Detection of hepatitis E virus genotypes 3 and 4 in donkeys in northern China

BACKGROUND

Hepatitis E virus (HEV) is the causative agent of acute self-limiting hepatitis in humans in developing countries. Hepatitis E virus RNA was first detected in donkeys in Spain, but little is known about the possible presence of HEV in donkeys in China.

OBJECTIVES

To investigate the prevalence of HEV in donkeys in northern China.

STUDY DESIGN

Investigation of the prevalence of HEV in donkeys using serological, molecular and phylogenetic approaches.

METHODS

A total of 401 donkey serum specimens were tested for serological and molecular detection of HEV via enzyme-linked immunosorbent assay and quantitative reverse transcription polymerase chain reaction. The amplified products were cloned in pMD18-T vector and sequenced. The alignment and phylogenetic analysis of partial HEV ORF2 genes were compared with the corresponding sequences of the obtained HEV representative strains.

RESULTS

Serological results showed that 49 donkeys (12.22%, 95% CI: 9.18-15.83%) were positive for anti-HEV-specific antibodies, and 17 donkeys (4.24%, 95% CI: 2.49-6.70%) were positive for HEV viral RNA. On the basis of sequence alignment and phylogenetic analysis, all isolated HEV strains belonged to genotype 3 (HEV-3) or HEV-4, sharing more than 76.2-96.3% identities with 67 other HEV representative strains of HEV-1 to HEV-8.

MAIN LIMITATIONS

Further studies about the prevalence of HEV in organs or faecal samples from donkeys are needed to evaluate the possible role of HEV reservoir and to determine the risk factors associated with the transmission of this zoonotic virus in donkeys in China.

CONCLUSIONS

This is the first report documenting the molecular analysis of donkey HEV strains worldwide and the serological evidence of HEV infection in donkeys in northern China. The results suggest that young donkeys are more susceptible to HEV infection compared with older donkeys. Further investigation is required to determine whether donkeys should be considered reservoirs for zoonotic HEV. The Summary is available in Chinese - see Supporting information.

Properties of Cosmic Helium Isotopes Measured by the Alpha Magnetic Spectrometer

Precision measurements by the Alpha Magnetic Spectrometer (AMS) on the International Space Station of ^{3}He and ^{4}He fluxes are presented. The measurements are based on 100 million ^{4}He nuclei in the rigidity range from 2.1 to 21 GV and 18 million ^{3}He from 1.9 to 15 GV collected from May 2011 to November 2017. We observed that the ^{3}He and ^{4}He fluxes exhibit nearly identical variations with time. The relative magnitude of the variations decreases with increasing rigidity. The rigidity dependence of the ^{3}He/^{4}He flux ratio is measured for the first time. Below 4 GV, the ^{3}He/^{4}He flux ratio was found to have a significant long-term time dependence. Above 4 GV, the ^{3}He/^{4}He flux ratio was found to be time independent, and its rigidity dependence is well described by a single power law ∝R^{Δ} with Δ=-0.294±0.004. Unexpectedly, this value is in agreement with the B/O and B/C spectral indices at high energies.

Characteristics Analysis Reveals the Progress of Volvariella volvacea Mycelium Subculture Degeneration

Volvariella volvacea is a typical edible Basidiomycete with a high-temperature tolerance. It has a strong fibrinolysis capability and consumes abundant agricultural wastes. In agricultural cultivation, mycelial subculturing has been adopted, leading to serious strain degeneration. In this study, continuous mycelial subculturing of the common V. volvacea strain V971 (original strain recorded as M0) was performed in potato dextrose agar (PDA) medium. One generation of the strain was preserved every 3 months (90 days); thus, six generations of degenerated strains (M1-M6) were obtained after 18 months of mycelial subculturing. The original and degenerated strains were preserved in sterile paraffin liquid at room temperature (18-25°C). The biological traits and nutrients of M0 and M1-M6 were studied. The mycelial growth rate and biomass initially increased and then decreased as the degeneration progressed, reaching minimum levels of 0.041 ± 0.001 cm/h and 1.82 ± 0.25 g, respectively, at M6. Additionally, the polysaccharide, protein, polyphenol, flavone, total amino acid, and total mineral element contents of the strains decreased continuously, reaching minimum levels of 30.12 ± 3.12 g/100 g, 26.42 ± 2.1 g/100 g, 1.08 ± 0.05 g/100 g, 4.23 ± 0.21 g/100 g, 12.51 mg/g, and 398.05 mg/kg, respectively, at M6. The decolorization capability of V. volvacea in liquid medium supplemented with bromothymol blue and lactose reflected the degree of strain degeneration, with the capability weakening as the degeneration intensified. These results are highly significant for V. volvacea production. The mycelial characteristics during subculture-associated degeneration were described and provide an early identification method for V. volvacea's degeneration.

[Genetic variants of familial hematuria associated genes in three families with hematuria with probands initially diagnosed as IgA nephropathy]

Objective: To examine genetic variants of familial hematuria (FH) associated genes in 3 families with hematuria with probands initially diagnosed with IgA nephropathy (IgAN). Methods: A retrospective analysis was performed on the clinical data, laboratory tests and genetic test results of three children with hematuria and the probands in three families with hematuria. The families were ascertained at the Department of Pediatrics, Fuzhou General Hospital of Nanjing Military Command from August 2014 to May 2018. Results: The proband of Family One, an 8-year-old boy, manifested gross hematuria. His renal biopsy pathology revealed IgAN. His father also manifested hematuria. Genetic testing showed that the proband and his father carried a heterozygous variant of the CFHR5 gene,533A>G (Asn178Ser). The child of Family Two, a 4-year-old girl, manifested hematuria. Her father, the proband of the family, was 36 years old, and manifested hematuria, proteinuria, high-frequency sensorineural deafness and renal insufficiency. He was diagnosed as IgAN according to clinical manifestations, renal pathology and routine immunohistochemistry without renal biopsy electron microscopy, renal tissue type Ⅳ collagen α3, α4, α5 chains immunofluorescence and skin type Ⅳ collagen α5 chain immunofluorescence. Genetic testing showed that the girl carried a heterozygous variant of the COL4A5 gene,566G>T (Gly189Val), and her father carried the hemizygous variant. The child of Family Three, a 7-year-old girl, manifested hematuria and proteinuria. Her mother, the proband of the family, was 34 years old, and manifested hematuria and proteinuria as well. The proband was diagnosed as IgAN by the same method used for Family Two. The girl's grandfather died of uremia at the age of 44. Genetic testing showed that the girl and her mother carried a heterozygous variant 539G>A (Gly180Glu)in COL4A5 gene. Conclusions: The variant of the CFHR5 gene identified in Family One is of uncertain signifance, and the two variants of the COL4A5 gene identified in Families Two and Three are pathogenic. The probands of Families Two and Three are diagnosed as Alport syndrome. The study suggests that clinicians should examine genetic variants of FH associated genes in families with hematuria when the probands were diagnosed as IgAN by their clinical manifestations, renal pathology and routine immunohistochemistry.

