[Application of three methods in occupational health risk assessment of automobile 4S shop]

Objective: To choose various occupational health risk assessment of the mature methods at home and abroad respectively occupational health risk assessment was carried out on the 4s stores, to explore different risk assessment methods on the 4 s shop the applicability of the occupational health risk assessment. Methods: Chemical was applied on the harmful factors of occupational health risk assessment technology guideline in the composite index method, quantitative cancer risk assessment method using the guidelines for the harmful factors of occupational health risk assessment of chemical technology of composite index method, quantitative cancer risk assessment method, international commission on mining and metals (ICMM) occupational health risk assessment quantitative method and the occupational-disease-inductive operation classification to evaluate chemical factors in 4S store, Combined with on-site occupational health investigation to compare with the result of risk assessment and analysis of international mining and metals (ICMM) committee occupational health risk assessment quantitative method and the occupational-disease-inductive operation classification of 4S store to evaluate chemical factors, combined with on-site occupational health investigation comparison and analysis the result of the risk assessment. Results: Except for 6 times, the results of ICMM matrix method and comprehensive index method were consistent, which were all higher than job classification. The other results were job classification of >of ICMM matrix method >comprehensive index method or job classification of >of ICMM matrix method. Conclusion: When the concentration of occupational-disease-inductive factors is lower than 1/2 limit, the risk assessment results tend to be ICMM quantitative >composite index method >operation classification. When the occupational-disease-inductive factors were involved with triphenyl, the quantitative non-carcinogenic risk assessment method was more likely to reach the conclusion that the occupational health risk was unacceptable.

[The prevalence of snoring and its related family factors of children from 3 to 14 years old in Beijing]

Objective: To investigate the snoring status and related family factors of children from 3 to 14 years old in Beijing. Methods: From May to July, 2015, data of children from 3 to 14 years old were obtained from a status survey from 7 districts(Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou) in Beijing. A total of 11 420 children from 25 primary and middle schools were randomly selected. Pediatric Sleep Questionnaire (PSQ) and a self-administered questionnaire were carried out for the adopted children. Self-administered questionnaire included the snoring related family factors. Logistic regression was used to estimate the odd ratio(OR) with 95% confidence intervals for variables. Results: A total of 9 198 children meet the inclusion criteria and are analyzed in the study, of whom 901 (9.80%) were found with snoring behavior. The incidence of boys is higher than girls. Obese children take higher risk of snoring. Compared with younger children (≤6 years old), older children (≥12 years old) have a significantly lower risk of snoring (OR=0.464, 95%CI 0.368-0.585). There is no statistical association between full-term infants, infant feeding pattern, parental cigarette smoking and child snoring.The children with family history of snoring have a significantly higher risk of snoring occurrence. The educational background of mother is statistically related to children snoring (OR=1.241, 95%CI 1.058-1.457). Conclusions: The incidence of children snoring in Beijing is 9.80%, male gender, obesity, and young age are all risk factors for children snoring. There is a significantly statistical relationship between snoring and related family factors, such as family snoring history and education experience.

[Clinical analysis of head and neck neurogenic tumor in childhood]

Objective:To investigate the clinical characteristics, imaging features and treatment of neurogenic tumor in chilehood and to improve the experience in diagnosis and treatment for the disease. Method:The twenty-nine inpatients of histopathologically proven neurogenic tumor from January 2015 to December 2018 were retrospectively analyzed. The pathological types, clinical characteristics, imaging findings, and management were analyzed. Result: There were five cases of schwannoma aged from 9 years to 14 years, five cases of neurofibroma aged from 9 months to 9 years, and nineteen cases of neuroblastic tumor aged from 3 months to 5 years in our series. The chief manifestations were soft tissue masses, snore, and Honer syndrome. As the tumors had different components pathologically, on scans they presented as masses with heterogeneous density. Schwannoma showed as oval masses with clear margins, with the characteristic of"tail sign". The imaging findings of neurofibromas showed unclear boundaries and plexiform neurofibromas showed multiple clumps with visible separation. The ultrasonography of neuroblastic tumor was characterized by hypoechoic, heterogeneous and spotty calcification. All the cases underwent surgical resections. In 5 cases of schwannoma, it was confirmed that the tumors originated from the vagus nerve during the operation, which could be completely removed without postoperative complications. Two cases of neurofibromas were completely resected, 2 cases were only partially resected, and 1 case which located at the entrance of the esophagus was resected under supportive laryngoscopic for three times. Thirteen of 19 children with neuroblastogenic tumors underwent resection in our department after chemotherapy, and 2 patients with postoperative recurrence underwent another operation. Conclusion:Neuroblastoma is the most common neurogenic tumor in the head and neck of children. Most neurogenic tumors have their corresponding characteristics on imaging and should be differentiated. Schwannoma has clear boundary and intact capsule, so it is easier to complete resection. The neurofibroma is commonly difficult to remove with safety margin because of its unclear boundaries. Neuroblastoma should be treated according to the lesion range and stage. Most of the lesions are difficult to remove completely due to the wide range, peripheral blood vessels and important nerves. So preoperative chemotherapy is generally required.

