Ferroelectric P(VDF-TrFE)/POSS nanocomposite films: compatibility, piezoelectricity, energy harvesting performance, and mechanical and atomic oxygen erosion

Poly(vinylidene difluoride) (PVDF) and its copolymers as the polymers with the highest piezoelectric coefficient have been widely used as sensors and generators. However, their relatively low performances limit their applications in some harsh environments. In this work, piezoelectric poly(vinylidene-trifluoroethylene) P(VDF-TrFE) matrices with different amounts of polyhedral oligomeric silsesquioxane (POSS) were prepared by a low temperature solvent evaporation method and thermal poling. The morphology, surface performance, crystalline phase, and piezoelectric and ferroelectric properties of the nanocomposites were investigated and the influence of POSS on these performances was studied. POSS had good compatibility with P(VDF-TrFE) and did not affect the crystalline phase formation of the matrix. The composites presented good piezoelectric properties. Piezo- and triboelectric nanogenerators were designed and fabricated. The voltage and current outputs were analyzed and the polarization effect was evaluated. The average output voltage and the current density of the matrix were 3 V and 0.5 μA cm⁻² when subjected to a force of 38 N on an area of 1 cm². The mechanical properties of P(VDF-TrFE)/POSS nanocomposites were also studied by the nanoindentation test. The hardness and modulus of samples increased 20% and 17% with a low addition of POSS. Atomic oxygen erosion properties of the composites were numerically simulated by the Monte Carlo method. The erosion cavity shape and depth were compared and studied. The influence of POSS addition on the P(VDF-TrFE) matrix and the associated reinforcing mechanism were analyzed.

Poly(vinylidene difluoride) (PVDF) and its copolymers as the polymers with the highest piezoelectric coefficient have been widely used as sensors and generators.

[Change of cervical sagittal alignment after the treatment of growing rods to the early-onset scoliosis]

Objective: To determine the impact of growing rods (GR) technique on cervical alignment in early-onset scoliosis (EOS) through the change of cervical alignment parameters after the GR surgery. Methods: Total of 24 consecutive EOS patients treated in Beijing Chao-Yang Hospital from 2009 to 2018 were retrospectively reviewed (17 males and 7 females). Cervical lordosis, T(1) slope and C(2-7) sagittal vertical axis (C(2-7)SVA), thoracic/lumbar Cobb angle, thoracic kyphosis (TK), global kyphosis Cobb angle, SVA were included in radiographic data in the full spinal standing X-ray before and post operation and at the last follow-up. Based on clinical data, including the upper instrumented vertebra (UIV), proximal junctional kyphosis (PJK) and the number of GR, patients were divided into different groups for statistical analysis. Logistic regression analysis was used to find the independent risk factors of the abnormality of C(2-7)SVA. Results: All patients received at least one time of distraction operation, the mean follow-up was (35±14) months. The C(2-7) Cobb angle increased from 17°±11° to 18°±9° and T(1) slope changed from 28°±13° to 28°±11° and C(2-7)SVA changed from (17±11) mm to (16±10) mm after the operation, but no significant differences were found in those indexes before and after the operation (t=-1.15, 0.14, 0.55, all P>0.05). At the last follow-up after GR technique, the C(2-7) Cobb angle, T(1) slope angle and C(2-7)SVA significantly increased when compared with those before the operation (t=-7.60, -4.08, -2.46, all P<0.05). The △C(2-7) Cobb angle and △T(1) slope angle PJK group was both more significant than those in non-PJK group (t=3.50, 3.25, both P<0.05); while there was no significant difference in the △C(2-7) Cobb angle and △T(1) slope angle when the choice of UIV and the number of GD were taken into account (t=-1.02, -1.61, -0.67, 0.31, all P>0.05). The occurrence of PJK was identified as an independent risk factor for the abnormality of C(2-7)SVA during the GR surgery with logistic regression analysis(OR=11.57, 95%CI: 1.49-91.54, P<0.05). Conclusions: When used for EOS to correct deformity, GR surgery will increase the cervical lordosis and T(1) slope angle of EOS patients. More attention should be paid to the cervical sagittal alignment and cervical sagittal imbalance in EOS patients with PJK.

[Epidemiological characteristics of COVID-19 in Shaanxi province]

Objective: To understand the incidence trend and epidemiological characteristics of COVID-19 in Shaanxi province. Methods: The incidence data of COVID-19 reported in Shaanxi as of 22 February, 2020 were collected for an epidemiological descriptive analysis. Results: A total of 245 confirmed cases of COVID-19 were reported in Shaanxi. Most cases were mild (87.76%). As time passed, the areas where confirmed cases were reported continued to increase. The case number in Xi'an was highest, accounting for nearly half of the total reported cases in the province. The epidemic pattern in Shaanxi had gradually shifted from imported case pattern to local case pattern, and the transmission of local cases was mainly based on family cluster transmission. The confirmed cases from different sources had caused the secondary transmission in Shaanxi. After February 7, the number of reported cases began to fluctuate and decrease stably, indicating a decrease-to-zero period. Conclusions: At present, the overall epidemic of COVID-19 in Shaanxi has gradually been mitigated. However, considering the approaching of return to work and study and the increasing of imported cases from other countries, the prevention and control of COVIS-19 in Shaanxi will face new challenges.

