Identification and Characterization of Major Constituents in Different-Colored Rapeseed Petals by UPLC-HESI-MS/MS

Oilseed rape (Brassica napus L.) is the second highest yielding oil crop worldwide. In addition to being used as an edible oil and a feed for livestock, rapeseed has high ornamental value. In this study, we identified and characterized the main floral major constituents, including phenolic acids and flavonoids components, in rapeseed accessions with different-colored petals. A total of 144 constituents were identified using ultrahigh-performance liquid chromatography-HESI-mass spectrometry (UPLC-HESI-MS/MS), 57 of which were confirmed and quantified using known standards and mainly contained phenolic acids, flavonoids, and glucosinolates compounds. Most of the epicatechin, quercetin, and isorhamnetin derivates were found in red and pink petals of B. napus, while kaempferol derivates were in yellow and pale white petals. Moreover, petal-specific compounds, including a putative hydroxycinnamic acid derivative, sinapoyl malate, 1-O-sinapoyl-β-d-glucose, feruloyl glucose, naringenin-7-O-glucoside, cyanidin-3-glucoside, cyanidin-3,5-di-O-glucoside, petunidin-3-O-β-glucopyranoside, isorhamnetin-3-O-glucoside, kaempferol-3-O-glucoside-7-O-glucoside, quercetin-3,4'-O-di-β-glucopyranoside, quercetin-3-O-glucoside, and delphinidin-3-O-glucoside, might contribute to a variety of petal colors in B. napus. In addition, bound phenolics were tentatively identified and contained three abundant compounds (p-coumaric acid, ferulic acid, and 8-O-4'-diferulic acid). These results provide insight into the molecular mechanisms underlying petal color and suggest strategies for breeding rapeseed with a specific petal color in the future.

[Construction of swept source optical coherence tomography imaging system for root canal endoscopy and application in diagnosis of root fractures]

OBJECTIVE

To construct swept source optical coherence tomography (SS-OCT) imaging system for root canal endoscopy, and to evaluate the accuracy of diagnosing artificial root fractures.

METHODS

An ultra-high-speed (40 kHz) swept laser source was developed based on the piezoelectric tuning filter and the Fourier domain mode locking (FDML) swept laser technology (patent number: 200620135940.2). Ultra-miniature gradient index lens technology (patent number: 201320241218.7) was used to create a thin endoscopic probe with a diameter of 0.86 mm for real-time image transmission. The SS-OCT light source had a wavelength of 1 310 nm and a bandwidth of 100 nm. The axial and transverse image resolutions were 15 μm and 25 μm, respectively. Artificial fractures were created on human mandibular premolars with single root and the premolar roots were prepared to 41 horizontal sections (1 mm thick). 27 root sections with fractures (width: 52-284 μm) and 14 the sections without fractures were observed under an optical stereomicroscope with a cold light source as the gold standard. The horizontal root sections were scanned by self-developed SS-OCT imaging system for root canal endoscopy with a central wavelength of 1 310 nm and bandwidth of 100 nm. The data were reconstructed with 30 μm thick slices at an interval of 30 μm. Two observers, a radiologist and an endodontist, were trained and independently evaluated all the reconstructed images blindly. The diagnostic performance of SS-OCT imaging system was calculated, and statistical analysis was performed.

RESULTS

SS-OCT root canal endoscopic imaging system composed of high-speed swept laser source, fiber coupler, endoscopic probe, reference arm and differential detector. Root sections could be scanned by SS-OCT and imaged in realtime at a depth of 1 to 2 mm. The kappa value for interobserver agreement was 0.792, and the intraobserver agreement was 1.000 and 0.709 for two observers respectively. All of 27 fractured root sections and 12 of 14 root sections without fractures were accurately diagnosed while 2 unfractured root sections were misdiagnosed. The sensitivity was 1.000 and the specificity was 0.857 for diagnosis of artificial root fractures by SS-OCT. The positive predictive value (PPV), negative predictive value (NPV) and the overall accuracy rate were 0.931, 1.000 and 0.951 respectively.

CONCLUSION

The swept source optical coherence tomography imaging system for root canal endoscopy is a promising imaging method for observing root fractures．.

[The influence of probiotics and synbiotics on intestinal inflammation and microbiota in mice with acute colitis]

Objective: To investigate the effects of probiotics and synbiotics on inflammation and microbiota of acute colitis in mice. Methods: C57BL/6J mice were divided into 4 groups randomly. Each group had 10 mice and was given 2.5% dextran sulfate sodium (DSS) drinking water for 5 days other than the blank control group. Except for model control group, other two groups were administrated with probiotics and synbiotics, respectively. Probiotics was composed of Lactobacillus acidophilus, Lactobacillus rhamnosus and Bifidobacterium lactis, while synbiotics was composed of the aforementioned probiotics, inulin and galactooligosaccharide. Feces of different periods and mucosa samples were collected to analyze the differences of enteric flora by 16s rDNA sequencing. Results: (1) Pathological scores in probiotics group and synbiotics group were 5.40±2.79 and 7.25±2.87, respectively, which were significantly lower than those in the model control group with scores 27.00±7.94. Model control group, probiotics group and synbiotics group showed lower flora diversity, increased Bacteroides and decreased Faecalibacterium than blank control group. The mucosal microbiota was different from fecal flora in abundance and species for each group, and Mucispirillum was more common in mucosa. Conclusions: Probiotics and synbiotics alleviate the inflammation of acute colitis in mice. Imbalance of beneficial genera to harmful genera is the characteristic of acute colitis. Supplementation of probiotics and synbiotics contributes to regulating the balance of intestinal microbiota.

