[Textual research on the birthplace of Chen Xunzhai, a doctor of the Republic of China]

Chen Xunzhai was a famous Fujian traditional Chinese medicine expert in the period of the Republic of China. There are different records of his native place in the existing literature. By reviewing the published journals and books, interviewing Chen Xunzhai's scattered works and genealogy and visiting his descendants, this article conducted investigations and researches and confirmed that Chen Xunzhai, also named Guangcheng, was born in Shangyang Village, Gaopo Town in Yongding County of Fujian Province. He was the 22nd generation of descendants of Chen family in Shangyang Yingchuan County, not the descendant of the Chen family in Jiang Tian Nanyang of Chang Le City. Neither was he the seventh-generation grandson of Chen Xiuyuan. The findings of this paper will lay the foundation for the further researches on Chen Xunzhai.

[Progress in the application of exposomics in risk assessment of environmental chemicals]

With the increasing number of environmental chemicals, the risk assessment system based on animal toxicity testing is difficult to satisfy the current demands and needs to be reformed urgently. With the wide application of high-throughput screening technology, the advantage of exposomics in risk assessment is gradually emerging. Exposomics aims to study the health effects of mixed environmental exposure at different stages of life (especially in the early stage of life) through the dynamic monitoring of external and internal exposure levels. Exposomics is introduced into risk assessment to systematically study gene-environment interaction so as to provide a reliable basis for the construction of exposure-biomarker-disease network. This review summarized the importance and application prospect of exposomics in risk assessment of environmental chemicals in terms of the research progress, application in risk assessment and existing problems, opportunities and challenges.

[Early clinical effects of total knee arthroplasty with kinematic alignment assisted by patient-specific instrumentation]

Objective: To examine the clinical effects of the treatment of knee osteoarthritis patients with kinematic alignment technique of total knee replacement (KA-TKA) assisted by patient-specific instrumentation (PSI). Methods: The clinical data of 14 patients with knee osteoarthritis treated with unilateral KA-TKA assisted by PSI at Department of Orthopaedic Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University from May 2018 to August 2019 were analyzed retrospectively. There were 6 males and 8 females, aged 66.6 years (range: 56 to 79 years), 9 left knees and 5 right knees. The operation time, soft tissue release and extra varus or valgus osteotomy were recorded. The data of osteotomy blocks were measured and compared with the corresponding position of the prostheses. The hip knee ankle angle (HKA), the mechanical distal femoral lateral angle (mLDFA) and the proximal tibial medial angle (MPTA) were measured before and 3 months after the operation. The knee joint functional score (KS-F) , knee joint clinical score (KS-C) and the Western Ontario McMaster (WOMAC) Osteoarthritis Index were recorded and compared by paired t test or Wilcoxon non-parametric test. Results: The operation time was (81.8±16.9) minutes (range: 60 to 115 minutes), 2 cases were manually increased varus osteotomy by 2 mm and 1 patient received lateral retinaculum release. There was no extra medial or lateral soft tissue release. Intraoperative measurement of the resection showed that the femoral side mismatch was within 2 mm. The medial and lateral condyle, the medial and lateral posterior condyles were relatively overcut by 0.50 mm, 0.21 mm, 0.93 mm, and 0.71 mm, respectively. The tibial side mismatch was within 1.5 mm, the medial and lateral plateau were relatively undercut by 0.43 mm and 0.32 mm. HKA was corrected from (8.8±5.6) ° to (1.6±4.3) ° (t=20.723, P=0.000) .KS-C improved from 28.21±13.47 preoperative to 78.07±8.01 postoperative (t=-16.570, P=0.000); KS-F improved from 41.00±15.25 preoperative to 84.93±10.85 postoperative (t=-14.675, P=0.000).WOMAC Osteoarthritis Index decreased from 53.5 (25.75) (M(Q(R))) preoperative to 5.5 (5.25) postoperative (Z=-3.297, P=0.001) .No statistically significant difference was found in mLDFA and MPTA before and after surgery. No significant patellofemoral complication was recorded during follow-up time. Conclusions: PSI assisted TKA resection has high accuracy. KA-TKA aims to restore the native anatomy of the knee joint, only corrects the malalignment of lower extremities caused by articular cartilage wear, with less interference to soft tissues, easy to obtain satisfactory knee joint laxity and has a promising early clinical effect.