Identification of genetic associations of ECHS1 gene with milk fatty acid traits in dairy cattle

Our previous genome-wide association study identified 83 genome-wide significant SNPs and 20 novel promising candidate genes for milk fatty acids in Chinese Holstein. Among them, the enoyl-CoA hydratase, short chain 1 (ECHS1) and enoyl-CoA hydratase and 3-hydroxyacyl CoA dehydrogenase (EHHADH) genes were located near two SNPs and one SNP respectively, and they play important roles in fatty acid metabolism pathways. We herein validated whether the two genes have genetic effects on milk fatty acid traits in dairy cattle. By re-sequencing the full-length coding region, partially adjacent introns and 3000 bp up/downstream flanking sequences, we identified 12 SNPs in ECHS1: two in exons, four in the 3' flanking region and six in introns. The g.25858322C>T SNP results in an amino acid replacement from leucine to phenylalanine and changes the secondary structure of the ECHS1 protein, and single-locus association analysis showed that it was significantly associated with three milk fatty acids (P = 0.0002-0.0013). The remaining 11 SNPs were found to be significantly associated with at least one milk fatty acid (P = <0.0001-0.0040). Also, we found that two haplotype blocks, consisting of nine and two SNPs respectively, were significantly associated with eight milk fatty acids (P = <0.0001-0.0125). However, none of polymorphisms was observed in the EHHADH gene. In conclusion, our findings are the first to indicate that the ECHS1 gene has a significant genetic impact on long-chain unsaturated and medium-chain saturated fatty acid traits in dairy cattle, although the biological mechanism is still undetermined and requires further in-depth validation.

Pedunculoside attenuates pathological phenotypes of fibroblast-like synoviocytes and protects against collagen-induced arthritis

Objectives: The discovery of alternative and well-tolerated anti-arthritic drugs, especially from natural products, is becoming an area of active research. Pedunculoside (PE) is a novel triterpene saponin extracted from the dried bark of Ilex rotunda Thunb. Limited published papers have reported its pharmacological properties, including anti-inflammatory, anti-myocardial ischaemia, anti-liver injury, and hypocholesterolaemic activities. However, the effect of PE on rheumatoid arthritis (RA) remains unknown. Here, we investigated the anti-arthritic effect of PE in both in vitro and in vivo models. Method: The inhibitory effects of PE on proliferation, migration, and production of inflammatory mediators in primary fibroblast-like synoviocytes (FLSs) were examined by a 5-ethynyl-2'-deoxyuridine incorporation assay, wound-healing assay, and real-time polymerase chain reaction, respectively. Cellular signalling mechanisms were analysed by Western blot. The in vivo studies were performed using a collagen-induced arthritis (CIA) rat model. Multiple methods, including arthritis scoring, enzyme-linked immunoassay, radiography, and histopathological assessment, were used to evaluate the therapeutic effects of PE on CIA rats. Results: The in vitro studies revealed that PE significantly inhibited proliferation and migration of FLSs. PE also decreased the production of pro-inflammatory cytokines, including interleukin-1β (IL-1β), IL-6, IL-8, and tumour necrosis factor-α (TNF-α). Western blot results suggested that PE suppressed TNF-α-stimulated activation of p38 and extracellular signal-regulated kinase. The in vivo studies showed that PE treatment significantly inhibited synovial inflammation and bone destruction in CIA rats. Conclusion: These results demonstrate that PE exerts an inhibitory role in FLSs and CIA rats, and therefore may have therapeutic value for the treatment of RA.

[Mid-to-long term outcomes and influence factors of postoperative concurrent chronic ankle instability and posterior ankle impingement]

OBJECTIVE

To investigate the mid-to-long-term efficacy of patients with chronic ankle instability combined with posterior impingement syndrome after 3-9 years of follow-up, and to analyze the influencing factors.

METHODS

From February 2010 to December 2015, 46 patients underwent concurrent lateral ankle ligament repair with posterior ankle arthroscopic surgery at the Institute of Sports Medicine, Peking University Third Hospital. The patient was first placed in a prone position and underwent arthroscopic debridement for the posterior impingement. After finishing the posterior arthroscopy, the surgeon and assistants first translated the patient to the affected side, then turned to the healthy side, and changed the position to the supine position. During the turning over, another assistant held the arthroscope and the instrument to ensure that it was sterile and could be used without replacement. The anterior ankle arthroscopy was operated if necessary and the lateral ankle ligament repair was anatomic repaired with anchors. The 42 patients were followed up, including 26 males and 16 females. The average age was (28.9±10.0) years. The patient's clinical symptoms, joint stability, mobility and motor function were compared by questionnaire and physical examination. The preoperative and postoperative visual analogue scale (VAS) scores, American Orthopaedic Foot and Ankle Society (AOFAS) scores, Tegner scores were compared, and the clinical scores and the patient age, gender, height and weight were compared. The correlations between body mass index (BMI), preoperative duration, surgery duration, and cartilage injury were analyzed.

