[Clinical effects of combined application of skin-stretching device and vacuum sealing drainage in repairing the diabetic foot wounds]

Objective: To investigate the clinical effects of skin-stretching device (hereinafter referred to as stretcher) combined with vacuum sealing drainage (VSD) in repairing diabetic foot wounds. Methods: From March 2016 to January 2020, 25 patients with diabetic foot wounds were admitted to the First Affiliated Hospital of Air Force Medical University, including 18 males and 7 females, with age of 40 to 70 years. After debridement, intermittent VSD was performed for 3 to 10 days, with negative pressure value of -10.67 kPa. Then, the wound area was 5.0 cm×3.0 cm to 10.0 cm×7.0 cm. After infection control and detumescence, the wound was treated with stretcher for 3 to 5 days. The wound area after stretching ranged from 5.0 cm×0.3 cm to 10.0 cm×0.5 cm. The wound was closed with full-thickness suture. Two weeks after the suturing operation, the healing grade of the foot wound of patients was observed, and the serious complications such as recurrence of ulcer wound and gangrene on the foot, scar condition of the wound were observed during follow-up. Results: Two weeks after the suturing operation, the wounds of 23 patients were healed with grade A. Soft tissue infection ulcer relapsed in 2 patients during the stretch period. After anti-infection, thorough debridement, and VSD, the wounds were healed after another 16 days of stretch treatment. During the follow-up of 3 to 36 months, 23 patients had linear scar left on the stretch wounds, and the skin elasticity, color, sensation was similar to the surrounding normal tissue, and the limb mobility was good, and 2 patients had obvious scar hyperplasia. One patient had recurrence of diabetic foot and serious vascular occlusion and gangrene in the affected limb at follow-up of 10 months, which was treated with amputation of the lower leg. Conclusions: The use of stretcher combined with VSD in treating diabetic foot wound can avoid donor site injury, with healed wound achieving similar appearance to adjacent skin and satisfactory repair effects.

[Study on clinical phenotype of coal workers pneumoconiosis]

Objective: To explore the clinical phenotypic characteristics of coal worker's pneumoconiosis for guiding the individualized treatment of various types of patients with coal worker's pneumoconiosis. Methods: Collect clinical data of 121 cases of coal worker's pneumoconiosis in different stages, and select 16 clinical variables (age, smoking index, years of underground dust exposure, stages of pneumoconiosis, types of work, family history, main symptoms, secondary symptoms, CAT score, imaging manifestations, FVC%, FEV(1)/FVC, FEV(1)%, DLCO%, respiratory failure complications, pulmonary heart disease complications) . Principal Component Factor Analysis (PCA) was used to analyze 16 clinical variables of 121 patients with coal worker's pneumoconiosis. Extracted 2 principal components and 8 related variables from 16 clinical variables, then coal worker's pneumoconiosis patients were divided into three types according to CCC values. Variance analysis or χ(2) test were used to analyze the characteristics of these three types of clinical data, then summarized the clinical phenotype composition ratio and clinical data characteristics. Results: The patients with coal worker's pneumoconiosis were initially divided into three types, including 73 cases (60.3%) in type 1, 18 cases (14.9%) in type 2 and 30 cases (24.8%) in type 3. Patients in type 1 are mainly middle-aged, with little damage to lung function and mild clinical symptoms, the imaging manifestations of type 1 patients are mainly diffuse nodules, and the stages of pneumoconiosis are mostly one-stage and second-stage. Patients in type 2 are mainly in middle-aged and elderly patients.the main pulmonary impairment is diffuse function decline. The clinical symptoms are severe and the imaging manifestations are complex. The stages of pneumoconiosis are one, second and third stages. Patients in type 3 are mainly middle-aged and elderly patients, with more pulmonary function impairment (decreased ventilation and diffusion) , severe clinical symptoms, complex imaging manifestations (micro nodules, emphysema, mass shadow, fibrosis) , and those pneumoconiosis stages are mainly in the second and third stages. Conclusion: According to the clinical characteristics, the patients with coal worker's pneumoconiosis were divided into 3 types by cluster analysis method, the treatment plan has certain guiding value in clinical work according to different classifications.

[Clinicopathological features and prognosis of gastrointestinal stromal tumor with PDGFRA-D842V mutation]

Objective: Platelet-derived growth factor alpha (PDGFRA) mutations are respectively rare in gastrointestinal stromal tumors (GIST). Most GIST with PDGFRA exon 18 mutations including D842V mutation are highly resistant to imatinib. The treatment of GIST harboring PDGFRA primary drug-resistant mutation is a major challenge. This article aims to investigate clinicopathologic features of GIST with PDGFRA-D842V mutation and the efficacy of comprehensive treatment, providing a reference for clinical practice. Methods: A retrospective cohort study was conducted to collect the clinicopathological and follow-up data of patients with GIST harboring PDGFRA mutation who were diagnosed and treated in the GIST Clinic of Renji Hospital from January 2005 to May 2020. According to the mutation site, the enrolled patients were divided into D842V mutation group and non-D842V mutation group. The differences of clinicopathologic characteristics between the two groups were compared. Furthermore, overall survival and prognostic factors were analyzed. Results: A total of 71 patients with PDGFRA-mutant GIST were included in this study, including 47 cases of D842V mutation (66.2%) and 24 cases of non-D842V mutation (33.8%). There were 28 male patients and 19 female patients in D842V mutation group, with a median age of 60 (36-82) years. There were 16 male patients and 8 female patients in non-D842V mutation group, with a median age of 62 (30-81) years. There were no significant differences in age, gender, primary location, surgical procedure, tumor size, mitotic count, expression of CD117 and DOG1, Ki-67 proliferation index and modified NIH grade between the two groups (all P>0.05). The positive rate of CD34 was 89.4% (42/47) and 62.5% (15/24) in the D842V mutation group and the non-D842V mutation group, respectively, with a statistically significant difference (χ(2)=5.644, P=0.018). Among all the cases, 66 cases underwent R0 resection without preoperative treatment; two cases underwent emergency operation with R1 resection because of tumor rupture; 2 cases were not operated after the pathological and mutation types were confirmed by biopsy (one case received avapritinib treatment and obtain partial remission). One case was diagnosed as wild-type GIST per needle biopsy in another institute, and underwent R0 resection after preoperative imatinib treatment for 6 months. After surgery, 5 high-risk GIST patients with D842V mutation and 5 high-risk GIST patients with non-D842V mutation were treated with imatinib for more than one year. The median follow-up time was 37 (1-153) months. As of the last follow-up among the patients who received R0 resection, 4 patients with D842V mutation had relapse, of whom 1 was in the period of imatinib administration, and the 3-year relapse-free survival rate was 94.2%; none of the patients with non-D842V mutation had relapse. There was no statistically significant difference in relapse-free surivval between two groups (P=0.233). Univariate analysis revealed that mitotic count (P=0.002), Ki-67 proliferation index (P<0.001) and modified NIH grade (P=0.025) were the factors associated with relapse-free survival of patients with D842V mutation after R0 resection (all P<0.05). However, the above factros were not testified as independant prognostic facors in multivariate Cox analysis (all P<0.05). Conclusion: Clinicopathologic features and the efficacy of radical resection in patients with PDGFRA-D842V mutation are similar to those in patients with non-D842V mutation.

[Follow-up and retrospective investigation of patients with pneumoconiosis in Jiangsu Province, China]

Objective: To investigate the features, changing trend, and rules of pneumoconiosis in Jiangsu Province, China, as well as the health status of patients with pneumoconiosis. Methods: From July to October 2019, the patients with pneumoconiosis, reported up to the end of 2018 in Jiangsu Province, were enrolled as respondents, and follow-up and retrospective investigation were performed. A total of 24405 patients with pneumoconiosis were investigated, and related data were collected from the monitoring system of cause of death for residents, pneumoconiosis network reporting system, occupational disease diagnosis institution, management institutions for the reporting of occupational diseases, and related residents' committee or village committee. The patients with pneumoconiosis, who had been reported, were followed up by telephone or on-site visit to obtain the information on their conditions. A descriptive analysis was performed for age of onset, working years, sex, category of industry, type of pneumoconiosis, annual disease onset, geographic distribution, and medical security. Results: Among the 24405 patients, a male/female ratio was 16.81∶1. Of all 24405 patients, 15948 (65.35%) had stage 1 pneumoconiosis, 5289 (21.67%) had stage 2 pneumoconiosis, and 1637 (6.71%) had stage 3 pneumoconiosis. The mean working years for dust exposure was 16.25±9.95 years for all patients, and the mean working years for dust exposure was 15.80±9.95 years for patients with stage 1 pneumoconiosis, 17.82±9.80 years for patients with stage 2 pneumoconiosis, and 16.31±9.90 years for patients with stage 3 pneumoconiosis. The highest number of cases of pneumoconiosis was reported in Wuxi (5744 cases, accounting for 23.54%) , followed by Zhenjiang (4160 cases, accounting for 17.05%) , Xuzhou (3851 cases, accounting for 15.78%) , Yancheng (3340 cases, accounting for 13.69%) , and Suzhou (2948 cases, accounting for 12.08%) . Major types of pneumoconiosis included silicosis (15392 cases, accounting for 63.07%) and coal workers' pneumoconiosis (5253 cases, accounting for 21.52%) . In this survey, 21115 completed follow-up, among whom 15924 survived and 5191 died, 15924 patients with pneumoconiosis survived, among whom 7461 (46.85%) had an age of ≥70 years and 2515 (15.79%) were exposed to dust for 5-9 years. The industries involved were mainly coal mining and washing industry (5687 cases, accounting for 35.71%) and public management, social security, and social organization (3349 cases, accounting for 21.03%) ; in terms of security, 7999 patients (50.23%) were covered by occupational injury insurance, 946 (5.94%) were compensated by employers, 4537 (28.49%) were covered by basic medical insurance for urban and rural residents, 1590 (9.98%) were covered by critical illness insurance, and 5458 (34.28%) were covered by other types of social security, such as medical assistance and poverty relief. Conclusion: Silicosis and coal worker's pneumoconiosis are the key points for the prevention and treatment of pneumoconiosis in Jiangsu Province, and supervision should be strengthened for industries and regions with serious dust hazards.