[Percutaneous endoscopic transforaminal discectomy for L5~S1 disc herniation]

Objective: To evaluate the clinical results of percutaneous endoscopic transforaminal discectomy (PETD) for L5~S1 lumbar disc herniation (LDH). Methods: One hundred and two cases of L5~S1 LDH from April 2016 to June 2018 were retrospectively analyzed, including 13 patients with high iliac crest. Pre-and postoperative pain was measured by Visual Analog Scale (VAS) and functional status was assessed by Oswestry Disability Index (ODI). Results: All the operations were successful and no severe complications occurred such as hemorrhages, infections, injury of nerves. The operation time was (87.6±21.0) min; the frequencies of intraoperative fluoroscopy were 29.1±11.7; the postoperative bedridden time was (4.6±1.1) hours and the hospital stay was (3.6±0.5) days. The mean VAS and ODI scores were significantly improved (P<0.01) postoperatively. The efficiency of 102 cases were excellent in 89 cases (87.3%), good in 8 cases (7.8%), fair in 4 cases (3.9%) and poor in 1 cases (1.0%). One patient (1.0%) relapsed at 6 months after surgery. Conclusions: PETD is a safe and effective method for treatment of L5~S1 LDH. The "transverse process localization method" might be an effective technique for patient with high iliac crest and/or hypertrophic transverse process.

Directional massless Dirac fermions in a layered van der Waals material with one-dimensional long-range order

One or a few layers of van der Waals (vdW) materials are promising for applications in nanoscale electronics. Established properties include high mobility in graphene, a large direct gap in monolayer MoS₂, the quantum spin Hall effect in monolayer WTe₂ and so on. These exciting properties arise from electron quantum confinement in the two-dimensional limit. Here, we use angle-resolved photoemission spectroscopy to reveal directional massless Dirac fermions due to one-dimensional confinement of carriers in the layered vdW material NbSi_0.45Te₂. The one-dimensional directional massless Dirac fermions are protected by non-symmorphic symmetry, and emerge from a stripe-like structural modulation with long-range translational symmetry only along the stripe direction as we show using scanning tunnelling microscopy. Our work not only provides a playground for investigating further the properties of directional massless Dirac fermions, but also introduces a unique component with one-dimensional long-range order for engineering nano-electronic devices based on heterostructures of vdW materials.

[The treatment effect of opening,debridement and double-row fixation using suture anchor for severe patellar tendinopathy]

Objective: To evaluate clinical treatment efficacy of double-row fixation with bridging suture anchors for chronic, severe patellar tendinopathy. Methods: A retrospective study of 18 patients suffered from severe patellar tendinopathy and underwent surgical treatment during January 2009 and June 2014 at Department of Orthopedic, Beijing Chao Yang Hospital, Capital Medical University was conducted. All patients had received conservative therapy for more than 6 months(range: 6-30 months) but the effect was unsatisfactory. There were 10 males (12 knees) and 8 females (12 knees)with age of 47.2 years(range: 32-63 years). Seven cases on the left and 17 cases on the right. The surgical treatment included a midline incision at patellar tendon, complete debridement, and double-row fixation with bridging suture anchors. Visual analogue scale(VAS), Lysholm score were collected preoperatively and postoperatively, and compared by paired-t test. The postoperative complications was recorded. Results: All patients were followed up for 35.7 months (range:24-64 months) without any dropout.VAS decreased from 7.5±1.6 preoperative to 1.4±1.0 (t=4.45, P=0.00) postoperative, Lysholm score increased from 48.3±5.2 to 89.6±5.4 (t=-4.88,P=0.00).The Lysholm score was excellent in 3 cases and good in 15 cases.No patellar tendon rupture or suture fixation failure was recorded during the follow-up period. Conclusions: The effect of double-row fixation with bridging suture anchors is satisfactory with few postoperative complications.It can not only improve clinical symptoms of patients, but also restore knee joint function.

[Preliminary study on effect of intraoperative goal-directed fluid management on pulmonary function and oxygen dynamics in patients with severe burns]

