[Association of polycyclic aromatic hydrocarbon exposure and CYP1A1 gene and enzyme activity of peripheral blood monocyte cells in coke oven workers]

Objective: To explore the association between polycyclic aromatic hydrocarbons (PAHs) exposure and cytochrome P450 CYP1A1 expression at gene and enzyme activity levels in the peripheral blood monocyte cells in coke oven workers, and to provide a certain basis for the biological monitoring of health damage in coke oven workers. Methods: We surveyed 118 coke oven workers and 63 controls (energy power workers in the same company) using self-designed questionnaire, determined their post-shift urinary 1-hydroxypyrene (1-OH-Py) concentration using high performance liquid chromatography (HPLC)-fluorescence detector method. We also isolated the peripheral blood mononuclear cell (PBMC) from fasting venous blood, and detected DNA damage using comet assay, CYP1A1 mRNA level using the real-time fluorescent quantitative PCR (FQ-PCR), and EROD activity using spectrophotometry. Statistical analyses including one-way analysis of variance and multiple linear regressions were used to analyze the association of urinary 1-OH-Py and CYP1A1 mRNA level and EROD activity. Results: Compared to the control group, the urinary 1-OH-Py concentration and PBMC DNA tail moment were significantly increased in coke oven workers (P<0.05), and CYP1A1 gene level and EROD activity in PBMC were significantly decreased (P<0.05). Multiple linear regression showed that a ten-fold increase of urinary 1-OH-Pycon centration was associated with a decrease of 0.77 (95%CI: -1.33--0.21) in CYP1A1 gene level, and a decline of 0.15 (95%CI: -0.76--0.16) in EROD activity of PBMC in coke oven workers (P<0.05). Conclusion: Occupational PAHs exposure induced DNA damage, which was associated with the decreased level in CYP1A1 gene cavel and EROD activity in PBMC of coke oven workers.

First Detection of Photons with Energy beyond 100 TeV from an Astrophysical Source

We report on the highest energy photons from the Crab Nebula observed by the Tibet air shower array with the underground water-Cherenkov-type muon detector array. Based on the criterion of a muon number measured in an air shower, we successfully suppress 99.92% of the cosmic-ray background events with energies E>100  TeV. As a result, we observed 24 photonlike events with E>100  TeV against 5.5 background events, which corresponds to a 5.6σ statistical significance. This is the first detection of photons with E>100  TeV from an astrophysical source.

[Incidence and trend of occupational diseases in a district of Beijing from 2004 to 2017]

Objective: To investigate the incidence of occupational diseases in a District of Beijing, from 2004 to 2017 and to analyze the distribution characteristics and incidence trends of occupational diseases. Methods: The data of confirmed occupational disease cases data in the occupational disease and occupational health information monitoring system in a district of Beijing from 2004~2017 were collected to analyze the incidence and trends of occupational diseases. Results: In 2004~2017, a total of 161cases of occupational diseases were reported in a district of Beijing, mainly pneumoconiosis (113 cases, 70.19%) . The average age of onset of pneumoconiosis was (51.65 ±11.10) years old, and the average age of dust exposure was (13.14±8.07) years, mainly including silicosis accounting for 85.84%, concentrated in small collective enterprises. Pneumoconiosis was mainly female, with 80 cases accounting for 70.80% of the disease; most of the working years were 10-20 years, the age of onset of dust pneumoconiosis and the duration of dust exposure were statistically different (P<0.05) ; The distribution of pneumoconiosis industry was concentrated on the manufacture of jewellery and related articles in 91cases (80.53%) , Compared with the non-jewellery and related articles manufacturing industry, the average age of onset were statistically significant (P<0.05) . Occupational diseases other than pneumoconiosis were mainly male; occupational ear, nose and throat (ENT) and oral disease male accounted for 86.96% of the disease, mainly concentrated in small enterprises, state-owned enterprises, the majority of working years wereconcentrated in 20~30 years; occupational infectious diseases accountded for 93.33% of the disease, mainly concentrated in small collective enterprises, most of the working years were less than 10 years. Conclusion: Occupational diseases in a district of Beijing are mainly pneumoconiosis, mainly in small collective enterprises, mostly historical issues, the number of reports of occupational ENT and oral disease and occupational infectious diseases are increasing, it is important to strengthen supervision and protect the health of workers.