[Clinical study of anti-human T cell porcine immunoglobulin with recombinant human tumor necrosis factor-α receptor II: IgG Fc in the treatment of 35 cases of grade III/IV acute graft-versus-host disease after allo-HSCT]

Objective: To evaluate the efficacy and safety of anti-human T lymphocyte porcine immunoglobulin (P-ATG) with recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein (rhTNFR∶Fc, Etanercept) on grade Ⅲ/Ⅳ acute graft-versus-host disease (aGVHD) after allogenic hematopoietic stem cell transplantation (allo-HSCT) . Methods: Thirty-five patients with Grade Ⅲ/Ⅳ aGVHD who received P-ATG with etanercept therapy after allo-HSCT were retrospectively analyzed. P-ATGs (5 mg·kg(-1)·d(-1)) were administrated for 3 to 5 days, and then 5mg/kg was sequentially administrated, QOD to BIW. Etanercepts were administrated 25 mg, twice a week (12.5 mg, BIW for pediatric patients) . Results: Among the 35 patients with grade Ⅲ/Ⅳ aGVHD, 21 were males and 14 females, with a median age of 10 (3-54) years. A total of 19 cases of acute myeloid leukemia, 13 of acute lymphoblastic leukemia, 1 of severe aplastic anemia, 1 of myelodysplastic syndrome, and 1 of mixed phenotypic acute leukemia were noted. The overall response (OR) rate of P-ATG with etanercept was 85.7% (30/35) , with complete response (CR) and partial response (PR) rates of 34.3% (12/35) and 51.4% (18/35) , respectively, on day 28. The OR rate of grade Ⅲ aGVHD group was higher than of grade IV aGVHD group [100% (19/19) vs. 68.8% (11/16) , P=0.004]. On day 56, the OR rate became 77.2% (27/35) , with CR and PR rates of 62.9% (22/35) and 14.3% (5/35) , respectively. The OR rate of grade Ⅲ aGVHD group was also higher than of grade Ⅳ aGVHD group [89.5% (17/19) vs. 62.5% (10/16) , P=0.009]. Thirty-five patients had no adverse effects such as fever, chills, and rash during the P-ATG infusion, and no obvious liver and kidney function damage was observed after treatment. The main treatment-related complication was infection. The reactivation rates of CMV and EBV were 77.1% (27/35) and 22.9% (8/35) , respectively, and the bacterial infection rate was 48.6% (17/35) . With a median follow-up time of 13 (1-55) months after HSCT, the 1-year and 2-year OS rates were (68.1±8.0) % and (64.3±8.4) % , respectively. The 1-year OS rate of grade Ⅲ aGVHD group was superior to grade Ⅳ aGVHD group [ (84.2±8.4) % vs. (47.6±13.1) % , χ(2)=3.38, P=0.05]. Conclusion: This study demonstrated that P-ATG with etanercept was effective and safe in treating grade Ⅲ-Ⅳ aGVHD after allo-HSCT.

[A systematic review on quality of life of esophageal cancer patients in China]

Objective: To systematically review the quality of life of esophageal cancer patients in China. Methods: Based on CNKI, Wanfang, PubMed and EMbase database, related articles published from January 2009 to August 2019 were systematically retrieved. We extracted the basic information, synthesized and summarized related instruments evaluation results. Results: A total of 127 studies were included (121 in Chinese, 6 in English), involving 26 provinces, of which 79 studies were published in the past 5 years and only 4 studies were multicenter study. More than half of included studies had a sample size of <150 cases (72 studies). Most studies were from the medical care and nursing field (58 studies) and were about the evaluation and comparison of treatments and medicine (40 studies). Six specific tools, including most commonly used Core Quality of Life Questionnaire (QLQ-C30) reported in 74 studies, 4 generic instruments, including most commonly used 36-item Short Form Health Survey (SF-36) reported in 17 studies and several self-designed questionnaires, were used. All the instruments focused on physical, physiological and social dimensions, but the specific contents and numbers of items were different. The index of quality of life used were dimension scores and total scores, and only 2 studies were about the health-related utility of esophageal cancer patients. Conclusions: In China, the research on the quality of life of esophageal cancer patients increased rapidly over the past decade, but most were single-center and small sample studies. The esophageal cancer-specific QLQ-C30 and generic SF-36 were the most commonly used instruments in the studies. The medical care and nursing and evaluation of treatments were the main concerns, but the research on health utility scores of esophageal cancer was still limited in China.

Improved Constraints on Sterile Neutrino Mixing from Disappearance Searches in the MINOS, MINOS+, Daya Bay, and Bugey-3 Experiments

Searches for electron antineutrino, muon neutrino, and muon antineutrino disappearance driven by sterile neutrino mixing have been carried out by the Daya Bay and MINOS+ collaborations. This Letter presents the combined results of these searches, along with exclusion results from the Bugey-3 reactor experiment, framed in a minimally extended four-neutrino scenario. Significantly improved constraints on the θ_{μe} mixing angle are derived that constitute the most constraining limits to date over five orders of magnitude in the mass-squared splitting Δm_{41}^{2}, excluding the 90% C.L. sterile-neutrino parameter space allowed by the LSND and MiniBooNE observations at 90% CL_{s} for Δm_{41}^{2}<13  eV^{2}. Furthermore, the LSND and MiniBooNE 99% C.L. allowed regions are excluded at 99% CL_{s} for Δm_{41}^{2}<1.6 eV^{2}.

[Meta-analysis of clinical effects of microskin grafting and Meek microskin grafting in repairing extensively deep burn wounds]

Objective: To systematically evaluate the clinical effects of microskin grafting and Meek microskin grafting in repairing extensively deep burn wounds using meta-analysis. Methods: Foreign language databases including PubMed and Cochrane Library were searched with the terms of " Meek micrografting, burn" , and Chinese databases including Chinese Journal Full-Text Database, Chinese Biomedical Database, VIP database, and Wanfang Data were searched with the terms in Chinese version of ", Meek," to retrieve the publicly published randomized controlled trials on the microskin grafting and Meek microskin grafting in repairing extensively deep burn wounds from the establishment of each database to March 20, 2019. The outcome indexes included the survival rate of skin graft, primary healing rate, operation time, and surgical treatment cost after the first operation, as well as the wound healing time and length of hospital stay. RevMan 5.3 and Stata 14.0 statistical software were used to conduct a meta-analysis of eligible studies. Results: A total of 821 patients with extensively deep burns were included in 15 studies, including 410 patients in microskin group who received microskin grafting and 411 patients in Meek microskin group who received Meek microskin grafting. The bias risks of the 15 studies included were uncertain. Compared with those of microskin group, the survival rate of skin graft and primary healing rate of patients in Meek microskin group were significantly increased, with relative risks of 0.76 and 0.66 (95% confidence interval=0.66-0.88, 0.50-0.88, P<0.01), the surgical treatment cost was significantly reduced, with a standardized mean difference of 3.19 (95% confidence interval=1.36-5.01, P<0.01), and the operation time, wound healing time, and length of hospital stay were significantly shortened, with standardized mean differences of 6.05, 2.39, and 2.35 (95% confidence interval=3.66-8.44, 1.43-3.35, 2.03-2.68, P<0.01). Subgroup analysis showed that microskin grafting combined with allogenic skin graft might be a heterogeneous source of operation time. Sensitivity analysis showed that the combined effect size was stable in the operation time, surgical treatment cost, and wound healing time. There was no publication bias in the survival rate of skin graft, operation time, wound healing time, and length of hospital stay (P>0.05), while the primary healing rate and surgical treatment cost had publication bias (P<0.01). Conclusions: Compared with microskin grafting, Meek microskin grafting improves the rates of skin graft survival and primary healing, shortens operation time, wound healing time, and length of hospital stay, and reduces the treatment cost in treating extensively deep burn wounds.

