[Local combined with systemic glucocorticoid treatment of young and middle-aged patients with severe and profound hearing loss]

Objective:To investigate the clinical effect of local combined with systemic glucocorticoid injection on young and middle-aged patients with severe and profound hearing loss. Method:Ninety-three cases of young and middle-aged patients with severe and profound hearing loss admitted to our hospital from May 2013 to May 2017 were retrospectively analyzed. Patients were divided into two groups according to the different treatment. Forty-six cases in control group were treated with systemic injection of glucocorticoids.Forty-seven cases in observation group were treated with local administration combined with systemic glucocorticoid therapy. The efficacy, changes of average hearing threshold and the incidence of adverse reactions were evaluated.Result:The total effective rate in the observation group was 68.09%, which was significantly higher than that in the control group (45.65%,P<0.05).After treatment, the average hearing thresholds in the observation groups of 0.5,1.0,2.0 and 4.0kHz were(35.77±13.28)dB HL,(39.71±14.09)dB HL, (32.99±10.73)dB HL and (30.17±9.29)dB HL respectively,which were significantly higher than that in the control group(26.30±14.03)dB HL,(25.14±13.28)dB HL,(20.54±9.27)dB HL,and (20.98±8.71)dB HL(P<0.05).Among all the patients received systemic injection of dexamethasone sodium phosphate injection,there was no other complications were found except for one patient whose blood pressure instability was relieved after treatment stopping. In the observation group, intratympanic methylprednisolone sodium succinate did not cause serious complications such as tympanic cavity infection and perforation of the tympanic membrane on the basis of systemic injection.While in the observation group,one case complained of earache and one case complained of a slight burning sensation in the ear, and both of them eased after rest.Conclusion:Local combined with systemic glucocorticoid treatment of young and middle-aged patients with severe and profound hearing loss can significantly improve the efficiency and increase the average hearing threshold changes at 0.5,1.0,2.0 and 4.0 kHz,and there was no serious adverse reactions.

[Development of HIV infection risk assessment tool for men who have sex with men based on Delphi method]

Objective: To develop a HIV infection risk assessment tool for men who have sex with men (MSM) based on Delphi method. Methods: After an exhaustive literature review, we used Delphi method to determine the specific items and relative risk scores of the assessment tool through two rounds of specialist consultation and overall consideration of the opinions and suggestions of 17 specialists. Results: The positivity coefficient through first and second round specialist consultation was 100.0% and 94.1%, respectively. The mean of authority coefficients (Cr) was 0.86. Kendall's W coefficient of the specialist consultation was 0.55 for the first round consultation (χ(2)=84.426, P<0.001) and 0.46 for the second round consultation (χ(2)=65.734, P<0.001), respectively, suggesting that the specialists had similar opinions. The final HIV infection risk assessment tool for MSM has 8 items. Conclusions: The HIV infection risk assessment tool for MSM, developed under the Delphi method, can be used in the evaluation of HIV infection risk in MSM and individualized prevention and intervention. However, the reliability and validity of this risk assessment tool need to be further evaluated.

[Diagnostic value of urinary free cortisol in the subclinical Cushing's syndrome in patients with adrenal incidentaloma]

Objective: To evaluate the efficacy of 24 h urinary free cortisol (24 h UFC) in the diagnosis of subclinical Cushing's syndrome (SCS), and explore the best diagnostic cut-off value. Methods: The clinical data of patients with adrenal incidentaloma in Chinese PLA General Hospital between January 2008 and December 2016 was retrospectively reviewed and analyzed. All SCS patients were diagnosed based on the current Cushing's syndrome (CS) guidelines and confirmed by histopathology and then treated as study group, and additional patients with non-functional adrenal adenoma (NFA) were enrolled as control group. ROC curve was used to evaluate efficacy of 24 h UFC and 24 h UFC to creatinine ratio (UFCCR), and explore their best cut-off values. Results: There were 161 patients with NFA, of which contained 84 males and 77 females, with a mean age of (51.02±10.49) years old. There were 88 patients with SCS, of which contained 26 males and 62 females, with a mean age of (51.74±10.29) years old. The 24 h UFC and UFCCR levels were significant higher in SCS group than those in NFA group[510 (363, 698) nmol vs 335 (209, 467) nmol for 24 h UFC, and 7.82(4.79, 12.13) ml vs 4.82(2.41, 6.57)ml for UFCCR, both P<0.05]. ROC analysis showed that the optimal cut-off for 24 h UFC was 480 nmol (AUC 0.716, 95% CI: 0.648-0.784, with a sensitivity of 58.0% and a specificity of 79.4%) and the optimal cut-off for UFCCR was 6.84 ml (AUC 0.729, 95% CI: 0.662-0.796, with a sensitivity of 59.1% and a specificity of 78.7%). Conclusions: The recommended cut-off points of 24 h UFC and UFCCR for diagnosing SCS in AI patients were 480 nmol and 6.84 ml, respectively.