[Re-recognition of occult hepatitis B virus infection]

Hepatitis B virus (HBV) infection remains to be a serious public health problem in China. There used to be a high prevalence of HBV infection in China, which resulted in a large number of HBV susceptible and post-infected population. Single anti-HBc positive usually indicates post HBV infection and its prevalence is particularly high among people over 40 years old, some of whom may be occult hepatitis B virus infection (OBI). The clinical diagnosis of OBI is difficult and easily missed. Since OBI may cause chronic liver disease progression and even lead to cirrhosis and hepatocellular carcinoma eventually, and more importantly, patients with OBI may leed to HBV reactivation when the immune function decreases or immunosuppressive therapy is performed, the accurate identify of OBI is of particular importance. Moreover, OBI is the potential source of HBV infection, which may transmit through blood transfusion, organ transplantation and mother-to-child transmission. In view of this situation, we reviewed the mechanism, prevalence and definition of OBI, and proposed a determination system for replication-competent HBV DNA based on our understanding of the updated OBI definition. It is expected to be beneficial for OBI diagnosis, treatment and management.

[Comparison of cortical bone trajectory screw fixation and pedicle screw fixation in posterior lumbar fusion]

Objective: To evaluate the efficacy and safety of cortical screw fixation in posterior lumbar spine fixation with cortical bone trajectory (CBT) fixation or pedicle screw (PS) fixation in posterior lumbar fusion. Methods: It was a prospective study and CBT or PS for the treatment of lumbar disease from August 2015 to August 2017 in Beijing Chaoyang Hospital were analyzed. There were 53 males and 51 females, aged 56-78 years (mean age, (67±5) years). The patient's gender, age, operative time, intraoperative blood loss, postoperative bleeding, postoperative hospital stay, and postoperative patient satisfaction were collected. The Oswestry disability index (ODI) and visual analogue scale (VAS) of back pain were used to evaluate preoperative and half-year, one-year and two-year postoperative function and quality of life. Complications such as wound infection, cage displacement, screw extraction and fixation fracture were compared between the two groups. The data of normal distribution were compared with Student t test between the two groups. Results: There was no significant difference in the operation time between the CBT group (n=50) and the PS group (n=54) ((223±17) min vs (221±16) min, t=0.74, P=0.46). The intraoperative blood loss and wound drainage volume were significantly lower in the CBT group than those in the PS screw group (t=-24.20, -57.62, both P<0.05). The average length of hospital stay in the CBT group was significantly shorter than that in the PS group (t=-7.65, P=0.00). Patients with CBT screws had better postoperative satisfaction than patients in PS group (91±6 vs 86±7, t=3.89, P=0.00). The ODI score in the CBT group was significantly lower than that in the PD screw group half a year after the operation (3.9±1.9 vs 5.8±3.1, t=-3.66, P=0.00). The VAS and ODI scores in the CBT group were significantly lower than those in the PS group 1 year after the surgery (t=-3.03, -4.09, both P<0.05). There was no significant differences in wound infection, cage displacement, screw extraction and fixation fracture between the two groups. Conclusion: CBT screw technique is minimally invasive, with short operation time, less intraoperative blood loss, rapid postoperative recovery and low complications. It can be effectively used in posterior lumbar cone fusion.

[The role of histone deacetylases in the pathogenesis of idiopathic pulmonary fibrosis and cryptogenic organizing pneumonia]

Objective: To explore the role of histone deacetylases(HDAC) in the pathogenesis of idiopathic pulmonary fibrosis(IPF) and cryptogenic organizing pneumonia(COP). Methods: Fifteen IPF patients [14 males and 1female, age 40-73 years, mean age (59±8) years] and 15 COP patients [5 males and 10 females, age 41-71 years, mean age (59±8) years] from Peking Union Medical College Hospital were recruited from March 2018 to October 2018. Fifteen healthy donors[4 males and 11females, age 43-70 years, mean age (58±6) years] were enrolled as controls. Peripheral blood mononuclear cells (PBMC) were isolated by density gradient centrifugation. The nuclear and cytoplasmic proteins were extracted by Nuclear Extraction Kit. HDAC activity was measured by fluorimetric method. The relations between HDAC activity and clinical parameters were analyzed with SPSS. Results: The HDAC activity of cytoplasmic protein and nuclear protein from patients with IPF were (724±216) nmol/L and (2 309±708) nmol/L, which were higher than that of health controls (409±105) nmol/L and (1 572±611) nmol/L (P<0.01 for both). So as to the HDAC activity of cytoplasmic protein and nuclear protein from patients with COP which were (718±245) nmol/L and (3 310±1 005) nmol/L (P<0.01 for both).The HDAC activity of nuclear protein from COP patients was higher than that from IPF patients (Z=-2.840, P=0.005). The HDAC activity of nuclear protein was negatively correlated with FEV(1) and D(L)CO in IPF patients (r=-0.574, P=0.025; r=-0.583, P=0.029), and negatively correlated with FVC and TLC in COP patients(r=-0.846, P=0.016; r=-0.900, P=0.015). Conclusion: HDAC may be involved in the pathogenesis of COP and IPF.

