Abstract Purpose: to evaluate the protective effect of omega-3 long-chain unsaturated fatty acids on the progression of wet age-related macular degeneration (wAMD). Methods: this meta-analysis was designed, implemented, and analyzed in accordance with the Meta-analysis of Observational Studies in Epidemiology (MOOSE) protocol and is reported following PRISMA guidelines. Results: in this study we included 5 observational trials, including 2 cross-sectional studies, 2 case-control studies, and 1 confrontation study. These tests are conducted in the U.S., Europe and Japan, and are of high quality. In general, people with high dietary long-chain omega-3 polyunsaturated fatty acids (omega-3 LCPUFAs) have a lower risk of progression to advanced age-related macular degeneration (AMD) (effect size, ES: 0.51, 95 % CI [0.34, 0.75], I2 = 70 %, p = 0.01). When assessing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) intake and wAMD risk a total of the three above studies were included, which also produced similar results. Conclusions: the highest DHA consumption reduced the risk of disease by 39 % (effect size: 0.61, 95 % CI [0.50, 0.74], I2 = 14 %, p = 0.31); compared with the lowest EPA consumption, the highest EPA consumption reduced the risk of wAMD by 32 % (ES: 0.68, 95 % CI [0.57, 0.82], I2 = 39 %, p = 0.20).

Resumen Propósito: evaluar el efecto protector de los AGPICL omega-3 sobre la degeneración macular húmeda asociada a la edad (DMAE). Métodos: este metaanálisis fue diseñado, implementado y analizado de acuerdo con el protocolo de Metaanálisis de Estudios Observacionales en Epidemiología (MOOSE) y se informa siguiendo las directrices de PRISMA. Resultados: en este estudio se incluyeron 5 ensayos observacionales, entre ellos 2 estudios transversales, 2 estudios de casos y controles y 1 estudio de confrontación. Estos ensayos se realizan en Estados Unidos, Europa y Japón y son de alta calidad. En general, las personas con una dieta alta en ácidos grasos poliinsaturados de cadena larga (AGPICL omega-3) tienen un menor riesgo de progresión hacia la degeneración macular avanzada relacionada con la edad (DMAE) (tamaño del efecto, ES: 0,51, IC 95 % [0,34, 0,75], I2 = 70 %, p = 0,01). Al evaluar la ingesta de ácido docosahexaenoico (DHA) y ácido eicosapentaenoico (EPA) y el riesgo de DMAE se incluyeron en total tres de los estudios anteriores, que también arrojaron resultados similares. Conclusiones: el mayor consumo de DHA redujo el riesgo de enfermedad en un 39 % (tamaño del efecto: 0,61, IC del 95 % [0,50, 0,74], I2 = 14 %, p = 0,31); en comparación con el menor consumo de EPA, el mayor consumo de EPA redujo el riesgo de wAMD en un 32 % (ES: 0,68, IC del 95 % [0,57, 0,82], I2 = 39 %, p = 0,20).

This study aimed to explore the prognostic role of dipeptidyl peptidase 4 (DPP4) expression in hepatocellular carcinoma (HCC). DPP4 expression was measured in formalin-fixed paraffin-embedded specimens that were gathered from 327 HCC patients. Immunohistochemistry analyses were utilized to examine DPP4 expression characteristics and prognostic values (overall survival (OS) and time to recurrence) of DDP4 in HCC tissues. In addition, a patient-derived xenograft (PDX) model was used to assess the correlation between DPP4 expression and tumor growth in vivo. DPP4 was expressed in low levels in HCC tissues in contrast to paired peritumoral tissues (38 cases were down-regulated in a total of 59 cases, 64.4%. P=0.0202). DPP4 expression was significantly correlated with TNM stage (P=0.038), tumor number (P=0.035), and vascular invasion (P=0.024), and significantly reduced in patients who were in TNM stages II and III-V, with multiple tumors, and with microvascular invasion compared to patients with TNM stage I, single tumor, and no microvascular invasion. Notably, HCC tissues with low expression of DPP4 had poor OS (P=0.016) compared with HCC tissues with high expression of DPP4, and results from PDX model showed that tumor growth was significantly faster in HCC patients that lowly expressed DPP4 compared to those with highly expressed DPP4. Our findings suggested that low levels of DPP4 could impact the aggressiveness of HCC and contribute to a poor prognosis.