Evolutionary and Comparative Expression Analyses of TCP Transcription Factor Gene Family in Land Plants

The plant-specific Teosinte-branched 1/Cycloidea/Proliferating (TCP) transcription factor genes are involved in plants' development, hormonal pathways, and stress response but their evolutionary history is uncertain. The genome-wide analysis performed here for 47 plant species revealed 535 TCP candidates in terrestrial plants and none in aquatic plants, and that TCP family genes originated early in the history of land plants. Phylogenetic analysis divided the candidate genes into Classes I and II, and Class II was further divided into CYCLOIDEA (CYC) and CINCINNATA (CIN) clades; CYC is more recent and originated from CIN in angiosperms. Protein architecture, intron pattern, and sequence characteristics were conserved in each class or clade supporting this classification. The two classes significantly expanded through whole-genome duplication during evolution. Expression analysis revealed the conserved expression of TCP genes from lower to higher plants. The expression patterns of Class I and CIN genes in different stages of the same tissue revealed their function in plant development and their opposite effects in the same biological process. Interaction network analysis showed that TCP proteins tend to form protein complexes, and their interaction networks were conserved during evolution. These results contribute to further functional studies on TCP family genes.

[Impact of cessation of antiviral therapy at delivery on postpartum liver function in mothers with chronic hepatitis B virus infection]

Objective: To investigate the impact of immediate cessation of antiviral therapy on postpartum liver function and the factors influencing postpartum abnormality in mothers with chronic hepatitis B virus infection. Methods: A retrospective cohort study was conducted. One hundred eighty-eight pregnant women with HBV DNA level > 2×106 IU/ml were enrolled from June 2014 to June 2018. Demographic information and clinical data of liver function and HBV DNA load during gravidity, intrapartum and postpartum period were collected. According to the antiviral treatment recommendations during pregnancy, the women were divided into three groups, namely, tenofovir (TDF), telbivudine (LdT) and control group. Liver function abnormalities among the three groups were compared within 6 months after delivery, and the factors influencing abnormal liver function were analyzed by unconditional logistic regression. Results: Of the 188 cases, 72 cases were in the TDF group, 80 cases in the LdT group, and 36 cases in the control group. Pregnant women in the TDF and LdT groups received oral TDF (300 mg/d) and LdT (600 mg/d) from 28 ± 4 weeks of gestation till delivery. Among the 188 patients, 30 (16.0%) had abnormal postpartum liver function abnormality. The incidence of postpartum liver function abnormality [alanine aminotransferase (ALT) > 2 × upper limit of normal (ULN)] in the TDF, LdT, and control groups was 19.4%, 12.5%, and 16.7%, respectively. The postpartum peak levels of ALT (median, range) in the three groups were 34.5 (12.0-946.0) U/L, 37.5 (12.0-733.8) U/L, and 39.0 (7.0-513.0) U/L, respectively. There was no significant difference between the two indexes among the three groups (P > 0.05). There was no statistically significant difference in the degree of postpartum liver function abnormalities between the three groups (P = 0.944). Most of the liver function abnormalities were mild to moderate (2 × ULN≤ALT < 10 × ULN), and usually resolved spontaneously or by treatment. Univariate and multivariate analysis showed that baseline ALT level during pregnancy was an independent factor associated with postpartum liver function abnormality (OR = 1.031, CI 95%: 1.005-1.058; χ(2) = 5.340, P = 0.021), whereas age, antiviral therapy, HBeAg-positivity, baseline HBV DNA levels, gravidity, parity, preterm delivery and delivery mode were not significantly associated with postpartum liver function abnormality. Conclusion: Cessation of antiviral therapy after delivery did not significantly increase the risk of postpartum liver function abnormality in pregnant women with chronic HBV infection. The ALT level during pregnancy is a factor influencing postpartum liver function abnormality.

[Diagnostic value analysis of capsule endoscopy in obscure gastrointestinal bleeding patients of different ages]

Objective: To evaluate the diagnostic value of capsular endoscopy in patients with obscure gastrointestinal bleeding (OGIB) in different age groups, and assess its effectiveness and safety. Methods: A total of 216 patients who were diagnosed with OGIB between March 2005 and March 2016 at Department of Gastroenterology of Peking Union Medical College Hospital were retrospectively reviewed. They were assigned into three groups: young adults, middle-aged and elderly. The demographic characteristics, clinical manifestations, working performance as well as endoscopic features in each group were collected and analyzed. Results: The detection rate and diagnosis rate of the young adults and middle-aged group were 98.53% vs 98.51% (P=0.992), 92.65% vs 91.04% (P=0.734), while those between the young adults and the elderly group were 98.53% vs 91.14% (P=0.109), 92.65% vs 87.34% (P=0.289), and 98.51% vs 91.14% (P=0.113) and 91.04% vs 87.34 (P=0.475) between the middle-aged and elderly group. No significant difference existed in either detection rates nor diagnostic rates between the different age groups. The distribution of the small intestinal lesions varied between the different age groups. The top three common lesions in young adults were vascular malformation, small intestine ulcer and Crohn's disease, while in the middle-aged group vascular malformation, non-specific enteritis and small intestine ulcer were the most common. Patients in elderly group were most likely to have vascular malformation, small intestine ulcer and erosion. Conclusions: For patients of any age with OGIB, capsule endoscopy is a safe, effective and comfortable examination which can be widely used in clinical practice.