[Effect of reduced nitrogen fertilization on carbon footprint in spring maize-late rice production system]

With the growing concerns on global climate change and food security, low carbon agriculture in food production attracts more attention. Low carbon agriculture needs to balance higher-level crop yields and lower greenhouse gas emission in production process. Improving nitrogen mana-gement may help mitigate greenhouse gas emission and achieve stable or higher crop yields in crop production systems. In this study, we investigated the effects of nitrogen application rates (150, 225, 300 kg N·hm^-2) on the carbon footprint of spring maize-late rice rotation system in paddy field using the life cycle assessment. The results showed that greenhouse gas emission and carbon footprint increased with the nitrogen fertilizer application rates in both crops. Nitrogen fertilizer was the most important contributor to carbon footprint of spring maize ecosystem, accounting for 36.2%-50.2%. Methane emission increased with nitrogen fertilizer input and contributed the most to the carbon footprint of late rice production, accounting for 42.8%-48.0%. When the nitrogen application rate was reduced by 25% (225 kg N·hm^-2) and 50% (150 kg N·hm^-2), greenhouse gas emission of maize production decreased by 21.9% and 44.3%, and the carbon footprint decreased by 20.3% and 39.1%, respectively. Meanwhile, the greenhouse gas emissions of late rice decreased by 12.3% and 20.4%, and the carbon footprint of late rice decreased by 13.7% and 16.7%, respectively. The reduction of nitrogen fertilizer rate had no significant effect on maize yield, with the treatment of 225 kg N·hm^-2 rate holding the highest yield in late rice ecosystem. The treatment of 150 kg N·hm^-2 rate in spring maize production and 225 kg N·hm^-2 rate in late rice production was the sustainable N fertilizer application rate for achieving high grain yield and reducing the carbon footprint in crop system.

[Preliminary application of one-step hybrid operation in the treatment of carotid artery occlusion]

Objective: To evaluate the prognosis and surgical complication of the recanalization treatments for internal carotid artery (ICA) occlusion by using one-step hybrid carotid endarterectomy and endovascular surgery. Methods: Retrospective analysis was performed on the clinical data and follow-up data of 22 patients with occluded ICA treated by one-step hybrid surgery. Difference in Barthel score and occurrence of ischemic stroke were compared with surgical group and conventional group which was treated by oral taking anti-platelet drugs. Further, the complications were analyzed to evaluate the safety and effectiveness of the surgery. Results: The difference in ischemic event rate and Barthel scores improvement between the two groups were significant. Occlusive ICAs in 19 cases were recanalized successfully. The possibility of brain hyperperfusion related to the surgery was 10.5% (2/19) while the possibility of carotid artery cavernous fistula was 9.1% (2/22). We also observed rare dissecting ICA caused by the treatment (4.5%) and distal restenosis (5.3%). Conclusions: One-step hybrid carotid endarterectomy and endovascular surgery could help recanalize the ICA, improve the blood supply and improve the prognosis. It's a safe and effective treatment for ICA occlusion.

Visual preconditioning reduces emergence delirium in children undergoing ophthalmic surgery: a randomised controlled trial

BACKGROUND

Emergence delirium is a common complication in children, especially in preschool children undergoing ophthalmic surgery. The aim of the study was to investigate the effects of visual preconditioning (application of an eyepatch over the eye to be operated for ≥3 h the day before surgery) on emergence delirium after ophthalmic surgery under sevoflurane anaesthesia.

METHODS

One hundred and seventy-nine children undergoing unilateral cataract surgery, aged 3-7 yr, were involved in this prospective, blinded, randomised study. Subjects were randomised to receive visual preconditioning (Group P, n=89) or to receive programmed explanation the day before surgery (Group C, n=90). The primary outcome was incidence of emergence delirium evaluated by the paediatric anaesthesia emergence delirium (PAED) scale. The secondary outcomes included emergence time and post-anaesthesia care unit (PACU) stay time.

RESULTS

Children in Group P had a significantly lower incidence of emergence delirium than those in Group C [16.9% vs 44.4%, odds ratio (OR) 4.0, 95% confidence interval (CI) 2.0 to 8.0]. The maximal PAED score was lower in Group P than in Group C [4 (0-20) vs 9 (0-20), median difference -3.0, 95% CI -5.0 to -1.0]. Visual preconditioning prolonged emergence time (P<0.001) and PACU stay time (P=0.002).