Objective: To preliminarily investigate the effect of intraoperative goal-directed fluid management (GDFM) on pulmonary function and oxygen dynamics in patients with severe burns. Methods: From February 2017 to May 2018, 30 patients admitted to Burn Department of our hospital with severe burns who met the criteria for inclusion and needed escharectomy and skin grafting were enrolled in this prospective randomized controlled trial. The patients were divided into group GDFM of 15 cases [14 males and 1 female, (45±14) years old] and conventional liquid management group of 15 cases [12 males and 3 females, (42±10) years old] according to the random number table. During escharectomy and skin grafting, volume of patients in group GDFM was managed according to the GDFM scheme, based on cardiac output index, stroke volume variation, stroke volume index, hemoglobin, central venous oxygen saturation (ScvO(2)), and other parameters; volume of patients in conventional liquid management group was managed according to clinical experience and conventional liquid management scheme, based on mean arterial pressure, central venous pressure, urine output, hemoglobin, and other parameters. At post operation hour (POH) 1, 6, 12, and 24, arterial and venous blood was collected from patients of the two groups to determine the levels of extravascular lung water index (ELWI), global end-diastolic volume index (GEDI), oxygenation index, ScvO(2), central venous-to-arterial blood carbon dioxide partial pressure difference (Pcv-aCO(2)), lactic acid, pH value, bicarbonate ion, and base excess routinely. Data were processed with Fisher's exact probability test, t test, analysis of variance for repeated measurement, and least significant difference test. Results: (1) The ELWI of patients in group GDFM was (4.3±1.1) mL/kg at POH 1, which was significantly lower than (6.5±3.6) mL/kg in conventional liquid management group (t=2.26, P<0.05). The ELWI levels of patients in group GDFM at POH 6, 12, and 24 were (6.8±2.2), (6.6±2.0), and (6.9±1.6) mL/kg, respectively, significantly higher than the level at POH 1 within the same group (P<0.01), and similar to (8.5±3.1), (7.8±2.3), and (8.0±3.5) mL/kg in conventional liquid management group (t=1.73, 1.53, 1.10, P>0.05). The GEDI levels between patients of the two groups were similar, and there was no significantly statistical difference between the two groups as a whole (treatment factor main effect F=2.35, time factor main effect F=0.44, interaction F=0.07, P>0.05). (2) The oxygenation index of patients in group GDFM was (350±78) mL/kg at POH 1, which was significantly higher than (259±109) mL/kg in conventional liquid management group (t=2.63, P<0.05). In conventional liquid management group, the oxygenation index of patients at POH 6 was significantly higher than that at POH 1, 12, or 24 (P<0.01). The ScvO(2) levels of patients in group GDFM at POH 1, 6, and 12 were 0.516±0.105, 0.679±0.121, and 0.713±0.104, respectively, which were significantly higher than 0.382±0.194, 0.545±0.194, and 0.595±0.191 in conventional liquid management group (t=2.35, 2.27, 2.10, P<0.05). The ScvO(2) levels of patients in the two groups at POH 6, 12, and 24 were significantly higher than those levels at POH 1 within the same group (P<0.01), and the ScvO(2) of patients in conventional liquid management group at POH 24 was significantly higher than that at POH 6 or 12 within the same group (P<0.05 or P<0.01). The Pcv-aCO(2) levels of patients in group GDFM were significantly lower than those in conventional liquid management group at POH 1 and 6 (t=2.55, 2.71, P<0.05). The Pcv-aCO(2) of patients in group GDFM at POH 12 was significantly lower than that at POH 6 or 24 within the same group (P<0.05). (3) The blood lactic acid levels and pH values between patients of the two groups were similar at POH 1, 6, 12, and 24 (t=0.89, 0.19, 0.26, 0.23; 1.55, 0.71, 0.77, 0.77, P>0.05). In conventional liquid management group, the blood lactic acid levels of patients at POH 6, 12, and 24 were significantly lower than the level at POH 1 within the same group (P<0.05), and the pH values of patients at POH 6, 12, and 24 were significantly higher than the value at POH 1 within the same group (P<0.05). The levels of bicarbonate ion and base excess between patients of the two groups were similar, and there were no significantly statistical differences between the two groups as a whole (treatment factor main effect F=0.06, 0.11, time factor main effect F=2.07, 1.59, interaction F=1.45, 0.91, P>0.05). Conclusions: GDFM is helpful to improve the pulmonary function and oxygen dynamics in patients with severe burns in the short term after escharectomy and skin grafting. It has certain significance in preventing and reducing pulmonary edema and pulmonary complications in patients with severe burn after operation.

[Effect of comprehensive intervention on hypertension control program in workplaces in China]

Objective: To evaluate the effect of comprehensive intervention program on hypertension control in workplaces in China. Methods: The study design was a non-randomized controlled trial. First, 20 sub-centers were selected across China, then hypertension patients in 2-4 workplaces were selected as the intervention group, and hypertension patients in 1 comparable workplace selected, as the control group in each sub-center. The comprehensive intervention strategy which integrating workplace primary prevention of cardiovascular diseases and standardized management of hypertension was adopted in the intervention group for at least 2 years. Patients in the control group continued their usual health care, and only baseline data and 2-year data was collected. Analyses were conducted for hypertension patients in 30 stated-owned enterprises (SOEs), including 20 for the intervention group and 10 for the control group. The primary outcome was the control rate ofhypertension while the intervention effect (IE) was estimated by using the formula: differential value of intervention group[rate (mean)]-differential value of control group[rate (mean)]. Results: Overall, 2 622 patients completed the 2-year follow-up, of which 2 055 were in the intervention group and 567 in the control group, respectively. After 2 years of intervention, the IE on the level of SBP and DBP for intervention group and control group were-7.5 and-3.9 mmHg, respectively (P<0.05). BMI decreased by 0.4 kg/m(2), with the regular exercise rate as 36.4% and alcohol consumption rate decreased by 14.0%, respectively (P<0.05). The smoking rate decreased by 6.1% (P>0.05). The overall hypertension control rate was 25.0%, and further subgroup analysis showed that our intervention program was particularly effective for those with high education level (27.6%), white-collar employees (41.9%), and those from SOEs whose affiliated hospital had been separated away (41.9%). Conclusion: The comprehensive intervention program could greatly improve the hypertension control in the workplaces in China.

