Background The internet hospital is an innovative organizational form and service mode under the tide of internet plus in the Chinese medical industry. It is the product of the interaction between consumer health needs and supply-side reform. However, there has still been no systematic summary of its establishment and definition, nor has there been an analysis of its service content. Objective The primary purpose of this study was to understand the definition, establishment, and development status of internet hospitals. Methods Data on internet hospitals were obtained via the Baidu search engine for results up until January 1, 2019. Based on the results of the search, we obtained more detailed information from the official websites and apps of 130 online hospitals and formed a database for descriptive analysis. Results By January 2019, the number of registered internet hospitals had expanded to approximately 130 in 25 provinces, accounting for 73.5% of all provinces or province-level municipalities in China. Internet hospitals, as a new telehealth model, are distinct but overlap with online health, telemedicine, and mobile medical. They offer four kinds of services—convenience services, online medical services, telemedicine, and related industries. In general, there is an underlying common treatment flowchart of care in ordinary and internet hospitals. There are three different sponsors—government-led integration, hospital-led, and enterprise-led internet hospitals—for which stakeholders have different supporting content and responsibilities. Conclusions Internet hospitals are booming in China, and it is the joint effort of the government and the market to alleviate the coexistence of shortages of medical resources and wasted medical supplies. The origin of internet hospitals in the eastern and western regions, the purpose of the establishment initiator, and the content of online and offline services are different. Only further standardized management and reasonable industry freedom can realize the original intention of the internet hospital of meeting various health needs.

Background The COVID-19 pandemic has become a global public health event, attracting worldwide attention. As a tool to monitor public awareness, internet search engines have been widely used in public health emergencies. Objective This study aims to use online search data (Baidu Index) to monitor the public’s attention and verify internet search engines’ function in public attention monitoring of public health emergencies. Methods We collected the Baidu Index and the case monitoring data from January 20, 2020, to April 20, 2020. We combined the Baidu Index of keywords related to COVID-19 to describe the public attention’s temporal trend and spatial distribution, and conducted the time lag cross-correlation analysis. Results The Baidu Index temporal trend indicated that the changes of the Baidu Index had a clear correspondence with the development time node of the pandemic. The Baidu Index spatial distribution showed that in the regions of central and eastern China, with denser populations, larger internet user bases, and higher economic development levels, the public was more concerned about COVID-19. In addition, the Baidu Index was significantly correlated with six case indicators of new confirmed cases, new death cases, new cured discharge cases, cumulative confirmed cases, cumulative death cases, and cumulative cured discharge cases. Moreover, the Baidu Index was 0-4 days earlier than new confirmed and new death cases, and about 20 days earlier than new cured and discharged cases while 3-5 days later than the change of cumulative cases. Conclusions The national public’s demand for epidemic information is urgent regardless of whether it is located in the hardest hit area. The public was more sensitive to the daily new case data that represents the progress of the epidemic, but the public’s attention to the epidemic situation in other areas may lag behind. We could set the Baidu Index as the sentinel and the database in the online infoveillance system for infectious disease and public health emergencies. According to the monitoring data, the government needs to prevent and control the possible outbreak in advance and communicate the risks to the public so as to ensure the physical and psychological health of the public in the epidemic.

Mucoepidermoid carcinoma (MEC) arises in many glandular tissues and contributes to the most common malignant salivary gland cancers. MEC is specifically associated with a unique t(11;19) translocation and the resulting CRTC1-MAML2 fusion is a major oncogenic driver for MEC initiation and maintenance. However, the molecular basis underlying the CRTC1-MAML2 oncogenic functions remain very limited. Through gene expression profiling analysis, we observed that LINC00473, a long noncoding RNA (lncRNA), was the top down-regulated target in CRTC1-MAML2-depleted human MEC cells. LncRNAs belong to a new class of non-coding RNAs with emerging roles in tumorigenesis and progression, but remain poorly characterized. In this study, we investigated the role of LINC00473 in mediating CRTC1-MAML2 oncogenic activity in human MEC. We found that LINC00473 transcription was significantly induced in human CRTC1-MAML2-positive MEC cell lines and primary MEC tumors, and was tightly correlated with the CRTC1-MAML2 RNA level. LINC00473 induction was dependent on the ability of CRTC1-MAML2 to activate CREB-mediated transcription. Depletion of LINC00473 significantly reduced the proliferation and survival of human MEC cells in vitro and blocked the in vivo tumor growth in a human MEC xenograft model. RNA in situ hybridization analysis demonstrated a predominantly nuclear localization pattern for LINC00473 in human MEC cells. Furthermore, gene expression profiling revealed that LINC00473 depletion resulted in differential expression of genes important in cancer cell growth and survival. LINC00473 likely regulates gene expression in part through its ability to bind to a cAMP signaling pathway component NONO, enhancing the ability of CRTC1-MAML2 to activate CREB-mediated transcription. Our overall results demonstrate that LINC00473 is a downstream target and an important mediator of the CRTC1-MAML2 oncoprotein. Therefore, LINC00473 acts as a promising biomarker and therapeutic target for human CRTC1-MAML2-positive MECs.

