[Relationship between cognitive impairment and sleep-related respiratory indexes in patients with obstructive sleep apnea]

Objectives: To investigate the cognitive impairment in patients with obstructive sleep apnea (OSA), and it's relationship with sleep-related respiratory indexes. Methods: A total of 126 patients who were diagnosed with OSA and received treatment in the Sichuan Mental Health Center from March 2018 to September 2018 were selected as the OSA group, and 92 healthy volunteers with matched age, gender and education level were also recruited as the control group. All participants were assessed by polysomnography and the montreal cognitive assessment scale (MOCA). Results: (1) The total score of MOCA, visual space/executive function score, attention score, language function score and memory score in OSA group were significantly lower than those in the control group (23±4 vs 25±4, 2.0±1.7 vs 2.9±1.5, 5.4±1.0 vs 5.7±0.7, 2.7±0.6 vs 2.9±0.3, 2.6±1.4 vs 3.0±1.4, all P<0.05). The correlation analysis showed that MOCA score was in positive correlation with education level (r=0.585, P<0.001) and mean oxygen saturation (r=0.207, P=0.020). However, the MOCA score was in negative correlation with age (r=-0.564, P<0.001) and time in bed (TIB) (r=-0.205, P=0.021). There was no correlation between MOCA score and apnea-hypopnea index (AHI) (r=-0.006, P=0.949). Multiple linear regression analysis revealed that age (t=-4.133, P<0.001), education level (t=4.001, P<0.001) and mean oxygen saturation (t=2.036, P=0.044) were the major factors that contributed to the cognitive impairment of OSA patients. Conclusions: Patients with OSA have cognitive impairment. The impairment gets more obvious when more severe hypoxia occurs at night, but it's not related to AHI.

[Overview of multi-center registry of aortic dissection]

Aortic dissection is a life-threatening cardiovascular disease. Multi-center registration databases for aortic dissection have been established in many countries. The International Registry of Acute Aortic Dissection has produced a number of research results, which had a significant impact on the diagnosis and treatment of aortic dissection worldwide. The Society for Thoracic Surgeons Adult Cardiac Surgery Database summarizes perioperative data on aortic dissection. German Registry for Acute Aortic Dissection Type A has made remarkable achievements in the neurological protection and organ perfusion of type A aortic dissection. The Nordic Consortium for Acute Type A Aortic Dissection provides guidelines for perioperative administration of aortic dissection. However, the first Registry of Aortic Dissection in China (Sino-RAD) has not reported any new aortic dissection data in the past five years, although it has proposed a number of pathogenic characteristics of Chinese people. Therefore, it is necessary to establish our own aortic dissection database.

A radiomics model of liver CT to predict risk of hepatic encephalopathy secondary to hepatitis B related cirrhosis

PURPOSE

To build a radiomics model of liver contrast-enhanced computed tomography (CT) to predict hepatic encephalopathy secondary to Hepatitis B related cirrhosis.

MATERIALS AND METHODS

This study consisted of 304 consecutive patients with first-diagnosed hepatitis B related cirrhosis. 212 and 92 patients were randomly computer-generated into training and testing cohorts, among which 38 and 21 patients endured HE, respectively. 356 radiomics features of liver were extracted from portal venous-phase CT data, and 3 clinical features were collected from medical record. After data were standardized by Z-score, we used least absolute shrinkage and selection operator to choose useful radiomics features. Ultimately, three predictive models including a radiomics model, a clinical model and an integrated model of radiomics and clinical features were built by analysis of R-software. Predictive performance was tested by multivariable logistic regression, and evaluated by area under receiver-operating characteristic curve (AUC), and accuracy.

RESULTS

19 radiomics features of liver CT were selected. The selected radiomics features and 3 relevant clinical features were applied to develop a radiomics model, a clinical model, and an integrated model of both radiomics and clinical features. The integrated model showed better performance than the radiomics model or clinical model to predict HE (AUC = 0.94 vs. 0.91 or 0.76, and 0.87 vs. 0.86 or 0.73; accuracy = 0.93 vs. 0.89 or 0.83, and 0.83 vs. 0.84 or 0.77) in the training and testing cohorts, respectively.

CONCLUSION

The integrated model of radiomics and clinical features could well predict HE secondary to hepatitis B related cirrhosis.