Causes of ozone pollution in summer in Wuhan, Central China

In August 2016, continuous measurements of volatile organic compounds (VOCs) and trace gases were conducted at an urban site in Wuhan. Four high-ozone (O₃) days and twenty-seven non-high-O₃ days were identified according to the China's National Standard Level II (∼100 ppbv). The occurrence of high-O₃ days was accompanied by tropical cyclones. Much higher concentrations of VOCs and carbon monoxide (CO) were observed on the high-O₃ days (p < 0.01). Model simulations revealed that vehicle exhausts were the dominant sources of VOCs, contributing 45.4 ± 5.2% and 37.3 ± 2.9% during high-O₃ and non-high-O₃ days, respectively. Both vehicle exhausts and stationary combustion made significantly larger contributions to O₃ production on high-O₃ days (p < 0.01). Analysis using a chemical transport model found that local photochemical formation accounted for 74.7 ± 5.8% of the daytime O₃, around twice the regional transport (32.2 ± 5.4%), while the nighttime O₃ was mainly attributable to regional transport (59.1 ± 9.9%). The local O₃ formation was generally limited by VOCs in urban Wuhan. To effectively control O₃ pollution, the reduction ratio of VOCs to NO_x concentrations should not be lower than 0.73, and the most efficient O₃ abatement could be achieved by reducing VOCs from vehicle exhausts. This study contributes to the worldwide database of O₃-VOC-NO_x sensitivity research. Its findings will be helpful in formulating and implementing emission control strategies for dealing with O₃ pollution in Wuhan.

Evidence of a Coulomb-Interaction-Induced Lifshitz Transition and Robust Hybrid Weyl Semimetal in T_{d}-MoTe_{2}

Using soft x-ray angle-resolved photoemission spectroscopy we probed the bulk electronic structure of T_{d}-MoTe_{2}. We found that on-site Coulomb interaction leads to a Lifshitz transition, which is essential for a precise description of the electronic structure. A hybrid Weyl semimetal state with a pair of energy bands touching at both type-I and type-II Weyl nodes is indicated by comparing the experimental data with theoretical calculations. Unveiling the importance of Coulomb interaction opens up a new route to comprehend the unique properties of MoTe_{2}, and is significant for understanding the interplay between correlation effects, strong spin-orbit coupling and superconductivity in this van der Waals material.

[Endoplasmic reticulum-mitochondrial contact regulates osteogenic differentiation of periodontal ligament stem cells via mitofusion 2 in inflammatory microenvironment]

