[Current status and prospects of population exposure assessment of nanomaterials consumer products]

With the wide application of nanomaterials in consumer products in the market, it is necessary to understand the existence and release of nanomaterials in consumer products, as well as the current situation of exposure assessment of consumers. China has been a large industrial producer with a huge consumer market, but the supervision of consumer goods with nanomaterials is almost blank. This article summarized and classified the existing consumer products of nanomaterials in the international market, and discussed the release of key nanomaterials in consumer products and the exposure assessment methods of consumers, in order to provide a scientific basis for the establishment of a regulatory system for consumer products of nanomaterials in China in the future.

[Analysis of clinical characteristics of 49 cases of COVID-19]

Objective: To analyze the epidemiological and clinical characteristics, and imaging features of patients with COVID-19 in Henan Province People's Hospital. Methods: The epidemiology, clinical symptoms, laboratory and radiologic data of 49 patients with COVID-19 infection admitted to the department of infectious disease in our hospital from January 23, 2020 to February 22, 2020 were retrospectively analyzed. All analyses were performed with SPSS software, version 22.0. Results: A total of 49 patients with COVID-19 were enrolled, of which 28 were ordinary, 16 were severe, and 5 were critical in disease severity. The average ages of the 3 groups were (46±19) , (60±16) and (68±20) years, with statistical differences (P=0.015). Common symptoms at the onset were fever (41 patients), dry cough (35 patients), and fatigue (21 patients). Epidemiological investigations found that 31 (63%) patients had direct or indirect contact with confirmed cases, and 14 cases were family clustered. Laboratory test results showed that the lymphocyte counts progressively decreased [0.85 (0.5-1.6) ×10(9)/L,0.51 (0.4-0.9) ×10(9)/L and 0.43 (0.47-0.61) ×10(9)/L, respectively], while LDH [162 (145.1-203.5) U/L,265 (195.3-288.4) U/L and 387 (312.3-415.5) U/L, respectively] and D-dimer [0.15 (0.09-0.40) mg/L,0.4 (0.2-0.6) mg/L and 0.9 (0.5-1.4) mg/L, respectively] were significantly increased (P<0.05), in all the 3 groups. The levels of IL-6 [(43.2±15.4) μg/L, (78.5±31.2) μg/L and (132.4±47.9) μg/L, respectively] and IL-10 [(3.5±3.2) μg/L, (7.6±6.4) μg/L and (9.4±7.2) μg/L respectively] increased significantly with disease severity. Pulmonary imaging of ordinary patients mainly showed unilateral or bilateral multiple infiltrates, while severe and critically ill patients showed diffuse exudation and consolidation of both lungs, and a few patients showed signs of "white lungs". Conclusions: Patients with COVID-19 has a definite history of contact with diagnosed patients, and has family aggregation. The clinical symptoms were mainly fever and dry cough. Laboratory results showed that lymphocyte count, LDH, D-dimer, interleukin-6 and interleukin-10 levels had a significant correlation with the severity of the disease, which could be used as markers for disease progression and prognosis. Pulmonary imaging showed unilateral or bilateral ground glass infiltration. In severe and critically ill patients, diffuse infiltration and consolidation or even "white lung" were present.

[Predictors for perioperative blood loss in pediatric patients with congenital scoliosis]

Objective: To identify predictors of massive blood loss after posterior hemivertebra resection for patients with congenital scoliosis. Methods: The data of 106 children with congenital scoliosis were collected from June 2017 to June 2019 in Beijing Children's Hospital. All the cases received posterior hemivertebra resection and internal fixation. The blood volume was estimated by weight and height. The visible blood loss was recorded according to medical record, and the hidden blood loss was calculated by OSTHEO formula. Perioperative information including age, gender, height, weight, Cobb and kyphosis angle, level fused, number of screws, operative time, and laboratory examinations was collected. Then multivariable linear regression was performed to determine the independent risk factors of blood loss. Results: All the surgeries were completed successfully. The mean age of the children was (7.3±2.3) years and the operative time was (162±56) min. The mean fused levels were 3 and the correction rate for deformity was 78.4%. The amount of blood loss was (568±208) ml which accounted for 42.3% of total blood volume. The visible and hidden blood loss was (334±193) ml and (234±199) ml, respectively, and which accounted for 58.8% and 41.2% of total blood loss. Multivariable linear regression analysis indicated that age, preoperative Cobb angle, the time of surgery and the number of fused levels were independent risk factors of total blood loss. Preoperative Cobb angle ≥40°, spinal fusion ≥4 levels and operative duration ≥140 min indicated more blood loss (all P<0.05). Conclusions: The perioperative blood loss of congenital scoliosis is massive with a high percentage of hidden blood loss. The patients with severe deformity, more fused levels and increased operative time brings higher risk of massive blood loss.