[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.

[Effect of death decoy receptor 3 on prognosis of breast cancer and function of breast cancer cells in vitro]

Objective: To study the effect of death decoy receptor 3 on the prognosis of breast cancer and the invasive function of breast cancer cells in vitro. Methods: Expression of DcR3 were assessed qualitatively by Q-PCR to analyze the correlation in 115 mammary tissue samples with a 10-year median follow-up. The expression of DcR3 was examined in MCF7 and MDA-MB-231 cell lines using immunocytochemical staining and RT-PCR. DcR3 knock-down cell sub-lines were constructed. The effects of reduced DcR3 expression were observed by establishing invasion and migration models. Results: Patients were divided into the good prognosis group (n=81) and the poor prognosis group (n=26). The expression of DcR3 in the poor prognosis group (133 350+49 646 copies/50 ng RNA)was significantly higher than that in the good prognosis group (5 393+1 428 copies/50 ng RNA, P=0.020). DcR3 transcripts were found to be increased significantly in grade 2 cancers compared to well differentiated grade 1(82 844±34 068 copies/50 ng RNA, n=39,) vs (5 371±3 500 copies/50 ng RNA, n=20, P=0.029).The DcR3 gene of MCF7 cell line and MDA-MB-231 cell line were successfully knocked out and verified that DcR3 knockout. And the invasion and migration of MCF7 cells were inhibited (P=0.009, P=0.001). However, no significant difference was found in these two aspects of the MDA-MB-231 cell line (P=0.475, P=0.102). Conclusion: DcR3 promotes the capacity of invasion of breast cancer cells and plays an important role in the metastasis of breast cancer. DcR3 detection is helpful to the judgment about prognosis of breast cancer.

Impact of spatial variations in water quality and hydrological factors on the food-web structure in urban aquatic environments

Global aquatic ecosystems are essential to human existence and have deteriorated seriously in recent years. Understanding the influence mechanism of habitat variation on the structure of the food-web allows the effective recovery of the health of degraded ecosystems. Whereas most previous studies focused on the selection of driving habitat factors, the impact of habitat variation on the food-web structure was rarely studied, resulting in the low success rate of ecosystem restoration projects globally. This paper presents a framework for exploring the effects of spatial variations in water quality and hydrological habitat factors on the food-web structure in city waters. Indices for the evaluation of the food-web structure are first determined by integrating model-parameter extraction via literature refinement. The key water quality and hydrological factors are then determined by coupling canonical correspondence analysis with partial least squares regression. Their spatial variation is investigated using spatial autocorrelation. Finally, fuzzy clustering is applied to analyze the influence of the spatial variations in water quality and hydrological factors on the food-web structure. The results obtained in Ji'nan, the pilot city of water ecological civilization in China, show that the Shannon diversity index, connectance index, omnivory index, and the ratio of total primary production to the total respiration are important indicators of food-web structural change. They show that the driving factors affecting the aquatic food-web structure in Ji'nan are hydrological factors (e.g., river width, water depth, and stream flow), physical aspects of water quality (e.g., air temperature, water temperature, electrical conductivity, and transparency), and chemical aspects (e.g., potassium, dissolved oxygen, calcium, and total hardness). They also show that the stability of the food-web is more prone to spatial variations in water quality than in hydrological factors. Higher electrical conductivity, potassium, total hardness, and air temperature lead to deteriorated food-web structures, whereas better transparency improves structure and stability. We found that water and air temperature are the most important factors in the spatial variation of the food-web structure in the study area, followed by total hardness. Transparency is the least important factor. Large disparities and varied spatial distributions exist in the driving effects of water quality and hydrological factors across regions attributable to differences in geographical environments, water salinity (fresh vs. sea water), and environmental factors (e.g., water pollution). The above methods and results serve as a theoretical and scientific basis for a high success rate of aquatic ecosystem restoration projects in the study area and other cities worldwide.