Objective: To investigate the effect of endoplasmic reticulum (ER)-mitochondria coupling and the expression of mitofusion 2 (Mfn2) in periodontal ligament stem cells (PDLSC), so as to provide a theoretical basis and therapeutic target for promoting periodontal regeneration in treatment of periodontitis. Methods: The periodontal ligament tissue was scraped from extracted intact human teeth and teeth with periodontitis collected in the Department of Oral and Maxillofacial Surgery, the Fourth Military Medical University. The health PDLSC (H-PDLSC) and inflammatory PDLSC (P-PDLSC) were obtained respectively from the primary culture of the human teeth and cloned using 1imited diluted method. The level of ER-mitochondrial coupling was observed by transmission electron microscopy and organelle-specific fluorescence staining. Quantitative real-time PCR (qPCR) was used to detect the expression of Mfn2 in H-PDLSC and P-PDLSC. Tumor necrosis factor alpha (TNF-α) was used to simulate the inflammatory microenvironment. H-PDLSC was cultured in normal medium and media containing 5 and 10 mg/L TNF-α, named as H-PDLSC group, H-PDLSC+TNF-α (5 mg/L) group and H-PDLSC+TNF-α (10 mg/L) group, respectively. At the 7th day, qPCR was applied to detect the mRNA level of Mfn2. The expression of Mfn2 in P-PDLSC was down-regulated by small interfering RNA siMfn2. The osteogenic differentiation of P-PDLSC and P-PDLSC+siMfn2 were examined by qPCR at the 7th day, and alizarin red staining and cetyl pyridine chloride quantitative analysis at the 28th day after osteogenic induction. Results: The level of ER-mitochondrial coupling in the P-PDLSC group (the length of the coupling structure/mitochondrial perimeter was 0.55±0.10, the length of the coupling structure/endoplasmic reticulum perimeter was 0.44±0.08) was significantly higher than that in the H-PDLSC group (P<0.01). The co-localization of endoplasmic reticulum and mitochondria of P-PDLSC group was 0.71±0.09, which was significantly higher than that of H-PDLSC group (P<0.01). The expression level of Mfn2 in P-PDLSC (1.46±0.10) was higher than that in H-PDLSC (0.99±0.08). The expression levels of Mfn2 in H-PDLSC+TNF-α (5 mg/L) and H-PDLSC+TNF-α (10 mg/L) groups were 1.28±0.19, 1.54±0.43, respectively, which were both significantly higher than that in H-PDLSC (0.82±0.14) (P<0.01). P-PDLSC transfected with siMfn2 down-regulated the expression of Mfn2, and the osteogenic differentiation ability of P-PDLSC was restored. The results showed that the expression of alkaline phosphatase, Runt-related transcription factor-2 (RUNX2) and osteocalcin mRNA in P-PDLSC+siMfn2 group were significantly higher than that of the control group (P<0.01). The alizarin red staining and quantitative results of cetyl pyridinium chloride were consistent with the qPCR results. Conclusions: In the microenvironment of inflammation, ER-mitochondrial coupling and the expression of Mfn2 of PDLSC increased, which might lead to a decrease in osteogenic differentiation of PDLSC. The specific mechanism needs to be further studied.

[The dynamic change of cytokines associated with the speccificimmunotherapy and its clinical significance]

Objective:This project aimed to study the dynamic change of the cytokines associated with specific immunotherapy(SIT) pre- and post-SIT.Searching for immune regulatory indicators would used in SIT.Method:One hundred cases who had accepted SIT were enrolled in the project.Data of serum specific IgE and cytokines were statistically analyzed.In the three periods,pre-SIT,17 weeks post-SIT,57 weeks post-SIT,the levels of the eight kinds of cytokines(IL-4,IL-5,IL-8,IL-10,IL-13,IL-17,IFN-γ and TNF-α)were detected,and the dynamic change of the nasal symptoms score were analyzed.Result:The six kinds of cytokines(IL-5,IL-8,IL-10,IL-13,IL-17 and TNF-α)had no significant difference before and after SIT.The level of house dust mite sIgE level was positively correlated with serum IL-5 when the SIT pre-treatment and 57weeks (P<0.05).Pre-treatment and in 17 weeks after treatment,serum IL-5,IL-17 content difference and reduce the magnitude of nasal symptom scores were positively correlated (P<0.01).In 17 weeks of treatment and 57 weeks of treatment,difference of serum IL-10,IL-13,TNF-α levelsand the difference of nasal symptom scores were negatively correlated(P<0.01).Pre- treatment and 57 weeks,difference of serum IL-13,IL-17,TNF-α and the difference of nasal symptom scores were positively correlated (P<0.05),serum IL-10 levels of difference between the nose ministry of magnitude lower symptom scores were negatively correlated (P<0.01).Conclusion:The cytokines (IL-4,IL-5,IL-8,IL-10,IL-13,IL-17,IFN-γ and TNF-α) associated with the SIT play an important role in allergy and can objectively reflect the immune status during SIT.

[Formulation and evaluation of diagnostic questionnaire for benign paroxysmal positional vertigo]

Objective: To formulate and evaluate a rapid assessment questionnaire for benign paroxysmal positional vertigo(BPPV). Methods: The rapid assessment questionnaire for benign paroxysmal positional vertigo was developed based on the core clinical manifestations of BPPV.A total of 235 dizzy patients, with an average age of 56±16, were recruited from the Navy General Hospital during October 2015 to March 2016.The assessments were made by two specialists for BPPV, and the diagnoses were confirmed through follow-up.The reliability and validity of the scale questionnaire were analyzed with the SPSS 19.0 and the cutoff point was confirmed with the Receiver operating characteristic(ROC) curve analysis. Results: Reliability test: Cronbach α value for the questionnaire was 0.644; Validity: KMO (Kasier-Meyer-Olkin) value for the questionnaire was 0.711.Two factors were used with a characteristic root of higher than 0.9.The total cumulative contribution rate was 53.816%.The load of each item was over 0.5.The range of the scale is 0 to 6 points, with the largest ROC curve area (0.894) at 3 points for the diagnosis of BPPV.The relative sensitivity and specialty were 92.45% and 71.60% , respectively. Conclusions: This rapid assessment questionnaire for benign paroxysmal positional vertigo posses good reliability and validity, and can be used as a tool for a quick diagnosis of BPPV for patients with dizziness. BPPV can be diagnosed with a score of 3 by using this questionnaire.

