[Effectiveness and safety of anti-fibrinolytic therapy in on-pump CABG]

Objective: To evaluate the effectiveness and safety of anti-fibrinolytic therapy in on-pump coronary artery bypass grafting (CABG). Methods: Two hundred and eleven patients receiving on-pump CABG in Fuwai Hospital were recruited and randomized into treatment group (group T) and control group (group C) between October 2014 and February 2017. Tranexamic acid was given with a 10 mg/kg loading dose and 10 mg·kg(-1)·h(-1) infusion dose to group T and equal volume of saline was given to group C throughout the surgery. Postoperative drainage, allogeneic transfusion, complications, adverse events and mortality were recorded. Results: Patients of group T had less postoperative drainage [860 (670, 1 190)ml vs 985 (783, 1 365)ml], decreased red blood cell [2 (0, 8)U vs 6 (2, 10)U] and fresh frozen plasma [1 (0, 3) U vs 2 (0, 3)U] transfusion volume, lower fresh frozen plasma transfusion rate (53.33% vs 70.75%) than patients of group C (all P<0.05). No statistically significant differences existed in the rate of postoperative complications, adverse events and death between the two groups (all P>0.05). Conclusion: Tranexamic acid has definite anti-fibrinolytic effect, which can significantly reduce postoperative bleeding and allogeneic transfusion while no severe side effects were observed.

Rifampicin Resistance and Multidrug-Resistant Tuberculosis Detection Using Xpert MTB/RIF in Wuhan, China: A Retrospective Study

BACKGROUND

The Xpert MTB/RIF test (Cepheid, Sunnyvale, CA) can simultaneously detect the Mycobacterium tuberculosis (MTB) complex DNA and rifampicin (RFP) resistance and can rapidly determine RFP resistance and predict multidrug-resistant tuberculosis (MDR-TB). In this study, we analyzed clinical examination results of a hospital specializing in TB treatment in Wuhan, Hubei, China, and examined the use of traditional culture and drug-sensitive test (DST) results as a gold standard to assess the diagnosis value of the Xpert MTB/RIF test in RFP resistance and MDR-TB.

MATERIALS AND METHODS

A total of 2,910 specimens were received in the Mycobacteriology Laboratory, Wuhan Pulmonary Hospital, for Xpert MTB/RIF testing between December 2013 and December 2014. After the results were reviewed by exclusion criteria, 1,066 Xpert test results were eligible for our study. We then compared the Xpert test results with sputum acid-fast bacilli staining, cultures, and DST results.

RESULTS

In total, Xpert correctly identified 96.71% (147/152) RFP-resistant TB and 98.25% (898/914) RFP-sensitive TB specimens. Of the 147 RFP-resistant TB specimens detected by Xpert, 122 MDR-TB (82.99%) were identified by traditional culture and DST techniques.

CONCLUSIONS

Xpert can simultaneously detect MTB and RFP resistance with high sensitivity and specificity. Thus, Xpert testing aids in saving a considerable amount of time in the diagnosis and treatment of MDR-TB.

[Exploration of training pattern on periodontal probing during pre-clinical periodontal practice of undergraduate students]

Objective: To explore the training pattern of periodontal probing practice so as to improve the accuracy of probing depth measurements of undergraduate students. Methods: Sixty-two undergraduate dental students in their pre-clinical training course were divided into two groups (31 students in each group): the reform group and the control group. The students in reform group learned and practiced periodontal probing by using transparent gingiva models for 30 minutes, and using conventional periodontal probing models for further 90 minutes in two sessions. The total practicing time was 2 hours. The students in control group learned and practiced periodontal probing using conventional periodontal probing models only for 1 hour of practicing time. After the training, new conventional periodontal probing models were used to evaluate the accuracy of probing depth measurements of the students in the two groups. The probing depths of Ramfjord index teeth were recorded by the students and were compared with the results of an experienced teacher's measurements. Results: The percentage of absolutely consistent sites in the reform group (63.4% [708/1 116]) was significantly higher than that of the control group (60.0% [670/1 116]) (P=0.012). In both reform group and control group, the percentages of absolutely consistent sites of the incisors (reform group: 69.1% [257/372], control group: 65.9% [245/372]) were significantly higher than those of the molars (reform group 58.9% [219/372], control group 54.3% [202/372])(P< 0.01), meanwhile, the percentages of absolutely consistent sites of the buccal-lingual sites (reform group: 88.7% [330/372], control group: 80.4% [299/372]) were significantly higher than those of the interproximal sites (reform group: 50.8% [378/744], control group: 49.9% [371/744])(P<0.01). Conclusions: The comprehensive reform of periodontal probing training could improve the accuracy of probing depth measurement of the undergraduate students. During the pre-clinical practice, probing training in the molar areas and the interproximal sites should be reinforced.