[Clinical value of spectral CT imaging in preoperative evaluation of pathological grading of esophageal squamous cell carcinoma]

Objective: To investigate the value of spectral computed tomography quantitative parameters in the assessment of pathological grade of esophageal squamous cell carcinoma before operation. Methods: The imaging findings of 52 patients with confirmed esophageal squamous cell carcinoma by surgery and pathology were prospectively analyzed in Henan Provincial People's Hospital from June 2016 to May 2017.There were 43 males and 9 females, aged 49-76 years, with an average age of (66±8) years.All the patients were divided into three groups based on the pathological finding: well-differentiated group (n=12), moderately-differentiated group (n=20), poorly-differentiated group (n=20). All the patients received chest plain scan and double phase enhanced scan of gemstone spectral computed tomography.The enhancement attenuation (HU), the average of the slope of the spectral Hounsfield Unit curve (λ(HU)), normalized iodine concentration (NIC), normalized effective atomic number (Z(eff-a)) were measured and calculated.The difference in HU, λ(HU), NIC, Z(eff-a) among different grades were statistically analyzed.The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of single and combined parameters in the differentiation of poorly-differentiated and well-moderately differentiated esophageal squamous cell carcinoma. Results: There were significant differences in HU, λ(HU), NIC, Z(eff-a) among different pathological grading of the esophageal squamous cell carcinoma in arterial phase and venous phase (F=4.496-9.056, H=23.204, 20.724, all P<0.05). The best single parameter to differentiate poorly-differentiated from well-moderately differentiated esophageal squamous cell carcinoma was NIC in arterial phase with areas under the ROC curve (AUC), the cutoff value, sensitivity, specificity, accuracy of 0.860, 0.197, 65.0%, 96.9%, 84.6%, respectively; the best combination of parameters was HU+ NIC+ λ(HU) in arterial phase with AUC, the threshold of predicted probability, sensitivity, specificity, accuracy of 0.913, 0.380, 85.0%, 81.3%, 82.7%, respectively. Conclusion: Gemstone spectral imaging quantitative parameters can be used to evaluate the pathological grading of esophageal squamous cell carcinoma, the NIC and HU+ NIC+ λ(HU) in arterial phase have the highest differential diagnostic efficiency.

[Clinical characteristics of 128 hospitalized patients with syndrome of inappropriate antidiuretics of different etiologies]

Objective: To summarize and analyze the clinical features and etiologies in hospitalized patients with syndrome of inappropriate antidiuretics (SIAD) during the past 25 years. Methods: All data of 128 patients with SIAD admitted to Chinese PLA General Hospital since January 1991 to January 2016 were collected. SIAD was diagnosed based on the 1957 criterion. Results: (1) The most frequent causes of increased inappropriate secretion of vasopressin were malignant tumors, lung diseases (e. g. pneumonia), and central nervous system diseases, in which malignant tumors accounted for 38.28% of the SIAD. (2) During the past 25 years, the proportion of malignant diseases declined from 4/7 to 35.29%, while, the proportion of pulmonary infection increased from 1/7 to 35.29% (P<0.05). (3) The patients with malignant tumors had the lowest serum sodium and serum osmolality among all SIAD patients. (4) CT scan had a high diagnostic value for chest and brain detection. (5) Among three SIAD subjects with unknown reasons at onset, two were diagnosed with small cell lung cancer and one with gastric cancer during follow-up. Conclusion: The etiology of SIAD is complex and it could be attributed to multifarious etiological factors. Malignant tumors account for the largest proportion of all patients, and pulmonary infection was ranked in second place. Cautions on tumors have to be taken when serum sodium of a SIAD patient is below 118.1 mmol/L.

[Surgery versus conservative management for subclinical Cushing's syndrome in adrenal incidentalomas]

Objective: To determine the effect of the surgical and conservative approaches on the metabolic profiles in patients with subclinical Cushing's syndrome (SCS) in adrenal incidentalomas (AI). Methods: A hundred and thirty AI patients with SCS in Department of Endocrinology, PLA General Hospital between January 2008 and December 2016 were studied, surgery was performed in 88 patients (surgical group), and the rest received conservative approach (conservative group). The improvement/worsening of blood pressure, blood glucose, lipid profiles and body weight after a duration of >18 months follow-up were analyzed, respectively. Results: Baseline demographics, clinical characteristics were similar between surgical and conservative groups. In the surgical group, blood pressure, blood glucose, lipid profiles and body weight improved more frequently than that in conservative group (29.69% vs 3.12%, P=0.003; 10.94% vs 3.12%, P=0.262; 7.81% vs 3.12%, P=0.660; 39.06% vs 9.38%, P=0.004, respectively). In conservative group, blood pressure, blood glucose, lipid profiles and body weight worsened more frequently than that in surgical group (28.13% vs 0, P<0.001; 25.0% vs 0, P<0.001; 18.75% vs 0, P=0.003; 40.62% vs 20.31%, P=0.051, respectively). Logistic regression analysis indicated surgical treatment was associated with improvement of blood pressure (OR=10.687, 95%CI: 1.279-89.299) and weight loss (OR=5.541, 95%CI: 1.404-21.872) independently of gender, age, duration of follow-up, serum cortisol level after 1 mg-dexamethasone suppression test and the mass size. Conclusion: In AI patients with SCS, surgery was beneficial in the aspect of metabolic profiles.

