Measurement of Proton Electromagnetic Form Factors in e^{+}e^{-}→pp[over ¯] in the Energy Region 2.00-3.08 GeV

The process of e^{+}e^{-}→pp[over ¯] is studied at 22 center-of-mass energy points (sqrt[s]) from 2.00 to 3.08 GeV, exploiting 688.5  pb^{-1} of data collected with the BESIII detector operating at the BEPCII collider. The Born cross section (σ_{pp[over ¯]}) of e^{+}e^{-}→pp[over ¯] is measured with the energy-scan technique and it is found to be consistent with previously published data, but with much improved accuracy. In addition, the electromagnetic form-factor ratio (|G_{E}/G_{M}|) and the value of the effective (|G_{eff}|), electric (|G_{E}|), and magnetic (|G_{M}|) form factors are measured by studying the helicity angle of the proton at 16 center-of-mass energy points. |G_{E}/G_{M}| and |G_{M}| are determined with high accuracy, providing uncertainties comparable to data in the spacelike region, and |G_{E}| is measured for the first time. We reach unprecedented accuracy, and precision results in the timelike region provide information to improve our understanding of the proton inner structure and to test theoretical models which depend on nonperturbative quantum chromodynamics.

Measurement of the Cross Section for e^{+}e^{-}→Ξ^{-}Ξ[over ¯]^{+} and Observation of an Excited Ξ Baryon

Using a total of 11.0  fb^{-1} of e^{+}e^{-} collision data with center-of-mass energies between 4.009 and 4.6 GeV and collected with the BESIII detector at BEPCII, we measure fifteen exclusive cross sections and effective form factors for the process e^{+}e^{-}→Ξ^{-}Ξ[over ¯]^{+} by means of a single baryon-tag method. After performing a fit to the dressed cross section of e^{+}e^{-}→Ξ^{-}Ξ[over ¯]^{+}, no significant ψ(4230) or ψ(4260) resonance is observed in the Ξ^{-}Ξ[over ¯]^{+} final states, and upper limits at the 90% confidence level on Γ_{ee}B for the processes ψ(4230)/ψ(4260)→Ξ^{-}Ξ[over ¯]^{+} are determined. In addition, an excited Ξ baryon at 1820  MeV/c^{2} is observed with a statistical significance of 6.2-6.5σ by including the systematic uncertainty, and the mass and width are measured to be M=(1825.5±4.7±4.7)  MeV/c^{2} and Γ=(17.0±15.0±7.9)  MeV, which confirms the existence of the J^{P}=3/2^{-} state Ξ(1820).

[Association of glycosylated hemoglobin level at admission with outcomes of intracerebral hemorrhage patients]

Objective: To explore the association of the glycosylated hemoglobin (HbA1c) level at admission with 90 days functional outcome in patients with spontaneous intracerebral hemorrhage (ICH). Methods: Patients admitted to the Department of Neurology, Tongji Hospital from January to December 2017 were prospectively and continuously enrolled in this study. Clinical data were collected at admission and functional outcomes 90 days after ICH were assessed by using the modified RANKIN scale. Univariate and multivariate conditional logistic regression models were constructed. Patients were divided into four groups according to the quartile of HbA1c values. The median value of HbA1c in each group was taken as the substitute value and P for trend was calculated. The logistic regression model was fitted by restricted cubic splines to investigate the association between HbA1c level and outcome of ICH. Results: A total of 345 patients with ICH were enrolled, including 214 with favorable outcomes and 131 with poor outcomes (99 severe disability cases and 32 deaths). The risk of poor 90 days outcomes was significantly associated with HbA1c level at admission indicated by multivariate logistic regression analysis, and the P for trend test was <0.001 (middle-level group vs. low-level group: OR=2.33, 95%CI: 1.07-5.07; high-level group vs. low-level group: OR=2.52, 95%CI: 1.12-5.64; extremely high-level group vs. low-level group: OR=6.80, 95%CI: 3.01-15.34). Results from the restricted cubic spline showed that there was a linear correlation between HbA1c level at admission and poor 90 days outcomes of ICH (χ(2)=14.81, P<0.001; non- linear test: P=0.118). Compared with patients with HbA1c level of 6.5%, the risk of poor outcomes in patients with HbA1c level of <6.5% decreased linearly with the decrease in HbA1c level at admission, and the risk in patients with HbA1c level >6.5% was higher but not significantly. Conclusion: There was correlation between high HbA1c level at admission and 90 days poor outcome of ICH. High HbA1c level is an independent prediction indicator for ICH.

