[Clinical strategies for preservation of the exposed implant in chronic wounds and wound repair]

Objective: To explore the clinical strategies for preservation of the exposed implant in chronic wounds and wound repair. Methods: From January 2016 to January 2019, totally 8 patients (4 males and 4 females, aged 10 to 73 years) sustaining postoperative chronic wounds with exposed implants were admitted to the Fourth Medical Center of PLA General Hospital. There were 2 cases of abdominal patch exposure after abdominal trauma surgery, 2 cases of titanium plate exposure post craniocerebral surgery, 3 cases of internal fixator exposure post orthopedic surgery, and 1 case of cerebrospinal fluid drainage tube exposure after craniocerebral surgery. The wound exudate was collected for bacterial culture on admission. On the basis of glycemic control and correction of anemia and hypoproteinemia, thorough wound debridement was performed as soon as possible and the wound area after debridement ranged from 2.0 cm×0.5 cm to 6.0 cm×5.0 cm. The wounds of 4 patients were immediately closed after debridement, including 1 case by primary closure, 1 case by primary closure after local filling of platelet rich plasma gel, and 2 cases by local flap transplantation, with flap size of 10.0 cm×8.0 cm and 12.0 cm×8.0 cm, respectively. The donor sites of flaps were sutured directly and all the incisions were treated with continuous vacuum sealing drainage (VSD) after surgery. The other 4 patients were treated with continuous VSD after debridement to improve the wound bed. The wound of 1 case healed gradually, 1 case received direct wound suturing, and the wounds of 2 cases were repaired with thin split-thickness skin grafts from the thigh or the head. The results of bacterial culture of wound exudate on admission, wound healing post surgery, and follow-up were observed and recorded. Results: The bacterial culture of wound exudate on admission was positive in 6 patients, and 10 strains of bacteria were isolated with Staphylococcus epidermidis as the main pathogen. All the skin grafts or flaps of patients survived post surgery, with the incisions and wounds healed and all the implants preserved. After 1 to 3 years of follow-up, no recurrence of wound was found in any patient. Conclusions: The postoperative chronic wounds with exposed implants can be closed in primary stage by direct suturing or flap transplantation if it is clean enough on the basis of thorough debridement. The wounds with large defects or serious infection can be treated with continuous VSD firstly and then closed with direct suturing or skin grafting for delayed wound closure, thereby to reach the treatment goal of preserving the implants and repairing the wounds simultaneously.

[microRNA-16-5p targeted tetraspanin 15 gene to inhibit the proliferation, migration and invasion of osteosarcoma cell through phospoinositide 3-kinase/protein kinase B signaling pathway]

Objective: To study the effects of miR-16-5p on proliferation, migration and invasion of osteosarcoma cells and its mechanism. Methods: Quantitative polymerase chain reaction (qPCR) and Western blotting were used to detect the mRNA and protein expression of miR-16-5p and TSPAN15 in human normal osteoblasts hFOB 1.19 and osteosarcoma cells MG63, Saos2 and HOS. The miR-16-5p or si-TSPAN15 was transfected into MG63 cells to observe its role in cell proliferation, migration and invasion. Cell proliferation was measured with MTT assay, cell migration and invasion were examined by Transwell, and the protein expression of CyclinD1, matrix metalloproteinase 2 (MMP-2), MMP-9, tetraspanin 15 (TSPAN15), phospha-tidylinositol3-kinase(p-PI3K) and phospha-protein kinase B(p-AKT) were determined by using Western blotting. The starbase website prediction combined with dual luciferase gene reporter assay was performed to analyze the targeting relationship between miR-16-5p and TSPAN15. miR-16-5p and pcDNA-TSPAN1 were co-transfected to assess the effect of high expression of TSPAN15 on overexpression of miR-16-5p-induced proliferation, migration and invasion of MG63 cells. Data comparison between the two groups was performed by using t test. Results: Compared with hFOB 1.19 cells (1.00±0.12), the expression of miR-16-5p was significantly decreased in MG63, Saos2 and HOS cells (0.32±0.05, 0.40±0.04, 0.45±0.06, respectively)(F=156.204, P<0.05), and TSPAN15 mRNA and protein levels were greatly increased (F=71.718, 110.350, both P<0.05). Overexpression of miR-16-5p obviously reduced the expression of CyclinD1, MMP-2, MMP-9 protein, cell viability, cell migration and invasion (F=150.136,117.228, 154.971, 89.479, 98.373, 130.880, all P<0.05) in MG63 cells. Knockdown of TSPAN15 greatly reduced CyclinD1, MMP-2, MMP-9 protein levels, cell survival rate, cell migration, and invasion number (F=93.206, 107.030, 109.326, 115.625, 146.113, 139.300, all P<0.05). Overexpression of miR-16-5p markedly decreased the expression of p-PI3K and p-AKT protein in MG63 cells (F=156.755, 181.419, both P<0.05). miR-16-5p targeted to regulate the expression of TSPAN15. High expression of TSPAN15 partially reversed the inhibitory effect of miR-16-5p on TSPAN15, CyclinD1, MMP-2, MMP-9, p-PI3K, p-AKT protein expression, cell viability, cell migration number and invasion number in MG63 cells. Conclusion: miR-16-5p inhibits the proliferation, migration and invasion of osteosarcoma cells by targeting the TSPAN15 gene and regulating the PI3K/AKT signaling pathway.