Diagnostic development for parallel wave-number measurement of lower hybrid waves in EAST

An eight-channel magnetic probe diagnostic system has been designed and installed adjacent to the 4.6 GHz lower hybrid (LH) grill antenna in the low-field side of the Experimental Advanced Superconducting Tokamak (EAST) in order to study the n_∥ evolution of LH waves in the first pass from the launcher to the core plasma. The magnetic probes are separated by 6.6 mm, which allows measurement of the dominant parallel refractive index n_∥ up to n_∥ = 5 for 4.6 GHz LH waves. The magnetic probes are designed to be sensitive to the magnetic field component perpendicular to the background magnetic field with a slit on the casing that encloses the probe. The intermediate frequency stage, which consists of two mixing stages, down-coverts the frequency of the measured wave signals at 4.6 GHz to 20 MHz. A bench test demonstrates the phase stability of the magnetic probe diagnostic system. By evaluating the phase variation of the measured signals along the background magnetic field, the dominant n_∥ of the LH wave in the scrape-off layer has been deduced during the 2019 experimental campaign. In the low density plasma, the measured dominant n_∥ of the LH waves is about 2.1, corresponding to the main peak 2.04 of the launched n_∥ spectrum. n_∥ deduced by the least-squares linear fit method remains near this value in the low density plasma with a high spatial correlation magnitude of 0.9. With an eight-channel probe system, a wave-number spectrum has also been deduced, which has a peak near to the measured dominant n_∥.

Metabolomic Insights Into the Synergistic Effect of Biapenem in Combination With Xuebijing Injection Against Sepsis

The drug combination of biapenem (BIPM) and xuebijing injection (XBJ) is commonly applied for the treatment of sepsis in China. However, the potential synergistic mechanism is still enigmatic. There have been no studies focused on the plasma metabolome alterations in sepsis after the intervention of this combination. In this work, an untargeted metabolomics approach was performed by liquid chromatography-mass spectrometry coupled with multivariate statistical analysis to provide new insights into the synergistic effect of BIPM in combination with XBJ. We characterized the metabolic phenotype of sepsis and described metabolic footprint changes in septic rats responding to XBJ and BIPM individually and in combination, in addition to histopathological and survival evaluation. A total of 91 potential biomarkers of sepsis were identified and 32 disturbed metabolic pathways were constructed. Among these biomarkers, 36 metabolites were reversely regulated by XBJ, mainly including glycerophospholipids, sphingolipids, free fatty acids (FFAs), bile acids and acylcarnitines; 42 metabolites were regulated by BIPM, mainly including amino acids, glycerophospholipids, and acylcarnitines; 72 metabolites were regulated after XBJ-BIPM combination treatment, including most of the 91 potential biomarkers. The results showed that the interaction between XBJ and BIPM indeed exhibited a synergistic effect by affecting some key endogenous metabolites, 15 metabolites of which could not be regulated when XBJ or BIPM was used alone. Compared with Model group, 13, 22, and 27 metabolic pathways were regulated by XBJ, BIPM, and XBJ-BIPM combination, respectively. It suggested that many more endogenous metabolites and metabolic pathways were significantly regulated after combination treatment compared with XBJ or BIPM monotherapy. Metabolisms of lipids, amino acids, acylcarnitines, and bile acids were common pathways involved in the synergistic action of XBJ and BIPM. This study was the first to employ metabolomics to elucidate the synergistic effect and decipher the underlying mechanisms of BIPM in combination with XBJ against sepsis. The results provide some support for clinical application of antibiotics in combination with traditional Chinese medicines and have important implications for the treatment of sepsis in clinic.