[Analysis of sleep quality and related factors among children in Beijing]

Objective: To investigate the sleep quality of children in Beijing and to analyze the related factors. Methods: The data were collected from the survey of 3-14 years old children in 7 urban districts of Beijing in 2015. By using multi-stage stratified cluster random sampling method, 26 kindergartens and primary and secondary schools in 7 districts and counties, including Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou, were randomly selected, with a total of 11 420 children. Children's sleep status was investigated with Children's Sleep Questionnaire (PSQ), and the proportion of children with sleep quality problems when the PSQ score was greater than 7. Various sleep related factors were investigated with self-made questionnaire. A multilevel model was used to analyze the relationship between PSQ score and related factors. Results: The average PSQ score of the children was 3.60±2.69. The proportion of children with sleep quality problems was 8.87%(816/9 198). Multilevel model analysis showed that the younger the children, the higher the PSQ score (<6 years old vs. 6~12 years old vs. >12 years old: 3.94±2.58 vs. 3.58±2.66 vs. 3.30±2.84, F=33.015, P<0.001); male PSQ score higher than female (3.89±2.75 vs. 3.30±2.60, t=10.560, P<0.001); and snoring, obesity, father/mother snoring, playing games before bed, surfing the internet, eating and other factors were statistically related to PSQ. Conclusions: Sleep quality of children in Beijing should not be neglected, especially preschool children with high PSQ scores. Parents should pay attention to children's snoring problems and try to reduce some pre-sleep behaviors that may affect sleep quality.

[Protective effects of berberine against exhaustion exercise induced myocardial injury in rats]

Objective: To investigate the effect and possible mechanism of berberine (Ber) on myocardial injury induced by exhaustion exercise (Ee). Methods: Forty healthy male SPF Sprague-Dawley rats were randomly divided into 5 groups using the random unit group design method: control group, Ee group and Ee plus Ber group (low: 50 mg·kg(-1)·d(-1), medium: 100 mg·kg(-1)·d(-1) and high dose: 150 mg·kg(-1)·d(-1), n=8 each). Ber (1.5 ml) or equal volume saline was given per gavage for 14 days. Rats assigned to Ee groups underwent Ee swimming once daily and rats in control group remain sedentary. After 14 days, echocardiographic measurements were performed and left ventricular ejection fraction (LVEF) and fractional shortening (LVFS), left ventricular diastolic diameter (LVIDd) and left ventricular systolic diameter (LVIDs) were obtained. The morphological structure of heart was detected by HE and Masson staining. Serum superoxide dismutase (SOD) and malondialdehyde (MDA) were measured by enzyme-linked immunosorbent assay. Cardiomyocytes apoptosis was detected by TUNEL method. The protein expression of myocardial hypertrophy marker protein B-type natriuretic peptide (BNP) and apoptotic marker protein (Bcl-2, Bax) in rat myocardial tissue was detected by Western blot. Results: (1) Both LVFS and LVEF were significantly lower, and LVIDs and LVIDd were significantly larger in Ee group than those in control group (all P<0.01). The LVFS and LVEF in medium dose of Ber and high-dose Ber groups were significantly higher, and the LVIDs and LVIDd were significantly smaller than those in Ee group (all P<0.01). (2) The results of HE staining showed that the myocardial cells in control group were closely arranged, regular, normal in morphology, clear in structure, and uniform in staining. The myocardial cells of rats in Ee group were disarranged, cell staining was uneven, and vacuoles appeared in the cytoplasm. The disorder of myocardial cell arrangement and unequal staining in the medium dose of Ber were attenuated than in Ee group. The Masson staining results showed that the myocardial cells in control group were closely arranged, regular, normal in shape, clear in structure, and rarely blue-stained (fibrosis). Myocardial cells in rats in Ee group showed obvious fibrosis. The myocardial cell fibrosis in rats with medium dose of Ber was significantly reduced than exercise group. (3) MDA content in myocardial tissue of rats in Ee group was significantly higher than that of control group, and MDA content in myocardial tissue of rats in medium dose of Ber group was significantly lower than in Ee group (P<0.01). The SOD activity of myocardial tissue in rats was significantly lower than that of control group, while that of rats with medium dose of Ber was significantly higher than that of rats in Ee group (P<0.01). (4) TUNEL staining results showed that only a small amount of apoptosis myocardial cells were seen in control group, and a large number of apoptosis myocardial cells were seen in rats in Ee group. However, the number of apoptotic cardiomyocytes in medium dose of Ber was significantly lower than that in Ee group. The AI of rat cardiomyocytes was significantly higher than that of control group (P<0.01), and the AI of rat cardiomyocytes in median dose of Ber group was significantly lower than in Ee group (P<0.01). (5) BNP and Bax protein expression in the myocardial tissues of rats in Ee group were significantly higher than in control group (P<0.01). BNP and Bax protein expression in the myocardial tissues in median dose of Ber group were significantly lower than that of Ee group (P<0.01). The myocardial protein expression level of Bax was significantly higher, and the myocardial protein level of Bcl-2 was significantly lower in Ee group than in control group (both P<0.01), treatment with median dose of Ber could partly reverse above changes (both P<0.01). Conclusion: Ber can attenuate exhaustion exercise induced myocardial injury and remodeling in rats, and the beneficial effects of Ber might possibly be mediated by reducing free radical release and cardiomyocytes apoptosis.