First report of Giardia duodenalis genotypes in Zangxiang pigs from China

Giardia duodenalis is an important zoonotic intestinal protozoan of animals and humans. We collected 450 faecal specimens from four age groups (pre-weaned piglets, weaned piglets, juveniles, adults) of Zangxiang pigs from Shaanxi and Qinghai provinces, to investigate the prevalence and genetic diversity of G. duodenalis at the β-giardin (bg), triosephosphate isomerase (tpi) and glutamate dehydrogenase (gdh) loci using nested PCRs in the present study. A total of 28 faecal samples were positive for presence of G. duodenalis, with an overall prevalence of 6.2%. Giardia duodenalis was detected in pigs from all age groups and in both investigated provinces. Significant differences (P < 0.0001) in prevalence were observed among the four age groups with prevalence decreasing with age. Sequence analysis indicated existence of genetic diversity of G. duodenalis isolates from Zangxiang pigs, with 4, 2 and 4 haplotypes at the bg, tpi and gdh loci, respectively. Two assemblages were identified, including the zoonotic assemblage B and assemblage E, with the latter as the predominant assemblage found in both locations and all age groups except adults. The present study expanded the host range of G. duodenalis and provided fundamental data for controlling G. duodenalis infection in Zangxiang pigs.

[Correlation of orexin-2 receptor gene polymorphisms with Alzheimer's disease]

Objective: To investigate the association between orexin-2 receptor (OX2R) gene polymorphisms and Alzheimer's disease (AD). Methods: A total of 350 patients with AD diagnosed at the People's Hospital of Zhengzhou University from January 2014 to January 2018 were enrolled as the case group, and 350 healthy subjects were selected as the control group, and their general demographic data were collected. The peripheral blood samples were collected for DNA extraction, and the polymorphisms of 6 loci in OX2R gene in the two groups were detected by polymerase chain reaction (PCR) and gene sequencing. The differences in genotype and gene frequency distribution between the two groups were compared. Results: The genotype distribution of OX2R gene rs2653349 and rs2292041 in the case group was significantly different from that in the control group (P<0.05). Multivariate Logistic regression analysis showed that rs2653349(GA+AA) genotype was an independent risk factor for AD(P=0.009). Five haplotypes were found in the haplotype analysis, and there were differences between the case group and the control group: rs2653349+rs2292041 GA type(χ(2)=10.922, P=0.000 1), rs2653349+rs2292041+ rs3122169 GAA type (χ(2)=8.687, P=0.003), ATC type(χ(2)=8.329, P=0.003 9), rs2653349+ rs2292041 AT type(χ(2)=6.504, P=0.010 8), rs2653349+rs2292041+rs3122169 ATA type(χ(2)=17.511, P=0.000 1). Conclusion: The OX2R gene rs2653349 and rs2292041 polymorphisms in the Han population of Henan may be associated with AD, and the A allele may be a susceptible factor for AD.

[The necessity of artificial kidney seeper in the ultrasonography-guided percutaneous nephrolithotomy: a randomized controlled study]