Observation of the Semileptonic D^{+} Decay into the K[over ¯]_{1}(1270)^{0} Axial-Vector Meson

By analyzing a 2.93  fb^{-1} data sample of e^{+}e^{-} collisions, recorded at a center-of-mass energy of 3.773 GeV with the BESIII detector operated at the BEPCII collider, we report the first observation of the semileptonic D^{+} transition into the axial-vector meson D^{+}→K[over ¯]_{1}(1270)^{0}e^{+}ν_{e} with a statistical significance greater than 10σ. Its decay branching fraction is determined to be B[D^{+}→K[over ¯]_{1}(1270)^{0}e^{+}ν_{e}]=(2.30±0.26_{-0.21}^{+0.18}±0.25)×10^{-3}, where the first and second uncertainties are statistical and systematic, respectively, and the third originates from the input branching fraction of K[over ¯]_{1}(1270)^{0}→K^{-}π^{+}π^{0}.

Observation of the Leptonic Decay D^{+}→τ^{+}ν_{τ}

We report the first observation of D^{+}→τ^{+}ν_{τ} with a significance of 5.1σ. We measure B(D^{+}→τ^{+}ν_{τ})=(1.20±0.24_{stat}±0.12_{syst})×10^{-3}. Taking the world average B(D^{+}→μ^{+}ν_{μ})=(3.74±0.17)×10^{-4}, we obtain R_{τ/μ}=Γ(D^{+}→τ^{+}ν_{τ})/Γ(D^{+}→μ^{+}ν_{μ})=3.21±0.64_{stat}±0.43_{syst}., which is consistent with the standard model expectation of lepton flavor universality. Using external inputs, our results give values for the D^{+} decay constant f_{D^{+}} and the Cabibbo-Kobayashi-Maskawa matrix element |V_{cd}| that are consistent with, but less precise than, other determinations.

[Clinical value of MRI in the diagnosis of Brucellosis spondylitis]

Objective: To analyze the MRI characteristics of Brucellosis spondylitis (BS) and evaluate the clinical value of MRI in the diagnosis of BS. Methods: A total of 47 patients clinically diagnosed as BS from General Hospital of Jizhong Energy Xingtai Mining Industry Bloc and Xingtai Second Hospital from January 2015 to December 2017 were collected, including 32 males and 15 females, aged 24-77 years, with an average age of (57±11) years, and the course of disease was 1 month-2 years. Routine spinal MRI sequence were acquired for patients. Images were assessed by two senior imaging diagnostic physician independently. The evaluation included signal changes in the affected area of the vertebral body, vertebral body and intervertebral disc, the signal of paravertebral soft tissue, the signal of abscess around the vertebral body, whether the dural sac, spinal cord and nerve root were compressed or not, and its signal changes. Results: (1) Spinal involvement, in 47 patients with BS, 112 vertebral bodies were involved, including 11 cervical vertebrae (9.8%), 5 thoracic vertebrae (4.5%), 91 lumbar vertebrae (81.2%), and 5 sacral vertebrae (4.5%), the lumbar vertebrae was dominant. (2) MRI features, 112 vertebral bodies were involved, including 105 (93.8%) vertebral bodies morphology showed no significant changes, only 7 (6.2%) vertebral bodies showed mild collapse changes; 71 vertebral bodies showed diffuse destruction (63.4%), and 41 vertebral bodies showed localized destruction (36.6%). Among the 47 cases, 40 cases were continuous destruction of adjacent vertebral bodies, 6 cases showed non-adjacent damage; 37 cases of intervertebral disc involvement; 29 cases of narrowing of intervertebral space; 11 cases of paravertebral soft tissue swelling and 28 cases showed paravertebral abscess. Conclusion: MRI has certain characteristics in the diagnosis of Brucella spondylitis and has a high clinical value in the differential diagnosis of spinal disease.