[Correlations between gastric Helicobacter pylori infection and colorectal polyps or cancer]

Objective: To investigate the correlations between gastric Helicobacter pylori (Hp) infection and colorectal polyps or cancer. Methods: Among patients who finished colonoscopy exams in Peking Union Medical College Hospital (PUMCH) between May 2012 and May 2017, 3 483 patients were diagnosed with colorectal polyps, 135 patients with newly diagnosed colorectal cancer. A total of 1 925 healthy subjects were enrolled as normal controls. Gastric rapid urease tests (RUT) were done in all patients. General clinical data, RUT results, sizes and numbers of polyps, cancer location were analyzed. Results: The proportion of Hp infection in patients with colorectal polyps was 31.5%, higher than that in healthy controls. The odds ratio (OR) of Hp infection in polyp group was 1.17 (95%CI 1.04-1.32) after age and gender were adjusted. The Hp infection rate in patients with polyps over or equal to 1 cm was significantly higher than that in patients with polyps smaller than 1 cm. Patients with more than 1 polyps presented a higher rate of Hp infection than patients with only 1 polyp. Hp infection rate in patients with colorectal cancer was 36.3%, with the adjusted OR 1.56 (95%CI 1.06-2.30). The location of colorectal cancer was not correlated with Hp infection. Conclusions: Gastric Hp infection is more common in patients with colorectal polyps than in healthy controls. Polyps ≥1 cm, multiple polyps and colorectal cancer are correlated with higher rates of Hp infection. Cancer location is irrelevant to Hp infection.

[Clinical application of computed tomography angiography and three-dimensional reconstruction in repairing high-voltage electrical burn wounds in necks, shoulders, axillas, and upper arms with tissue flaps]

Objective: To explore the application value of computed tomography angiography (CTA) and three-dimensional reconstruction in repairing high-voltage electrical burn wounds in necks, shoulders, axillas, and upper arms with tissue flaps. Methods: From December 2014 to December 2018, 12 patients with high-voltage electrical burns in necks, shoulders, axillas, and upper arms were hospitalized. The size of wounds ranged from 13 cm×10 cm to 32 cm×15 cm after complete debridement. Before tissue flap repair, the subclavian artery-axillary artery-brachial artery and their branches were examined by CTA. The main target vessels and their branches were conducted by three-dimensional reconstruction, and the development of the axis vessels for the tissue flaps planning to dissect and their branches were observed. For wounds in upper arms, amputation stump bone exposed wounds, and wounds in axillas and the anterior, the latissimus dorsi myocutaneous flap is the first choice for repair, if the thoracodorsal artery and internal and external branches are well developed according to CTA examination. Latissimus dorsi myocutaneous flaps were used in 6 patients with the area of myocutaneous flap ranging from 16 cm×12 cm to 32 cm×17 cm. All the donor sites were covered by split-thickness skin graft of thighs. For large wounds in occiputs, necks, and scapulas, the contralateral lower trapezius myocutaneous flap is the first choice for repair, if the superficial descending branch and deep branch of the contralateral transverse cervical artery are well developed according to CTA examination. For small wounds in necks and scapulas, the ipsilateral lower trapezius myocutaneous flap can be used for repair, if the superficial descending branch of the ipsilateral transverse cervical artery is well developed according to CTA examination. Lower trapezius myocutaneous flaps were used in 4 patients with the area of myocutaneous flap ranging from 18 cm×12 cm to 25 cm×17 cm. The donor site of one patient was sutured directly and the donor site of the other 3 patients was covered by split-thickness skin graft of thighs. For wounds in the posteromedial side of upper arms and the anterior side of axillas, the lateral thoracic skin flaps can be used for repair, if the latissimus dorsi myocutaneous flap can not be utilized for reasons of back burn or no muscle is needed for dead space, when the blood supply of side chest skin is reliable according to CTA examination. Lateral thoracic skin flaps were used in 2 patients with the area of skin flap ranging from 16 cm×12 cm to 17 cm×14 cm. The donor site of one patient was sutured directly and the donor site of the other one patient was covered by split-thickness skin graft of thigh. Results: During the operation of tissue flap repair in 12 patients, the orientation and starting position of the axis vessels were consistent with those observed by CTA examination before operation. All the tissue flaps survived after operation. During follow-up of 1 to 24 months, the patients were satisfied with no serious scar contracture affecting the function nor secondary infection or chronic ulcer. Conclusions: CTA and its three-dimensional reconstruction technique can clearly reconstruct the subclavian artery-axillary artery-brachial artery and their branches before repair of high-voltage burn wounds in necks, shoulders, axillas, and upper arms. It can be used to observe whether the vessels are embolized or not and the starting position and orientation of blood vessels, which can provide an important reference for the selection of tissue flap transplantion.

[Trend of clinical features in patients with acute coronary syndrome undergoing emergent percutaneous coronary intervention]

Objective: To investigate the clinical features and change trend of patients with acute coronary syndrome(ACS) undergoing emergent percutaneous coronary intervention(PCI). Methods: In this retrospective study, we retrieved all medical records of 4 907 ACS patients who underwent emergent PCI in Fuwai hospital from January 1,2010 to December 31,2016. We analyzed the clinical features and change trend in these patients. According to clinical diagnosis, patients were grouped as ST-elevated myocardial infarction(STEMI) group (3 719 cases) and NSTE-ACS group (patients with non-STEMI and unstable angina, 1 188 cases). Results: The ACS patients were aged (59.5±11.8) years old. There were 3 772 males and 1 135 females. The annual number of ACS patients underwent emergent PCI increased from 412 patients in 2010 to 1 067 patients in 2016. The number of NSTE-ACS patients increased from 11.4% (47/412) in 2010 to 26.5% (283/1 067) in 2016. Compared with STEMI group, patients in NSTE-ACS group were significantly older ((61.2±10.9) years old vs. (58.9±12.1) years old,P<0.01).The percent of female patients (30.1% (358/1 188) vs. 20.9% (777/3 719), P < 0.01), history of hypertension (69.1% (821/1 188) vs. 60.4% (2 248/3 719,P <0.01), previous PCI (25.8% (307/1 188) vs. 12.4% (461/3 719), P <0.01), and previous coronary artery bypass grafting (3.0% (36/1 188) vs. 1.0% (37/3 719), P <0.01) were all significantly higher in NSTE-ACS group than in STEMI group. On the other hand, NSTE-ACS patients presented less chronic renal failure (2.9% (35/1 188) vs. 4.3% (173/3 719), P <0.05) and hepatic dysfunction (8.5% (101/1 188) vs. 13.3% (495/3 719), P<0.01) as compared to ACS patients. In coronary angiography, NSTE-ACS patients had a higher prevalence of left-main disease (14.0% (166/1 188) vs. 7.8% (291/3 719), P<0.012 5) and triple vessel disease (47.8% (568/1 188) vs. 43.5% (1 619/3 719), P<0.012 5). There were no differences in prevalence of diabetes mellitus (31.9% (1 187/3 719) vs. 34.8% (414/1 188),P>0.05) and acute renal failure (0.1% (38/3 719) vs. 0.6% (7/1 188),P>0.05) between STEMI group and NSTE-ACS group. Conclusions: This single center retrospective analysis reveals that there is an increasing trend of NSTE-ACS patients from 2010 to 2016. Furthermore, there are more high-risk clinical characteristics in NSTE-ACS patients than in STEMI patients.