Objective: To investigate the necessity of artificial kidney seeper which made through inserting a ureteral tube in the ureter to the ultrasonography-guided percutaneous nephrolithotomy (PCNL). Methods: This was a randomized prospective study. Patients who conformed to the inclusion and exclusion criteria were enrolled at Department of Urology, Frist Affiliated Hospital of Wenzhou Medical University from January 2016 to May 2017. Totally 291 patients were included in the study. Patients were randomly assigned into two groups (artificial kidney seeper group and non-artificial kidney seeper group) in different kidney seeper level (5 to <10 mm, 10 to 20 mm) respectively. The artificial kidney seeper group was inserted by a ureteral cathedral, then were underwent the ultrasonography-guided PCNL in prone position. The non-artificial kidney seeper group were underwent the ultrasonography-guided PCNL in prone position directly. The t test, χ(2) test, repeated measure analysis was used to data measurement, respectively. Results: Four patients who diagnosed pyonephrosis were excluded. On the 5 to <10 mm level, fever rate (14.6% vs. 4.8%, χ(2)=5.07, P=0.03), operation time ((65.7±9.9)min vs. (50.3±7.4)min, t=11.47, P=0.00), cost ((18 327±903) yuan vs. (14 583±784) yuan, t=24.50, P=0.00) about artificial kidney seeper group and non-artificial kidney seeper group had statistical differences. And on the 10 to 20 mm level, fever rate (14.5% vs. 3.39%, χ(2)=4.53, P=0.03), operation time ((66.0±9.9)min vs. (52.4±8.9)min, t=8.30, P=0.00), cost ((16 548±537) yuan vs. (13 102±629) yuan, t=32.10, P=0.00) about artificial kidney seeper group and non-artificial kidney seeper group had statistical differences. And there were no statistical differences in the success rate of puncturing, the failures of the treatment to the stone pieces falling into the ureter and clearance rate of the stone and so on. In this study, 2 cases recovered after received transfusion and digital subtraction angiography artery embolization treatments; D-J tube was indwelled into 4 cases guiding by super smooth thread; 4 cases were finished the surgeries with the help of ureteroscopy, because the stone pieces fell into the ureter during the surgeries. And there was no patients developing septic shock, adjacent viscera injury or other serious complications. Conclusion: For seasoned doctors, there is no necessity of regularly artificial kidney seeper for PCNL when the pre-operation seeper ranging from 5 to 20 mm.

[Abnormal functional connectivity between sublaterodorsal nucleus and the motor cortex in Parkinson's disease with rapid-eye-movement sleep behavior disorder]

Objective: To investigate the abnormal functional connectivity between sublaterodorsal nucleus (SLD) and the brain motor areas in Parkinson's disease with or without rapid-eye-movement (REM) sleep behavior disorder by resting state functional magnetic resonance imaging (rfMRI). Methods: A total of 64 subjects recruited in the Department of Neurology, the People's Hospital of Zhengzhou University were enrolled in this study from August 2014 to December 2017 according to international diagnosis criteria, 20 cases with PD-RBD (PD-RBD group), 23 cases without PD-nRBD (PD-nRBD group) and 21 age, gender-matched healthy controls (HC group). All subjects were examined by Hoehn-Yahr, UPDRS-Ⅲ and rfMRI. Resluts: UPDRS-Ⅲ scores and Hoehn-Yahr staging were showed significantly different from that in the HC group(KW=-27.35, P<0.001) but showed no significantly difference from that in the PD-nRBD group(KW=6.01, P=0.807). Compared with the control group, the FC analysis showed reduced correlations from the left SLD to the right orbital middle frontal gyrus(T=-4.567 8, P<0.001), the left cingulate gyrus(T=-3.196 0,P<0.001), the left cerebellum(T=-4.267 0,P<0.001) and the right midbrain(T=-4.773 7, P<0.001), from the right SLD to the bilateral cerebellum (T(left)=-5.040 1, T(right)=-4.210 5, P<0.001), the left precuneus(T=-4.468 2,P<0.001) and the left precentral gyrus (T=-4.473 9,P<0.001) in the PD-RBD. The correlations between the left SLD and left cerebellum, right midbrain and between the right SLD and left precuneus, left precentral gyrus were negative correlated with the motor functional tests. Conclusions: There are abnormal functional connectivity from the SLD to the motor areas in PD-RBD patients, leading to clinical PD-RBD motor symptoms and movement disorders.

Analysis of EEG Lemple-Ziv complexity and correlative aspects before and after treatment of anti-syphilis therapy for neurosyphilis

Objective To investigate the diagnostic value of electroencephalogram (EEG) complexity in patients with neurosyphilis by comparing the changes of electroencephalogram Lempel-Ziv complexity (EEG-LZC) before and after anti-syphilis treatment. Methods The EEG complexity of neurosyphilis patients diagnosed in our hospital from July in 2015 to June in 2017 was analyzed and compared with other diagnostic results such as serology examination and cerebrospinal fluid examination. Results A total of 27 patients were diagnosed, including 19 males and 8 females, of which 6 were mesenchymal(cerebrospinal membrane and meningeal vascular), 16 were parenchymal(paralytic dementia, spinal cord tuberculosis and optic neuropathy), and 5 were asymptomatic. After intensive anti-syphilis therapy, the LZC increased significantly in all patients while the trend and degree of change were consistent with other diagnostic results. Conclusion The LZC can be used as one of the diagnostic indexes meanwhile the trend and degree of its change can be used as the reference index of curative effect to neurosyphilis.

[Risk factors and sonographic findings associated with the type of placenta accreta spectrum disorders]

Objective: To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods: Totally, 2 219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1%, 1 755/2 219) and the placenta percreta (PP) group (20.9%, 464/2 219) , according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results: The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ(2)=157.961) and placenta previa (χ(2)=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions: Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.