Assessment of earthworm activity on Cu, Cd, Pb and Zn bioavailability in contaminated soils using biota to soil accumulation factor and DTPA extraction

The study aims to investigate effect of earthworm activity on metal bioavailability in soils using their BSAF-metals. Based on a microcosmic laboratory experiment, epigeic species Amynthas corticis (A. corticis) and endogeic species Amynthas robustus (A. robustus) were cultured in two types of soils contaminated by Cd, Zn, Pb and Cu for 120 days. Earthworm characteristics (i.e. numbers, biomass and BSAF), soil properties (i.e. pH, organic C and N contents along with their components such as mineralization and microbial masses) and DTPA extracted metals in soil were determined. After the incubation, the biomass and survival numbers of both earthworm species decreased significantly (P < 0.05). The accumulation of Cd, Zn and Pb in earthworm tissues and BSAF-metals were earthworm species dependent. According to two-way ANOVA, BSAF-Pb clearly showed the effect of different species of earthworms while BSAF-Cu indicated an interactive effect of earthworms and soil type. Earthworms changed soil properties significantly, especially for mineralized C (C_min), dissolved N (N_dis) and pH (P < 0.05). Earthworm activity increase DTPA extracted Zn and Cu, and the effect of A. robustus were stronger than for A. corticis. Redundancy analysis (RDA) showed that BSAF-Cu and BSAF-Pb contributed for respectively 51.9% and 51.7% of soil properties and DTPA metal changes, indicating that the effects of BSAF-Cu and BSAF-Pb on soil properties and on metal bioavailability in soil were similar. BSAF-Cu, indicating the interactive effect of earthworms and soil, accounted for 38.5% and 45.1% of soil properties and soil metal bioavailability changes. BSAF-Pb, representing the effect of earthworm species, accounted for 13.3% and 6.6% of soil property and soil metal bioavailability variations. Stepwise regression indicated that earthworm might change soil properties through their activities and interactions with soil, and hence increase heavy metal bioavailability. It suggested that BSAF is an important indicator for evaluating the effect of earthworm activity on soil metal bioavailability and designing remediation strategies.

[Discriminations for the Chinese Name of Gelsemium elegans]

In this paper, an in-depth historical research and name analysis on the confusion of homonymous of different herbs and homonyms between the Chinese name of the plant and the name of medicinal materials of Gelsemium elegans (Gardn. & champ.) Benth was made. There are more than 38 different general name and distinct names in the description of ancient and modern literature. After collating and analyzing, it is believed that some names are caused by miswriting or misunderstanding of the form and function. The author proposes that the Chinese name of G. elegans and the medicinal name of its whole medicinal material should be " Gelsemium elegans " (Gou Wen) as the general name, and puts forward suggestions for strengthening the research and arrangement of the name of Chinese materia medica.

Magnetic resonance imaging for preoperative staging of pancreatic cancer based on the 8th edition of AJCC guidelines

Background

Preoperative staging of pancreatic cancer determines the choice of treatment. Magnetic resonance imaging (MRI) plays an important role in preoperative staging of pancreatic cancer. The American Joint Committee on Cancer (AJCC) TNM staging system was revised to its 8^th version in 2016, there has been no report correlating the 8^th edition of the AJCC TNM staging with preoperative MRI examinations and pathological findings. The purpose of our study is to determine the staging accuracy and evaluate the resectability by using MRI about pancreatic cancer compared with intraoperative or pathological findings according to the 8^th edition of the AJCC TNM staging system.

Methods

One hundred thirty-two patients with a pathological diagnosis of pancreatic cancer who underwent preoperative MRI were identified. The clinical data, MRI findings and pathological findings were analyzed. Preoperative MRI staging and resectability evaluation were compared with pathological findings. The accuracy of MRI for preoperative T and N staging was evaluated, and the sensitivity, specificity and accuracy of MRI in evaluating the resectability were assessed. All the staging and resectability assessments were according to the 8^th edition of the AJCC TNM staging system.

Results

Analysis showed that the accuracy of MRI for evaluation of the T and N stages was 82.6% (109/132) and 74.2% (98/132), respectively. The sensitivity and specificity of MRI in assessing the resectability were 94.2% and 71.4%, respectively. Integrating the 8^th edition of the AJCC TNM stage, no significant differences were identified between the preoperative MRI and pathological results for the staging of pancreatic cancer (P=0.805).

Conclusions

MRI is highly accurate for T staging and moderately accurate for N staging. MRI provides important preoperative evaluation of the stage and resectability of pancreatic cancer based on the 8^th edition of the AJCC TNM staging system.

Extrapancreatic Inflammation on Magnetic Resonance Imaging for the Early Prediction of Acute Pancreatitis Severity

OBJECTIVES

This work aimed to study the early predictive value of extrapancreatic inflammation on magnetic resonance imaging (EPIM) for acute pancreatitis (AP) severity.

METHODS

The EPIM score, magnetic resonance severity index, Acute Physiology and Chronic Health Evaluation (APACHE II) score, bedside index of severity in AP, and high-sensitivity C-reactive protein levels were evaluated for 337 AP patients. The extrapancreatic inflammation on computed tomography (EPIC) was also assessed for 86 patients undergoing computed tomography. The predictive values of these scores for severe AP and organ failure were evaluated using receiver operating characteristic curve analyses.