CONCLUSION

Visual disturbance contributes to emergence delirium in preschool children undergoing ophthalmic surgery with sevoflurane, and prophylactic eyepatch treatment can reduce emergence delirium.

CLINICAL TRIALS REGISTRATION

NCT02590744.

[The plasma level and gene expression in peripheral blood of interleukin-35 in patients with sarcoidosis and its clinical significance]

Objective: To investigate the expression of interleukin(IL)-35 protein and gene in peripheral blood of patients with sarcoidosis and its clinical significance. Methods: Peripheral blood samples from 98 patients with sarcoidosis and 98 healthy volunteers were collected at Peking Union Medical College Hospital between January 2016 and March 2017. The plasma levels of IL-35 were detected by enzyme-linked immunosorbent assays (ELISA), and the relationship between IL-35 and the clinical characteristics was analyzed. Real-time quantitative PCR was used to detect the expression levels of IL-35 subunit EBI3, p35 and T regulatory cell transcription factor Foxp3 mRNA in peripheral blood mononuclear cells, and their correlations were analyzed. Results: The plasma levels of IL-35 in patients with sarcoidosis (44±12) ng/L was significantly lower than that in the normal control group (55±12) ng/L (P<0.001). There was a positive correlation between the plasma levels of IL-35 and D(L)CO% predicted values (r=0.76, P<0.001), but it showed no significantly correlation with other clinical parameters. The expression of EBI3 and Foxp3 mRNA in peripheral blood mononuclear cells of patients with sarcoidosis (1.54±0.74, 0.92±0.36) were significantly lower than those in the normal control group respectively (2.12±0.61, 1.10±0.27, all P<0.05). There was a significant positive correlation between the expression of EBI3 and Foxp3 mRNA in the sarcoidosis group (r=0.786, P<0.001). Conclusion: IL-35 may be involved in the inflammatory process of sarcoidosis and play an important role in the pathogenesis of the disease.

[Clinical characteristics and surgical effect observation of congenital aniridia combined with cataract]

Objective: To analyze the clinical manifestations, surgical approaches and postoperative prognosis for the cases of congenital aniridia combined with cataract. Methods: In this retrospective case series, 26 patients diagnosed with congenital aniridia combined with cataract were collected from Zhongshan Ophthalmic Center from February 2002 to August 2016. The Clinical data were collected to analyze the clinical features, surgical approaches and postoperative prognosis. T-test was used for statistical analysis. Results: Twenty-six bilateral congenital aniridia patients were included in the case series, with 50% male cases. The average age for the first visit was (8.72±8.06) years old. Hereditary patients constitutes 30.8% (8/26) of the total number. The proportions for bilateral and unilateral cataracts were 88.5% (23/26) and 11.5% (3/26) respectively, and 49 eyes suffering from both congenital aniridia and cataract were therefore included in the final analysis. The most common morphology cataract subtypes were lamellar cataract (24.5%, 12/49), posterior subcapsular cataract (22.4%, 11/49), and total cataract (18.4%,9/49). The observed ocular comorbidities included nystagmus (36.7%, 18/49), vitreous opacity (28.6%, 14/49), foveal hypoplasia (20.4%, 10/49), ametropia (12.2%, 6/49), exotropia (12.2%, 6/49), congenital glaucoma (12.2%, 6/49), esotropia (4.1%, 2/49), congenital ptosis (4.1%, 2/49), lens ectopia (4.1%, 2/49), scleral staphyloma (2.0%, 1/49) and pigmentary degeneration of retina (2.0%, 1/49). 30.6% (15/49) eyes were performed the cataract extraction surgery. The percentage of postoperative best corrected visual acuity (BCVA) for ≥0.1 and ≥0.3 were 93.3% (14/15) and 20.0% (3/15) respectively. Evaluated ocular pressure (33.3%, 5/15), severe posterior capsular opacification (PCO) (13.3%, 2/15) and choroidal hemorrhage combined with choroidal detachment (6.7%, 1/15) were detected as the postoperative complications. Followed by cataract extraction, 80.0% (12/15) eyes were sequentially performed the intraocular lens implantation, while, 20.0% (3/12) eyes remained aphakia due to ocular comorbidities. Conclusions: Congenital aniridia combined with cataract are rare diseases, calling for the precious retrospective researches. This disorder tended to affect both eyes and occurred hereditary. The clinical courses of the cases presented progressive features. Ocular comorbidities were the crucial factors to influence the surgical approaches and postoperative prognosis. (Chin J Ophthalmol, 2017, 53: 821-827).

