Association between non-wire based computational angiography fractional flow reserve treatment threshold and major adverse cardiac events in patients with stable coronary artery disease

Introduction

Despite class IA guideline recommendations, the use of fractional flow reserve (FFR) in guiding percutaneous coronary intervention (PCI) in stable coronary artery disease (CAD) patients remains low due to limitations including the need of guidewire placement and hyperaemic stimulus. A novel non-invasive index, computational pressure-flow dynamics derived FFR (caFFR), was developed for measuring functional myocardial ischemia and overcoming the limitations of FFR. However, the clinical relevance of caFFR remains to be investigated. In the present study, we aim at evaluating the prognostic value of caFFR among stable CAD patients.

Methods

We retrospectively included patients with stable CAD who underwent coronary angiography during 2014–2016 at our center. Based on the caFFR value, patients were considered to be ischemic (caFFR ≤0.8) and non-ischemic (caFFR >0.8). Further, we recombined the patients to form the adherence cohort, where patients were defined as adherent-to-caFFR if they were ischemic with PCI or non-ischemic without PCI, and nonadherent-to-caFFR if they were ischemic without PCI or non-ischemic with PCI. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause mortality, non-fatal myocardial infarction, and any revascularization. Inverse probability of treatment weighting was used to account for treatment selection bias (PCI vs without PCI, or adherent vs non-adherent), and Cox proportional hazard model was used to evaluate the association with MACE.

Results

A total of 1322 patients, 782 patients in the ischemic cohort and 540 patients in the non-ischemic cohort respectively, were included in our analysis. PCI was associated with a lower risk of MACE in the ischemic cohort (hazard ratio [HR] 0.52; 95% confidence interval [CI], 0.34–0.80; P=0.002), but was not associated with MACE in the non-ischemic cohort. In the adherence cohort, adherent-to-caFFR group (n=803) had a lower risk of MACE compared with nonadherent-to-caFFR group (n=566) (HR, 0.61; 95% CI, 0.44–0.85; P=0.003).

Conclusion

Our study is the first to demonstrate the prognostic value of caFFR, a non-wire based assessment of myocardial ischemia, in patients with stable CAD undergoing PCI. These findings support the use of caFFR that bears the potential of a wider adoption compared with wire-based FFR through a reduction in procedure time, risk and costs.

Funding Acknowledgement

Type of funding sources: None. Weighted Kaplan-Meier curvesWeighted Cox proportional hazards model

Survival benefits and optimal timing for surgical intervention for infective endocarditis

Background

Surgery is often indicated in patients with infective endocarditis (IE), but the survival benefits of surgical intervention have not been validated in large-scale studies. Although previous studies appeared to support early surgical intervention, the optimal timing of intervention remains uncertain.

Purpose

We aim to evaluate the benefits of surgery and identify the optimal timing of surgical intervention for patients with IE.

Methods

From a well-validated territory-wide database in Hong Kong, all patients aged 20 or above diagnosed with incident IE from 2000–2019 were included. Patients were divided into those who received surgical intervention within 1 year of IE (surgical cohort) and those who did not (control cohort). The two cohorts were then compared using inverse probability weighting of the covariate balancing propensity score, which included demographics, comorbidities, and causative organism as covariates. Outcomes of interest include, at 1 year, all-cause death, and the development of complications. A Cox proportional hazards model was used to evaluate the association between surgical intervention and death, with “doubly-robust estimation” used to minimise the effect of confounders. For complications, a Fine-Gray model was used to account for competing risk.

The surgical cohort was subdivided into early (≤7 days of hospitalisation) or late surgical intervention; a similar propensity score analytic approach was used to evaluate the effects of early vs. late intervention, with those who died within the 7 days excluded to ensure a fair comparison.

Results

A total of 5,657 patients (age 59.9±18.3 years, 37.2% females) were included, of which 930 (16.4%) received surgical intervention in 1 year. Overall, the surgical cohort had a 45% risk reduction in all-cause death (hazard ratio [HR] 0.55, 95% CI [0.46 to 0.65], P<0.001) (Figure). This association remained consistent in subgroup analysis stratified by age, sex, and causative organisms (Table 1).

The surgical cohort also had a lower risk of complications, including acute kidney injury (HR 0.61, 95% CI 0.43 to 0.87, P=0.006), systemic embolism (HR 0.35 [0.23 to 0.55], P<0.001), ischaemic stroke (HR 0.37 [0.24 to 0.55], P<0.001), cardiac dysrhythmia (HR 0.79 [0.66 to 0.95], P=0.011), and pneumonia (HR 0.36 [0.26 to 0.49], P<0.001).

In the surgical cohort, compared to those who had early surgery (N=181), those with delayed surgery had a lower risk of all-cause death (HR 0.58 [0.34 to 0.99], P=0.045) (Figure) and complications (Table 2) at 1 year. In those who had early surgery, patients who received ultra-early surgery (≤3 days of hospitalisation, N=104) did not have a significantly different risk of death (HR 1.19 [0.47 to 3.34], P=0.654).

Conclusions

Surgical intervention significantly reduced the risk of death and complications in patients with infective endocarditis. Delayed surgical intervention appeared to be more protective.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): The Shenzhen Key Medical DisciplineThe Sanming Project of HKU-SZH Cardiology

Prognostic value of per-vessel treatment adherence in stable coronary artery disease based on novel computational pressure-flow dynamics derived fractional flow reserve

Background

Computational pressure-flow dynamics derived fractional flow reserve (caFFR) is a novel index developed to evaluate the extent of myocardial ischemia in patients with coronary artery disease (CAD), which eliminates the need of invasive pressure guidewire and hyperaemic stimulus in conventional fractional flow reserve (FFR) measurement. Studies have shown improved clinical outcomes associated with adherence to functional myocardial ischemia assessment when deciding to perform percutaneous coronary intervention (PCI) at a per-patient level. However, the clinical significance of such treatment adherence at a per-vessel level remains uncertain.

Methods

A total of 928 patients (mean age 66.2±10.5, male 72.7%) with stable CAD were included in this study. The caFFR of all three major coronary vessels were obtained for every patient, and the FFR threshold of 0.8 was adopted as the threshold for caFFR to indicate functionally significant artery stenosis which warrants PCI, and vice versa. Based on the caFFR of each major coronary vessel and whether PCI was performed to the respective vessel, patients were stratified into 0–1 vessel with treatment adherence group (group 1) (n=105), 2 vessels with treatment adherence group (group 2) (n=338), and 3 vessels with treatment adherence group (group 3) (n=485). The primary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause mortality, non-fatal myocardial infarction and any subsequent revascularization.

Results

The severity of CAD based on SYNTAX score assessment was 18.6±10.2 in group 1, 14.6±8.9 in group 2, and 11.5±9.9 in group 3 (P<0.001). The rates of MACE at 3 years were significantly different across groups 1, 2 and 3 (17.1% vs. 12.1% vs. 7.4%; P=0.004). With reference to group 3, the risk of MACE at 3 years was increased in group 2 (adjusted hazard ratio [HR]=1.597; 95% confidence interval [CI]=1.020–2.501; P=0.041), and further increased in group 1 (adjusted HR=1.933; 95% CI=1.081–3.457; P=0.026).

Conclusion

In stable CAD patients, the risk of MACE is incremental when fewer major coronary vessels are treated with adherence to caFFR threshold of 0.8. Per-vessel treatment adherence significantly affects clinical outcomes in terms of MACE.

Funding Acknowledgement

Type of funding sources: None.

Long-term prognostic implications of PCI in ACS patients without ischemia on the basis of computational pressure-flow dynamics derived fractional flow reserve

Background

A substantial proportion of patients with acute coronary syndrome (ACS) may have intermediate lesion that are non-ischemic during emergency coronary angiography. The prognosis of such patients, compared to those with stable ischemic heart disease (SIHD) without ischemic lesion is however uncertain. Recently, a novel index, computational pressure-flow dynamics derived fractional flow reserve (caFFR), has been developed to assess myocardial ischemia, without the need of invasive pressure wire and hyperaemic stimulus as required in conventional fractional flow reserve (FFR). By utilizing caFFR to assess for ischaemic status during coronary angiography, the aim of our study is first to assess the prognostic difference between ACS and SIHD with non-ischaemia intermediate lesions. Second, we ascertain whether PCI in patients with ACS with non-ischaemia intermediate lesions provides survival benefit in addition to medical therapy.

Methods

We retrospectively recruited 551 patients (mean age 64.4 years; male 59.9%) with absence of myocardial ischaemia, defined as caFFR ≥0.80 in all vessels, from our Hospital. Patients were stratified into those with index presentation of ACS (n=132) and those with SIHD (n=491). Among the ACS cohort, patients were further divided into those with PCI (n=83) and with medical therapy alone (n=49). The SIHD cohort (n=491), all of whom were treated with medical therapy alone, was considered as referent group. The primary end point was major adverse cardiovascular events (MACE) at 3 years, which was defined as a composite of all-cause mortality, non-fatal myocardial infarction (MI), and any unplanned revascularization.

Results

During a median follow-up of 36 months, 54 composite events occurred, including 38 all-cause mortality, 5 MI, and 14 unplanned revascularization. Compared to those with SIHD, patients with ACS was independently associated with MACE even in the absence of myocardial ischaemia (adjusted Hazard Ratios=2.531; 95% confidence interval=1.397–4.586; P=0.002). The 3-year incidence rate of MACE was the highest in ACS patients with medical therapy alone, followed by ACS patients with immediate PCI; the SIHD cohort had the lowest incidence rates (30.6% vs 12.0% vs 5.9%, P<0.001). This was mainly driven by the rate of all-cause death (26.5% vs 12.0% vs 3.1%; P<0.001). Similar findings were observed for hospitalisation due to heart failure (14.3% vs 6.0% vs 3.1%, P=0.031) and cardiac death (8.2% vs 4.8% vs 0.4%, P<0.001) at 3 years.

Conclusion

In patients with intermediate lesion without myocardial ischaemia (defined as caFFR ≥0.8), those presented with ACS had a higher risk of MACE at 3 years compared to SIHD. Among ACS patients with intermediate lesion without myocardial ischaemia, PCI significantly reduces the rate of MACE. In patients with ACS, our finding suggests that PCI should be advocated to intermediate lesion even without myocardial ischaemia.