[Multi-center empirical study of virtual gastroscopy simulator in the examination of clinical practice skills of specialist physicians]

Objective: To study the role of virtual gastroscopy simulator in the examination of clinical practice skills of gastrointestinal specialists. Methods: A multi-center empirical study was carried out. In June 2018, ninety participants from three tertiary care teaching hospitals in China, including Zhongshan Hospital of Fudan University, Shanghai Tongji Hospital and Xiangya Hospital of Central South University, took part in the examination. Participants were selected as follows: 30 specialists without any experience of gastroscopy exams, 30 with basic knowledge (gastroscopy exams <500 cases) and 30 with good skill (gastroscopy exams ≥500 cases). These 90 students participated in this empirical study after theoretical study and simulator training. Among them, 50 (55.6%) were undergraduates, 25 (27.8%) masters, and 15 (16.7%) doctors; 42 (46.7%) were residents, 39 (43.3%) attending physicians, and 9 (10.0%) deputy chief physicians. The assessment was divided into two parts. The first part was to use the simulator (GI mentor II) for ballooning within 10 minutes, with a total score of 40 points. The second part was a complete gastroscopy exam on the simulator, including preparation before gastroscopy exam, gastroscopy exam, post - exam management and related knowledge quiz. The difficulty and discrimination of the assessment plan were evaluated by the extreme grouping method parameters (difficulty P definition: <0.3 was difficult, 0.3 to 0.7 was medium, ≥0.7 was easy; discrimination degree D definition: <0 was poor, 0 to 0.2 was medium, ≥0.2 was good), and by comparing the virtual gastroscopy assessment scores of different experience, academic, and professional title groups. The score analysis of the student group was expressed using the mastering rate (the average score divided by the total score). The data of the normal distribution was represented by (mean±SD) (range), and the data of the nonnormal distribution was represented by M (P25, P75). Kruskal-Wallis non-parametric test was used for comparison between groups. Results: The total score of 90 students was (82.9±10.9) (55.8 to 99.0), and the mastering rate was 82.9%. The overall difficulty of the first and the second parts were 0.78 and 0.76, respectively, and the difficulty level was easy. The overall discrimination of the first and the second parts were 0.70 and 0.67, respectively, and the discrimination was good. The stratified analysis was performed according to the professional title. The median score was 83.2 (75.5, 89.0) in the residents, 82.5 (71.7, 93.6) in the attending physicians, and 93.5 (88.5, 99.0) in the deputy chief physicians, and the difference was statistically significant (H=6.213, P=0.045). According to the stratification analysis of academic qualifications, the median score was 81.7 (73.0, 87.5) in participants with undergraduate degree, 91.0 (79.0, 95.0) in those with master degree and 88.0 (81.7, 93.5) in those with doctor degree, whose difference was statistically significant (H=9.233, P=0.010). The stratified analysis of the second part showed that the median scores of the "operational process" part of the low, medium and high basis group were 33.0 (30.5, 36.5), 34.0 (32.0, 36.0) and 37.0 (35.0, 37.5), respectively, whose difference was statistically significant (H=7.603, P=0.022). The median scores of the "operational process" section of the resident, attending physician, and deputy chief physician were 33.0 (30.5, 35.0) points, 36.0 (34.0, 37.5) points and 37.0 (37.0, 37.5) points, respectively, whose difference was statistically significant (H=18.563, P=0.001). Conclusions: The virtual gastroscopy simulator can reflect the true level of gastroscopy exam skills of the students. The examination questions are moderately difficult, and there is a good discrimination of the exam.