[Significance and expression of PAX8, PAX2, p53 and RAS in ovary and fallopian tubes to origin of ovarian high grade serous carcinoma]

Objective: To explore the origin of ovarian high grade serous carcinoma (HGSC) through analysing the expression and significance of PAX8, PAX2, p53 and RAS in the ovary and fallopian tube of different types and grades of serous carcinoma. Methods: A total of 44 cases tissue samples of ovarian tumor including 34 malignant ovarian tumor and 10 normal normal tissue (as control group) were collected from the admitted patients in Affiliated Tumor Hospital of Guangxi Medical University from January 2015 to January 2016. Fallopian tube tissues were segmented in accordance with the fimbria, ampulla, isthmus and the corresponding ovarian tissues were by the side. There were 34 cases of patients with ovarian cancer including 29 cases of epithelial ovarian cancer (27 serous carcinoma, 1 mucinous carcinoma,1 endometrioid adenocarcinoma) and 5 non-epithelial ovarian cancer (sex cord-interstitial tumor). Among 27 cases of patients with ovarian serous cancer, there were 23 HGSC and 4 low-grade ovarian serous cancer (LGSC). One hundred fifty-three cases of samples were diagnosed as ovarian serous cancer by Shandong University Affiliated Qilu Hospital from 2005 to 2013 and these samples were made tissue microarray. (1) To analyze the expression and differences of PAX8, PAX2, p53 and RAS in the above tissues and tissue microarray from ovarian and tubal of HGSC and control women by immunohistochemistry methods. (2) To compare the expression levels of PAX8, PAX2, p53 and RAS in ovarian and fallopian tubes of ovarian cancer patients with different pathological types. (3) To analyze the correlations of tubal and ovarian tissue in PAX8, PAX2, p53 and RAS expression of HGSC. (4) To analyze the factors of the prognosis of ovarian serous cancer in tissue microarray by single factor analysis method. Results: (1) PAX8, PAX2, p53 and RAS expression was negative in normal ovarian epithelium of control group, but the expression of PAX8, PAX2, p53 and RAS were strongly positive brown in secrete cells of normal fallopian tube epithelium. (2) p53 and RAS expression of fallopian tube epithelium in the epithelial ovarian cancer group were significantly higher than those in the non-epithelial ovarian cancer groups (P<0.05), but the expression of PAX8 and PAX2 in fallopian tube and the expression of PAX8, PAX2, p53 and RAS in ovarian tissue was not statistically significant in the groups (P>0.05). PAX8, PAX2 and p53 expression of the ovarian in HGSC group were significantly higher than those in LGSC group (P<0.05), while the expression of RAS was lower in the ovarian of the high-grade group (P<0.05), while the expression of PAX8, PAX2, p53 and RAS in fallopian tube was not statistically significant in the groups (P>0.05). (3) There was a significantly positive correlation between fallopian tube and the corresponding ovary of HGSC in PAX8 and PAX2 expression (r=0.422, P=0.045; r=0.693, P=0.000), but not correlation in p53 and RAS expression (r=0.058, P=0.793; r= -0.190, P=0.384). (4) Univariate survival analysis showed that the progression free survival time in patients with ovarian serous cancer group was significantly correlated with the protein expression of PAX8, PAX2 and RAS (P<0.05), but there were not correlated with age, surgical staging, cell differentiation, lymph node metastasis and preoperative chemotherapy and p53 protein expression (P>0.05). The total survival time in patients with ovarian serous cancer group was significantly correlated with the protein expression of PAX8 (P<0.05), but there were not correlated with age,surgical staging, cell differentiation, lymph node metastasis and preoperative chemotherapy and the protein expression of PAX2, RAS and p53 (P>0.05). Conclusions: PAX8, PAX2, p53, RAS are of great significance for the study of origin of HGSC. HGSC may be derived from fallopian tube, but further investigation would be necessary to confirm this. PAX8, PAX2, p53, RAS could be expected to be used as predictors of survival prognosis in patients with ovarian serous cancer.

The gall wasp Leptocybe invasa (Hymenoptera: Eulophidae) stimulates different chemical and phytohormone responses in two Eucalyptus varieties that vary in susceptibility to galling

Gall-inducing insects produce various types of galls on plants, but little is known about the gall-induction mechanism of these galling insects. The gall wasp Leptocybe invasa Fisher & LaSalle (Hymenoptera: Eulophidae) forms galls of different sizes on several Eucalyptus species. To clarify the physiological responses of Eucalyptus to L. invasa infestation, we measured the dynamics of nitrogen (N), carbon (C), total phenolics, total tannins and four types of phytohormones (zeatin [Z] + zeatin riboside [ZR], gibberellins [GA], indole-3-acetic acid [IAA] and abscisic acid [ABA]) in galled and ungalled leaf tissues of two Eucalyptus horticultural varieties (DH201-2 [Eucalyptus grandis × Eucalyptus camaldulensis] and EA [Eucalyptus exserta]) with different susceptibility to galling throughout the larval developmental stages. Nitrogen, total phenolics, tannins and four kinds of phytohormones strongly accumulated in tissues galled by L. invasa (especially during early larval feeding stages). While N, Z + ZR and GA levels were higher, tannins and ABA levels were lower in the galled tissues on the highly susceptible variety. Nitrogen, total phenolics, GA, Z + ZR and IAA levels in the galled tissues gradually decreased during gall development, but ABA and tannins conversely increased in the galled tissues of the less susceptible variety. Our results suggest that the effects of gall-inducing insects on plants depend not only on the susceptibility of the plant infested but also on the developmental stage of galled tissues. Gall formation process is thus synergistically influenced by both gall-inducing insect and plant genotypes.