Abstract Purpose To develop a rabbit model of a short peripheral catheter (SPC) and to observe the effects of different flushing methods on blood vessels. Methods Thirty rabbits were randomly divided into three groups (A, B, and C), with ten rabbits per group. In group A, we used pulsed flush; in group B, we used uniform flush; and no treatment was used in group C. Results We observed that a uniform flush reduced blockage, phlebitis, and exudation compared to a pulsed flush by visual observation. The histopathological examination found that the morphological changes in group A were more severe than in group B and C related to loss of venous endothelial cells, inflammatory cell infiltration, edema, epidermal and chondrocyte degeneration, except for the thrombosis on group B that was more serious than in group A, especially in the distal side of puncture points. The distal region of groups A and B had more inflammatory cell infiltration than the proximal region. Thrombosis was more severe in the distal region than in the proximal region in group B. Conclusions The uniform flush produced less damage to the vascular endothelium and surrounding tissues and was superior to the pulsed flush. However, the uniform flush is prone to thrombosis.

Abstract Heparanase activity is involved in cancer growth and development in humans and single nucleotide polymorphisms (SNPs) in the heparanase gene (HPSE) have been shown to be associated with tumors. In this study, we investigated whether SNPs in HPSE were a risk factor for hepatocellular carcinoma (HCC) by undertaking a comprehensive haplotype-tagging, case-control study. For this, six haplotype-tagging SNPs (htSNPs) in HPSE were genotyped in 400 HCC patients and 480 controls by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. A log-additive model revealed significant correlations between the HPSE polymorphisms rs12331678 and rs12503843 and the risk of HCC in the overall samples (p = 0.0046 and p = 0.0055). When the analysis was stratified based on hepatitis B virus (HBV) carrier status, significant interactions between rs12331678 and rs12503843 and HBV were observed. Conditional logistic regression analysis for the independent effect of one significant SNP suggested that rs12331678 or rs12503843 contributed an independent effect to the significant association with the risk of HCC, respectively. Our findings suggest that the SNPs rs12331678 and rs12503843 are HCC risk factors, although the potential functional roles of these two SNPs remain to be fully elucidated.

Abstract Streptococcus pneumoniae is one of the most frequent opportunistic pathogens worldwide. DNA processing protein A (DprA) is an important factor involved in bacterial uptake and DNA integration into bacterial genome, but its role in S. pneumoniae virulence remains unclear. The aim of this study was to characterize the effects of the pneumococcal dprA gene on the pathogenesis of S. pneumoniae. To construct a dprA-deficient pneumococcal strain, the dprA gene of the S. pneumoniae strain D39 was inactivated. The virulence of this dprA-deficient strain, designated ΔD39, was compared with that of the wild-type strain by evaluating their respective capabilities to adhere to human pulmonary epithelial cells (PEC-A549) and by analyzing their choline-binding protein expression levels. In addition, the expression profiles of genes associated with virulence and host survival assays were also conducted with the mutant and the wild-type strain. Our results indicate that the capability of ΔD39 to adhere to the PEC-A549 airway cells was significantly lower (p < 0.01) compared with D39. Additionally, the 100-KD choline-binding protein was not detected in ΔD39. The addition of competence-stimulating peptide (CSP) lead to a significantly reduction of psaA mRNA expression in the dprA-deficient mutant and an increased level of psaA transcripts in the wild-type strain (p < 0.01). The median survival time of mice intraperitoneally infected with ΔD39 was significantly higher (p < 0.01) than that of mice infected with D39. The results of this study suggest that DprA has a significant effect on virulence characteristics of S. pneumoniae by influencing the expression of choline-binding protein and PsaA.

OBJECTIVE: To describe breastfeeding practices in rural China using globally recommended indicators and to compare them with practices in neighbouring countries and large emerging economies. METHODS: A community-based, cross-sectional survey of 2354 children younger than 2 years in 26 poor, rural counties in 12 central and western provinces was conducted. Associations between indicators of infant and young child feeding and socioeconomic, demographic and health service variables were explored and rates were compared with the most recent data from China and other nations. FINDINGS: Overall, 98.3% of infants had been breastfed. However, only 59.4% had initiated breastfeeding early (i.e. within 1 hour of birth); only 55.5% and 9.4% had continued breastfeeding for 1 and 2 years, respectively, and only 28.7% of infants younger than 6 months had been exclusively breastfed. Early initiation of breastfeeding was positively associated with at least five antenatal clinic visits (adjusted odds ratio, aOR: 3.48; P < 0.001) and negatively associated with delivery by Caesarean (aOR: 0.53; P < 0.001) or in a referral-level facility (aOR: 0.6; P = 0.014). Exclusive breastfeeding among children younger than 6 months was positively associated with delivery in a referral-level facility (aOR: 2.22; P < 0.05). Breastfeeding was not associated with maternal age or education, ethnicity or household wealth. Surveyed rates of exclusive and continued breastfeeding were mostly lower than in other nations. CONCLUSION: Despite efforts to promote breastfeeding in China, rates are very low. A commitment to improve infant and young child feeding is needed to reduce mortality and morbidity.

