[Analysis of treatment modalities and prognosis of patients with gallbladder cancer in China from 2010 to 2017]

Objective: To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China. Methods: This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed. Results: Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn't be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%. Conclusions: More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.

Prescriptive analytics for reducing 30-day hospital readmissions after general surgery

INTRODUCTION

New financial incentives, such as reduced Medicare reimbursements, have led hospitals to closely monitor their readmission rates and initiate efforts aimed at reducing them. In this context, many surgical departments participate in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP), which collects detailed demographic, laboratory, clinical, procedure and perioperative occurrence data. The availability of such data enables the development of data science methods which predict readmissions and, as done in this paper, offer specific recommendations aimed at preventing readmissions.

MATERIALS AND METHODS

This study leverages NSQIP data for 722,101 surgeries to develop predictive and prescriptive models, predicting readmissions and offering real-time, personalized treatment recommendations for surgical patients during their hospital stay, aimed at reducing the risk of a 30-day readmission. We applied a variety of classification methods to predict 30-day readmissions and developed two prescriptive methods to recommend pre-operative blood transfusions to increase the patient's hematocrit with the objective of preventing readmissions. The effect of these interventions was evaluated using several predictive models.

RESULTS

Predictions of 30-day readmissions based on the entire collection of NSQIP variables achieve an out-of-sample accuracy of 87% (Area Under the Curve-AUC). Predictions based only on pre-operative variables have an accuracy of 74% AUC, out-of-sample. Personalized interventions, in the form of pre-operative blood transfusions identified by the prescriptive methods, reduce readmissions by 12%, on average, for patients considered as candidates for pre-operative transfusion (pre-operative hematoctic <30). The prediction accuracy of the proposed models exceeds results in the literature.

CONCLUSIONS

This study is among the first to develop a methodology for making specific, data-driven, personalized treatment recommendations to reduce the 30-day readmission rate. The reported predicted reduction in readmissions can lead to more than $20 million in savings in the U.S. annually.

[Meta-analysis study on occupational wood dust exposure association with chronic obstructive pulmonary disease]

Objective: To clarify the association between occupational exposure to wood dust and chronic obstructive pulmonary disease risk by a meta-analysis. Methods: A systematic search of the studies was conducted using 3 English databases (Pubmed, Embase, and Cochrane library) and 3 Chinese databases (CNKI, WanFang, and VIP) before March 2019. The following key words was used: 1) wood, 2) hardwood, 3) softwood, 4) saw, 5) dust, 6) chronic obstructive pulmonary disease, 7) chronic obstructive airway disease, 8) lung function. A quality score was evaluated by Newcastle-Ottawa Scale, NOS (Wells, 2012). Pooled effect value with 95% confidence interval (CI) was calculated using fixed-effect model (Heterogeneity test I(2)<25%) or random-effect model (Heterogeneity test I(2)≥25%). Meta-regression was used to explore heterogeneous source. Sensitivity analysis was used to verify the stability of the results. Publication bias was assessed by Egger＇s test. Fill and trim method was used to correct the pool effect value with 95%CI for studies which wit publication bias. The TSA threshold was calculated by the O＇Brien-Fleming loss function in the TSA data. The studies were evaluated based on the accrued information size (AIS) . Results: A total of 9 studies were included in the analysis. The occupational exposure to wood dust was not significantly associated with increased chronic obstructive pulmonary disease risk (ES=1.01, 95%CI: 0.856-1.194). TSA showed that the cumulative Z-value curve neither gone beyond the traditional (Z=1.96) threshold line, nor exceed the TSA threshold, but has reached the expected amount of information. This result was consistent with the meta-analysis. Conclusion: This study does not yet consider that COPD is associated with occupational wood dust exposure.

