

Interventions: The patient received a simple treatment mode consisting of an incision made from the original incision, but the new incision did not penetrate the abdominal cavity; treatment included resection of the fistula, removal of the mesh, repair of the intestine and local tissue, and continuous irrigation of vacuum sealing drainage (VSD) devices for NPWT.

Outcomes: The infected mesh was completely removed. Five VSD devices were utilized to treat the EF and wound. The time from intervention to wound healing was 35 days, and follow-up for 6 months revealed no infection and no hernia recurrence in the right groin.

Lessons: The NPWT is effective in treating CMI concomitant with EF and does not increase the risk of hernia recurrence.
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http://dx.doi.org/10.1097/MD.0000000000018192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6919388PMC
December 2019

A Novel Analytical Model for Pore Volume Compressibility of Fractal Porous Media.

Sci Rep 2019 Oct 9;9(1):14472. Epub 2019 Oct 9.

King Fahd University of Petroleum & Minerals, College of Petroleum Engineering & Geosciences, Dhahran, 31261, Saudi Arabia.

Over the past decades, many scholars have been studying the pore volume compressibility (PVC) of porous media. However, the fundamental controls on PVC of porous media are not yet definitive. Some scholars suggest a negative correlation between PVC and initial porosity, while others suggest a positive correlation. Motivated by this discrepancy, this paper presents a new analytical model to study the PVC of fractal porous media. The predictions are compared with test results and thereby validated to be accurate. In our attempt not only to complement but also to extend the capability beyond available models, the derived model accounts for multiple fundamental variables, such as the microstructural parameters and rock lithology of porous media. Results suggest that, there is a negative correlation between PVC and initial porosity, if all other parameters are fixed, the relationship between initial porosity and PVC is not monotonic. In addition, PVC decreases with rougher pore surfaces and smaller initial minimum pore radius. Besides providing theoretical foundations for quantifying PVC of porous media, this analytical model could be applied to estimate pore structure parameters of porous media using inverse modeling.
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http://dx.doi.org/10.1038/s41598-019-51091-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785546PMC
October 2019

Comparison of combined compression and surgery with high ligation-endovenous laser ablation-foam sclerotherapy with compression alone for active venous leg ulcers.

Sci Rep 2019 Oct 1;9(1):14021. Epub 2019 Oct 1.

Department of Vascular and Hernial Surgery, Ganzhou People's Hospital (The Affiliated Ganzhou hospital of Nanchang University), No. 17, Red flag avenue, Ganzhou city, Jiangxi Province, 341000, PR China.

We aimed to assess the ulcer healing time and recurrence rates after treatment with compression therapy (CT) with or without high ligation-endovenous laser ablation-foam sclerotherapy (HL-EVLA-FS) in people with active venous leg ulcers (VLUs). A retrospective cohort study was conducted with 350 patients with active VLUs treated by compression with or without HL-EVLA-FS in our hospital from 2013 to 2017. The primary outcome was the ulcer healing time; secondary outcomes were the 12-month recurrence rates, the relationship between recurrence and venous reflux, and the complications of the two treatments. In total, 193 patients (200 limbs) underwent compression plus HL-EVLA-FS, and 157 patients (177 limbs) underwent CT alone. The ulcer healing time was shorter in the compression plus HL-EVLA-FS group than in the CT alone group (Hazard Ratio [HR] for ulcer healing, 1.845 [95% CI, 1.474-2.309], P = 0.0001). The 12-month ulcer recurrence rates were significantly reduced in the compression plus HL-EVLA-FS group (HR for ulcer recurrence, 0.418 [95% CI, 0.258-0.677], P = 0.0001). Calf perforator vein reflux (CPVR) and isolated superficial venous reflux (ISVR) were risk factors for ulcer recurrence. The combined operation with CT resulted in faster healing of VLUs, a lower ulcer recurrence rate and lower VCSS values after intervention than CT alone.
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http://dx.doi.org/10.1038/s41598-019-50617-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773849PMC
October 2019

Neoadjuvant Modified FOLFOX6 With or Without Radiation Versus Fluorouracil Plus Radiation for Locally Advanced Rectal Cancer: Final Results of the Chinese FOWARC Trial.