[A multicenter clinical study for the comparison of S-1 versus capecitabine in the treatment of advanced breast cancer]

Objective: To investigate the safety, efficacy and prognostic factors of S-1 versus capecitabine in patients with advanced breast cancer (ABC). Methods: From January 1, 2012 to December 31, 2014, 154 ABC patients with pathological diagnosis were separated into two groups: S-1 with or without the 3rd generation chemotherapy drug (group S-1) and capecitabine with or without the 3rd generation chemotherapy drug (Group capecitabine). The efficacy, side effects and prognostic factors were compared between the two groups. Results: There were 70 patients in group S-1 and 84 patients in group capecitabine. The objective response rates (ORR) were 31.4% (22/70) in group S-1 and 28.6% (24/84) in group capecitabine. The disease control rates (DCR) were 74.3% (52/70) and 83.3% (70/84), respectively. There were no significant differences in DCR and ORR between two groups (P>0.05). The DCR of patients treated with capecitabine monotherapy was significantly higher than that of S-1 monotherapy [94.4%(17/18) and 64.0%(16/25), P=0.028]. The median PFS was 7.5 and 8.9 months for the patients in the group S-1 and group capecitabine, with no statistically significant difference (P=0.423). The 1-year survival rates of group S-1 and group capecitabine were 81.4% and 66.7%, respectively, with no significant differences(P=0.020). Univariate analysis showed that ER and/or PR status (P=0.004), T stage (P=0.041), and molecular typing (P=0.046) were associated with PFS. Multivariate analysis showed ER and/or PR status (P=0.034) was an independent prognostic factor related with PFS. The incidence of hemoglobin reduction was 14.3% (10/70) and 36.9% (31/84) in the group S-1 and group capecitabine, and the differences were statistically significant (P=0.002). There was no significant difference in the incidence of leukopenia, neutropenia, thrombocytopenia and hand-foot syndrome between the two groups(P>0.05). Conclusions: S-1 and capecitabine are both effective for advanced breast cancer. Neither ORR nor DCR were significantly different between these two groups. The incidence of gastrointestinal reactions and thrombocytopenia of S-1 was slightly lower than that of capecitabine.

Thermoelectric transport in temperature-driven two-dimensional topological insulators

We theoretically investigate on the thermoelectric (TE) transport properties of edge and bulk states in a temperature-driven two-dimensional (2D) topological insulator (TI) realized from CdTe/HgTe/CdTe quantum wells (QWs). It is found that the temperature can effectively drive a TI phase in CdTe/HgTe/CdTe QWs. We find that the TE transport properties of 2D TI can be governed by edge states, bulk states, or their interplay, depending on driving temperature and chemical potential of the system. Moreover, we find that the TE figure of merit ZT shows a peak at relatively low temperatures due to the competition between bulk and edge transports. This peak vanishes at relatively high temperatures due to the dominance of bulk states in the TE transport. With decreasing the ribbon width of the temperature-driven 2D TI, the low-temperature ZT exhibits two peaks, among which one occurs due to the bulk-edge competition and the other occurs due to the edge-edge hybridization; while the high-temperature ZT first exhibits the bulk-state behavior and then the edge-state one, which is indicative of a bulk-to-edge transition in the TE transport.

[Association between the time of sedentary behaviors and risk of type 2 diabetes]

Objective: To explore the relationship between the time of sedentary behaviors and the risk of type 2 diabetes mellitus (T2DM) among rural adults in Henan Province. Methods: A total of 1 227 adults from Houzhai village in Zhengzhou City and Qiaomiao village in Jiaozuo City in Henan Province were randomly selected to participate in the survey; each of them finished a questionnaire and accepted physical examination and test of biochemical indicators. The participants were divided into case and control groups according to whether suffering from T2DM. A Pearson linear correlation and linear regression model analysis were used to investigate the relevance between the time of sedentary behaviors and fasting plasma glucose (FPG); meanwhile, a multi factor logistic regression model was used to analyze the relationship between the time of sedentary behaviors and T2DM. Results: The average FPG level among the participants was (5.4±2.5) mmol/L, and the average time of sedentary behaviors was (234.5±156.5) min per day. The prevalence rate of T2DM in subgroups whose time of sedentary behaviors were separately 0-<2.5, 2.5-<4.5, 4.5-<6.5 and ≥6.5 h/day were 15.8% (72/457), 19.3% (73/379), 16.7% (35/210) and 20.4% (37/181), respectively. There was a linear regression relationship between the time of sedentary behaviors(x) and FPG(y), the regression equation was: y=5.081+0.001x (t=3.01, P=0.003). Logistic regression model analysis showed that participants whose time of sedentary behaviors ≥6.5 h/day had significantly higher risk of T2DM than those whose time of sedentary behaviors between 0-2.4 h/day (OR=1.77, 95%CI: 1.11-2.81) after age and gender adjusted. However, the associations only exist in males and adults ≥50 years old according to sex and age stratification. It showed that participants with sedentary time ≥6.5 h/day had significantly higher risk of T2DM than those with sedentary time between 0-<2.5 h/d, with the corresponding OR (95%CI) at 2.34 (1.21-4.52) and 2.22 (1.19-4.16), respectively. Conclusion: The prolonged sedentary time is a risk factor of type 2 diabetes. After stratification by gender and age, the correlation only found in males and adults aged ≥50 years old.