[Clinical outcome of postchemotherapy retroperitoneal lymph node dissection and predicting retroperitoneal histology in advanced nonseminomatous germ cell tumours of the testis]

Objective: To explore the clinical outcome of advanced testicular nonseminomatous germ cell cancer patients undergoing post chemotherapy retroperitoneal lymph node dissection (PC-RPLND), and to analyze the relevant prognostic factors of lymph node pathological. Methods: A total of 43 consecutive testicular nonseminomatous germ cell cancer patients underwent PC-RPLND between March 2001 and December 2014 in Department of Urology at Sun Yat-sen University Cancer Center were retrospectively reviewed. The average age of the patients was (29.0±11.5) years (ranging from 12 to 58 years). Before PC-RPLND, 22 patients were classified as phase Ⅱ, while 21 were phase Ⅲ. Primary tumor histology revealed seminomatous elements in 19 cases, embryonal cell carcinoma in 22 cases, yolk sac tumor in 13 cases, chorionic carcinoma in 3 cases, mature teratomatous elements in 11 and immature teratomatous elements in 2 cases. Patients were treated with cisplatin-based chemotherapy after orchectomy and then underwent surgical resection of retroperitoneal lymph nodes.After PC-RPLND, all patients underwent a periodic review including the blood routine, biochemistry routine and computed tomography or ultrasonograph of the chest, the abdomen and the pelvis. The association of pathological data with patient's clinic features and the correlations between molecular features detected with each other were assessed by the t test, χ(2) and Fisher's exact test. Multivariate logistic regression were used to assess prognostic factors. Results: The median operative time was 278 minutes (ranging from 50 to 715 minutes). Median blood loss was 425 ml (ranging from 50 to 5 000 ml). Eight patients received blood transfusion intra-operatively, 2 patients underwent adjunctive surgical procedures, 4 patients developed ileus and 4 had an ascites chylosus following PC-RPLND, 1 patient had a postoperative hyperthermia and retrograde ejaculation was present in 10 patients. The transverse diameter of the residual tumor in patients ranged from 0.8 to 18.2 cm. Necrosis, teratoma and viable germ cell tumors were found in 15, 17 and 11 of all patients. The median follow-up time was 46 months (ranging from 6 to 169 months). There were 39 patients had no tumor recurrence, 7 patients were found recurrence after PC-RPLND, 5 died of malignant germ cell tumor. The normal serum lactate dehydrogenase (LDH) level before chemotherapy (HR=25.811, 95%CI: 0.678 to 982.624, P=0.017) and relative changes more than 50% in retroperitoneal lymph node size (HR=0.016, 95%CI: 0 to 0.698, P=0.032) were statistically significant prognostic factors of the presence of necrosis. Conclusions: Since most residual masses are not sensitive to chemotherapy, PC-RPLND is still an essential part of the treatment of metastatic testicular nonseminomatous germ cell cancer. Patients with the normal serum LDH level before chemotherapy and a shrinkage of 50% or more in retroperitoneal mass have a considerably chance of having necrosis in the retroperitoneum resection. This may help to refine the selection of candidates for PC-RPLND.

[A randomized single blind comparison of conventional bowel preparation and unplanned preoperative preparation for pelvic organ prolapse]

Objective: To investigate the influence of conventional preoperative intestinal preparation and unplanned preparation on the visual field of pelvic organ prolapse repair surgery. Methods: The patients who underwent transvaginal pelvic organ prolapse repair surgery in Peking University People's Hospital from September 2017 to July 2018 were selected as the research objects except those who had undergone colorectal surgery and chronic constipation. The surgery doctor was blinded by intestinal preparation. There was no intestinal preparation in non intestinal preparation group and polyethylene glycol was taken orally in intestinal preparation group. The main outcome measures were the effect of intestinal contents on the surgical field, the presence of fecal leakage, and the nature and volume of fecal leakage. The standard of fecal contamination was: mild, less than 15 ml, moderate, 15-30 ml, and severe, >30 ml. Secondary indicators were patient satisfaction and symptoms of routine bowel preparation. Results: A total of 120 patients (60 cases of non intestinal preparation group, 60 cases of intestinal preparation group) were selected, including transvaginal hysterectomy, vaginal anterior or posterior colporrhaphy (some patients with anterior prolapse repair with mesh), sacrospinal ligament suspension, total colpectomy and colpocleisis, laparoscopic sacral colpopexy, anti-incontinence surgery. The median age of the patients in non intestinal preparation group was 62 years, and the median age of intestinal preparation group was 60 years. There were no significant differences in median age, anesthesia, operation method, blood loss, operation time and perioperative infection between the two groups (all P>0.05). Fecal contamination occurred in 10% (6/60) of the patients without intestinal preparation and 32% (19/60) of the patients with intestinal preparation (P=0.042). Comparing the two groups, 10% (6/60) of the patients with intestinal preparation had moderate and severe contamination, and the patients without intestinal preparation was only 2% (1/60), there was significant difference (P=0.017). In intestinal preparation group, nausea (8%, 5/60), vomiting (5%, 3/60), abdominal distension (22%, 13/60), fatigue (5%, 3/60) and palpitation (2%, 1/60) were higher than those in non intestinal preparation group. Conclusions: Intestinal preparation with oral laxatives before pelvic organ prolapse repair surgery is not beneficial to the cleaning of the surgical field and increases the discomfort of intestinal preparation. It is safe and feasible for most patients with pelvic organ prolapse to perform pelvic organ prolapse repair surgery without intestinal preparation.