[The Research of Present Situation and Influencing Factors of Inflammatory Bowel Disease Nursing Competence in Gastroenterology Department of Grade A of level Ⅲ Hospital in Shandong Province]

Objective: The research is to study the present situation and influencing factors of inflammatory bowel disease (IBD) nursing competency in grade A of level Ⅲ hospital in Shandong province. and provided reference for further training and education of IBD nurses. Methods: From October, 2018 to May, 2019, the research is a cross-sectional study including 17 cities, 327 IBD nurses (qualified group n=197, unqualified group n=130) based on the IBD nursing competency questionnaire. The questionnaire is self-designed on the reference of registered nurse core competence scale and the reliability and validity have been tested very well. Results: The IBD nursing competence questionnaire has 8 categories and 68 entries. The content validity index (CVI) is 0.90, while the Cronbach index is 0.992. The median score of IBD nursing competency is 70.59 and each category vary from 55.00 to 84.38. Among them, the critical thinking skills or research ability (55.00) and continuing nursing (58.33) behave not very well. According to the single factor analysis, the hierarchy (P=0.031) and the follow-up numbers of IBD patients (P=0.001) are two significant factors for the IBD nursing competency. In the Logistic multiple factors analysis, the hierarchy (N(1) and N(2)) and the follow-up numbers of IBD patients (21-50 patients) are also important factors. Conclusion: The present situation of IBD nursing competency of Shandong province is acceptable. But there is still a long way to go in the aspect of critical thinking skills, research ability, and continuing nursing. Nurse hierarchy level and follow-up of IBD patients affect nursing competence and we should reinforce the training and education of IBD nurses.

Incidence and mortality of nasopharyngeal carcinoma: interim analysis of a cluster randomized controlled screening trial (PRO-NPC-001) in southern China

BACKGROUND

Previous mass screening studies have shown that IgA antibodies against Epstein-Barr Virus (EBV) can facilitate early detection of nasopharyngeal carcinoma (NPC), but the impact of EBV-antibody screening for NPC-specific mortality remains unknown.

PATIENTS AND METHODS

A prospective, cluster randomized, controlled trial for NPC screening (PRO-NPC-001) was conducted in 3 selected towns of Zhongshan City and 13 selected towns of Sihui City in southern China beginning in 2008. Serum samples of the screening group were tested for two previously selected anti-EBV antibodies. Subjects with serological medium risk were subsequently retested annually for 3 years, and those with serological high risk were referred to otorhinolaryngologists for diagnostic check-up. An interim analysis was carried out to evaluate the primary end points of the NPC-specific mortality and the early diagnostic rate, and the secondary end point of the NPC incidence, through linkage with the database of Zhongshan City.

RESULTS

Among 70 296 total subjects, 29 413 screened participants (41.8% of the total subjects) in the screening group and 50 636 in the control group, 153 (43.3 per 100 000 person-year), 62 (55.3 per 100 000 person-year) and 99 (33.1 per 100 000 person-year) NPC cases were identified. The early diagnostic rates of NPC were significantly higher in the participants (79.0%, P < 0.0001) and the screening group (45.9%, P < 0.0001) compared with the control group (20.6%). Although no differences were found between NPC-specific mortality of the screening group and the control group [relative risk (RR)= 0.82, 95% confidence interval (CI) 0.37-1.79], lower NPC-specific mortality was noticed among participants from the screening group versus the control group (RR = 0.22, 95% CI 0.09-0.49).

CONCLUSION

IgA antibodies against EBV can identify high-risk population and was effective in screening for early asymptomatic NPC. Although the mortality reduction was not significant in the primary end point, we noted encouraging evidence of a mortality reduction in screening participants in this interim analysis.

CLINICAL TRIAL NUMBER

NCT00941538.

