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Existing data on folate status and hepatocellular carcinoma (HCC) prognosis are scarce. We prospectively examined whether serum folate concentrations at diagnosis were associated with liver cancer-specific survival (LCSS) and overall survival (OS) among 982 patients with newly diagnosed, previously untreated HCC, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study between September 2013 and February 2017. Serum folate concentrations were measured using chemiluminescent microparticle immunoassay. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95 % CI by sex-specific quartile of serum folate. Compared with patients in the third quartile of serum folate, patients in the lowest quartile had significantly inferior LCSS (HR = 1·48; 95 % CI 1·05, 2·09) and OS (HR = 1·43; 95 % CI 1·03, 1·99) after adjustment for non-clinical and clinical prognostic factors. The associations were not significantly modified by sex, age at diagnosis, alcohol drinking status and Barcelona Clinic Liver Cancer (BCLC) stage. However, there were statistically significant interactions on both multiplicative and additive scale between serum folate and C-reactive protein (CRP) levels or smoking status and the associations of lower serum folate with worse LCSS and OS were only evident among patients with CRP > 3·0 mg/l or current smokers. An inverse association with LCSS were also observed among patients with liver damage score ≥3. These results suggest that lower serum folate concentrations at diagnosis are independently associated with worse HCC survival, most prominently among patients with systemic inflammation and current smokers. A future trial of folate supplementation seems to be promising in HCC patients with lower folate status.
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2–3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P < 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P < 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2–3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.
Nitrogen (N) inputs have been found to exert strong influence on leaf stoichiometry in natural ecosystems, but there are few studies investigating the effects of N in agroecosystems. Using a 5-yr fertilization experiment in rice fields, we examined the effects of N inputs on leaf stoichiometry of one crop, rice (Oryza sativa L.), and its four common weeds, barnyardgrass [Echinochloa crus-galli (L.) P. Beauv.], Monochoria korsakowii Regel and Mack, alligatorweed [Alternanthera philoxeroides (Mart.) Griseb.], and Japanese mazus [Mazus pumilus (Burm. f.) Steenis], and further evaluated whether and how straw return mediates these effects. We found that rice and weed leaf nitrogen:phosphorus:potassium (N:P:K) stoichiometry exhibited divergent responses to N fertilizer. Weed leaf N:P:K stoichiometry was not sensitive to low (120 kg N ha−1) and regular (240 kg N ha−1) N inputs, but rice plants were, with significantly increased leaf N concentration and N:P and N:K ratios. The opposite trend was found for high N inputs (360 kg N ha−1). Rice leaf N concentration [N] did not increase further, and N:P ratios even decreased, whereas E. crus-galli and M. korsakowii had significantly increased [N] and N-related stoichiometry. We also found that the positive effects of regular N inputs on rice leaf N:P and N:K ratios were significantly dampened by straw return, but the positive effects on N:P ratios in M. pumilus leaves were enhanced by straw return. Compared with weeds, rice leaves contained low elemental concentrations across fertilization levels at grain-filling stages. These results indicate that rice has a lower N requirement than weeds at grain-filling stages, and the N supply should be managed at a relative low level to reduce the nutrient acquisition and competitive abilities of weeds. From a stoichiometric perspective, this study highlights the importance of N management in combination with straw return in controlling weeds and increasing the nutrient-use efficiency of crops.
The aim of the study was to investigate any association between extrauterine growth restriction (EUGR) and intestinal flora of <30-week-old preterm infants. A total of 59 preterm infants were assigned to EUGR (n=23) and non-EUGR (n=36) groups. Intestinal bacteria were compared by using high-throughput sequencing of bacterial rRNA. The total abundance of bacteria in 344 genera (7568 v. 13,760; P<0.0001) and 456 species (10,032 v. 18,240; P<0.0001) was significantly decreased in the EUGR group compared with the non-EUGR group. After application of a multivariate logistic model and adjusting for potential confounding factors, as well as false-discovery rate corrections, we found four bacterial genera with higher and one bacterial genus with lower abundance in the EUGR group compared with the control group. In addition, the EUGR group showed significantly increased abundances of six species (Streptococcus parasanguinis, Bacterium RB5FF6, two Klebsiella species and Microbacterium), but decreased frequencies of three species (one Acinetobacter species, Endosymbiont_of_Sphenophorus_lev and one Enterobacter_species) compared with the non-EUGR group. Taken together, there were significant changes in the intestinal microflora of preterm infants with EUGR compared to preterm infants without EUGR.
A high-power, Joule-class, nanosecond temporally shaped multi-pass ring laser amplifier system with two neodymium-doped phosphate glass (Nd:glass) laser heads is demonstrated. The laser amplifier system consists of three parts: an all-fiber structure seeder, a diode-pumped Nd:glass regenerative amplifier and a multi-pass ring amplifier, where the thermally induced depolarization of two laser heads is studied experimentally and theoretically. Following the injection of a square pulse with the pulse energy of 0.9 mJ and pulse width of 6 ns, a 0.969-J high-energy laser pulse at 1 Hz was generated, which had the ability to change the waveform arbitrarily, based on the all-fiber structure front end. The experimental results show that the proposed laser system is promising to be adopted in the preamplifier of high-power laser facilities.