Funding Acknowledgement

Type of funding sources: None. Kaplan-Meier curve for MACECumulative Events at 3 Years

[Reoperation and perioperative management of residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors]

Objective: To investigate the reoperation and perioperative management of residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors. Methods: The clinical data of 29 patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors in Affiliated Cancer Hospital of Zhengzhou University from January 2014 to August 2019 were reviewed, including the characteristics of the residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors, surgical method, and perioperative management. Results: Twenty-nine patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors, including 9 cases of epidermoid cysts, 7 cases of dermoid cysts, 10 cases of mature teratomas and 3 cases of malignant cysts (including malignant transformation of caudate cyst and teratoma); The 29 patients underwent posterior approaches for cyst resection in other hospital before, of whom 1 patient underwent posterior combined with transabdominal approach. All of thes patients underwent resection of residual presacral cyst wall and perineal intractable sinus in our hospital, of whom 25 patients underwent a transperineal approach through an arc-shaped incision anterior to the apex of the coccyx, and the other 4 patients underwent transperineal arc-shaped incision combined with transabdominal approach. All of the patients were cured without serious complications occurring, postoperative pathological and the magnetic resonance imaging diagnosis showed that the residual cyst wall and perineal intractable sinus were all completely removed. Conclusion: Appropriate surgical approache and perioperative treatment for the patients with residual cyst wall and perineal intractable sinus are very important to promote the resection of residual cyst wall and the healing of perineal intractable sinus.

P6: ANTIPLATELET AND ANTICOAGULANT USE IN RANDOMISED TRIALS OF PATIENTS UNDERGOING ENDOVASCULAR INTERVENTION FOR PERIPHERAL ARTERIAL DISEASE: SYSTEMATIC REVIEW

Introduction

Guideline recommendations for antithrombotic (antiplatelet and anticoagulant) therapy during and after endovascular intervention are patchy and conflicted, in part due to a lack of evidence. The aim of this systematic review was to examine the antithrombotic specifications in randomised trials for peripheral arterial endovascular intervention.

Method

This review was conducted according to PRISMA guidelines. Randomised trials including participants with peripheral arterial disease undergoing endovascular arterial intervention were included. Trial methods were assessed to determine whether an antithrombotic protocol had been specified, its completeness, and the agent(s) prescribed. Antithrombotic protocols were classed as periprocedural (preceding/during intervention), immediate postprocedural (up to 14 days following intervention) and maintenance postprocedural (therapy continuing beyond 14 days). Trials were stratified according to type of intervention.

Result

Ninety-four trials were included. Only 29% of trials had complete periprocedural antithrombotic protocols, and 34% had complete post-procedural protocols. In total, 64 different periprocedural protocols, and 51 separate postprocedural protocols were specified.

Antiplatelet monotherapy and unfractionated heparin were the most common choices of regimen in the periprocedural setting, and dual antiplatelet therapy (55%) was most commonly utilised postprocedure. There is an increasing tendency to use dual antiplatelet therapy with time or for drug-coated technologies.

Conclusion

Randomised trials comparing different types of peripheral endovascular arterial intervention have a high level of heterogeneity in their antithrombotic regimens, and there has been an increasing tendency to use dual antiplatelet therapy over time. Antiplatelet regimes need to be standardised in trials comparing endovascular technologies.

Take-home message

To determine the benefits of any endovascular intervention within a randomised trial, antithrombotic regimens should be standardised to prevent confounding. This systematic review demonstrates a high level of heterogeneity of antithrombotic prescribing in randomised trials of endovascular intervention, and an increasing tendency to utilise dual antiplatelet therapy, despite a lack of evidence of benefit, but an increased risk of harm.

LncRNA XIST regulates cell proliferation, migration and invasion of glioblastoma via regulating miR-448 and ROCK1

Long non-coding ribonucleic acids (lncRNAs) have been recognized as markers in several cancers and play important roles in glioblastoma (GBM). But the role of lncRNA X inactive-specific transcript (XIST) in GBM and its possible mechanisms are rarely studied in depth. This study was conducted to explore the detailed roles of XIST in cell proliferation, migration, and invasion of GBM. Expressions of XIST, miR-448, and ρ associated coiled coil containing protein kinase 1 (ROCK1) were detected by qRT-PCR or Western blot in A172 and U251 cells. The interactions among XIST, miR-448 and ROCK1 were verified through luciferase reporter assay and RNA immunoprecipitation (RIP) assay. Cell Counting Kit-8 (CCK-8) assay and Transwell assay were introduced to detect how XIST knockdown, miR-448 overexpression, or along with ROCK1 overexpression affect cellular malignancy of GBM cells. XIST and ROCK1 were up-regulated while miR-448 expression was decreased in GBM cells. XIST knockdown or miR-448 overexpression could dramatically inhibit GBM cell proliferation, migration, and invasion. Moreover, XIST negatively regulated miR-448 expression through the function as competing endogenous RNA (ceRNA), thus leading to the up-regulation of ROCK1, one miR-448 target gene. Moreover, ROCK1 overexpression could reverse the suppression of XIST knockdown or miR-448 upregulation on cellular malignancy. In brief, the effects of XIST may promote cellular malignancy of GBM through miR-448/ROCK1 axis, which will provide new understanding of GBM pathogenesis and progression.

Modeling and improvement of a low-frequency micro-accelerometer

A sensitivity- and resolution-improving method for a low-frequency micro-vibration accelerometer is presented in this paper. A sensitivity model of the measurement system is derived and established. The key parameters that limit the sensitivity and the resolution of the accelerometer were identified through the sensitivity coefficient analysis method. The structural parameters and the signal process method were then optimized. Experimental results show that the sensitivity of the accelerometer has improved from 1.10 V/(m/s²) to 19.21 V/(m/s²), and the resolution has improved from 1.47 mm/s² to 0.21 mm/s². The lowest working frequency range has expanded from 1 Hz to 0.7 Hz. The presented method is effective and cheap and can be applied to other sensors.

Improved Constraints on Sterile Neutrino Mixing from Disappearance Searches in the MINOS, MINOS+, Daya Bay, and Bugey-3 Experiments

Searches for electron antineutrino, muon neutrino, and muon antineutrino disappearance driven by sterile neutrino mixing have been carried out by the Daya Bay and MINOS+ collaborations. This Letter presents the combined results of these searches, along with exclusion results from the Bugey-3 reactor experiment, framed in a minimally extended four-neutrino scenario. Significantly improved constraints on the θ_{μe} mixing angle are derived that constitute the most constraining limits to date over five orders of magnitude in the mass-squared splitting Δm_{41}^{2}, excluding the 90% C.L. sterile-neutrino parameter space allowed by the LSND and MiniBooNE observations at 90% CL_{s} for Δm_{41}^{2}<13  eV^{2}. Furthermore, the LSND and MiniBooNE 99% C.L. allowed regions are excluded at 99% CL_{s} for Δm_{41}^{2}<1.6 eV^{2}.

There "ain't no mountain high enough"?: The drivers, diversity and sustainability of China's Rhodiola trade

ETHNOPHARMACOLOGICAL RELEVANCE

Across Asia, Rhodiola species have been used in Bhutanese, Mongolian, Nepalese, Kazakh, Kyrgyz and Uzbek traditional medical systems. China is globally significant in terms of Rhodiola species diversity, with over 60% (55 species) of the world's 90 Rhodiola species, including 16 species found nowhere else in the world. Since the late 1980's there has been a shift from relatively low demand for infusions using chopped dried Rhodiola roots, to high 21st century demand for a wide variety of processed products. China's trade in Rhodiola products is now very diverse, with use in cosmetics and foods in addition to herbal products. Rhodiola crenulata (Hook.f. & Thomson) H.Ohba is the most widely traded species in China. In addition to R. crenulata and Rhodiola rosea L., 19 Rhodiola other species are used.

AIMS OF THE STUDY

These were to: (i) better understand why adulteration occurs in Rhodiola products; (ii) become more aware of what drives the growing market demand for Rhodiola products in China; (iii) find out whether increased demand is reflected in wholesale prices for Rhodiola raw materials traditional medicine markets; (iv) to examine Rhodiola supply chains and (v) given that wild populations are the primary supply source, to review the implications of growing demand for conservation and sustainable use.

MATERIALS AND METHODS

Firstly, we assessed growth in the diversity of Rhodiola products using three approaches: (i) by assessing patent applications for Rhodiola products in China (1990-2019); (ii) in 2018, through on-line searches of CFDA (China Food and Drug Administration) records for medicines and dietary supplements that had Rhodiola as an ingredient and (iii) by visiting retail stores in 2018 and 2019 to assess the diversity of commercial Rhodiola based products in trade. Secondly, we visited traditional medicine markets in Yunnan, Sichuan, and Qinghai provinces to investigate the trade in Rhodiola (folk taxonomy, trade names, prices, source areas, levels of processing and grading). Thirdly, we analysed the wholesale price data for Rhodiola raw materials in trade over a 16-year period (2002-2018). Fourthly, as most products come from wild collected Rhodiola species, we documented the extent of Rhodiola cultivation in China.

RESULTS

International exports of Rhodiola products from China, particularly extracts, is a major driver of commercial trade. One proxy indicator of Rhodiola product diversification in China has been the rapid rise in patent applications from single applications in 1990 and 1991, to a peak of 1017 patent applications in 2015. Wholesale price data from 2002 to 2018 shows a steady increase in wholesale prices. As the growing market for Rhodiola products in China is currently supplied entirely from wild collection, there are justifiable concerns about sustainability. Commercial cultivation needs to expand to meet future demand.

CONCLUSIONS

In contrast to Europe and North America, where R. rosea is the focal species in commerce, the trade in Rhodiola products in China is much more diverse. In the face of growing demand, both effective conservation of wild populations and cultivation are needed.