Complete Measurement of the Λ Electromagnetic Form Factors

The exclusive process e^{+}e^{-}→ΛΛ[over ¯], with Λ→pπ^{-} and Λ[over ¯]→p[over ¯]π^{+}, has been studied at sqrt[s]=2.396  GeV for measurement of the timelike Λ electric and magnetic form factors, G_{E} and G_{M}. A data sample, corresponding to an integrated luminosity of 66.9  pb^{-1}, was collected with the BESIII detector for this purpose. A multidimensional analysis with a complete decomposition of the spin structure of the reaction enables a determination of the modulus of the ratio R=|G_{E}/G_{M}| and, for the first time for any baryon, the relative phase ΔΦ=Φ_{E}-Φ_{M}. The resulting values are R=0.96±0.14(stat)±0.02(syst) and ΔΦ=37°±12°(stat)±6°(syst), respectively. These are obtained using the recently established and most precise value of the asymmetry parameter α_{Λ}=0.750±0.010 measured by BESIII. In addition, the cross section is measured with unprecedented precision to be σ=118.7±5.3(stat)±5.1(syst)  pb, which corresponds to an effective form factor of |G|=0.123±0.003(stat)±0.003(syst). The contribution from two-photon exchange is found to be negligible. Our result enables the first complete determination of baryon timelike electromagnetic form factors.

Diversification of the downy mildew resistance gene pool by introgression of a new gene, Pl35, from wild Helianthus argophyllus into oilseed and confection sunflowers (Helianthus annuus L.)

We have mapped a new downy mildew resistance gene, Pl₃₅, derived from wild Helianthus argophyllus to sunflower linkage group 1. New germplasms incorporating the Pl₃₅ gene were developed for both oilseed and confection sunflower Sunflower downy mildew (DM), caused by the oomycete pathogen Plasmopara halstedii, is an economically important and widespread sunflower disease worldwide. Non-race-specific resistance is not available in sunflower, and breeding for DM resistance relies on race-specific resistance to control this disease. The discovery of the novel DM resistance genes is a long-term task due to the highly virulent and aggressive nature of the P. halstedii pathogen, which reduces the effectiveness of resistance genes. The objectives of this study were to: (1) transfer DM resistance from a wild sunflower species Helianthus argophyllus (PI 494576) into cultivated sunflowers; (2) map the resistance gene; and (3) develop diagnostic single-nucleotide polymorphism (SNP) markers for efficient targeting of the gene in breeding programs. The H. argophyllus accession PI 494576 previously identified with resistance to the most virulent P. halstedii race 777 was crossed with oilseed and confection sunflower in 2012. Molecular mapping using the BC₂F₂ and BC₂F₃ populations derived from the cross CONFSCLB1/PI 494576 located a new resistance gene Pl₃₅ on linkage group 1 of the sunflower genome. The new gene Pl₃₅ was successfully transferred from PI 494576 into cultivated sunflowers. SNP markers flanking Pl₃₅ were surveyed in a validation panel of 548 diversified sunflower lines collected globally. Eleven SNP markers were found to be diagnostic for Pl₃₅ SNP alleles, with four co-segregating with Pl₃₅. The developed oilseed and confection germplasms with diagnostic SNP markers for Pl₃₅ will be very useful resources for breeding of DM resistance in sunflower.

[Enlightenment of the United Nations high-level summit on non-communicable disease prevention and control on the development of public health system in China]

The Third UN High-level Meeting on Non-Communicable Diseases was held on September 2018. The conference carried out a series of activities on the theme of "Time To Deliver", and adopted the 2018 Political Declaration on Non-Communicable Diseases. The new "5×5" strategy for non-communicable diseases prevention and control was clearly put forward, slow progress of non-communicable diseases prevention and control was criticized and the seven major challenges hindering the progress of non-communicable diseases prevention and control was analyzed, the main role and responsibility of governments at all levels in coping with the challenges of non-communicable diseases was reiterated, and put forward clear requirements. The declaration also reiterates the importance of strengthening public health measures. The meeting and declaration aroused strong repercussions and were regarded as a milestone to promote the global prevention and control of non-communicable diseases, and also brought a series of important inspirations for the development of public health in China in the new era. In order to cope with the heavy burden of non-communicable diseases in China, we must give full play to our institutional advantages, mobilization advantages and organizational advantages, adhere to prevention-oriented, emphasize the role of professional public health institutions, and consolidate and strengthen the disease control system and capacity building.

[Clinical features and prognosis of infective endocarditis patients with acute kidney injury]

OBJECTIVE

To investigate the clinical features and treatment of infective endocarditis (IE) patients with acute kidney injury (AKI), and to compare the adverse complications and outcome with IE patients without AKI.