[Comparison of epidemic characteristics between SARS in 2003 and COVID-19 in 2020 in Guangzhou]

Objective: By analyzing the epidemic characteristics and related indicators of SARS and COVID-19, to explore the reasons for the similarities and differences of the two epidemics, so as to provide reference for epidemic prevention and control. Methods: The general situation, clinical classification, activity history, contact history, family members' contact and incidence of the two infectious diseases in Guangzhou were collected and used to analyze the time characteristics, occupational characteristics, age characteristics and other key indicators of the two diseases, including the number of cases, composition ratio (%), mean, median, crude mortality, etc. Results: A total of 1 072 cases of SARS were included in the study. Three hundred and fifty three were severe cases with the incidence of 30.13%. Forty three cases of death were reported with a mortality rate of 4.01%. The average age was 46 years old, and 26.31% of the cases were medical staff. The interval time between first report to continuous zero reports was 129 days. As to COVID-19, a total of 346 cases were included. 58 of which were severe cases with the incidence of 16.67%. One case of death was reported with a mortality rate of 0.29%. The average age was 38 years old, and no hospital infection among medical staff was reported. The interval time between first report to continuous zero reports was 35 days. Conclusions: The prevention and control strategies for COVID-19 were more effective compared to that of SARS, and the emergency response procedures were worth to be evaluated and summarized.

[Cerebrospinal fluid TP53 gene mutation in patients with lung cancer associated meningitis and its clinical implications]

Objective: To observe the role of cerebrospinal fluid (CSF) TP53 gene mutation in lung cancer associated meningitis. Methods: A retrospective analysis was performed on 35 patients diagnosed with lung cancer associated meningitis at the Second Hospital of Hebei Medical University from December 2015 to December 2018.All patients underwent the next-generation sequencing of CSF, and TP53 gene was found to be mutant or wild type, including 23 patients with TP53 mutant type and 12 patients with TP53 wild type. The clinical characteristics, CSF leukocyte, protein, glucose, chloride, Karnofsky performance (KPS) and overall survival were observed. Results: Headache, nausea and vomiting were the main clinical manifestations in both groups.There were no significant differences in CSF pressure, leukocyte, biochemical indicators and KPS between the two groups. The average time from diagnosis of lung cancer to diagnosis of lung cancer associated meningitis in the TP53 mutant group was significantly shorter than that in the TP53 wild type group (5.79 months vs 25.5 months).The median survival time of patients in the TP53 mutant group from lung cancer diagnosis to the observation endpoint was 19.77 months, while it was 88.73 months in the TP53 wild type group, and the difference was statistically significant (P=0.043). Conclusions: Mutation in the tumor suppressor gene TP53 can be detected in the CSF of patients with lung cancer associated meningitis. Patients with such mutation have earlier meningeal metastasis and shorter median survival time.

Direct Detection Constraints on Dark Photons with the CDEX-10 Experiment at the China Jinping Underground Laboratory

We report constraints on the dark photon effective kinetic mixing parameter (κ) with data taken from two p-type point-contact germanium detectors of the CDEX-10 experiment at the China Jinping Underground Laboratory. The 90% confidence level upper limits on κ of solar dark photon from 205.4 kg-day exposure are derived, probing new parameter space with masses (m_{V}) from 10 to 300  eV/c^{2} in direct detection experiments. Considering dark photon as the cosmological dark matter, limits at 90% confidence level with m_{V} from 0.1 to 4.0  keV/c^{2} are set from 449.6 kg-day data, with a minimum of κ=1.3×10^{-15} at m_{V}=200  eV/c^{2}.

[Clinical characteristics of pneumoconiosis complicated with chronic obstructive pulmonary disease]

Objective: To analyze the pulmonary function and clinical features of coal worker's pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD) , coal worker's pneumoconiosis and COPD, in order to improve the diagnosis and treatment of coal worker's pneumoconiosis complicated with chronic obstructive pulmonary disease. Methods: Selected patients in respiratory department of General Hospital of Jincheng Coal Industry Group were classified as pneumoconiosis complicated with COPD group (n=52) , pneumoconiosis group (n=70) and COPD group (n=50) . Clinical data were collected and compared between three groups, including age, history of smoking, BMI, pulmonary function, CAT score and complication with Hypoxemia and respiratory faliure. Results: The mean age, smoking index and BMI of the three groups were not significantly different. The FEV1% pred, FEV(1)/FVC%, DLco-SB%, FVC% pred were significantly lower in pneumoconiosis complicated with COPD group than pneumoconiosis group (P<0.05) ; The FEV(1)% pred, DLco-SB%, FVC% pred were significantly lower in pneumoconiosis complicated with COPD group than COPD group (P<0.05) , but, the FEV(1)/FVC% was no significant different between pneumoconiosis complicated COPD group and COPD group (P>0.05) ; The CAT score for clinical symptoms of pneumoconiosis complicated with COPD group was significantly higher than that of pneumoconiosis group (P<0.05) , but there was no significant difference between pneumoconiosis complicated COPD group and COPD group (P>0.05) . The rate of hypoxemia in coal workers' pneumoconiosis combined with chronic obstructive pulmonary disease was 78.8%, which was higher than that of coal workers' pneumoconiosis group (61.4%) and chronic obstructive pulmonary disease group (72%) ; The respiratory failure rate of coal worker's pneumoconiosis combined with chronic obstructive pulmonary disease group was 44.2%, which was higher than that of coal worker's pneumoconiosis group (4.3%) and chronic obstructive pulmonary disease group (16%) . Conclusion: In pneumoconiosis patients, once complicate with COPD, the pulmonary function indexes are worse, the clinical symptoms are heavier, and the probability of hypoxemia and respiratory failure are higher. Compared with the COPD group, the patients with pneumoconiosis complicated with COPD have more restrictive ventilation dysfunction and diffuse dysfunction, and the clinical symptoms are heavier, and the probability of combined respiratory failure is higher.

[Occupational hazards and risk assessment of benzene-related enterprises in yangzhou city from 2014 to 2018]

Objective: To investigate the benzene concentration in the workplace of benzene-related enterprises in Yangzhou City from 2014 to 2018, and the abnormal blood routine of workers exposed to benzene, and to assess their occupational hazards. Methods: The environmental monitoring data of benzene-related enterprises and the health examination data of benzene exposed workers were collected in March 2019. The inhalation risk assessment model of the National Environmental Protection Agency (EPA) was used to assess the carcinogenic and non-carcinogenic risks of benzene workers. Results: The qualified rate of benzene detection in the workplace was 100% from 2014 to 2018, the highest concentration was 1.42 mg/m(3) in five years. The abnormal rates of blood routine detection in benzene exposed workers in five years was 7.10% (213/2 998) 、5.17% (218/4 214) 、5.61% (196/3 493) 、7.65% (288/3 767) 、7.83% (280/3 574) and 7.83%. respectively. The results of risk assessment showed that the minimum carcinogenic risk value was 7.56×10(-6) and the maximum carcinogenic risk value was 31.33×10(-6) in 2014-2018. The hazard quotient values were than 1. Conclusion: Benzene monitoring concentration in benzene-related enterprises in Yangzhou City from 2014 to 2018 was low, which meets the occupational exposure limit in China. However, the abnormal rate of blood routine in five years is still high, and there are both carcinogenic and non-carcinogenic risks. We should pay more attention to the health risk of workers exposed to low concentrat in benzene.

[Endovascular treatment for non-thrombotic right iliac vein compression syndrome with intravascular ultrasound]

Objective: To evaluate the clinical efficacy of endovascular treatment for non-thrombotic right iliac vein compression syndrome with intravascular ultrasound. Methods: The clinical data of 40 patients with non-thrombotic right iliac vein compression syndromereceiving intravascular ultrasound-assisted balloon dilatation combined with stent implantation from January 2012 to December 2018 were retrospectively analyzed. There were 32 males and 8 females, the average age of whom was 63 (46-81) years old. The patients were classified according to the CEAP (Clinical-Etiology- Anatomy-Pathophysiology) classification: 7 cases as C3, 18 as C4, 10 as C5 and 5 as C6. All patients underwent percutaneous right femoral vein puncture, intravascular ultrasound, and balloon dilatation combined with stentimplantation in the right iliac vein lesion location. Results: The success rate of clinical operations was 100%. There were no serious complications during the perioperative period. All patients were followed up for 4-58 months. During the follow-up period, the relief rate of limb edema was 88.6% (31/35), the pain relief rate was 86.7%(13/15), and the healing rate of ulcers was 100% (6/6). After the stent implantation, the endovascular area of the compression site was significantly enlarged (34.5mm(2)± 11.1mm(2)vs129.8 mm(2)±17.2 mm(2), P<0.001). The follow-up of color Doppler and/or anterograde angiography for deep veins of lower limb with digital subtraction angiography showed that the blood flow in the stentsweres mooth in all patients. Three cases were observed that the intimal hyperplasia led to mild in-stent restenosis, no obvious in stent restenosis (>50%). The abdominal X-ray plain film showed no obvious displacement and fracture of the stents. The venous clinical severity score (VCSS) was statistically significant (13.0±2.4 vs 6.2±2.0, P<0.001). The statistical results of short-form health surver SF-36 showed that the scores of life quality in all dimensions of the affected limb were significantly improved after operation (P=0.000). Conclusion: Intravascular ultrasound-assisted balloon dilatation combined with stent implantation is not only a safe and effective treatment for non-thrombotic right iliac vein compression syndrome, but also has a good mid-term patency rate.