[The 465th case: intestinal obstruction, gastrointestinal hemorrhage and duodenal fistula]

This is a complicated and difficult case. The onset symptom of a 62-year-old male was recurrent intestinal obstruction. Ileocecal and ileocolic operation was done twice. Massive gastrointestinal bleeding occurred due to giant fistula of descending duodenum, which connected to ileocolic anastomosis. After consultation by multidisciplinary team, jejunal-feeding tube was placed to provide enteral nutrition. With general condition improving, duodenal fistula repair and involved bowel resection were performed. Postoperative pathology confirmed Crohn's disease. The patient was treated with thalidomide and recovered well during follow-up.

[Contemporary use of ticagrelor in patients with acute coronary syndrome after discharge]

Objective: To investigate the degree and determinants of using ticagrelor among discharged patients with acute coronary syndrome (ACS). Methods: Patients with ACS in Fuwai hospital who were given ticagrelor after discharge between Jan. 2015 to Jun. 2015 were analyzed.The clinical characteristics and adherence to ticagrelor of these patients were collected by reviewing the electronic medical records and telephone interview.Date were statistically-analyzed. Results: Among all screened 404 patients, 158 (39.1%) patients prematurely stopped ticagrelor within 12 months, while 119(29.5%) patients switched from ticagrelor to clopidogrel.Unavailable locally (34.8%), economic reasons (17.7%) and hemorrhagic events (18.4%) were the main causes of the premature discontinuation of ticagrelor.Univariate analysis showed left main disease (P=0.04) and the frequency of outpatient follow-up (P<0.01) as relative factors for prematurely stopping ticagrelor outside hospital after discharge.Multivariate analysis revealed medical insurance payment (OR 1.79, 95%CI 1.03-3.11) and the frequency of outpatient follow-up (OR 0.61, 95%CI 0.43-0.86) as independent predictors of prematurely stopping ticagrelor outside hospital.Prematurely stopping ticagrelor has no significant effect on the ischemic events (myocardial infaction or stroke) (P=0.76). Conclusion: Social cinditions is the main factor for the persistence to ticagrelor among ACS patients after dischcrge.Medical insurance payment and low frequency of outpatient follow-up were independent predictors of prematurely stopping ticagrelor and it may not have impact on ischemic events.

Genome-Wide Identification and Expression Profiling of Cytokinin Oxidase/Dehydrogenase (CKX) Genes Reveal Likely Roles in Pod Development and Stress Responses in Oilseed Rape (Brassica napus L.)

Cytokinin oxidase/dehydrogenases (CKXs) play a critical role in the irreversible degradation of cytokinins, thereby regulating plant growth and development. Brassica napus is one of the most widely cultivated oilseed crops worldwide. With the completion of whole-genome sequencing of B. napus, genome-wide identification and expression analysis of the BnCKX gene family has become technically feasible. In this study, we identified 23 BnCKX genes and analyzed their phylogenetic relationships, gene structures, conserved motifs, protein subcellular localizations, and other properties. We also analyzed the expression of the 23 BnCKX genes in the B. napus cultivar Zhong Shuang 11 ('ZS11') by quantitative reverse-transcription polymerase chain reaction (qRT-PCR), revealing their diverse expression patterns. We selected four BnCKX genes based on the results of RNA-sequencing and qRT-PCR and compared their expression in cultivated varieties with extremely long versus short siliques. The expression levels of BnCKX5-1, 5-2, 6-1, and 7-1 significantly differed between the two lines and changed during pod development, suggesting they might play roles in determining silique length and in pod development. Finally, we investigated the effects of treatment with the synthetic cytokinin 6-benzylaminopurine (6-BA) and the auxin indole-3-acetic acid (IAA) on the expression of the four selected BnCKX genes. Our results suggest that regulating BnCKX expression is a promising way to enhance the harvest index and stress resistance in plants.

[Retrospective analysis of auditory neuropathy patients after cochlear implantation]

Objectives: To study an effects on hearing ability and speech performance of the patients with auditory neuropathy (AN) after cochlear implantation (CI). Methods: Thirty-five AN patients (26 males and 9 females) after CI in our center since 2007 were chosen, including 5 postlingual patients (implanted age from 14.3 to 38.6 years old) and 30 prelingual patients (implanted age from 1.1 to 13.7 years old). Hearing sensitivity and speech performance were estimated via following methods: (1) implanted hearing thresholds by sound field audiometry; (2) speech audiometry, including monosyllable, disyllable and sentences recognition test by computer-controlled software and sentence recognition test under noise condition (signal to noise ratio=+ 10dB); (3) Mandarin Early Speech Perception test (MESP), Mandarin Pediatric Speech Intelligibility test (MPSI), MAIS, or IT-MAIS for prelingual AN implantees. Results: The average implanted hearing threshold (250-4 000 Hz) was (41.1±11.7) dBHL in 22 AN implantees, while those prelingual implantees was (39.1±10.9) dBHL, and (44.9±12.3) dBHL in postlingual implantees. Speech audiometry were implemented in four of 5 postlingual AN implantees, the results showed increasing tendency in monosyllable recognition scores, dramatic individual variation in computer-controlled disyllable and sentences recognition test, and poor scores (<30%) in speech recognition test in noise condition. Four of 30 prelingual implantees reconstruct their speech recognition ability within 1-3 years after switch-on, characterized as recognition scores (>60%) in monosyllable, disyllable and sentences. The one of prelingual implantee gained recognition scores of speech in noise within 1 year after switch-on. MAIS or IT-MAIS were implemented in twenty-five prelingual implantees, the average score in these patients was 28.6±11.7. Conclusion: Cochlear implant can improve the hearing thresholds of AN patients, however, the improvement in speech performance presented significant variations among the implanted individuals.