RESULTS

The mean follow-up time was (71.8±22.8) months. The postoperative VAS scores (1.0 vs. 5.0, P<0.001), AOFAS scores (92 vs. 80, P<0.001), and Tegner scores (6.5 vs. 2, P<0.001) were significantly superior to the preoperative levels. The excellent and good rate was 97.6%. The postoperative VAS score (t=2.719, P=0.10), AOFAS score (t=-2.853, P=0.10), Tegner score (t=-3.443, P=0.001) and time to return exercise (t=2.814, P=0.008) were negatively correlated with the patient age, and the postoperative VAS score was negatively correlated with cartilage injury (Z=-2.195, P=0.028).

CONCLUSION

The mid-to-long-term clinical outcomes of the chronic ankle ligament instability combined with the posterior impingement were good. The age of the patients was negatively correlated with the clinical outcome. The combined cartilage injury could aggravate the postoperative pain.

[Association between maternal dietary intake and the incidence of babies with small for gestational age]

Objective: To investigate the relations between dietary intake during pregnancy and the incidence of their babies with small for gestational age (SGA). Methods: Data on demographics, dietary intake of protein, fat, and carbohydrates of the pregnant mothers during the first, second and third trimester, were collected. Information related to birth weight and gestational age of the infants were also gathered. A total of 8 102 women, who delivered their babies at the First Affiliated Hospital of Shanxi Medical University from March 2012 to September 2016, were enrolled in this project. Among them, 961 mothers had infants with SGA but the other 7 141 of them having normal infants. Unconditional logistic regression model was used to analyze the effect of dietary nutrient intake on SGA the first, second and third trimester. Results: We found that low dietary intake of protein during the first trimester and following trimesters during pregnancy were positively associated with higher risk of SGA (OR=1.534, 95%CI: 1.217-1.934; OR=1.268, 95%CI: 1.005-1.599; OR=1.310, 95%CI: 1.036-1.655). When adjusting for maternal pre-pregnancy BMI, we found that when mothers were with a pre-pregnancy BMI less than 18.5 or with low maternal intake of protein during the first trimester, positive association with higher risk of SGA (OR=1.872, 95%CI: 1.033-3.395; OR=1.754, 95%CI: 1.125-2.734), was noticed. However, for mothers with a pre-pregnancy BMI between 18.5 and 24.0 or with low protein intake during the first trimester, significant association with higher risk of SGA (OR=1.465, 95%CI: 1.089-1.972) was found. Conclusions: Through our observation, maternal dietary intake during pregnancy seemed to be associated with the risk of SGA but the effects of dietary intake were different, according to the BMI of pre-pregnancy population. Early pregnancy appeares as the key period for dietary intake which may influence the SGA.

[Association of arsenic with unexplained recurrent spontaneous abortion: a case-control study]

Objective: To explore the association of arsenic with unexplained recurrent spontaneous abortion (URSA). Methods: A case-control study was conducted to select URSA patients who were admitted to the Beijing Maternal and Child Health Care Hospital affiliated to Capital Medical University from April to October 2018 as a case group. Women who had a normal pregnancy in the Family Planning Department of the hospital but volunteered to have an abortion were selected as a control group. The case and control group were paired in a 1: 1 ratio. The inclusion criteria of the case group were patients with newly diagnosed recurrent spontaneous abortion who had clinically confirmed more than 2 spontaneous abortions and had 20 weeks prior to pregnancy, excluding patients with recurrent spontaneous abortion caused by abnormal blood coagulation (anti-phospholipid antibody positive), abnormal physiological anatomy (B-ultrasound), abnormal immune factors (anti-nuclear antibody positive, anti-cardiolipin antibody, etc.), genetic chromosomal abnormalities (karyotype analysis) and pathogenic microbial infection. The control group was matched according to the age of the case group (±3 years old) and the gestational age (±2 weeks) to exclude adverse pregnancy outcomes such as stillbirth, congenital malformation, premature delivery and low birth weight infants. A total of 192 subjects were included. Questionnaires were used to collect information of all subjects, and 12 ml of peripheral venous blood was collected to detect blood arsenic levels. Blood arsenic levels were divided into low concentration group (<1.00 μg/L), medium concentration group (1.00-1.50 μg/L) and high concentration group (>1.50 μg/L). The multivariate conditional logistic regression was performed to analyze the relationship between blood arsenic exposure and URSA and explore the influencing factors of blood Arsenic. Results: The geometric mean values of blood arsenic level in the cases group and control group were 1.68 (1.50-1.86) μg/L and 1.26 (1.17-1.37) μg/L, respectively. The blood arsenic level in the case group was significantly higher than that in the control group (P<0.05). The results of multivariate conditional logistic regression analysis showed that after adjusting for tobacco exposure during pregnancy, pre-pregnancy body mass index and the effects of residential decoration in past five years, the risk of URSA was higher in the high-concentration group compared with the low-concentration group (OR=2.56, 95%CI:1.06-6.24). Conclusion: Blood arsenic may increase the risk of URSA in women of childbearing age.

[Subjects with impaired glucose tolerance returned to normal glucose status for six years had lower long-term risk of diabetes: 20 years follow up of Daqing diabetes prevention study]

Objective: To explore the influence of lifestyle intervention on long-term diabetes in subjects with impaired glucose tolerance (IGT) returned to normal glucose tolerance (NGT) within 6 years. Methods: A total of 577 subjects (aged 25-74 years old) with IGT in Daqing were enrolled and randomly assigned to control, and diet, exercise and diet plus exercise groups in a six-year intervention trial in 1986. Subjects who were non-diabetic at the end of the intervention were followed up for additional 14 years. Results: Among all the subjects, 41.38% of them who had returned to NGT from IGT within 6 years maintained NGT status after 20 years, and had a lower incidence of diabetes than subjects maintained IGT status (46.55% vs. 75.25%). Of note, in the intervention group, the percentage of participants developed diabetes in the NGT subjects was significantly lower than that in the IGT group (43.71% vs. 76.25%) after 20 years. There was high long-term risk for diabetes in the IGT subjects after the adjustment of age, sex and baseline glucose (HR=1.81, 95%CI 1.27-2.58, P=0.001), whereas in the non-intervention group, no significant difference could be viewed in long-term diabetic risk between subjects maintained IGT status and those returned to NGT (71.43% vs. 65.22%) after adjusting of the same confounders (HR=1.03, 95%CI 0.45-2.35, P=0.94). Conclusions: IGT subjects who had returned to NGT in early years had lower risk for future diabetes than those who remained IGT. However, this beneficial effect could only be viewed in the intervention group, but not in the non-intervention group.