RESULTS

Of the 337 AP patients, 55 (16.3%) had organ failure and 17 (5.0%) had severe AP. The EPIM showed a strong correlation with the EPIC (r = 0.794, P < 0.001) and had a higher correlation with the APACHE II and hospital stay compared with the EPIC. The accuracy of the EPIM in predicting severe AP and organ failure (areas under the curve, 0.844 and 0.817) was consistent with that of the APACHE II and bedside index of severity in AP, and higher than that of the magnetic resonance severity index.

CONCLUSION

The EPIM is more helpful in assessing AP severity than the EPIC and can indicate the occurrence of severe AP and organ failure early.

[Transmission electron microscopic observation on gonad of Oncomelania hupensis offspring bred in Weishan Lake areas]

OBJECTIVE

To observe the morphological changes in the testes and ovaries of adult 12th-generation Oncomelania hupensis bred for 12 winters in Weishan Lake areas.

METHODS

The offspring of the adult O. hupensis snails bred in the Weishan Lake that were originated from the Yangzhou section of the Yangtze River was defined as the experiment group, while uninfected, adult O. hupensis snails captured from the marshland of the Yangzhou section of the Yangtze River served as the control group. Snails were dissected and intact testicular and ovarian specimens were sampled, routinely fixed, dehydrated, embedded, polymerized in an oven and sliced on an ultramicrotome. The sections were visualized under a transmission electron microscope, and the ultrastructure of the snail gonad was compared between the experiment and control groups.

RESULTS

Transmission electron microscopy showed "9 + 2" microtubules on the transverse sections of the tails of sperm cells in the testes of male snails in the control group, with triangular acrosomes and spiral, dense nuclei seen in the tip, while in the experiment group, the "9 + 2" microtubules disappeared on the transverse sections of the tails of sperm cells in the testes of male snails, with low chromatin density found in the tip. Transmission electron microscopy revealed clear nucleolus and nuclear membranes in the ova of female snail ovaries, and displayed yolk body, liposomes and endoplasmic reticulum in the cytoplasm, bilayer twists of nuclear membrane and a uniform nucleolus in the control group, while in the experiment group, smooth nuclear membrane and unclear nucleolus were observed in the ova of female snail ovaries, with few contents seen within cells.

CONCLUSIONS

Following breeding for 12 winters in the Weishan Lake, the 12th-generation O. hupensis snails fail to fully adapt to the natural environment in northern China, and the remarkable changes in the ultrastructure of the snail gonad may be a cause of gradual decline and even extinction of O. hupensis in the Weishan Lake areas.

12 novel atypical porcine pestivirus genomes from neonatal piglets with congenital tremors: A newly emerging branch and high prevalence in China

Atypical porcine pestivirus (APPV), a newly discovered member of the genus Pestivirus, is considered to be associated with congenital tremors (CT) in piglets. From June 2016 to January 2018, 440 serum and tissue samples from CT-affected piglets in Anhui, Guangdong and Guangxi provinces were collected to detect APPV. The results showed a high level of 63.4% preference for APPV in 27 swine farms and complicated co-infection cases between APPV and other 12 swine viruses. Meanwhile, 12 novel APPV genomes were screened and identified. Results showed that complete genomes, N^pro and NS5A genes of these novel 12 APPV sequences revealed 80.5%-99.8%, 78%-100% and 76.9%-99.8% nucleotide identities, respectively. Phylogenetic analyses based on sequences of full-length genomes, N^pro and NS5A genes of APPV indicated three well-defined clades including a newly emerging branch in China. This study provides novel epidemiological information of APPV in China.

[Influences on periodontal health and conditions of patients with periodontitis by clear aligner treatment]

No matter what kind of therapies you choose, clear aligner treatment (CAT) or fixed orthodontic treatment (FOT), the therapy must be performed on the basis of periodontal health and follow the rule that the treatment cannot be harmful to the periodontal tissues. Doctors and patients prefer the clear aligner treatment because of its features, such as aesthetic, removable and comfortable. There are many studies which consider the influences of CAT on the periodontal health, and the conclusions are relatively consistent. The CAT is more beneficial for the plaque-control and maintaining the periodontal health. However, there are a few articles which are talking about applying the CAT to the patients with severe periodontitis. This article mainly reviews the effect of CAT towards the patients with periodontitis, and provides some reference when the patients with severe periodontitis need to choose a proper treatment.

Radiomics model of contrast-enhanced computed tomography for predicting the recurrence of acute pancreatitis

OBJECTIVES

To predict the recurrence of acute pancreatitis (AP) by constructing a radiomics model of contrast-enhanced computed tomography (CECT) at AP first attack.