[Citrate anticoagulation hemoperfusion in the treatment of 273 patients]

Early hemoperfusion in poisoned patients can remove poisons rapidly and effectively, which plays an important role in improving the prognosis of patients. The key of hemoperfusion therapy is the safe and effective anticoagulation. The local citrate anticoagulation effect acid is good, it also has little effect on the systemic coagulation mechanism and internal environment of patients, so it is worthy of promotion. We retrospectively analyzed the clinical data and treatment of 273 patients who were poisoned by citrate anticoagulant in the emergency intensive care unit of the Second Affiliated Hospital of Shandong First Medical University, aiming at perfusion of citrate anticoagulant in patients with poisoning. Provide a certain clinical reference.

[Clinicopathological characteristics and therapeutic effects of adult rhabdomyosarcoma patients]

Objective: This study aimed to investigate the clinicopathological characteristics and prognosis of adult rhabdomyosarcoma (RMS) patients. Methods: The clinical data of 34 adult RMS patients were retrospectively analyzed. Based on their intervention and treatment, patients were divided into operation group (n=7), chemotherapy group (n=8) and operation plus chemotherapy group (n=19). The clinical characteristics and treatment outcomes of the three groups were compared. Results: A statically significant difference was found in IRSG surgical-pathological stage among the three groups (P=0.026), while no significant difference existed in gender, age of disease onset, primary site, tumor size, pathological subtypes and IRSG risk group in the three groups (all P>0.05). In the operation group, three CR, one PR, one SD and two PD were achieved and one CR, one PR, one SD and five PD were obtained in the chemotherapy group. While in the chemotherapy plus operation group, four CR, twelve PR, one SD and two PD were achieved. A significant difference was found in response (P=0.043) and median overall survival (OS) (P=0.036) among the three groups, which were 44.7, 26.9 and 53.6 months, respectively. Conclusions: Pleomorphic RMS was the main histological subtype for adult RMS patients, and the prognosis for adult RMS was usually poorer than that for pediatric RMS patients. Single therapeutic approach could not achieve satisfactory outcomes, while multimodal treatment consisted of surgery, chemotherapy and radiotherapy are helpful to improve the prognosis of adult patients with RMS.

[Interaction of notch signaling pathway with toll-like receptor 4 on the function of CD14+ monocytes in chronic hepatitis C patients]

Objective: To observe the expressional changes in Notch signaling pathway and toll-like receptor 4 (TLR4) and their interactions on the functions of CD14(+) monocytes in chronic hepatitis C patients. Methods: A total of 24 treatment-naïve chronic hepatitis C cases and 10 healthy individuals, who visited Shaanxi Provincial People's Hospital from August to October 2017, were enrolled. Selected CD14(+) monocytes were stimulated by the Notch signaling pathway inhibitor DAPT or transfected with TLR4 siRNA, and the levels of Notch1, Notch2, Hes1 and Hes5 mRNA were detected by real-time quantitative PCR. TLR4 protein levels and phosphorylation of NF-κB was detected by Western blot. ELISA was used to detect the level of cytokines secreted from CD14(+) monocytes. A t-test or paired t-test was used for comparison between groups. Results: The relative expression of Notch1 mRNA (3.97 ± 2.03 vs. 0.91 ± 0.76, P < 0.01) and downstream of Notch signaling pathway (5.96 ± 2.31 vs. 0.99 ± 0.45, P < 0.01), Hes1 mRNA and Hes5 mRNA (4.31 ± 1.05 vs. 0.84 ± 0.20, P < 0.01) in CD14+ monocytes of chronic hepatitis C patients was significantly higher than that of healthy individuals. The relative expression of TLR4 mRNA (5.14 ± 1.09 vs. 1.27 ± 0.39) and protein level in CD14(+) monocytes of chronic hepatitis C patients were significantly higher than those of healthy individuals (P < 0.01). An inhibition of Notch signaling pathway with DAPT had reduced the relative expression level of TLR4 mRNA (2.58 ± 1.36 vs. 4.34 ± 1.88, P < 0.05), protein expression and phosphorylation of NF-B in CD14(+) monocytes of chronic hepatitis C patients. Furthermore, the secretion level of MCP-1 [(94.32 ± 23.59) pg/ml vs. (64.07 ± 9.39) pg/ml, P < 0.01] and IL-8 [(12.54 ± 4.89) pg/ml vs. (7.92 ± 3.01) pg/ml, P < 0.05] was significantly reduced. TLR4 siRNA transfection reduced the expressions of Notch1 mRNA (2.09 ± 1.72 vs. 3.73 ± 1.75, P < 0.05), Hes1 (2.87 ± 0.84 vs. 5.54 ± 0.97, P < 0.01), and Hes5 (2.89 ± 0.93 vs. 4.51 ± 1.54, P < 0.01) in CD14(+) monocytes of chronic hepatitis C patients. Conclusion: Interaction of Notch signaling pathway with TLR4 can promote the function of CD14(+) monocytes in chronic hepatitis C patients.