Nodular fasciitis (NF) is a clonal self-limited neoplastic proliferation characterized by rearrangements of the USP6 locus in most examples. To our knowledge well-documented malignant behavior has never been previously observed in NF. In this report we present an unusual case of NF with classical histologic features that showed a protracted clinical course characterized by multiple recurrences and eventual metastatic behavior over a period of 10 years. Molecular analyses revealed the presence and amplification of the novel PPPR6-USP6 gene fusion, which resulted in USP6 mRNA transcriptional upregulation. These findings further support the oncogenic role of the USP6 protease in mesenchymal neoplasia and expand the biologic potential of NF. © 2016 Wiley Periodicals, Inc.

BackgroundThe impact of sex on the association of obstructive sleep apnea (OSA) with recurrent cardiovascular events following acute coronary syndrome (ACS) remains uncertain. This study sought to examine the association between OSA and long-term cardiovascular outcomes in women and men with ACS.MethodsIn this prospective cohort study, we recruited 2,160 ACS patients undergoing portable sleep monitoring between June 2015 and January 2020. The primary endpoint was major adverse cardiovascular and cerebrovascular event (MACCE), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure.ResultsAfter exclusion of patients with failed sleep study, central sleep apnea, regular continuous positive airway pressure therapy, and loss of follow-up, a total of 1,927 patients were enrolled. Among them, 298 (15.5%) were women and 1,014 (52.6%) had OSA (apnea-hypopnea index ≥15 events·h−1). The prevalence of OSA was 43.0% and 54.4% in women and men, respectively. In 4,339 person-years (median: 2.9 years; interquartile range: 1.5 to 3.6 years), the cumulative incidence of MACCE was significantly higher in OSA versus non-OSA groups in the overall population (22.4% versus 17.7%; adjusted HR=1.29, 95% CI 1.04–1.59, p=0.018). OSA was associated with greater risk of MACCE in women (28.1% versus 18.8%; adjusted HR=1.68, 95% CI 1.02–2.78, p=0.042) but not in men (21.6% versus 17.5%; adjusted HR=1.22, 95% CI 0.96–1.54, p=0.10). No significant interaction was noted between sex and OSA for MACCE (interaction p=0.32). The incremental risk in women was attributable to higher rates of hospitalization for unstable angina and ischemia-driven revascularization.ConclusionsIn hospitalized ACS patients, OSA was associated with increased risk of subsequent events, particularly among women. Female patients with ACS should not be neglected for OSA screening and dedicated intervention studies focusing on women with ACS and comorbid OSA should be prioritized.