[Current applications of artificial intelligence in tumor histopathology]

The tasks of artificial intelligence (AI) in tumor histopathology include image segmentation and classification. Currently, the specific contents including lymph node metastasis, pathological classification, grade and prognostic evaluation of malignant diseases, such as breast cancer, lung cancer and prostate cancer, have been studied by AI. Evaluation of sentinel lymph node metastasis of breast cancer has been the most mature application of AI technology, whose level can be analogous to the excellent pathologists. In the future, with the close cooperation of pathologists and engineers, the research of AI will be focus on improving the technology of simple and repetitive clinical diagnosis and differential diagnosis, such as the diagnosis of sentinel lymph node metastasis of breast cancer from biopsy frozen section and the judgment of incisal margin. Ultimately, AI will help us to precisely diagnose the tumor.

Relationship between sleep disorders and lymphocyte subsets and cytokines in patients with lung cancer

This study aimed to investigate the relationship between sleep disorders and lymphocyte subsets and cytokines in patients with lung cancer undergoing radiotherapy, and to establish a theoretical foundation for predicting sleep disorders and preventing interventions in radiotherapy in lung cancer patients. Ninety-two patients with lung cancer requiring radiotherapy were selected as the study subjects. The patients' demographic data and disease-related conditions were investigated. Their quality of sleep was measured before radiotherapy, after two and four weeks of radiotherapy, and at the end of radiotherapy. According to the Pittsburgh Sleep Quality Index Number Table (PSQI), patients with PSQI score> 7 points were put into a sleep disorder group, and patients with PSQI score 0-7 were put into a normal sleep group. Lymphocyte subsets were enumerated and cytokine levels (IL-6, IL-1b) were measured during these four periods. The difference in sleep disorders at four weeks between patients with or without synchronous chemotherapy was statistically significant (P less than 0.05). The levels of lymphocyte subsets in the sleep disorder group and the control sleep group showed no difference in the index of lymphocyte subsets before radiotherapy. In the sleep disorder group, CD4+ cells were lower after two weeks of radiotherapy (P less than 0.05). After four weeks of radiotherapy, CD3+, CD4+, and CD16+56+ subsets were lower (P less than 0.05). At the end of radiotherapy, there was no difference in each index. There was no significant difference in IL-6 levels between the two groups before radiotherapy, after two weeks, or after four weeks (P greater than 0.05). At the end of radiotherapy, IL-6 levels in the sleep disorder group were higher than those in the control sleep group (P less than 0.05). There was no significant difference in IL-1b between the two groups (P greater than 0.05). In conclusion, monitoring of T-lymphocyte subsets and IL-6 levels in patients is enhanced during radiotherapy. Clinically effective programs of radiotherapy for lung cancer improve the body's immune status.

Effects of dietary rapeseed meal supplementation on cecal microbiota in laying hens with different flavin-containing monooxygenase 3 genotypes

To evaluate the effect of dietary rapeseed meal (RM) supplementation on cecal trimethylamine and bacteria in laying hens with different flavin-containing monooxygenase 3 (FMO3) genotypes, a 3 × 2 2-factorial arrangement was employed using FMO3 genotypes (AA, AT, and TT) and dietary RM (0 and 14% of diet) as the main effects. At 50 wk of age, 36 hens of AT genotype and 36 hens of TT genotype were randomly allotted to one of the 2 dietary treatments, and each dietary treatment consisted of 3 replicates with 6 birds each. A total of 12 hens with AA genotype were allotted to one of the 2 dietary treatments that consisted of 3 replicates with 2 hens. Hens were fed 0% RM in a corn-soybean (SM) diet for one wk before the 6-week feeding trial period. Dietary RM supplementation increased trimethylamine (TMA) concentrations in both egg yolks (P < 0.0001) and cecal chyme (P < 0.0001). Dietary RM supplementation increased bacterial abundance and diversity (P < 0.0001). Weighted UniFrac, Nonmetric Multidimensional Scaling, and analysis of similarity (R-ANOSIM = 0.1516; P-value = 0.014) indicated distinct clustering was dependent on diets rather than FMO3 genotypes. Twenty-four phyla (most dominant, Bacteroides, Firmicutes, and Proteobacteria) and 229 genera were identified in the cecal samples. Compared with the SM diets, RM diets increased the proportion of Firmicutes (P = 0.004), Proteobacteria (P = 0.006), and Firmicutes:Bacteroides (P = 0.001), and some low-abundance phyla (P < 0.01), whereas the abundance of Bacteroides was lower (P = 0.0002). The abundance of 42 genera varied with dietary types. Six phyla and 35 genera were positively correlated with TMA concentration in the cecal chyme. In conclusion, the major TMA-producing bacteria in cecal were from Firmicutes and Proteobacteria phyla. The major TMA-producing bacterial genera could be from the genera that positively correlated with TMA concentration.