Production of tert-butyl (3R,5S)-6-chloro-3,5-dihydroxyhexanoate using carbonyl reductase coupled with glucose dehydrogenase with high space-time yield

tert-Butyl (3R,5S)-6-chloro-3,5-dihydroxyhexanoate ((3R,5S)-CDHH) is an important chiral intermediate for the synthesis of rosuvastatin. The biotechnological production of (3R,5S)-CDHH is catalyzed from tert-butyl (S)-6-chloro-5-hydroxy-3-oxohexanoate ((S)-CHOH) by a carbonyl reductase, and this synthetic pathway is becoming a primary route for (3R,5S)-CDHH production due to its high enantioselectivity, mild reaction conditions, low cost, process safety, and environmental friendship. However, the requirement of the pyridine nucleotide cofactors, reduced nicotinamide adenine dinucleotide (NADH) or reduced nicotinamide adenine dinucleotide phosphate (NADPH) limits its economic flexibility. In the present study, a recombinant Escherichia coli strain harboring carbonyl reductase R9M and glucose dehydrogenase (GDH) was constructed with high carbonyl reduction activity and cofactor regeneration efficiency. The recombinant E. coli cells were applied for the efficient production of (3R,5S)-CDHH with a substrate conversion of 98.8%, a yield of 95.6% and an enantiomeric excess (e.e.) of >99.0% under 350 g/L of (S)-CHOH after 12 hr reaction. A substrate fed-batch strategy was further employed to increase the substrate concentration to 400 g/L resulting in an enhanced product yield to 98.5% after 12 hr reaction in a 1 L bioreactor. Meanwhile, the space-time yield was 1,182.3 g L^-1 day^-1 , which was the highest value ever reported by a coupled system of carbonyl reductase and glucose dehydrogenase.

Polyphyllin VI induces apoptosis and autophagy in human osteosarcoma cells by modulation of ROS/JNK activation

Purpose

Polyphyllin VI, a main active saponin isolated from traditional medicinal plant Paris polyphylla, has exhibited antitumor activities in several cancer cell lines. In the present study, we investigated the antitumor effect of Polyphyllin VI against human osteosarcoma cells (U2OS) and the underlying molecular mechanisms.

Methods

The U2OS cell lines were used to determine the antiproliferative effect of Polyphyllin VI by CCK8 assay. Cell cycle was analyzed by flow cytometry. The Polyphyllin VI-induced apoptosis was determined by Annexin V-APC/7-AAD apoptosis detection kit and JC-1 staining. Meanwhile, the autophagy was determined by acridine orange staining. The apoptosis and autophagy-related proteins were monitored by Western blot assay. Subsequently, intracellular hydrogen peroxide (H₂O₂) and the activation of ROS/JNK pathway were detected.

Results

Polyphyllin VI could potently inhibit cell proliferation by causing G2/M phase arrest. Polyphyllin VI induced mitochondria-mediated apoptosis with the upregulation of proapoptotic proteins Bax and poly ADP-ribose polymerase, and downregulation of antiapoptotic protein Bcl-2 in U2OS cells. Concomitantly, Polyphyllin VI provoked autophagy with the upregulation of critical Atg proteins and accumulation of LC3B-II. Intracellular H₂O₂ production was triggered upon exposure to Polyphyllin VI, which could be blocked by ROS scavenger. Polyphyllin VI dramatically promoted JNK phosphorylation, whereas it decreased the levels of phospho-p38 and ERK.

Conclusion

Our results reveal that Polyphyllin VI may effectively induce apoptosis and autophagy to suppress cell growth via ROS/JNK activation in U2OS cells, suggesting that Polyphyllin VI is a potential drug candidate for the treatment of osteosarcomas.