METHODS

We retrospectively enrolled 389 first-attack AP patients (271 in the primary cohort and 118 in the validation cohort) from three tertiary referral centers; 126 and 55 patients endured recurrent attacks in each cohort. Four hundred twelve radiomics features were extracted from arterial and venous phase CECT images, and clinical characteristics were gathered to develop a clinical model. An optimal radiomics signature was chosen using a multivariable logistic regression or support vector machine. The radiomics model was developed and validated by incorporating the optimal radiomics signature and clinical characteristics. The performance of the radiomics model was assessed based on its calibration and classification metrics.

RESULTS

The optimal radiomics signature was developed based on a multivariable logistic regression with 10 radiomics features. The classification accuracy of the radiomics model well predicted the recurrence of AP for both the primary and validation cohorts (87.1% and 89.0%, respectively). The area under the receiver operating characteristic curve (AUC) of the radiomics model was significantly better than that of the clinical model for both the primary (0.941 vs. 0.712, p = 0.000) and validation (0.929 vs. 0.671, p = 0.000) cohorts. Good calibration was observed for all the models (p > 0.05).

CONCLUSIONS

The radiomics model based on CECT performed well in predicting AP recurrence. As a quantitative method, radiomics exhibits promising performance in terms of alerting recurrent patients to potential precautions.

KEY POINTS

• The incidence of recurrence after an initial episode of acute pancreatitis is high, and quantitative methods for predicting recurrence are lacking. • The radiomics model based on contrast-enhanced computed tomography performed well in predicting the recurrence of acute pancreatitis. • As a quantitative method, radiomics exhibits promising performance in terms of alerting recurrent patients to the potential need to take precautions.

[Associations between maternal exposure to chemical fertilizers during pregnancy and the risk of offspring's low birth weights]

Objective: To explore the association between the consumption of chemical fertilizers and the risk of low birth weight (LBW), to provide references for prevention programs on LBW and to improve the birth outcomes. Methods: Stratified multivariate logistic regression method was used in this study involving 153 preterm LBW infants, 179 term LBW infants and 204 normal control infants that were randomly selected from the birth monitoring data between October 2007 and September 2012 in Pingding county, Shanxi province. Associations between the risk of LBW and maternal exposure to chemical fertilizers during pregnancy were identified. A normal control group was set up to compare results between preterm and term LBW groups. Results: Totally, 18 749 infants were born between 2007 and 2012, with the total incidence rates of LBW as 48.5‰, preterm LBW as 19.4‰, and term LBW as 29.1‰. Concerning the case control study on preterm LBW, after adjustment for confounding factors, the risk of preterm LBW appeared 2.51 (95%CI: 1.05-5.99) times higher in villages with annual consumption of chemical fertilizer ≥100 tons than those villages that using chemical fertilizer less than 50 tons. No significant statistical associations were found between the amounts of household chemical fertilizer consumption and the risks of preterm LBW. Regarding the case control study on term LBW, after adjustment for confounding factors, in villages with ≥100 tons annual consumption of chemical fertilizers, the risk of term LBW was 4.03 (95%CI: 1.63-9.92) times of the risk in villages where the annal use of chemical fertilizers was less than 50 tons. There was no significant association between household consumption of chemical fertilizers and the risk of term LBW. Conclusions: Maternal exposure to chemical fertilizers during pregnancy was associated with the risk of LBW. Our findings suggested that the amount of chemical fertilizer consumption in rural areas seemed also associated with the risks of other adverse pregnancy outcomes. Women should avoid the chance of exposure to chemical fertilizers during pregnancy and the consumption of chemical fertilizers should be carefully managed.

[Clinical and pathological features and mutational types of WT1 mutation-associated nephropathy]

Objective: To explore the clinical and pathological features and mutational types and their relations with WT1 mutation-associated nephropathy (WT1MAN). Methods: The clinical and pathological data and the results of WT1 mutation analysis of the cases from Nanfang Hospital of Southern Medical University, Sun Yat-sen Memorial Hospital and The First Affiliated Hospital of Sun Yat-sen University whom we recruited recently and reported during the last ten years were analyzed. Results: Totally, 20 cases (6 males and 14 females), included 5 newly diagnosed cases, were recruited. (1) Ten children were diagnosed with Denys-Drash syndrome (DDS): The median onset age of proteinuria was 1 year and 7 months. Diffuse mesangial sclerosis (DMS) were revealed in 3 cases, minimal lesions (MCD) in 4 cases, and focal segmental glomerulosclerosis (FSGS) in 1 case; renal pathology was not available in the other 2 cases. Glomerular basement membrane (GBM) thickening was observed in 2 cases. Calcineurin inhibitors (CNIs) were administered in 5 cases, complete remission of proteinuria was observed in 3 cases, partial remission in the other 2 cases. Genetic analysis revealed that six cases had WT1 missense mutation, 3 had nonsense mutation, and 1 had frameshift mutation. (2) Two cases were diagnosed with Frasier syndrome (FS): proteinuria was observed at 1 year and 1 month of age and 1 year and 9 months of age, respectively. FSGS with GBM layering were observed in both cases. They progressed to ESRD at 1 year and 6 months of age and 6 years and 6 months of age, respectively. CNI was tried in 1 case with partial proteinuria remission. Both patients were detected to have WT1 splice mutation. (3) Isolated nephropathy (IN) was observed in 8 cases: three had splice mutation, 5 had missense mutation. Of the 3 patients with splice mutation, one was found to have nephropathy and renal failure at the age of 5 months. The other two cases (1 was FSGS and another MCD), both had GBM layering. CNIs were tried on both of them, one got partial remission with normal renal function at the age of fourteen years, the other one had no response and entered ESRD at the age of 6 years and 9 months. Of the 5 cases with missense mutation, 3 had DMS, 2 of them entered ESRD within 6 months of age, another case had DMS entered ESRD at 9 years of age. One case with FSGS, was treated with CNIs and got complete remission. Conclusions: Slow progression (7/10) nephropathy was observed in DDS patients. Missense mutation (11/20) was the most common type of WT1 variants, followed by splice mutation (5/20) in this group of patients. Early onset nephropathy (4/5), rapid progression (4/5) and GBM layering (4/4) wereobserved in patients with splice mutation. CNI was effective in reducing or even eliminating proteinuria in WT1 MAN patients (8/9).