Evaluation of efficacy of the essential oil from Ostericum viridiflorum (Turcz.) Kitagawa in control of stored product insects

The natural and ecologically safe control of stored product insects has gained considerable attention in modern society. In this study of further searching for botanical pesticides from wild-growing plant, the contact toxicity and repellency towards Tribolium castaneum and Liposcelis bostrychophila were assessed for the essential oil (EO) from Ostericum viridiflorum. The EO was distilled from aboveground parts of O. viridiflorum and checked by gas chromatography-mass spectrometry. Twenty-two compounds were identified and the main components were β-caryophyllene (24.3%), α-humulene (21.0%), apiol (10.2%), and carotol (2.5%). For bioactivity tests, results indicated that the EO and its two main compounds (β-caryophyllene and α-humulene) all showed potent contact toxicity towards L. bostrychophila with LD₅₀ values of 44.52 μg/cm², 74.11 μg/cm², and 118.56 μg/cm², respectively. The EO and the two main compounds also exhibited comparable repellency towards T. castaneum and L. bostrychophila. The results evidenced the EO of O. viridiflorum aboveground parts and its major compounds could be considered for the development of eco-friendly botanical insecticides and repellents in controlling stored product insects.

Theoretical investigation on the optical and EPR spectra for Cu2+ -doped ZnO-CdS nanocomposites

The three optical absorption bands and EPR parameters of the [CuO6 ]10- center in the ZnO-CdS composite nanopowders are theoretically studied from the perturbation formulas based on the cluster approach. In the formulas, the contributions to EPR parameters arising from the ligand orbital and spin-orbit coupling interactions via covalence effect are considered. For the studied [CuO6 ]10- cluster, the Cu-O bond lengths are suggested to show a relative elongation ratio ρ (≈ 4.1%) along the z-axis due to Jahn-Teller effect. The defect models suggested in this work are different from the previous assumption that the impurity Cu2+ can replace the host Zn2+ site when it enters the lattices of the ΖnO and ΖnS nanocrystals, forming the tetrahedral [CuΧ4 ]6- clusters (Χ = O, S). The validity of the proposed model is discussed. The differences between the present calculations and the previous ones for the interstitial Cu2+ center in ZnO nanocrystals are analyzed in view of the dissimilar impurity behaviors due to the new composition CdS and distinct preparation conditions.

[Technical specification for clinical application of critical ultrasonography]

Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound, the examiner and interpreter of the image are critical care medicine physicians. The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes. With the idea of critical care medicine as the soul, it can integrate the above information and clinical information, bedside real-time diagnosis and titration treatment, and evaluate the therapeutic effect so as to improve the outcome. CUS is a traditional technique which is applied as a new application method. The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept, implementation and application of CUS. It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure. At the same time, the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications, and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS. Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group, based on the rich experience of clinical practice in critical care and research, combined with the essence of CUS, to learn the traditional ultrasonic essence, established the clinical application technical specifications of CUS, including in five parts: basic view and relevant indicators to obtain in CUS; basic norms for viscera organ assessment and special assessment; standardized processes and systematic inspection programs; examples of CUS applications; CUS training and the application of qualification certification. The establishment of applied technology standard is helpful for standardized training and clinical correct implementation. It is helpful for clinical evaluation and correct guidance treatment, and is also helpful for quality control and continuous improvement of CUS application.