Orbital-Selective Kondo Entanglement and Antiferromagnetic Order in USb_{2}

In heavy-fermion compounds, the dual character of f electrons underlies their rich and often exotic properties like fragile heavy quasiparticles, a variety of magnetic orders and unconventional superconductivity. 5f-electron actinide materials provide a rich setting to elucidate the larger and outstanding issue of the competition between magnetic order and Kondo entanglement and, more generally, the interplay among different channels of interactions in correlated electron systems. Here, by using angle-resolved photoemission spectroscopy, we present the detailed electronic structure of USb_{2} and observe two different kinds of nearly flat bands in the antiferromagnetic state of USb_{2}. Polarization-dependent measurements show that these electronic states are derived from 5f orbitals with different characters; in addition, further temperature-dependent measurements reveal that one of them is driven by the Kondo correlations between the 5f electrons and conduction electrons, while the other reflects the dominant role of the magnetic order. Our results on the low-energy electronic excitations of USb_{2} implicate orbital selectivity as an important new ingredient for the competition between Kondo correlations and magnetic order and, by extension, in the rich landscape of quantum phases for strongly correlated f electron systems.

[The epidemiological characteristics of silicosis cases in Tianjin from 2001 to 2015]

Objective: To provide scientific evidence for the prevention and control measures of silicosis by analyzing the epidemiological characteristics of silicosis cases reported in Tianjin city during 2001-2015. Methods: The database of silicosis cases reported in Tianjin from 2001 to 2015 was established and analyzed by SPSS 24.0 software. Results: 2 213 cases of silicosis were reported during 2001~2015 in Tianjin, 2015 of them were new cases, and fewer reports of promoting stage cases and death cases, which were129 and 69 cases. The new cases were increasing by years, mainly stage I silicosis accounting for 99.2%, the years of dust exposure were concentrated from 1970 to 1989, accounting for 69.58%. From 2001 to 2015, the median length of service at the onset of silicosis was 19.30 years, the age of the onset of silicosis is decreasing. The median of onset age in new cases of silicosis was 53.28 years, and increased year by year. There were significant differences in indirect dust working age and diagnostic age in different reporting years. Most cases were distributed in non-mental mineral product industry, and ferrous metal smelting and rolling processing industry. The work types of these cases are various. Conclusion: The increasing incidence of silicosis and the shortening of dust-exposed working years suggest that the form of silicosis hazards is still severe in Tianjin. According to the epidemic characteristics of silicosis, we should strengthen the supervision and management of key industries and special investigation, carry out silicosis census and silicosis screening of dust-removal workers, and take pertinent measures to prevent and control the occurrence of silicosis.

[Analysis of occurrence characteristics and influencing factors of new occupational diseases in Tianjin city from 2008 to 2017]

Objective: To analyze the characteristics and influencing factors of new occupational diseases in Tianjin from 2008 to 2017, and to provide scientific basis for the formulation of prevention and control measures for occupational diseases in Tianjin. Methods: In 2018, data on the new occupational disease in Tianjin from 2008 to 2017 were collected from the China Disease Prevention and Control Information System. Statistical analysis was performed on the basic situation, the nature of the company, and the distribution of the industry. Results: A total of 5201 cases of occupational diseases were reported in Tianjin from 2008 to 2017, mainly including pneumoconiosis (92.37%) , followed by occupational poisoning (2.88%) , and the third occupational ENT disease (2.31%) . The male cases were higher than females, with a median age of 56 years and a median of 20 years of service. The most reported area was Hedong District (26.86%) . The economic type and scale of the cases belonged to state-owned large and medium-sized enterprises. The industry is mainly composed of non-metallic mineral products, and there are significant differences in the composition ratios of its economic type (χ(2)=19240.00, P<0.01) , enterprise size (χ(2)=3883.00, P<0.01) and industry (χ(2)=52050.00, P<0.01) . Conclusion: Pneumoconiosis, occupational poisoning and occupational ENT diseases are the key prevention and control occupational diseases in Tianjin city. It is necessary to strengthen the prevention and control of occupational diseases in large and medium-sized state-owned enterprises, and to respond to occupational disease hazards in such key industries as the manufacturing industry so as to protect the health of occupational groups.