Owing to lack of a definitive correlation between carbon supports and catalytic activity of single-atom Fe-active sites, rational design and preparation of single-atom Fe catalysts have so far been elusive. Herein we designed and prepared one-dimensional core–shell nanostructured single-atom Fe catalysts, in which carbon nanofibers and carbon nanotubes with different crystallinities and electrical conductivities were used as supports to host single-atom Fe-active sites. It was found that the carbon supports with higher electrical conductivity accelerate charge transfer and enhance the oxygen reduction reaction (ORR) activity of single-atom Fe-active sites as well as the ORR durability of the final catalyst.
The topological insulator/superconductor heterostructure is one of the most promising platforms to create and manipulate Majorana bound states. Here, we used molecular beam epitaxy to grow high-quality (Bi0.5Sb0.5)2Te3 films on Nb surfaces. To promote proper (Bi0.5Sb0.5)2Te3 film nucleation in the early growth stage, we developed a two-step growth method. Bi, Sb, and Te clusters were first evaporated at a low temperature of 180 °C, which is below the typical growth temperature and then annealed to form a crystalized passivation layer. Second, a standard (Bi0.5Sb0.5)2Te3 film was grown under the normal deposition temperature of 280 °C. We used reflection high-energy electron diffraction, high-resolution transmission electron microscopy, X-ray photoelectron spectroscopy, and X-ray diffraction to further characterize the (Bi0.5Sb0.5)2Te3 film and passivation layer quality. Finally, the top Nb film was laid down by magnetron sputtering at room temperature. The hetero-Nb/epitaxial (Bi0.5Sb0.5)2Te3/Nb stacks were further fabricated into micro-Josephson junctions and showed clear Josephson currents demonstrating an excellent material quality.
We previously reported four heterozygous missense mutations of MYH7, KCNQ1, MYLK2, and TMEM70 in a single three-generation Chinese family with dual Long QT and hypertrophic cardiomyopathy phenotypes for the first time. However, the clinical course among the family members was various, and the potential myocardial dysfunction has not been investigated.
The objective of this study was to investigate the echocardiographic and electrocardiographic characteristics in a genetic positive Chinese family with hypertrophic cardiomyopathy and further to explore the association between myocardial dysfunction and electric activity, and the identified mutations.
A comprehensive echocardiogram – standard two-dimensional Doppler echocardiography and three-dimensional speckle tracking echocardiography – and electrocardiogram were obtained for members in this family.
As previously reported, four missense mutations – MYH7-H1717Q, KCNQ1-R190W, MYLK2-K324E, and TMEM70-I147T – were identified in this family. The MYH7-H1717Q mutation carriers had significantly increased left ventricular mass indices, elevated E/e’ ratio, deteriorated global longitudinal stain, but enhanced global circumferential and radial strain compared with those in non-mutation patients (all p<0.05). The KCNQ1-R190W carriers showed significantly prolonged QTc intervals, and the MYLK2-K324E mutation carriers showed inverted T-waves (both p<0.05). However, the TMEM70-I147T mutation carriers had similar echocardiography and electrocardiographic data as non-mutation patients.
Three of the identified four mutations had potential pathogenic effects in this family: MYH7-H1717Q was associated with increased left ventricular thickness, elevated left ventricular filling pressure, and altered myocardial deformation; KCNQ1-R190W and MYLK2-K324E mutations were correlated with electrocardiographic abnormalities reflected in long QT phenotype and inverted T-waves, respectively.
Ga2−xFexO3 (GFO) bulks with x from 0.7 to 1.3 have been fabricated using the classic solid-state route. The structural, optical, and magnetic properties have been investigated systematically. X-ray diffraction spectra and FULLPROF profile fitting indicate that GFO bulks belong to the orthorhombic structure with the space group Pc21n. Phase separation appears at the Fe content of x = 1.3. The optical bandgap decreases almost linearly with the increase of iron content, which means that the bandgap of GFO bulks can be controlled by adjusting the Fe content in the samples. The magnetic property measurements suggest that GFO is ferromagnetic, and the magnetic properties are enhanced compared with other reported works, exhibiting the application in ferromagnetic semiconductors devices.
Dietary energy density (ED) might have influences on body composition. We therefore examined whether ED is associated with body composition among Chinese adults.
We collected dietary data through validated two-day 24 h recalls. ED, defined as the amount of energy per unit weight of food consumed, was calculated based on five methods. Multiple linear regression analyses were performed to explore the associations between ED and body composition parameters, including BMI, fat mass index (FMI), fat-free mass index (FFMI), percentage body fat (%BF) and waist circumference (WC).
Chinese adults (n 1933) in 2013.