Effect of insulin-like growth factor-1 on promoting healing of skin ulcers in diabetic rats

To investigate the effect of exogenous insulin-like growth factor-1 (IGF-1) on the healing of skin ulcers in diabetic rats, male Sprague Dawleys (SD) rats with back skin ulcers were selected and divided into control group, model group and IGF-1 treatment group which received different doses of IGF-1 (0.5, 1.0, 1.5, and 2.0mg/L). The results showed that the healing speed of the skin ulcers was significantly affected by IGF-1, which reduced the size of wound (P less than 0.05). The expression of MMP-9 was enhanced while the expression of TIMP-1 was decreased in diabetic rats with skin ulcers. The IGF-1 treatment helped to re¬store the normal expression of both MMP-9 and TIMP-1 in diabetic rats with skin ulcers, and diabetic skin ulcers in the 1.5 mg/L IGF-1 group showed the best healing. Histological examination showed that after 20 days, fibroblasts in the IGF-1 experimental group with an appropriate concentration increased and the numbers of fibroblasts and capillaries were significantly higher than those of the other groups. Moreover, there were obvious wound surface contractions and re-epithelialization, and the new epithelium moved to the center of the wound faster. Therefore, it is concluded that an appropriate concentration of IGF-1 can significantly promote the healing of skin ulcers in diabetic rats.

[Clinical features and MYH9 gene variant in two Chinese siblings with Fechtner syndrome]

Objective: To summarize the clinical data and molecular characteristics of two siblings with Fechtner syndrome. Methods: A retrospective analysis was made on the clinical data, laboratory tests and genetic test results of two siblings with Fechtner syndrome in a family who were followed up in the Department of Nephrology, Children's Hospital Affiliated to Nanjing Medical University from April 2018 to August 2018. Results: Both siblings showed proteinuria, microscopic hematuria and thrombocytopenia. Giant platelets and leucocyte inclusions were easily seen in peripheral blood smears and bone marrow cells, but the results of renal function, hearing and ophthalmologic examinations were normal. The father of the siblings presented with proteinuria, thrombocytopenia, and hearing loss. At the age of 26 years, he developed uremia and now requires hemodialysis. The renal biopsy of the elder sister suggested focal segmental glomerulosclerosis. Gene analysis showed that the siblings and their father MYH9 gene 25 exon c.3195_c.3215 delCGAGCTCCAGCCCAGATCGC (p.A1065_A1072 del) deletion mutation. The elder sister was treated with benazepril hydrochloride for 4 months and the proteinuria was improved. Her younger brother was given tacrolimus for 3 months, but the proteinuria did not improve significantly, then benazepril hydrochloride was given for 1 month and proteinuria improved. Conclusions: Fechtner syndrome is characterized by nephritis, thrombocytopenia, giant platelets and leucocyte inclusions. The variant of MYH9 gene is the cause of Fechtner syndrome. The deletion mutation of p.A1065_A1072del is the second international report. Angiotensin-converting enzyme inhibitors may be effective in reducing proteinuria in patients with Fechtner syndrome.

[Retrospective analysis of modified Karlsson surgery for chronic calcaneofibular ligament injury]

Objective: To retrospectively evaluate the therapeutic effect and influencing factors of the modified Karlsson operation (anchor method) in treating chronic rupture of the calcaneofibular ligament (CFL). Methods: From August 2010 to May 2014, the data of 24 patients with calcaneofibular ligament rupture treated in Institute of Sports Medicine, Third Hospital of Peking University were retrospectively analyzed. All cases were repaired with modified Karlsson operation (anchor method). There were 14 males and 10 females, with an average age of (30±9) years, and the average body mass index (BMI) was (25±5) kg/m(2). Visual analogue pain score (VAS), American Foot and Ankle Surgery Association score (AOFAS), Tegner knee motion score, ankle stability and mobility were followed up and analyzed. The paired t test was used to compare the normal distribution data before and after the operation. Results: The average follow-up time was (41±13) months. Compared with pre-operation, VAS score decreased significantly at the last follow-up [0(0,7) vs 5(0,8), Z=4.13,P=0.000], AOFAS score increased significantly (94±10 vs 70±14, t=8.94, P<0.05), Tegner score increased significantly (4.7±1.5 vs 2.8±1.3, t=6.87, P<0.05), all improved significantly. AOFAS score was excellent in 19 cases, good in 4 cases and moderate in 1 case, the excellent and good rate was 95.8%. Among them, 20 cases (83.3%) were satisfied with the recovery effect after the operation. Postoperative sprain occurred in 5 cases (20.8%) and ankle mobility was limited in 3 cases (12.5%). Conclusions: The modified Karlsson operation (anchor method) can restore the stability of the ankle joint by treating the chronic rupture of CFL. It is an effective therapy for lateral ankle instability.

Towards Understanding the Origin of Cosmic-Ray Electrons

Precision results on cosmic-ray electrons are presented in the energy range from 0.5 GeV to 1.4 TeV based on 28.1×10^{6} electrons collected by the Alpha Magnetic Spectrometer on the International Space Station. In the entire energy range the electron and positron spectra have distinctly different magnitudes and energy dependences. The electron flux exhibits a significant excess starting from 42.1_{-5.2}^{+5.4}  GeV compared to the lower energy trends, but the nature of this excess is different from the positron flux excess above 25.2±1.8  GeV. Contrary to the positron flux, which has an exponential energy cutoff of 810_{-180}^{+310}  GeV, at the 5σ level the electron flux does not have an energy cutoff below 1.9 TeV. In the entire energy range the electron flux is well described by the sum of two power law components. The different behavior of the cosmic-ray electrons and positrons measured by the Alpha Magnetic Spectrometer is clear evidence that most high energy electrons originate from different sources than high energy positrons.