[Interfacility transport with extracorporeal membrane oxygenation in pediatric patients: a multicenter study in China]

Objective: To investigate application and safety of pediatric interfacility-transport with extracorporeal membrane oxygenation (ECMO) in China. Methods: The data of 48 patients transported inter-hospital from February 2016 to May 2018 were collected from the following 4 centers: pediatric intensive care unit (PICU) of Bayi Children's Hospital Affiliated to the 7th Medical Center of PLA General Hospital, Pediatric Hospital of Fudan University, Henan Provincial People's Hospital and Children's Hospital of Zhejiang University School of Medicine. The data of patients' characteristics, ECMO mode and wean rate, and mortality were reviewed, which was further compared with the data of 57 compatible inner-hospital ECMO cases with t test, Rank sum test or chi-square test. Results: All the 48 interfacility-transports were accomplished by ambulance on land, with an average transfer distance of (435±422) km. The incidence of ECMO complications was 13% (6 case), without death. There were no significant differences in lactic acid, PaO(2) or SaO(2) before and after transport (4.0 (2.0, 7.5) vs. 3.0 (1.5, 6.0) mmol/L, Z=-1.579, P>0.05; 112(47, 405) vs. 166(122, 240) mmHg (1 mmHg=0.133 kPa), Z=-0.104, P>0.05; 0.97±0.02 vs. 0.96±0.03, t=1.570, P>0.05). Instead, PaCO(2) and pH were significantly different ((47±8) vs. (42±5) mmHg, t=2.687, P<0.05; 7.3±0.2 vs. 7.5±0.2, t=3.379, P<0.05). The total ECMO weaned rate was 73% (35/48) and the survival rate was 67% (32/48). No significant differences in demographic characteristics, ECMO mode or duration, transport distance or duration, or complications existed between the survival group and the death group (7/25 vs. 2/14, χ(2)=0.615, P>0.05; 4/28 vs. 2/14, χ(2)=0, P>0.05; (405±404) vs. (493±465) km, t=0.525, P>0.05; (5±4) vs. (5±5) h, t=0.388, P>0.05; 166 (128, 239) vs. 187(52, 405) h, Z=-0.104, P>0.05; 3/32 vs. 3/16, χ(2)=0.734, P>0.05). The lowest lactate value in survival group before ECMO transport was significantly lower than that in the death group ((5±5) vs. (8±6) mmol/L, t=2.151, P<0.05). There were neither significant differences in age, ECMO mode or support pattern (9/39 vs. 15/42, χ(2)=0.845, P>0.05; 6/42 vs. 7/50, χ(2)=0.001, P>0.05; 29/19 vs. 38/19, χ(2)=0.441, P>0.05), nor in ECMO weaned rate, survival rate or complications between interfacility-transport group and inner-hospital group (35/48 vs. 37/57, χ(2)=0.775, P>0.05; 32/48 vs. 35/57, χ(2)=0.313, P>0.05; 20/48 vs. 22/57, χ(2)=0.102, P>0.05). Conclusion: With appropriate transport equipment and mature teams who handle problems timely during the transport, critically ill children could be safely transported to the destination with ECMO.

[Canalplasty: surgical technique and analysis of the results]

Objective:To determine the applications and results of canalplasty for closed middle ear surgery.Method:Charts of 74 ears who underwent a canalplasty and closed middle ear surgery because of chronic otitis media or middle ear cholesterol granuloma between 2012 and 2016 were reviewed for general condition, disease, surgery methods,surgical outcome,complications,results of pure tone audiometry pre-and post-operatively.Result:Sixteen(21.6%) ears have some problems of their anterior ligament of malleus.Post-operative there are 69 ears totally epithelization, of which the rate is 93.2%,and the average epithelization time is 5.3 weeks. The myringoplasties are successful on 72 ears(97.3%).There are 5 ears(6.8%) occurring complications relating to canalplasty.One year after surgery the air-bone gap has decreased by 8 dB, which has been improved significantly than pre-operative(P<0.05).Conclusion:This study shows that technique for canalplasty is safe and effective,which can exposure the whole tympanic membrane and is easy for tympanoplasty. The epithelization rate of our technique is high.And it's good for myringoplasty and hearing outcomes.