Interactions between the cecal microbiota and non-alcoholic steatohepatitis using laying hens as the model

Chronic liver disease has caused increasing numbers of deaths worldwide. Fatty liver hemorrhagic syndrome, one of the chronic liver diseases in laying hens, has great similarity to non-alcoholic fatty liver disease (NAFLD) in humans. It is characterized by the pathological accumulation of liver fat. Non-invasive techniques are needed for early identification of fibrosis. As primary de novo lipogenesis in the liver of chicken is similar to that of humans, mature chicken is an ideal animal model for the understanding of NAFLD. This study was aimed to evaluate the relationships between gut microbiota and natural chronic liver disease (i.e., non-alcoholic steatohepatitis [NASH] and fibrosis stages) in a well-characterized laying hen population. One hundred 20-wk-old Hy-Line Brown laying hens were used and fed with basal diets until 52 wk of age. At the end of the experiment, birds were killed for sampling blood, liver, and cecal contents, and then classified by liver histology measurement into different groups. We investigated microbial community structure of cecum using 16S rRNA gene sequencing. Subjects in stage 0 fibrosis without NASH were classified as low NAFLD (Group A), subjects in stage 1-2 fibrosis with mild to moderate NASH were defined as low NASH (Group B), and subjects in stage 3 fibrosis were defined as severe NASH (Group C). The abundance of Firmicutes was reduced in Groups B and C (P < 0.001), whereas opposite results were observed for the abundance of Bacteroidetes. Additionally, the families Bacteroidaceae, Ruminococcaceae Lachnospiraceae, and lactobacillae were significantly different between groups of differing fibrosis stages (P < 0.001), driven entirely by alterations of Bacteroides and lactobacillus and lachnospiraceae genera (P < 0.001), were observed. Results indicated that cecal dysbiosis was linked with the severity of fibrosis and NASH; importantly, increased levels of serum AST, alkaline phosphatase, and uric acid were accompanied with liver fibrosis and NASH severity. Collectively, these data highlight the role of gut-liver axis and associations between the gut microbiota and fibrosis and NASH severity.

Analysis of Detection of Mixed Semen Stains with Different Immunological Test Methods and Case Applications

Objective To perform the separation and confirmation of mixed semen stains with immunological test method, and find a more effective method for the detection of mixed semen stains. Methods The semens of three volunteers were mixed. The mixed semen stains were processed and tested with prostate-specific antigen （PSA） colloidal gold immunoassay strip method, immunomagnetic beads method and laser capture microdissection, respectively. Statistics of the results of STR were gathered and compared with those of a single semen stain. Results After PSA colloidal gold immunoassay strip method testing, the samples showed a purplish red line in the test area and the control area. The results obtained with the immunomagnetic beads method showed a more complete and effective short tandem repeat （STR） sequence. The mixed semen stains were processed with laser capture microdissection and low volume amplified. The results were summarized and superimposed to obtain a complete single typing, which matched the single semen stain typing, with a typing success rate of 84.00%. Single suspect Y-STR typing was obtained with the application of the method above in actual cases, which provided evidence basis for rapid solving of the case. Conclusion The combination of PSA colloidal gold immunoassay strip method, immunomagnetic beads method and laser capture microdissection can be used to separate and confirm the mixed semen stains.

[The role of anatomical hepatectomy in the treatment of intrahepatic cholangiocarcinoma]

Objective: To evaluate the role of anatomical hepatectomy in the treatment of intrahepatic cholangiocarcinoma. Methods: The cases of intrahepatic cholangiocarcinoma who received curative surgery in two hospitals from 2010 to 2015 were analyzed retrospectively. Among the 98 patients enrolled in this study, 55 were male and 43 were female. The median age was 61 years. According to receiving anatomical hepatectomy or not, the 98 cases were divided into two groups: non-anatomical hepatectomy(n=30) and anatomical hepatectomy(n=68). The surgical results were compared between the two groups.Survival curves were plotted by the Kaplan-Meier method and compared by the log-rank test. The influence of each prognostic factor identified by univariate analysis was multivariate analysis by Cox's proportional hazard regression. Results: The duration of surgery was significantly prolonged in the anatomical hepatectomy group((196.4±94.9)minutes vs. (166.2±65.7)minutes, P=0.027), while there was no significant difference in terms of other surgical results such as intraoperative blood transfusion, postoperative morbidity and mortality rate. Compared to non-anatomical hepatectomy, anatomical hepatectomy significantly improved long-term survival results(14 months vs. 11 months)(χ²=4.641, P=0.031). Single variable analysis indicated that tumor differentiation, tumor numbers, T stage, N stage, anatomical hepatectomy and adjuvant therapy significantly affected overall survival. Multivariate analysis demonstrated that tumor numbers(HR=0.522, 95% CI: 0.259-0.974, P=0.042) and anatomical hepatectomy(HR=1.858, 95%CI: 1.092-3.161, P=0.022) were two independent prognostic factors for overall survival. Conclusion: Compared to non-anatomical hepatectomy, anatomical hepatectomy performed for intrahepatic cholangiocarcinoma is not only safe but also beneficial for long-term survival.

