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Background Cancer‐associated fibroblasts (CAFs) contributes to overall tumor progression. In the current survey, we explored the ability of microRNA‐20a (miR‐20a) within these CAF‐derived exosomes to influence non‐small‐cell lung cancer (NSCLC) progression. Materials and methods Normal tissue‐associated fibroblasts (NAFs) and CAFs were collected from samples of NSCLC patient tumors and paracancerous lung tissues. Exosomes derived from these cells were then characterized via Western blotting, nanoparticle tracking analyses, and transmission electron microscopy. The expression of miR‐20a was assessed via qPCR and fluorescence in situ hybridization (FISH). CCK‐8, EdU uptake, and colony formation assessments were used for evaluating tumor proliferation, while Hoechst staining was performed to monitor the in vitro apoptotic death of tumor cells. A model of xenograft tumor established in nude mice was also used to evaluate in vivo tumor responses. Results CAF‐derived exosomes exhibited miR‐20a upregulation and promoted NSCLC cell proliferation and resistance to cisplatin (DDP). Mechanistically, CAF‐derived exosomes were discovered to transmit miR‐20a to tumor cells wherein it was able to target PTEN to enhance DDP resistance and proliferation. Associated PTEN downregulation following exosome‐derived miR‐20a treatment enhanced PI3K/AKT pathway activation. Conclusion The achieved outcomes explain that CAFs can release miR‐20a‐containing exosomes capable of promoting NSCLC progression and chemoresistance, highlighting this pathway as a possible therapeutic target in NSCLC. CAFs‐derived exosomal miR‐20a promotes the progression of NSCLC. CAFs‐derived exosomal miR‐20a promotes chemoresistance of NSCLC. PTEN is a target gene of miR‐20a. 4. miRNA‐20a suppresses the PTEN/PI3K‐AKT pathway.

Background Biomedical named entity recognition (BioNER) is a basic and important medical information extraction task to extract medical entities with special meaning from medical texts. In recent years, deep learning has become the main research direction of BioNER due to its excellent data-driven context coding ability. However, in BioNER task, deep learning has the problem of poor generalization and instability. Results we propose the hierarchical shared transfer learning, which combines multi-task learning and fine-tuning, and realizes the multi-level information fusion between the underlying entity features and the upper data features. We select 14 datasets containing 4 types of entities for training and evaluate the model. The experimental results showed that the F1-scores of the five gold standard datasets BC5CDR-chemical, BC5CDR-disease, BC2GM, BC4CHEMD, NCBI-disease and LINNAEUS were increased by 0.57, 0.90, 0.42, 0.77, 0.98 and − 2.16 compared to the single-task XLNet-CRF model. BC5CDR-chemical, BC5CDR-disease and BC4CHEMD achieved state-of-the-art results.The reasons why LINNAEUS’s multi-task results are lower than single-task results are discussed at the dataset level. Conclusion Compared with using multi-task learning and fine-tuning alone, the model has more accurate recognition ability of medical entities, and has higher generalization and stability.

Objective To develop a Chinese visual analogue scale (VAS) value set for Europe Quality of Life Questionnaire (EQ-5D-3L) and compare it with the time trade-off (TTO) value set which was constructed based on the same sample. Methods An adapted Measurement and Valuation of Health (MVH) protocol was applied with VAS method. EQ-5D-3L was used in face-to-face interviews conducted by trained interviewers with participants selected via multi-stage stratified clustered random sample. Fifteen hypothetical health statuses (11 random states in MVH protocol, plus full health, severe problems for all dimensions, unconscious, and death) were assigned for assessment individually. Ordinary least square (OLS), general least square (GLS), and weighted least square (WLS) models were constructed. Five categories of indices, including quality of original data, distribution of rescaled values, goodness of fit of models, distribution of predicted values, and dimensions order were adopted to compare between Chinese VAS and TTO value sets. Results All 5,939 participants aged 15 and over were completely interviewed; 5,884 eligible participants were included in constructing models. Model 2 was the best for having 4 out of 7 indices of goodness of fit. Comparing with the TTO value set, Adjusted R-square of Model2 increased from 0.354 to 0.670;the mean absolute error decreased from 0.0838 to 0.0319; and the Pearson correlation coefficient between predicted and mean values increased from0.8989 to 0.9837. Model 2 gave uniformly lower values than Chinese TTO value set. VAS method had a higher responsive rate, less inconsistency, lower skewed values, and better goodness of fit values. Conclusions We recommend VAS value set, Model 2, as the reference of scoring algorithm when using EQ-5D-3L in large scale survey of Chinese population.