Soil microbial community structure in the rhizosphere of Robinia pseudoacacia L. seedlings exposed to elevated air temperature and cadmium-contaminated soils for 4 years

The co-occurrence of heavy metal contamination of soils and increasing air temperature can affect the microbial community in rhizosphere soils by altering the allocation of plant photosynthates to roots. Here, we investigated the community structure of bacteria, fungi, ammonia oxidizing bacteria (AOB) and ammonia oxidizing archaea (AOA) in the rhizosphere of Robinia pseudoacacia L. seedlings exposed to elevated air temperature (+1.99 °C) and cadmium (Cd) for 4 years. Elevated temperature increased the richness of bacterial and AOA communities by 15.1% to 43.8% and by 1.4% to 18.6%, respectively, and decreased fungal and AOB richness by 3.7% to 28.7% and by 2.1% to 30.6%, respectively, under Cd exposure. Elevated temperature combined with Cd exposure decreased fungal diversity by 1.5% to 14.0%. However, elevated temperature decreased the diversity of bacteria, AOB and AOA by 1.4%, 17.4% and 10.1%, respectively, under 1.0 mg Cd kg^-1 dry soil and increased the diversity of these taxa by 1.5%, 15.3% and 9.2%, respectively, under 5.0 mg Cd kg^-1 dry soil relative to Cd exposure alone. Elevated temperature led to increased abundance of genera such as Methylobacterium, Stenotrophomonas, and Archangium and decreased abundance of genera including Ramlibacter, Microascus and Nitrosospira under Cd exposure. Over all, 4 years of exposure to elevated temperature had a greater effect on the community structure of bacteria, fungi, AOB and AOA when combined with Cd pollution.

[Beginning of modern stomatology education of China in later Qing dynasty]

In the 19th century, modern stomatology education were introduced into China with the impact of the west medicine and education. The apprenticeship of modern stomatology education were carried out by missionaries firstly, and then changed to dental schools established by the missionaries or foreigners, which was replaced partly by local Chinese dentists later and improved the development of modern Chinese stomatology education preliminarily.

[3D computed tomographic study of concha bullosa drainage pathway]

Objective:The aim of this study is to study the related structures with concha bullosa drainage passway in inpatients with concha bullosa disease. Method:A total of 90 patients with peritubular middle turbinate (144 sides) were examined by 16-slice spiral CT. The distribution of the middle turbinate and the distribution of the drainage channel were analyzed by three-dimensional reconstruction technique and image workstation software. Result:The distribution of the morphology and drainage channel of 144 concha bullosa have statistically significant (P<0.05). There are 3 types of bubble in the middle turbinate: extensive gasification, lamina gasification, and globular gasification. We found that the mainly type was extensive gasification and the drainage pathways to anterior ethmoid sinus were much more than posterior ethmoid sinus. Individual concha bullosas had double way drainages to ethmoid sinus. Conclusion:The three-dimensional reconstruction technique and image workstation software can be more precisely analyze anatomical characteristics of concha bullosa, and clarify the clinical diagnosis of the turbinate middle turbinate disease and strengthen endoscopic surgical techniques.

[Spatial distribution of occupational disease prevalence in Guangzhou and Foshan city by geographic information system]

Objective: To explore the occupational disease spatial distribution characteristics in Guangzhou and Foshan city in 2006-2013 with Geographic Information System and to provide evidence for making control strategy. Methods: The data on occupational disease diagnosis in Guangzhou and Foshan city from 2006 through 2013 were collected and linked to the digital map at administrative county level with Arc GIS12.0 software for spatial analysis. Results: The maps of occupational disease and Moran's spatial autocor-relation analysis showed that the spatial aggregation existed in Shunde and Nanhai region with Moran's index 1.727, -0.003. Local Moran's I spatial autocorrelation analysis pointed out the "positive high incidence re-gion" and the "negative high incidence region" during 2006~2013. Trend analysis showed that the diagnosis case increased slightly then declined from west to east, increase obviously from north to south, declined from? southwest to northeast, high in the middle and low on both sides in northwest-southeast direction. Conclusions: The occupational disease is obviously geographical distribution in Guangzhou and Foshan city. The corresponding prevention measures should be made according to the geographical distribution.

[An in vivo biomechanical study of Chinese female with uterosacral ligament suspension]

Objective: To measure in vivo biomechanical properties of pelvic support structures associated with uterosacral ligament suspension (ULS) . Methods: Ten Chinese female cadavers (death within 48 hours) without embalming were carefully dissected to expose the ligament. After dissection, ligaments were sewn according to standard ULS surgical technique. They were stretched at a steady rate to breakage during constant electronic registration of load and displacement. In vivo biomechanical properties were evaluated by a load-displacement curve. Results: Ultimate load of uterosacral ligament, ring around cervix were (37.3±23.5) , (49.3±28.4) N, respectively. The differences between the two groups was not significant (P>0.05) . Ligament stiffness were (1.26±1.22) , (1.45±0.92) N/mm, respectively. There was no significant difference between groups (P>0.05) . Conclusions: The uterosacral ligament, ring around cervix with sufficient strength are not easy to deform. ULS is an effective procedure for treating middle pelvic defects from a biomechanics perspective.