Blind bedside postpyloric placement of spiral tube as rescue therapy in critically ill patients: a prospective, tricentric, observational study

Background

Various special techniques for blind bedside transpyloric tube placement have been introduced into clinical practice. However, transpyloric spiral tube placement facilitated by a blind bedside method has not yet been reported. The objective of this prospective study was to evaluate the safety and efficiency of blind bedside postpyloric placement of a spiral tube as a rescue therapy subsequent to failed spontaneous transpyloric migration in critically ill patients.

Methods

This prospective, tricentric, observational study was conducted in the intensive care units (ICUs) of three tertiary hospitals. A total of 127 consecutive patients with failed spontaneous transpyloric spiral tube migration despite using prokinetic agents and still required enteral nutrition for more than 3 days were included. The spiral tube was inserted postpylorically using the blind bedside technique. All patients received metoclopramide intravenously prior to tube insertion. The exact tube tip position was determined by radiography. The primary efficacy endpoint was the success rate of postpyloric spiral tube placement. Secondary efficacy endpoints were success rate of a spiral tube placed in the third portion of the duodenum (D3) or beyond, success rate of placement in the proximal jejunum, time to insertion, length of insertion, and number of attempts. Safety endpoints were metoclopramide-related and major adverse tube-associated events.

Results

In 81.9% of patients, the spiral feeding tubes were placed postpylorically; of these, 55.1% were placed in D3 or beyond and 33.9% were placed in the proximal jejunum, with a median time to insertion of 14 min and an average number of attempts of 1.4. The mean length of insertion was 95.6 cm. The adverse event incidence was 26.0%, and no serious adverse event was observed.

Conclusions

Blind bedside postpyloric placement of a spiral tube, as a rescue therapy subsequent to failed spontaneous transpyloric migration in critically ill patients, is safe and effective. This technique may facilitate the early initiation of postpyloric feeding in the ICU.

Trial registration

Chinese Clinical Trial Registry, ChiCTR-OPN-16008206. Registered on 1 April 2016.

Closing CO2 Loop in Biogas Production: Recycling Ammonia As Fertilizer

We propose and demonstrate a novel system for simultaneous ammonia recovery, carbon capture, biogas upgrading, and fertilizer production in biogas production. Biogas slurry pretreatment (adjusting the solution pH, turbidity, and chemical oxygen demand) plays an important role in the system as it significantly affects the performance of ammonia recovery. Vacuum membrane distillation is used to recover ammonia from biogas slurry at various conditions. The ammonia removal efficiency in vacuum membrane distillation is around 75% regardless of the ammonia concentration of the biogas slurry. The recovered ammonia is used for CO₂ absorption to realize simultaneous biogas upgrading and fertilizer generation. CO₂ absorption performance of the recovered ammonia (absorption capacity and rate) is compared with a conventional model absorbent. Theoretical results on biogas upgrading are also provided. After ammonia recovery, the treated biogas slurry has significantly reduced phytotoxicity, improving the applicability for agricultural irrigation. The novel concept demonstrated in this study shows great potential in closing the CO₂ loop in biogas production by recycling ammonia as an absorbent for CO₂ absorption associated with producing fertilizers.

[Evaluation of endometriosis fertility index in follow-up treatment of endometriosis combined with infertility patients after laparoscopic surgery]