Validation of in vitro digestion using simulated small intestinal fluid with specific digestive activity to predict the metabolizable energy of feed ingredients for duck

Two experiments were conducted to validate a method to prepare simulated small intestinal fluid (SSIF) for in vitro digestion in ducks. Experiment 1 compared the in vitro digestible energy (IVDE) of SSIF to endogenous small intestinal fluid (ESIF) on four feeds. The ESIF 1 or 2 obtained from two groups of jejunal cannulated ducks offered diet 1 (3,050 kcal/kg of ME and 19.95% of CP) or 2 (2,801 kcal/kg of ME and 14.90% of CP) was purified into raw enzyme power (REP) 1 or 2. SSIF 1 to 3 or 4 to 6 were prepared to mimic ESIF 1 or 2, respectively. The enzyme sources were REP 1 for SSIF 1 and 4, REP 2 for SSIF 2 and 5 or reagent enzymes for SSIF 3 and 6, respectively. The IVDE of each feed was determined with SSIF or ESIF. Experiment 2 was to validate whether REP 1 was more effective than only reagent enzymes to prepare SSIF. Ten feeds were determined with pepsin following SSIF 1 or 3 for IVDE 1 or 2, respectively. The accuracy of prediction model of true metabolizable energy (TME) from IVDE 1 or 2 was evaluated to validate the efficacy of SSIF. In experiment 1, higher activities of amylase, trypsin and chymotrypsin were observed in ESIF 1 than ESIF 2 (P < 0.05). The IVDE determined with SSIF 1 and 2 or 3 and 4 were more comparable to that of ESIF 1 or 2 than determinations with SSIF 3 or 6. In experiment 2, the mean IVDE 1 or 2 was 97.22% or 96.23% relative to TME, respectively, and both were highly correlated with TME (P < 0.01; R2 ≥ 0.98). However, the residual SD of TME prediction model with IVDE 1 was less than that generated with IVDE 2 (55 vs. 71 kcal/kg). In conclusion, the IVDE determined with in vitro digestion of pepsin following SSIF prepared with REP can predict accurately TME of feed for ducks.

Genetic association of DDIT3, RPL23A, SESN2 and NR4A1 genes with milk yield and composition in dairy cattle

Previously, we identified by RNA sequencing that DDIT3, RPL23A, SESN2 and NR4A1 genes were significantly differentially expressed between the mammary glands of lactating Holstein cows with extremely high and low milk protein and fat percentages; thus, these four genes are considered as promising candidates potentially affecting milk yield and composition traits in dairy cattle. In the present study, we further verified whether these genes have genetic effects on milk traits in a Chinese Holstein population. By re-sequencing part of the non-coding and the entire coding regions of the DDIT3, RPL23A, SESN2 and NR4A1 genes, a total of 35 SNPs and three insertions/deletions were identified, of which three were found in DDIT3, 12 in RPL23A, 16 in SESN2 and seven in NR4A1. Moreover, two of the insertions/deletions-g.125714860_125714872del and g.125714806delinsCCCC in SESN2-were novel and have not been reported previously. Subsequent single SNP analyses revealed multiple significant association with all 35 SNPs and three indels regressed against the dairy production traits (P-value = <0.0001-0.0493). In addition, with a linkage disequilibrium analysis, we found one, one, three, and one haplotype blocks in the DDIT3, RPL23A, SESN2 and NR4A1 genes respectively. Haplotype-based association analyses revealed that some haplotypes were also significantly associated with milk production traits (P-value = <0.0001-0.0461). We also found that 12 SNPs and two indels (two in DDIT3, two in RPL23A, nine in SESN2 and one in NR4A1) altered the specific transcription factor binding sites in the promoter, thereby regulating promoter activity, suggesting that they might be promising potential functional variants for milk traits. In summary, our findings first determined the genetic associations of DDIT3, RPL23A, SESN2 and NR4A1 with milk yield and composition traits in dairy cattle and also suggested potentially causal variants, which require in-depth validation.

No high Tibetan Plateau until the Neogene

The Late Paleogene surface height and paleoenvironment for the core area of the Qinghai-Tibetan Plateau (QTP) remain critically unresolved. Here, we report the discovery of the youngest well-preserved fossil palm leaves from Tibet. They were recovered from the Late Paleogene (Chattian), ca. 25.5 ± 0.5 million years, paleolake sediments within the Lunpola Basin (32.033°N, 89.767°E), central QTP at a present elevation of 4655 m. The anatomy of palms renders them intrinsically susceptible to freezing, imposing upper bounds on their latitudinal and altitudinal distribution. Combined with model-determined paleoterrestrial lapse rates, this shows that a high plateau cannot have existed in the core of Tibet in the Paleogene. Instead, a deep paleovalley, whose floor was <2.3 km above mean sea level bounded by (>4 km) high mountain systems, formed a topographically highly varied landscape. This finding challenges prevailing views on tectonic processes, monsoon dynamics, and the evolution of Asian biodiversity.

[Study on direct economic burden and influencing factors in patients with cervical cancer and precancerous lesions]

Objective: To account the direct cost of uterine cervix carcinoma treatment in China and to explore the related factors which influence the direct financial burden of the disease. Methods: Data was collected through the medical record system and telephone interviews in 14 county-level hospitals and 9 provincial and municipal hospitals from 14 provinces/municipalities enrolled in the Chinese National Health Industry Research Project in 2015. The direct financial burden of uterine cervix carcinoma treatment consisted of the direct medical cost and the direct non-medical cost of treatment in different pathological cervical cancer stages and precancerous lesions. Multiple liner regression method was used to analyze the factors affecting the costs. Results: The age of the 3 246 patients was (46.40±10.43) years, including 2 423 patients from provincial and municipal hospitals and 823 patients from county-level hospitals. The direct financial burden for one patient of pathological uterine cervix carcinoma stage or precancerous lesion ranged from 10 156.3 yuan to 75 716.4 yuan in provincial and municipal hospitals, and for patients from county-level hospitals, the cost was between 4 927.9 yuan and 47 524.8 yuan per person. There was a wide gap between the direct financial burden of patients in different disease stages. The direct financial burden of patients with precancerous lesions ranged from 4 927.9 yuan per person to 11 243.0 yuan per person, as for patients of pathological uterine cervix carcinoma stages, the direct financial burden was between 29 274.6 yuan and 75 716.4 yuan per person. The factors which influence direct financial burden would include: the levels of the hospital, pathological period, medicare reimbursement, days of treatment, and the methods of treatment (P<0.001). Conclusion: The direct financial burden of diseases in patients with pathological uterine cervix carcinoma stage or precancerous lesion differed in different levels of hospital and pathological periods. In addition, medicare reimbursement, days of treatment, and the methods of treatment all had impact on it.

