Isotonic Glycerol and Sodium Hyaluronate Containing Artificial Tear Decreases Conjunctivochalasis after One and Three Months: A Self-Controlled, Unmasked Study.

Dry eye complaints are ranked as the most frequent symptoms of patients visiting ophthalmologists. Conjunctivochalasis is a common dry eye disorder, which can cause an unstable tear film and ocular discomfort. The severe conjunctivochalasis characterized by high LId-Parallel COnjunctival Folds (LIPCOF) degree usually requires surgical intervention, where a conservative therapy would be highly desirable. Here we examined the efficacy of a preservative-free, inorganic salt-free unit-dose artificial tear, called Conheal containing isotonic glycerol and 0.015% sodium hyaluronate in a prospective, unmasked, self-controlled study involving 20 patients. The regular use of the glycerol/hyaluronate artificial tear in three months caused a significant improvement in the recorded parameters. Conjunctivochalasis decreased from a mean LIPCOF degree of 2.9 ± 0.4 on both eyes to 1.4 ± 0.6 on the right (median decrease of -2 points, 95% CI from -2.0 to -1.0), and to 1.4 ± 0.7 on the left eye (median decrease of -1 points, 95% CI from -2.0 to -1.0) (p<0.001 for both sides). The tear film breakup time (TFBUT) lengthened from 4.8 ± 1.9 seconds on both eyes to 5.9 ± 2.3 seconds (mean increase of 1.1 seconds, 95% CI from 0.2 to 2.0) and 5.7 ± 1.8 seconds (mean increase of 0.9 seconds, 95% CI from 0.3 to 1.5) on the right and left eyes, respectively (p(right eyes) = 0.020, p(left eyes) = 0.004). The corneal lissamine staining (Oxford Scheme grade) was reduced from 1.3 ± 0.6 on the right and 1.4 ± 0.6 on the left eye significantly (p<0.001) to 0.3 ± 0.4 and 0.2 ± 0.4 on the right and the left eyes. The Ocular Surface Disease Index (OSDI) questionnaire score indicating the subjective complaints of the patients also decreased from a mean value of 36.2 ± 25.3 to 15.6 ± 16.7 (p<0.001). In this study, the artificial tear, Conheal decreased the grade of the conjunctivochalasis significantly after one month of regular use already, from the LIPCOF degree 3, considered as indication of conjunctival surgery, to a LIPCOF degree 2 or lower requiring a conservative therapy. Our results raise the possibility that vision-related quality of life can be significantly improved by conservative therapies even in severe conjunctivochalasis

Analysis of the impact of length of stay on the quality of service experience, satisfaction and loyalty

Although length of stay is a relevant variable in destination management, little research has been produced connecting it with tourists' post-consumption behaviour. This research compares the post-consumption behaviour of same-day visitors with overnight tourists in a sample of 398 domestic vacationers at two Mediterranean heritage-and-beach destinations. Although economic research on length of stay posits that there are destination benefits in longer stays, same-day visitors score higher in most of the post-consumption variables under study. Significant differences arise in hedonic aspects of the tourist experience and destination loyalty. Thus, we propose that length of stay can be used as a segmentation variable. Furthermore, destination management organisations need to consider length of stay when designing tourism policies. The tourist product and communication strategies might be adapted to different vacation durations

Suppression of gas species signals in direct current glow discharge time-of-flight mass spectrometry

The possibility of suppressing gas species in direct current glow discharge mass spectrometry (dc-GDMS) with a linear time-of-flight mass analyzer was investigated. With this tic-GD ion source, a 'clean' mass spectrum rich in analyte could be obtained when the dc-GD was operated under a discharge current of 15-30 mA and a gas pressure of 300-500 Pa, in contrast to the strong signals of gas species in convention dc-GDMS, which operates at lower currents and pressures (typically 1-5 mA and 100 Pa). Such an experimental result is believed to be due to increased sputtering at higher pressures and currents, and the different ionization mechanisms of analyte and gas species. For a possible GD design to eliminate the background gas ions, a new discharge configuration was developed by attaching a TM,,, microwave resonator to the GD ion source. The mass spectrum of the cathode sample showed a low gas species background when the microwave-induced plasma (MIP) discharge was 'off' under different dc-GD parameters. The mass spectra of analyte and gas species obtained with 'MIP + dc-GD' and 'MIP only' modes are also compared and discussed. It was found that the analyte signals decrease and the gas species signals increase in the presence of the MIP, and that the analyte signals nearly disappear in the 'MIP only' mode. Preliminary results suggest that, for specific discharge conditions and with a suitable design of the GD source, an efficient suppression of gas species in dc-GDMS detection could be realized