[Effect of comprehensive AIDS intervention among men aged 50 or over who had non-marital sexual behavior]

Objective: To evaluate the effectiveness of AIDS intervention programs on men aged 50 or over and having had non-marital sexual behavior. Methods: A community-based intervention/experimental and based on individual level study was adopted. Stratified sampling method was used. 12 townships/streets in Fuyang district of Hangzhou were identified as intervention or control group (six research sites each). All of the subjects in the township (street) were included. The inclusion criteria of study objects would include men aged 50 or older who reported having unmarried sex in the last year. Estimated sample size was 290, with each 145 in the intervention group and the control group. All the intervention group participants were provided with a total of 4 intervention-related items (knowledge and education on AIDS prevention, information radiation and behavioral change, broadcast expert lectures), every 3 months, for 12 month, the main evaluation indicators would include: incidence of non-marital sex and commercial sex in the last year, condom use when having non-marital sex in the last episode. Results: A total of 312 subjects were recruited. 300 of them completed the baseline study while 284 of them completed the follow-up survey. Among the subjects who had undergone the baseline study, the average age was (65.58±7.89), 71.33% were married or cohabiting with someone, 52.00% having had primary school education. After the implementation of intervention programs, the incidence of non-marital sex dropped to 59.42% (82/138) and the incidence of commercial sex dropped from 79.73% (118/148) to 55.07% (76/138). Condom use rate in the last non-marital sexual contact increased from 19.59% (29/148) to 51.22% (42/82). In the control group, the incidence of non-marital sex in the year before dropped to 74.66% (109/146) and the incidence of commercial sex dropped from 91.45% (139/152) to 72.60% (106/146). Rates of condom use during the last non-marital sexual contact dropped from 32.89% (50/152) to 31.19% (34/109). Statistically, there were significant differences appeared between the two groups on the incidence of non-marital sex in the past year (χ(2)=7.48, P=0.008), the incidence of commercial sex in the last year (χ(2)=9.47, P=0.003) and the rate of condom use in the last sex experience (χ(2)=7.83, P=0.007). Conclusions: Results from this intervention study showed that: in the intervention group, both the incidence rates of non-marital or commercial sex had reduced, together with the increase of condom use in non-marital sex in the last sexual experience. Intervention strategies that involving knowledge and education on AIDS prevention, information radiation and behavioral change, broadcasting lectures by experts etc. were all proved effective.

Suppression of αvβ6 downregulates P-glycoprotein and sensitizes multidrug-resistant breast cancer cells to anticancer drugs

Multidrug resistance (MDR) in breast cancer treatment is the major cause leading to the failure of chemotherapy. P-glycoprotein (P-gp), the product of the human MDR1 gene, plays a key role in resistance to chemotherapy and confers cross-resistance to many structurally unrelated anticancer drugs. We have previously reported that integrin αvβ6 plays a critical role in breast cancer invasion and metastasis. However, whether and how αvβ6 is associated with P-gp and regulated by potential genetic mechanisms in breast cancer remains unclear. In the present study, we further investigated the reversal effect and underlying mechanisms of MDR in breast cancer. Two small interfering RNA constructs (pSUPER-β6shRNAs) targeting two different regions of the β6 gene have been designed to inhibit αvβ6 expression by transfecting them into adriamycin-resistant MCF-7/ADR cell lines. Suppression of αvβ6 dramatically downregulated the levels of MDR1 gene mRNA and P-gp. In particular, β6shRNA-mediated silencing of αvβ6 gene increased significantly the cellular accumulation of Rhodamine 123 and markedly decreased drug efflux ability, suggesting that β6shRNAs indeed inhibit P-gp mediated drug efflux and effectively overcome drug resistance. In addition, inhibition of integrin αvβ6 suppressed the expression of ERK1/2. Interestingly, our data demonstrate that suppression of integrin αvβ6 caused significant downregulation of Bcl-2, Bcl-xL and upregulation of caspase 3, Bad, accompanied by increasing activity of cytochrome C. A possible connection between αvβ6 and P-gp in drug resistance biology is suggested. Taken together, β6shRNA could efficiently inhibit αvβ6 and MDR1 expression in vitro and these findings may offer specifically useful means to reverse MDR in breast cancer therapy.

Methods and clinical outcomes of in situ fenestration for aortic arch revascularization during thoracic endovascular aortic repair

OBJECTIVE

Despite endovascular advances in fenestrated and branched devices, thoracic endovascular aortic repair (TEVAR) for arch pathologies remains challenging. The aim of this study was to provide a contemporary review on the current evidence for in situ fenestration during TEVAR and to evaluate its short- and mid-term clinical outcome in the management of arch pathology.

METHODS

A systematic literature review on in situ fenestration of thoracic aortic stent-graft from January 2003 to September 2018 was performed under the instruction of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement.

RESULTS

Our initial search yielded 169 studies, of which 21 articles were relevant to the topic and were finally included. One hundred and forty-five in situ fenestration procedures in 99 patients were reviewed, involving 25 innominate arteries (17%), 33 left common carotid arteries (23%) and 87 left subclavian arteries (60%). Twelve patients (12/99, 12%) had two-vessel fenestration and three-vessel fenestration was performed in 17 patients (17/99, 17%). Technical success was achieved in 136 arteries (136/145, 93%). Talent/Valiant with monofilament twill woven polyester fabric was the most common (50/99, 51%) stent-graft used for fenestration. Three methods reported for in situ fenestration were needle, laser and radiofrequency. Needle was the most frequently used device for fenestration, which was performed in 60 patients (60/99, 61%). Three patients (3/99, 3%) died with 30 days, none were in situ fenestration TEVAR procedure-related. Perioperative complications including one (1%) retrograde type A aortic dissection, two (2%) type II endoleaks, and three (3%) strokes were reported. The pooled estimate for overall technical success, perioperative mortality and stroke was 88.3% (95% CI, 78.6%-93.9%), 5.9% (95% CI, 2.5%-13.4%) and 9.5% (95% CI, 4.1%-20.6%), respectively. Four patients (4/96, 4%) died during follow-up, none were aortic-related. All the fenestration bridging stents were reportedly patent, with only 1 (1/96, 1%) asymptomatic left subclavian stent stenosis. Two patients (2/96, 2%) with type II endoleak from left subclavian artery required secondary intervention.

CONCLUSION

In situ fenestration appeared to be a feasible and effective method to extend proximal landing zone during TEVAR. It had an acceptable short-term result with high technical success and low fenestration related morbidity. Long-term durability data were lacking, and there was no high level evidence to recommend the routine use of in situ fenestration TEVAR for the management of arch pathology.

Extraction of the ^{235}U and ^{239}Pu Antineutrino Spectra at Daya Bay

This Letter reports the first extraction of individual antineutrino spectra from ^{235}U and ^{239}Pu fission and an improved measurement of the prompt energy spectrum of reactor antineutrinos at Daya Bay. The analysis uses 3.5×10^{6} inverse beta-decay candidates in four near antineutrino detectors in 1958 days. The individual antineutrino spectra of the two dominant isotopes, ^{235}U and ^{239}Pu, are extracted using the evolution of the prompt spectrum as a function of the isotope fission fractions. In the energy window of 4-6 MeV, a 7% (9%) excess of events is observed for the ^{235}U (^{239}Pu) spectrum compared with the normalized Huber-Mueller model prediction. The significance of discrepancy is 4.0σ for ^{235}U spectral shape compared with the Huber-Mueller model prediction. The shape of the measured inverse beta-decay prompt energy spectrum disagrees with the prediction of the Huber-Mueller model at 5.3σ. In the energy range of 4-6 MeV, a maximal local discrepancy of 6.3σ is observed.

[Clinical characteristics, treatment and outcome of chronic mercury-related nephrotic syndrome]

Objective: To investigate the etiology, clinical features, treatment and outcome of nephrotic syndrome associated with chronic mercury poisoning. Methods: From June 2013 to April 2018, Beijing Chaoyang Hospital, Capital Medical University received 33 patients with chronic mercury-neutral nephrotic syndrome. The clinical manifestations, laboratory tests, treatment methods, and outcomes were analyzed. Results: Among the 33 patients, 27 patients had mercury exposure due to daily-life contact and the other 6 patients were caused by iatrogenic mercury. The symptom was characterized by typical nephrotic syndrome such as lower extremity edema and proteinuria at first onset. The treatment was based on mercury-removing treatment, 19 cases were treated with mercury removal alone, 16 cases were completely relieved; 10 cases were treated with mercury removal and glucocorticoids, all of which were completely relieved; 4 cases were treated with mercury removal, glucocorticoids and immunosuppressive agents, all complete remission; clinical complete remission rate is about 90.9% (30 cases in total) . Urinary mercury levels decreased the fastest between the first and second courses of mercury treatment, but the total amount of urine protein increased. As the amount of urinary mercury excreted increased, the total amount of urine protein decreased gradually (Z=2.86, P<0.01) . Conclusion: The clinical features of chronic mercury-induced nephrotic syndrome are non-specific, easy to be misdiagnosed and missed. The treatment is mainly treated with mercury removal treatment. The prognosis is good. In severe cases, glucocorticoid therapy can be supplemented.

[A randomized controlled study of peramivir, oseltamivir and placebo in patients with mild influenza]

Objectives: To evaluate the effectiveness and safety of peramivir trihydrate in patients with influenza. Methods: This was a randomized, double-blind, double-dummy, placebo and positive control, multicenter clinical trial, comparing peramivir trihydrate with oseltamivir and placebo. The inclusive criteria were 15-70 years old, onset within 48 h, positive rapid influenza antigen test, and febrile (>38℃) accompanied with at least two associated symptoms. The severe cases complicated with chronic pulmonary and cardiac diseases, malignancies, organ transplantation, hemodialysis, uncontrolled diabetes, immunocompromised status, pregnancy and coexistence of bacterium infections were excluded. All patients were randomized 2∶2∶1 to receive peramivir, oseltamivir and placebo respectively. The primary endpoint was the disease duration, the secondary endpoints included time to normal axillary temperature and normal living activities, viral response, and adverse effects. Results: Following informed consent, 133 patients were included in this study. Four patients were exclude due to missing medical records, not fitting inclusion or exclusion criteria and poor compliance. A total of 129 patients were finally analyzed, including 49 cases, 54 cases and 26 cases in peramivir group, oseltamivir group and placebo group. The median disease duration were 96 (76, 120) hours, 105 (90,124) hours, and 124 (104, 172) hours in three groups respectively (P>0.05) . The time to normal axillary temperature, normal living activities and viral response were not significantly different in three groups (P>0.05) . Conclusion: The value of antiviral therapy in patients with mild influenza needs to be further determined.