Search for Light Weakly-Interacting-Massive-Particle Dark Matter by Annual Modulation Analysis with a Point-Contact Germanium Detector at the China Jinping Underground Laboratory

We present results on light weakly interacting massive particle (WIMP) searches with annual modulation (AM) analysis on data from a 1-kg mass p-type point-contact germanium detector of the CDEX-1B experiment at the China Jinping Underground Laboratory. Datasets with a total live time of 3.2 yr within a 4.2-yr span are analyzed with analysis threshold of 250 eVee. Limits on WIMP-nucleus (χ-N) spin-independent cross sections as function of WIMP mass (m_{χ}) at 90% confidence level (C.L.) are derived using the dark matter halo model. Within the context of the standard halo model, the 90% C.L. allowed regions implied by the DAMA/LIBRA and CoGeNT AM-based analysis are excluded at >99.99% and 98% C.L., respectively. These results correspond to the best sensitivity at m_{χ}<6  GeV/c^{2} among WIMP AM measurements to date.

[An interlaboratory comparison study on the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels]

Objective: To investigate the current status and real performance of the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels in China through interlaboratory comparison. Methods: Peking University People's Hospital (PKUPH) prepared the samples for comparison. That is, the fresh RUNX1-RUNX1T1 positive (+) bone morrow nucleated cells were serially diluted with RUNX1-RUNX1T1 negative (-) nucleated cells from different patients. Totally 23 sets with 14 different samples per set were prepared. TRIzol reagent was added in each tube and thoroughly mixed with cells for homogenization. Each laboratory simultaneously tested RUNX1-RUNX1T1 and WT1 transcript levels of one set of samples by real-time quantitative PCR method. All transcript levels were reported as the percentage of RUNX1-RUNX1T1 or WT1 transcript copies/ABL copies. Spearman correlation coefficient between the reported transcript levels of each participated laboratory and those of PKUPH was calculated. Results: ①RUNX1-RUNX1T1 comparison: 9 samples were (+) and 5 were (-) , the false negative and positive rates of the 20 participated laboratories were 0 (0/180) and 5% (5/100) , respectively. The reported transcript levels of all 9 positive samples were different among laboratories. The median reported transcript levels of 9 positive samples were from 0.060% to 176.7%, which covered 3.5-log. The ratios of each sample's highest to the lowest reported transcript levels were from 5.5 to 12.3 (one result which obviously deviated from other laboratories' results was not included) , 85% (17/20) of the laboratories had correlation coefficient ≥0.98. ②WT1 comparison: The median reported transcript levels of all 14 samples were from 0.17% to 67.6%, which covered 2.6-log. The ratios of each sample's highest to the lowest reported transcript levels were from 5.3-13.7, 62% (13/21) of the laboratories had correlation coefficient ≥0.98. ③ The relative relationship of the reported RUNX1-RUNX1T1 transcript levels between the participants and PKUPH was not always consistent with that of WT1 transcript levels. Both RUNX1-RUNX1T1 and WT1 transcript levels from 2 and 7 laboratories were individually lower than and higher than those of PKUPH, whereas for the rest 11 laboratories, one transcript level was higher than and the other was lower than that of PKUPH. Conclusion: The reported RUNX1-RUNX1T1 and WT1 transcript levels were different among laboratories for the same sample. Most of the participated laboratories reported highly consistent result with that of PKUPH. The relationship between laboratories of the different transcript levels may not be the same.

Constraints on Spin-Independent Nucleus Scattering with sub-GeV Weakly Interacting Massive Particle Dark Matter from the CDEX-1B Experiment at the China Jinping Underground Laboratory

We report results on the searches of weakly interacting massive particles (WIMPs) with sub-GeV masses (m_{χ}) via WIMP-nucleus spin-independent scattering with Migdal effect incorporated. Analysis on time-integrated (TI) and annual modulation (AM) effects on CDEX-1B data are performed, with 737.1 kg day exposure and 160 eVee threshold for TI analysis, and 1107.5 kg day exposure and 250 eVee threshold for AM analysis. The sensitive windows in m_{χ} are expanded by an order of magnitude to lower DM masses with Migdal effect incorporated. New limits on σ_{χN}^{SI} at 90% confidence level are derived as 2×10^{-32}∼7×10^{-35}  cm^{2} for TI analysis at m_{χ}∼50-180  MeV/c^{2}, and 3×10^{-32}∼9×10^{-38}  cm^{2} for AM analysis at m_{χ}∼75  MeV/c^{2}-3.0  GeV/c^{2}.

[Invasive breast lobular carcinoma with extracellular mucin: a clinicopathological analysis]

Objective: To study the clinicopathological features of invasive lobular carcinoma (ILC) of the breast with extracellular mucin and outcomes of patients. Method: Clinicopathological features and clinical follow-up (39-123 months and a median follow-up of 55 months) of seven ILC with extracellular mucin were obtained. Hematoxylin-and-eosin (H&E) and immunohistochemistry (IHC) stained sections were reviewed, and fluorescence in situ hybridization (FISH) assay was performed for tumors with HER2 IHC 2+. Patient prognosis was analyzed and literatures related to ILC with extracellular mucin were reviewed. Results: All seven patients were female, aged from 43 to 73 years (median age, 55 years). The tumors ranged in size from 1 to 5 cm (median size 2 cm). All seven cases were of histological grade 2. Most areas of the tumors presented with the morphology of classic ILC, and variable amount of extracellular mucin were observed focally. In six cases, part of the tumor cells contained intracellular mucin, and the nucleus were pushed to one side of the cells, creating the impression of signet-ring cells. Two patients had lymph node metastases at diagnosis, and developed liver and bone metastases at 38th and 48th month, respectively, after surgery, and died at 48th and 123th month, respectively. While the other five patients, except one lost to follow-up, had been disease-free during the follow-up period. IHC results showed estrogen receptor (ER) and progesterone receptor (PR) positivity in 7/7 and 6/7 cases, respectively. Tumors of six patients were HER2 IHC 0/1+. The remaining one was HER2 IHC 2+, while FISH assay revealed HER2 gene amplification in that tumor. The proportion of cases with HER2-positivity was 1/7. The proliferation index Ki-67 ranged from less than 5% to 30%, and Ki-67 less than or equal to 10% were in 5/7 cases. According to the 2013 St. Gallen International Expert Consensus on breast cancer, all tumors were of luminal types; of those, two were luminal A and five were luminal B. Conclusions: ILC with extracellular mucin tends to occur in women over 50 years old. All tumors in the study are grade 2 classic ILC, with signet-ring cells as a common feature. All seven tumors are classified as luminal types, with luminal B as the main molecular subtype.

[Estimates of influenza-associated excess mortality by three regression models in Shanxi Province during 2013-2017]

Objective: Using three models too estimate excess mortality associated with influenza of Shanxi Province during 2013-2017. Methods: Mortality data and influenza surveillance data of 11 cities of Shanxi Province from the 2013-2014 through 2016-2017 were used to estimate influenza-associated all cause deaths, circulatory and respiratory deaths and respiratory deaths. Three models were used: (i) Serfling regression, (ii)Poisson regression, (iii)General line model. Results: The total reported death cases of all cause were 157 733, annual death cases of all cause were 39 433, among these cases, male cases 93 831 (59.50%), cases above 65 years old 123 931 (78.57%). Annual influenza-associated excess mortality, for all causes, circulatory and respiratory deaths, respiratory deaths were 8.62 deaths per 100 000, 6.33 deaths per 100 000 and 0.68 deaths per 100 000 estimated by Serfling model, respectively; and 21.30 deaths per 100 000, 16.89 deaths per 100 000 and 2.14 deaths per 100 000 estimated by General line model, respectively; and 21.76 deaths per 100 000, 17.03 deaths per 100 000 and 2.05 deaths per 100 000, estimated by Poisson model, respectively. Influenza-related excess mortality was higher in people over 75 years old; influenza-associated excess mortalityfor all causes, circulatory and respiratory deaths, respiratory deaths were 259.67 deaths per 100 000, 229.90 deaths per 100 000 and 32.63 deaths per 100 000, estimated by GLM model, respectively; and 269.49 deaths per 100 000, 233.69 deaths per 100 000 and 31.27 deaths per 100 000, estimated by Poisson model,respectively. Conclusion: Excess mortality associated with influenza mainly caused by A (H3N2), Influenza caused the most associated death amongold people.