[Expression of hypoxia-inducible factor 1α is associated with lymph node metastasis in oral squamous cell carcinoma]

OBJECTIVE

To explore the association between hypoxia-inducible factor 1α (HIF-1α) expression and lymph node metastasis in oral squamous cell carcinoma (OSCC).

METHODS

Tumor specimens from 125 patients with histologically-proven, surgically-treated OSCC were examined by immunohistochemical staining for expression of HIF-1α. The patients were divided into two groups by the expression of HIF-1α, high expression of HIF -1α group (H-group) and low expression of HIF-1α group (L-group). The main assessment parameters were lymph node metastasis rate and disease-specific survival (DSS). The lymph node metastasis rate and clinicopathologic features were compared using Mann-Whitney test. The Kaplan-Meier curve was generated for each group and compared using the log-rank test. Cox proportional hazard models were utilized for multivariate analyses of HIF-1α expression and other baseline factors with DSS. All calculations and analyses were performed using the SPSS 17.0 software package.

RESULTS

The protein expression levels of HIF-1α were up-regulated in OSCC and two patients were unable to evaluate. There were 48 patients in L-group and 75 patients in H-group. Lymph node metastasis rate was 37.5% (18/48) for L-group and 58.7% (44/75) for H-group (P=0.027). Expression of HIF-1α was significantly correlated with lymph node metastasis. The patients of L-group had a significantly better DSS than the patients of H-group (70.8% vs. 46.7%, P=0.005), while the patients of L-group had a significantly better disease-free survival (DFS) than the patients of H-group (60.4% vs. 36.0%, P=0.009) by Kaplan-Meier method. A multivariate survival analysis also showed that HIF-1α expression (HR=2.164, 95%CI: 1.150-4.074, P=0.017) and T-stage (HR=1.387, 95%CI: 1.066-1.804, P=0.015) both were the independent factors associated with prognosis.

CONCLUSION

HIF-1α expression is significantly correlated with lymph node metastasis in OSCC. HIF-1α expression is an independent predictive factor for prognosis of OSCC patients, and may serve as a potential biomarker for molecular diagnosis and targeted therapy in future.

[Dosimetric analysis of volumetric modulated arc therapy and intensity modulated radiotherapy for patients undergone breast-conserving operation]

OBJECTIVE

To compare the dosimetric differences between volumetric modulated arc therapy and intensity modulated radiotherapy for breast cancer patients after breast-conserving surgery.

METHODS

Ten patients who received radiotherapy after breast-conserving surgery were selected. Eclipse planning system was used to design volumetric rotating intensity-modulated (2F-RapidArc) and two field intensity-modulated radiation therapy (2F-IMRT) planning for each patient. 2F-RapidArc plans were made using two partial arcs with gantry rotation from 287°-293° to 152°-162°, and 0° to 90 ° was avoidance sector. The gantry angle of 2F-IMRT were 301°-311° and 125°-135°. The prescription dose was 46 Gy/23 fractions. All plans required 95% of the target volume receiving the prescription dose. The dose distribution of the target, organs at risk, machine unit (MU) and treatment time were compared.

RESULTS

2F-RapidArc and 2F-IMRT plans' uniformity index was 1.12±0.02 and 1.11±0.03 (P=0.282), respectively; conformal index was 0.80±0.03 and 0.65±0.04 (P<0.001), respectively. V110 of plan target volume was 20.98%±14.47% and 10.43%±10.49% (P=0.030), respectively. Compared with the 2F-IMRT, 2F-RapidArc plans had a higher dosimetric parameters for left lung: V5 (48.06%±17.32% vs. 24.23%±6.56%,P=0.001), V10 (28.89±9.28 vs.17.07±4.78%,P=0.004), Dmean [(9.70±2.14) Gy vs. (6.86±1.77) Gy, P=0.002], increased the double lung: V5 (22.85%±7.55% vs. 11.01%± 2.95%,P=0.001), V10 (13.16%±4.33% vs. 7.76%± 2.16%, P=0.006), Dmean [(4.66±0.95) Gy vs. (3.17±0.82) Gy, P=0.001], reduced the left lung: V40 (3.58%±1.46% vs. 6.19%±3.04%, P=0.006), reduced the double lung: V40 (1.61%±0.64% vs. 2.81%± 1.39%,P=0.005), increased cardiac: V5 (39.3%±17.19% vs. 8.79%±4.24%, P<0.001), V10 (21.31%±13.8% vs. 5.73%±3.42%, P=0.002), V20 (7.80%±6.08% vs. 4.05%±2.85%,P=0.018), Dmean [(0.64±0.25) Gy vs. (0.29±1.39) Gy,P<0.001],reduced the heart: V40(0.50%±0.40% vs. 1.86%±1.94%,P=0.037),increased the contralateral breast Dmean [(1.63±1.26) Gy vs. (0.09±0.05) Gy, P=0.004]. Compared with 2F-IMRTplan, 2F-RapidArc increased the treatment time [(132.9±7.2) s vs. (140.3±11.6) s, P=0.030]. Both the machine units were almost the same [(467.0±30.4) MU vs. (494.7±44.9) MU, P=0.094].