[Diagnosis and treatment for unexpected gallbladder carcinoma(a retrospective study of 45 cases)]

Objective: To investigate the rationale for appropriate diagnostic methods and treatment protocols for unexpected gallbladder carcinoma(UGC). Methods: The clinical and pathological data of 45 patients with UGC admitted at Department of General Surgery, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine,from January 2008 to December 2017 were retrospectively collected and analyzed.There were 11 males(28.9%) and 34 females(71.1%),aged 68 years(range:27 to 68 years).And there were 20 cases who aged above 70 years. Twenty-four cases were diagnosed preoperatively as cholecystolithiasis plus chronic cholecystitis.Ten cases were diagnosed preoperatively as cholecystolithiasis plus actue cholecystitis.Six cases were diagnosed preoperatively as cholecystolithiasis plus choledocholith.Six cases were admitted because of gallbladder polyp and 1 case was admitted because of gallbladder adenomyomatosis. Results: Thirty-four patients with UGC received radical surgery.Among them,11 patients experienced postoperative complication and no posterative mortality occoured during hospital stay.Thirteen patients were diagnosed with T1b UGC, the harvested lymph node of Nx, N0, N1 and N2 was 2, 9, 1 and 1, respectively.In addition, 2 cases were identified to have local-regional tumor recurrence during our rescue radical surgery.The median overall survival time of the patients who did not receive radical surgery was 7 months(range:2-56 months).Nevertheless,the median overall survival time for patients diagnosed with T1, T2 and T3 tumors who received radical surgery, was 41 months(range: 19-82 months), 33.5 months(range: 31-36 months) and 17 months(range: 7-46 months), respectively. Conclusions: For patients with UGC, rescue radical surgery can achieve a better survival time.Furhtermore, our experience proved that rescue radical surgery for UGC is safe and feasible.Therefore,rescue radical surgery should be performed in patients with diagnose with UGC especially those T1b patients.

[Prevalence and risk factors of perivascular space in the population of Shunyi Study]

Objective: To investigate the prevalence on imaging, topographic distribution and risk factors of perivascular space (PVS) in community population. Methods: This study was based on the population of Shunyi Study in China from June 2013 to September 2016. One thousand two hundred and thirty-two stroke free participants older than 35 years, who completed cerebral MRI, were included. Cardiovascular risk factors were assessed by interview, physical examination and blood sample tests. PVS were evaluated on high-resolution 3-dimensional-T1WI, T2WI and FLAIR sequences. On T1WI, PVS were detected according to 3D imaging criteria. The number and anatomic location of large PVS (≥3 mm) were recorded. And severity of PVS was then semiquantitatively graded in both white matter (WM) and basal ganglia (BG). Associations between risk factors and PVS were analyzed by multinominal Logistic regression models and adjusted for age, gender and relevant confounders. Results: Perivascular spaces were observed in the BG or WM in every subject, aged (55±10) years and 37.3% male. Large PVS were detected in 19.0% (460/1 232) of participants. Severity of PVS was found to be strongly associated with age in both basal ganglia (severe versus mild: OR=1.81; 95%CI 1.45-2.27, P<0.01) and white matter (OR=1.39; 95%CI 1.13-1.71, P<0.01), and the proportion of subjects with hypercholesterolemia decreased with the severity of PVS in BG (OR=0.58, P=0.01) . The present of large PVS was found to be associated with age(present versus absent: OR=1.03, 95%CI 1.02-1.05, P<0.01) and ApoE ε4 carrier genotype(OR=1.53, 95%CI 1.01-2.23, P=0.04). Conclusions: Perivascular spaces are always detected in the BG or WM in elderly people, and large PVS are also prevalent in community-based population. The risk factors are different due to distribution and size, and may depend on anatomic or pathologic characteristics.