[Effect of APP on prognosis in patients with chronic rhinosinusitis after endoscopic sinus surgery]

Objective:To investigate interventional effect of APP on prognosis in patients with chronic rhinosinusitis after endoscopic sinus surgery. Method:One hundred and forty-four chronic rhinosinusitis patients in our hospital were divided into observation group and control group randomly; observation group had 71 patients, and control group had 73 patients. The control group was treated with standard discharge instruction. In addition to standard discharge instruction, observation group was followed up and directed by using of APP. Two groups' VAS scores and Lund-Kennedy scores were compared in admission time, and 6 months after discharge. Result:There was no significant difference in the Lund-Kennedy scores and VAS scores between the two groups in admission time. However, 6 months after discharge, Lund-Kennedy scores and VAS scores in observation group were obviously lower than control group(P< 0.05). Conclusion:The use of healthy APP can significantly promote patients with chronic rhinosinusitis recovery and re-visit after endoscopic sinus surgery.

[The analyze the epidemic trend and predict the incidence trend of occupational diseases in Guangdong province]

Objective: This study was aimed to analyze the epidemic trend and predict the incidence trend of occupational diseases during 2006-2015 in Guangdong province, which may provide the theoretical foundation for occupational disease risk assessment and precise control and prevention. Methods: We analyzed the number of reported occupational disease cases, the constituent ratio, the average age and working-age of patients. We also performed the linear-by-linear association test of new incidence, median age and median working-age by curve-fitting method, of which the diagnostic year was set as the independent variable. Meanwhile, we designed an ARIMA model to predict the variation tendency of occupational diseases in 2017-2020. Results: (1) During 2006-2015, the total reported cases of occupational disease is 5289, including 2101 cases of occupational pneumoconiosis (39.7%) , 1363 cases of occupational poisoning (25.8%) , and 864 cases of occupational otolaryngological and stomatological disease (16.3%) . (2) The number of occupational diseases and pneumoconiosis have a straight upward trend (R(2)=0.851, R(2)=0.856) , while the number of occupational otolaryngological and stomatological disease and occupational tumor have a exponential trend (R(2)=0.914, R(2)=0.696) . The constituent ratio of occupational poisoning is decreasing, and the constituent ratio of occupational otolaryngological and stomatological disease is increasing. (3) The average onset age is 40 (33, 46) years old, and the average onset working-age is 6 (3, 11) years. Both of them have a straight upward trend (R(2)=0.954、R(2)=0.792) . The onset age of pneumoconiosis, occupational poisoning and occupational otolaryngological and stomatological disease have a upward trend. In addition, the onset working-age of occupational poisoning and pneumoconiosis have a upward trend. (4) The number of occupational diseases in 2017-2020 is predicted to be between 902-1231. Conclusion: Occupational diseases in Guangdong province showed a trend of high incidence. The age and working-age of occupational diseases showed an extended trend. Therefore, our work of occupational epidemic trend may provide some bases for the occupational disease risk assessment and precise control and prevention.

Serum hepatitis B surface antigen correlates with fibrosis and necroinflammation: A multicentre perspective in China

The kinetics of serum hepatitis B surface antigen (HBsAg) during the natural history of hepatitis B virus (HBV) infection has been studied, but the factors affecting them remain unclear. We aimed to investigate the factors affecting HBsAg titres, using data from multicentre, large-sized clinical trials in China. The baseline data of 1795 patients in 3 multicentre trials were studied, and the patients were classified into 3 groups: hepatitis B early antigen (HBeAg)-positive chronic HBV infection (n = 588), HBeAg-positive chronic hepatitis B (n = 596), and HBeAg-negative chronic hepatitis B (n = 611). HBsAg titres in the different phases were compared, and multiple linear progression analyses were performed to investigate the implicated factors. HBsAg titres varied significantly in different phases (P = .000), with the highest (4.60 log10 IU/mL [10%-90% confidence interval: 3.52 log10 IU/mL-4.99 log10 IU/mL]) in patients with HBeAg-positive chronic HBV infection. In all phases, age and HBV DNA were correlated with serum HBsAg level. In HBeAg-positive chronic hepatitis B patients, a negative correlation between HBsAg titres and fibrosis stage was observed. Alanine amonitransferase or necroinflammatory activity was also correlated with HBsAg titres in HBeAg-negative chronic hepatitis B patients. In conclusion, decreased HBsAg titres may be associated with advancing fibrosis in HBeAg-positive chronic hepatitis B patients or increased necroinflammation in those with HBeAg-negative chronic hepatitis B. Our findings may help clinicians better understand the kinetics of HBsAg and provide useful insights into the management of this disease.