[Reconstruction of neglected Achilles tendon rupture: flexor hallucis longus transfer versus gastrocnemius turn-down flaps]

Objective: To compare the outcome of either flexor hallucis longus transfer or turn-down of proximal Achilles tendon tissue repair in treating chronic Achilles tendon rupture. Methods: The clinical data of 21 patients who underwent repair of Myerson type Ⅲ chronic Achilles tendon rupture at Peking University Sports Medicine Research Institute from May 2012 to March 2015 were retrospectively analyzed. Among them, 11 cases were treated with flexor hallucis longus (FHL) transfer, and 10 cases were treated with gastrocnemius turn-down flaps repair. The American Orthopedic Foot & Ankle Society (AOFOS) hindfoot score and Tegner motor function score before and after surgery were recorded and compared between the two groups. Data comparison between groups was performed with t test. Results: The patients in the both group were followed up for an average of (21±7) months. The postoperative AOFOS hindfoot score in the long flexor and gastrocnemius groups were both significantly higher than those before surgery, and the differences were statistically significant (97.7±2.6 vs 72.0±8.1 and 96.0±5.5 vs 78.5±6.4, t=10.70, 6.42, both P<0.05).The postoperative Tegner scores of the two groups were also significantly higher than those before surgery (4.2±1.4 vs 0.7±0.4 and 4.1±0.8 vs 0.6±0.5,t=7.29, 9.35, both P<0.05). There were no significant differences in postoperative AOFOS hindfoot scores and Tegner motor function scores between the two groups (both P>0.05). Conclusion: The flexor hallucis longus transfer and turn-down of proximal Achilles tendon tissue repair can both get satisfactory results in treating chronic Achilles tendon rupture.

Towards Understanding the Origin of Cosmic-Ray Positrons

Precision measurements of cosmic ray positrons are presented up to 1 TeV based on 1.9 million positrons collected by the Alpha Magnetic Spectrometer on the International Space Station. The positron flux exhibits complex energy dependence. Its distinctive properties are (a) a significant excess starting from 25.2±1.8  GeV compared to the lower-energy, power-law trend, (b) a sharp dropoff above 284_{-64}^{+91}  GeV, (c) in the entire energy range the positron flux is well described by the sum of a term associated with the positrons produced in the collision of cosmic rays, which dominates at low energies, and a new source term of positrons, which dominates at high energies, and (d) a finite energy cutoff of the source term of E_{s}=810_{-180}^{+310}  GeV is established with a significance of more than 4σ. These experimental data on cosmic ray positrons show that, at high energies, they predominantly originate either from dark matter annihilation or from other astrophysical sources.

[Cause and control of non-sampling error in China National Human Biomonitoring Program]

The size of the non-sampling error is directly related to the accuracy and reliability of the sampling survey result. This paper studied the non-sampling errors generated during the sampling process of the China National Human Biomonitoring Program(CNBP), mainly including the sampling frame error, non-response error and measurement error. The program reduced the influence of the non-sampling error on the quality of the survey effectively by scientifically designing the sampling scheme and questionnaire, strengthening investigator trainings and standardizing the data review, which could be used to provide reference for the control of non-sampling errors in public health monitoring projects in China.

[Advances in osteoradionecrosis of nasopharynx after radiotherapy for nasopharyngeal carcinoma]

Radiation therapy is the first choice for the treatment of nasopharyngeal carcinoma. However, it is inevitable that nasopharyngeal mucosa and tissue will be damaged after radiotherapy of nasopharyngeal carcinoma, which will cause corresponding complications. Nasopharyngeal osteonecrosis is a serious complication. Up to now, there are few reports about nasopharyngeal osteonecrosis, and the underlaying pathological mechanism remains unclear. The potential theories include radiotherapy damage, infection and trauma, but also the " three H" principle of hypoxic hypocellular hypovascular tissue, as well as the theory of radio induced fibrosis. It is controversial about the treatment of nasopharyngeal osteonecrosis. It takes comprehensive treatment, including local treatment, systemic treatment, surgical treatment and other treatments. Among them, local treatment as nasopharyngeal debridement usually is first choice. We reviewed the pathological mechanism and treatment methods of nasopharyngeal osteonecrosis, in order to provide a reference for better prevention and treatment of it.

Erratum: Observation of D^{0} Meson Nuclear Modifications in Au+Au Collisions at sqrt[s_{NN}]=200 GeV [Phys. Rev. Lett. 113, 142301 (2014)]

This corrects the article DOI: 10.1103/PhysRevLett.113.142301.

Thermal Camera Based Physiological Monitoring with an Assistive Robot

This paper presents a physiological monitoring system for assistive robots using a thermal camera. It is based on the detection of subtle changes in temperature observed on different parts of the face. First, we segment and estimate these face regions on thermal images. Then, by applying Fourier analysis on temperature data, we estimate respiration and heartbeat rate. This physiological monitoring system has been integrated in an assistive robot for elderly people at home, as part of the ENRICHME project. Its performance has been evaluated on a new thermal dataset for physiological monitoring, which is made publicly available for researchpurposes.