[Comparison of endoscopic features between colorectal sessile serrated adenoma/polyp with or without cytologic dysplasia and hyperplastic polyp]

Objective: To investigate the morphological features of colorectal sessile serrated adenoma/polyp (SSA/P) and hyperplastic polyp (HP) by white light endoscope (WLE) and Image enhancement endoscope (IEE) . Methods: The data of 7 384 patients who underwent colonoscopy at the Center of Digestive Endoscopy, Peking University International Hospital from August 1, 2016 to February 29, 2018 were analyzed retrospectively. WLE and IEE[Fuji intelligent chromo endoscopy (FICE) or Blue Laser Imaging (BLI) ]were used to compare the morphological features of SSA/P with HP, SSA/P-CD(+)with SSA/P-CD(-). The diagnostic values of endoscopic features in SSA/P and SSA/P-CD(+)were analyzed. Results: A total of 3 401 polyps were detected in 7 384 patients, including 164 SSA/Ps (135 patients). During the same period, there were 270 HPs (223 patients) in accordance with the admission criteria. Compared with HP group, SSA/P group was more common in the right colon with a diameter>5 mm and more likely to be manifested as: Ⅱ-O pit pattern, surface mucus, cumulus-like surface, irregular morphology, VMV, redness, and also more likely to be associated with colon adenoma, colon cancer elsewhere in the colorectum. The differences were statistically significant (P<0.01). Compared with SSA/P-CD(-)group, SSA/P-CD(+)group was more common in the right colon with a diameter>5 mm and more likely to be manifested as: Ⅱ-O pit pattern, surface mucus, cumulus-like surface, irregular morphology, VMV. The differences were statistically significant (P<0.001). The differential diagnosis between SSA/P and HP was predicted by combining any two endoscopic morphological features (right colon, Ⅱ-O pit pattern, surface mucus, cumulus surface, irregular morphology, VMV, diameter>5 mm, at least 2 of 7 endoscopic features). The sensitivity, specificity, accuracy, positive likelihood ratio and negative likelihood ratio were 59.15%, 95.56%, 81.80%, 13.32 and 0.43, respectively. Similarly, the differential diagnosis between SSA/P-CD(+) and HP was predicted. The sensitivity, specificity, accuracy, positive likelihood ratio and negative likelihood ratio were 92.16%, 95.56%, 95.02%, 20.76 and 0.08, respectively. Conclusion: Comprehensive analysis of the WLE and FICE/BLI morphological features of the lesions can effectively distinguish SSA/P from HP, especially SSA/P-CD(+) from HP.

[Early diagnosis of subtype in early clinical stage lung adenocarcinoma by using an autoantibody panel and computed tomography]

Objective: To explore the value of CT and autoantibody panel to diagnosis the subtype in early clinical stage lung cancer,especially lepidic predominant adenocarcinoma (LPA),and to provide the correct information for the clinical and the prognosis evaluation. Methods: A retrospective study was conducted of 60 patients (total 63 subsolid nodules,which included 39 PSN and 24 pGGN) who underwent surgical resection or needle biopsy for stage Ⅰa or Ⅰb lung adenocarcinoma at Affiliated Tumor Hospital of Zhengzhou University between June 2017 and April 2018,age from 28 to 82 years old,and the average age was (52±7) years. All patients underwent a pretreatment chest LDCT and the peripheral blood of all patients were used to detect the tumor related antibody (including p53, GAGE7, PGP9.5, CAGE, MAGEA1, SOX2, GBU4-5) through enzyme linked immunosorbent assay. All the patients were divided into LPA group (43 subsolid nodules, which included AIS 10 subsolid nodules, MIA 11 subsolid nodules, LPA 22 subsolid nodules) and invasive predominant adenocarcinoma (IPA) group (20 subsolid nodules). The information of CT scanning was measured and assessed in lung and mediastinal windows with double blind method. The mean computed tomography (m-CT) value and the solid component/tumor ratio in three-dimensional (3D) and two-dimensional (2D) planes were measured and analyzed using computer-aided diagnosis (CAD) system. Results: There were 20 partial solid nodules in IPA group, 19 partial solid nodules in LPA group and 24 ground-glass nodules (χ(2)=19.278,P=0.000). There were 4 circular nodules, 16 irregular nodules in the IPA group, 21 circular nodules, 5 oval nodules and 7 irregular nodules in the LPA group χ(2)=8.587,P=0.003). The incidence of burr, vascular aggregation and bronchial truncation in IPA group was higher than that in LPA group (40.0% vs 16.3%, 70.0% vs 18.6%, 30.0% vs 2.3%, χ(2)=4.234,15.860,10.580, P=0.040,0.000, 0.001). The incidence of clear tumor lung interface in patients in LPA group was significantly higher than that in patients in IPA group (97.7% vs 65.0%, χ(2)=13.146,P=0.00). Of all the quantitative analysis of nodules,the m-CT value, the solid component/tumor ratios in three-dimensional (3D) and two-dimensional (2D) planes in IPA group were higher than those of LPA group ((-180±156) vs (-410±213) HU, 0.44±0.32 vs 0.14±0.26, 0.54±0.26 vs 0.18±0.26, t=-4.208, -3.951、-5.166, P=0.000, 0.000, 0.000). Among the 60 patients with lung cancer, there were 33 cases with positive antibody in peripheral blood, with a positive rate of 55.0%. The positive rate of 7-AABs was 70.0% in IPA group and 44.2% in LPA group, which had no statistical difference (χ(2)=3.647, P=0.056), the positive expression of tumor-associated antibodies was independent of the patient's age, CT value and nodular solid components and lung nodular volume ratio and area ratio, P>0.05, only in correlation with pleural traction (χ(2)=3.866, P=0.049). Conclusion: Compared with IPA, the imaging features of LDCT about the mGGN and PGGN appearance, clear tumor-lung interface, low m-CT and the solid component/tumor ratio in two-dimensional or three-dimensional (3D) planes are benefit for the diagnosis of the LPA; the expression of tumor-associated antibody group is independent of the age of the patient and the number of nodular solid components, and is only related to pleural depression, which is not conducive to the identification of LPA and IPA.

[Diagnostic efficiency of NO/ET-1 and HCY level in severe OSAHS patients with cognitive impairment]

Objective:To investigate the diagnostic efficiency of HCY and NO/ET-1 to cognitive dysfunction in patients with severe obstructive sleep apnea hypopnea syndrome, and to interfere with the cognitive function of severe OSAHS patients. Method: Eighty-six patients with OSAHS were divided into mild group (22 cases), moderate group (23 cases), severe group (41 cases) and healthy physical examination group (50 cases). The levels of serum HCY and NO/ET-1 were compared between the four groups. The Montreal cognitive assessment scale was used to evaluate the incidence of mild cognitive impairment in severe OSAHS group, and the correlation between the level of serum HCY, NO/ET-1 and cognitive function in severe OSAHS group was analyzed. Result:The level of serum HCY in patients with severe OSAHS with cognitive impairment was(32.28±3.92)μmol/L, higher than that of the cognitive moderate group(26.34±4.05)μmol/L, and mild group (18.62±3.29)μmol/L. The level of serum NO/ET-1 in patients with severe OSAHS with cognitive impairment was (0.69±0.19), higher than that of the cognitive moderate group(2.76±0.28), and mild group (3.98±0.37), the difference was statistically significant (P<0.05). In severe group, there was a negative correlation between the level of serum HCY and the score of MoCA and its subscores (P<0.05), and there was a positive correlation between the total scores of NO/ET-1 and MoCA and their subscores (P<0.05), and negative correlation between HCY and NO/ET-1 (P<0.05). The area under the ROC curve of predicting serum HCY and NO/ET-1 levels in severe OSAHS patients with cognitive impairment were 0.788(95%CI0.654-0.921) and 0.770 (95%CI0.642-0.899). Conclusion:Serum HCY and NO/ET-1 were the factors influencing the formation of cognitive impairment in severe OSAHS patients. The level of HCY was negatively correlated with the degree of cognitive impairment, and NO/ET-1 was positively correlated with the degree of cognitive impairment.

Effect of dietary fermented oats in different nutrient-density diets on growth performance, nutrient digestibility and ileal microorganisms of weanling pigs

A total of 160 crossbred weanling pigs [(Landrace × Yorkshire) × Duroc, 28 days old] with an initial bodyweight of 8.01 ± 0.74 kg were used in a 42-day trial (Phase 1: Days 1–14, Phase 2: Days 14–42). The experiment was conducted to evaluate the effects of the inclusion of fermented oats (FO) to a corn and soybean meal-based diet on the performance of weanling pigs fed with high nutrient-density (HD) and low nutrient-density (LD) diets. Pigs were randomly distributed into one of four dietary treatments in a 2 × 2 factorial arrangement. Two levels of nutrient density [LD = 3323 (Phase 1: 1–14 days) and 3269 kcal/kg (Phase 2: 14–42 days); HD = 3446 (Phase 1: 1–14 days) and 3325 kcal/kg (Phase 2: 14–42 days), the differences in dietary energy were based on differences in the content of fish meal, animal fat, corn and FO [0%, 5% (Phase 1) or 2.5% (Phase 2)] were used according to the bodyweight and sex of pigs [8 replicate pens per treatment with 5 pigs in a pen (3 gilts and 2 barrows)]. During the overall trial period (Days 1–42), the average daily gain and gain:feed ratio of pigs fed HD and FO diets were significantly higher (P ≤ 0.05) than those of pigs fed with LD and non-fermented oats diets respectively. On Day 14, the apparent total tract digestibility of dry matter and nitrogen of the HD groups were significantly greater (P ≤ 0.05) than those of the LD groups. The apparent total tract digestibility of energy of the FO groups was significantly greater (P ≤ 0.05) than that of the non-fermented oats diet groups during the whole experimental period. Pigs fed with FO showed higher (P ≤ 0.05) ileal Lactobacillus and lower (P ≤ 0.05) Escherichia coli counts compared with those fed with the non-fermented oats diet. In conclusion, administration of FO to a LD diet demonstrated beneficial effects on the growth performance, nutrient digestibility and ileal microorganisms balance of weanling pigs.