METHODS

Clinical data of 100 IE cases in Peking University First Hospital from January 2002 to June 2018 were retrospectively reviewed. The patients were divided into AKI group (n=21) and non-AKI group (n=79) based on the AKI network (AKIN) definition. The clinical data and prognosis were compared between the two groups.

RESULTS

The incidence of AKI was 21%. The average age was (43.7±15.7) years, and the ratio of male to female was 3 ∶1. There was no significant difference in age and gender between the two groups. Compared with non-AKI group, the AKI group had more rash and lower limbs edema (P=0.017 and P=0.001), higher urine blood and protein positive rate (both P<0.001). Lower hemoglobin and serum albumin level (both P<0.001), worse clinical cardiac function (NYHA III-IV, P=0.033) were found in AKI group compared with non-AKI group. There was no significant difference in microbiologic positive rate and pathogenic bacteria sorts between the two groups. Nine patients refused surgery, and the other 91 cases underwent cardiac surgery with cardiopulmonary bypass under general anesthesia, including 19 cases of AKI group and 72 cases of non-AKI group. The ventilation time and intensive care unit (ICU) stay time were longer in AKI group than in non-AKI group (P=0.028 and P=0.003). AKI group needed more red blood cell transfusion (P=0.010). Using the last serum creatinine before surgery as basic level, there was more new-onset AKI cases in AKI group than in non-AKI group. During the median follow-up time 42 months, there was no significant difference in perioperative and follow-up mortality between the two groups (P=0.463 and P=0.581).

CONCLUSION

More perioperation complications occurred in IE patients with AKI, but no significant difference in in-hospital and follow-up mortality between the AKI and non-AKI groups was observed.

InAs/GaAs quantum dot semiconductor saturable absorber for controllable dual-wavelength passively Q-switched fiber laser

We experimentally demonstrate the first use of 1550-nm InAs/GaAs quantum dot semiconductor saturable absorber mirror (QD-SESAM) in the dual-wavelength passively Q-switched (QS) erbium doped fiber (EDF) laser. The dual-wavelength QS lasing was obtained at a pump threshold of 180 mW with the average output power of 2.2 mW and the spacing between the two lasing wavelengths is 14 nm. A large absorption ranging from 1520 to 1590 nm has been realized when no substrate rotation was employed during the molecular beam epitaxy growth of the QD-SESAM indicating the potential to generate a 60 nm spacing of the dual-wavelength QS lasing peaks by changing the positions in the QD-SESAM and replacing EDF by co-doped fiber as gain medium. These results have provided a new opportunity towards achieving the stable and wide wavelength-tunable dual-modes fiber lasers.

Beam Energy and Centrality Dependence of Direct-Photon Emission from Ultrarelativistic Heavy-Ion Collisions

The PHENIX collaboration presents first measurements of low-momentum (0.4<p_{T}<3  GeV/c) direct-photon yields from Au+Au collisions at sqrt[s_{NN}]=39 and 62.4 GeV. For both beam energies the direct-photon yields are substantially enhanced with respect to expectations from prompt processes, similar to the yields observed in Au+Au collisions at sqrt[s_{NN}]=200. Analyzing the photon yield as a function of the experimental observable dN_{ch}/dη reveals that the low-momentum (>1  GeV/c) direct-photon yield dN_{γ}^{dir}/dη is a smooth function of dN_{ch}/dη and can be well described as proportional to (dN_{ch}/dη)^{α} with α≈1.25. This scaling behavior holds for a wide range of beam energies at the Relativistic Heavy Ion Collider and the Large Hadron Collider, for centrality selected samples, as well as for different A+A collision systems. At a given beam energy, the scaling also holds for high p_{T} (>5  GeV/c), but when results from different collision energies are compared, an additional sqrt[s_{NN}]-dependent multiplicative factor is needed to describe the integrated-direct-photon yield.