[Nasal continuous positive airway pressure ventilation in children with community-acquired pneumonia under five years of age: a prospective, multi-center clinical study]

Objective: To analyze the clinical characteristics of community-acquired pneumonia (CAP) in children under five years of age and analyze the safety and efficiency of nasal continuous positive airway pressure (NCPAP) ventilation for CAP in this population. Method: This was a prospective multicenter study. Children who were admitted to these six centers with CAP and met the NCPAP ventilation indications, aged from 29 d to 5 years, were continuously included during November 2013 to October 2015. The baseline data were collected and NCPAP ventilation were then followed up by operation standards, and the vital signs and arterial blood gas change at special time points were observed and recorded. Any side effect associated with NCPAP were recorded. For categorical variables, comparisons were performed using Fisher test. Rank-sum test and t test were performed respectively for abnormal and normal distribution continuous variables. The variables pre-NCPAP and post-NCPAP were analyzed by repeated measures ANOVA analysis. Result: Totally 145 children were included, and 13 children were excluded due to incomplete data. One hundred and two children(77.3%)were ≤12 months; 91 children (68.9%) were from rural area. NCPAP ventilation was effective in 123 children, with a response rate of 93.2%, were all discharged with a better condition; it was ineffective in 9 children(6.8%), and they were all intubated and went on mechanical ventilation, 5 were discharged with a better condition, and 4 died after gaving up treatment. The gender, age, body weight, residence, main symptoms, main signs, imaging diagnosis, medications, partial pressure of oxygen(PaO(2)), breath and heart rate before NCPAP treatment of two groups had no significant differences(allP>0.05). The rates of combining underlying diseases, trouble with feeding and cyanosis, and the partial pressure of carbon dioxide(PaCO(2) ) before NCPAP ventilation were higher in NCPAP ineffective group ((59±11 )vs.( 49±11) mmHg, 1 mmHg=0.133 kPa, t=-2.597, P=0.028); while the PaO(2)/fraction of inspiration O(2) (FiO(2) ) before NCPAP was lower((150±37) vs. (207±63) mmHg, t=2.697, P=0.008). The breathing, heart rate and PaCO(2) of NCPAP effective group decreased significantly, while the PaO(2) and PaO(2)/FiO(2) increased significantly after 2, 8, 24 h of NCPAP ventilation(all P=0.000). PaCO(2) in children with hypercapnia before NCPAP ventilation in NCPAP effective group decreased significantly ((48±9), (47±12), (45±11)vs.(58±7)mmHg, all P=0.000). All children tolerated well to NCPAP ventilation, and there were no severe side effects or complications associated with NCPAP ventilation. Conclusion: NCPAP ventilation is safe and effectively improved the oxygenation and hypercapnia in infants with CAP. But it may not work well in children with underlying diseases, manifest as difficulty in feeding/cyanosis and extremely high PaCO(2) or low PaO(2)/FiO(2), and they may need early intubation.

Development of the Forensically Important Beetle Creophilus maxillosus (Coleoptera: Staphylinidae) at Constant Temperatures

Creophilus maxillosus (L., 1758) is a common and widely distributed beetle species found on corpses, and its development duration is far longer than species belonging to the genus Calliphoridae and Sarcophagidae. Therefore, C. maxillosus can be used as a supplementary indicator to estimate minimum postmortem interval (PMImin), and could greatly extend the range of PMImin when the primary colonizers are no longer associated with the corpse or have emerged from pupae. Better descriptions of C. maxillosus development are needed to apply this species for forensic investigations. In this study, the development of C. maxillosus at seven constant temperatures ranging from 17.5-32.5 °C was studied. Through regression analyses, the simulation equations of larval body length variation with time after hatching were obtained. Isomegalen diagrams of the changes of larval body length over time at specific temperatures, and the isomorphen diagrams on the duration of different developmental milestones at specific temperatures were generated. In addition, thermal summation models of different developmental stages and the overall development process of C. maxillosus were generated through regression analysis, by estimating the development threshold temperatures (D0) and the thermal summation constants (K). These results provide important tools for forensic investigations to generate a long-range of PMImin estimation based on the development of C. maxillosus.