[Analysis of the impact of job characteristics and organizational support for workplace violence]

Objective: To analyze the effect of job characteristics and organizational support for workplace violence, explore the influence path and the theoretical model, and provide a theoretical basis for reducing workplace violence. Methods: Stratified random sampling was used to select 813 medical staff, conductors and bus drivers in Chongqing with a self-made questionnaire to investigate job characteristics, organization attitude toward workplace violence, workplace violence, fear of violence, workplace violence, etc from February to October, 2014. Amos 21.0 was used to analyze the path and to establish a theoretical model of workplace violence. Results: The odds ratio of work characteristics and organizational attitude to workplace violence were 6.033 and 0.669, respectively, and the path coefficients were 0.41 and-0.14, respectively (P<0.05). The Fitting indexes of the model: Chi-square (χ(2)) =67.835, The ratio of the chi-square to the degree of freedom (χ(2)/df) =5.112, Good-of-fit index (GFI) =0.970, Adjusted good-of-fit index (AGFI) =0.945, Normed fit index (NFI) =0.923, Root mean square error of approximation (RMSEA) =0.071, Fit criterion (Fmin) =0.092, so the model fit well with the data. Conclusion: The job characteristic is a risk factor for workplace violence while organizational attitude is a protective factor for workplace violence, so changing the job characteristics and improving the enthusiasm of the organization to deal with workplace violence are conducive to reduce workplace violence and increase loyalty to the unit.

[Analysis on occupational health surveillance to workers exposed to toxic environment in a city]

Objective: To understand the status of occupational health surveillance to workers exposed to toxic environment in a city, so as to provide scientific basis for strategy of occupational diseases prevention. Methods: In January 2017, collecting the data of on-the-job poisonous and harmful workers occupational health surveillance in the city from January 1, 2010 to December 31, 2016 in China Information System for Disease Control and Prevention, the trend of occupational health monitoring in the city was analyzed, and the differences between diverseeconomic types, enterprise scale, industry nature and hazard factors were analyzed and compared. Results: The occupational health examination rate showed an overall upward trend in workers exposed to dust in the city from 2010-2016 (t=3.607, P<0.05) , and the detection rate of occupational contraindications was on the rise in workers exposed to chemical factors (t=3.071, P<0.05). The detection rate of occupational contraindications and suspected occupational diseaseswere significant in different economic types, enterprise scale, industry nature and hazard factors (P<0.05). The detection rate of occupational contraindications was the highest among the large enterprises (1.24%) , the manufacturing industry (0.84%) and the state-owned economy (1.49%). The detection rate of suspected occupational diseases (0.04%) and occupational contraindications (1.15%) were the highest in the physical factors. Conclusion: Occupational health monitoring in the city is not optimistic. It is necessary to focuson the occupational health care of manufacturing practitioners, raise the detection rate of suspected occupational diseases, and standard the occupational health check work to protect the occupational health.

Performance evaluation of histone deacetylases in lungs of mice exposed to ovalbumin aerosols

This study was to investigate expression levels and functional activities of histone deacetylases (HDACs) with potential therapeutic targets selected in animal model of allergic asthma. Mice were sensitized and then challenged with saline (control) or ovalbumin (OVA) for 8 weeks. Airway resistance was determined by increasing concentrations of acetyl-β-methacholine chloride (0 - 50 mg/ml). The number of cells and cytokine production in bronchoalveolar lavage fluid (BALF) were determined by ELISA. Pathological changes of lung specimens were examined by histochemical staining methods under the light microscope. Expression and quantification of HDACs in lungs were measured using immunohistochemistry and Western blotting analysis. HDAC activity was identified using colorimetric and fluorometric methods. The OVA-treated mice had a significant enhancement in airway resistance with a large number of cells and increased interleukin (IL)-4 and -5 levels in BALF. Morphologically, an infiltration of inflammatory cells into epithelial layer with mucus accumulation and subepithelial fibrosis were seen in the OVA-exposed lungs. The expression levels for HDAC1, HDAC5, HDAC6, and HDAC8 were significantly elevated with weak induction of HDAC 2-4, which was identical with their catalytic activities detected in the lungs. In contrast, HDAC1 and HDAC5 activities were higher than others in the lungs. Individual HDACs are differently regulated in expression levels and functional activities in animal model of allergic asthma. Selective targeting of HDAC1/5 offers an opportunity to improve therapeutic effects of the disease.