CYP4A in tumor-associated macrophages promotes pre-metastatic niche formation and metastasis

Tumor-associated macrophages (TAMs) play an essential role in metastasis. However, what enables TAMs to have a superior capacity to establish pre-metastatic microenvironment in distant organs is unclear. Here we have begun to uncover the effects of cytochrome P450 (CYP) 4A in TAMs on lung pre-metastatic niche formation and metastasis. CYP4A⁺ TAM infiltration was positively associated with metastasis, pre-metastatic niche formation and poor prognosis in breast cancer patients. The pharmacological inhibition of CYP4A reduced lung pre-metastatic niche formation (evidenced by a decrease in vascular endothelial growth factor receptor 1 positive (VEGFR1⁺) myeloid cell recruitment and pro-metastatic protein expression) and metastatic burden, accompanied with TAM polarization away from the M2 phenotype in spontaneous metastasis models of 4T1 breast cancer and B16F10 melanoma. Co-implantation of 4T1 cells with CYP4A10^high macrophages promoted lung pre-metastatic niche formation and metastasis. Depletion of TAMs disrupted lung pre-metastatic niches and thereby prevented metastasis. Treatment with the CM from CYP4A10^high M2 macrophages (M2) increased pre-metastatic niche formation and metastatic burden in the lungs, whereas CYP4A inhibition attenuated these effects. In vitro TAM polarization away from the M2 phenotype induced by CYP4A inhibition decreased VEGFR1⁺ myeloid cell migration and fibronectin expression, accompanied with downregulation of STAT3 signaling. Conversely, overexpression of CYP4A or exogenous addition of 20-hydroxyeicosatetraenoic acid promoted M2 polarization and cytokine production of macrophages and thereby enhanced migration of VEGFR1⁺ myeloid cells, which were reversed by siRNA or pharmacological inhibition of STAT3. Importantly, a combined blocking M2 macrophage-derived factors TGF-β, VEGF and SDF-1 abolished VEGFR1⁺ myeloid cell migration and fibroblast activation induced by CYP4A. In summary, CYP4A in TAMs is crucial for lung pre-metastatic niche formation and metastasis, and may serve as a potential therapeutic target in human cancer.

[Coexistence of sarcoidosis and primary Sjögren syndrome: a clinical analysis and literature review]

Four patients with coexistence of sarcoidosis and primary Sjögren syndrome (pSS) were retrospectively analyzed.All patients were female, who were referred to our department mainly because of respiratory symptoms.Positive antinuclear antibody(ANA) was detected in 2 patients and anti-Sjögrens syndrome A (SSA) antibody positive in 1 patient.All patients presented specific histologic patterns of both sarcoidosis and pSS.Publications related to coexistence of these two diseases were reviewed.Forty-one patients were finally included in the analysis, among whom 37 confirmed patients were from literature search.There were 37 women and 4 men.The main clinical features presentation were xerophthalmia in 40, xerostomia in 38, hilaradenopathies in 28, interstitial lung disease in 15, respiratory symptoms in 13.The main immunologic data were positive ANA in 23, SSA antibody in 19, anti-Sjögrens syndrome B antibody in 10 and rheumatoid factor in 12.All patients presented specific histologic patterns of both diseases.Patients with both sarcoidosis and pSS of ten represent multisystemic involvement and positive immunologic parameters, as well as the dual expression of specific histologic characteristics.

[Topping-off surgery versus double-segment fusion for treatment of lumbar degenerative disease with mid-long term follow-up]