Objective: To explore the application of endometriosis fertility index (EFI) in guidance after laparoscopic surgery of endometriosis patients combined with infertility and to explore methods to improve pregnancy rate in different EFI groups. Methods: A prospective research was done in endometriosis patients combined with infertility in Beijing Obstetrics and Gynecology Hospital from January 2010 to June 2011, after laparoscopic surgery, these 146 patients were divided into 3 groups by EFI score. Using different pregnancy guidance, these patients had 5 years follow-up. Results: (1) The 5 years overall pregnancy rate was 89.0% (130/146). The pregnancy rate was 95.7% (45/47) in EFI≥9 group, 92.8% (77/83) in EFI 5-8 group and 8/16 in EFI≤4 group, three groups were all reach satisfactory pregnancy rate; the rate of the first two groups had no statistically significance (P=0.498), but had significant difference with the last group (P<0.01). (2) In EFI≥5 patients, pregnancy rate was the highest in 6 months after operation; in EFI≥9 group, the pregnancy rate was 66.7% (30/45), and EFI 5-8 group was 50.6% (39/77). (3) EFI≥9 group had the highest natural pregnancy rate [83.6% (46/55)], natural pregnancy rate was significant statistical different in different EFI groups (P=0.001). Conclusions: EFI score is a useful evaluation in predicting and guiding pregnancy in endometriosis patients combined with infertility after laparoscopic surgery. EFI score guidance, strict post-operation management and positive pregnancy scheme could significantly improve the pregnancy rate of endometriosis patients with infertility.

High Contribution of Nonfossil Sources to Submicrometer Organic Aerosols in Beijing, China

Source apportionment of organic carbon (OC) and elemental carbon (EC) from PM₁ (particulate matter with a diameter equal to or smaller than 1 μm) in Beijing, China was carried out using radiocarbon (¹⁴C) measurement. Despite a dominant fossil-fuel contribution to EC due to large emissions from traffic and coal combustion, nonfossil sources are dominant contributors of OC in Beijing throughout the year except during the winter. Primary emission was the most important contributor to fossil-fuel derived OC for all seasons. A clear seasonal trend was found for biomass-burning contribution to OC with the highest in autumn and spring, followed by winter and summer. ¹⁴C results were also integrated with those from positive matrix factorization (PMF) of organic aerosols from aerosol mass spectrometer (AMS) measurements during winter and spring. The results suggest that the fossil-derived primary OC was dominated by coal combustion emissions whereas secondary OC was mostly from fossil-fuel emissions. Taken together with previous ¹⁴C studies in Asia, Europe and USA, a ubiquity and dominance of nonfossil contribution to OC aerosols is identified not only in rural/background/remote regions but also in urban regions, which may be explained by cooking contributions, regional transportation or local emissions of seasonal-dependent biomass burning emission. In addition, biogenic and biomass burning derived SOA may be further enhanced by unresolved atmospheric processes.

[The understanding of Epstein-Barr virus associated lymphoproliferative disorder]

In recent years, there are increasing articles concerning Epstein-Barr virus associated lymphoproliferative disorder (EBV+ LPD), and the name of EBV+ LPD is used widely. However, the meaning of EBV+ LPD used is not the same, which triggered confusion of the understanding and obstacles of the communication. In order to solve this problem. Literature was reviewed with combination of our cases to clarify the concept of EBV+ LPD and to expound our understanding about it. In general, it is currently accepted that EBV+ LPD refers to a spectrum of lymphoid tissue diseases with EBV infection, including hyperplasia, borderline lesions, and neoplastic diseases. According to this concept, EBV+ LPD should not include infectious mononucleosis (IM) and severe acute EBV infection (EBV+ hemophagocytic lymphohistiocytosis, fatal IM, fulminant IM, fulminant T-cell LPD), and should not include the explicitly named EBV+ lymphomas (such as extranodal NK/T cell lymphoma, aggressive NK cell leukemia, Burkitt lymphoma, and Hodgkin lymphoma, etc.) either. EBV+ LPD should currently include: (1) EBV+ B cell-LPD: lymphomatoid granulomatosis, EBV + immunodeficiency related LPD, chronic active EBV infection-B cell type, senile EBV+ LPD, etc. (2) EBV+ T/NK cell-LPD: CAEBV-T/NK cell type, hydroa vacciniforme, hypersensitivity of mosquito bite, etc. In addition, EBV+ LPD is classified, based on the disease process, pathological and molecular data, as 3 grades: grade1, hyperplasia (polymorphic lesions with polyclonal cells); grade 2, borderline (polymorphic lesions with clonality); grade 3, neoplasm (monomorphic lesions with clonality). There are overlaps between EBV+ LPD and typical hyperplasia, as well as EBV+ LPD and typical lymphomas. However, the most important tasks are clinical vigilance, early identification of potential severe complications, and treating the patients in a timely manner to avoid serious complications, as well as the active treatment to save lives when the complications happened.