[Clinical characteristics of patients with delayed hepatolenticular degeneration]

Objective: To evaluate the clinical manifestations, metal metabolism, imaging characteristics and treatment response in patients with delayed Wilson disease (WD). Methods: Patients with untreated WD (40 with delayed onset and 40 with non-delayed onset) were enrolled. Twenty healthy people were included as normal controls. All patients were evaluated with modified Young scale neural symptom scores, grade of Child liver function and mental symptoms rating scale, magnetic resonance imaging (MRI) scan, magnetic sensitive imaging (susceptibility weighted imaging, SWI), metal metabolism. Corrected phase (CP) was measured at SWI. After 2 week treatment, neurologic symptoms, liver function, and metal metabolism were reviewed. Results: The total score of neurological symptoms in WD patients with delayed onset was lower than that of non-delayed onset (13.00±6.87 vs. 21.13±5.53, P=0.033). The scores of SCL-90 and HAMA depression scales in patients with delayed onset were lower than those of non-delayed onset. On T(2) weighted imaging, areas including substantia nigra and thalamus, the caudate nucleus, globus pallidus, putamen presented high signal rate in patients with delated onset than those with non-delayed (P=0.022, 0.037, 0.022, 0.037, 0.029 respectively). The SWI CP values of cangbai sphere and shell nucleus in patients with delayed onset were lower than those with non-delayed onset. Patients with delayed onset had higher urinary copper than those with non-delayed onset before and after treatment (P=0.040, 0.036). After treatment, the score of abnormal tremor and gait in patients with delayed onset was decreased (P=0.037, 0.044), while as the occurrence of neurological symptoms was increased by 10%, and the liver function level in patients with delayed WD was decreased in 3 cases. Conclusions: The brain of WD patients with delayed onset is mainly composed of metal deposits, however the cell damage is not apparent. Clinical symptoms are characterized by significant liver injury, but relatively mild neurological and psychiatric symptoms. Patients with delayed WD have higher urinary copper excretion than those with non-delayed WD. Chelating agents improves the neurological symptoms in patients with delayed onset.

Study of e^{+}e^{-}→γωJ/ψ and Observation of X(3872)→ωJ/ψ

We study the e^{+}e^{-}→γωJ/ψ process using 11.6  fb^{-1} e^{+}e^{-} annihilation data taken at center-of-mass energies from sqrt[s]=4.008  GeV to 4.600 GeV with the BESIII detector at the BEPCII storage ring. The X(3872) resonance is observed for the first time in the ωJ/ψ system with a significance of more than 5σ. The relative decay ratio of X(3872)→ωJ/ψ and π^{+}π^{-}J/ψ is measured to be R=1.6_{-0.3}^{+0.4}±0.2, where the first uncertainty is statistical and the second systematic (the same hereafter). The sqrt[s]-dependent cross section of e^{+}e^{-}→γX(3872) is also measured and investigated, and it can be described by a single Breit-Wigner resonance, referred to as the Y(4200), with a mass of 4200.6_{-13.3}^{+7.9}±3.0  MeV/c^{2} and a width of 115_{-26}^{+38}±12  MeV. In addition, to describe the ωJ/ψ mass distribution above 3.9  GeV/c^{2}, we need at least one additional Breit-Wigner resonance, labeled as X(3915), in the fit. The mass and width of the X(3915) are determined. The resonant parameters of the X(3915) agree with those of the Y(3940) in B→KωJ/ψ and of the X(3915) in γγ→ωJ/ψ observed by the Belle and BABAR experiments within errors.

Observation of the Decay X(3872)→π^{0}χ_{c1}(1P)

Using a total of 9.0  fb^{-1} of e^{+}e^{-} collision data with center-of-mass energies between 4.15 and 4.30 GeV collected by the BESIII detector, we search for the processes e^{+}e^{-}→γX(3872) with X(3872)→π^{0}χ_{cJ} for J=0, 1, 2. We report the first observation of X(3872)→π^{0}χ_{c1}, a new decay mode of the X(3872), with a statistical significance of more than 5σ for all systematic fit variations. Normalizing to the previously established process e^{+}e^{-}→γX(3872) with X(3872)→π^{+}π^{-}J/ψ, we find B(X(3872)→π^{0}χ_{c1})/B(X(3872)→π^{+}π^{-}J/ψ)=0.88_{-0.27}^{+0.33}±0.10, where the first error is statistical and the second is systematic. We set 90% confidence level upper limits on the corresponding ratios for the decays to π^{0}χ_{c0} and π^{0}χ_{c2} of 19 and 1.1, respectively.