Effect of dietary supplementation of organic or inorganic zinc on carbonic anhydrase activity in eggshell formation and quality of aged laying hens

This study evaluated the effects of different dietary levels and sources of zinc (Zn) on performance and carbonic anhydrase (CA) activity in eggshell formation and quality in aged laying hens. A total of 504 Hy-line Grey layers aged 59 wk were fed a basal diet (Zn, 28.4 mg/kg) for 4 wks, then randomly allocated to 7 groups that were fed a basal diet or a basal diet supplemented with inorganic (ZnSO4·H2O) or organic (amino acid metals, 9.58%) Zn at 35, 70, or 140 mg Zn per kg of feed for 6 weeks. Each group had 6 replicates of 12 hens. Results showed that egg weight decreased linearly with the supplemental level of organic Zn (P < 0.05). Dietary Zn supplementation had linear and quadratic effects on the CA activity in plasma (P < 0.05), and it was higher in the organic Zn-added groups at wks 2 and 4 (P < 0.05). Dietary Zn supplementation had a quadratic effect on the CA activity in the eggshell gland (P < 0.05). Shell thickness was greater in the organic Zn-added groups (P < 0.05), and its relationship with the supplemental level of Zn showed linearly and quadratically, increasing with the organic Zn and with the inorganic Zn at wk 4, while linearly increasing with the inorganic Zn at wk 6 (P < 0.05). At wk 4, the supplemental level of inorganic Zn had a linear effect on shell weight, and linear and quadratic effects on shell index and ratio (P < 0.05), while shell weight, the index, and ratio increased linearly and quadratically with the organic Zn level in the diet (P < 0.05), with more obvious effects in the organic Zn-added groups (P < 0.05). Overall, dietary Zn supplementation, up to 140 mg/kg feed, could increase eggshell thickness by enhancing CA activity in the plasma and eggshell gland of aged layers; thicker eggshells were found in the organic Zn-added groups, but the breaking strength did not increase despite the eggshell thickness increasing.

Dietary choline and phospholipid supplementation enhanced docosahexaenoic acid enrichment in egg yolk of laying hens fed a 2% Schizochytrium powder-added diet

The aim of this study was to evaluate the effect of dietary phospholipid supplementation on laying hen performance, egg quality, and the fatty acid profile of egg yolks from hens fed a 2% Schizochytrium powder diet. Three-hundred-sixty 28-wk-old Hy-line W-36 laying hens were randomly allocated to one of the 5 dietary treatments, each treatment with 6 replicates of 12 birds each. All diets included 2% Schizochytrium powder (docosahexaenoic acid [DHA], 137.09 mg/g). The control group was not supplemented with any additional phospholipids, whereas the other 4 experimental diets were supplemented with 1,000 mg/kg choline (CHO), 1,000 mg/kg monoethanolamine (MEA), 1,000 mg/kg lysophosphatidylcholine (LPC), or 500 mg/kg LPC + 500 mg/kg MEA (LPC + MEA). The experimental diets were isocaloric (metabolizable energy, 11.15 MJ/kg) and isonitrogenous (crude protein, 16.60%). The feeding trial lasted 28 days. Laying hen performance and egg quality were not affected (P > 0.05) by the diets used. The monounsaturated fatty acid (MUFA) level was reduced in the LPC group at d 28 (P < 0.01), whereas the polyunsaturated fatty acid (PUFA) level was increased (P < 0.05). The omega-6 (n-6) PUFA level of the egg yolks in the LPC group had a trend to increase in comparison to the control (P = 0.07). The CHO and LPC groups had higher omega-3 (n-3) PUFA and DHA levels and lower n-6/n-3 ratios than the other groups at d 28 (P < 0.01). The DHA content in egg yolk reached a plateau after the laying hens consumed the experimental diets for 14 days, and higher yolk DHA contents were observed in the CHO and LPC groups as compared with the other groups at d 14. It was concluded that dietary choline supplementation for more than 14 d enhanced egg yolk enrichment with n-3 PUFA and DHA when laying hen diets were supplemented with 2% Schizochytrium powder. All the diets had no adverse effect on hen performance, egg quality, or egg components under the experimental condition.