CT-guided 125I brachytherapy for locally recurrent nasopharyngeal carcinoma

Purpose: The study evaluated the feasibility, clinical effectiveness, and quality of life of computed tomography (CT)-guided 125I brachytherapy for locally recurrent nasopharyngeal carcinoma (NPC). Methods: We recruited 81 patients diagnosed with locally recurrent NPC after previous radiotherapy with or without chemotherapy. Thirty-nine patients received 125I brachytherapy (group A) and 42 received re-irradiation (IMRT, group B). The evaluated outcomes were local control, complications, and quality of life. Cox proportional hazards regression analysis was used to compare local tumor progression-free survival (LTPFS) and overall survival (OS) in the two treatment groups. Results: The median follow-up was 30 months (range, 5-68 months), median LTPFS was 21 in group A and 17 months in group B. The 1-, 2-, and 3-year OS in group A were 84.6%, 51.3%, 30.7%, and 85.7%, 50.0%, and 32.6% in group B. In group A, 10/39 patients (25.6%) experienced at least one ≥grade III complication; no grade V complications occurred. In group B, 28/42 (66.7%) experienced at least one ≥grade III complication and 6/42 (14.3%) died of severe grade V complications. No significant between-group difference existed in the Quality of Life score on the EORTC QLQ-H&N35 questionnaire before treatment. In group A, quality of life was significantly improved after treatment; but did not improve, or even deteriorated in group B. Conclusions: 125I brachytherapy was a feasible, safe, and effective treatment for locally recurrent NPC. 125I brachytherapy significantly reduced complications caused by re-irradiation and improved patients' quality of life.

[Expression of Fra-1 in laryngeal squamous cell carcinoma]

Objective:To investigate expressions of Fra-1 in laryngeal squamous cell carcinoma. Method:Using immunohistochemical method and RT-PCR detecting 47 cases of laryngeal squamous carcinoma tissues and 21 cases of para-carcinoma tissues with the level of protein and mRNA, we analyzed the relationship of the genes expression and clinical parameters. Result:The level of protein positive expression of Fra-1 genes in laryngeal squamous cancer tissue were higher than adiacent tissues (P<0.05). The expression of Fra-1 protein in laryngeal squamous cancer tissue were significant correlation with the clinical stages, lymph metastasis, smoking. They had no significant correlation with the pathological grade, age, anatomic zonation. The mRNA level expression of Fra-1 genes in laryngeal squamous cancer tissue were higher than adjacent tissues (P<0.01). The expression of Fra-1 gene in the mRNA level was correlated with pathologic stage, clinical stage, lymph metastasis, and smoking, but wasn't correlated with age and anatomic zonation. Conclusion:In laryngeal squamous cell carcinoma, the expression of Fra-1 gene are overexpressed. Fra-1 may play a role in the occurrence and development of the laryngeal cancer.

[A study on the effects of exposure to benzene on the activity of immunoglobulin E]

Objective: To analyze the level of immunoglobulin E (IgE) changes with benzene exposure workers. Methods: Firstly, through occupational health monitoring, 68 hospitalized cases were discovered who were suspected chronic benzene poisoning. Secondly, according to the GBZ68-2013《The diagnosis of occupational benzene poisoning》standard diagnosis and indexing, 68 cases were divided into the benzene poisoning group (n= 29) and the benzene exposure group (n=39) . 50 cases of healthy workers without benzene exposure were for the control group. Use the immune luminescence method to detect IgE levels. Thirdly, Case-control study was used, observing IgE changes though the three groups by statistical analysis. Results: Compared with control group, the level of leukocyte、neutrophil and IgE was drop in benzene exposure group with statistically significant (P<0.05) . Compared with benzene exposure group, IgE of benzene poisoning group was rise, with statistically significant (P<0.05) , IgE of mild benzene poisoning group rise the most obvious, with statistically significant (P<0.05) . Compared with benzene exposure group, IgE of moderate benzene poisoning group was drop, without statistically significant (P>0.05) . Conclusion: Benzene occupational exposure can induce immunosuppression, IgE decreases, and reduces immune surveillance. The response of the IgE level in the mild benzene poisoning patients was significantly elevated, whether it is protective response of the body immune function needs to be studied further investigated.