[The morphplogical and its influencing factors research after supracricoid partial laryngectory with cricohyoidoepiglottopexy]

Objective:The aim of this study for observing laryngeal morphology, and motion characteristics after supracricoid partial laryngectomy with cricohyoidoepiglottopexy（SCPL-CHEP），exploring the relevant factors affecting the morphology of new laryngeal. Method:Choose 46 cases of patients with laryngeal cancer for SCPL-CHEP as the object of study, dynamic laryngoscope were performed in all the patients, to observe the movement of laryngeal pronunciation (neoglottis closure , supraglottic situation) . Combined with the patient's clinical data, the relevant factors that may affect the pronunciation and movement characteristics of the new throat were analyzed. Result:46 patients after SCPL-CHEP were included in the study. The neoglottis completely closed in 31 cases (67.4%), insufficiency closed in 15 cases (32.6%). Supraglottic vibration in 33 cases (71.7%), 13 cases (28.3%) of supraglottic structure vibration free.The Spearman 's analysis showed that, neoglottal closure status was positively correlated with age and subglottic lesions (r=0.313, P=0.034; r=0.592, P=0.000), and negatively correlated with the postoperative time (r=-0.446, P=0.002). The supraglottic vibration was negatively correlated with postoperative radiotherapy. Conclusion:The anatomy of neolarynx changes greatly,the function of neolarynx only depends on the movement of he remaining cricoarytenoid unit and arytenoid mucosa vibration. The age, tumor type, and postoperative time are related factors that affect glottic closure. Postoperative radiotherapy can reduce the occurrence of supraglottic vibration.

[The predictive value of parathyroid hormone levels and decreases for postoperative hypocalcemia after total thyroidectomy]

Objective:To investigate the predictive value of parathyroid hormone levels and decreases for postoperative hypocalcemia after total thyroidectomy. Method:We reviewed 71 consecutive patients who underwent total thyroidectomy, measured postoperative hypocalcemia, parathyroid hormone (PTH) values within 24 hours after surgery, divided them into subgroups accroding to hypocalcemia symptom. Combining with postoperative serum calcium，postoperative PTH values and decreases (△PTH), we used the receiver operating characteristic curve (ROC) analysis to assessment of predictive value. Result:The mean value of postoperative serum calcium, postoperative PTH and △PTH between subgroups have a significant difference (P<0.01). ROC area under the curve (AUC) of △PTH is 0.9706, with cutoff value 0.7366. AUC of postoperative PTH is 0.9580, with cutoff value 14.82 ng/L. Conclusion:The postoperative PTH and △PTH is a reliable indicator to judging postoperative hypocalcemia after total thyroidectomy.

[One case of 28+ weeks pregnancy with esthesioneuroblastoma]

A 21 years old female patient was admitted to hospital for "menolipsis of 28 weeks, discovery of nasal neoplasm for 2 months, headache for 10 days" .check: The left nasal cavity was filled with a red neoplasm extending to the edge of the nasal vestibule , with incrustation on its surface and easy haemorrhage when touched.Sinus CT: the left side of the nasal vestibule, nasal meatus and the whole sets of sinuses were full of soft tissue density with nasal bone absorption, malignant diseases not excluded.MRI: The left side of the nasal vestibule, nasal passages, cribriform roof and frontal sinus were filled with equal T1 and long T2 signal, with obvious tortuous signal of voids of vessel , partially extending into the left orbit, and accompanied with obstructive sinusitis.Postoperative pathologic and immunohistochemical results diagnosed as esthesioneuroblastoma.

Localisation of mineralised tissue in a complex spinner flask environment correlates with predicted wall shear stress level localisation

Spinner flask bioreactors have often been employed for bone tissue engineering. However, the reasons for their success in facilitating bone growth remain inconclusive. It was hypothesised that engineered bone tissue formation can be attributed to mechanical stimuli, which can be predicted in the tissue engineered construct. To test the hypothesis and draw conclusions as to how mechanical stimulation affects cell behaviour, a multi- disciplinary approach using cell culture experiments and computational fluid dynamics (CFD) to simulate the complex flow within the spinner flask and scaffold was employed. Micro-computed tomography and histology showed that statically cultured human bone marrow derived stromal cells on silk fibroin scaffolds did not form extracellular matrix (ECM) or deposit minerals. However, constructs cultured at 60 rpm resulted in ECM formation and mineralisation, mainly at the bottom of the scaffold (bottom: 78 ± 7 %, middle: 17 ± 5 %, top: 5 ± 2 % of total mineralised volume). Culturing at 300 rpm led to a more homogeneously distributed ECM (bottom: 40 ± 14 %, middle: 33 ± 1 %, top: 27 ± 14 % of total mineralised volume). These observations were in agreement (Pearson correlation coefficient: 97 %) with the computational simulations that predicted maximal scaffold mineralisation, based on wall shear stress stimulation, in the bottom at 60 rpm and in the main body at 300 rpm. Such combinations of CFD modelling and experimentation could advance our knowledge of the mechanical stimuli that cells experience in vitro and link them to biological responses.

[Spatial-temporal analysis on pulmonary tuberculosis in Beijing during 2005-2015]

Objective: To analyze the spatial distribution and identify the high risk areas of pulmonary tuberculosis at the township level in Beijing during 2005-2015. Methods: Data on pulmonary tuberculosis cases was collected from the tuberculosis information management system. Global autocorrelation analysis, local indicators of spatial association and Kulldorff's Scan Statistics were applied to map the spatial distribution and detect the space-time clusters of the pulmonary tuberculosis cases during 2005-2015. Results: Spatial analysis on the incidence of pulmonary tuberculosis at the township level demonstrated that the spatial autocorrelation was positive during the study period. The values of Moran's I ranged from 0.224 3 to 0.291 8 with all the P values less than 0.05. Hotspots were primarily distributed in 8 towns/streets as follows: Junzhuang, Wangping, Yongding and Tanzhesi in Mentougou district, Yancun in Fangshan district, Wangzuo town in Fengtai district, Tianqiao street in Xicheng district and Tianzhu town in Shunyi district. Spatiotemporal clusters across the entire study period were identified by using Kulldorff's spatiotemporal scan statistic. The primary cluster was located in Chaoyang and Shunyi districts, including 17 towns/streets, as follows: Cuigezhuang, Maizidian, Dongfeng, Taiyanggong, Zuojiazhuang, Hepingjie, Xiaoguan, Xiangheyuan, Dongba, Jiangtai, Wangjing, Jinzhan, Jiuxianqiao, Laiguangying, Sunhe towns/streets in Chaoyang district, Houshayu and Tianzhu town in Shunyi district, during January to December 2005. Conclusion: Incidence rates of pulmonary tuberculosis displayed spatial and temporal clusterings at the township level in Beijing during 2005-2015, with high risk areas relatively concentrated in the central and southern parts of Beijing.