[Clinical features of late-onset neuromyelitis optica spectrum disorders]

Objective: To study the clinical features of late-onset neuromyelitis optica spectrum disorders(LONMOSD). Methods: Twenty-eight patients with LONMOSD and fifty-one patients with early-onset neuromyelitis optica spectrum disorders(EONMOSD) hospitalized in Navy General Hospital from January 2014 to May 2017 were enrolled and were followed up by telephone or outpatient visiting. The clinical manifestations, laboratory examinations and imaging features of the two groups were compared. Results: (1)The average age of onset in group LONMOSD was(59±6) years old, and 24 cases were female(85.7%). (2) The history of prodromal infection in LONMOSD patients was less reported than that in group EONMOSD(14.3 vs 37.3%, P<0.05), but concomitant diseases were more common in LONMOSD patients(53.6% vs 3.9%, P<0.05). (3) In group of LONMOSD, the patients with transverse myelitis(TM )as the first symptom were less than that of EONMOSD group (39.3% vs 64.7%, P<0.05). (4) There was no significant difference in EDSS score either in acute or remission stage, laboratory and imaging findings between the two groups. Conclusion: Patients with LONMOSD have less history of prodromal infection, and those with TM as the first symptom are less than EONMOSD patients.

[Association between high-sensitivity C-reactive protein and both cardiovascular, total mortality events in middle-aged Chinese adults]

Objective: To estimate the association between high-sensitivity C-reactive protein (hs-CRP) and cardiovascular events as well as all-cause mortality events. Methods: During 2009- 2010, out of the 11 623 individuals, 1 000 participants aged 35-64 years, were recruited and divided into 12 age-groups, to have received a study on CVD risk factors. Information on the risk factors of cardiovascular diseases was also collected. Fasting blood sample was gathered for all the participants, with hs-CRP tested. Participants in 7 out of the 12 sites were followed, with 6.21 years (36 075 person-years) as the median follow-up period. Cardiovascular and all-cause mortality events were collected. A total of 6 177 participants had been followed after excluding participants who had baseline infections, or did not take hs-CRP test/physical examination at the baseline. Finally, 5 984 participants were included for analysis. Participants were categorized into three groups based on the hs-CRP (mg/L) values: <1, 1-3 and >3, respectively. Cox proportional hazards regression model was used to analyze the relationships between hs-CRP with cardiovascular events or all-cause mortality events, after adjusting for confounding factors. Results: Mean age of the participants was 50.2 years. The incidence rates of cardiovascular disease events were 3.6/1 000 person-years, 7.1/1 000 person-years,and 10.4/1 000 person-years among three groups and 3.0/1 000 person-years, 5.7/1 000 person-years, 9.1/1 000 person-years for all-cause mortality events, respectively. After adjusting for confounding factors, the hazard risks (HR) for cardiovascular events were 1.33 (95%CI: 0.95-1.84) in the hs-CRP 1-3 mg/L group and 1.76 (95%CI: 1.20-2.60) in the hs-CRP>3 mg/L group when comparing with the hs-CRP<1 mg/L group (trend test P=0.003). The HRs for all-cause mortality events were 1.76 (95%CI: 1.23-2.54) and 2.64 (95%CI: 1.74-4.01) (trend test P<0.001), respectively. Conclusion: Hs-CRP appeared an independent predictor for cardiovascular events and all-cause mortality events.

Assessment of the Combined Effect of Plasma Exchange and Plasma Perfusion on Patients with Severe Hepatitis Awaiting Orthotopic Liver Transplantation

To determine if plasma exchange combined with plasma perfusion is a reliable and effective temporary liver support treatment for patients on the waiting list for OLT, we tested this method in 5 patients with end-stage and 3 patients with middle-stage severe hepatitis. Four patients were successfully controlled until a donor liver was available 4 to 13 days later. In contrast, the remaining 4 patients were not adequately controlled by this treatment and experienced aggravated disease progression, dying 3 to 8 days after treatment while still awaiting OLT. Of those 4 patients who received OLT, 2 patients died from multi-organ failure caused by hepatic failure, while the other 2 survived. These findings show that plasma exchange combined with plasma perfusion provides temporary support for some patients on the waiting list for OLT. The ability of patients to successfully bridge to OLT is closely associated with the degree of liver failure, complications, multi-organ failure, and the length of the waiting period for a donor liver.