After adjusting the covariates, all ED definitions were positively associated with BMI, FMI, FFMI, %BF and WC among women (P<0·01). In men, however, ED with foods only was positively associated with BMI, FMI, FFMI and %BF (P<0·05), but not with WC (P=0·07); we also found null associations between ED with foods and all beverages and body composition among men. Additionally, ED contributed to higher increases of body composition in women than in men (P<0·01).
The present study supports the positive association between ED and body composition among adults in Southwest China, in which beverages may play an important role.
We model conditional market beta and alpha as flexible functions of state variables identified via a formal variable-selection procedure. In the post-1963 sample, the beta of the value premium comoves strongly with unemployment, inflation, and the price–earnings ratio in a countercyclical manner. We also uncover a novel nonlinear dependence of alpha on business conditions: It falls sharply and even becomes negative during severe economic downturns but is positive and flat otherwise. The conditional capital asset pricing model (CAPM) performs better than the unconditional CAPM, but this does not fully explain the value premium. Our findings are consistent with a conditional CAPM with rare disasters.
Although many studies worldwide have focused on the relationship between vitamin D and insulin resistance, results remain controversial. Furthermore, concentrations of serum 25-hydroxyvitamin D (25(OH)D) in the Chinese population are unclear. We aimed to investigate vitamin D status and its correlation with insulin resistance among a Chinese adult population.
Serum 25(OH)D, fasting blood glucose, fasting insulin, glycated Hb (HbA1c) and other metabolic parameters were assessed. Neck circumference, waist circumference, hip circumference, weight and height were also measured. Lifestyle factors including smoking and drinking status were obtained. Diabetes mellitus was diagnosed by HbA1c according to the 2010 American Diabetes Association criteria.
Of 7200 residents included, 6597 individuals were ultimately analysed.
We enrolled 2813 males (mean age 52·7 (sd 13·5) years) and 3784 females (52·3 (sd 13·5) years); mean serum 25(OH)D concentration was 43·1 (sd 11·6) and 39·6 (sd 9·8) nmol/l, respectively. Additionally, 83·3 % of participants were 25(OH)D deficient. A significant difference in 25(OH)D was observed between males and females in winter and spring (P<0·001). Furthermore, 25(OH)D concentrations were inversely associated with the homeostasis model assessment of insulin resistance (HOMA-IR) in the overweight and pre-diabetic populations. After adjusting for several variables, 25(OH)D was significantly associated with HOMA-IR in winter. When 25(OH)D values were categorized into quartiles, HOMA-IR was significantly associated with decreasing 25(OH)D.
The majority of the Chinese population was vitamin D deficient and this deficiency was negatively associated with insulin resistance, particularly in the overweight and pre-diabetic populations. Moreover, these associations might be more evident in the winter.
This article outlines the evolution of a rescue team in responding to adenovirus prevention with a deployable field hospital. The local governments mobilized a shelter hospital and a rescue team consisting of 59 members to assist with rescue and response efforts after an epidemic outbreak of adenovirus. We describe and evaluate the challenges of preparing for deployment, field hospital maintenance, treatment mode, and primary treatment methods. The field hospital established at the rescue scene consisted of a medical command vehicle, a computed tomography shelter, an X-ray shelter, a special laboratory shelter, an oxygen and electricity supply vehicle, and epidemic prevention and protection equipment. The rescue team comprised paramedics, physicians, X-ray technicians, respiratory therapists, and logistical personnel. In 22 days, more than 3000 patients with suspected adenovirus infection underwent initial examinations. All patients were properly treated, and no deaths occurred. After emergency measures were implemented, the spread of adenovirus was eventually controlled. An emergency involving infectious diseases in less-developed regions demands the rapid development of a field facility with specialized medical personnel when local hospital facilities are either unavailable or unusable. An appropriate and detailed prearranged action plan is important for infectious diseases prevention. (Disaster Med Public Health Preparedness. 2018;12:109–114)
Brief cognitive–behavioural therapy (CBT) is an emerging treatment for
schizophrenia in community settings; however, further trials are needed,
especially in non-Western countries.
To test the effects of brief CBT for Chinese patients with schizophrenia
in the community (trial registration: ChiCTR-TRC-13003709).
A total of 220 patients with schizophrenia from four districts of Beijing
were randomly assigned to either brief CBT plus treatment as usual (TAU)
or TAU alone. Patients were assessed at baseline, post-treatment and at
6- and 12-month follow-ups by raters masked to group allocation.
At the post-treatment assessment and the 12-month follow-up, patients who
received brief CBT showed greater improvement in overall symptoms,
general psychopathology, insight and social functioning. In total, 37.3%
of those in the brief CBT plus TAU group experienced a clinically
significant response, compared with only 19.1% of those in the TAU alone
group (P = 0.003).
Brief CBT has a positive effect on Chinese patients with schizophrenia in
In this paper we show that a polygonal quasiconformal mapping always corresponds to a chord-arc curve. Furthermore, we find that the set of curves corresponding to polygonal quasiconformal mappings is path connected in the set of all bounded chord-arc curves.