Complete Measurement of the Λ Electromagnetic Form Factors

The exclusive process e^{+}e^{-}→ΛΛ[over ¯], with Λ→pπ^{-} and Λ[over ¯]→p[over ¯]π^{+}, has been studied at sqrt[s]=2.396  GeV for measurement of the timelike Λ electric and magnetic form factors, G_{E} and G_{M}. A data sample, corresponding to an integrated luminosity of 66.9  pb^{-1}, was collected with the BESIII detector for this purpose. A multidimensional analysis with a complete decomposition of the spin structure of the reaction enables a determination of the modulus of the ratio R=|G_{E}/G_{M}| and, for the first time for any baryon, the relative phase ΔΦ=Φ_{E}-Φ_{M}. The resulting values are R=0.96±0.14(stat)±0.02(syst) and ΔΦ=37°±12°(stat)±6°(syst), respectively. These are obtained using the recently established and most precise value of the asymmetry parameter α_{Λ}=0.750±0.010 measured by BESIII. In addition, the cross section is measured with unprecedented precision to be σ=118.7±5.3(stat)±5.1(syst)  pb, which corresponds to an effective form factor of |G|=0.123±0.003(stat)±0.003(syst). The contribution from two-photon exchange is found to be negligible. Our result enables the first complete determination of baryon timelike electromagnetic form factors.

Amplitude Analysis of D_{s}^{+}→π^{+}π^{0}η and First Observation of the W-Annihilation Dominant Decays D_{s}^{+}→a_{0}(980)^{+}π^{0} and D_{s}^{+}→a_{0}(980)^{0}π^{+}

We present the first amplitude analysis of the decay D_{s}^{+}→π^{+}π^{0}η. We use an e^{+}e^{-} collision data sample corresponding to an integrated luminosity of 3.19  fb^{-1} collected with the BESIII detector at a center-of-mass energy of 4.178 GeV. We observe for the first time the W-annihilation dominant decays D_{s}^{+}→a_{0}(980)^{+}π^{0} and D_{s}^{+}→a_{0}(980)^{0}π^{+}. We measure the absolute branching fraction B(D_{s}^{+}→a_{0}(980)^{+(0)}π^{0^{(}+)},a_{0}(980)^{+(0)}→π^{+(0)}η)=(1.46±0.15_{stat}±0.23_{sys})%, which is larger than the branching fractions of other measured pure W-annihilation decays by at least one order of magnitude. In addition, we measure the branching fraction of D_{s}^{+}→π^{+}π^{0}η with significantly improved precision.

Extraction of the ^{235}U and ^{239}Pu Antineutrino Spectra at Daya Bay

This Letter reports the first extraction of individual antineutrino spectra from ^{235}U and ^{239}Pu fission and an improved measurement of the prompt energy spectrum of reactor antineutrinos at Daya Bay. The analysis uses 3.5×10^{6} inverse beta-decay candidates in four near antineutrino detectors in 1958 days. The individual antineutrino spectra of the two dominant isotopes, ^{235}U and ^{239}Pu, are extracted using the evolution of the prompt spectrum as a function of the isotope fission fractions. In the energy window of 4-6 MeV, a 7% (9%) excess of events is observed for the ^{235}U (^{239}Pu) spectrum compared with the normalized Huber-Mueller model prediction. The significance of discrepancy is 4.0σ for ^{235}U spectral shape compared with the Huber-Mueller model prediction. The shape of the measured inverse beta-decay prompt energy spectrum disagrees with the prediction of the Huber-Mueller model at 5.3σ. In the energy range of 4-6 MeV, a maximal local discrepancy of 6.3σ is observed.

[Occupational acute mixed gas poisoning due to improper disposal of hazardous waste]

Objective: To investigate an occupational hazardous gas poisoning incident caused by gas leakage in the process of hazardous waste treatment. Methods: An investigation was conducted on a case of occupational acute hazardous gas poisoning caused by waste treatment gas leakage in Shandong province in December 2017. Meanwhile, the clinical data of 5 cases of poisoning patients were analyzed, and the accident related poison test report and other relevant data were analyzed. Results: The incident was caused by the toxic waste did not do labeling work, the workers' protection measures were not in place, the illegal operation and the blind rescue, resulting in a total of 5 people died on the spot, 12 people were hospitalized with poisoning. Among them, 5 patients admitted to our hospital showed varying degrees of damage to the nervous system and respiratory system. After active treatment, they all got better and were discharged. Conclusion: The poisoning is mainly caused by hydrogen sulfide dichloromethane hydrogen cyanide gas leakage serious production liability accident, clinical main performance for the nervous system circulatory system respiratory system and other system damage.

[Efficacy and safety of active transfer of plaque versus provisional stenting with drug-eluting stents for the treatment of coronary bifurcation lesions]

Objective: To compare the efficacy and safety of active transfer of plaque (ATP) versus provisional stenting (PS) with drug-eluting stents (DES) for the treatment of coronary bifurcation lesions. Methods: A total of 1 136 patients with bifurcation lesions hospitalized in 6 selected hospitals between January 2010 and January 2014 were included in this prospective observational trial, patients were divided into either ATP (n=560) or PS group (n=576) accordingly. The primary endpoint was target lesion revascularization within 1 year, and the second endpoints were all-cause death, cardiogenic death, myocardial infarction, stent thrombosis, stroke, recurrent angina within 1 year. Results: There were no significant differences in age, sex, hypertension, diabetes, hyperlipidemia and smoking history between the two groups (P>0.05). The incidence of TIMI blood flow <3 grade in the side branch (1.6%(9/560) vs. 7.5% (43/576), P<0.01), acute occlusion of the side branch (1.3%(7/560) vs. 7.1%(41/576), P<0.01) and implanted stents of side branch (1.8%(10/560) vs. 7.8% (45/576), P<0.01) were significantly lower in the ATP group than those in the PS group. During the one year follow up, the rate of target lesion revascularization was similar between ATP group and PS group (4.6%(26/560) vs. 4.0%(23/576), P=0.66). Conclusions: The effectiveness and safetyof ATP techniquein the patients with coronary bifurcation lesions is comparable to the PS technique. However, ATP technique is superior to PS technique on effectively reducing the incidence of implanted stents in the side branch.

[Post-marketing multi-center safety surveillance of inactivated enterovirus A71 vaccine (Vero cell)]

Objective: To evaluate the post-marketing safety profiles of the inactivated enterovirus type 71 (EV-A71) vaccine (Vero cell) after routine inoculation. Methods: Eleven cities of Zhejiang Province, Fengtai district of Beijing, Qinnan district, two counties as Pingle and Pingguo of Guangxi Zhuang Autonomous Region, and Dongtai city of Jiangsu Province were selected as the field sites. A total of 45 239 subjects were enrolled in this study from children who seeked the vaccination of EV-A71 vaccine during the period from July, 2016 to June, 2018. Different sampling method were adopted in different sites. All vaccinated children were invited to participate in the study in Fengtai and Dongtai, however, systematic sampling method were adopted in other sites. Active surveillance was conducted and information about adverse reactions (ARs) occurred in 30 min, 3 d and 30 d following each dose of EV-A71 immunization was collected by field observation, phone-call or face-to-face interview. The incidence of ARs in different types, symptoms and grades were described. Results: In total, there were 45 239 children who received 71 243 doses EV-A71 vaccine. The overall incidence of ARs was 1.079% (769 doses), with the highest incidence of 1.182% (177/14 973) in 5-11 month group and the lowest incidence of 0.849% (18/2 119) in ≥ 36 month group among different age groups. There was a higher incidence in solicited ARs, which was 1.047% (746 doses). The incidences of grade 1 and grade 2 ARs were also higher, which were 0.404% (288 doses) and 0.554% (395 doses), respectively. No grade 4 ARs occurred. The doses of the first and the second vaccination was 40 736 and 30 507, respectively, and the incidences of ARs were 1.281% (522 doses) and 0.810% (247 doses). Also, the incidences of ARs were 0.091% (37 doses) and 0.043% (13 doses) in local, and 1.168% (476 doses) and 0.760% (232 doses) in system. The symptoms of ARs after the two doses of vaccination were basically the same. Redness at the injection site was the most common local ARs after each dose vaccination, with doses of 24 and 11, while fever was the most common systemic ARs, with doses of 362 and 190. Moreover, ARs mainly occurred in 30 min to 3 d after each dose vaccination, with incidence of 1.016% (414 doses) and 0.698% (213 doses) in the first and second dose, respectively. Conclusion: The ARs had a low incidence after vaccination in children and most were mild or moderate. EV-A71 vaccine with good safety is suitable for inoculation in a large scale.

[Spectrometric analyses of larotaxel and larotaxel liposomes quantification by high performance liquid chromatography]

OBJECTIVE

Larotaxel is a new chemical structure drug, which has not been marketed worldwide. Accordingly, the standard identification and quantification methods for larotaxel remain unclear. The spectrometric analyses were performed for verifying weight molecular formula, molecular weight and chemical structure of larotaxel. Besides, a quantification method was developed for measuring larotaxel in the liposomes.