Longissimus dorsi muscle transcriptomic analysis of Yunling and Chinese simmental cattle differing in intramuscular fat content and fatty acid composition

Intramuscular fat (IMF) content and fatty acid (FA) composition vary significantly across beef cattle breeds, which play an important role in taste and nutritional value. However, the molecular mechanisms underlying these phenotypic differences remain unknown. The present study compared meat quality traits between Yunling cattle and Chinese Simmental cattle. Yunling cattle showed a lower IMF content and proportion of monounsaturated fatty acids (MUFA), as well as higher proportions of saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), and short-chain fatty acids (sc-FA) in the longissimus dorsi (LD) muscle than Chinese Simmental cattle. To further identify the candidate genes and pathways responsible for these phenotypic differences, the transcriptome of LD muscle from the two breeds were measured using RNA-seq. A total of 1347 differentially expressed genes were identified. The major metabolic pathways that were differentially modulated were lipolysis and glycometabolism. Yunling cattle showed a higher expression of lipolysis genes (ALDH9A1, ACSL5, ACADM, ACAT2, ACOT2) and a lower expression of genes related to glycometabolism (PGM1, GALM, PGM1, GPI, LDHA). This research identified candidate genes and pathways for IMF content and FA composition in the LD muscle of beef cattle, which may facilitate the design of new selection strategies to improve meat quality.

Theoretical studies of the EPR parameters and local structures for the two Cu2+ centers in Cd(HCOO)2 ·2H2 O

Based on the studies of the electron paramagnetic resonance parameters for two types of the Cu²⁺ centers in Cd(HCOO)₂ ·2H₂ O by using the high-order perturbation formulas for a 3d⁹ ion in a rhombically elongated octahedron, local structure of the doped copper ion is determined. Research suggests that the impurity Cu²⁺ replaces the host Cd²⁺ and undergoes the local rhombic elongation distortion, characterized by the axial elongation ratios of 4.1%, and 3.8% along the z-axis and the planar bond length variation ratios of 3.8%, and 3.1% along the x-axis and y-axis, for Cu²⁺ Centers, I and II, respectively. The above slightly different axial elongation ratios and planar bond length variation ratios may suitably account for the slightly dissimilar axial g anisotropies Δg (≈0.351 and 0.339) and perpendicular g anisotropies δg (≈0.028 and 0.022) of the two centers, respectively.

Highly sensitive flexible three-axis tactile sensors based on the interface contact resistance of microstructured graphene

The lack of high-performance tactile sensors, especially for pressure/force, is a huge obstacle for the widespread application of intelligent robots. Current pressure sensors are often operated in the high range of pressure and normal direction, showing a little ability in the low range of pressure and three-axis direction simultaneously. Herein, a highly sensitive flexible tactile sensor with three-axis force sensing capacity is presented by combining microstructured polydimethylsiloxane (PDMS) arrays and a reduced graphene oxide (rGO) film. The deformation of microstructured rGO/PDMS results in a change in the contact area between the rGO film and electrode, leading to a high sensitivity of -1.71 kPa-1 in the low range pressure of 0-225 Pa with a fast response time of 6 ms at a large feature size of 100 μm. To realize three-axis sensing, a sensing unit was built up, which was composed of the adjacent four parts of patterns and electrodes underneath a bump. A mechanical model of the exerted spatial force was established to calculate each axis force component via the deformation of the rGO/PDMS pattern. The experimental results show that the current difference between the adjacent two parts has a strong relationship with the applied force. As a proof of concept, we have demonstrated a 3 × 3 array sensor for arbitrary force sensing. Our tactile sensor would be used in transmitting information from a gentle spatial force and would exhibit broad applications as e-skin in integrated robots.

Differential research of inflammatory and related mediators in BPH, histological prostatitis and PCa