Age distribution and metabolic disorders in people with Type 1 diabetes in Beijing and Shantou, China: a cross-sectional study

AIMS

To examine whether the age profile of people with Type 1 diabetes differs from that of the general population and in what manner, and to study the clinical characteristics related to metabolic disorders among people with Type 1 diabetes in China.

METHODS

We sequentially enrolled 849 people with Type 1 diabetes from hospital records review, inpatient wards and outpatient clinics. Data were collected via face-to-face interviews, medical records and venous blood samples. Beijing census data for 2011 were used to provide the general population statistics. Descriptive analysis of the results and tests for differences were performed.

RESULTS

The median (interquartile range) age at diagnosis of diabetes was 16 (9-28) years and the duration of diabetes was 4 (1-8) years. The mean ± sd HbA_1c concentration was 76±28 mmol/mol (9.1±2.5%). Compared with the general population, the population with Type 1 diabetes comprised more young individuals and fewer elderly individuals. The overall prevalence of metabolic syndrome among those with Type 1 diabetes was 10.1% (95% CI 7.9-12.2). People with metabolic syndrome were older and were diagnosed with diabetes at an older age. Hypertension and dyslipidaemia were more common in obese individuals with Type 1 diabetes than in their non-obese counterparts.

CONCLUSIONS

Compared with the general population, people with Type 1 diabetes comprised more young and fewer elderly individuals. The prevalence of metabolic syndrome in the Type 1 diabetes population was 10.1%. Hypertension and dyslipidaemia were more prevalent in obese than non-obese individuals.

In vitro effects of inulin and soya bean oligosaccharide on skatole production and the intestinal microbiota in broilers

The experiment was conducted to investigate the in vitro effects of inulin and soya bean oligosaccharide (SBO) on the metabolism of L-tryptophan (L-try) to skatole production, and the intestinal microbiota in broilers. Treatments were as follows: caecal microbiota control (Cc), Cc + inulin, Cc + SBO, rectal microbiota control (Rc), Rc + inulin and Rc + SBO. Microbial suspensions were anaerobically incubated at 38°C for 24 hr. The results showed that concentrations of skatole and acetic acid were significantly lower in caecal microbiota fermentation broth (MFB) than those in rectal MFB (p < .05). Addition of inulin or SBO significantly decreased the concentrations of indole and skatole and rate of L-try degradation (p < .05). Inulin groups had lower indole than SBO groups (p < .05). PCR-DGGE analysis revealed that addition of inulin or SBO decreased the microbiota richness (p < .05), but no significant differences in Shannon index (p > .05). Four distinct bands were detected in inulin and SBO groups, which were related to two of Bacteroides, one of Firmicutes and Bifidobacteria. Six bands were detected only in control groups, which represented uncultured Rikenellaceae, Roseburia, Escherichia/Shigella dysenteriae, Bacteroides uniformis (T), Parabacteroides distasonis and Enterobacter aerogenes. Populations of Lactobacilli, Bifidobacteria and total bacteria in inulin groups were higher than those in control groups (p < .05). For SBO groups, only population of total bacteria increased (p < .05). However, there were no significant differences in Escherichia coli population among treatments (p > .05). These results suggest that reduced concentrations of skatole and indole in the presence of inulin and SBO may be caused by decrease in L-try degradation rate, which were caused by change in microbial ecosystem and pH value. Uncultured B. uniformis (T) and E. aerogenes may be responsible for degradation of L-try to skatole.

[Epidemiological analysis on mortality of cancer in China, 2015]

Objective: To understand the distribution of cancer deaths in China in 2015 and provide reference for the prevention and control of cancer. Methods: Based on the results of Global Burden of Disease 2015, the cancer death distributions in different age groups, sex groups, provinces or by different malignant tumor in Chinese were described. Results: The age-standardized mortality rate of cancer was 159.01/100 000 in China in 2015. The mortality rate was highest in age group ≥70 years (1 102.73/100 000), and lowest in age group 5-14 years (5.40/100 000). The mortality rate in males was 2.15 times higher than that in females. The first 5 provinces with high cancer mortality rate were Anhui, Qinghai, Sichuan, Guangxi and Henan. Lung cancer, liver cancer, stomach cancer, esophageal cancer and colorectal cancer ranked 1-5 in term of mortality rate. Conclusion: The cancer mortality differed with age, gender, area and different malignant tumors, suggesting the necessity to develop targeted prevention and control strategies.

[Effects of sural nerve nutrition vess els-supported flap for reconstruction of distal lower leg and ankle soft tissue defects]

Objective: To observe the effects of sural nerve nutrition vessels-supported flap for reconstruction of distal lower leg and ankle soft tissue defects. Methods: From June 2014 to June 2017, 37 patients with calf distal and ankle soft tissue defect were repaired with sural nerve nutrition vessels-supported flap, of them 12 cases with calf distal soft tissue defect wounds and 25 cases with ankle soft tissue defect wounds.The scope of flaps was 9 cm×4 cm to 18 cm×9 cm, anti-infection, anti-freezing and dressing treatments were carried out after operation.The results of two-point discrimination among reexamination were recorded. Results: All the flaps survived without ulcer and effusion, only 1 flap for reconstruction of medial malleolus swelled and deactivated at the beginning while it recovered with proper dressings.During the follow-up periods, all the flaps kept favorable feelings, aspects and functions, and the two-point discrimination was 5 to 15 mm [averaged (11.2±1.7) mm]. Conclusion: Sural nerve nutrition vessels-supported flap brings significant effects with excellent safety and reliability in repairing calf and ankle soft tissue defects.