CONCLUSION

Both 2F-RapidArc and 2F-IMRT plans could reach the clinical requirements. 2F-RapidArc had a better conformal index, reduced the high dose area, but increased the low dose regions of the lung, heart, body area, and increased the average dose of the contralateral breast. The treatment time of 2F-RapidArc was longer than that of 2F-IMRT, and the MU of 2F-RapidArc and 2F-IMRT plans were almost the same.

[Value of evaluating the coronary collateral circulation by transluminal attenuation gradient in patients with chronic total occlusion and related influencing factors]

Objective: To observe the value of evaluating the coronary collateral circulation of chronic total occlusion (CTO) by transluminal attenuation gradient (TAG) and Rentrop grading, and analyze the influencing factors for coronary collateral circulation. Methods: A total of 179 CTO patients admitted to Beijing Anzhen hospital during June 2013 to August 2016 were included in this study.All patients received coronary computed tomographic angiography (CCTA) examination before coronary angiography.Finally, 75 patients (79 vessels) were enrolled.Patients were divided into two groups on the basis of Rentrop classification.The Rentrop 3 was defined as a well-developed coronary collateral circulation group, including 50 CTO vessels, Rentrop 2 or below was defined as poorly-developed collateral circulation group, including 29 vessels.TAG values in patients with various Rentrop grades were analyzed.Univariate and multivariate analysis were used to determine the predictors of collateral circulation. Results: TAG increased consistently in proportion to the angiographic extent of collateral flow (TAG was (-33.6±24.4), (-16.5±15.7) and (-12.8±15.8) HU/10 mm in patients with Rentrop grade 0 or 1, 2 and 3, respectively, P=0.007). Number of good collateral circulation vessels predicted by TAG≥15.6 HU/10 mm was 45(57.0%, 45/79), and 50 (63.3%, 50/79) by Rentrop grade (P=0.383). Prevalence of diabetes was significantly lower (20.8%(10/48) vs. 48.1%(13/27), P=0.01), while history of previous myocardial infarction (MI) was significantly higher (35.4%(17/48) vs. 11.1%(3/27), P=0.02) in patients with good collateral circulation than in patients with poor collateral circulation.The TAG of the good collateral circulation group was significantly higher than in poorly collateral circulation group ((-12.8±15.8) HU/10 mm vs. (-21.2±19.6) HU/10mm, P=0.041). Multiple logistic regression analysis revealed that history of MI (OR=0.196, 95%CI 0.041-0.936, P=0.041) and diabetes(OR=6.604, 95%CI 1.726-25.274, P=0.006) were independent predictors of coronary collateral circulation. Conclusions: TAG could be used to evaluate status of coronary collateral circulation.Presence of MI history and absence of diabetes history are the two independent predictors of well-developed coronary collateral circulation in CTO patients.

[SOX10 mutation is relevant to inner ear malformation in patients with Waardenburg syndrome]

Objective: To determine the relevance between the SOX10 mutation and Waardenburg syndrome (WS) accompanied with inner ear abnormality by analyzing the inner ear imaging results and molecular and genetic results of the WS patients with the SOX10 mutation. Methods: This study included 36 WS in patients during 2001 and 2015 in the department of otorhinolaryngology head and neck surgery, Chinese Peoples's Liberation Army General Hospital. The condition of the inner ear of each patient was assessed by analyzing HRCT scans of the temporal bone and MRI scans of the brain and internal auditory canal. Meanwhile, the possible pathogenic genes of WS, including SOX10, MITF, and PAX3, were also screened. Patients were divided into two groups according to SOX10 mutation.The Fisher accuracy test was used to determine statistical difference of inner ear deformation incidence between the two groups. Results: Among all 36 patients, 12 were found to have inner ear abnormality. Most abnormalities were posterior semicircular canal deformations, some accompanied with cochlear deformation and an enlarged vestibule. Among all patients, 9 patients were SOX10 heterozygous mutation carriers, among which six showed bilateral inner ear abnormality. Fisher accuracy test results suggested a significant correlation between the SOX10 mutation and inner ear abnormality in WS patients (P=0.036). Conclusion: This study found that WS patients with the SOX10 mutation are more likely to have deformed inner ears when compared to WS patients without the SOX10 mutation.

[An analysis of clinical characteristics of twelve cases of mesenteric panniculitis]

Objective: Mesenteric panniculitis is an idiopathic, uncommon disease involving the adipose tissue of mesentery. The etiology, diagnosis and treatment are still unnoticed. We thus reported a case series to improve the understanding of this rare disorder. Methods: We retrospectively analyzed the clinical data of 12 patients with mesenteric panniculitis including manifestation, diagnosis, treatment and prognosis. Results: We found a male predominance (M∶F 3∶1) with the median age of 58 years old at diagnosis. The most common symptom was abdominal pain (9/12), followed by abdominal distension (3/12) and weight loss (3/12). Physical examination was unremarkable in the majority of patients (8/12). C reactive protein (9/12) and erythrocyte sedimentation rate (10/12) were normal in majority of patients. CT findings were of much diagnostic value. All patients had small intestinal mesentery involvement and multi-nodular appearance with increased fat density. Pseudo-capsule sign (8/12) and fat halo sign (6/12) were common. Pathological diagnosis was obtained in 4 cases showing fat tissue inflammation with local necrosis and fibrosis. Six cases all received prednisone, 2 with combined cyclophosphamide, 1 with azathioprine, 1 with tripterygium wilfordii. Short-term clinical response was achieved in all cases, but two patients relapsed. Conclusions: Mesenteric panniculitis occurs predominantly in middle-aged and elderly. Abdominal pain is the leading symptom. Inflammatory markers are often normal while computed tomography is the most important diagnostic tool. Surgery combined with cortical steroid and immunosuppressant agents is effective.