J Clin Oncol 2019 12 26;37(34):3223-3233. Epub 2019 Sep 26.

The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangzhou, People's Republic of China.

Purpose: In the multicenter, open-label, phase III FOWARC trial, modified infusional fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) plus radiotherapy resulted in a higher pathologic complete response rate than fluorouracil plus radiotherapy in Chinese patients with locally advanced rectal cancer. Here, we report the final results.

Methods: Adults ages 18 to 75 years with stage II/III rectal cancer were randomly assigned (1:1:1) to five cycles of infusional fluorouracil (leucovorin 400 mg/m, fluorouracil 400 mg/m, and fluorouracil 2.4 g/m over 48 hours) plus radiotherapy (46.0 to 50.4 Gy delivered in 23 to 25 fractions during cycles 2 to 4) followed by surgery and seven cycles of infusional fluorouracil, the same treatment plus intravenous oxaliplatin 85 mg/m on day 1 of each cycle (mFOLFOX6), or four to six cycles of mFOLFOX6 followed by surgery and six to eight cycles of mFOLFOX6. The primary end point was 3-year disease-free survival (DFS).

Results: In total, 495 patients were randomly assigned to treatment. After a median follow-up of 45.2 months, DFS events were reported in 46, 39, and 46 patients in the fluorouracil plus radiotherapy, mFOLFOX6 plus radiotherapy, and mFOLFOX6 arms. In each arm, the probability of 3-year DFS was 72.9%, 77.2%, and 73.5% ( = .709 by the log-rank test), the 3-year probability of local recurrence after R0/1 resection was 8.0%, 7.0%, and 8.3% ( = .873 by the log-rank test), and the 3-year overall survival rate was 91.3%, 89.1%, and 90.7% ( = .971 by log-rank test), respectively.

Conclusion: mFOLFOX6, with or without radiation, did not significantly improve 3-year DFS versus fluorouracil with radiation in patients with locally advanced rectal cancer. No significant difference in outcomes was found between mFOLFOX6 without radiotherapy and fluorouracil with radiotherapy, which requires additional investigation of the role of radiotherapy in these regimens.
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http://dx.doi.org/10.1200/JCO.18.02309DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6881102PMC
December 2019

Underestimated disease prevalence and severe phenotypes in patients with biallelic variants: A cohort study of primary familial brain calcification from China.

Parkinsonism Relat Disord 2019 07 11;64:211-219. Epub 2019 Apr 11.

Department of Neurology, Huzhou Central Hospital, Huzhou, Zhejiang, China.

Background: Primary familial brain calcification (PFBC) is a rare calcifying disorder of the brain with extensive clinical and genetic heterogeneity. Its prevalence is underestimated due to clinical selection bias (compared with symptomatic PFBC patients, asymptomatic ones are less likely to undergo genetic testing).

Methods: A total of 273 PFBC probands were enrolled in a multicenter retrospective cohort study by two different approaches. In Group I (nonsystematic approach), 37 probands diagnosed at our clinic were enrolled. In Group II (systematic approach), 236 probands were enrolled by searching the medical imaging databases of 50 other hospitals using specific keywords. Genetic testing of four genes known to be causative of autosomal dominant PFBC was performed in all probands using cDNA. All identified variants were further confirmed using genomic DNA and classified according to ACMG-AMP recommendations.

Results: Thirty-two variants including 22 novel variants were detected in 37 probands. Among these probands, 83.8% (31/37) were asymptomatic. Two probands with homozygous pathogenic SLC20A2 variants presented more severe brain calcification and symptoms. Based on the variant detection rate of probands in Group II, we extrapolated an overall minimal prevalence of PFBC of 6.6 per 1,000, much higher than previously reported (2.1 per 1000).

Conclusions: We identified a higher proportion of genetically confirmed PFBC probands who were asymptomatic. These patients would be overlooked due to clinical selection bias, leading to underestimation of the disease prevalence. Considering that PFBC patients with biallelic variants had more severe phenotypes, this specific condition should be focused on in genetic counseling.
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http://dx.doi.org/10.1016/j.parkreldis.2019.04.009DOI Listing
July 2019
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