[Application of multimode MRI in prediction of nuclear grade of clear cell renal cell carcinoma]

Objective: To investigate the predictive value of multimode MRI features for nuclear grade of clear cell renal cell carcinoma (ccRCC). Methods: From January 2016 to October 2017, 381 patients (387 tumors) with ccRCC proven by pathology in Chinese PLA General Hospital First Medical Center were enrolled (male 293, female 88, age 24-87 years old). The clinical and imaging data of these patients were retrospectively analyzed, including clinical information (gender, age, BMI, smoke, hypertension) and preoperative renal MRI. Pre-and post-contrast MRI features were subjectively scored. The largest diameter of each lesion was measured. Two-sample t-test,Chi-squared test and binuary Logistic regression analysis were used to evaluate the predictive efficacy of clinical and MRI data. Results: According to WHO/ISUP nuclear grade system,all ccRCCs (n=387) were divided into low grade (n=322) and high grade group (n=65). Between two groups, there were significant differences in age and diameter((54±12) vs (59±10) years old, P=0.001; (4.1±2.2) vs (6.2±3.0) cm, P<0.01). In MRI scores,there were significant differences in scores of pseudocapsule, shape and margin,hemorrhage,enhancement degree,cystic-solid,intratumoral vessel,peritumoral vessel, renal sinus invasion, vein thrombosis, lymphadenopathy, necrosis, perinephric invasion and metastasis, DWI signal intensity between high grade group and low grade group (all P<0.01). Binuary Logistic regression analysis showed that shape and margin, enhancement degree and DWI signal intensity were independent predictors for high grade ccRCC (OR=0.181, 95%CI 0.049-0.666; OR=0.393, 95%CI 0.182-0.846; OR=0.336, 95%CI 0.155-0.728). A nomogram model for predicting the risk of high grade ccRCC was constructed. Conclusions: Multimode MRI features can differentiate low grade and high grade ccRCC. The nomogram developed in this study might aid urologist in the pre-operative prediction of nuclear grade of ccRCC,which might contribute to developing treatment strategy.

[Practice and application of enhanced recovery after surgery in perioperative period of liver operation]

Objective: To investigate the feasibility and safety of enhanced recovery after surgery (ERAS) in perioperative period of liver operation. Methods: One hundred and sixty-six patients who underwent liver operation were enrolled as control group, and additional 170 patients were chosen as ERAS group. Preoperative and postoperative indexes of the two groups were compared. Results: Compared with the control group, patients in ERAS group had higher preoperative enteral nutrition support rate, lower incidence of thirst and hunger, earlier initial postoperative feeding, higher prophylactic analgesia rate, lower incidence of outbreak pain, more daily activities, lower incidence of abdominal distention and shorter hospitalization days (all P<0.05). Conclusion: Application of enhanced recovery after surgery on perioperative nursing care in elective liver surgical patients is safe, and it can relieve patients' perioperative discomfort and accelerate postoperative rehabilitation.

Microglia M1/M2 polarization contributes to electromagnetic pulse-induced brain injury

The development of electronic technology has attracted attention on the biological effects of electromagnetic fields (EMFs) and electromagnetic pulse (EMP). It remains controversial whether EMP irradiation is neurotoxic or beneficial for recovery from injuryies such as cerebral ischemia. Microglia is innate immune cells in the brain, exhibiting either neurotoxicity or neuroprotection effect during various central nervous system diseases, depending on their activation into a classical (M1) or alternative (M2) phenotype, respectively. The Toll-like receptor-4 (TLR4), myeloid differentiation factor 88 (MyD88) and nuclear factor kappa B (NFκB) pathway is important for microglia activation. In this study, we investigated the effect of EMP on neuronal apoptosis and microglia polarization in vivo and in vitro, using an EMP of 400 kV/m and 1 hertz for 200 pulses. Short EMP irradiation (≤24 h) resulted in microglial conversion from the resting to the M1-type state, activation of the TLR4/MyD88/NFκB pathway, higher levels of inflammatory cytokines including interleukin (IL)-6, IL-1β and tumor necrosis factor-α, as well as neuronal apoptosis induction. In contrast, long EMP irradiation (3 days) resulted in microglial activation into the M2-type, decreased apoptosis and inflammatory mediator production, and increased levels of the neuroprotective effectors IL-10, transforming growth factor beta, and brain-derived neurotrophic factor. EMP induces both neuronal damage and neuronal recovery by influencing the switch of M1/M2 polarization and the TLR4/MyD88/NFκB pathway.