METHODS

The molecular formula, molecular weight and chemical structure of larotaxel were studied by using mass spectrometry (MS), infra-red (IR), nuclear magnetic resonance (NMR) and ultraviolet-visible (UV-vis) spectrometric techniques. The absorption wavelength of larotaxel was investigated by UV-vis spectrophotometry full-wavelength scanning. Besides, a quantification method was developed by high performance liquid chromatography (HPLC), and then validated by measuring the encapsulation efficacy of larotaxel liposomes.

RESULTS

The four spectral characteristics of larotaxel were revealed and the corresponding standard spectra were defined. It was confirmed that larotaxel had the structure of tricyclic diterpenoids, with the molecular formula of C45H53NO14, the molecular weight of 831.900 1, and the maximum absorption wavelength of 230 nm. The quantitative method of larotaxel was established by using HPLC with a reversed phase C18 column (5 μm, 250 mm×4.6 mm), a mobile phase of acetonitrile-water (75:25, volume/volume), and a detection wavelength of 230 nm. The validation study exhibited that the established HPLC method was stable, and had a high recovery and precision in the quantitative measurement of larotaxel in liposomes. In addition, a new kind of larotaxel liposomes was also successfully prepared. The particle size of the liposomes was about 105 nm, with an even size distribution. And the encapsulation efficiency of larotaxel in the liposomes was above 80%.

CONCLUSION

The present study offers reference standard spectra of larotaxel, including MS, IR, NMR, and UV-vis, and confirms the molecular formula, molecular weight and chemical structure of larotaxel. Besides, the study develops a rapid HPLC method for quality control of larotaxel liposomes.

Study of e^{+}e^{-}→γωJ/ψ and Observation of X(3872)→ωJ/ψ

We study the e^{+}e^{-}→γωJ/ψ process using 11.6  fb^{-1} e^{+}e^{-} annihilation data taken at center-of-mass energies from sqrt[s]=4.008  GeV to 4.600 GeV with the BESIII detector at the BEPCII storage ring. The X(3872) resonance is observed for the first time in the ωJ/ψ system with a significance of more than 5σ. The relative decay ratio of X(3872)→ωJ/ψ and π^{+}π^{-}J/ψ is measured to be R=1.6_{-0.3}^{+0.4}±0.2, where the first uncertainty is statistical and the second systematic (the same hereafter). The sqrt[s]-dependent cross section of e^{+}e^{-}→γX(3872) is also measured and investigated, and it can be described by a single Breit-Wigner resonance, referred to as the Y(4200), with a mass of 4200.6_{-13.3}^{+7.9}±3.0  MeV/c^{2} and a width of 115_{-26}^{+38}±12  MeV. In addition, to describe the ωJ/ψ mass distribution above 3.9  GeV/c^{2}, we need at least one additional Breit-Wigner resonance, labeled as X(3915), in the fit. The mass and width of the X(3915) are determined. The resonant parameters of the X(3915) agree with those of the Y(3940) in B→KωJ/ψ and of the X(3915) in γγ→ωJ/ψ observed by the Belle and BABAR experiments within errors.

[An incident of toadstool poisoning]

Objective: To investigate a poisonous mushroom poisoning incident and analyze its clinical data. Methods: Investigate a poisonous mushroom poisoning incident in a place in Shandong in July 2018, at the same time, the clinical data of 2 cases of mushroom poisoning were analyzed and summarized. Results: The incident was caused by a poisoning incident caused by residents eating poisonous mushrooms. The poisonous mushroom in this incident was identified as a scaled white goose cream. Two patients with poisoning developed gastrointestinal symptoms such as nausea and vomiting, abdominal pain and diarrhea, and liver damage occurred later. After active rescue and treatment, one patient was discharged from hospital, and the other patient developed acute pulmonary embolism during the treatment. He was discharged after interventional thrombolysis and follow-up treatment. Conclusion: After investigation, the incident was caused by the ingestion of poisonous mushrooms mainly based on the scalloped white goose cream. After active treatment, they were cured and discharged.

Proton Shell Evolution below ^{132}Sn: First Measurement of Low-Lying β-Emitting Isomers in ^{123,125}Ag

The β-delayed γ-ray spectroscopy of neutron-rich ^{123,125}Ag isotopes is investigated at the Radioactive Isotope Beam Factory of RIKEN, and the long-predicted 1/2^{-} β-emitting isomers in ^{123,125}Ag are identified for the first time. With the new experimental results, the systematic trend of energy spacing between the lowest 9/2^{+} and 1/2^{-} levels is extended in Ag isotopes up to N=78, providing a clear signal for the reduction of the Z=40 subshell gap in Ag towards N=82. Shell-model calculations with the state-of-the-art V_{MU} plus M3Y spin-orbit interaction give a satisfactory description of the low-lying states in ^{123,125}Ag. The tensor force is found to play a crucial role in the evolution of the size of the Z=40 subshell gap. The observed inversion of the single-particle levels around ^{123}Ag can be well interpreted in terms of the monopole shift of the π1g_{9/2} orbitals mainly caused by the increasing occupation of ν1h_{11/2} orbitals.

Observation of the Decay X(3872)→π^{0}χ_{c1}(1P)

Using a total of 9.0  fb^{-1} of e^{+}e^{-} collision data with center-of-mass energies between 4.15 and 4.30 GeV collected by the BESIII detector, we search for the processes e^{+}e^{-}→γX(3872) with X(3872)→π^{0}χ_{cJ} for J=0, 1, 2. We report the first observation of X(3872)→π^{0}χ_{c1}, a new decay mode of the X(3872), with a statistical significance of more than 5σ for all systematic fit variations. Normalizing to the previously established process e^{+}e^{-}→γX(3872) with X(3872)→π^{+}π^{-}J/ψ, we find B(X(3872)→π^{0}χ_{c1})/B(X(3872)→π^{+}π^{-}J/ψ)=0.88_{-0.27}^{+0.33}±0.10, where the first error is statistical and the second is systematic. We set 90% confidence level upper limits on the corresponding ratios for the decays to π^{0}χ_{c0} and π^{0}χ_{c2} of 19 and 1.1, respectively.

[Ocular natural killer/T cell lymphoma: a clinicopathologic analysis]

Objective: To evaluate the clinicopathological features of ocular natural killer(NK)/T cell lymphoma. Methods: Data of 21 patients (22 eyes) with ocular NK/T cell lymphoma treated at Eye & ENT Hospital of Fudan University from January 2006 to March 2018 were retrospectively analyzed for clinical data, morphology, immunophenotype and outcomes. Results: There were 10 males and 11 females with ages from 3 to 77 years (mean, 43 years). There were 20 unilateral cases (10 left eyes and 10 right eyes) and 1 bilateral case. Except for 1 case of corneal perforation resulting from the involvement of the conjunctiva and cornea, the other cases all involved the orbit (including eyelids and conjunctiva) as demonstrated by radiologic studies, with the lacrimal sac involved in 3 cases, and the nasal cavity or maxillary sinus involved in 2 cases. Three patients had been previously diagnosed sinonasal NK/T cell lymphoma with radiotherapy and chemotherapy. Two patients had a history of ovarian NK/T cell lymphoma with chemotherapy. One patient had multiple ulcers of skin and mucosa at presentation. There were 13 primary ocular NK/T cell lymphomas without evidence of nasal or systemic involvement. All patients presented with eyelid swelling and decreased visual acuity. There were proptosis in 18 cases, motility restriction in 13 cases, eyelid ulceration in 3 cases, and fever in 4 cases. They had all been previously diagnosed as orbital pseudotumor or cellulitis and there was no response to steroids and antibiotics. Pathological examination showed atypical lymphoid infiltration with an angioinvasive growth pattern causing coagulative necrosis. Cytologically, the medium-sized neoplastic cells showed irregular folded nuclei. The neoplastic cells were positive for cytoplasmic CD3ε, CD56, and cytotoxic molecules and Epstein-Barr virus-encoded RNA (EBER) in situ hybridization. Seven patients were lost to follow-up. Ten patients died 2.0 to 17.0 months after diagnosis (mean, 6.3 months) despite treatment with chemotherapy and radiotherapy. Conclusions: Ocular NK/T cell lymphoma is a rare form of ocular lymphoma. There are primary NK/T cell lymphoma and secondary ocular NK/T cell lymphoma with nasal or systemic involvement. The rarity of this tumor and inflammatory signs make it challenging to identify these tumors early. The neoplastic cells are positive for cytoplasmic CD3ε, CD56, cytotoxic molecules and EBER in situ hybridization. Despite aggressive therapy, it demonstrates high lethality with poor prognosis. (Chin J Ophthalmol, 2019, 55: 374-380).