Effects of dietary gallic acid supplementation on performance, antioxidant status, and jejunum intestinal morphology in broiler chicks

Gallic acid (GA), widely distributed in plants and feeds, is known to have a diverse range of activities such as anti-oxidant, anti-inflammatory, antibacterial, anti-allergic, anti-mutagenic, and anti-carcinogenic. The purpose of this study was to investigate the efficacy of inclusion of dietary GA at levels 0, 25, 50, 75, 100, or 150 mg/kg on growth performance, antioxidant status, and jejunum intestinal morphology of broiler chicks. In total, 630 one-day-old Arbor Acres (AA) male broiler chicks were randomly allotted to 6 treatment groups for a period of 6 weeks. The results indicate that dietary addition of GA at 75 to 100 mg/kg improved feed conversion efficiency in both the grower (d 21 to 42, P = 0.045) and overall (d 1 to 42, P = 0.026) periods. Dietary addition of GA at a concentration ≥100 mg/kg was able to exhibit higher breast muscle ratio at 42 d (P = 0.043). Interestingly, dietary GA inclusion level from 50 to 100 mg/kg reduced the crypt depth (P = 0.009) and increased the villus height:crypt depth ratio (VCR) of the birds (P = 0.006). Dietary supplementation of GA at 100 mg/kg decreased plasma malondialdehyde (MDA) content at 42 d of age (P = 0.030). Moreover, dietary addition of GA linearly increased plasma total antioxidant capacity (P = 0.039) and plasma total superoxide dismutase activities (P = 0.049) at 21 d of age. However, analysis of plasma biochemical markers revealed that dietary supplementation of GA did not exhibit beneficial health effects. Overall, we conclude that 75 to 100 mg/kg of GA are suitable for enhanced growth performance and health benefits in a broiler diet.

Research on characteristics of symmetric optothermal microactuators

This paper proposes and studies symmetric optothermal microactuators (OTMAs) which are directly controlled by a laser beam. Based on the principle of thermal flux, a theoretical model is established to describe the laser-induced temperature rises and optothermal expansions of the OTMAs' expansion arms. Temperature rise distributions of the arms with lengths of 590, 990, and 2260 μm are simulated separately, which reveals that, under 2 mW laser irradiation, the maximum temperature rises are invariably less than 75.9°C. Simulations are also made to consider optothermal expansions of the arms caused by laser irradiation, which turns out that expansion increases considerably when the arm's length increases from 250 to 1000 μm, while insignificantly between 1250 and 2500 μm. Under a laser beam of 2 mW power, experiments on three microfabricated OTMAs have been further conducted, which demonstrate that the OTMAs are capable of generating maximum deflections of 7.3, 11.3, and 13.6 μm, and that the growth of deflection is comparatively obvious in the case when the total length changes from 750 to 1200 μm, while insignificant for the range between 1200 and 2380 μm. With regard to simulations and experiments, it has been proved that the OTMAs are capable of implementing direct laser-controlled microactuation in which only about 2 mW laser power is demanded. Moreover, it has been proved that twofold total length or arm length does not correspondingly result in doubling the deflection, nor the expansion. Therefore, total length/expansion arm's length around or less than 1200/1000 μm is more appropriate for obtaining satisfactory characteristics of OTMAs, which may be potentially applied in MEMS/MOEMS and micro-/nano-technology.

[Clinical comparison of modified laparoscopic and conventional placement of peritoneal dialysis catheters]

Objective: To explore the clinical efficacy of the modified laparoscopic placement of peritoneal dialysis catheters by nephrologists. Methods: A total of 188 patients diagnosed as end-stage renal disease (ESRD) were enrolled, who received catheter and continuous ambulatory peritoneal dialysis (CAPD) therapy from January 2011 to May 2016 in Zhejiang Provincial People's Hospital. They were divided into group A (with modified laparoscopic placement of peritoneal dialysis catheters, n=59) and group B (with conventional placement of peritoneal dialysis catheter, n=129). The demographic and clinical characteristics, past abdominal operation history, surgery time, hospital stay after operation, expenses for surgery and hospitalization, early and late complications including bleeding, pain, leakage, peritonitis and catheter displacement were observed. Results: Patients with previous abdominal surgery accounted for 11.9% in group A and 0 in group B(χ²=15.897, P<0.001). The duration of the operation was (38.9±12.8)min in group A and (64.1±12.7)min in group B(t=-6.466 6, P=0.000 0). The cost of the operation was (5 488.4±156.1) yuan in group A and (1 602.7±48.92) yuan in group B (t=257.129, P=0.000 0). Catheter displacement within one month was observed in 0 and 11.6%(χ²=7.455 3, P=0.003), pain in 15.3% and 41.9% (χ²=12.862 2, P=0.000), and catheter displacement after one month in 0 and in 16.3% (χ²=10.812 4, P=0.000) of the patients, respectively in group A and group B. The incidences of peritonitis within one month and beyond one month, leakage, bleeding and so on showed no difference between the two groups(P>0.05). Conclusions: Placement of PD catheter with laparoscope is suitable for renal failure patients with abdominal operation history and replacement PD catheter. It also has the advantages of shorter surgery time, less pain and lower incidences of catheter displacement, expanding the application of PD. However, bleeding, leakage, hernia and other complications are frequently seen.