Ion cyclotron emission diagnostic system on the experimental advanced superconducting tokamak and first detection of energetic-particle-driven radiation

A passive and noninvasive diagnostic system based on high-frequency B-dot probes (HFBs) has been designed and developed for the measurement and identification of ion cyclotron emission (ICE) in the Experimental Advanced Superconducting Tokamak (EAST). Details of the hardware components of this system including HFBs, direct current blockers, radio frequency splitters, filters, and power detectors as well as data acquisition systems are presented. A spectrum analyzer is used in addition to the ordinary speed acquisition card for data registration and analysis. The reliability of a HFB based diagnostic system has been well validated during the 2018 spring experiments on the EAST. ICE signals corresponding to fundamental cyclotron frequency of hydrogen ions and harmonics of deuterium ions were observed in experiments where deuterium plasmas were heated with deuterium neutral beams. The field dependence of ICE has been verified by recent experiments with three different background magnetic fields. The observed ratio of the ICE frequency is consistent with the ratio of the magnetic field intensity within measurement errors of a few percent.

[Effect of esmolol in septic shock patients with tachycardia: a randomized clinical trial]

Objective: To investigate the effect of esmolol in septic shock patients with tachycardia. Methods: A prospective randomized controlled trial was conducted. Screening septic shock patients that admitted to Department of General Intensive Care Unit of the First Affiliated Hospital of Zhengzhou University from June 2016 to August 2017. After 24 h resuscitation therapy, 100 cases of septic shock patients with tachycardia (heart rate>100 bpm) were divided into esmolol group (n=50) and control group (n=50) with random number table. Patients in esmolol group accepted standard treatment plus esmolol injection with an initial dose of 25 mg/h. Heart rate target is 80 to 100 bpm. Patients in esmolol group continued to use esmolol for 7 days or to the day the patient left the ICU when the heart rate didn't achieve the target. Patients in control group were given standard treatment. Primary outcome was 28 d mortality. Secondary outcomes included heart rate, norepinephrine dosages, lactate level, inflammatory markers in per day during the trial; acute physiology and chronic health evaluation (APACHE Ⅱ) and sequential organ failure assessment (SOFA) on day 1, 3, 5, 7; length of hospital stay, length of mechanical ventilation, medication time of vasoactive agent. The data were compared with t test or rank sum test between the two groups. Results: The 28 d mortality of esmolol group and control group was 62%, 68%, respectively(χ(2)=0.529, P=0.529). Logistic regression analysis showed that primary heart rate (increase of 10 bpm, OR=1.568, 95%CI: 1.039-1.238, P=0.027), primary APACHEⅡ (OR=1.134, 95%CI: 1.026-1.239, P=0.005), integral heart rate (per 10 bpm, OR=2.207, 95%CI: 1.400-3.479, P=0.001) were independent risk factors for 28 d mortality. Compared with control group, the esmolol group had a lower heart rate on day 1-7; but over all, there was no statistically significant difference in heart rate between the two groups (P>0.05). There was no significant difference in total does of norepinephrine, lactate level, inflammatory markers, APACHE Ⅱ, SOFA, length of hospital stay between the two groups (all P>0.05). Conclusion: Tachycardia significantly increases the risk of death in patients with septic shock, esmolol may decrease the mortality by controlling heart rate.

TT genotype of rs10036748 in TNIP1 shows better response to methotrexate in a Chinese population: a prospective cohort study

BACKGROUND

Methotrexate (MTX) is an efficacious treatment for psoriasis; however, its widespread application is limited by its unpredictable efficacy.

OBJECTIVES

To investigate the association of clinical factors and variants of psoriasis susceptibility genes with clinical responses to MTX in a prospective cohort.

METHODS

A total of 221 patients with psoriasis were recruited. Patients who achieved Psoriasis Area and Severity Index (PASI) improvement ≥ 75% at week 12 were defined as responders, whereas those with PASI improvement < 50% were defined as nonresponders. In 90 screening patients, genetic variants for 18 single-nucleotide polymorphisms in 14 susceptibility genes, and HLA-Cw6 status were initially compared for responders and nonresponders. Statistically significant associations in genetic variants were verified in all 221 patients.