[Diagnostic value of serum cystatin C for acute kidney injury in patients with liver cirrhosis]

Objective: To determine the diagnostic value of serum cystatin C (Cys C) for acute kidney injury (AKI) in patients with liver cirrhosis. Methods: Serum Cys C levels in 150 liver cirrhosis patients (88 AKI and 62 non-AKI patients) were measured by the Particle-Enhanced Nephelometric Immuno-Assay. The accuracy of serum Cys C for the diagnosis of AKI in liver cirrhosis was evaluated by the ROC curve. Results: Liver cirrhosis patients with AKI had significantly higher serum Cys C levels [2.37 (1.75-2.83) mg/L] than those without AKI [0.97 (0.85-1.09) g/L] (P <0.001). Serum Cys C level was highest in the acute tubular necrosis group [5.41 (2.77-6.19) mg/L], followed by the hepatorenal syndrome group [2.55 (2.28-3.59) mg/L] and prerenal azotemia group [2.07 (1.70-2.41) mg/L], and the serum Cys C level was significantly different between the three groups (P <0.001). In addition, patients with AKI were further divided into infection group and non-infection group. Serum Cys C level was significantly higher in the infection group than in the non-infection group (P <0.05). The area under the ROC curve of serum Cys C for the diagnosis of AKI in liver cirrhosis was 0.99 (0.98-1.00) at a cut-off value of 1.36 mg/L, and the sensitivity and specificity were 97% and 95%, respectively. Conclusion: Serum Cys C is a good marker for detecting AKI in liver cirrhosis, and the different levels of increase in Cys C may be useful in differentiating the different types of AKI.

[Malignant solitary fibrous tumor of the lung metastatic to the thyroid gland:a case report]

Solitary fibrous tumors(SFT) of the thyroid gland are rarely reported，especially metastases from a malignant solitary fibrous tumor(MSFT) of lung. We herein present a 35 year old man with history of SFT of lung and a 6 month history of rapidly enlarging thyroid masses. The CT showed masses in the left thyroid lobe. We performed thyroid lobectomy plus central compartment neck dissection. Immunohistochemically,Bcl2,Vim and CD99 were positive,while CK,CD34,EMA,TG,P53 and S100 were negative. Combined with patient medical history and pathological diagnosis,it confirmed that MSFT of the lung metastatic to the thyroid gland. within a period of 7 months of follow up,no reoccurrence was found so far.

Geniposide accelerates proteasome degradation of Txnip to inhibit insulin secretion in pancreatic β-cells

PURPOSE

To analyze the role of geniposide in the protein degradation of Txnip and to determine the impact of Txnip on geniposide-regulated GSIS in pancreatic INS-1 cells.

METHODS

The content of Txnip protein was measured by western blot; insulin content and glucose uptake were determined by ELISA; and knockdown of Txnip was the method of RNA interference.

RESULTS

Glucose induces a rapid increase in Txnip protein, and geniposide accelerates the degradation of Txnip via proteasome pathway in the presence of high glucose (25 mM) in INS-1 pancreatic β-cells. And MG132, a proteasomal inhibitor, potentiates glucose uptake, metabolism (ATP production) and glucose-stimulated insulin secretion (GSIS) in high-glucose (25 mM)-treated INS-1 cells, but geniposide significantly prevents these effects. Furthermore, the combination of geniposide and Txnip knockdown shows substantial synergistic effects to reduce glucose uptake, metabolism and GSIS in high-glucose (25 mM)-treated INS-1 cells.

CONCLUSIONS

Txnip protein played an essential role in glucose uptake, metabolism and GSIS, and geniposide could accelerate the degradation via proteasome pathway in high-glucose-treated pancreatic INS-1 cells.

[Study on application of two risk assessment methods in coal dust occupational health risk assessment]

Objective: To evaluate the applicability of quantitative grading method (GBZ/T 229.1-2010) and occupational hazard risk index method in coal dust occupational health risk assessment. Methods: Taking 4 coal mines as the research object of risk assessment and making occupational health field testing and investigation. Based on two risk assessment methods, we analysed the health risk levels of 20 occupations which were exposed to coal dust in workplaces. Results: Coal dust working post had different risk levels in 4 coal mines, the post of higher risk level were mainly concentrated in the underground workplace of coal mine, especially the post of coal mining and tunneling system. The two risk assessment results showed that the risk levels of coal-mining machine drivers and tunneling machine drivers were the highest. The risk levels of coal dust working post used by two risk assessment methods had no significant difference (P>0.05) and were highly correlated (r=0.821, P<0.001) . Evaluation results of two risk assessment methods were supported by the field investigation and literatures. Conclusion: The two risk assessment methods can be used in coal dust occupational health risk assessment.