Canonical three-dimensional (3D) genome structures represent the ensemble average of pairwise chromatin interactions but not the single-allele topologies in populations of cells. Recently developed Pore-C can capture multiway chromatin contacts that reflect regional topologies of single chromosomes. By carrying out high-throughput Pore-C, we reveal extensive but regionally restricted clusters of single-allele topologies that aggregate into canonical 3D genome structures in two human cell types. We show that fragments in multi-contact reads generally coexist in the same TAD. In contrast, a concurrent significant proportion of multi-contact reads span multiple compartments of the same chromatin type over megabase distances. Synergistic chromatin looping between multiple sites in multi-contact reads is rare compared to pairwise interactions. Interestingly, the single-allele topology clusters are cell type-specific even inside highly conserved TADs in different types of cells. In summary, HiPore-C enables global characterization of single-allele topologies at an unprecedented depth to reveal elusive genome folding principles. Here the authors establish a high throughput Pore-C (HiPore-C) method increasing the sequencing output of multi-way chromatin contacts and reveal single-allele topology diversity and cell type-specificity of 3D genome folding.

Presurgical molecular therapy (PMT) including tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) showed various outcomes for renal cell carcinoma (RCC) with tumor thrombus (TT). We aimed to evaluate the impact of PMT on Mayo level or TT height and the treatment-related adverse events (AEs). A systematic literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science up to June 2023 to identify relevant studies investigating the impact of PMT on RCC patients with TT. The literature investigating the impact of PMT on RCC patients with venous TT, whether followed by surgery or not, was included. Overall, 184 patients were enrolled in this study. 30.7% (95% CI, 17.6-43.8%, I = 79%, p<0.01) patients experienced a decrease in TT levels after receiving PMT, while only 1.5% (95% CI, 0-0.044%, I = 0%, p=0.98) exhibited an increase in TT levels. An average decrease of 15.2mm (95% CI, 22.4-8.0, I = 77%, p<0.01) of TT in 117 patients was observed after PMT. The most common AEs was hypertension (49.9%, 95% CI, 27.1-77.7, I = 88%, p<0.01), diarrhea (20.2%, 95% CI, 2.7-37.6, I = 83%, p<0.01), fatigue (25.3%, 95% CI, 6.1-44.4, I = 84%, p<0.01) and hand-foot syndrome (25.5%, 95% CI, 5.6-45.5, I = 86%, p<0.01). PMT is available to assist in lowering the TT level in RCC patients aiming to simply the surgical procedures, particularly in patients with Mayo grade 3/4. The frequency and severity of AEs during PMT are tolerable. https://www.crd.york.ac.uk/prospero/, identifier CRD420234399128.