OBJETIVO: Describir las prácticas de lactancia en las zonas rurales de China por medio de los indicadores recomendados a nivel internacional y compararlas con las prácticas de los países vecinos y de las grandes economías emergentes. MÉTODOS: Se llevó a cabo una encuesta transversal comunitaria de 2354 niños menores de 2 años en 26 condados rurales pobres de 12 provincias del centro y oeste del país. Se investigaron las relaciones entre los indicadores de la alimentación de lactantes y niños pequeños y las variables socioeconómicas, demográficas y del sistema sanitario, y se compararon los índices con los datos más recientes tanto de China como de otros países. RESULTADOS: En general, el 98,3% de los niños había sido amamantado. Sin embargo, solo el 59,4% inició la lactancia pronto (esto es, una hora tras el nacimiento); solo el 55,5% y el 9,4% había continuado con la lactancia durante 1 y 2 años, respectivamente, y solo el 28,7% de los lactantes menores de 6 meses había sido amamantado de forma exclusiva. El comienzo temprano de la lactancia estuvo relacionado de forma positiva con al menos cinco visitas clínicas prenatales (coeficiente de posibilidades ajustado, CPa: 3,48; P < 0,001) y relacionado de forma negativa con partos por cesárea (CPa: 0,53; P <0,001) o en un centro de derivación (CPa: 0,6; P = 0,014). La lactancia exclusiva entre los niños menores de 6 meses estuvo asociada de forma positiva con un parto en un centro de derivación (CPa: 2,22; P < 0,05). La lactancia no estuvo asociada con la edad o la educación de la madre, la etnia o la riqueza del hogar. Los índices medidos de lactancia exclusiva y continuada fueron en la mayoría de casos inferiores que los de otras naciones. CONCLUSIÓN: A pesar de los esfuerzos para promover la lactancia en China, los índices son muy bajos. Con objeto de reducir la mortalidad y la morbilidad, es necesario un compromiso para mejorar la alimentación de lactantes y niños pequeños.

OBJECTIF: Décrire les pratiques d'allaitement maternel dans la Chine rurale en utilisant des indicateurs recommandés au niveau mondial et en les comparant avec les usages des pays voisins et des grandes économies émergentes. MÉTHODES: Une étude transversale a été menée, sur base communautaire, auprès de 2354 enfants âgés de moins de 2 ans, répartis dans 26 comtés ruraux pauvres de 12 provinces du centre et de l'ouest du pays. Les corrélations entre les indicateurs d'allaitement infantile et du jeune enfant et les variables socio-économiques, démographiques et des services de santé ont été explorées et les taux ont été comparés avec les données les plus récentes en provenance de Chine et d'autres pays. RÉSULTATS: Dans l'ensemble, 98,3% des nourrissons avaient été nourris au sein. Cependant, seulement 59,4% avaient bénéficié d'un allaitement précoce (c'est-à-dire au cours de la première heure après la naissance), seuls 55,5% et 9,4% avaient poursuivi l'allaitement maternel pendant respectivement 1 et 2 ans et seulement 28,7% des nourrissons âgés de moins de 6 mois avaient été exclusivement nourris au sein. L'initiation précoce de l'allaitement maternel a été positivement corrélée à au moins cinq consultations prénatales (odds ratio ajusté ORa: 3,48; P<0,001) et négativement corrélée à la naissance par césarienne (ORa: 0,53; P<0,001) ou en hôpital d'aiguillage (ORa: 0,6; P=0,014). L'allaitement maternel exclusif chez les enfants âgés de moins de 6 mois a été associé positivement à une naissance dans un hôpital d'aiguillage (ORa: 2,22; P<0,05). L'allaitement n'a pas été associé à l'âge ni à l'éducation de la mère, ni même à l'ethnicité ou au niveau de richesse du foyer. L'étude a révélé des taux d'allaitement exclusif et continu généralement plus faibles que dans d'autres pays. CONCLUSION: Malgré les efforts pour promouvoir l'allaitement maternel en Chine, les taux restent très faibles. Un engagement visant à améliorer l'alimentation du nourrisson et du jeune enfant est nécessaire afin de réduire le taux de mortalité et de morbidité dans cette catégorie de la population.