[Visual quality comparison after multifocal toric intraocular lens or monofocal toric intraocular lens implantation]

Objective: To compare visual quality and satisfaction after multifocal toric intraocular lens (Acrysof IQ Restor toric, ART) and monofocal toric intraocular lens implantation in patients. Methods: It was a prospective nonrandomized Phase Ⅲ clinical trial. Patients with age-related cataract and corneal astigmatism were enrolled and accepted phacoemulsification combined with implantation of intraocular lens (IOL) in Henan Provincial Eye Hospital during March 2013 to December 2014. Fifty-six cases were divided into two groups according to which IOL they chose. ART group included 28 cases (3l eyes) aged from 41.0 to 72.0 years, with an average age of 61.5 years; toric group included 28 cases (33 eyes) aged from 42.0 to 75.0 years, with an average age of 63.5 years. Three months postoperatively, uncorrected distance visual acuity (UDVA) at 5, 70, 40 cm, corrected distance, intermediate, and near visual acuities, defocus curve, residual refractive astigmatism, rotational stability of the IOL, contrast sensitivity and patientsatisfaction were evaluated. All data were processed by statistic package deal SPSS 16.0. Postoperative visual acuity, residual astigmatism, IOL axial rotation and contrast sensitivity were compared by independent samples t test; preoperative and postoperative corneal astigmatism were compared by paired t-test; spectacle independency and halo incidence were processed by χ(2) test; visual satisfaction score was analyzed by Mann-Whitney test. Results: At 3 months postoperatively, in ART group, UDVA was (0.04±0.05), UIVA was (0.24±0.15), UNVA was (0.20±0.24). While in Toric group, UDVA was (0.06±0.04), UIVA was (0.30±0.13), UNVA was (0.47±0.21). There was no significant difference in UDVA between two groups(t=0.79, P=0.433). But in ART group, UIVA and UNVA were markedly better than those in Toric group(t=2.74, P=0.008; t=3.45, P<0.01). Depth of focus was 5.50 D (+2.00--3.50 D) in the ART group and 2.50 D (+1.00--1.50 D) in the Toric group. Average postoperative residual astigmatism was (-0.45±0.41)D in ART group and (-0.41±0.32)D in the Toric group. There was no significant difference between two groups (t=1.05, P=0.304). Average IOL rotation test was (2.95°±1.34°) in the ART group and (2.75°±1.64°) in the Toric group. There was no significant difference between two groups (t=0.67, P=0.452). Spectacle independency was achieved by 85.7% of patients in the ART group and 32.1% in the Toric group. There was no signifcant difference in distant visual satisfaction scores between the two groups(Z=0.71, P>0.05), while the intermediate and near visual satisfaction scores were significantly different(Z=2.27, P<0.05; Z=2.60, P<0.05) Conclusions: Both of the ART IOL and toric IOL can correct patients astigmatism. Implantation of ART IOL in patients with cataract and corneal astigmatism provided excellent distance, intermediate, and near visual outcomes. It provided better predictability of the refractive results, nice rotational stability, and good optical performance. At the same time, it improved the spectacle independency of cataract patients with astigmatism. (Chin J Ophthalmol, 2017, 53: 274-280).

An alternative parameter to characterize biogas materials: Available carbon-nitrogen ratio

Available carbon-nitrogen ratio (AC/N) was proposed as an alternative parameter for evaluating the potential of biogas materials in this paper. In the calculation of AC/N ratio, only the carbon that could be effectively utilized in anaerobic digestion (AD) process is included. Compared with total C/N, AC/N is particularly more suitable for the characterization of biogas materials rich in recalcitrant components. Nine common biogas materials were selected and a series of semi-continuous tests for up to 110days were carried out to investigate the source of available carbon and the relationship between AC/N and the stability of AD process. The results showed that only the carbon existing in proteins, sugars, fat and hemicelluose should be considered as available carbon for anaerobic microbes. Besides, the optimal AC/N for semi-continuous AD process was preliminarily determined to be 11-15. Taken together, our results demonstrate that AC/N is more effective than total C/N in the evaluation of the potential performance of AD process.