Effect of pregnancy on the proliferation of rat adipose-derived stem cells

Stem cell therapy faces many problems including poor survival rates and low viability. Enhancing the biological functions of stem cells improves efficacy of therapies. Estrogen, whose levels are elevated during pregnancy, affects the properties of bone marrow mesenchymal stem cells. Evidence suggests that adipose-derived stem cells (ADSCs), which are a type of adult mesenchymal stem cells, can be used in regenerative medicine. In fact, ADSCs from pregnant animals have been used in clinical therapies. However, the effect of the donor's reproductive status on proliferation of ADSCs is unknown. We investigated the effect of 17β-estradiol (E2) and progesterone (P) on the in vitro proliferation of ADSCs from laboratory rats. ADSCs were obtained from five different groups of 15 rats each - non-pregnant, pregnant, in perinatal period, non-pregnant and treated with E2, and non-pregnant and treated with P. Adhesion and viability of ADSCs were determined by MTT assay, and cell cycle was followed by flow cytometry. The proliferation rate of ADSCs from pregnant rats was significantly higher than those from the non-pregnant rats (P < 0.05); however, there was no statistically significant difference in proliferation rates during different phases of pregnancy (P > 0.05). Additionally, ADSCs from pregnant rats possess higher adhesion property in early stage (P1 passage) and higher proliferation rate than ADSCs from non-pregnant rats. Interestingly, ADSCs from non-pregnant rats that were treated with E2, but not those treated with P, showed higher proliferation rates than those from their untreated counterparts. These results suggest that the proliferative capacity and residence time in different cell cycle phases of ADSCs can be regulated by extrinsic factors such as estrogen concentration.

[Comparisons of efficacy and safety of levetiracetam versus phenytoin for seizure prophylaxis in patients with brain injury: a meta analysis]

Objective: To systematically review the efficacy, side effects and case-fatality rate of levetiracetam (LEV) versus phenytoin (PHT) for seizure prophylaxis of brain injured patients. Methods: Randomized controlled trials of high quality about LEV versus PHT in seizure prophylaxis of brain injured patients from 2000 to 2016 were collected according to the key word PHT, LEV, brain injury in PubMed, Medline, Ovid, Springer, CNKI, Wanfang data and so on. Valid data were extracted to conduct meta-analysis by RevMan 5.3 software according to inclusion and exclusion criteria. Results: A total of 13 English articles were finally included with 2 529 patients in total.Meta-analysis showed that no significant differences were observed in LEV versus PHT at preventing the occurrence of seizures (RR=0.88, 95%CI: 0.61-1.27). No superiority of either drug at preventing early seizures (RR=0.74, 95%CI: 0.42-1.27). As to the occurrence of late seizures, the differences of the two drugs were not statistically significant (RR=0.71, 95%CI: 0.43-1.20). Number of patients with side effect was not statistically significantly different between the two groups (RR=0.73, 95%CI: 0.48-1.11). But significant difference was found between LEV and PHT in discontinuation because of side effect (RR=0.11, 95%CI: 0.06-0.23); no significant differences were noted in the case-fatality rate of patients received pretreatment between the two drugs (RR=1.57, 95%CI: 0.92-2.67). There were no significant differences between the two groups in the length of stay (WMD=-1.03, 95%CI: -4.97-2.91). Conclusions: LEV and PHT demonstrate equal efficacy in seizure prevention after brain injury. The differences are insignificant in the side effect, the case-fatality rate and the length of stay between LEV and PH treatment, but adverse drug reactions requiring change in therapy occur more in PHT. Phenytoin remains the first choice for seizure prevention after brain injury based on the existing evidence, while levetiracetam seems to be a favorable choice where there is risk of drug-drug interactions and drug toxicity. However, very few randomized controlled trials on this topic were found, and larger prospective trials are warranted.

Genome-Wide Analysis, Classification, Evolution, and Expression Analysis of the Cytochrome P450 93 Family in Land Plants

Cytochrome P450 93 family (CYP93) belonging to the cytochrome P450 superfamily plays important roles in diverse plant processes. However, no previous studies have investigated the evolution and expression of the members of this family. In this study, we performed comprehensive genome-wide analysis to identify CYP93 genes in 60 green plants. In all, 214 CYP93 proteins were identified; they were specifically found in flowering plants and could be classified into ten subfamilies—CYP93A–K, with the last two being identified first. CYP93A is the ancestor that was derived in flowering plants, and the remaining showed lineage-specific distribution—CYP93B and CYP93C are present in dicots; CYP93F is distributed only in Poaceae; CYP93G and CYP93J are monocot-specific; CYP93E is unique to legumes; CYP93H and CYP93K are only found in Aquilegia coerulea, and CYP93D is Brassicaceae-specific. Each subfamily generally has conserved gene numbers, structures, and characteristics, indicating functional conservation during evolution. Synonymous nucleotide substitution (d_N/d_S) analysis showed that CYP93 genes are under strong negative selection. Comparative expression analyses of CYP93 genes in dicots and monocots revealed that they are preferentially expressed in the roots and tend to be induced by biotic and/or abiotic stresses, in accordance with their well-known functions in plant secondary biosynthesis.

[Feasible study for evaluating upper cervical reduction by the clivo-axial angle]

OBJECTIVE

To measure the clivo-axial angle (CAA) and cervicomedullary angle (CMA) in upper cervical deformity patients who underwent computer-assisted posterior upper cervical reduction and fixation surgery, and analyze their correlation.

METHODS

In the study, 25 patients with symptomatic upper cervical deformity were chosen for measurement of preoperative and postoperative CMA and CAA using magnetic resonance imaging (MRI) and intraoperative C-arm. The angle between the clivus plane and the straight line parallel to that of the posterior margin of the C2 vertebral body was defined as CAA; moreover, the angle between the straight line parallel to the ventral side of the cervical spinal cord and the straight line parallel to that of the ventral side of the medulla oblongata was defined as CMA. Two experienced spinal surgeons performed the measurements. The CAA and CMA were measured three times, and the mean value was considered as the result.