Microwave-induced plasma boosted microsecond-pulse glow discharge optical emission spectrometry

A microsecond-pulse (mu s-pulse) glow discharge (GD) source boosted by a microwave-induced plasma (MIP) has been developed and studied for optical emission spectrometry (OES), The excitation processes of the tandem GD source were investigated, The analytical characteristics of the GD-OES source in the presence and absence of the MIP were compared, including the operating parameters, signal-to-background ratios (S/B) and relative standard deviation (RSD), The results show that under a relatively low discharge pressure (<180 Pa), the mu s-pulse GD can couple fairly well with the MIP and emit intense analytical lines, When the GD source is operated under a pressure higher than 200 Pa, tao emission peaks appear, independent in time, for a given resonance atomic line, because sample atoms are independently structurally excited, first by the mu s-pulse GD and then by the MIP. The time interval between the tao peaks for Zn I 213.8 nm is longer than that for Cu I 324.7 nm, which is believed to be due to the faster diffusing velocity of copper atoms, When the mu s-pulse GD lamp is operated under a gas pressure higher than 220 Pa, the ion population is so high that Cu II ionic line at 224.7 nm 'becomes' two peaks because of a possible self-absorption. The results show that the supplementary nse of an MIP can eliminate the self-absorption of ionic and atomic lines, When the mu s-pulse GD source is coupled with the MTP, S/Bs are improved by a factor of more than one order of magnitude for several analytical lines. A short-term RSD of 0.2% is achieved for the 'mu s-pulse GD+MIP' configuration compared with that of 1.0% for 'mu s-pulse GD only' mode. The experimental results show that the MIP boosted mu s-pulse GD is a promising technique for solid sample and surface analysis

Distinct distribution and prognostic significance of molecular subtypes of breast cancer in Chinese women: a population-based cohort study

<p>Abstract</p> <p>Background</p> <p>Molecular classification of breast cancer is an important prognostic factor. The distribution of molecular subtypes of breast cancer and their prognostic value has not been well documented in Asians.</p> <p>Methods</p> <p>A total of 2,791 breast cancer patients recruited for a population-based cohort study were evaluated for molecular subtypes of breast cancer by immunohistochemical assays. Data on clinicopathological characteristics were confirmed by centralized pathology review. The average follow-up of the patients was 53.4 months. Overall and disease-free survival by molecular subtypes of breast cancer were evaluated.</p> <p>Results</p> <p>The prevalence of the luminal A, luminal B, human epidermal growth factor receptor 2 (HER2), and triple-negative subtypes were 48.6%, 16.7%, 13.7%, and 12.9%, respectively. The luminal A subtype was more likely to be diagnosed in older women (P = 0.03) and had a stronger correlation with favorable clinicopathological factors (smaller tumor size, lower histologic grade, and earlier TNM stage) than the triple-negative or HER2 subtypes. Women with triple-negative breast cancer had a higher frequency of family history of breast cancer than women with other subtypes (P = 0.048). The 5-year overall/disease-free survival percentages for the luminal A, luminal B, HER2, and triple-negative subtypes were 92.9%/88.6%, 88.6%/85.1%, 83.2%/79.1%, and 80.7%/76.0%, respectively. A similar pattern was observed in multivariate analyses. Immunotherapy was associated with improved overall and disease-free survival for luminal A breast cancer, but reduced disease-free survival (HR = 2.21, 95% CI, 1.09-4.48) for the HER2 subtype of breast cancer.</p> <p>Conclusions</p> <p>The triple-negative and HER2 subtypes were associated with poorer outcomes compared with the luminal A subtype among these Chinese women. The HER2 subtype was more prevalent in this Chinese population compared with Western populations, suggesting the importance of standardized HER2 detection and anti-HER2 therapy to potentially benefit a high proportion of breast cancer patients in China.</p

The 3′ UTR Variants in the GRP78 Are Not Associated with Overall Survival in Resectable Hepatocellular Carcinoma