[Review of 60 years' development of Department of Burns and Plastic Surgery in West China Hospital of Sichuan University]

Burn medicine of China started in 1958. Over the past 60 years, through the efforts of numerous burn discipline scholars, China's burn clinical and scientific research have reached the world's advanced level. Department of Burns and Plastics Surgery of West China Hospital of Sichuan University was founded in 1963. Department of Burns of our hospital was established earlier in China. In the past 60 years, professor Yu Baoliang, Ren Linsen, and Cen Ying had been working hard for the development of our department. Department of Burns and Plastic Surgery in West China Hospital of Sichuan University has developed from a pure therapeutic specialty group into one of the burn centers with strong technical force, first-class medical level, advanced instruments and equipment, rich scientific research achievements, and integrated medicine, teaching, and research in southwestern China, which enjoys high prestige at home and abroad.

[The therapeutic effect of HSV1-hGM-CSF combined with doxorubicin on the mouse breast cancer model]

Objective: To evaluate the oncolytic effect of herpes simplex virus type 1 which carried recombined human granulocyte-macrophage colony-stimulating factor (HSV1-hGM-CSF) on the mouse breast cancer cell line 4T1 and compare the anticancer effects of HSV1-hGM-CSF, doxorubicin alone or combination on the breast cancer in mice. Methods: We investigated the cytotoxic effect on 4T1 cells in vitro, the cell growth, cell apoptosis and cell cycle of 4T1 cells treated with oncolytic HSV1-hGM-CSF at different MOIs (0, 0.5, 1 and 2) and doxorubicin at different concentrations (0, 2, 4 and 8 μg/ml). The effects of oncolytic HSV1-hGM-CSF and doxorubicin on the tumor growth, survival time and their side effects on the mouse breast cancer model were observed. Results: Both oncolytic HSV1-hGM-CSF and doxorubicin significantly inhibited the proliferation of 4T1 cells in vitro. Doxorubicin induced the G(2)/M phase arrest of 4T1 cells, while the cytotoxicity of oncolytic HSV1-hGM-CSF was no cell cycle-dependent.At day 16 after treatment with doxorubicin and HSV1-hGM-CSF, the tumor volume of 4T1 tumor bearing mice were (144.40±27.68)mm(3,) (216.80±57.18)mm(3,) (246.10±21.90)mm(3,) (327.50±44.24)mm(3,) (213.30±32.31)mm(3) and (495.80±75.87)mm(3) in the groups of doxorubicin combined with high dose HSV1-hGM-CSF, doxorubicin combined with low dose HSV1-hGM-CSF, doxorubicin alone, high dose HSV1-hGM-CSF alone, low dose HSV1-hGM-CSF alone and control, respectively.Compared with the control group, both doxorubicin and HSV1-hGM-CSF treatment exhibited significant reduction of primary tumor volume in vivo (P<0.001). The median survival times were 48, 50, 40, 42, 43 and 37 days in the six groups mentioned above, respectively. The median survival period of doxorubicin alone, high dose HSV1-hGM-CSF alone and low dose HSV1-hGM-CSF alone were significantly longer than that of control (P<0.05). Conclusion: Synergistic effect of sequential treatment with doxorubicin and oncolytic HSV1-hGM-CSF is observed in 4T1 mouse breast cancer.