International hospital-based studies have indicated a high risk of cognitive impairment after stroke, evidence from community-based studies in China is scarce. To determine the prevalence of post-stroke cognitive impairment (PSCI) and its subtypes in stroke survivors residing in selected rural and urban Chinese communities, we conducted a community-based, cross-sectional study in 599 patients accounting for 48% of all stroke survivors registered in the 4 communities, who had suffered confirmed strokes and had undergone cognitive assessments via the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), and Hachinski Ischemia Scale (HIS). Detection of PSCI was based on scores in these neuropsychological scales. Factors potentially impacting on occurrence of PSCI were explored by comparing demographic characteristics, stroke features, and cardiovascular risk factors between patients with and without PSCI. The overall prevalence of PSCI was 80.97% (95%CI: 77.82%-84.11%), while that of non-dementia PSCI (PSCI-ND) and post-stroke vascular dementia (PSD) was 48.91% (95%CI: 44.91%-52.92%) and 32.05% (95%CI: 28.32%-35.79%), respectively. Prior stroke and complications during the acute phase were independent risk factors for PSCI. The risk of recurrent stroke survivors having PSCI was 2.7 times higher than for first-episode survivors, and it was 3 times higher for those with complications during the acute phase than for those without. The higher prevalence of PSCI in this study compared with previous Chinese studies was possibly due to the combined effects of including rural stroke survivors, a longer period from stroke onset, and different assessment methods. There is an urgent need to recognize and prevent PSCI in stroke patients, especially those with recurrent stroke and complications during the acute phase.

In this paper, to explore the current situation and future trend of the healthy development of China’s sports industry, the health evaluation index system of the sports industry was established by deconstructing the health dimension of the sports industry. The health evaluation model of the sports industry was constructed by using the entropy method and the multi-objective linear weighting method. The model was used to empirically analyze the characteristics and laws of the health of China’s sports industry from 2008 to 2017 and predict the health status of China’s sports industry in the next 10 years with the combination with the GM (1.1) model. The results show that the potential health degree of China’s sports industry exhibits a fluctuating growth trend, the actual health degree of the sports industry, and the health degree of the supporting environment in the sports industry show a steady growth trend on the whole. In the next 10 years, the health degree of China’s sports industry will maintain a healthy state in which the actual health degree and potential health degree of the sports industry will enter a healthy state in 2021 and 2024, respectively. In contrast, the health degree of the supporting environment in the sports industry is always in a very unhealthy state.

Background Although years have passed since the implementation of China’s universal two-child policy, the effectiveness of this policy remains unclear. To address this knowledge gap, we, here, assessed the impact of the two-child policy on total live births, preterm births, and multiple live births. Methods Data identifying pregnancies resulting in at least one live birth between April 1 2013 and December 31 2018 were collected from the Hospital Quality Monitoring System database. Using an interrupted time-series analysis, we estimated immediate level changes and long-term trends in total, preterm (birth before 37 weeks’ gestation), and multiple live births that had occurred after July 2016, when the universal two-child policy had taken effect. Results A total of 8,273,622 live births were reported during the study time frame. The number of live births ( p  = 0.277), preterm births ( p  = 0.052), and multiple births ( p  = 0.856) per month slightly increased immediately after July 2016, but these increases did not meet statistical significance. Further, all three outcomes showed a significant downward trend that lasted until the end of 2018 ( p  < 0.0001 for all). Among all live births, the percentage of preterm births remained stable ( p  = 0.101), while the percentage of multiple live births that were preterm significantly increased (trend change = 0.21% per month, 95% CI 0.14 to 0.28, p  < 0.0001). The percentage of live multiple births among all live births significantly decreased ( p for trend = 0.0039). Conclusions Overall, our data reveal a transient baby boom, as well as an increase in the proportion of live multiple births that were preterm, after China’s two-child policy took effect. The latter should be noted by healthcare professionals due to the high risk of complications and special medical care required by preterm babies. Key messages • Eight years have passed since the implementation of China’s universal two-child policy in October 2015, and a further three-child policy was announced in August 2021. • The two-child policy led to a temporary “baby boom”, but the overall total number of live births declined thereafter. • Among all live births, the percentage of preterm births remained stable, while the percentage of multiple live births that were preterm increased. This should be noted by healthcare professional due to the high risk of complications and special medical care required by preterm babies.