[The prevalence of snoring and its association with academic performance among school-aged children in Beijing]

Objective: To investigate the snoring status of school-aged children in Beijing and explore the association of snoring and academic performance. Methods: A total of 7 925 children aged from 6 to 14 were selected from 15 primary and middle schools at 7 districts (Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou) in Beijing in 2015, using multi-stage stratified cluster random sampling method. The recruited children were asked to complete the Pediatric Sleep Questionnaire (PSQ) and a questionnaire related to sleep behavior. The multiplelogistic regression was used to analyze the association of snoring and academic performance. Results: A total of 794 (12.44%) children showed a decline in academic performance among 6 383 eligible respondentsfor data analysis. 580 (9.08%) children with snoring was identified, of which 333 and 247 were in frequency of 1-2 times per week and frequency of ≥3 times per week, respectively; 357, 170 and 53 were in snoring grade Ⅰ, grade Ⅱ and grade Ⅲ, respectively. Compared with the children without snoring, the OR (95%CI) for children with 1-2 times per week and ≥3 times per week was 1.363 (1.000-1.857) and 1.605 (1.135-2.269), respectively; and the OR (95%CI) for children with grade Ⅰ, grade Ⅱ and grade Ⅲ of snoring was 1.226 (0.893-1.683), 1.595 (1.062-2.397) and 2.31 (1.17-4.565), respectively. Conclusion: There is a statistical relationship between snoring and the decline of academic performance. The decline of academic performance positively associated with increased frequency and grade of snoring.

[Importance of segmental lymph nodes in the pathological staging of non-small cell lung cancer]

Objective: To explore the role of the segmental lymph node dissection in the pathologic staging of non-small cell lung cancer. Methods: A total of 370 consecutive non-small cell lung cancer patients who underwent radical resection between August 2008 and July 2016 were retrospectively reviewed. All the operations were performed by the same group of surgeons. The relationship of the segmental lymph nodes with pathological stages after radical resection was analyzed in order to explore the role of the lymph node dissection in the pathologic staging of non-small cell lung cancer (using the 7th edition of the American Joint Committee on Cancer and Union for International Cancer Control TNM classification for lung cancer ). Results: The detection rates of hilar nodes, interlobar nodes, lobar nodes and segmental nodes were 69.7%, 86.8%, 84.0%, 67.0%, respectively. The metastasis rates of hilar nodes, interlobar nodes, lobar nodes and segmental nodes were 6.5%, 10.8%, 15.7% and 10.3%, respectively. There were 238 cases of N0 disease, 62 cases of N1 disease, 69 cases of N2 disease and 1 case of N3 disease. If the analysis of segmental lymph nodes had been omitted, 16 patients (25.8% of N1 disease) would have been down-staged to N0, and 5 cases of multiple-station N1 disease would have been misdiagnosed as single-station N1 disease, 2 patients would have been misdiagnosed as N2 disease with skip metastases. Conclusion: Segmental nodes play an important role in the accurate staging of non-small cell lung cancer.

[The role of estrogen related-receptor γ and ATP-dependent K(+) channel Kcnj1 in renal ischemia-reperfusion injury]

Objective: To investigate the correlation between estrogen related-receptorγ (ERRγ) and ATP-dependent K(+) channel Kcnj1 in renal ischemia-reperfusion injury and its possible role in regulating ischemic preconditioning. Methods: The expression of ERRγ in kidney tissues was detected by immunohistochemistry. The expressions of ERRγ and Kcnj1 in human renal tubular epithelial cells (HK-2) under hypoxia (1% O(2)) were detected by RT-PCR. The ERRγ-deficient heterozygous mice model and the ERRγ-deficient completely mice model were established. The pretreatedischemia-reperfusion model were constructed in wild-type mice, ERRγ-deficient heterozygous mice and ERRγ-deficient completely mice, respectively. Renal injury was observed under a light microscope with PAS staining. ERRγ and Kcnj1 were tested by immunohistochemistry and RT-PCR. Results: ERRγ in mice kidney tissue was mainly expressed in renal tubules, and the expressions of ERRγ and Kcnj1 were decreased 59% and 29.5% respectively after hypoxia in the renal tubular cells (HK-2). In the animal model, the expressions of ERRγ and Kcnj1 were decreased 31.9% and 11% in early ischemic mice kidney tubular cells of wild type. The expressions of ERRγ and Kcnj1 in renal tubular cells were decreased 33.2% and 19.1% after ischemia and reperfusion. When ERRγ were overexpressed in renal tubular cells, ERRγ was increased by 89%, and the expression of Kcnj1 was increased by 72.5%. The expression of Kcnj1 was decreased by 75.7% in ERRγ-deficient completely mice. However, Kcnj1 expression in renal tissue of ERR-γ-deficient mice was stable, but ischemic preconditioning failed to interfere with renal ischemia-reperfusion injury. Conclusion: ERRγ-Kcnj1 is closely related to ischemic preconditioning and protects renal ischemia-reperfusion injury, and may be one of the regulatory factors. To explore the protective effect of the regulating pathway on ischemia reperfusion injury couldprovide a theoretical basis for the development of drug pretreatment.