Objective: To compare the mid-long term clinical effect of Topping-off surgery and lumbar fusion surgery for two-segmental lumbar degenerative disease. Methods: From March 2009 to March 2012, one hundred and twenty-six consecutive patients (Topping-off surgery and two-segment PLIF surgery) were studied in Orthopedics Department, Beijing Chao-Yang Hospital, Capital Medical University.The VAS and ODI were used to assess clinical symptoms.All patients underwent flexion/extension radiographs examinations before surgery, 1, 2 years and last follow-up postoperatively.Lumbar lordosis, sacral slop, data of Coflex segment and adjacent segment (disc height index, range of motion, foraminal height, foraminal width and Pfirrmann classification of intervertebral disc in MRI) were recorded.The paired double-tailed t test was used to analyze the differences in the results from baseline to each postoperative time point.The paired double-tailed t test was used in both groups to analyze the differences in the results from baseline to each postoperative time point.The Chi-square test was used to evaluate the differences between the incidences of adjacent segment degeneration(ASD) in the groups. Logistic regression analysis was used to analyze risk factors for developing radiographic ASD. Results: In topping-off group, 60 patients, average operation time was (134.5±10.2) min. The average blood loss was (301.5±64.6) ml.In fusion group, 68 patients, average age (58.3±4.6) years.The average follow-up time was (47.5±5.1) months.The average operation time was (158.6±19.3) min (P=0.000). The average blood loss was (413.6±131.3) ml (P=0.000). Sex, age, body mass index and intervertebral disc grading were matched between the two groups.Better improvement in VAS back pain score was noted in the topping-off group over the fusion group (P=0.030). Both groups achieved good recovery in ODI and improvement in VAS leg pain and back pain scores at last follow-up postoperatively.In the Topping-off group, FH increased from 10.5 mm at baseline to 11.8 mm at 1 year after surgery (P=0.000) and then decreased mildly in the third postoperative year, while in the fusion group, showed no significant change at all postoperative time points.In the fusion group, the disc height and FW at the same segment were no significant change after first year follow-up, while ROM was significantly decreased after surgery (P=0.000). Foraminal height, foraminal width and intervertebral disc height of adjacent segment of Coflex implant level were found decreased at the end of the postoperative follow-up, while compared with preoperative data no significant difference (P>0.05). At last follow-up, eight patients (13.3%) in the Topping-off group and eighteen patients (26.5%) in the fusion group developed ASD (P=0.033). Conclusions: Topping-off surgery compared with two-segment lumbar fusion surgery can achieve a good result in cases with pre-existing mild or moderate adjacent segment degeneration, restrict the adjacent segment's range of motion and reduce the adjacent segment degeneration. Under strict indications, Topping-off surgery is an acceptable alternative to fusion surgery for the treatment of two-segment lumbar disease.

Cloning and characterization of ChiMYB in Chrysanthemum indicum with an emphasis on salinity stress tolerance

v-myb avianmyeloblastosis viral oncogene homolog (MYB) transcription factors are key regulators of stress responsive gene expression in plants. In this study, the MYB gene, ChiMYB (GenBank accession No. KT948997), was isolated from Chrysanthemum indicum, and was functionally characterized with an emphasis on salinity stress tolerance. The full ChiMYB cDNA sequence (948 bp) encoded a typical R2R3 MYB transcription factor that contained 315 amino acid residues and two MYB domains. The temporal expression pattern of ChiMYB was noted in C. indicum, and the highest level was detected in the roots, followed by leaves and stems. ChiMYB expression was induced by NaCl treatments, and transient expression of the fusion of ChiMYB and green fluorescent protein (GFP) indicated that the protein was targeted to the nuclei of onion epidermal cells. Arabidopsis plants overexpressing ChiMYB displayed improved tolerance to drought and salt stress. When under salt stress conditions, transgenic Arabidopsis plants had higher survival rates than non-transgenic wild-type plants. Chlorophyll content, intercellular CO₂ concentration, photosynthetic rate, and stomatal conductance were higher in the transgenic Arabidopsis plants than in non-transgenic control plants. Further investigation revealed that ChiMYB was able to regulate the expression of RD29A, RAB18, COR15, ABI1, and ABA genes, which are involved in salt stress signaling pathways. Our findings demonstrated that ChiMYB is essential for plant responses to salt stress, and it may have great potential for the improvement of salt tolerance in crops.

[Carpal canal ultrasound examination in patients with mild hand-arm vibration disease]

Objective: To investigate the clinical value of ultrasound examination of carpal canal structure in patients with mild hand-arm vibration disease. Methods: A total of 29 patients (58 wrists) with mild hand-arm vibration disease who were treated in Shenzhen Prevention and Treatment Center for Occupational Diseases from May to December, 2015 were enrolled as observation group, and 20 healthy volunteers (40 wrists) were enrolled as the control group. Color Doppler ultrasound was used to observe the morphology and echo of the median nerve in the carpal canal and 9 muscle tendons and transverse carpal ligament. The thickness of transverse carpal ligament and diameter of the median nerve at the level of the hamulus of hamate bone were measured, as well as the cross-sectional area of the median nerve at the level of pisiform bone. Results: In the 29 patients with hand-arm vibration disease patients in the observation group, 8 experienced entrapment of the median nerve in the carpal canal, among whom 5 had entrapment in both wrists; there were 13 wrists (23%) with nerve entrapment and 45 wrists (77%) without nerve entrapment. Compared with the control group, the patients with hand-arm vibration disease and nerve entrapment in the observation group showed significant thickening of the transverse carpal ligament at the level of the hamulus of hamate bone and a significant increase in the cross-sectional area of the median nerve at the level of pisiform bone (P<0.05) , while there were no significant differences in the thickness of transverse carpal ligament at the level of the hamulus of hamate bone and the cross-sectional area of the median nerve at the level of pisiform bone (t=-9.397 and -4.385, both P>0.05) . Conclusion: Ultrasound examination can clearly show the radiological changes of carpal canal contents in patients with mild hand-arm vibration disease and has a certain diagnostic value in nerve damage in patients with hand-arm vibration disease.