Precision Measurement of the Branching Fractions of η^{'} Decays

Based on a sample of (1310.6±7.0)×10^{6}J/ψ events collected with the BESIII detector, we present measurements of J/ψ and η^{'} absolute branching fractions using the process J/ψ→γη^{'}. By analyzing events where the radiative photon converts into an e^{+}e^{-} pair, the branching fraction for J/ψ→γη^{'} is measured to be (5.27±0.03±0.05)×10^{-3}. The absolute branching fractions of the five dominant decay channels of the η^{'} are then measured for the first time and are determined to be B(η^{'}→γπ^{+}π^{-})=(29.90±0.03±0.55)%, B(η^{'}→ηπ^{+}π^{-})=(41.24±0.08±1.24)%, B(η^{'}→ηπ^{0}π^{0})=(21.36±0.10±0.92)%, B(η^{'}→γω)=(2.489±0.018±0.074)%, and B(η^{'}→γγ)=(2.331±0.012±0.035)%, where the first uncertainties are statistical and the second systematic.

[Effects of local transplantation of autologous adipose-derived stromal vascular fraction on the hyperplastic scar formation in rabbit ears and the mechanism]

Objective: To explore the effects of local transplantation of autologous adipose-derived stromal vascular fraction (SVF) on the hyperplastic scar (HS) formation in rabbit ears and the mechanism. Methods: Twenty-four New Zealand white rabbits were used to reproduce HSs by making four full-thickness skin defect wounds with a diameter of 1 cm on the ventral surface of left ear of each rabbit. Wound epithelization and local-tissue proliferation were observed, and wound healing (complete epithelization) time and formation time of HS were recorded. The 24 rabbits were divided into SVF group, pure DMEM group, and pure HS group according to the random number table, with 8 rabbits and 32 wounds in each group. On post injury day (PID) 25 (after the complete epithelization of wounds), 0.2 mL of low glucose DMEM medium containing CM-Dil labeled autologous SVF was injected into HSs of rabbits in SVF group, while the same amount of low glucose DMEM medium was injected into HSs of rabbits in pure DMEM group. The frequency of injection was once every 5 days, totally for 3 times. HSs of rabbits in pure HS group did not receive any treatment. On PID 40, HSs of rabbits' ears in each group were harvested, then the histological form was observed by hematoxylin and eosin staining, the arrangement of collagen in HS was observed by Van Gieson staining, the distribution of CM-Dil-labeled SVF in the HS was observed with fluorescence microscope, and the mRNA expression and the protein expression of transforming growth factor β(1) (TGF-β(1)), Smad3, and Smad7 in HS were determined by real-time fluorescent quantitative reverse transcription-polymerase chain reaction and Western blotting, respectively. Data were processed with one-way analysis of variance and Tukey test. Results: (1) Complete epithelization time of wounds of rabbits' ears was (20.0±2.0) d post injury, and HSs were formed on PID 25. On PID 40, HSs of rabbits' ears in pure DMEM group and pure HS group were still in hyperplasia, while those in SVF group became smaller, flat, soft, and light colored. (2) On PID 40, compared with those in pure DMEM group and pure HS group, the number of epithelium foot like structures was more and the amount of inflammatory cells was less. The collagen of HSs of rabbits' ears in SVF group was arranged more regularly with broader gap between collagens. (3) On PID 40, CM-Dil-labeled SVF could still be observed in the HSs of rabbits' ears in SVF group. (4) On PID 40, compared with those in pure DMEM group and pure HS group, the mRNA expressions of TGF-β(1) and Smad3 in the HSs of rabbits' ears in SVF group were significantly down-regulated (P<0.05), while the mRNA expression of Smad7 was significantly up-regulated (P<0.05). There were no significant differences in the mRNA expressions of TGF-β(1), Smad3, and Smad7 in the HSs of rabbits' ears between pure DMEM group and pure HS group (P>0.05). (5) On PID 40, compared with those in pure DMEM group (0.74±0.03, 0.73±0.10, 0.54±0.09) and pure HS group (0.72±0.08, 0.71±0.12, 0.53±0.06), the protein expressions of TGF-β(1) and Smad3 in the HSs of rabbits' ears in SVF group (0.57±0.06, 0.42±0.09) were significantly down-regulated (P<0.05), while the protein expression of Smad7 (0.71±0.05) was significantly up-regulated (P<0.05). The protein expressions of TGF-β(1), Smad3, and Smad7 in the HSs of rabbits' ears in pure DMEM group and pure HS group were close (P>0.05). Conclusions: Autologous SVF transplantation can inhibit the formation of HS in the early stage of scar formation of rabbit, the mechanism may be related to the TGF-β(1)/Smad signaling pathway.

Measurement of the Dynamics of the Decays D_{s}^{+}→η^{(')}e^{+}ν_{e}

Using e^{+}e^{-} annihilation data corresponding to an integrated luminosity of 3.19  fb^{-1} collected at a center-of-mass energy of 4.178 GeV with the BESIII detector, we measure the absolute branching fractions B_{D_{s}^{+}→ηe^{+}ν_{e}}=(2.323±0.063_{stat}±0.063_{syst})% and B_{D_{s}^{+}→η^{'}e^{+}ν_{e}}=(0.824±0.073_{stat}±0.027_{syst})% via a tagged analysis technique, where one D_{s} is fully reconstructed in a hadronic mode. Combining these measurements with previous BESIII measurements of B_{D^{+}→η^{(')}e^{+}ν_{e}}, the η-η^{'} mixing angle in the quark flavor basis is determined to be ϕ_{P}=(40.1±2.1_{stat}±0.7_{syst})°. From the first measurements of the dynamics of D_{s}^{+}→η^{(')}e^{+}ν_{e} decays, the products of the hadronic form factors f_{+}^{η^{(')}}(0) and the Cabibbo-Kobayashi-Maskawa matrix element |V_{cs}| are determined with different form factor parametrizations. For the two-parameter series expansion, the results are f_{+}^{η}(0)|V_{cs}|=0.4455±0.0053_{stat}±0.0044_{syst} and f_{+}^{η^{'}}(0)|V_{cs}|=0.477±0.049_{stat}±0.011_{syst}.

[Comparison of risk factors and short-term and long-term prognosis of pulmonary embolism between the Tibetan and Han people]

Objective: To compare the differences of risk factors and prognosis of pulmonary embolism (PE) between the Tibetans and the Hans. Methods: Patients over 18 years old with confirmed PE and complete clinical data from West China Hospital of Sichuan University from January 2010 to January 2016 were prospectively enrolled and divided into Tibetan group and Han group. Clinical data were collected to compare risk factors and short-term prognosis between Han group and Tibetan group. In addition, a 2-year follow-up was conducted among patients after discharge to investigate the long-term prognosis. Results: A total of 90 patients in Tibetan group and 626 patients in Han group were finally included in this study. Patients in Tibetan group were younger than Han group [(52.2±15.8) vs (59.8±16.6) years old, P<0.001], and the proportion of elderly patients (age ≥70 years) in Tibetan group was significantly lower than that of Han group (15.6% vs 33.7%, P=0.001). The hemoglobin, hematocrit, platelet counts and fibrinogen in Tibetan group were higher than those in Han group [(134.0±32.0) vs (122.2±25.7) g/L, (41.2±9.2)% vs (37.6±7.3)% and (222.2±97.5)×10(9)/L vs (187.5±87.2)×10(9)/L, 3.71(2.51, 4.89) vs 3.31(2.44, 4.42) g/L; P<0.001, <0.001 and P=0.001, 0.048, respectively]. Malignancy and chronic obstructive pulmonary disease were more common in Han group (P=0.011, 0.001), while prior venous thromboembolism history, pregnancy or a history delivery within 1 month were more common in Tibetan group (P=0.041, 0.001). Both short-term and long-term mortality in Tibetan group were significantly lower than that in Han group (2.2% vs 11.5%, 13.6% vs 24.9%; P=0.005, 0.020). Conclusions: Hypercoagulable state plays an important role in the pathogenesis of PE in Tibetan patients. Both short-term and long-term prognosis of PE in Tibetan patients are better than that in Han patients.

Evidence of a Resonant Structure in the e^{+}e^{-}→π^{+}D^{0}D^{*-} Cross Section between 4.05 and 4.60 GeV

The cross section of the process e^{+}e^{-}→π^{+}D^{0}D^{*-} for center-of-mass energies from 4.05 to 4.60 GeV is measured precisely using data samples collected with the BESIII detector operating at the BEPCII storage ring. Two enhancements are clearly visible in the cross section around 4.23 and 4.40 GeV. Using several models to describe the dressed cross section yields stable parameters for the first enhancement, which has a mass of 4228.6±4.1±6.3  MeV/c^{2} and a width of 77.0±6.8±6.3  MeV, where the first uncertainties are statistical and the second ones are systematic. Our resonant mass is consistent with previous observations of the Y(4220) state and the theoretical prediction of a DD[over ¯]_{1}(2420) molecule. This result is the first observation of Y(4220) associated with an open-charm final state. Fits with three resonance functions with additional Y(4260), Y(4320), Y(4360), ψ(4415), or a new resonance do not show significant contributions from either of these resonances. The second enhancement is not from a single known resonance. It could contain contributions from ψ(4415) and other resonances, and a detailed amplitude analysis is required to better understand this enhancement.