A new angle and its relationship with early fixation failure of femoral neck fractures treated with three cannulated compression screws

BACKGROUND

The Pauwels angle has been used widely, however an accurate evaluation of this angle is difficult because of deformity of the affected lower extremity. Therefore we designed a new measurement of the orientation of femoral neck fracture and applied this in a retrospective study to assess: (1) its reproducibility, (2) its advantages compared with the Pauwels angle, (3) its relationship with the short-term prognosis treated with three cannulated compression screws.

HYPOTHESIS

This new measurement is reproducible and has some reference meaning for the treatment of femoral neck fractures.

METHODS

Two hundred and twenty-eight patients with femoral neck fractures treated with three cannulated compression screws were retrospectively analyzed. The VN angle, which was the angle between the fracture line and the vertical of the neck axis, and the Pauwels angle were measured respectively. The method of ICC was performed to assess the reproducibility of the two angles, and the absolute value of difference in pre-operative and post-operative radiographs was used to evaluate the uniformity of the two angles. These fractures were divided into four groups according to VN angle (VN<0° (n=92), 0°≤VN<10° (n=82), 10°≤VN<15° (n=26), VN≥15° (n=28)), and the short-term (within 6 months) fixation results of radiographs in these fractures were evaluated.

RESULTS

The ICC of the VN angle and the Pauwels angle in pre-operative radiographs were 0.937 (95% confidence interval (CI): 0.922-0.950) and 0.942 respectively (95% CI: 0.914-0.970), indicating both angles had a good inter-rater reproducibility. However, there was a great difference between the Pauwels angle in pre-operative and post-operative radiographs (P=0.037), the absolute difference was 10.66±6.47 (range: 1.72-38.48), while no statistical difference for the VN angle (P=0.084) and the absolute difference was 2.20±1.63 (range: 0.05-7.56). The overall fixation failure rate which was defined as screw loosening, varus collapse, obvious fracture displacement or femoral neck shortening was 11.84%, and the mean failure rates according to VN angles were respectively 0%, 3.24% (95% CI: 1.64-4.84), 22.69% (95% CI: 16.43-28.96), 65.45% (95% CI: 59.36-71.53). The mean failure rates of fractures according to post-operative Pauwels angle (<30°, 30-50°, >50°) were respectively 0%, 1.46% (95% CI: 1.42-1.50) and 36.24% (95% CI: 34.93-37.54).

DISCUSSION

The VN angle has a good inter-rater reproducibility, a higher reliability than the Pauwels angle and is closely related to the short-term prognosis of femoral neck fractures treated with cannulated compression screws.

LEVEL OF EVIDENCE

Level IV, retrospective diagnostic study.

[Application of narrow band imaging in laryngeal tumor]

Objective:To explore the application of narrow band imaging(NBI) technology in laryngeal tumor.Method:From Appril 2014 to Otober 2016, three hundred and twenty-two patients with suspected laryngeal cancer or precancerous lesions were enrolled in the First Central Hospital of Tianjin. Each patient was examined by electronic nasopharyngolaryngoscope under white light and NBI model. The sensitivity, specificity and accuracy of laryngeal tumor diagnosis under white light mode and NBI mode was compared based on pathological results. Result:The sensitivity, specificity and accuracy of white light mode in laryngeal tumor diagnosis were 77.17%,62.07% and 74.36%, respectively whereas the NBI model were 92.91%,77.59% and 90.06%, respectively.The sensitivity and accuracy of NBI model in laryngeal tumor diagnosis were significantly higer than white light model(P<0.05),but not the specificity. Conclusion:The electronic nasopharyngolaryngoscope of NBI technology not only found early lesions of laryngeal cancer, but also can improve the sensitivity and accuracy of laryngeal tumor diagnosis.

Dynamics of Polarons in Organic Conjugated Polymers with Side Radicals

Based on the one-dimensional tight-binding Su-Schrieffer-Heeger (SSH) model, and using the molecular dynamics method, we discuss the dynamics of electron and hole polarons propagating along a polymer chain, as a function of the distance between side radicals and the magnitude of the transfer integrals between the main chain and the side radicals. We first discuss the average velocities of electron and hole polarons as a function of the distance between side radicals. It is found that the average velocities of the electron polarons remain almost unchanged, while the average velocities of hole polarons decrease significantly when the radical distance is comparable to the polaron width. Second, we have found that the average velocities of electron polarons decrease with increasing transfer integral, but the average velocities of hole polarons increase. These results may provide a theoretical basis for understanding carriers transport properties in polymers chain with side radicals.