[Clinical outcome of mid-term follow-up of anterior cervical non-fusion surgery versus anterior cervical discectomy and fusion for cervical spondylosis]

OBJECTIVE

To evaluate the clinical and radiological outcomes of artificial cervical disc replacement (Prodisc-C), dynamic cervical implant and anterior cervical discectomy and fusion (ACDF) in the treatment of cervical spondylosis.

METHOD

From May 2011 to May 2013, a total of 44 cervical spondylosis patients that received cervical disc arthroplasty (Prodisc-C), dynamic cervical implant (DCI) or ACDF were retrospectively reviewed in Orthopedics Department, Beijing Chaoyang Hospital, Capital Medical University.The patients were divided into three groups by surgical methods.Parameters as gender, age, the operation time, blood loss and average hospital stay of three groups were compared.The patients were followed 3 months, 6 months, 12 months and 24 months postoperatively.Neck disability index (NDI), Japanese Orthopaedic Association (JOA) Score and Visual Analogue Scale (VAS) were used to evaluate the clinical outcomes of the three groups.We also measured the cervical lordosis, range of motion of surgical segment and adjacent segment and height of disc at pre-op and post-op.

RESULT

All the patients were got at least 24 months follow-up.The differences between postoperative JOA, NDI and VAS scores and preoperative scores were of statistical significance (P<0.05). There was no statistical difference in average hospital stay, JOA, NDI and VAS recovery rate (P>0.05) among three groups.But the operative time and intraoperative blood loss were statistically different (P<0.05). Compared the pre-and postoperative ROM of C2-7, operative, upper and lower levels of each group respectively, the difference between pre-and postoperative ROM of ACDF group were of statistically significant [(16.6±3.6)°, (22.3±4.6)°, (18.1±3.1)°, P<0.05], while was no statistically significant of non-fusion group(P>0.05). There was no statistically significant difference between pre-and postoperative ROM of upper and lower levels among three groups (P>0.05), but had statistically difference in operative levels [(7.0±1.0) mm, (9.2±1.5) mm, (6.8±1.4) mm, P<0.05]. And there are no serious postoperative complications.

CONCLUSION

Two cervical non-fusion surgery and ACDF have received good clinical effects in the treatment of spondylotic myelopathy or radicular spondylosis.The artificial cervical disc replacement and dynamic cervical implant can not only recover cervical lordosis and keep the range of motion and stability of the surgical segment, but also reduce the incidence of compensatory motion at adjacent segments and will prevent from adjacent segment degeneration.

[One case of Horner's syndrome after thyroid gland operation]

The patient find the nodule unintentionally for 2 weeks, painless, no voice hoarse, no swallowing and drinking difficulties. no dizziness, no fatigue, no tremor of the hand, no irritability,no palpitations, no fever chills, no nausea, no vomiting, no chest tightness, no shortness of breath and other discomfort.Ultrasonic report：The size of thyroid was normal, and was scattered in the middle of the right lobe with a large solid echo of about 12 mm×7 mm. The left lobe of the thyroid gland was found to have an echo of the size of about 10 mm×7 mm,the shape was irregular,the boundary was unclear, lymph nodes with no obvious swelling in the neck. CDFI: right lobe of the thyroid low echo mass surrounding the actuate color flow, short rod color flow; left thyroid lobe inferior echo mass around and see the short rod color flow.Diagnose：nodular goiter；subacute thyroiditis；Hornor's symptoms.

[Objective evaluation the application of femtosecond laser in cataract surgery]

Femtosecond laser-assisted cataract surgery (FLACS) is a novel technology and the biggest revolution in the field of cataract in the latest several years. However, increasing large-scale population randomized controlled trials (RCT) have demonstrated that FLACS does not provide significant advantages over conventional phacoemulsification cataract surgery (CPCS) for common cataract patients. Furthermore, the cost and space requirement of the femtosecond equipment are another two limitations for the universal application of FSL in cataract surgery. However, FLACS may be beneficial for complex cataract situations, such as lens dislocation, zonular laxity, traumatic cataract, low preoperative endothelial cell values, and significant corneal astigmatism. With the progress of science and technology, FLACS can be expected to achieve integration with phacoemulsification systems, and equipment costs can be reduced, making it more widely used in clinical practice in the future.