OBJECTIVE: To estimate influenza-associated mortality in urban China. METHODS: Influenza-associated excess mortality for the period 2003-2008 was estimated in three cities in temperate northern China and five cities in the subtropical south of the country. The estimates were derived from models based on negative binomial regressions, vital statistics and the results of weekly influenza virus surveillance. FINDINGS: Annual influenza-associated excess mortality, for all causes, was 18.0 (range: 10.9-32.7) deaths per 100000 population in the northern cities and 11.3 (range: 7.3-17.8) deaths per 100000 in the southern cities. Excess mortality for respiratory and circulatory disease was 12.4 (range: 7.4-22.2) and 8.8 (range: 5.5-13.6) deaths per 100000 people in the northern and southern cities, respectively. Most (86%) deaths occurred among people aged >65 years. Influenza-associated excess mortality was higher in B-virus-dominant seasons than in seasons when A(H3N2) or A(H1N1) predominated, and more than half of all influenza-associated mortality was associated with influenza B virus. CONCLUSION: Between 2003 and 2008, seasonal influenza, particularly that caused by the influenza B virus, was associated with substantial mortality in three cities in the temperate north of China and five cities in the subtropical south of the country.

OBJETIVO: Calcular la mortalidad asociada a la gripe en la China urbana. MÉTODOS: Se calculó el exceso de mortalidad asociado a la gripe durante el periodo comprendido entre 2003 y 2008 en tres ciudades del norte de China con clima templado y en cinco ciudades del sur del país con clima subtropical. Los cálculos se obtuvieron de modelos basados en regresiones binomiales negativas, estadísticas vitales y de los resultados de la vigilancia semanal del virus de la gripe. RESULTADOS: El exceso de mortalidad anual asociado a la gripe, por todas las causas, fue de 18,0 (rango: 10,9-32,7) muertes por cada 100000 habitantes en las ciudades del norte y de 11,3 (rango: 7,3-17,8) muertes por cada 100000 habitantes en las ciudades del sur. La mayor parte de este exceso de mortalidad - 12,4 (rango: 7,4-22,2) y 8,8 (rango: 5,5-13,6) muertes por cada 100000 habitantes en las ciudades del norte y del sur, respectivamente - se atribuyeron a una enfermedad respiratoria y/o circulatoria. La mayoría de las muertes (el 86%) ocurrió en personas con una edad >65 años. El exceso de mortalidad asociado a la gripe fue superior en épocas con un virus B dominante que en épocas en las que predominaron los virus A(H3N2) o A(H1N1). Más de la mitad de la mortalidad total asociada a la gripe se asoció al virus B de la gripe. CONCLUSIÓN: Entre 2003 y 2008, la gripe estacional, particularmente la causada por el virus B de la gripe, estuvo asociada a la mortalidad sustancial en tres ciudades de China con clima templado y en cinco ciudades del sur del país con clima subtropical.

OBJECTIF: Estimer la mortalité associée à la grippe en Chine urbaine. MÉTHODES: La mortalité excessive associée à la grippe pour la période 2003-2008 a été évaluée dans trois villes de la zone tempérée du nord de la Chine et dans cinq villes de la zone subtropicale du pays. Les estimations ont été établies sur des modèles basés sur des régressions binomiales négatives, des statistiques vitales et les résultats de la surveillance hebdomadaire de la grippe. RÉSULTATS: La mortalité annuelle excessive associée à la grippe, dans tous les cas, a été de 18 (plage: 10,9-32,7) décès pour une population de 100 000 personnes dans les villes du nord et de 11,3 (plage: 7,3-17,8) décès pour une population de 100 000 personnes dans les villes du sud. La plus grande partie de cette mortalité excessive - respectivement 12,4 (plage: 7,4-22,2) et 8,8 (plage: 5,5-13,6) décès pour une population de 100 000 personnes dans les villes du nord et du sud - a été attribuée à des maladies respiratoires et/ou circulatoires. La plupart des décès (86%) sont survenus chez des personnes de >65 ans. La mortalité excessive associée à la grippe a été plus élevée lors des saisons où prédominait le virus B plutôt que lors de celles où prédominaient les virus A(H3N2) ou A(H1N1) et plus de la moitié de l'ensemble de la mortalité associée à la grippe a été associée au virus B de la grippe. CONCLUSION: De 2003 à 2008, la grippe saisonnière, surtout celle provoquée par le virus B, a été associée à une mortalité substantielle dans trois villes du nord tempéré de Chine et dans cinq villes du sud subtropical du pays.