Effects of Moringa oleifera silage on milk yield, nutrient digestibility and serum biochemical indexes of lactating dairy cows

This study investigated the effects of Moringa oleifera (MO) as a partial substitute of alfalfa hay on milk yield, nutrient apparent digestibility and serum biochemical indexes of dairy cows. MO was harvested at 120 days post-seeding. Fresh MO was cut, mixed with chopped oat hay (425:575 on a DM basis), ensiled and stored for 60 days. Sixty healthy Holstein dairy cows were allocated to one of three groups: NM (no MO or control), LM (low MO; 25% alfalfa hay and 50% maize silage were replaced by MO silage) or HM (high MO; 50% alfalfa hay and 100% maize silage were replaced by MO silage). The feeding trial lasted 35 days. The LM and HM diets did not affect dry matter (DM) intake, milk yield or milk composition (lactose, milk fat, milk protein and somatic cell count). The apparent digestibility of DM and NDF was lower for HM group than NM group. Additionally, there were no significant differences in serum biochemical indexes between the LM and NM groups. The HM group had lower serum concentrations of total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol and higher serum concentrations of urea than the NM group. The partial replacement of alfalfa hay (≤50%) and maize silage with MO silage had no negative effects on milk yield, in vivo nutrient apparent digestibility or serum biochemical indexes of lactating cows.

Increased expression of nerve growth factor correlates with visceral hypersensitivity and impaired gut barrier function in diarrhoea-predominant irritable bowel syndrome: a preliminary explorative study

BACKGROUND

Neural-immune-endocrine network mechanism has attracted increased attention in diarrhoea-predominant irritable bowel syndrome (IBS-D). Pre-clinical evidence indicates that nerve growth factor (NGF) mediates visceral hypersensitivity and gut barrier dysfunction, via interactions with mast cells and sensory nerve fibres.

AIM

To explore the role of nerve growth factor, as well as mast cell-nerve growth factor-nerve interaction in IBS-D pathophysiology.

METHODS

In this cross-sectional study, IBS-D patients and healthy controls first underwent clinical and psychological assessments. Visceral sensitivity to rectal distension was tested. As gut barrier function markers, serum diamine oxidase and d-lactate were detected. Rectosigmoid biopsies were taken for the analyses of nerve growth factor expression, mast cell count and activation, and sensory nerve fibres expressing transient receptor potential vanilloid 1 and calcitonin gene-related peptide. Correlations between these parameters were examined in patients.

RESULTS

Thirty-eight IBS-D patients (28 males, 10 females; average age 30.2 years) and 20 healthy controls (12 males, 8 females; average age 26.8 years) participated in the study. The patients presented increased psychological symptoms, visceral hypersensitivity and impaired gut barrier function. NGF gene expression, mast cell count and sensory nerve fibres were significantly increased in the patients (P < 0.05). In correlation analysis, NGF expression was positively correlated with the disease severity, anxiety and serum diamine oxidase; visceral sensitivity thresholds were negatively associated with NGF expression (Bonferroni corrected P < 0.0029).

CONCLUSIONS

Elevated mucosal NGF may interact with mast cells and sensory nerve fibres, contributing to visceral hypersensitivity and impaired gut barrier function in IBS-D.

Tropospheric volatile organic compounds in China

Photochemical smog, characterized by high concentrations of ozone (O₃) and fine particles (PM_2.5) in the atmosphere, has become one of the top environmental concerns in China. Volatile organic compounds (VOCs), one of the key precursors of O₃ and secondary organic aerosol (SOA) (an important component of PM_2.5), have a critical influence on atmospheric chemistry and subsequently affect regional and global climate. Thus, VOCs have been extensively studied in many cities and regions in China, especially in the North China Plain, the Yangtze River Delta and the Pearl River Delta regions where photochemical smog pollution has become increasingly worse over recent decades. This paper reviews the main studies conducted in China on the characteristics and sources of VOCs, their relationship with O₃ and SOA, and their removal technology. This paper also provides an integrated literature review on the formulation and implementation of effective control strategies of VOCs and photochemical smog, as well as suggestions for future directions of VOCs study in China.