[Effect and mechanism of antimicrobial peptide cathelicidin secreted by tumor associated macrophage on the growth of colorectal cancer in mice]

Objective: To investigate the effect and mechanism of the antibacterial peptide cathelicidin secreted by tumor associated macrophages on the growth of colorectal cancer in mice. Methods: Azoxymethane (AOM)/ dextran sodium sulfate (DSS) method was used to establish a mouse model of colitis associated colon cancer. To induce tumor formation, cathelicidin antibody, IgG antibody (positive control) or PBS (negative control) was respectively injected into mice once every 3 days and lasted one month. Then the pictures of mice colon were taken, and the numbers of tumor were counted and evaluated. Expressions of cathelicidin in tumor associated macrophages isolated from tumor and adjacent normal tissues of mice were examined by quantitative RT-PCR (qRT-PCR) and Western blot. Expressions of the tumor proliferating antigen Ki-67, macrophage marker CD68 and cathelicidin in tumor and non-tumor tissues were determined by immunohistochemistry analysis. Apoptosis of cells from tumor tissues was analyzed by using TdT-mediated dUTP nick-end labeling (TUNEL). Results: In colon tumor tissues, cathlicidin strongly expressed in inflammatory cells (macrophages), but weakly expressed in tumor cells. The tumor number and size in mice injected with cathelicidin neutralizing antibody were 4.50±1.18 and (1.74±0.18) mm, respectively, significantly lower than 13.88±1.98 and (3.74±0.38) mm of mice injected with PBS (t=4.07, t=4.72; P< 0.01) and 15.25±1.82 and (3.40±0.36) mm of mice injected with IgG antibody (t=4.96, t=4.08; P<0.01). The Ki-67 positive rate of cells in tumor tissues of mice injected with cathelicidin neutralizing antibody was (28.20±3.44) %, significantly lower than (68.20±3.51) % of mice injected with PBS (t=8.135, P<0.01) and (69.20±3.41) % of mice injected with IgG antibody (t=8.461, P<0.01). Immunohistochemistry analyses showed that the expression of CD68 in tumor tissues of mice injected with cathelicidin antibody was significantly lower than that of mice injected with IgG antibody or PBS. TUNEL result showed that treatment with cathelicidin neutralizing antibody had negligible effect on the apoptosis of tumor cells. Conclusions: Cathelicidin secreted by tumor associated macrophages can promote the growth of colorectal cancer in mice, and neutralizing cathelicidin activity can inhibit the growth and proliferation of colorectal cancer. Cathelicidin mediated promotion of colon cancer proliferation may mainly be exerted by recruiting inflammatory cells such as macrophages into the tumor microenvironment.

[Research progress of conscious pain and neurosensory abnormalities in dry eye disease]

Dry eye is one of the most common ocular problems in ophthalmology clinic. With the change of social environment and people's life style, the prevalence of dry eye disease is increasing. Currently, the diagnosis criteria for dry eye is controversial, diagnosis of dry eye mainly rely on the comprehensive assessment of symptoms and the presence of associated ocular surface signs. However, previous studies have shown a poor correlation between dry eye symptoms and objective clinical signs in patients. Recent studies have found that neuropathic pain plays an important role in the occurrence of discordance between symptoms and signs in dry eye disease. The purpose of this paper is to present the conception of pain, the distribution and function of sensory nerves in ocular surface, the prevalence and mechanism of neuropathic pain and analgesic treatment in dry eye disease. (Chin J Ophthalmol, 2018, 54: 144-148).

[Analysis of risk factors and outcomes for delayed gastric emptying following pancreaticoduodenectomy: a single center experience of 492 cases]

Objective: To evaluate risk factors for delayed gastric emptying(DGE)following pancreaticoduodenectomy(PD). Methods: There were 492 consecutive patients who underwent PD in Pancreas Center, the First Affiliated Hospital with Nanjing Medical University between January 2012 and December 2014 were identified from a prospective database.There were 315 male and 177 female patients with a median age of 60.5 years.Univariate and multivariate analyses were performed to investigate the independent risk factors for clinically relevant DGE(CR-DGE). Results: The overall incidence of DGE was 29.5%, with Grade B and C occurring at 4.3% and 5.9%, respectively.In multivariate analysis, pancreatic duct diameter less than 3 mm(OR=1.888, P=0.042), pylorus-preserving pancreaticoduodenectomy(OR=2.627, P=0.005) and clinically relevant postoperative pancreatic fistula(OR=2.740, P=0.007) were independently associated with CR-DGE.Other main complications such as postoperative pancreatic fistula, pyoperitoneum, intraabdominal infection were also associated with the severity of DGE(χ(2)=21.360, 14.422, 14.378; P=0.011, 0.002, 0.002). DGE patients had a significantly prolonged postoperative length of stay(31(24-41)d vs. 13(11-17)d) and increased medical cost((122 367.5±66 068.3)yuan vs. (78 200.7±27 043.9)yuan)(both P<0.01). Conclusions: Small pancreatic duct, underwent pylorus-preserving pancreaticoduodenectomy and suffered postoperative pancreatic fistula might indicate a high risk of CR-DGE.