Prostate cancer (PCa) is one of the most common male malignancies in the world. It was aimed to investigate differential expression of inflammatory and related factors in benign prostatic hyperplasia (BPH), prostate cancer (PCa), histological prostatitis (HP) and explore the role of Inducible nitric oxide synthase (iNOS), (VEGF) Vascular endothelial growth factor, androgen receptor (AR) and IL-2, IL-8 and TNF-α in the occurrence and development of prostate cancer. RT-PCR was used to detect the mRNA expression level of iNOS, VEGF, AR and IL-2, IL-8 and TNF-α in BPH, PCa and BPH+HP. Western blotting and immunohistochemical staining were used to detect the protein levels of various proteins in three diseases. The results showed the mRNA and protein levels of iNOS, VEGF and IL-2, IL-8 and TNF-α were significantly increased in PCa and BPH+HP groups compared with BPH group (p < .05), while the AR was significantly lower than those in PCa and BPH+HP groups (p < .05). There was no significant difference in the mRNA and protein levels of iNOS, VEGF, AR and IL-2, IL-8 and TNF-α between PCa and BPH+HP groups (p > .05). iNOS, VEGF, AR and IL-2, IL-8 and TNF-α are involved in the malignant transformation of prostate tissue and play an important role in the development and progression of Prostate cancer (PCa).

[Combined T2-weighted and diffusion-weighted MR imaging for staging of rectal cancers]

Objective: To compare the diagnostic value of T2 weighted imaging (T2WI), diffusion-weighted imaging (DWI), and T2WI+ DWI magnetic resonance imaging (MRI) for staging of rectal cancers for improving the accuracy of tumor staging. Methods: From January 2011 to December 2013, 120 cases of rectal cancers proved by colonoscopy without receiving any anti-tumor treatment were enrolled retrospectively. The MRI data for these patients were divided into three groups, ie., T2WI, DWI and T2WI+ DWI, for evaluating the tumor stages. The results were compared with histopathologic findings. The sensitivity and specificity were calculated and compared with chi-square test. The nodal staging was predicted by using T2WI+ DWI. Results: The accuracy for prediction of tumor staging was 83.3%, 65.0% and 92.5% for T2WI, DWI, and T2WI+ DWI respectively. The specificity for evaluating T1 and T2 stage, and the sensitivity for evaluating T3 by DWI was significantly lower than those using T2WI and T2WI+ DWI in rectal cancers. The sensitivity for evaluation of T2 by DWI was lower than that using T2WI+ DWI (63.0% vs. 88.9%). The sensitivity for evaluation T2 and specificity for T3 by T2WI+ DWI was higher than thouse using T2WI only (88.9% vs. 51.9%, 94.0% vs. 72.0%). The accuracy for prediction of nodal staging by using T2WI+ DWI was 62.1% (72/116). Conclusions: T2WI is the key sequence for staging of rectal cancers. Although the diagnostic accuracy was not good by using DWI alone, the combination of T2WI and DWI can improve the accuracy significantly for tumor staging in rectal cancers, whereas the nodal staging was still a hard task for radiologists.

[Measurement reproducibility of parameters derived from introvoxel incoherent motion diffusion-weighted MRI imaging of rectal cancer]