Clinical significance of angiopoietin-like protein 3 expression in patients with glioblastoma

There is strong evidence that angiopoietin-like peptide family is involved in the invasiveness and metastasis of cancer. Angiopoietin-like protein 3 (ANGPTL3) is proven to be involved in angiogenesis and tumor development. However, there is no published data on the role ANGPLT3 plays in glioblastomas. The present study was conducted to examine ANGPLT3 proteins expression and its association with clinicopathological factors and prognosis in human glioblastomas. Immunohistochemistry was used to evaluate the expression of ANGPTL3, EGFR and VEGFR. We found that 33 cases (57.9%) that showed strong immunostaining for ANGPTL3 proteins. However, there was no significant difference between the expression of ANGPTL3 and the proangiogenic factors, including EGFR or VEGFR. Patients with high/moderate expression of ANGPTL3 had a significantly shorter survival time (6.3 months) than those (median survival time 13.8 months) with low/negative expression. The overall survival (OS) was also investigated and analyzed by the Kaplan-Meier method, which showed a significant difference (P=0.0045, Breslow test). The present data leads to new insights into the role of ANGPTL3 in glioblastomas and provides an independent predictive factor.

Measurement of the Electron Antineutrino Oscillation with 1958 Days of Operation at Daya Bay

We report a measurement of electron antineutrino oscillation from the Daya Bay Reactor Neutrino Experiment with nearly 4 million reactor ν[over ¯]_{e} inverse β decay candidates observed over 1958 days of data collection. The installation of a flash analog-to-digital converter readout system and a special calibration campaign using different source enclosures reduce uncertainties in the absolute energy calibration to less than 0.5% for visible energies larger than 2 MeV. The uncertainty in the cosmogenic ^{9}Li and ^{8}He background is reduced from 45% to 30% in the near detectors. A detailed investigation of the spent nuclear fuel history improves its uncertainty from 100% to 30%. Analysis of the relative ν[over ¯]_{e} rates and energy spectra among detectors yields sin^{2}2θ_{13}=0.0856±0.0029 and Δm_{32}^{2}=(2.471_{-0.070}^{+0.068})×10^{-3}  eV^{2} assuming the normal hierarchy, and Δm_{32}^{2}=-(2.575_{-0.070}^{+0.068})×10^{-3}  eV^{2} assuming the inverted hierarchy.

[Clinicopathologic features and immunophenotype of pseudosarcomatous myofibroblastic proliferation of urinary bladder]

Objective: To investigate the clinicopathologic features, immunohistochemical phenotypes and biological behavior of pseudosarcomatous myofibroblastic proliferation (PMP) of the urinary bladder which may be misdiagnosed as a malignant neoplasm and undergo extensive treatment. Methods: Six cases of PMP of the urinary bladder were collected from 2001 to 2016 at Beijing Tiantan Hospital, Capital Medical University. The clinicopathologic features and immunophenotypic profile were studied by histopathological and immunohistochemical investigations with clinical follow-up. At the same time, the translocation of ALK gene was detected by fluorescence in situ hybridization (FISH). Immunohistochemistry was carried out using EnVision method for the expression of AE1/AE3, vimentin, EMA, SMA, Caldesmon, Calponin, desmin, ALK, Ki-67, MyoD1, myoglobin, CD34, S-100, CD117, CK7, CK20, GATA3, p63 and CK5/6. The related literature was reviewed. Results: There were two male and four female patients, significantly more common in women. The age of the patients was 27 to 53 years, and the median age was 35 years. The main clinical symptom was painless gross hematuria, one case with dysuria, and one case showed recurrent cystitis. There was no history of surgery and trauma. Follow-up ranged from 4 months to 13 years and showed five cases without recurrence and one case with recurrence. Microscopy showed submucosal lesion with inflammatory exudate and bleeding on the surface, in some cases extending to the superficial muscles of the bladder wall. The lesion was characterized by the proliferation of plump spindle cells, which were loose or dense in arrangement. There were varying degrees of acute and chronic inflammatory cells infiltration in the myxoid matrix. Spindle cells arranged in disorder, or a dense stranding, especially abundant in the cell region. The median mitotic rate was <2/10 HPF cells, but there were no pathological mitotic figures and without nuclear atypia in most spindle cells. Spindle cells with eosinophilic cytoplasm showed long tapering cytoplasmic projections. Oval or short spindle nuclei had vacuolization with prominent nucleoli, looking like ganglionic cells. There were scarce collagen fibers, and a few spindle cells degenerated with chromatin blurred. Some areas showed a granuloma-like pattern and neutrophils within vascular cavity. Immunohistochemically, the spindle cells were diffusely positive for vimentin, SMA and caldesmon. CKpan was strongly and diffusely positive. Desmin and calponin expression was varying. Ki-67 positive cells were about 35% to 55%, but the spindle cells were negative for myoglobin, S-100, CD117, CD34, p63 and CK5/6. FISH test showed that there was no ALK isolated signal in 6 cases of PMP, and so no positive cases were found. Conclusions: PMP of the urinary bladder is a benign non-neoplastic myofibroblastic proliferative lesion. Morphology is extremely easy to be misdiagnosed as malignant tumors, and therefore more attention should be paid to avoid this misdiagnosis.

[Research on blood distribution of Tibetan population in Ali area]

Objective: To explore the distribution of ABO blood group in the healthy population in the Ali area of Tibet, and to analyze the difference of blood group distribution between the Tibetan population in Ali and the Tibet Tibetan population. Methods: The blood distribution of 509 apparent healthy volunteers of Tueti County and Gal County, Tibet, which were randomly selected from September to November in 2016; 137 Tibetan blood donors, from 2016 September to2017 July and 84 Tibetan blood donors from 2015 August to 2017 July was analyzed retrospectively. The blood type was tested by the slide method. By reviewing the Chinese and foreign language database, seven articles on Tibetan blood group distribution were obtained. And the data of the blood distribution of the Ali area population and the Tibet Tibetan population were compared. Results: The ABO phenotype frequencies of 507 apparent healthy people, 137 blood donors and 84 recipients were B>O>A>AB. The composition ratio were 36.1%, 34.5%, 21.5 %, 7.9%; 40.1%, 35.0%, 17.5%, 7.3%; 39.3%, 34.5%, 20.2%, 6.0%.There was no statistically significant difference in blood group distribution between the donors and the recipients (P>0.05). And there was no significant difference in the blood group distribution between Ali and Shigatse, Nagqu, Lhasa, Shannan. However, the differences between Ali and Qamdo, Nyingchi areas were statistically significant. Conclusion: The geographical position of the blood from the west to east, B type shows a downward trend, O type blood composition ratio shows an upward trend.

[Different states of otitis media were retrospectively analyzed of myringoplasty]

Objective:Through analysis of the tympanic membrane perforation rate and hearing improvement rate with chronic suppurative otitis media (CSOM) by myringoplasty,to observe the effect of different preoperative conditions such as middle ear lesion,eustachian tube (ET) function and infection status on the postoperative curative effect.Method:Retrospective analysis of EENT Hospital of Fudan University from January 2012 to November 2016 during the 203 cases (203 ears) with clinical data of myringoplasty: according to intraoperative exploration of the presence of purulent secretions in the tympanic cavity,divided into infection active group and infection quiescence group; according to the preoperative results of the function of ET with acoustic impedance test divided into dysfunction or good group; according to the preoperative temporal bone HRCT suggested that the middle ear (mastoid cells,tympanic antrum and tympanic cavity) with or without soft tissue density,divided into the group with no focal lesion and the group with focal lesion. Review endoscopy and pure tone audiometry after 3 to 6 months. Using SPSS 19.0 statistical software to compare the differences among them of tympanic membrane perforation rate and hearing improvement rate.Result:Single factor analysis: ①The infection quiescence group of tympanic membrane perforation rate was 11.93%(13/109),higher than the infection active group ［8.51%(8/94)］; the infection quiescence group of hearing improvement rate was 75.23%(82/109),below the infection active group ［79.79%(75/94)］,no statistically significant differences of them (P>0.05).②The group with dysfunction of ET of tympanic membrane perforation rate was 14.06%(9/64),significantly higher than the group［4.04%(4/99)］with good function ET,with statistical difference of them (P<0.05); the group with dysfunction of ET of hearing improvement rate was 76.56% (49/64),lower than the group［81.82%(81/99)］with good function of ET,no significant difference of them (P>0.05).③The group with no obvious lesion of tympanic membrane perforation rate was 9.09% (10/110),lower than the group ［11.83%(11/93)］with focal lesion; the group with no obvious lesion of hearing improvement rate was 78.18% (86/110),higher than the group with focal lesion ［76.34%(71/93)］,no significant difference of them (P>0.05).Multivariate analysis: ①There was a significant correlation of postop-erative tympanic membrane perforation rate with preoperative ET functi-on (P<0.05).There was no significant correlation of the postoperative tympanic membrane perforation rate with the infection status and the temporal bone HRCT images in the middle ear lesions (P>0.05).②There was no significant correlation of the postoperative hearing improvement rate with the infection status,the ET function and the temporal bone HRCT images in the middle ear lesions (P>0.05).Conclusion:Dysfunction of ET and localized lesions of the ear were more common in infection active;the accumulation of purulent exudate on the surface of the tympanic mucosa and localized lesions of the middle ear did not affect the healing rate of the tympanic membrane and the hearing improvement rate; ET function is one of the most important factors that affect the healing rate of tympanic membrane after operation,the patients with ET dysfunction are more likely to affect tympanic membrane perforation,but does not affect the hearing improvement rate.

[Clinical analysis of tympanoplasty combined with ventilation tube insertion in otitis media]

Objective:The aim of this study is to explore the feasibility and clinical effect of tympanoplasty combined with ventilation tube insertion in otitis media.Method: Retrospective analysis of 35 patients with eustachian tube obstruction or tympanic adhesions for tympanoplasty combined with ventil ation tube insertion in otitis media in EENT Hospital of Fudan University from April 2008 to December 2010. Preoperative routine hearing tests and temporal bone CT examination. Completely remove of lesions at the same time and as much as possible to protect the integrity of the tympanic wall mucosa during operation. Reconstruction of the ossicular chain and simultaneous tympanic membrane hole and placed silicone T-type ventilation tube. All patients were tested for pure tone auditory threshold at 3 months after operation. The patients were followed up for 12 to 44 months.Result:The average hearing level of PTA (0.5,1.0,2.0 kHz) was (31.71±12.25) dBHL. 28 cases (80.0%) had improved to 40 dBHL after operation, 5 cases (14.3%) had hearing enhancement of 10-20 dBHL, and 2 patients (5.7%) had no change in hearing. The number of cases with air bone gap (ABG)(0.5, 1.0, 2.0 kHz) reduced to less than 20 dBHL was 25, 32 and 34 after operation. Ventilation tube self-prolapse in15 cases, 12 cases of artificial removal and 8 cases of inpatient. Twenty seven cases were left perforation of tympanic membrane, of which 22 cases (81.5%) were spontaneously healed and 5 cases(18.5%) were left with small perforations less than 2 mm in diameter. All of them had dry ear after operation, none of them had recurrence after operation, 33 cases (94.3%) had dry ear within 12 weeks, and only 2 cases(5.7%) had dry ear for more than 6 months.Conclusion: Tympanoplasty combined with ventilation tube insertion for the middle ear mucosal dysfunction and eustachian tube mucosal dysfunction of otitis media treatment effect is obvious. It does not extend the dry ear time and cause postoperative recurrence. This operation is feasible, reliable and effective.