Circulating n-3 PUFA, which integrate endogenous and exogenous n-3 PUFA, can be better used to investigate the relationship between n-3 PUFA and disease. However, studies examining the associations between circulating n-3 PUFA and colorectal cancer (CRC) risk were limited, and the results remained inconclusive. This case–control study aimed to examine the association between serum n-3 PUFA and CRC risk in Chinese population. A total of 680 CRC cases and 680 sex- and age-matched (5-year interval) controls were included. Fatty acids were assayed by GC. OR and 95 % CI were calculated using multivariable logistic regression after adjustment for potential confounders. Higher level of serum α-linolenic acid (ALA), docosapentaenoic acid (DPA), DHA, long-chain n-3 PUFA and total n-3 PUFA were associated with lower odds of CRC. The adjusted OR and 95 % CI were 0·34 (0·24, 0·49, P for trend < 0·001) for ALA, 0·57 (0·40, 0·80, P for trend < 0·001) for DPA, 0·48 (0·34, 0·68, P for trend < 0·001) for DHA, 0·39 (0·27, 0·56, P for trend < 0·001) for long-chain n-3 PUFA and 0·31 (0·22, 0·45, P for trend < 0·001) for total n-3 PUFA comparing the highest with the lowest quartile. However, there was no statistically significant association between EPA and odds of CRC. Analysis stratified by sex showed that ALA, DHA, long-chain n-3 PUFA and total n-3 PUFA were inversely associated with odds of CRC in both sexes. This study indicated that serum ALA, DPA, DHA, long-chain n-3 PUFA and total n-3 PUFA were inversely associated with odds of having CRC in Chinese population.

Background Colorectal cancer is one of the most common cancers in the world. Several studies suggest using the Asia-Pacific colorectal screening (APCS) score and its modified versions to select high-risk populations for early colonoscopy, but external validation remains rare, and which score should be selected for CRC screening in China is unclear. Validation of multiple scores in the same population might help to choose the best performing score. Methods We conducted a cross-sectional study under the framework of Cancer Screening Program in Urban China, data from asymptomatic colorectal cancer screening in Xuzhou was used to validate the APCS score, the colorectal neoplasia predict (CNP) score, the Korean colorectal screening (KCS) score, the Modified APCS score and the 8-point risk score in predicting colorectal advanced neoplasia (CAN). Results 1804 subjects were included in the analysis and 112 CAN (6.21%) was detected. In each score, the detection rate of CAN was higher in the high-risk group than in the non-high-risk group ( P  < 0.05), and the RR (95% C.I. ) ranged 2.20 (1.50–3.22) [8-point risk] to 4.00 (2.41–6.65) [Modified APCS]. The c-statistics (95% C.I. ) of the scoring systems ranged from 0.58 (0.53–0.62) [8-point risk] to 0.65 (0.61–0.69) [KCS]. The sensitivity (95% C.I. ) of these systems ranged from 31.25 (22.83–40.70) [8-point risk] to 84.82 (76.81–90.90) [Modified APCS], while the specificity (95% C.I. ) ranged from 43.50 (41.12–45.90) [Modified APCS] to 83.81 (81.96–85.53) [8-point risk]. Using the APCS scoring system as a comparator, the net reclassification improvement (NRI) of each modified version ranged from − 10.34% (95% C.I. : − 22.63 to 1.95%) [8-point risk] to 4.79% (95% C.I. : − 1.50% to 11.08) [KCS]. The colonoscopy resource load (95% C.I. ) ranged from 9 [1–3] [8-point risk] to 11 [3–5] [APCS and Modified APCS]. Conclusions The APCS score and its modified versions have certain ability to predict the risk of advanced neoplasia and reduce the resource load. The modified APCS score and the KCS score seemed the preferable systems to classify high risk subjects based on its high RR , sensitivity and predictive ability in the selected population. Future research could focus on adding risk factors or combining with laboratory test results to improve the predictive power of the scoring system.