Objective: To study the measurement reproducibility of parameters derived from introvoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI)-MRI of rectal cancer between- and within- radiologists. Methods: Clinical data of 34 patients with rectal cancer were prospective analyzed. Conventional MRI sequences, IVIM DWI-MRI with sixteen b values and dynamic contrast enhancement (DCE)-MRI sequences of rectum were acquired by GE 3.0-T MRI imager. The IVIM sequence images with b value=1000 sec/mm(2) were selected to measure the maximum axial section of tumor by a radiologist with 15 year-experiences in gastrointestinal cancer imaging.Two radiologists (radiologist 1 and radiologist 2 with 2 and 10 years of experience in gastrointestinal cancer imaging, respectively) independently draw a freehand region of interest (ROI) that contained the largest available tumor area on the selected section. Monoexponential apparent diffusion coefficient (ADC) and biexponential IVIM metrics maps and IVIM parameters were generated automatically by the software. The repeated measurement was performed at an interval of one week. The average values of each measurement were used for statistical analysis. ADC values and IVIM parameters obtained between- and within- radiologists were analyzed by Wilcoxon signed-rank test. Intraclass correlation coefficients (ICC) and Bland-Altaman plots were used to analyze the parameter reproducibility of two measurements between- and within- radiologists. Results: The first and second measured ADC (×10(-3)mm(2)/s), true diffusivity (D, ×10(-3)mm(2)/s), false diffusivity (D(*,) mm(2)/s) and perfusion fraction (f, %) by radiologist 1 were 0.997, 0.692, 0.043, 34.6 and 0.993, 0.691, 0.038, 32.8, respectively. The first and second measured ADC (×10(-3)mm(2)/s), D (×10(-3)mm(2)/s), D(*) (mm(2)/s), f (%) by radiologist 2 were 0.987, 0.651, 0.046, 32.8 and 0.996, 0.689、0.041, 32.7, respectively. No statistically significant differences were observed in ADC and IVIM parameters obtained between- and within- radiologists (P>0.05). The ADC values and the f values of two times were significantly correlated between- and within- radiologists. The D values were significantly correlated within a radiologist, and the correlation of D(*) values within a radiologist was significantly higher than that between radiologists. The 95% limits of agreement (LoA) of ADC values and f values were smaller than those of D values and D(*) values between- and within- radiologists. The 95% LoA of ADC values was the least, while that of D(*) values varied most.The 95% LoA of f values and D values kept steady within a radiologist, and 95% LoA of f values was slightly smaller than that of D values. The 95% LoA of IVIM parameters (ADC, D, f, D(*) values) within radiologists 2 were better than those within radiologist 1. Conclusions: The reproducibilities of ADC and f values are the best, while the reproducibility of D(*) values is relatively poorer in rectal cancer. Measurement reproducibility of parameters derived from IVIM may be improved by increasing radiologists' experiences in drawing ROI.

Evaluation of the Interplanetary Magnetic Field Strength Using the Cosmic-Ray Shadow of the Sun

We analyze the Sun's shadow observed with the Tibet-III air shower array and find that the shadow's center deviates northward (southward) from the optical solar disk center in the "away" ("toward") interplanetary magnetic field (IMF) sector. By comparing with numerical simulations based on the solar magnetic field model, we find that the average IMF strength in the away (toward) sector is 1.54±0.21_{stat}±0.20_{syst} (1.62±0.15_{stat}±0.22_{syst}) times larger than the model prediction. These demonstrate that the observed Sun's shadow is a useful tool for the quantitative evaluation of the average solar magnetic field.

[Experts consensus on the management of the right heart function in critically ill patients]