[Analysis of curative effect of transoral radiofrequency ablation microsurgery on glottic carcinoma with anterior commissure involvement at the early stage]

Objective: To explore the key technique and outcome of transoral radiofrequency ablation microsurgery for early stage of glottic carcinoma with anterior commissure involvement (ACI). Methods: A retrospective analysis was conducted on 31 patients, who were diagnosed as early stage glottic carcinoma during January 2010 to March 2016 in ENT Department. According to whether the anterior commissure was involved or not, two groups were divided. There were eleven cases with ACI (stages T1a, T1b, and T2). Twenty cases without ACI (stages Tis, T1a, and T2). All the patients received transoral radiofrequency ablation microsurgery and followed up closely.Only one case received radiotheraphy after surgery. SPSS19.0 software was used to analyze data. Results: The follow-up time was 12-67 months, and the median follow-up time was 30 months. Nine among 11 cases with ACI obtained good oncologic outcomes, initial local recurrence was identified in 2/11 cases, including 2 cases of T2. Two cases ultimately required salvage total laryngectomy. Meanwhile, initial local recurrence was identified in 2/20 cases without ACI, including 1 case of T1a and 1 case of T2. One case underwent elective neck dissection, and another one received salvage total laryngectomy.Compared to the patients without ACI, it seemed that the cases with ACI always accomponied with a little higher initial local recurrence and lower overall laryngealpreservation, but the difference had no significance (P>0.05). Conclusions: Transoral radiofrequency ablation microsurgery is an effective treatment for glottic carcinoma with ACI. Its advantages, such as more flexibility and deformability, make it more feasible to operate at the narrow space of anterior commissure assisted with laryngeal endoscopy.Good oncologic outcomes can be obtained by this technique with lower initial local recurrence as well as higher overall laryngeal preservation rate.

Systematic review with meta-analysis: thiopurines decrease the risk of colorectal neoplasia in patients with inflammatory bowel disease

BACKGROUND

Patients with inflammatory bowel disease (IBD) have a high risk of developing colorectal neoplasia.

AIM

To investigate whether thiopurines can decrease the risk of developing colorectal neoplasia in patients with ulcerative colitis (UC) or Crohn's disease (CD).

METHODS

We conducted a meta-analysis of 24 observational studies involving 76,999 participants to evaluate the risks of developing colorectal neoplasia in IBD patients receiving thiopurine treatment. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) for the risks of colorectal neoplasia were calculated using a random-effects model.

RESULTS

The overall pooled estimate revealed a protective effect of thiopurine use on colorectal neoplasia in patients with IBD (OR = 0.63, 95% CI 0.46-0.86). The effect was significant in UC patients (OR = 0.67, 95% CI 0.45-0.98), but was not significant in CD patients (OR = 1.06, 95% CI 0.54-2.09). Thiopurines exposure significantly decreased the risk of colorectal cancer (CRC) (OR = 0.65, 95% CI 0.45-0.96) and advanced colorectal neoplasia (CRC and/or high-grade dysplasia) (OR = 0.62, 95% CI 0.44-0.89), but did not decrease the risk of dysplasia alone (OR = 0.90, 95% CI 0.37-2.21). Tendencies towards the protective effect of thiopurines were distinct in clinic-based studies (OR = 0.59, 95% CI 0.42-0.82) and case-control studies (OR = 0.40, 95% CI 0.26-0.62), but not in population-based studies (OR = 0.95, 95% CI 0.55-1.62) and cohort studies (OR = 0.98, 95% CI 0.81-1.18). Interestingly, studies conducted in Europe (OR = 0.48, 95% CI 0.31-0.77), rather than in North America (OR = 0.91, 95% CI 0.67-1.24), showed the protective effect of thiopurines.

CONCLUSIONS

This meta-analysis revealed an antineoplastic effect of thiopurines on colorectal neoplasia in patients with IBD, particularly amongst patients with UC.

Molecular identification of hemoplasma and piroplasma species from Rattus edwardsi based on sequences analysis of ribosomal DNA, China

The present study provides the first report on the molecular epidemiological data regarding infection by hemoplasma and piroplasma species in wild Rattus edwardsi, from China. In the current study, blood samples were investigated from 32 wild Rattus edwardsi from Hunan (23) and Guangxi (9) provinces, China. The prevalence of hemoplasma and piroplasma was 65.63% (21/32) and 6.25% (2/32), respectively. Phylogenetic analyses indicated that hemoplasmas (HQ183731, HQ183732) derived from wild Rattus edwardsi in China, can be grouped into a solitary clade closely related to H. muris (HMU82963) and M. haemomuris (AB758435). In addition, it was shown that piroplasmas from this study have very close genetic distance to other unidentified piroplasma species isolated from China (AB242140) and Japan (AB188086). The results suggested that hemoplasmas isolated in this study should be represented as a new genotype. Piroplasmas on the other hand needs more sequenced samples in its life-cycle and evidence to check its taxonomic status. These data may have important implications for researching on the epidemiology and population biology as well as for studying the taxonomy status of hemoplasmas and piroplasmids of wild rodents.