Large-scale screening and characterisation of Lemna aequinoctialis and Spirodela polyrhiza strains for starch production

Duckweed is considered a promising feedstock for bioethanol production due to its high biomass and starch production. Selection of duckweed strains with high starch accumulation is essential for application of duckweeds to bioethanol production. Geographic differentiation had a large influence on genetic diversity of duckweeds. Biomass production, starch content and starch amount in geographically isolated strains of 20 Lemna aequinoctialis and Spirodela polyrhiza were calculated to evaluate their potential for bioethanol production. The influence of different collection time, culture medium and NaCl concentration on starch accumulation of the best strains were analysed. The results showed that biomass production, starch content and starch production of duckweeds demonstrated clonal dependency. The best strain was L. aequinoctialis 6000, with biomass production of 15.38 ± 1.47 g m^-2 , starch content of 28.68 ± 1.10% and starch production of 4.39 ± 0.25 g m^-2 . Furthermore, starch content of L. aequinoctialis 6000 was highest after 8 h of light, tap water was the best medium for starch induction, and NaCl did not induce starch accumulation. This study suggests duckweed biomass production and starch production demonstrate clonal dependency, indicating that extensive clonal comparisons will be required to identify the most suitable isolates for duckweed selective breeding for bioethanol.

Identification of genes related to floral organ development in pak choi by expression profiling

Pak choi is a highly nutritious vegetable that is widely grown in China, Southeast Asia, and other parts of the world. Because it reproduces by seed, it is very important to understand the mechanism of floral organ development. Therefore, using the Chinese cabbage genome as a reference, this study analyzed the expression profiles of shoot apex genes at flower bud differentiation stages 1 and 5, in order to identify genes related to floral organ development. The results showed that the proportion of mapped genes was high, with 84.25 and 83.80% of clean reads from the two sample saligned to the reference genome, respectively. A total of 525 differentially expressed genes (DEGs) were identified, 224 of which were upregulated and 301 were downregulated. The expression levels of genes homologous to Chinese cabbage flowering genes were also analyzed at stages 1 and 5; the expression levels of Bra012997 (ap1), Bra000393 (SOC1), and Bra004928 (SOC1) were significantly upregulated at stage 5, suggesting that these three genes positively regulate floral development in pak choi. DEGs involved in floral organ development were analyzed with homologous genes from Arabidopsis thaliana; the homologous genes Bra029281 (AGL42), Bra026577 (ARPN), Bra022954 (SPL3), Bra029293 (ARF2), Bra007978 (AtRLP12), Bra033221 (SPL8), Bra008037 (LOX4), Bra001598 (IAA19), Bra003892 (PATL1), Bra038778 (AT4G21323), Bra025315 (KLCR2), and Bra013906 (DTX35) are directly related to floral organ development in Arabidopsis, suggesting that these genes have corresponding functions during flower organ development in pak choi, and could be candidates for further genetic research. These results provide a foundation for research on the molecular mechanism of flower organ development in pak choi and other Brassica rapa vegetables.

[Method and significance of specimens standardized pathological treatment in pancreaticoduodenectomy for pancreatic head cancer]

Pancreatic ductal adenocarcinoma is a highly aggressive disease with a grim prognosis. Surgical resection offers the best chance for long-term survival. Negative-margin resection still remains the goal, the influence of margin status on outcomes in pancreatic head carcinoma remains controversial, as conflicting data have been plagued by a lack of standardization in R0 resection and margin definitions, pathologic analysis, and reporting. In contrast to common belief, a high rate of R1 resections in pancreatic cancer is not a marker of low-quality surgery but rather of high-quality pathology. The international pathological consensus of pancreatic head carcinoma is still needed to fully understand the prognostic value of margin status in order to optimize treatment strategy for this disease.