[The experimental study of diquat on the half-Lethal dose and pothological injuny of related organs in wistor rats]

Objective: To explore the acute toxicity of Diquat in mice and to calculate the median lethal dose (LD(50)) of Diquat to rats and observe the pathological changes of tissues and organs in rats with different concentrations of Diquat. Methods: Diquat solution of 50 mg/kg was prepared freshly with 1 000 mg of Diquat and dilute the solution with water to a total of 20 ml. A total of 99 healthy adult male Wistar rats were randomly divided into part one, part two and control groups. In the first part, 36 rats were randomly divided into 4 groups: 100 mg/kg group, 200 mg/kg group, 300 mg/kg group and 400 mg/kg group, which were treated with 100 mg/kg, 200 mg/kg, 300 mg/kg and 400 mg/kg of Diquat solution by gavage, respectively. The death and symptoms of poisoning after intragastric administration were recorded, and the maximum tolerated dose and absolute lethal dose were measured. In the second part, 54 rats were randomly divided into 6 groups: 200 mg/kg group, 220 mg/kg group, 240 mg/kg group, 260 mg/kg、280 mg/kg group and 300 mg/kg group, whichwere treated with 200 mg/kg, 220 mg/kg, 240 mg/kg, 260 mg/kg, 280 mg/kg and 300 mg/kg of Diquat solution by gavage, respectively. The survival of rats in different concentration of Diquat was observed and the LD(50) was calculated by Excel processing the formula of Koch's method. The control group were given equal volume water under the same experimental conditions. And moreover, the lungs, kidneys, hearts, livers, and brain tissues were collected and fixed by formaldehyde, embedded by paraffin, and sectioned for histopathological light microscopy. Results: The maximum tolerated dose was 240 mg/kg and the absolute lethal dose was 300 mg/kg. The LD(50) of Diquat for Rats was 280.58 mg/kg. The high-dose group had significantly more organ damage than the low-dose group after diquat poisoning. Conclusion: The determination of the half-lethal dose of diquat, at the same time observed multiple organs damaged in rats after the diquat quickly poisoned. Kidneys, lungs and heart might be the main organ which was heavily damaged. With the extension of observation time, the organ damage of rats exposed to small doses gradually stabilized.

Determination of the Pseudoscalar Decay Constant f_{D_{s}^{+}} via D_{s}^{+}→μ^{+}ν_{μ}

Using a 3.19  fb^{-1} data sample collected at an e^{+}e^{-} center-of-mass energy of E_{cm}=4.178  GeV with the BESIII detector, we measure the branching fraction of the leptonic decay D_{s}^{+}→μ^{+}ν_{μ} to be B_{D_{s}^{+}→μ^{+}ν_{μ}}=(5.49±0.16_{stat}±0.15_{syst})×10^{-3}. Combining our branching fraction with the masses of the D_{s}^{+} and μ^{+} and the lifetime of the D_{s}^{+}, we determine f_{D_{s}^{+}}|V_{cs}|=246.2±3.6_{stat}±3.5_{syst}  MeV. Using the c→s quark mixing matrix element |V_{cs}| determined from a global standard model fit, we evaluate the D_{s}^{+} decay constant f_{D_{s}^{+}}=252.9±3.7_{stat}±3.6_{syst}  MeV. Alternatively, using the value of f_{D_{s}^{+}} calculated by lattice quantum chromodynamics, we find |V_{cs}|=0.985±0.014_{stat}±0.014_{syst}. These values of B_{D_{s}^{+}→μ^{+}ν_{μ}}, f_{D_{s}^{+}}|V_{cs}|, f_{D_{s}^{+}} and |V_{cs}| are each the most precise results to date.

First Measurement of the Form Factors in D_{s}^{+}→K^{0}e^{+}ν_{e} and D_{s}^{+}→K^{*0}e^{+}ν_{e} Decays

We report on new measurements of Cabibbo-suppressed semileptonic D_{s}^{+} decays using 3.19  fb^{-1} of e^{+}e^{-} annihilation data sample collected at a center-of-mass energy of 4.178 GeV with the BESIII detector at the BEPCII collider. Our results include branching fractions B(D_{s}^{+}→K^{0}e^{+}ν_{e})=[3.25±0.38(stat)±0.16(syst)]×10^{-3} and B(D_{s}^{+}→K^{*0}e^{+}ν_{e})=[2.37±0.26(stat)±0.20(syst)]×10^{-3}, which are much improved relative to previous measurements, and the first measurements of the hadronic form-factor parameters for these decays. For D_{s}^{+}→K^{0}e^{+}ν_{e}, we obtain f_{+}(0)=0.720±0.084(stat)±0.013(syst), and for D_{s}^{+}→K^{*0}e^{+}ν_{e}, we find form-factor ratios r_{V}=V(0)/A_{1}(0)=1.67±0.34(stat)±0.16(syst) and r_{2}=A_{2}(0)/A_{1}(0)=0.77±0.28(stat)±0.07(syst).

Observation of D^{+}→f_{0}(500)e^{+}ν_{e} and Improved Measurements of D→ρe^{+}ν_{e}

Using a data sample corresponding to an integrated luminosity of 2.93  fb^{-1} recorded by the BESIII detector at a center-of-mass energy of 3.773 GeV, we present an analysis of the decays D^{0}→π^{-}π^{0}e^{+}ν_{e} and D^{+}→π^{-}π^{+}e^{+}ν_{e}. By performing a partial wave analysis, the π^{+}π^{-} S-wave contribution to D^{+}→π^{-}π^{+}e^{+}ν_{e} is observed to be (25.7±1.6±1.1)% with a statistical significance greater than 10σ, besides the dominant P-wave contribution. This is the first observation of the S-wave contribution. We measure the branching fractions B(D^{0}→ρ^{-}e^{+}ν_{e})=(1.445±0.058±0.039)×10^{-3}, B(D^{+}→ρ^{0}e^{+}ν_{e})=(1.860±0.070±0.061)×10^{-3}, and B(D^{+}→f_{0}(500)e^{+}ν_{e},f_{0}(500)→π^{+}π^{-})=(6.30±0.43±0.32)×10^{-4}. An upper limit of B(D^{+}→f_{0}(980)e^{+}ν_{e},f_{0}(980)→π^{+}π^{-})<2.8×10^{-5} is set at the 90% confidence level. We also obtain the hadronic form factor ratios of D→ρe^{+}ν_{e} at q^{2}=0 assuming the single-pole dominance parametrization: r_{V}={[V(0)]/[A_{1}(0)]}=1.695±0.083±0.051, r_{2}={[A_{2}(0)]/[A_{1}(0)]}=0.845±0.056±0.039.

[Analysis of psychological status and relevant factors of patients with esophageal and gastric cardia precancerous lesions in Linzhou of Henan]

Objective: To explore the psychological status and related factors in patients with precancerous of esophageal and gastric cardia in Linzhou of Henan. Methods: Clinical psycho-rating scale of Social Support Rating Scale (SSRS), Self-Rating Anxiety Scale (SAS, score ≥50 points with symptoms of anxiety) and Self-Rating Depression Scale (SDS, score ≥53 points with the symptoms of depression) were applied to survey life events and psychological status of subjects who aged 40-69 years old and participated in"The Early diagnosis and Early Treatment"program in Linzhou cancer hospital from July 2015 to Jan 2016. Patients with lower intraepithelial neoplasia or high-grade intraepithelial neoplasia were selected as precancerous lesions (n=118), and patients with normal grade were selected as healthy controls (n=210). Compare the differences of the scores between the two groups, and the logistic regression model was used to analyze the related factors of precancerous lesions and psychological status of the study subjects. Results: Precancerous lesions included esophageal (72 cases), gastric cardia (40 cases), esophageal and cardia dual source (6 cases); Precancerous lesions and healthy controls aged (57.17±7.71) and (53.12±7.99) years old, the difference was statistically significant (P<0.001). The anxiety and depression scale showed that the scores of SAS and SDS scores in the precancerous lesions were (37.18±10.01), (40.44±8.37) points, and (34.02±6.63), (38.49±8.73) points in control group, the difference was statistically significant (P=0.002, 0.032). While the social support total score (38.26±5.26), and subjective support score (24.08±3.83) and objective support score (7.50±1.89) in control group were all higher than those of precancerous group (36.80±6.18, 23.01±3.93, 6.93±1.57), and the difference were statistically significant (P=0.024, 0.016, 0.004). In addition, the Logistic analysis showed that subjects with low objective social support, subjective social support and anxiety symptoms were more likely to develop precancerous lesions, and the OR were 0.81, 0.72 and 1.05, respectively (P=0.028, 0.005, 0.009). Conclusion: Social support, anxiety and depression status may be related to the occurrence and development of esophageal and gastric cardia precancerous lesions.