[Effects of noninvasive proportional assist vs pressure support ventilation on respiratory work in chronic obstructive pulmonary disease patients with hypercapnia]

Objective: To investigate the effect of noninvasive proportional assist ventilation (PAV) on respiratory work in chronic obstructive pulmonary disease(COPD) patients, in comparison to noninvasive pressure support ventilation(PSV). Methods: Ten severe COPD patients with hypercapnia during acute exacerbation were examined. The baseline inspiratory pressure of PSV (PS) and the assistance level of PAV(PA) were titrated by patients' tolerance. In addition to the baseline PS and PA, an additional decrease by 25% (PS-=75% PS, PA-=75% PA) or increase by 25% (PS+ =125% PS, PA+ =125% PA) of the assist level were applied to the patients. After the assessment of unassisted spontaneous breathing (SB), the patient was placed on the 6 levels of noninvasive-PSV and noninvasive-PAV in random sequence. Each level lasted at least 20 minutes. Respiratory rate (RR), tidal volume (Vt), and respiratory work(Wex, Wip and Wv) were measured. Asynchrony index (AI) was calculated. Results: During ventilation, Vt was significantly higher with each assist level than with SB. The Vt was significant increased with PS+ than with PA+ . An increase in expiratory work(Wex) and decrease in inspiratory work(Wip) were observed respectively, with the increasing assist level. The inspiratory muscles assessed by Wip were more unloaded at PS compared with PA [PS: (1.59±1.27) J/min vs PA: (4.99±3.48) J/min P<0.01]. However, the Wex was significantly higher with PS+ than with PA+ [PS+ : (1.17±0.54) J/min vs PA+ : (0.49±0.56)J/min, P<0.01]. The AI was increased with the increasing assist level of PSV [PS-: (0.46±0.57)%, PS: (1.36±1.24)% PS+ : (5.26±4.77)]. No asynchrony events were observed at PA- and PA. "Runaway" (expiratory asynchrony) was observed during PA+ [AI: (2.62±2.72)%]. Conclusions: Noninvasive-PAV can increase the Vt and decrease the Wip of the COPD patients with hypercapnia and avoid the over-assistance. The "Runaway" will occur at assist level higher than that set by tolerance. Physiological data can monitor the patient's responses and the ventilator-patient interaction, which may provide objective criteria for ventilator setting.

[Assessment of comprehensive nutritional status and eating behavior among 311 middle aged and aged women with osteoporosis in Chengdu]

Objective: To investigate the comprehensive nutritional status and diet behavior of middle aged and elderly women with osteoporosis, and thereby to explore the relationship between diet behavior and comprehensive nutritional status. Methods: 311 middle-aged and elderly women with osteoporosis in Chengdu were included in this study. Mini Nutritional Assessment (MNA) was applied to assess their comprehensive nutritional status. Information of social-demographic characteristics and diet behavior (about meals, snacks and water drinking, etc.) of the subjects was collected by questionnaire. Chi square test was used to assess the differences in nutritional status among patients who have different eating behaviors. Logistic regression analysis was performed to evaluate the relationship between diet behaviors and comprehensive nutritional status. Results: The mean MNA score of subjects was 25.8±2.5. 20.3% (63/311) of the subjets were at risk of potential malnutrition, but there was no malnourished subjects found. 46.9% (46/311) of the subjects were in good appetite. 95.2% (296/311) of them had a fixed food intake each meal. 65.8% (198/311) of them had snacks every day, and the most common choice was fruit (86.4% (248/287)). 54.8% (165/311) of them had initiative drinking water habits, and the most common choice was plain boiled water (79.9%, 246/308). 76.5% (238/311) of them had daily portable water less than 1 500 ml. After adjusting the effects of age, occupation and education level, bad appetite (OR=3.50, 95%CI: 1.18-10.62), unfixed food intake (OR=7.27, 95%CI: 1.40-35.83), and seldom or never intake of snack (OR=3.71, 95%CI: 1.42-9.72) were risk factors for malnutrition risk, while tea drinking was protective factor(OR=0.31, 95%CI: 0.11-0.93). Conclusion: Risk of potential malnutrition and unhealthy diet behavior among the middle aged and elderly women with osteoporosis should be paid more attention. Unhealtghy diet behavior has a negative effect on their comprehensive nutritional status.

[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.