Electric- and magnetic-field dependence of the electronic and optical properties of phosphorene quantum dots

Recently, black phosphorus quantum dots were fabricated experimentally. Motivated by these experiments, we theoretically investigate the electronic and optical properties of rectangular phosphorene quantum dots (RPQDs) in the presence of an in-plane electric field and a perpendicular magnetic field. The energy spectra and wave functions of RPQDs are obtained numerically using the tight-binding approach. We find edge states within the band gap of the RPQD which are well separated from the bulk states. In an undoped RPQD and for in-plane polarized light, due to the presence of well-defined edge states, we find three types of optical transitions which are between the bulk states, between the edge and bulk states, and between the edge states. The electric and magnetic fields influence the bulk-to-bulk, edge-to-bulk, and edge-to-edge transitions differently due to the different responses of bulk and edge states to these fields.

[Multi-centric clinical study of trial of labor after cesarean section]

OBJECTIVE

To study the feasibility and safety of trial of labor after cesarean section (TOLAC).

METHODS

Retrospective analysis of five medical center of Guangdong province from January 2011 to December 2015 hospitalized delivery information, compare the same scar TOLAC (research group) with the scar pregnancy (control group) pregnancy outcomes, to study the feasibility and safety of TOLAC.

RESULTS

(1) During 2011-2015, total delivery 95 600 cases in five medical center, 13 824 cases of thme with uterine scar pregnancy, including 12 027 cases elective repeat cesarean section and 1 797 cases (13.00%, 1 797/13 824) with scar uterus vaginal trial of labor. Among 1 308 cases of vaginal delivery, the success for trial of labor rate was 72.79% (1 308/1 797). From 2011 to 2015, there were increased rate of pregnancy after cesarean section, which were respectively 10.71%, 13.28%, 14.45%, 15.54% and 16.98%. The will of vaginal birth were rising and the rate were respectively 11.85%, 12.25%, 13.49%, 13.82% and 12.93%. (2) There were 489 (27.21%, 489/1 797) cases of scar uterus maternal emergency cesarean section in the trial of labor, reason for "social factors" require for cesarean delivery have 68 cases, the percentage was 13.91% (68/489), compared with control group (7.18%, 206/2 869), the difference was statistically significant difference (χ(2)=27.356, P=0.000). Doctors diagnosed as "aura uterine rupture" in the labor was 11.86% (58/489), compared with that in control group (1.43%, 41/2 869), the differences were statistically significant difference (χ(2)=1 578.223, P=0.000). (3) The incidence of uterine rupture of the research group (0.74%, 9/1 211) was significantly higher than that of control group (0.01%,2/31 200; χ(2)> 2 000, P=0.000). The incidence of postpartum hemorrhage in research group was 6.94% (84/1 211), compared with that in the control group (3.05%, 951/31 200), there was statistically significant difference (χ(2)=16.328, P=0.000). While, there were no statistical significancefor the labor time limit, birth rate of severe asphyxia and neonatal birth weight average differences between two groups (P>0.05).

CONCLUSIONS

The rate of pregnancy after cesarean section is increasing year by year, and the will of vaginal birth is increasing, while it still are generally low. TOLAC is safe and feasible, but also significantly higher risk, strictly labor monitoring and can proceed fast cesarean delivery in delivery room is an important guarantee of safe delivery.

Effects of arsenic supplementation in feed on laying performance, arsenic retention of eggs and organs, biochemical indices and endocrine hormones

1. The primary objective of this experiment was to estimate the toxic effects of arsenic (As) supplementation in feed on laying performance, As retention by eggs and organs, serum biochemical indices and endocrine hormones in laying hens. 2. A total of 320 "Jinghong Number 1" hens, 56-week-old, were randomly allocated into four treatments of four replicates with 20 layers in each. Graded arsenical was added to the basal diet in the experimental diets at As levels of 0, 17, 34 and 51 mg/kg, respectively. The trial lasted for 9 weeks including 1 week for acclimatisation. 3. Supplementation of dietary As for eight weeks had no effect on laying performance. As retention in albumen, yolk, egg, liver and kidney increased as As levels increased The level of serum phosphorus (P) was minimised at the 17 mg As/kg group. The activity of serum glutamic oxaloacetic transaminase (GOT) increased linearly. No differences were observed for levels of serum calcium (Ca), alkaline phosphatase (AKP) and serum glutamic pyruvic transaminase (GPT). Concentrations of estradiol (E₂) and progesterone (PG) declined at 34 and 51 mg/kg As levels compared with the control group. As supplementation exerted no influence on levels of serum follicle stimulating hormone (FSH), luteinising hormone (LH), triiodothyronine (T₃), thyroxine (T₄) and the ratio between T₃ and T₄. 4. In conclusion, dietary As supplementation accelerated retention in tissues and eggs, and affected the laying rate by diminishing hormone levels of E2 and PG at 51 mg/kg.