Topological cell clustering in the ATLAS calorimeters and its performance in LHC Run 1

The reconstruction of the signal from hadrons and jets emerging from the proton-proton collisions at the Large Hadron Collider (LHC) and entering the ATLAS calorimeters is based on a three-dimensional topological clustering of individual calorimeter cell signals. The cluster formation follows cell signal-significance patterns generated by electromagnetic and hadronic showers. In this, the clustering algorithm implicitly performs a topological noise suppression by removing cells with insignificant signals which are not in close proximity to cells with significant signals. The resulting topological cell clusters have shape and location information, which is exploited to apply a local energy calibration and corrections depending on the nature of the cluster. Topological cell clustering is established as a well-performing calorimeter signal definition for jet and missing transverse momentum reconstruction in ATLAS.

[Analysis of curative effect on chronic suppurative otitis media by tympanoplasty with or without mastoidectomy]

Objective:Analysis of perforation rate and hearing improvement rate of patients with chronic suppurative otitis media after operation, to observe the effect of tympanoplasty with or without mastoidectomy.Method:Retrospective analysis the clinical data of EENT Hospital of Fudan University from January 2011 to December 2016, 167 cases (ears) by tympanoplasty. According to the surgical approach were divided into simple tympanoplasty in 108 cases (group A), tympanoplasty with mastoidectomy in 59 cases(group B)(CWU in 23 cases, IBM in 11 cases, CWD in 25 cases). Endoscopy and pure tone audiometry after 3 to 6 months, using SPSS19.0 software to compare the difference of tympanic membrane perforation rate and hearing improvement rate. Result:The tympanic membrane perforation rate of group A and group B were 8.33%(9/108) and 5.08%(3/59),there was no significant difference(χ²= 0.604, P> 0.05). The hearing improvement rate of group A and group B were 83.33%(90/108) and 77.97%(46/59), there was no significant difference (χ²= 0.727, P> 0.05).Conclusion:For chronic suppurative otitis media with lesions confined to the mastoid and tympanic sinus, the removal of mastoid lesions in the treatment of tympanic membrane healing and improvement of hearing can not achieve better results than simple tympanoplasty.

[Differences in myringoplasty between endoscopic and microscope]

Objective:The intraoperative and postoperative clinical indexes of myringoplasty performed by endoscope or by microscope were collected retrospectively, the differences between the two different surgical methods were analysized. Method:Retrospective analysis of the clinical data of 70 cases (70 ears) udergoing myringoplasty in the department of Otolaryngology-Head and Neck Surgery, at the Second People's Hospital of Kashi from June 2014 to August 2015. According to the surgical approach cases were divided into two groups, 30 cases in group A by endoscopic myringoplasty and 40 cases in group B by microscope myringoplasty. The operation time, blood loss, postoperative dry ear time, wound healing scar hyperplasia, tympanic membrane perforation rate and hearing improvement rate were compared between the two groups, and SPSS 19.0 statistical software was used to analyze the differences between the two groups. Result:The operation time: Group A had an average of (35.23±6.38)min, less than group B (42.60±7.97)min, with statistical difference (P<0.05). The intraoperative blood loss: the average of group A was (7.33±2.11)ml, less than group B (17.93±3.84)ml, with statistical difference (P<0.05). The postoperative dry ear time more than 1 month: group A was 40%, lower than Group B (75%), with statistical difference (P<0.05). The postoperative incision healing scar hyperplasia: group A was 0%, lower than group B (5%), no significant difference (P>0.05). The tympanic membrane perforation rate: group A was 3.33%, lower than group B (7.5%), no significant difference (P>0.05). The postoperative hearing improvement rate: group A was 76.67%, lower than group B (80.00%), no significant difference (P>0.05). Conclusion:Compared with the traditional microscope surgery, endoscopic myringoplasty is a minimally invasive surgical technique which can get the same curative effect, but with a shorter operation time, less intraoperative blood loss, dry ear in shorter time , recovery more quickly, beautiful incision and other advantages. So it is worthy of clinical application.

Morphology, Molecular Characteristics, and Demonstration of a Definitive Host for Sarcocystis rommeli from Cattle (Bos taurus) in China

Sarcocysts of Sarcocystis rommeli were found for the first time in 6 of 34 (17.6%) cattle (Bos taurus) in China. With light microscopy, sarcocysts of S. rommeli were up to 1,130 μm long, with a striated, 4-8-μm-thick cyst wall. Using transmission electron microscopy, the villar protrusions (vp) were 4.7-5.2 × 0.2-0.3 μm, and 0.3-0.5 μm apart from each other. The vp contained microtubules extending from the top of the vp to the middle of the ground substance layer (gsl). A BLAST search of the near full-length 18S rRNA and partial mitochondrial cox1 sequences of S. rommeli revealed 98.7% identity and 99.2% identity with sequences of Sarcocystis bovini in GenBank, respectively. Two domestic cats (Felis catus) fed sarcocysts of S. rommeli shed oocysts/sporocysts in their feces with a prepatent period of 14 to 15 days; the partial mitochondrial cox1 sequences of these oocysts/sporocysts shared the high identities, that is, 99.4% and 99.5%, with cox1 sequences of S. rommeli sarcocysts and S. bovini sarcocysts, respectively. This is the first demonstration of a definitive host for S. rommeli.

Reconstruction of primary vertices at the ATLAS experiment in Run 1 proton-proton collisions at the LHC

This paper presents the method and performance of primary vertex reconstruction in proton-proton collision data recorded by the ATLAS experiment during Run 1 of the LHC. The studies presented focus on data taken during 2012 at a centre-of-mass energy of [Formula: see text] TeV. The performance has been measured as a function of the number of interactions per bunch crossing over a wide range, from one to seventy. The measurement of the position and size of the luminous region and its use as a constraint to improve the primary vertex resolution are discussed. A longitudinal vertex position resolution of about [Formula: see text] is achieved for events with high multiplicity of reconstructed tracks. The transverse position resolution is better than [Formula: see text] and is dominated by the precision on the size of the luminous region. An analytical model is proposed to describe the primary vertex reconstruction efficiency as a function of the number of interactions per bunch crossing and of the longitudinal size of the luminous region. Agreement between the data and the predictions of this model is better than 3% up to seventy interactions per bunch crossing.

[Clinicopathologic characteristics of plasma cell myeloma with marrow fibrosis]

Objective: To study the clinicopathologic features of plasma cell myeloma(PCM) with bone marrow fibrosis (MF). Methods: The clinicopathologic data of 175 cases of newly diagnosed PCM patients were retrospectively analyzed. Based on reticular fiber staining, these cases were divided into PCM-MF and non-PCM-MF groups. Results: Sixty-three cases were PCM-MF(36%), 112 were non-PCM-MF (64%). No statistical difference in gender, age, hemoglobin level, platelet counts, the classification of immunoglobulin, ISS staging, immunohistochemical phenotypes and genetic features was found between PCM-MF and non-PCM-MF groups (P>0.05). Compared to non-PCM-MF group, lactate dehydrogenase (LDH)level and renal impairmentrate were higher in PCM-MF group (P<0.05). The degree of bone marrow hyperplasia, the percentage of myeloma cells and cells with plasmablastic morphology were significantly higher in PCM-MF group(P<0.05). Conclusion: The higher LDH level, renal impairment rate, and more significant bone marrow hyperplasia, proliferation of plasma cells and plasmablastic myeloma cells infiltration indicate poor prognosis of PCM-MF patients.