Safety and pharmacodynamic mechanism of ropivacaine lumbar anesthesia in Cesarean section

Lumbar anesthesia is the preferred anesthetic approach for puerperae undergoing cesarean section in China. To observe the safety of administering different doses of ropivacaine for cesarean section and its pharmacodynamic mechanism, we randomly divided 180 pregnant women undergoing cesarean section into three groups: group A, 10 mg ropivacaine (0.50%); group B, 12 mg ropivacaine (0.50%); and group C, 14 mg ropivacaine (0.50%). Pharmacodynamic index, anesthesia quality and incidence of untoward reactions of each group were observed. Group A performed the poorest and group C the best in evaluation of sensory and motory block (P less than 0.05). With regard to evaluation of hemodynamic index, hemodynamic parameters of the three groups had significant differences after medication; mean arterial pressure (MAP) of patients in group B decreased at time points T1, T2 and T3 and heart rate (HR) became much higher at T1 (P less than 0.05); MAP of the patients in group C decreased at T1, T2, T3 and T4, but HR became higher at T1 and T2 (P less than 0.05); HR of group B was higher than that of group A at T1 (P less than 0.05); MAP of the patients in group C had a significant decrease at T1, T2, T3 and T4, but HR became higher at T2 (P less than 0.05); MAP of patients in group C significantly decreased compared to group B at T1 and T2, but HR became higher at T2 (P less than 0.05). Fluctuation of oxyhemoglobin saturation (SpO2) of all patients was between 95% and 99%. There was no occurrence of myocardial ischemia or arrhythmia. 1-min Apgar score of neonates of the three groups had no significant difference (P0.05). The incidence of adverse reactions of the patients in group C was much higher than that of the patients in the other groups (P less than 0.05). Twelve mg ropivacaine (5%) is the most suitable dose for pregnant women undergoing cesarean section as it can achieve a sound anesthetic effect and high safety and, moreover, has little influence on respiratory and circulatory functions.

Changes of expression of estrogen and progestrone receptors, human epithelial growth factor receptor 2 and Ki-67 after neoadjuvant chemotherapy in the treatment of breast cancer

Recent studies suggest that the development and prognosis of breast cancer is in close correlation to molecular subtype of breast cancer. Neoadjuvant chemotherapy has been extensively applied in the treatment of local breast cancer in advanced stage. In order to verify the correlation between expression changes of estrogen receptor, progestrone receptor, human epithelial growth factor receptor 2 and Ki-67 after neoadjuvant chemotherapy and neoadjuvant chemotherapy, we studied 120 patients with stage IIAIIIC breast cancer who underwent neoadjuvant chemotherapy in Binzhou Medical University Hospital, Shandong, China from February 2011 to February 2015. Clinical characteristics were retrospectively analyzed. The expression of estrogen receptor, progesterone receptor, human epithelial growth factor receptor 2 and Ki-67 of patients were detected using the immunohistochemical method before and after neoadjuvant chemotherapy. The results suggest that the overall remission rate of neoadjuvant chemotherapy was 76.7% (92/120) of which 16.7% (20/120) of cases had complete remission, 60% (72/120) had partial remission and 23.3% (28/120) were stable. There were no cases of progressive disease. The property of estrogen receptor and the expression of Ki-67 of primary tumor were correlated to the remission rate of neoadjuvant chemotherapy (P less than 0.05). The expression of Ki-67 had a significant decline after neoadjuvant chemotherapy, and the difference had statistical significance (P less than 0.05). The difference in expression of estrogen receptor, progesterone receptor and human epithelial growth factor receptor 2 before and after neoadjuvant chemotherapy had statistical significance (P > 0.05). Hence, it can be concluded that breast cancer patients with negative estrogen receptor expression and high Ki-67 expression before neoadjuvant chemotherapy can achieve better curative effects. Neoadjuvant chemotherapy cannot change the expression states of estrogen receptor, progesterone receptor and human epithelial growth factor receptor 2, but it can lower the expression level of Ki-67. Ki-67 can also be used for predicting the curative effect of neoadjuvant chemotherapy.

Preparation and identification of an antiserum against recombinant UL31 protein of pseudorabies virus

Pseudorabies virus (PRV) early protein UL31 is a homologue of herpes simplex virus 1 (HSV-1) UL31, which is a multifunctional protein important for HSV-1 infection. However, the precise roles of PRV UL31 in virus life cycle are still poorly understood. A relatively crucial tool for uncovering the function of UL31 is an antiserum that specifically detects UL31 in the PRV-infected cells. For this purpose, a recombinant UL31 protein consisting of N-terminal 27 aa of UL31 fused to EYFP and His-tag was expressed, purified and used for the preparation of antiserum in BALB/c mice. Our results show that Western blot analysis and immunofluorescence assay showed that this antiserum could specifically detect the purified recombinant UL31 as well as full-length UL31 in the PRV infected cells. These results demonstrate that the prepared antiserum could serve as a valuable tool for further studies of UL31 functions in PRV infection.