[Current status of Chinese herbal preparations included in LiverTox database]

Objective: To investigate the contents and features of drug-induced liver injury (DILI) database called LiverTox, as well as 37 herbal preparations included in this database. Methods: Firstly, the source and contents of LiverTox were briefly introduced, including the clinical features, types, severity, and causality assessment scale of DILI. Secondly, detailed information of 37 herbal preparations included in the class of "Herbals and Dietary Supplements" were extracted, including drug name, origin, efficacy, constituents, type of liver injury, and manifestations, to perform a preliminary statistical analysis. Finally, a comparative analysis was performed between such information and current knowledge of Chinese herbal medicine-induced liver injury in China. Results: LiverTox was a DILI database with open access and rich information and provided practical information on treatment, typing, causality assessment, and treatment. Among the 37 herbal preparations, 28 had the risk of liver injury. The most common indication was weight loss, followed by arthritis and constipation. The latency of hepatotoxicity ranged from 4 weeks to 6 months. Compared with the current knowledge in China, there were differences in the varieties and indications for herbal preparations with hepatotoxicity included in LiverTox, and many herbals with acknowledged hepatotoxicity in China were not included. Conclusion: LiverTox database is concise and practical, but there are certain differences between the herbal preparations included in this database and current knowledge in China.

Inverse Doppler Effects in Broadband Acoustic Metamaterials

The Doppler effect refers to the change in frequency of a wave source as a consequence of the relative motion between the source and an observer. Veselago theoretically predicted that materials with negative refractions can induce inverse Doppler effects. With the development of metamaterials, inverse Doppler effects have been extensively investigated. However, the ideal material parameters prescribed by these metamaterial design approaches are complex and also challenging to obtain experimentally. Here, we demonstrated a method of designing and experimentally characterising arbitrary broadband acoustic metamaterials. These omni-directional, double-negative, acoustic metamaterials are constructed with 'flute-like' acoustic meta-cluster sets with seven double meta-molecules; these metamaterials also overcome the limitations of broadband negative bulk modulus and mass density to provide a region of negative refraction and inverse Doppler effects. It was also shown that inverse Doppler effects can be detected in a flute, which has been popular for thousands of years in Asia and Europe.

De novo interstitial deletion in the long arm of chromosome 11: a case report

The 11q terminal deletion disorder is a rare genetic disorder associated with numerous clinical features. A few case reports have been made about de novo interstitial deletion of chromosome 11q. However, due to the heterogeneity in size and position of the deletions, a clear genotype-phenotype correlation is not easily made. Here we report a case interstitial 20.5-Mb deletion at chromosome 11q13.4q21, as confirmed by array comparative genomic hybridization. Dysmorphic features such as coarse facial features, congenital laryngomalacia, oblique inguinal hernia, high-arched palate, and camptodactyly were observed in the subject. The present case broadens the spectrum of clinical findings observed in individuals with 11q interstitial deletion.

Association of IL-18 polymorphisms with rheumatoid arthritis: a meta-analysis

Interleukin-18 (IL-18), an important proinflammatory cytokine, has been reported to play a potential pathological role in rheumatoid arthritis (RA). Results from previous studies on the association between IL-18 polymorphisms and RA are conflicting. To clarify this, an updated meta-analysis of all available studies on IL-18 polymorphisms and RA was conducted. Eligible articles were identified by searching databases, including PubMed, Ovid, Cochrane Library, EMBASE, and China Knowledge Resource Integrated Database, for the period up to May 1, 2015. The pooled odds ratios (ORs) with 95% confidence intervals (95%CIs) were used to assess the strength of association in the homozygote, heterozygote, dominant, recessive, and additive models. The software STATA (Version 13.0) was used for statistical analysis. Finally, 14 articles were included in the present meta-analysis. The IL-18 -607C/A polymorphism showed pooled ORs and 95%CIs for the homozygote model (AA vs CC: OR = 0.598; 95%CI = 0.395-0.907), and the association between the IL-18 -137G/C polymorphism and RA showed pooled ORs and 95%CIs for the homozygote (CC vs GG: OR = 0.699; 95%CI = 0.364-1.342) and heterozygote (CG vs GG: OR = 0.924; 95%CI = 0.803-1.064) models. In summary, the current meta-analysis, which was based on the most current studies, showed that the -607A/C, -920C/T, and -105A/C polymorphisms in IL-18 were significantly associated with increased RA risk. However, the -137C/G polymorphism was not associated with RA risk under any genetic model. More evidence is needed to support or deny such a conclusion.