Asymptotically Safe Standard Model via Vectorlike Fermions

We construct asymptotically safe extensions of the standard model by adding gauged vectorlike fermions. Using large number-of-flavor techniques we argue that all gauge couplings, including the hypercharge and, under certain conditions, the Higgs coupling, can achieve an interacting ultraviolet fixed point.

Network meta-analysis of lorcaserin and oral hypoglycaemics for patients with type 2 diabetes mellitus and obesity

In addition to weight loss, randomized controlled trials have shown improvement in glycaemic control in patients taking lorcaserin. The aim of this study aim was to compare adding lorcaserin or other glucose lowering medications to metformin on weight and glycaemic control. A systematic review and network meta-analysis of randomized controlled trials were conducted. Included studies (published 1990-2014) were of lorcaserin or glucose lowering medications in type 2 diabetic patients compared to placebo or different active treatments. Studies had to report ≥1 key outcome (change in weight or HbA1c, % HbA1c <7, hypoglycaemia). Direct meta-analysis was performed using DerSimonian and Laird random effects models, and network meta-analysis with Bayesian Markov-chain Monte Carlo random effects models; 6552 articles were screened and 41 included. Lorcaserin reduced weight significantly more than thiazolidinediones, glinides, sulphonylureas and dipeptidyl peptidase-4 inhibitors, some of which may have led to weight gain. There were no significant differences in weight change between lorcaserin and alpha-glucoside inhibitors, glucagon-like peptide-1 agonists and sodium/glucose cotransporter 2 inhibitors. Network meta-analysis showed lorcaserin was non-inferior to all other agents on HbA1c reduction and % achieving HbA1c of <7%. The risk of hypoglycaemia was not significantly different among studied agents except that sulphonylureas were associated with higher risk of hypoglycaemia than lorcaserin. Although additional studies are needed, this analysis suggests in a population of patients with a body mas index of ≥27 who do not achieve glycaemic control on a single agent, lorcaserin may be added as an alternative to an add-on glucose lowering medication.

[Association between the types of obesity and the 10-year-coronary heart disease risk, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region]

Objective: To investigate the association between types of obesity and the 10-year-coronary heart disease risk in Tibet and Xinjiang of China. Methods: Using the multi-stage random sampling method, 7 631 participants aged 35 or older were examined under the International Standardized Examination process but with only 5 802 were eligible for analysis, in the 2015-2016 season. Results: The prevalence rates of general obesity, central obesity, visceral obesity and compound obesity were 0.53%, 12.62%, 10.08% and 42.35%, respectively. Out of all the compound obesity cases, 58.65% (1 441/2 457) of them appeared as having all types of obesity in our study. Risk related to the 10-year-coronary heart disease was higher in men than in women [(3.05±4.14)% vs. (1.42±2.37) %, P<0.000 1. Compound obesity (30.16%) showed the highest proportion on the risk of 10-year-coronary heart disease than central obesity (28.01%), visceral obesity (18.46%) or the general obesity (19.35%). After adjustment for confounding factors, results from the multivariate analysis showed the risk in compound obesity was higher than central obesity, visceral obesity or general obesity and was associated with the highest risk on the 10-year-coronary heart disease (OR=2.889, 95%CI: 2.525-3.305). People with anomalous BMI and WC seemed to have had the higher risk (OR=3.168, 95%CI: 2.730-3.677). Conclusions: Obesity was popular in the residents of Tibet and Xinjiang areas of China. Men and people with compound obesity (especially both BMI and WC were abnormal) seemed to carry greater risk on the 10-year-coronary heart disease.

[The library of Chinese Medical Association in the Republican Period]

The library of Chinese Medical Association was founded in 1925. The source of books and periodicals in the library are mainly from purchasing and donation. The library provides services such as lending, exchanging books, translating and publishing the contents and abstracts of medical journals in Chinese and other languages. It has played an active and important role in promoting medical development in the period of Republic of China.

[Sinus pericranii in adults: clinical features and therapeutic management (13 cases report)]

Objective: To study the character of sinus pericranii in the adults and enhance the levels of the diagnosis and treatment of sinus pericranii. Methods: The clinical data of 13 adult patients with sinuses pericranii undergoing surgery in Beijing Hospital from 1992 to 2016 were analyzed retrospectively, including clinical manifestations, imaging data, surgical results. Results: Each of the patients presented with a nonpulsatile and soft tissue mass in their heads.Their ages ranged from 18 to 48 years (mean, 26 years). The diagnosis of the sinus pericranii was made by the clinical manifestations combined with CT and/or MRI examinations.The sinus pericranii did not play the main role in the drainage of the cerebral vein blood.All the patients were cured.The follow up time was from 6 months to 20 years with no sinus pericranii recurrence in all the patients. Conclusions: The analysis of the drainage pattern of sinus pericranii was necessary before surgery in order to get a safe and good operation.The curative effect of the surgery on the sinus pericranii in adult was reliable.