Background: Elevated glucose-regulated protein 78 (GRP78) levels in tissues have been known to be related with poor prognosis in hepatocellular carcinoma (HCC) patients. Though the variants in the 3′ untranslated region (UTR) of GRP78 gene were not associated with HCC risk, we wonder whether these polymorphisms affect survival of HCC patients. Methodology/Principal Findings: Blood samples of HCC patients were maintained in our specimen bank between 1996 to 2003. DNA from 576 unrelated and resectable patients with HCC was typed for rs16927997 (T>C), rs1140763 (T>C) and rs12009 (T>C) by TaqMan assays. The Kaplan-Meier method and log-rank test were used to estimate overall survival. Linkage disequilibrium (LD) analysis identified a total of 3 haplotypes and 6 diplotypes in this region. The distribution of haplotype was not related to the clinical characteristics. Univariate analysis showed that the allele, genotype, haplotype and diplotype did not effect the survival. None of the clinical features show a significant association (P correced>0.05) with overall patient outcome in multiple comparisons. Conclusions/Significance: There is no noteworthy influence of 3′ UTR variants in the GRP78 on prognosis of resectable HCC in the Chinese population. © 2011 Zhu et al.published_or_final_versio

Clinical characteristics of the autumn-winter type scrub typhus cases in south of Shandong province, northern China

<p>Abstract</p> <p>Background</p> <p>Before 1986, scrub typhus was only found endemic in southern China. Because human infections typically occur in the summer, it is called "summer type". During the autumn-winter period of 1986, a new type of scrub typhus was identified in Shandong and northern Jiangsu province of northern China. This newly recognized scrub typhus was subsequently reported in many areas of northern China and was then called "autumn-winter type". However, clinical characteristics of associated cases have not been reported.</p> <p>Methods</p> <p>From 1995 to 2006, all suspected scrub typhus cases in five township hospitals of Feixian county, Shandong province were enrolled. Indirect immunofluorescent assay (IFA) was used as confirmatory serodiagnosis test. Polymerase chain reaction (PCR) connected with restriction fragment length polymorphism (RFLP) and sequence analyses were used for genotyping of <it>O. tsutsugamushi </it>DNAs. Clinical symptoms and demography of confirmed cases were analyzed.</p> <p>Results</p> <p>A total of 480 scrub typhus cases were confirmed. The cases occurred every year exclusively between September and December with a peak occurrence in October. The case numbers were relatively higher in 1995, 1996, 1997, and 2000 than in other years. 57.9% of cases were in the group aged 21–50. More cases occurred in male (56%) than in female (44%). The predominant occupational group of the cases was farmers (85.0%). Farm work was reported the primary exposure to infection in 67.7% of cases. Fever, rash, and eschar were observed in 100.0%, 90.4%, and 88.5% of cases, respectively. Eschars formed frequently on or around umbilicus, abdomen areas, and front and back of waist (34.1%) in both genders. Normal results were observed in 88.7% (WBC counts), 84.5% (PLT counts), and 89.7% (RBC counts) of cases, respectively. Observations from the five hospitals were compared and no significant differences were found.</p> <p>Conclusion</p> <p>The autumn-winter type scrub typhus in northern China occurred exclusively from September to December with a peak occurrence in October, which was different from the summer type in southern China. In comparison with the summer type, complications associated with autumn-winter type scrub typhus were less severe, and abnormalities of routine hematological parameters were less obvious.</p

Genetic Dissection of Epidermal Growth Factor Receptor Signaling during Luteinizing Hormone-Induced Oocyte Maturation

Recent evidence that luteinizing hormone (LH) stimulation of ovulatory follicles causes transactivation of the epidermal growth factor receptor (EGFR) has provided insights into the mechanisms of ovulation. However, the complete array of signals that promote oocyte reentry into the meiotic cell cycle in the follicle are still incompletely understood. To elucidate the signaling downstream of EGFR involved in oocyte maturation, we have investigated the LH responses in granulosa cells with targeted ablation of EGFR. Oocyte maturation and ovulation is disrupted when EGFR expression is progressively reduced. In granulosa cells from mice with either global or granulosa cell-specific disruption of EGFR signaling, LH-induced phosphorylation of MAPK3/1, p38MAPK, and connexin-43 is impaired. Although the LH-induced decrease in cGMP is EGFR-dependent in wild type follicles, LH still induces a decrease in cGMP in Egfrdelta/f Cyp19-Cre follicles. Thus compensatory mechanisms appear activated in the mutant. Spatial propagation of the LH signal in the follicle also is dependent on the EGF network, and likely is important for the control of signaling to the oocyte. Thus, multiple signals and redundant pathways contribute to regulating oocyte reentry into the cell cycle