Denis RD, Stabile A, Stamen R, Stamm S, Stanecka E, Stanek RW, Stanescu C, Stanescu-Bellu M, Stanitzki MM, Stapnes S, Starchenko EA, Stark GH, Stark J, Staroba P, Starovoitov P, Stärz S, Staszewski R, Steinberg P, Stelzer B, Stelzer HJ, Stelzer-Chilton O, Stenzel H, Stewart GA, Stillings JA, Stockton MC, Stoebe M, Stoicea G, Stolte P, Stonjek S, Stradling AR, Straessner A, Stramaglia ME, Strandberg J, Strandberg S, Strandlie A, Strauss M, Strizenec P, Ströhmer R, Strom DM, Stroynowski R, Strubig A, Stucci SA, Stugu B, Styles NA, Su D, Su J, Suchek S, Sugaya Y, Suk M, Sulin VV, Sultansoy S, Sumida T, Sun S, Sun X, Sundermann JE, Suruliz K, Susinno G, Sutton MR, Suzuki S, Svatos M, Swiatlowski M, Sykora I, Sykora T, Ta D, Taccini C, Tackmann K, Taenzer J, Taffard A, Tafirout R, Taiblum N, Takai H, Takashima R, Takeshita T, Takubo Y, Talby M, Talyshev AA, Tan KG, Tanaka J, Tanaka M, Tanaka R, Tanaka S, Tanioka R, Tannenwald BB, Tapia Araya S, Tapprogge S, Tarem S, Tartarelli GF, Tas P, Tasevsky M, Tashiro T, Tassi E, Tavares Delgado A, Tayalati Y, Taylor AC, Taylor GN, Taylor PTE, Taylor W, Teischinger FA, Teixeira-Dias P, Temming KK, Temple D, Ten Kate H, Teng PK, Teoh JJ, Tepel F, Terada S, Terashi K, Terron J, Terzo S, Testa M, Teuscher RJ, Theveneaux-Pelzer T, Thomas JP, Thomas-Wilsker J, Thompson PD, Thompson AS, Thomsen LA, Thomson E, Tibbetts MJ, Ticse Torres RE, Tikhomirov VO, Tikhonov YA, Timoshenko S, Tipton P, Tisserant S, Todome K, Todorov T, Todorova-Nova S, Tojo J, Tokár S, Tokushuku K, Tolley E, Tomlinson L, Tomoto M, Tompkins L, Toms K, Tong B, Tornambe P, Torrence E, Torres H, Torró Pastor E, Toth J, Touchard F, Tovey DR, Trefzger T, Tricoli A, Trigger IM, Trincaz-Duvoid S, Tripiana MF, Trischuk W, Trocmé B, Trofymov A, Troncon C, Trottier-McDonald M, Trovatelli M, Truong L, Trzebinski M, Trzupek A, Tseng JCL, Tsiareshka PV, Tsipolitis G, Tsirintanis N, Tsiskaridze S, Tsiskaridze V, Tskhadadze EG, Tsui KM, Tsukerman II, Tsulaia V, Tsuno S, Tsybychev D, Tu Y, Tudorache A, Tudorache V, Tuna AN, Tupputi SA, Turchikhin S, Turecek D, Turgeman D, Turra R, Tuts PM, Tyndel M, Ucchielli G, Ueda I, Ughetto M, Ukegawa F, Unal G, Undrus A, Unel G, Ungaro FC, Unno Y, Unverdorben C, Urban J, Urquijo P, Urrejola P, Usai G, Usui J, Vacavant L, Vacek V, Vachon B, Valderanis C, Valdes Santurio E, Valencic N, Valentinetti S, Valero A, Valery L, Valkar S, Valls Ferrer JA, Van Den Wollenberg W, Van Der Deijl PC, van der Graaf H, van Eldik N, van Gemmeren P, Van Nieuwkoop J, van Vulpen I, van Woerden MC, Vanadia M, Vandelli W, Vanguri R, Vaniachine A, Vankov P, Vardanyan G, Vari R, Varnes EW, Varol T, Varouchas D, Vartapetian A, Varvell KE, Vasquez JG, Vasquez GA, Vazeille F, Vazquez Schroeder T, Veatch J, Veeraraghavan V, Veloce LM, Veloso F, Veneziano S, Ventura A, Venturi M, Venturi N, Venturini A, Vercesi V, Verducci M, Verkerke W, Vermeulen JC, Vest A, Vetterli MC, Viazlo O, Vichou I, Vickey T, Boeriu OEV, Viehhauser GHA, Viel S, Vigani L, Villa M, Perez MV, Vilucchi E, Vincter MG, Vinogradov VB, Vittori C, Vivarelli I, Vlachos S, Vlasak M, Vogel M, Vokac P, Volpi G, Volpi M, von der Schmitt H, von Toerne E, Vorobel V, Vorobev K, Vos M, Voss R, Vossebeld JH, Vranjes N, Vranjes Milosavljevic M, Vrba V, Vreeswijk M, Vuillermet R, Vukotic I, Vykydal Z, Wagner P, Wagner W, Wahlberg H, Wahrmund S, Wakabayashi J, Walder J, Walker R, Walkowiak W, Wallangen V, Wang C, Wang C, Wang F, Wang H, Wang H, Wang J, Wang J, Wang K, Wang R, Wang SM, Wang T, Wang T, Wang W, Wanotayaroj C, Warburton A, Ward CP, Wardrope DR, Washbrook A, Watkins PM, Watson AT, Watson MF, Watts G, Watts S, Waugh BM, Webb S, Weber MS, Weber SW, Weber SA, Webster JS, Weidberg AR, Weinert B, Weingarten J, Weiser C, Weits H, Wells PS, Wenaus T, Wengler T, Wenig S, Wermes N, Werner M, Werner MD, Werner P, Wessels M, Wetter J, Whalen K, Whallon NL, Wharton AM, White A, White MJ, White R, Whiteson D, Wickens FJ, Wiedenmann W, Wielers M, Wiglesworth C, Wiik-Fuchs LAM, Wildauer A, Wilk F, Wilkens HG, Williams HH, Williams S, Willis C, Willocq S, Wilson JA, Wingerter-Seez I, Winklmeier F, Winston OJ, Winter BT, Wittgen M, Wittkowski J, Wolf TMH, Wolter MW, Wolters H, Worm SD, Wosiek BK, Wotschack J, Woudstra MJ, Wozniak KW, Wu M, Wu M, Wu SL, Wu X, Wu Y, Wyatt TR, Wynne BM, Xella S, Xu D, Xu L, Yabsley B, Yacoob S, Yamaguchi D, Yamaguchi Y, Yamamoto A, Yamamoto S, Yamanaka T, Yamauchi K, Yamazaki Y, Yan Z, Yang H, Yang H, Yang Y, Yang Z, Yao WM, Yap YC, Yasu Y, Yatsenko E, Yau Wong KH, Ye J, Ye S, Yeletskikh I, Yildirim E, Yorita K, Yoshida R, Yoshihara K, Young C, Young CJS, Youssef S, Yu DR, Yu J, Yu JM, Yu J, Yuan L, Yuen SPY, Yusuff I, Zabinski B, Zaidan R, Zaitsev AM, Zakharchuk N, Zalieckas J, Zaman A, Zambito S, Zanello L, Zanzi D, Zeitnitz C, Zeman M, Zemla A, Zeng JC, Zeng Q, Zenin O, Ženiš T, Zerwas D, Zhang D, Zhang F, Zhang G, Zhang H, Zhang J, Zhang L, Zhang M, Zhang R, Zhang R, Zhang X, Zhang Z, Zhao X, Zhao Y, Zhao Z, Zhemchugov A, Zhong J, Zhou B, Zhou C, Zhou L, Zhou L, Zhou M, Zhou N, Zhu CG, Zhu H, Zhu J, Zhu Y, Zhuang X, Zhukov K, Zibell A, Zieminska D, Zimine NI, Zimmermann C, Zimmermann S, Zinonos Z, Zinser M, Ziolkowski M, Živković L, Zobernig G, Zoccoli A, zur Nedden M, Zwalinski L. Measurements of top-quark pair differential cross-sections in the [Formula: see text] channel in pp collisions at [Formula: see text] TeV using the ATLAS detector

This article presents measurements of [Formula: see text] differential cross-sections in a fiducial phase-space region, using an integrated luminosity of 3.2 fb[Formula: see text] of proton-proton data at a centre-of-mass energy of [Formula: see text] TeV recorded by the ATLAS experiment at the LHC in 2015. Differential cross-sections are measured as a function of the transverse momentum and absolute rapidity of the top quark, and of the transverse momentum, absolute rapidity and invariant mass of the [Formula: see text] system. The [Formula: see text] events are selected by requiring one electron and one muon of opposite electric charge, and at least two jets, one of which must be tagged as containing a b-hadron. The measured differential cross-sections are compared to predictions of next-to-leading order generators matched to parton showers and the measurements are found to be consistent with all models within the experimental uncertainties with the exception of the Powheg-Box [Formula: see text] Herwig++ predictions, which differ significantly from the data in both the transverse momentum of the top quark and the mass of the [Formula: see text] system.

[The joint effects of major lifestyle factors on stomach cancer risk among Chinese men: a prospective cohort study]

Objective: To investigate the combined impact of lifestyle factors on stomach cancer risk. Methods: We analyzed the data from the Shanghai Men's Health Study (SMHS) (2002-2013). The SMHS was conducted in eight neighborhood communities of urban Shanghai. From 2002 through June 2006, 61 480 residents aged 40 to 74 years old with no history of cancer were recruited. Failure time was the date of stomach cancer incidence, death or date of the last follow-up (December 31, 2013). The first two in-person follow-up surveys were conducted in 2004-2008, and 2008-2011, respectively. Using data on lifestyle, the healthy lifestyle index (HLI) was developed. The following lifestyle factors were included: smoking, alcohol consumption, diet habit, overweighted and physical activity. Cox proportional hazard models were used to evaluate the association of stomach cancer risk with lifestyle factors and HLI. Results: Over 9.28 years' follow-up, 477 incident cases of stomach cancer were identified from 59 503 study participants. Participants with zero, one, two, three, four, and five favorable lifestyle behaviors accounted for 3.44% (n=2 045), 18.14% (n=10 793), 33.68% (n=20 041), 29.43% (n=17 511), 12.82% (n=7 627), and 2.50% (n=1 486), respectively. Among all the five lifestyle factors, smoking and alcohol use were significantly related to stomach cancer risk. The relative risk of stomach cancer was 0.71 (95%CI: 0.57-0.87) for those who never smoked or quitted smoking for no less than 10 years and 0.70 (95%CI: 0.55-0.90) for those who consumed alcohol no more than 14 drinks per week. For each increment of healthy lifestyle index, the relative risk of stomach cancer was 0.86 (95%CI: 0.79-0.95). Compared to men with none or one healthy lifestyle factor, the relative risk for those with four or five was 0.62 (95%CI: 0.46-0.83). When we rebuilt HLI using more categories of each lifestyle factors, the HLI ranged from 0 to 11. For each point increase, the relative risk of stomach cancer was 0.93 (95%CI: 0.89-0.97). Compared those with 0 to 3 points, the relative risk of those with 8 to 11 points was 0.64 (95%CI: 0.47-0.87). Conclusion: In the SMHS, only a small proportion of men adhered to all the five healthy lifestyle factors. Compared to those with none or one healthy lifestyle behaviors, those with five may prevent about 1/3 stomach cancer incidence and the HLI was inversely associated with stomach cancer risk.