[Laparoscopic pancreaticoduodenectomy with a novel artery first and uncinate process first approach through Treitz ligament]

Objective: To explore the clinical effect of a novel artery first and uncinate process first approach for laparoscopic pancreaticoduodenectomy(LPD), emphasizing the left lateral and posterior dissection of uncinate process (UP) via Treitz ligament approach. Methods: From April to November 2016, 18 patients received LPD with a novel approach in Pancreas Center of the First Affiliated Hospital with Nanjing Medical University. All patients were diagnosed as pancreatic head or peri-ampulla tumor, without major vessel invasion nor distant metastasis. For resection, routine caudal view was used in the first step, to dissect the anterior medial border between uncinate process and superior mesenteric vein(SMV). Lymphatic tissues were completely dissected form anterior surface of hepatoduodenal ligament. In the second step, left lateral view with camera from left para-umbilical trocar was used, Treitz ligament was incised, SMA root was exposed. After anticlockwise rotation and retraction of mesentery, the anatomic relationship between SMA trunk, inferior pancreaticoduodenal artery(IPDA), jejunal branch of SMV, and distal part of UP, could be perfectly exposed from left lateral view. SMA was dissected from its root until the position above the uncinate process and duodenum, IPDA was transected, distal part of UP was freed from SMA. In the third step, right lateral view and caudal view were alternatively used; proximal UP mesentery was completely dissected out from SMA root, CA root and posterior surface of hepatoduodenal ligament. Pancreaticoduodenectomy was completed in the forth step after transection of pancreatic neck and common hepatic duct. Results: The SMA root and distal UP were successfully dissected out via Treitz ligament approach in all 18 patients, among them, distal UP was completely excised in 8 patients from left view. Postoperative pathology showed R0 resection rate in 69%. Postoperative complication included intra-abdominal hemorrhage in 1 patient, pancreatic fistula in 7 patients(6 cases with grade A and 1 case with grade B), delayed gastric emptying in 4 patients (2 cases with grade A, 2 cases with grade B). Average postoperative hospital stay was (15.5±6.8)days. Conclusion: The novel artery first and uncinate process first approach through Treitz ligament could help surgeons to completely dissect the full length of meso-pancreas along celiac axis-SMA axis in LPD.

[Population-based study on infection and genotype distribution of high-risk human among women in rural areas of China, 2014]

Objective: To explore the epidemiologic characterization of high-risk human papillomavirus (HR-HPV) infection and genotype distribution of HR-HPV among women in rural areas of China. Methods: This study used multiple layers of stratified cluster random sampling method. During January to December in 2014, 117 counties of 27 provinces were selected as the HPV test screening pilot project counties. The women aged 35-64 years with rural areas Hukou in these project counties were selected as the study subjects. A total 457 799 women received HPV DNA test. Among them, 118 237 women from 32 counties in 11 provinces received qualified HPV DNA test by fluorescent PCR to detect HPV genotypes. Results: Among 118 237 rural women, the overall HR-HPV positive infection rate was 7.8% (9 249/118 237). The infection rate increased with age and reached an infection peak at the 60-64 age groups (9.9%, 831/8 394). The HR-HPV positive infection rate in western regions (6.9%, 2 144/31 130) was statistical significantly lower than in central regions (8.2%, 1 894/23 023) and eastern regions (8.1%, 5 211/64 084) (χ(2)=51.46, P<0.001). Among 9 249 women with specific genotypes of HR-HPV, 6 496 (97.6%) cases were infected with single HR-HPV type, and 163 cases (2.4% ) were infected with multiple types. HR-HPV type 52, 16 and 58 were the most common infection types in rural areas of China. The single infection rates were 20.9% (1 355/6 496), 18.7% (1 215/6 496), and 11.2% (725/6 496), respectively. The multiple infection rates were 47.2% (77/163), 17.8% (29/163), and 18.4% (30/163), respectively. Conclusion: The HR-HPV positive infection rate in rural areas of Chinese woman was 7.8%, western region has lower infection rate compared with central and eastern regions. HPV 52 was first of the most common genotypes in rural areas of China.

Changes of platelet parameters in early severe preeclampsia

3ummary Objective: The aim of this study was to investigate the changes and clinical values of platelet parameters in different types of severe preeclampsia (SP).

MATERIALS AND METHODS

The pregnant women with SP or normal conditions were selected for the study, the platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW). and plateletcrit (PCT) were tested every four weeks, starting from 12(+1) to 16 gestational weeks, to compare the difference in platelet parameters between SP and normal pregnant women.