To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle. (2) Right heart function management is a key step of the hemodynamic therapy in critically ill patients. (3) Fluid resuscitation means the process of fluid therapy through rapid adjustment of intravascular volume aiming to improve tissue perfusion. Reversed fluid resuscitation means reducing volume. (4) The right ventricle afterload should be taken into consideration when using stroke volume variation (SVV) or pulse pressure variation (PPV) to assess fluid responsiveness.(5)Volume overload alone could lead to septal displacement and damage the diastolic function of the left ventricle. (6) The Starling curve of the right ventricle is not the same as the one applied to the left ventricle,the judgement of the different states for the right ventricle is the key of volume management. (7) The alteration of right heart function has its own characteristics, volume assessment and adjustment is an important part of the treatment of right ventricular dysfunction (8) Right ventricular enlargement is the prerequisite for increased cardiac output during reversed fluid resuscitation; Nonetheless, right heart enlargement does not mandate reversed fluid resuscitation.(9)Increased pulmonary vascular resistance induced by a variety of factors could affect right heart function by obstructing the blood flow. (10) When pulmonary hypertension was detected in clinical scenario, the differentiation of critical care-related pulmonary hypertension should be a priority. (11) Attention should be paid to the change of right heart function before and after implementation of mechanical ventilation and adjustment of ventilator parameter. (12) The pulmonary arterial pressure should be monitored timingly when dealing with critical care-related pulmonary hypertension accompanied with circulatory failure.(13) The elevation of pulmonary aterial pressure should be taken into account in critical patients with acute right heart dysfunction. (14) Prone position ventilation is an important measure to reduce pulmonary vascular resistance when treating acute respiratory distress syndrome patients accompanied with acute cor pulmonale. (15) Attention should be paid to right ventricle-pulmonary artery coupling during the management of right heart function. (16) Right ventricular diastolic function is more prone to be affected in critically ill patients, the application of critical ultrasound is more conducive to quantitative assessment of right ventricular diastolic function. (17) As one of the parameters to assess the filling pressure of right heart, central venous pressure can be used to assess right heart diastolic function. (18). The early and prominent manifestation of non-focal cardiac tamponade is right ventricular diastolic involvement, the elevated right atrial pressure should be noticed. (19) The effect of increased intrathoracic pressure on right heart diastolic function should be valued. (20) Ttricuspid annular plane systolic excursion (TAPSE) is an important parameter that reflects right ventricular systolic function, and it is recommended as a general indicator of critically ill patient. (21) Circulation management with right heart protection as the core strategy is the key point of the treatment of acute respiratory distress syndrome. (22) Right heart function involvement after cardiac surgery is very common and should be highly valued. (23) Right ventricular dysfunction should not be considered as a routine excuse for maintaining higher central venous pressure. (24) When left ventricular dilation, attention should be paid to the effect of left ventricle on right ventricular diastolic function. (25) The impact of left ventricular function should be excluded when the contractility of the right ventricle is decreased. (26) When the right heart load increases acutely, the shunt between the left and right heart should be monitored. (27) Attention should be paid to the increase of central venous pressure caused by right ventricular dysfunction and its influence on microcirculation blood flow. (28) When the vasoactive drugs was used to reduce the pressure of pulmonary circulation, different effects on pulmonary and systemic circulation should be evaluated. (29) Right atrial pressure is an important factor affecting venous return. Attention should be paid to the influence of the pressure composition of the right atrium on the venous return. (30) Attention should be paid to the role of the right ventricle in the acute pulmonary edema. (31) Monitoring the difference between the mean systemic filling pressure and the right atrial pressure is helpful to determine whether the infusion increases the venous return. (32) Venous return resistance is often considered to be a insignificant factor that affects venous return, but attention should be paid to the effect of the specific pathophysiological status, such as intrathoracic hypertension, intra-abdominal hypertension and so on. Consensus can promote right heart function management in critically ill patients, optimize hemodynamic therapy, and even affect prognosis.

Oxidative stress induced necroptosis activation is involved in the pathogenesis of hyperoxic acute lung injury

Necroptosis has been found to be involved in the pathogenesis of some lung diseases, but its role in hyperoxic acute lung injury (HALI) is still unclear. This study aimed to investigate contribution of necroptosis to the pathogenesis of HALI induced by hyperbaric hyperoxia exposure in a rat model. Rats were divided into control group, HALI group, Nec-1 (necroptosis inhibitor) group and edaravone group. Rats were exposed to pure oxygen at 250 kPa for 6 h to induce HALI. At 30 min before hyperoxia exposure, rats were intraperitoneally injected with Nec-1 or edaravone, and sacrificed at 24 h after hyperoxia exposure. Lung injury was evaluated by histology, lung water to dry ratio (W/D) and bronchoalveolar lavage fluid (BALF) biochemistry; the serum and plasma oxidative stress, expression of RIP1, RIP3 and MLKL, and interaction between RIP1 and RIP3 were determined. Results showed hyperoxia exposure significantly caused damage to lung and increased necroptotic cells and the expression of RIP1, RIP3 and MLKL. Edaravone pre-treatment not only inhibited the oxidative stress in HALI, but also reduced necroptotic cells, decreased the expression of RIP1, RIP3 and MLKL and improved lung pathology. Nec-1 pretreatment inhibited necroptosis and improved lung pathology, but had little influence on oxidative stress. This study suggests hyperoxia exposure induces oxidative stress may activate necroptosis, involving in the pathology of HALI, and strategies targeting necroptosis may become promising treatments for HALI.