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Vykydal Z, Wagner P, Wagner W, Wahlberg H, Wahrmund S, Wakabayashi J, Walder J, Walker R, Walkowiak W, Wallangen V, Wang C, Wang C, Wang F, Wang H, Wang H, Wang J, Wang J, Wang K, Wang R, Wang SM, Wang T, Wang T, Wang X, Wanotayaroj C, Warburton A, Ward CP, Wardrope DR, Washbrook A, Watkins PM, Watson AT, Watson IJ, Watson MF, Watts G, Watts S, Waugh BM, Webb S, Weber MS, Weber SW, Webster JS, Weidberg AR, Weinert B, Weingarten J, Weiser C, Weits H, Wells PS, Wenaus T, Wengler T, Wenig S, Wermes N, Werner M, Werner P, Wessels M, Wetter J, Whalen K, Wharton AM, White A, White MJ, White R, White S, Whiteson D, Wickens FJ, Wiedenmann W, Wielers M, Wienemann P, Wiglesworth C, Wiik-Fuchs LAM, Wildauer A, Wilkens HG, Williams HH, Williams S, Willis C, Willocq S, Wilson JA, Wingerter-Seez I, Winklmeier F, Winter BT, Wittgen M, Wittkowski J, Wollstadt SJ, Wolter MW, Wolters H, Wosiek BK, Wotschack J, Woudstra MJ, Wozniak KW, Wu M, Wu M, Wu SL, Wu X, Wu Y, Wyatt TR, Wynne BM, Xella S, Xu D, Xu L, Yabsley B, Yacoob S, Yakabe R, Yamaguchi D, Yamaguchi Y, Yamamoto A, Yamamoto S, Yamanaka T, Yamauchi K, Yamazaki Y, Yan Z, Yang H, Yang H, Yang Y, Yang Z, Yao WM, Yap YC, Yasu Y, Yatsenko E, Wong KHY, Ye J, Ye S, Yeletskikh I, Yen AL, Yildirim E, Yorita K, Yoshida R, Yoshihara K, Young C, Young CJS, Youssef S, Yu DR, Yu J, Yu JM, Yu J, Yuan L, Yuen SPY, Yusuff I, Zabinski B, Zaidan R, Zaitsev AM, Zakharchuk N, Zalieckas J, Zaman A, Zambito S, Zanello L, Zanzi D, Zeitnitz C, Zeman M, Zemla A, Zeng JC, Zeng Q, Zengel K, Zenin O, Ženiš T, Zerwas D, Zhang D, Zhang F, Zhang G, Zhang H, Zhang J, Zhang L, Zhang R, Zhang R, Zhang X, Zhang Z, Zhao X, Zhao Y, Zhao Z, Zhemchugov A, Zhong J, Zhou B, Zhou C, Zhou L, Zhou L, Zhou M, Zhou N, Zhu CG, Zhu H, Zhu J, Zhu Y, Zhuang X, Zhukov K, Zibell A, Zieminska D, Zimine NI, Zimmermann C, Zimmermann S, Zinonos Z, Zinser M, Ziolkowski M, Živković L, Zobernig G, Zoccoli A, zur Nedden M, Zurzolo G, Zwalinski L. Performance of algorithms that reconstruct missing transverse momentum in [Formula: see text]= 8 TeV proton-proton collisions in the ATLAS detector

The reconstruction and calibration algorithms used to calculate missing transverse momentum ([Formula: see text] ) with the ATLAS detector exploit energy deposits in the calorimeter and tracks reconstructed in the inner detector as well as the muon spectrometer. Various strategies are used to suppress effects arising from additional proton-proton interactions, called pileup, concurrent with the hard-scatter processes. Tracking information is used to distinguish contributions from the pileup interactions using their vertex separation along the beam axis. The performance of the [Formula: see text] reconstruction algorithms, especially with respect to the amount of pileup, is evaluated using data collected in proton-proton collisions at a centre-of-mass energy of 8 [Formula: see text] during 2012, and results are shown for a data sample corresponding to an integrated luminosity of [Formula: see text]. The simulation and modelling of [Formula: see text]  in events containing a Z boson decaying to two charged leptons (electrons or muons) or a W boson decaying to a charged lepton and a neutrino are compared to data. The acceptance for different event topologies, with and without high transverse momentum neutrinos, is shown for a range of threshold criteria for [Formula: see text] , and estimates of the systematic uncertainties in the [Formula: see text]  measurements are presented.

[Size exclusionchromatography-high-performance liquid chromatography-inductively coupled plasma mass spectrometry for measuring the stability of cadmium telluridequantum dots]

Objective: To investigate the peak time and peak area of elements in cadmium telluride quantum dots (CdTe QDs) using size exclusion chromatography-high-performance liquid chromatography-inductively coupled plasma mass spectrometry, as well as the biological stability of CdTe QDs in vivo and in vitro. Methods: Transmission electron microscope and ultraviolet fluorescence were used for characterization and synthesis of water-soluble CdTe QDs, and CdTe QDs were added to double-distilled water, mobile phase, or bovine serum medium to observe the change in stability after different periods of time. CdTe QDs were injected into the vein of mice, and the changes in the morphology of CdTe QDs in serum and the liver were measured at 1, 24, and 72 hours after exposure. Size exclusion chromatography-high-performance liquid chromatography was used for the elution of the compounds in the solution based on their volume, and then inductively coupled plasma mass spectrometry was performed for the eluent. The flow time of (114)Cd and (130)Te and molar ratio were used for qualitative analysis of CdTe QDs, and the peak area was used to judge whether CdTe QDs were degraded. Results: CdTe QDs were diluted to a concentration of 0.5 mmol/L with double-distilled water and then placed in a dark place at room temperature; CdTe QDs were completely degraded after 60 minutes. CdTe QDs were diluted to a concentration of 0.005 mmol/L with a mobile phase, and the peak of CdTe QDs was not detected. After CdTe QDs were placed in a dark place at room temperature for 48 hours at a concentration of 0.005 mmol/L in bovine serum mediumin vitro, the peak area of (114)Cd was 6179841-7346084, and the peak area of (130)Te was 1077913-1191066. CdTe QDs had the highest peak area at 1 hour after exposure, and the peak areas of (114)Cd and (130)Te were 18183894 and 25187987, respectively. CdTe QDs were quickly degraded in the liver; at 1 hour after exposure, the degradation products of CdTe QDs containing Cd were observed in liver tissue homogenate, and CdTe QDs were largely degradedat 24 hours. Conclusion: This method can be used to investigate the biological stability of CdTe QDs. CdTe QDs are degraded in the liver and produce Cd(2+), which may cause toxic reaction.

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Wielers M, Wiglesworth C, Wiik-Fuchs LAM, Wildauer A, Wilk F, Wilkens HG, Williams HH, Williams S, Willis C, Willocq S, Wilson JA, Wingerter-Seez I, Winklmeier F, Winston OJ, Winter BT, Wittgen M, Wittkowski J, Wolf TMH, Wolter MW, Wolters H, Worm SD, Wosiek BK, Wotschack J, Woudstra MJ, Wozniak KW, Wu M, Wu M, Wu SL, Wu X, Wu Y, Wyatt TR, Wynne BM, Xella S, Xu D, Xu L, Xu T, Yabsley B, Yacoob S, Yamaguchi D, Yamaguchi Y, Yamamoto A, Yamamoto S, Yamanaka T, Yamauchi K, Yamazaki Y, Yan Z, Yang H, Yang H, Yang Y, Yang Z, Yao WM, Yap YC, Yasu Y, Yatsenko E, Yau Wong KH, Ye J, Ye S, Yeletskikh I, Yen AL, Yildirim E, Yorita K, Yoshida R, Yoshihara K, Young C, Young CJS, Youssef S, Yu DR, Yu J, Yu JM, Yu J, Yuan L, Yuen SPY, Yusuff I, Zabinski B, Zaidan R, Zaitsev AM, Zakharchuk N, Zalieckas J, Zaman A, Zambito S, Zanello L, Zanzi D, Zeitnitz C, Zeman M, Zemla A, Zeng JC, Zeng Q, Zengel K, Zenin O, Ženiš T, Zerwas D, Zhang D, Zhang F, Zhang G, Zhang H, Zhang J, Zhang L, Zhang R, Zhang R, Zhang X, Zhang Z, Zhao X, Zhao Y, Zhao Z, Zhemchugov A, Zhong J, Zhou B, Zhou C, Zhou L, Zhou L, Zhou M, Zhou N, Zhu CG, Zhu H, Zhu J, Zhu Y, Zhuang X, Zhukov K, Zibell A, Zieminska D, Zimine NI, Zimmermann C, Zimmermann S, Zinonos Z, Zinser M, Ziolkowski M, Živković L, Zobernig G, Zoccoli A, Nedden MZ, Zwalinski L. Search for triboson [Formula: see text] production in pp collisions at [Formula: see text] [Formula: see text] with the ATLAS detector

This paper reports a search for triboson [Formula: see text] production in two decay channels ([Formula: see text] and [Formula: see text] with [Formula: see text]) in proton-proton collision data corresponding to an integrated luminosity of 20.3 [Formula: see text] at a centre-of-mass energy of 8 [Formula: see text] with the ATLAS detector at the Large Hadron Collider. Events with exactly three charged leptons, or two leptons with the same electric charge in association with two jets, are selected. The total number of events observed in data is consistent with the Standard Model (SM) predictions. The observed 95% confidence level upper limit on the SM [Formula: see text] production cross section is found to be 730 fb with an expected limit of 560 fb in the absence of SM [Formula: see text] production. Limits are also set on WWWW anomalous quartic gauge couplings.

[Recombinant human bone morphogenetic protein 7 inhibits the proliferation and extracellular matrix secretion of fibroblast of urethral scars]

Objective: To study the effect and its mechanism of recombinant human bone morphogenetic protein 7 (rhBMP-7) on urethral keloid fibroblast. Methods: Urethral fibroblasts were extracted and cultured, and the fourth-generation fibroblasts were used for experiment. Urethral fibroblasts were treated with rhBMP-7. Proliferation rate was detected by CCK-8 method. RT-PCR was applied to test changes of mRNA in α smooth muscle actin (α-SMA) and type Ⅰ collagen protein (COL-1) of each group. Western blot was used to measure α-SMA protein expression and the effect of rhBMP-7 on signaling pathway of urethral keloid fibroblasts. Results: With the increase of rhBMP-7 concentrations, the proliferation rate of urethral keloid fibroblast was generally decreased. Cells kept proliferating with time at the same concentration of rhBMP-7. mRNA level of COL-1 and α-SMA in rhBMP-7-treated (>20 ng/ml) urethral keloid fibroblasts was greatly reduced with statistical significance (P<0.05) and dose dependency. It was found rhBMP-7 inhibited the overexpression of p-smad2/3 and α-SMA mediated by transforming growth factor beta 1 (TGF-β(1)) signaling pathway. Conclusion: rhBMP-7 could adjust TGF-β(1) signaling pathway to inhibit gene expression of COL-1 and a-SMA in urethral keloid fibroblast, which provided evidences for further animal experiments or clinical trials.