Antibiotics in the agricultural soils from the Yangtze River Delta, China

This study focused on the occurrence and spatial distribution of 13 common antibiotics in the agricultural soils of the Yangtze River Delta (YRD), China. Antibiotics were detected in all the 241 soil samples (i.e., 100% detection rate) with the total concentrations ranging from 4.55 to 2,010 ng/g dry weight. The concentrations of three antibiotic classes decreased in the order: quinolones (mean 48.8 ng/g) > tetracyclines (mean 34.9 ng/g) > sulfonamides (mean 2.35 ng/g). Ciprofloxacin was the prevalent compound with a mean concentration of 27.7 ng/g, followed by oxytetracycline (mean of 18.9 ng/g). A distinct spatial distribution was observed, where high concentrations of antibiotics were detected in the sites adjacent to the livestock and poultry farms. The potential sources of antibiotics in the agricultural soils were the application of manure and wastewater irrigation in this region. Risk assessment for single antibiotic compound indicated that tetracyclines and quinolones could pose a potential risk, in which doxycycline and ciprofloxacin had the most severe ecological effect in the agricultural soils. Antibiotic resistance genes (ARGs), such as tetA, sulI, and qnrS, were detected in 15 analyzed soil samples, and sulI showed significant correlations with quinolones, tetracyclines, copper, and zinc. Further studies on the distribution of other ARGs in agricultural soil at a region-scale are needed for the risk management of extensively used antibiotics and major ARGs.

Meta-analysis comparing denosumab and zoledronic acid for treatment of bone metastases in patients with advanced solid tumours

The purpose of this meta-analysis was to evaluate the efficacy of denosumab, compared with zoledronic acid (ZA), in delaying skeletal-related events (SREs) and enhancing overall survival in patients with advanced solid tumours and bone metastases. A systematic literature search of several electronic databases, including PubMed, Medline, Embase, the Cochrane Library, CKNI and Web of Science with Conference Proceedings, was performed. Only randomised controlled trials assessing denosumab in comparison with ZA, in patients with advanced solid tumours and metastatic-stage disease, were included. The primary outcome was the time to first SRE. The risk of developing subsequent on-study SREs and overall survival were also evaluated. Three randomised controlled trials with a total of 5,544 patients with advanced solid tumours and bone metastases were included in the meta-analysis. There were 2,776 patients treated with denosumab and 2,768 treated with ZA. The pooled analysis showed that denosumab was superior to ZA in delaying time to first on-study SRE (odds ratio [OR]: 0.82; 95% CI: 0.75-0.89, p < 0.0001) and multiple SREs (risk ratio: 0.81; 95% CI: 0.74-0.88, p < 0.0001). However, no significant difference was found in overall survival improvement between denosumab and ZA (OR: 1.02; 95% CI: 0.91-1.15, p = 0.71). This meta-analysis indicates that denosumab is superior to ZA in delaying SREs for patients with bone metastases. No significant difference was observed between denosumab and ZA, regarding overall survival. We support denosumab as a potential novel treatment option for the management of bone metastases in advanced solid tumours.

[Effect of preoperative monocyte-lymphocyte ratio on prognosis of patients with resectable esophagogastric junction cancer]

Objective: To investigate the associations between various blood test parameters including MLR (monocyte-lymphocyte ratio) and prognosis in post-operative esophagogastric junction cancer patients. Methods: We retrospectively studied the preoperative and postoperative data of 309 patients who underwent radical surgery for esophagogastric junction cancer. The relationship between MLR, neutrophil lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and overall survival (OS) was analyzed. Results: The cutoff values of MLR、NLR and PLR were 0.201, 1.697 and 96.960, respectively. The median OS was 51.4 months for all the patients in the study group (n=309). MLR in patients with esophagogastric junction carcinoma was associated with gender, depth of invasion, histological grade, TNM stage, NLR and PLR (P<0.05). PLR was associated with tumor size, TNM stage, NLR and MLR (P<0.05). NLR was associated with gender, tumor size, TNM stage, PLR and MLR (both P<0.05). Univariate analysis showed that tumor size, depth of tumor invasion, metastasis of lymph nodes, pathological grading, nerve infiltration, lymphovascular invasion, TNM staging, PLR and MLR were associated with the median overall survival time (P<0.05). Multivariate analysis showed that TNM stage, nerve infiltration and MLR were independent prognostic predictors for patients with esophagogastric junction cancer (P<0.05), but not PLR or NLR. Setting the optimal cut-off value of the MLR in 0.201, the area under the curve was 0.603, significantly larger than that of PLR and NLR (P<0.05). Conclusions: Preoperative MLR is a very useful predictor of patients with esophagogastric junction cancer who underwent radical rescetion. Preoperative MLR> 0.201 is an independent risk factor for postoperative survival in patients with esophagogastric cancer, and PLR> 96.960 may predict a poor prognosis risk.