[Postoperative complications following dental rehabilitation under general anesthesia in children]

Objective: To assess the postoperative complications in systemically healthy children treated for dental caries under general anesthesia (GA) after discharge and analysis of the correlative factors. Methods: This prospective observational study included 124 children aged 2-8 years old who received extensive dental treatment under GA. General conditions and treatment information were obtained from questionnaires filled by the dentist and the anesthesiologist. Postoperative data were collected from a questionnaire filled by the parents in one week. Pain was assessed by using the dental discomfort questionnaire-8 (DDQ-8) pain assessment scale. Results: The mean anesthesia time for GA procedures was 102.6 min and the mean number of treated teeth was 13.5. Approximately 66.9% (83/124) of the children had one or more postoperative complaints on the first day after the treatments. The most common complaints reported were cough, hoarseness, and dental pain followed by throat discomfort, problems in eating, swelling, weakness, sleepiness, vomiting, fever and nausea. By the seventh day after the treatment, the main complications remained were dental pain and cough, while most of other symptoms disappeared. Preoperative DDQ-8 score and the number of extracted teeth were the factors that showed a significant association with postoperative dental pain on the first day. Conclusions: Dental pain and pharynx discomfort were most frequently noted postoperative symptoms. Postoperative dental discomfort on the first day might be predicted by dental pain before GA and tooth extraction under GA.

[Philosophical basis of original thinking in Chinese medicine]

Chinese Medicine, being one of the most creative disciplines, with the superiority of its disciplinary theory and thinking pattern closely related to the studies of Sinology.Chinese Medicine has taken on its great aspect with good favorable prospects of timing, geographical and unity and coordination of human relationship, hence, the development of CM needs the recognition of its original advantage, making clear of its sources of original thought.The XIANG thought (iconic thinking) is the basic connotation and basic features of traditional Chinese thinking. The imported western culture depresses the XIANG (iconic) thinking of original thought, and, as a result, conceptual thinking of scientism and western medicine became the mainstream. Actually, conceptual thinking shouldn't be rejected, whereas the original thinking and original superiority characterized by our own nation should also be manifested. The knowledge, both oriental and occidental, are to be accepted simultaneously, while Chinese medicine and western medicine should be all mastered thoroughly and integrated as a whole so as to further proceed together.

[Study on HIV-1 subtype among elderly male clients and female sex workers of low-cost venues in Guangxi Zhuang Autonomous Region, China]

Objective: To understand HIV-1 subtype characteristics and transmission clusters in elderly male clients and female sex workers (FSWs) of low-cost commercial sex venues in Guangxi Zhuang Autonomous Region, China. Methods: A cross sectional survey was conducted in FSWs and elderly male clients (≥50 years) of low-cost commercial sex venues in 4 cities and 9 counties in Guangxi Zhuang Autonomous Region by convenient sampling in 2012. The blood sample was collected from each case for HIV-1 antibody detection. The pol gene fragments were amplified and sequenced from viral RNA template extracted from plasma samples. The phylogenetic tree was constructed and the subtypes were identified. Results: A total of 4 048 elderly male clients and 784 FSWs were surveyed, and 116 HIV-1 infections were detected, the positive rate was 2.5% (103/4 048) in the clients and 1.7% (13/784) in FSWs. The gene amplification and sequencing of HIV-1 detected in 84 blood samples indicated that 53 pol gene sequences were successfully determined (48 blood samples from elderly male clients and 5 blood samples from FSWs). Among 53 pol sequences, 48(90.6% ), 4(7.5% ), and 1(1.9% ) sequences were identified as CRF01_AE, CRF08_BC, and CRF07_BC, respectively. Two transmission clusters were identified among CRF01_AE, including 4 sub-clusters. One transmission cluster was identified among CRF08_BC. The transmission cluster or sub-cluster were from the infected individuals at same low-cost commercial sex venue, or different low-cost commercial sex venues in the same town, or same place, or adjacent villages and towns. Conclusions: CRF01_AE was the predominant HIV-1 subtype among elderly male clients and FSWs of low-cost commercial sex venues in Guangxi Zhuang Autonomous Region, circulating in same venue or adjacent villages and towns. The HIV-1 positive male clients and FSWs might play an important role in the spread of the strains.