Sevoflurane downregulates interleukin-6 and interleukin-8 levels in patients after cardiopulmonary bypass surgery: a meta-analysis

This study aimed to investigate the effect of sevoflurane on serum levels of interleukin (IL)-6 and IL-8 in patients who underwent cardiopulmonary bypass (CPB). The strength of the association between sevoflurane treatment and serum level of IL-6 and IL-8 was determined in patients who underwent CPB by summary standard mean differences (SMDs); 95% confidence interval (CI) was used. In total, seven case-control studies showed decreased IL-6 and IL-8 levels in sevoflurane-treated patients than in controls (IL-6: SMD = 1.56, 95%CI: 0.95-2.17, P < 0.001; IL-8: SMD = 1.63, 95%CI: 0.30-2.96, P < 0.001, respectively). Further, IL-6 and IL-8 levels were significantly higher in sevoflurane-treated patients than in sevoflurane-pretreated patients (IL-6 post vs pre: SMD = 2.17, 95%CI: 1.40-2.95, P < 0.001; IL-8 post vs pre: SMD = 4.01, 95%CI: 2.80-5.21, P < 0.001, respectively). CPB-stratified analysis showed significant decrease in IL-6 and IL-8 levels in sevoflurane-treated patients than in controls, irrespective of the time after CPB surgery (P < 0.05). Moreover, sevoflurane-pretreated patients under the <12-h subgroup showed decreased IL-6 levels (P = 0.698), while all other subgroups showed decreased IL-8 levels (P < 0.05). Further, subgroup analysis by different dose of sevoflurane showed decreased IL-6 and IL-8 levels in subgroups administered with a dose of <2 and ≥ 2% sevoflurane under the case vs control and pre- vs post-treatment of sevoflurane models. Serum IL-6 and IL-8 levels were significantly lower in sevoflurane-treated patients who underwent CPB, suggesting sevoflurane pretreatment to be more beneficial than post-treatment.

Aetiology of diarrhoeal disease and evaluation of viral-bacterial coinfection in children under 5 years old in China: a matched case-control study

Globally, diarrhoeal diseases are the second leading cause of death among children under 5 years old. Few case-control studies on the aetiology of diarrhoea have been conducted in China. A case-control study on 922 children under 5 years old who presented with diarrhoea and individually matched controls was conducted in China between May 2011 and January 2013. Quantitative PCR was used to analyze stool samples for 10 diarrhoeal pathogens. Potential enteric pathogens were detected in 377 (81.8%) of 461 children with diarrhoea and 215 controls (46.6%, p <0.001). Rotavirus, norovirus GII, Shigella and adenovirus were qualitatively associated with diarrhoea. Using receiver operating characteristic curves, the optimal cutoff threshold for defining a symptomatic individual was 72, 5840, and 10(4) copies per reaction for rotavirus (odds ratio 259), norovirus GII (odds ratio 10.6) and Shigella (odds ratio 5.1). The attributable fractions were 0.18 for rotavirus, 0.08 for norovirus GII, 0.01 for Shigella and 0.04 for adenovirus. Coinfections between pathogens were common. Two pairs, rotavirus and adenovirus, and norovirus GII and Salmonella were positively associated. The co-occurrence of rotavirus and sapovirus, astrovirus, enterotoxigenic Escherichia coli or Campylobacter jejuni only occurred in children with disease. Coinfection was not correlated with clinical symptoms. Quantitative data are critical. Our results indicate that increased pathogen loads increase the OR between diarrhoea and rotavirus, norovirus GII and Shigella. Coinfections with rotavirus and norovirus GII are common and occur in a nonrandom distribution. Despite testing for ten diarrhoeal pathogens, over two-thirds of cases do not have a recognized attributable cause.

Cloning and identification of the ASIP gene in Chinese raccoon dog (Nyctereutes procyonoides procyonoides)

The quantity, quality, and distribution of eumelanin and pheomelanin determine a wide variety of coat colors in animals. Three coat color variants exist in farmed wild-type Chinese raccoon dog (Nyctereutes procyonoides procyonoides), which is an important fur-bearing animal species. The ASIP gene is an important candidate gene for coat color variation in some species. In this study, the complete cDNA sequences of ASIP were amplified from a wild-type Chinese raccoon dog. Sequence analysis revealed the coding region of ASIP in Chinese raccoon dog to be 396-bp in length and two transcripts (accession Nos. KT224450 and KT224451) were identified due to the alternative use of exon 1 (1A and 1C). However, the alternative splicing pattern and the coding sequence of ASIP in three types of coat color variants were the same as those identified in the wild-type individual. Based on the results obtained in this study, we can exclude a role for alternative splicing of exon 1 and the coding sequence of ASIP in coat color variation in Chinese raccoon dog.