Background With the spread of COVID-19, an infodemic is also emerging. In public health emergencies, the use of information to enable disease prevention and treatment is incredibly important. Although both the information adoption model (IAM) and health belief model (HBM) have their own merits, they only focus on information or public influence factors, respectively, to explain the public’s intention to adopt online prevention and treatment information. Objective The aim of this study was to fill this gap by using a combination of the IAM and the HBM as the framework for exploring the influencing factors and paths in public health events that affect the public’s adoption of online health information and health behaviors, focusing on both objective and subjective factors. Methods We carried out an online survey to collect responses from participants in China (N=501). Structural equation modeling was used to evaluate items, and confirmatory factor analysis was used to calculate construct reliability and validity. The goodness of fit of the model and mediation effects were analyzed. Results The overall fitness indices for the model developed in this study indicated an acceptable fit. Adoption intention was predicted by information characteristics (β=.266, P<.001) and perceived usefulness (β=.565, P<.001), which jointly explained nearly 67% of the adoption intention variance. Information characteristics (β=.244, P<.001), perceived drawbacks (β=–.097, P=.002), perceived benefits (β=.512, P<.001), and self-efficacy (β=.141, P<.001) jointly determined perceived usefulness and explained about 81% of the variance of perceived usefulness. However, social influence did not have a statistically significant impact on perceived usefulness, and self-efficacy did not significantly influence adoption intention directly. Conclusions By integrating IAM and HBM, this study provided the insight and understanding that perceived usefulness and adoption intention of online health information could be influenced by information characteristics, people’s perceptions of information drawbacks and benefits, and self-efficacy. Moreover, people also exhibited proactive behavior rather than reactive behavior to adopt information. Thus, we should consider these factors when helping the informed public obtain useful information via two approaches: one is to improve the quality of government-based and other official information, and the other is to improve the public’s capacity to obtain information, in order to promote truth and fight rumors. This will, in turn, contribute to saving lives as the pandemic continues to unfold and run its course.

Background. Obstructive sleep apnea (OSA) is closely related to the incidence and progression of coronary artery disease (CAD), and the mechanisms linking OSA and CAD are multifactorial. C1q/TNF-related protein-9 (CTRP9) is a novel adipokine that protects the heart against ischemic injury and ameliorates cardiac remodeling. We aimed to ascertain the clinical relevance of CTRP9 with OSA prevalence in patients with CAD. Methods. From August 2016 to March 2019, consecutive eligible patients with CAD (n=154; angina pectoris, n=88; acute myocardial infarction [AMI], n=66) underwent cardiorespiratory polygraphy. OSA was defined as an apnea-hypopnea index (AHI) ≥15 events·h−1. Plasma CTRP9 concentrations were measured by ELISA method. Results. Moderate/severe OSA was present in 89 patients (57.8%). CTRP9 levels were significantly decreased in the moderate/severe OSA group than in the no/mild OSA group (4.7 [4.1-5.2] ng/mL vs. 4.9 [4.4-6.0] ng/mL, P=0.003). The difference between groups was only observed in patients with AMI (3.0 [2.3-4.9] vs. 4.5 [3.2-7.9], P=0.009). Correlation analysis showed that CTRP9 levels were negatively correlated with AHI (r=−0.238, P=0.003) and oxygen desaturation index (r=−0.234, P=0.004) and positively correlated with left ventricular ejection fraction (r=0.251, P=0.004) in all subjects. Multivariate analysis showed that male gender (OR 3.099, 95% CI 1.029-9.330, P=0.044), BMI (OR 1.148, 95% CI 1.040-1.268, P=0.006), and CTRP9 levels (OR 0.726, 95% CI 0.592-0.890, P=0.002) were independently associated with the prevalence of moderate/severe OSA. Conclusions. Plasma CTRP9 levels were independently related to the prevalence of moderate/severe OSA in patients with CAD, suggesting that CTRP9 might play a role in the pathogenesis of CAD exacerbated by OSA.

Housing is one of the social determinants of health and the most basic survival needs of human beings. Many studies have preliminarily confirmed that housing factors can influence residents’ health. The aims of this study were: to evaluate the housing factors associated with self-rated health and mental health among Chinese residents; to explore the regional heterogeneity of the impact of housing on health; and to assess the effects of housing on health among different age groups. Data was derived from the Chinese General Social Survey (CGSS). Housing factors were analyzed along six dimensions: housing property, living space, number of living people, number of houses, living region and housing price. Self-rated health and mental health were used to measure health outcomes. Multivariate ordered logistic regression was performed to assess the relationship between housing and health. The living space, living region and housing price was significantly associated with self-rated health. The number of living people living region and housing price were related to mental health. The influence of housing factors on health were more pronounced among residents living in eastern and central area and among the middle-aged group (41–65). Present findings support the notion that housing factors were related to health outcomes. Future studies may focus on the impact of interventions that target on these factors, and the impact of housing on health among special groups such as migrant population and low-and-middle income families.