[The validity and reliability of simplified Chinese version of the pediatric sleep questionnaire for screening children with obstructive sleep apnea syndrome in Beijing]

Objective: To evaluate the validity and reliability of the simplified Chinese version of pediatric sleep questionnaire (PSQ) used in screening obstructive sleep apnea syndrome (OSAS) of children in Beijing. Methods: Children with snoring who presented to the Sleep Center of Beijing Children's Hospital between August 2014 and July 2015 and healthy children were included in the study. All children underwent PSG and then were divided into OSAS group and control group based on the PSG and their guardians were asked to complete the simplified Chinese version of PSQ that was formed by both translation from PSQ and retroversion to PSQ. Structure validity evaluation included confirmatory factor analysis which used Amos structural equation model and exploratory factor analysis which used principal component analysis. Predictive validity were measured with Logistic regression model. Internal reliability and test-retest reliability were evaluated by Cronbach 's alpha coefficient and intra-class correlation coefficient (ICC), respectively. The screening efficiency was evaluated by the receiver operating characteristic curve (ROC). Results: The study included 235 children aged 3-16 years old, 145 children of them with the age of (5.8±2.1) in OSAS group and 90 children with the age of (7.7±3.3) in control group. Confirmatory factor analysis indicated most items belonging to individual factors with load coefficient ≥ 0.5. Predictive validity analysis revealed 13 items positively related to the diagnosis of OSAS (all OR>1, all P<0.05). Cronbach's alpha coefficients were respectively 0.703 (overall reliability), 0.767 (breathing factor), 0.849 (sleepiness factor) and 0.689 (behavior factor). The test-retest ICC reliability was 0.986 (PSQ), 0.991 (breathing factor), 0.727 (sleepiness factor), and 0.870 (behavior factor) with P<0.05. In receiver operating characteristic curve, the area under curve of simplified Chinese version PSQ score was 0.922 with P<0.05 and the cutoff value of PSQ score was 7 in 22 items with the sensitivity of 0.776, specificity of 0.867, positive predictive value of 0.868 and negative prediction value of 0.774. Conclusions: The simplified Chinese version of PSQ is suitable to the screen of OSAS for the children in Beijing area with good reliability and validity. It also has acceptable sensitivity and specificity for screening children with OSAS when the cutoff score is 7 points.

Atrazine contamination in agricultural soils from the Yangtze River Delta of China and associated health risks

Atrazine is one of the most widely applied and persistent herbicides in the world. In view of limited information on the regional contamination of atrazine in soils in China, this study investigated the spatial distribution and environmental impacts of atrazine in agricultural soils collected from the Yangtze River Delta (YRD) as an illustrative analysis of rapidly developing regions in the country. The results showed that the concentrations of atrazine in the YRD agricultural soils ranged from <1.0 to 113 ng/g dry weight, with a mean of 5.7 ng/g, and a detection rate of 57.7 % in soils. Pesticide factory might be a major source for the elevated levels of atrazine in Zhejiang Province. The contamination of atrazine was closely associated with land use types. The concentrations and detection rates of atrazine were higher in corn fields and mulberry fields than in rice paddy fields. There was no significant difference in compositions of soil microbial phospholipids fatty acids among the areas with different atrazine levels. Positive relationship (R = 0.417, p < 0.05, n = 30) was observed between atrazine and total microbial biomass. However, other factors, such as soil type and land management practice, might have stronger influences on soil microbial communities. Human health risks via exposure to atrazine in soils were estimated according to the methods recommended by the US EPA. Atrazine by itself in all the soil samples imposed very low carcinogenic risks (<10^-6) and minimal non-cancer risks (hazard index <1) to adults and children.

[Mechanism of the Piezo1 protein-induced apoptosis of the chondrocytes through the MAPK/ERK1/2 signal pathway]

OBJECTIVE

To invstigate the mechanism of new mechanically-activated cation channel protein (Piezo1) can cause the apoptosis of the human chondrocytes under compressive loading, using a Flexercell unit by activating classical Mitogen-activated protein kinase (MAPK) signal pathyway(ERK1/2).

METHODS

Primary human chondrocytes were isolated, cultured, and then subjected to the static compressive loading for 0, 2, 12, 24, 48 h, respectively.The expressions of Piezo1 and the ERK1/2 were assessed by reverse transcription-polymerase chain reaction(PT-PCR), as well as the apoptosis gene B cell lymphoma/leukemia-2(Bcl-2) Bel-associated X protein(Bax). In addition, Piezo1inhibitor, Grammostola spatulata mechanotoxin 4(GsMTx4), was used to block Piezo1, served as a positive control.The immunofluorescence was used to locate the expression of Piezo1 protein and ERK1/2.AnnexinV-PI was used to detect the apoptosis of chondrocytes.

RESULTS

The expression of the Piezo1 in chondrocytesis was weak, the 12 h group was significant increased(0.198 1 vs 0.021 4, P<0.05), the 24 h group was the highest expression while the expression of the 48 h group was lower than the 24 h group, as well as the ERK1/2, Bcl-2 and caspase3.The result of AV-PI had shown that the 2 h group had increased early stage of apoptosis.The 12 h group had increased late stage of apoptosis, and the 24 h group's apoptotic rate was the highest, while the apoptotic rate of the 48 h group was lower than the 24 h group(0.497 1 vs 0.743 1, q=0.035 9). The GsMTx4 could inhibit the late stage of apoptosis, and the location of the Piezo1 was expressed in the nucleus and cytoplasm of the chondrocytes.

CONCLUSIONS

Piezo1 plays an important role in the apoptosis of the human chondrocyte through the classic MAPK/ERK1/2 signal pathway.