RESULTS

Analyses of the CAA and CMA were performed with Wilcoxon rank test, which showed that there was consistency between the CAAs measured with MRI and intraoperative C-arm. The result showed that the postoperative CAA and CMA increased significantly compared with preoperation (P<0.001). Through Spearman rank correlation analysis, the preoperative CAA was positively correlative with the CMA (r=0.902, P<0.001), and so was the postoperative CAA (r=0.921, P<0.001).

CONCLUSION

Preoperative and postoperative CAA in upper cervical deformity patients is significantly correlative with preoperative and postoperative CMA. CAA can be measured during surgery using intraoperative CT or C-arm based three-dimension navigation, and may predict the patient's CMA, which cannot be measured during operation, but is essential for evaluating the decompression and reduction of the spinal cord.

Molecular Mapping and QTL for Expression Profiles of Flavonoid Genes in Brassica napus

Flavonoids are secondary metabolites that are extensively distributed in the plant kingdom and contribute to seed coat color formation in rapeseed. To decipher the genetic networks underlying flavonoid biosynthesis in rapeseed, we constructed a high-density genetic linkage map with 1089 polymorphic loci (including 464 SSR loci, 97 RAPD loci, 451 SRAP loci, and 75 IBP loci) using recombinant inbred lines (RILs). The map consists of 19 linkage groups and covers 2775 cM of the B. napus genome with an average distance of 2.54 cM between adjacent markers. We then performed expression quantitative trait locus (eQTL) analysis to detect transcript-level variation of 18 flavonoid biosynthesis pathway genes in the seeds of the 94 RILs. In total, 72 eQTLs were detected and found to be distributed among 15 different linkage groups that account for 4.11% to 52.70% of the phenotypic variance atrributed to each eQTL. Using a genetical genomics approach, four eQTL hotspots together harboring 28 eQTLs associated with 18 genes were found on chromosomes A03, A09, and C08 and had high levels of synteny with genome sequences of A. thaliana and Brassica species. Associated with the trans-eQTL hotspots on chromosomes A03, A09, and C08 were 5, 17, and 1 genes encoding transcription factors, suggesting that these genes have essential roles in the flavonoid biosynthesis pathway. Importantly, bZIP25, which is expressed specifically in seeds, MYC1, which controls flavonoid biosynthesis, and the R2R3-type gene MYB51, which is involved in the synthesis of secondary metabolites, were associated with the eQTL hotspots, and these genes might thus be involved in different flavonoid biosynthesis pathways in rapeseed. Hence, further studies of the functions of these genes will provide insight into the regulatory mechanism underlying flavonoid biosynthesis, and lay the foundation for elaborating the molecular mechanism of seed coat color formation in B. napus.

Genome-Wide Survey of Flavonoid Biosynthesis Genes and Gene Expression Analysis between Black- and Yellow-Seeded Brassica napus

Flavonoids, the compounds that impart color to fruits, flowers, and seeds, are the most widespread secondary metabolites in plants. However, a systematic analysis of these loci has not been performed in Brassicaceae. In this study, we isolated 649 nucleotide sequences related to flavonoid biosynthesis, i.e., the Transparent Testa (TT) genes, and their associated amino acid sequences in 17 Brassicaceae species, grouped into Arabidopsis or Brassicaceae subgroups. Moreover, 36 copies of 21 genes of the flavonoid biosynthesis pathway were identified in Arabidopsis thaliana, 53 were identified in Brassica rapa, 50 in Brassica oleracea, and 95 in B. napus, followed the genomic distribution, collinearity analysis and genes triplication of them among Brassicaceae species. The results showed that the extensive gene loss, whole genome triplication, and diploidization that occurred after divergence from the common ancestor. Using qRT-PCR methods, we analyzed the expression of 18 flavonoid biosynthesis genes in 6 yellow- and black-seeded B. napus inbred lines with different genetic background, found that 12 of which were preferentially expressed during seed development, whereas the remaining genes were expressed in all B. napus tissues examined. Moreover, 14 of these genes showed significant differences in expression level during seed development, and all but four of these (i.e., BnTT5, BnTT7, BnTT10, and BnTTG1) had similar expression patterns among the yellow- and black-seeded B. napus. Results showed that the structural genes (BnTT3, BnTT18, and BnBAN), regulatory genes (BnTTG2 and BnTT16) and three encoding transfer proteins (BnTT12, BnTT19, and BnAHA10) might play an crucial roles in the formation of different seed coat colors in B. napus. These data will be helpful for illustrating the molecular mechanisms of flavonoid biosynthesis in Brassicaceae species.

Identification of Candidate Genes for Seed Glucosinolate Content Using Association Mapping in Brassica napus L

Rapeseed contains glucosinolates, a toxic group of sulfur-containing glucosides, which play critical roles in defense against herbivores and microbes. However, the presence of glucosinolates in rapeseed reduces the value of the meal as feed for livestock. We performed association mapping of seed glucosinolate (GS) content using the 60K Brassica Infinium single nucleotide polymorphism (SNP) array in 520 oilseed rape accessions. A total of 11 peak SNPs significantly associated with GS content were detected in growing seasons of 2013 and 2014 and were located on B. napus chromosomes A08, A09, C03, and C09, respectively. Two associated regions of GS content covered by these markers were further verified, and three B. napus homologous genes involved in the biosynthesis and accumulation of GS were identified. These genes were multigene family members and were distributed on different chromosomes. Moreover, two genes (BnGRT2 and BnMYB28) associated with GS content were validated by the qRT-PCR analysis of their expression profiles. The further identification and functionalization of these genes will provide useful insight into the mechanism underlying GS biosynthesis and allocation in B. napus, and the associated SNPs markers could be helpful for molecular maker-assisted breeding for low seed GS in B. napus.