RESULTS

Overall, 49% and 45% of patients achieved PASI 75 improvement during screening and verification stages, respectively. Concomitant arthritis with psoriasis and high body mass index (BMI) negatively affect the efficacy of MTX. TT genotype of rs10036748 in TNIP1 was significantly associated with PASI 75 response at week 12 (54% and 37%, P < 0·05). A significantly higher PASI 90 response was observed in patients with TT genotype of rs10036748 (27% vs. 12%, P < 0·01) and TC/TT genotype of rs4112788 in LCE3D (25% vs. 13%, P < 0·05) at week 12 compared with those who had other genotypes. After adjustment for all confounding factors, only BMI (P < 0·05), arthritis (P < 0·05) and genotype of rs10036748 (P < 0·05) were significantly associated with clinical responses to MTX.

CONCLUSIONS

Patients with psoriasis with TT genotype of rs10036748 in TNIP1, with lower BMI, without arthritis will achieve a better response to MTX.

[Three-level logistic analysis related to influencing factors on condom use among female sex workers aged 35 years and above in Qingdao]

Objective: To analyze the influencing factors on condom use among 35-years-or-older female sex workers (OFSWs) in Qingdao by using the three-level logistic model. Methods: From March to June 2014, OFSWs were recruited in Qingdao, using respondent-driven sampling. Related information on OFSWs and their recent five sexual partners (not including husband) were obtained by conducting a questionnaire survey on OFSWs. A Three-level logistic regression model was conducted to analyze the influencing factors of condom use between OFSWs and their sexual partners. Results: A total of 420 OFSWs participated the survey as well as information on 2 100 sexual partners. Results from the empty model showed that the use of condoms among OFSWs having an aggregation that related to the levels of working sites and their own behaviors. Results from the three-levels of logistic model analysis showed that, OFSWs that having had junior middle school education (OR=1.450, 95%CI: 1.054-1.994)/high school education or above (OR=2.264, 95%CI: 1.215-4.222), knowing the function of condom use (OR=2.004, 95%CI: 1.273-3.154) would have higher rates of condom use. OFSWs with higher score of attitude on condom use (OR=0.796, 95%CI: 0.745-0.849), having had syphilis infections in the past (OR=0.657, 95%CI: 0.478-0.902) would have lower rate of condom use. For the sexual partners, the rate of condom use among OFSWs' regular partners were higher than that of OFSWs' boyfriends (OR=15.291, 95%CI: 8.441-27.700; OR=29.032, 95%CI: 15.413-54.682). Conclusion: Condom use of OFSWs was affected by behaviors of both OFSWs themselves and their sexual partners. Prevention and control programs should focus on OFSWs and their sexual partners at the same time. The key intervention contents should include target populations as: OFSWs with low level of education, having had infections of syphilis, those who do not use condoms with their trusted partners.

[Significance of pelvic contrast enhanced MRA prior to prostatic artery embolization]

Objective: To assess the values of pelvic contrast enhanced magnetic resonance angiography (MRA) in detection of prostatic artery prior to prostatic arterial embolization(PAE). Methods: This multicenter, prospective study from 5 hospitals in China consisted of 47 patients (mean age (69±16) years, range 56-83 years) who underwent PAE for benign prostatic hyperplasia (BPH) between January 2016 and April 2018, preprocedural prediction of prostatic arteries were determined using contrast enhanced MRA.CE-MRA findings were compared with subsequent intraprocedural digital subtraction angiography (DSA) or DSA combined with cone-beam computed tomography (CT) to assess the sensitivity and specificity with which contrast enhanced MRA predicted the number and origins of prostatic artery, also to assess the optimal oblique projection of PA. Results: In total, 47 patients (94 pelvic sides) with 97 PAs confirmed by DSA or DSA combined with cone-beam CT at the time of embolization, MR angiography successfully identified 88 PAs and their origins , the sensitivity and specificity was 90.7% (88/97) and 93.6% (88/94), respectively.MR angiography correctly determined the bilateral prostatic artery origins in 36 (76.6%) cases.According to the optimal oblique projection of PAs suggested by MR angiography, the origins and trajectory of PAs of all patients underwent PAE with the same oblique projection (20°-45°ipsilateral anterior oblique direction) were clearly displayed when performed the first arteriography. Conclusion: Pelvic contrast enhanced MR angiography with high sensitivity and specificity in detection the origin, trajectory and number of PAs, and it could provide useful information regarding prostatic arteries before PAE.