Cloning and association analysis of KIT and EDNRB polymorphisms with dominant white coat color in the Chinese raccoon dog (Nyctereutes procyonoides procyonoides)

The Chinese raccoon dog (Nyctereutes procyonoides procyonoides) is one of the most important fur-bearing animal species. The dominant white individual, a coat color variant in farmed Chinese raccoon dog, shows a completely white phenotype over the entire body. The KIT and EDNRB genes have been reported to be associated with the dominant white coat color in some mammalian species. In the present study, the full-length coding sequences of KIT and EDNRB were amplified from a dominant white and a wild-type Chinese raccoon dog. Sequence analysis revealed that the coding region of KIT and EDNRB in Chinese raccoon dog was 2919 and 1332 base pairs in length (accession No. KM083121 and KM083122), respectively, and 2 single-nucleotide polymorphisms (SNPs; c.600C>T and c.967G>A) in KIT and 1 SNP (c.259A>C) in EDNRB was found only in the dominant white individual. An alternative splicing site at the boundary of 4 and 5 of the KIT gene was identified in both individuals. We further investigated the association between the 3 SNPs of KIT and EDNRB and dominant white coat color by genotyping 18 individuals. We found no association between these SNPs and dominant white coat color. Based on these results, we can exclude the coding regions of the KIT and EDNRB genes as determinants of the dominant white coat color in Chinese raccoon dog.

Association between p53 codon 72 polymorphisms and clinical outcome of nasopharyngeal carcinoma

We conducted a cohort study to investigate whether polymorphisms in p53 at codon 72 are associated with tumor response and survival time of advanced nasopharyngeal carcinoma (NPC) patients treated with radiotherapy. The study population included 127 subjects with NPC who were enrolled at Binzhou Medical University between September 2008 and December 2009. Cox proportional hazard regression was used to assess the association between polymorphisms in the p53 gene and progression-free survival (PFS) and overall survival (OS) of NPC patients. During the follow-up period, 42 patients died and 72 patients showed progression at the end of the study. Of the 127 patients, median PFS was 22.5 ± 1.2 months (1-36 months), and the median OS time was 28.2 ± 1.1 months (2-36 months). The p53 codon 72 Pro/Pro genotype was associated with a longer median PFS time of 30.3 months compared with 18.2 months for patients with Arg/Arg variants. Moreover, the p53 codon 72 Pro/ Pro genotype was associated with a longer median OS time of 31.6 months compared with 25.8 months for those with Arg/Arg variants; the P value was marginally significant. We showed that variants in p53 codon 72 may be an independent predictor for PFS and OS of NPC patients.

Molecular cloning and characterization of the pseudorabies virus UL31 gene

We amplified a 816-bp sequence of the UL31 gene from the pseudorabies virus (PRV) Becker strain genome. Evidence that this was the UL31 gene was confirmed by cloning and sequencing. The PRV UL31 gene encodes a putative protein of 271-amino acid residues, which was designated the UL31 protein. Bioinformatic analysis indicated that PRV UL31 contains a conserved PHA03328 domain, closely related with the herpes virus nuclear egress lamina protein UL31 family and highly conserved among counterparts encoded by herpes UL31 genes. Nucleic acid sequence and amino acid sequence alignments demonstrated that PRV UL31 has a relatively higher homology with UL31 homologous proteins of subfamily Alphaherpesvirinae than other subfamilies. In addition, phylogenetic analysis showed that PRV UL31 has a close evolutionary relationship with members of the subfamily Alphaherpesvirinae, especially bovine herpesvirus 1 (BoHV-1), BoHV-5, equine herpesvirus 4 (EHV-4), EHV-9 and EHV-1. Antigen prediction demonstrated that several potential B-cell epitopes are located in PRV UL31. Additionally, secondary structure and three-dimension structure prediction revealed that PRV UL31 predominantly consists of α-helix. Taken together, these results provide insight on the function and mechanism of UL31 during PRV infection.