Clinical and cytogenetic results of a series of amniocentesis cases from Northeast China: a report of 2500 cases

The aims of this study were to demonstrate the clinical and cytogenetic results of amniocentesis (AS) cases in Northeast China, to compare the incidence of different kinds of chromosomal abnormalities, and to study the association between the detection rate of chromosomal abnormalities and different indications for prenatal diagnosis. Cytogenetic analysis was performed on long-term tissue cultures of 2500 second-trimester amniotic fluid samples. The most common indication for genetic AS was abnormal maternal serum-screening test (69.56%), followed by advanced maternal age (15.04%). Chromosomal abnormality was detected in 206 (8.24%) of the 2500 samples. The detection rate of abnormal karyotypes was 62.5% in the group in which one member of the couple was a carrier of a chromosome abnormality; in the group having a positive result from noninvasive prenatal testing, the frequency was 50%. To determine the origin of fetal chromosome abnormal karyotype, 45 fetuses were analyzed. Of these, 20 were found to be de novo abnormalities and 25 were familial. The frequency and proportion of abnormal karyotypes varied substantially across different maternal AS indications. Knowing the origin and type of chromosomal abnormality would help determine termination or continuation of the pregnancy.

Correlation between chromosomal polymorphisms and male infertility in a Northeast Chinese population

The aim of this study was to evaluate the correlation between chromosomal polymorphisms and male infertility. The patients were diagnosed with azoospermia or oligospermiaby a semen analysis. Chromosomal analysis was performed on peripheral blood lymphocytes obtained from the patients, with standard G-banding and C-banding. Y chromosome microdeletions were detected by multiplex polymerase chain reaction (PCR) amplification. The parents of 35 polymorphic probands were also subjected to chromosomal analysis, and their detailed reproductive histories were surveyed. The frequency of autosomal polymorphisms did not differ significantly among the infertile patients and fertile control individuals. The frequency of the Yqh-variant increased with the decrease in sperm count; this appeared at a significantly higher frequency in the azoospermia group (57.2 vs 24.3 vs 0%). The results of PCR amplification indicated that 32.14% of the patients with Yqh ± had microdeletions in the Y chromosome. The parents of the probands with the same chromosomal polymorphisms as the probands (among the 35 recalled families) did not show any adverse reproductive history. We observed no significant correlations between autosomal polymorphisms and male infertility. However, we observed a significant increase in the frequency of Yqh- in the azoospermic patients. This may be attributed to Y chromosome microdeletions, although the association between Y chromosome microdeletions and Y chromosome variants remains to be elucidated.

Molecular cloning and characterization of GbMECT and GbMECP gene promoters from Ginkgo biloba

Ginkgolides are key pharmaceutical components in Ginkgo biloba. Using the cDNA sequence of the MECP and MECT genes to design primers, we obtained the promoters of these genes from Ginkgo genomic DNA using the genome walking method. The two promoters were 744 and 982 bp in length, respectively. The cis-elements of the GbMECPs and GbMECT promoters were predicted and analyzed using the plant cis-acting regulatory element database. We found major cis-elements in the sequence of the GbMECT and GbMECPs promoters. The GbMECP promoter contains six TATA boxes and eight CAAT boxes. The GbMECT contains five TATA boxes and seven CAAT boxes. Furthermore, some cis-elements in the promoters of GbMECPs and GbMECT included hormone and light-regulated elements, UB-B-induced elements, and stress-related dehydration-responsive elements. Expression analysis results showed that the MECP gene is mainly involved in responses to CCC (cycocel) and UV-B, and that MECT is mainly involved in responses to wounding treatment. These results also showed that the expression model was consistent with the cis-elements present. During the annual growth cycle, the level of GbMECPs was significantly correlated with terpene lactones accumulation in leaves. A fitted quadratic curve showed the best model for correlating GbMECPs with terpene lactones in leaves. These results will help us to understand the transcriptional regulatory mechanisms involved in key gene expression and ginkgolide accumulation in G. biloba.

Cloning and characterization of a benzoic acid/salicylic acid carboxyl methyltransferase gene involved in floral scent production from lily (Lilium 'Yelloween')

In lily flowers, the volatile ester methyl benzoate is one of the major and abundant floral scent compounds; however, knowledge regarding the biosynthesis of methyl benzoate remains unknown for Lilium. In this study, we isolated a benzoic acid/salicylic acid carboxyl methyltransferase (BSMT) gene, LiBSMT, from petals of Lilium 'Yelloween'. The gene has an open reading frame of 1083 base pairs (bp) and encodes a protein of 41.05 kDa. Sequence alignment and phylogenetic analyses of LiBSMT revealed 40-50% similarity with other known benzenoid carboxyl methyltransferases in other plant species, and revealed homology to BSMT of Oryza sativa. Heterologous expression of this gene in Escherichia coli yielded an enzyme responsible for catalyzing benzoic acid and salicylic acid to methyl benzoate and methyl salicylate, respectively. Quantitative real-time polymerase chain reaction analysis showed that LiBSMT was preferentially expressed in petals. Moreover, the expression of LiBSMT in petals was developmentally regulated. These expression patterns correlate well with the emission of methyl benzoate. Our results indicate that LiBSMT plays an important role in floral scent methyl benzoate production and emission in lily flowers.