[Association between body fat percentage, visceral fat index and cardiometabolic risk factor clustering among population aged 35 year old or over, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region]

Objective: To investigate the association between body fat percentage (BFP), visceral fat index (VFI) and Cardiometabolic Risk Factor Clustering (CRFC), among population aged 35 or older in Tibet and Xinjiang areas. Methods: Using the stratified multi-stage random sampling method, 7 571 residents aged 35 or above were examined with international standardized examination between 2015 and 2016. Of the eligible 5 643 participants, association of BFP and VFI with CRFC was defined as having two or more of the four risk factors: hypertension, diabetes mellitus, high TG and low HDL-C, at the same time. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were employed to further explore the relationships. Results: The overall prevalence of CRFC among aged 35 and older population in Tibet and Xinjiang areas was 9.78%. BFP and VFI were divided into four groups by quartile. After adjustment for age, gender, race, cigarette smoking, alcohol consumption, education attainments, and altitude of residence, ORs of CRFC seemed to have increased with BFP and VFI. Compared with people having BFP of 5.0%-27.0%, the OR(95% CI) were 1.15(0.86-1.54), 1.48(1.05-2.07) and 1.72(1.10-2.68) for the ones who presented 27.1%-31.7%, 31.8%-36.6% and 36.7%-50.0% of BFP. Compared to people of having 1-6 of VFI, with OR (95%CI) as 1.20(0.81-1.79), 1.91(1.30-2.80) and 3.91(2.64-5.77) for the ones having 7-9, 10-13 and 14-30 of VFI. Areas under the curve (AUC) of CRFC appeared as 0.55 for BFP and 0.70 for VFI, respectively, with statistically significant difference (P<0.01). Conclusion: Both BFP and VFI levels were closely associated with CRFC while VFI seemed to have a better predictive value than the BFP.

[The study of using salvianolate treat acute lung injury in rats induced by paraquat]

Objective: To establish to paraquat poisoning acute lung injury animal model to study the therapeutic effect of Salvia polyphenols acid salt of paraquat-induced acute lung injury. Methods: Adult male Wister rats 120, were randomly divided into three groups: the paraquat exposure group, the start of the experiment to give a one-time 20% paraquat dope orally 50 mg/kg body weight of rats; salvianolate treatment group, the start of the experiment paraquat to give a one-time 20% the stock solution orally 50 mg/kg body weight of rats, and then given daily intraperitoneal injection of 200 mg/kg body weight of rats salvianolate; blank control group was given the same amount normal saline. The exposure group, the treatment group and control group rats were sacrificed after anesthesia in the 3rd, 7th, 14th, 21st day from the beginning of the experiment respectively, and taken out and preserved venous blood specimens and lung tissue to be tested. Venous detection heme oxygenase-1 (HO-1) , the lung tissue detection heme oxygenase-1 (HO-1) , hydroxyproline (HYP) . And do biopsy specimens from some of the lung tissue, HE and Masson staining observed by optical microscope. Results: Compared with control group, model group 7, 14, 21 days had elevated levels of serum and lung tissue HO-1 (all P<0.05) ; Treatment group 3, 7, 14, 21 days increased (all P<0.05) , and 3, 7, 14 days is higher than the model group (compared with model group, P<0.05) . Compared with control group, treatment group 3 days and model group, 14, 21 days HYP content in lung tissue increased significantly (all P<0.05) ; 21 days, compared with model group, HYP content of treatment group reduce obviously, the difference was statistically significant (P<0.05) . Optical microscope observation, lung tissue damage and aggravated with the experimental increase in the number of days, inflammatory cell infiltration, alveolar septal fibrosis gradually formed. The treatment group experimental animal lung tissue to reduce inflammation, lung fibrosis relief. Conclusion: Paraquat (50 mg/kg body weight) to fill the stomach can be induced model of acute lung injury in the rats. The serum HO-1 expression and HO-1, HYP content in lung tissue increased obviously in model rats. Salvia miltiorrhiza polyphenols acid salt to a certain degree and stage influenced the expression of HO-1 and HYP, relieve acute lung injury and pulmonary fibrosis, has certain curative effect in the treatment of paraquat poisoning.