RESULTS

PLT, MPV, and PDW of the early onset group exhibited statistically significant differences than the normal group from 20(+1) gestational weeks, and PCT of the early onset group exhibited statistically significant differences than the normal group from 28(+1) gestational weeks (p < 0.05); PLT, MPV, and PDW of the late onset group exhibited statistically significant differences than the normal group (p < 0.05), while PCT of the late onset group exhibited no statistically significant difference than the normal group from 12(+1) gestational weeks until childbirth (p > 0.05). The comparison between the early onset group and the late onset group revealed that there existed statistically significant differences in PLT, MPV, and PDW (p < 0.05), but PCT showed no statistically significant difference throughout the pregnancy period (p < 0.05).

CONCLUSIONS

The changes of platelet parameters in early onset SP patients were earlier than the late onset group, and the difference was statistically significant (p < 0.05). Measuring the platelet parameters could better reveal early-stage SP, thus guiding more personalized clinical treatments to better protect maternal and child safety.

[A Fisher discriminant model to predict the outcome of postoperative blood pressure in primary aldosteronism]

Objective: To establish a Fisher discriminant model in order to predict the outcome of postoperative blood pressure for primary aldosteronism (PA). Methods: A total of 83 cases from the First Affiliated Hospital of Chongqing Medical University were enrolled and divided into two groups: cure group and not cure group according to postoperative blood pressure. Fisher stepwise discriminant analysis was used to establish a discriminant model, and compared with aldosteronoma resolution score (ARS) and nomogram model by receiver operating characteristic curve. Results: Hypertension was cured in 52 cases, and 31 cases remained uncured. Patients in uncured group were older, and had bigger body mass index (BMI), longer duration of hypertension, higher serum triglyceride (TG), more types of antihypertensive drug, higher incidence of diabetes, smoking and alcohol intake, less typical nodules on computed tomography imaging, lower estimated glomerular filtration rate (eGFR) and high density lipoprotein cholesterol. The discriminant model based on BMI, types of antihypertensive drugs, typical nodules on CT, eGFR and TG was established and the cut-off value was 0.195 9, with a sensitivity of 86.5% and a specificity of 83.9%. The area under the curve was 0.857 (95% CI: 0.764-0.951), which was higher than that of ARS (0.733, 95% CI: 0.619-0.847) and the nomogram model (0.735, 95% CI: 0.619-0.851). Conclusion: The Fisher discriminant model had a high value to predict the outcome of postoperative blood pressure in PA.

Optical Temperature Sensing Behavior Through Stark Sublevels Transitions of Green and Red Upconversion Emissions for Er3+-Yb3+-Li+ Codoped TiO2 Phosphors

The Er3+-Yb3+-Li+ codoped TiO2 phosphors have been prepared by sol-gel method. The green and red upconversion emissions were observed under a 976 nm laser diode excitation, which were ascribed to 2H11/2 --> 4I15/2, 4S3/2(I)/4S3/2(II) -->4I15/2, and 4F9/2(I)/4F9/2(II) -->4I15/2 transitions of Er3+ Stark sublevels. The fluorescence intensity ratios (FIR), which are corresponding to the transitions of 2H11/2/(4S3/2(I)+4S3/2(II))--> 4I5/2, 4S3/2(I)/4S3/2(II) -->4I15/2, and 4F9/2(II)/4F9/2(II) -->4I15/2, have been studied as a function of temperature in the range of 303 673 K. The temperature sensitivities have been calculated at the maximum value of 0.0020 K-1, 0.0015 K-1, and 0.0011 K-1 at the temperatures of 427 K, 350 K, and 273 K for the three coupled energy level transitions, respectively. The Er3+-Yb3+-Li+ codoped Ti02 phosphor with different temperature sensitivities by Stark sublevels indicated that it is a promising material for application in optical temperature sensing at a wide range of temperature.

Upconversion Luminescence Properties of Er3+ Doped Yb2Ti20 Nanophosphor by Gd3+ Codoping

Er3+ doped Yb2Ti207 nanophosphors by Gd3+ codoping with nominal composition of (Er0.05Yb0.95-xGd3+)2Ti2O7 (x = 0, 0.2, 0.4, 0.6, 0.8, and 0.95) have been prepared by sol-gel method. Er3+-Gd3+ codoped Yb2Ti2O7 was characteristic of a typical face-centered cubic crystal phase, and the unit cell parameter increased linearly with the increase of Gd3+ concentration. Under a 976 nm laser diode excitation, both green and red upconversion emissions were observed and the upconversion emissions were enhanced significantly by Gd3+ codoping, showing the strongest green and red emissions at 80 mol% Gd3+ codoping. The intensity ratio of green to red emissions (Igreen/Ired) increased monotonously with the increase of Gd3+ concentration. The energy transfer between Yb3+ and Er3+ and the variation of local crystal field symmetry of Er3+ by the substitution of Yb3+ by Gd3+ ions led to the improvement of upconversion properties of Er3+-Gd3+ codoped Yb2TiO7 nanophosphors.