[The comparison among the guidelines for the diagnosis and treatment of hepatocellular carcinoma in China, AASLD and EASL]

This article makes a comparative analysis of the key recommendations in surveillance, diagnosis, staging and treatment for hepatocellular carcinoma(HCC) from the newest updated guidelines issued by American Association for the Study Liver Disease, European Association for the Study of Liver, and Chinese Society of Clinical Oncology, respectively. It is agreed that patients at high risk for developing HCC should undergo surveillance with ultrasound every six months. Detected hepatic nodules should be diagnosed and followed-up by further imaging examination or liver biopsy. The HCC staging system varies among different guidelines. The studies and clinical trials of system therapy in advanced HCC are becoming new highlights.

[Analysis of mortality and leading causes of death in Chinese children under 5-year-old between 2010 and 2016]

We collected death data of children under 5-year-old in China from the national child mortality surveillance system from 2010 to 2016. The change of mortality rate and causes of death were described. The mortality rate of Chinese children under 5-year-old decreased from 16.4‰ to 10.2‰ in all areas between 2010 and 2016, from 20.1‰ to 12.4 ‰ in rural areas and from 7.3‰ to 5.2‰ in urban areas, respectively, with a greater average annual decreasing rate in rural areas than urban area. During these years, in addition to traffic accidents and sepsis, other 8 cause-specific mortality rates showed a downward trend. There were substantial decreases of mortality rates of premature birth or low birth weight, birth asphyxia and neural tube defects. In urban areas, the mortality rate of premature birth or low birth weight, birth asphyxia decreased, and the mortality rate of congenital heart disease and diarrhea substantially decreased. However, there was a substantial increase of mortality rate of septicemia in urban areas. In rural areas, the change of major cause-specific mortality rates were consistent with the national trend.

[Influence of vagus nerve on multiple organ function and immune reaction of T lymphocytes in septic rats]

Objective: To explore influence of vagus nerve on multiple organ function and immune reaction of T lymphocytes in septic rats. Methods: Forty Sprague-Dawley rats were divided into sham injury group, sepsis group, vagus nerve stimulation (VNS) group, and vagotomy (VGX) group, according to the random number table, with 10 rats in each group. Rats in sepsis group, VNS group, and VGX group were inflicted with sepsis by cecal ligation and puncture (CLP). Rats in VNS group were given electrical stimulation on left cervical vagus nerve for 15 min right after CLP. Rats in VGX group underwent vagotomy of left cervical vagus nerve at 30 min before CLP. At 24 h after CLP, serum of rats was collected to detect levels of alanine transaminase (ALT), aspartate aminotransferase (AST), glycocholic acid (CG), creatine kinase (CK), myocardial creatine kinase (CK-MB), blood urea nitrogen (BUN), and serum creatinine by fully automatic biochemistry analyzer. The left lung of rats was collected to determine wet or dry mass, and wet to dry (W/D) ratio was calculated. The right lung of rats was collected to measure the activity of pulmonary myeloperoxidase (MPO) by enzyme linked immunosorbent assay (ELISA). Spleen of rats was collected to determine the proliferative activity of CD4(+) T lymphocytes by cell counting kit 8, and real-time fluorescence quantitative polymerase chain reaction and ELISA were used to quantify mRNA expressions and levels of interleukin 2 (IL-2), interferon-γ, and IL-4, respectively. Data were processed with one-way analysis of variance and Tukey's honest significant difference test. Results: (1) The levels of serum ALT, AST, CG, CK, CK-MB, BUN, and creatinine, pulmonary W/D ratio, as well as MPO activity of rats in sepsis group were significantly higher than those in sham injury group and VNS group (P<0.01) and were significantly lower than those in VGX group (P<0.01). (2) The proliferative activity of CD4(+) T lymphocytes of rats in sepsis group was 0.93±0.03, which was significantly lower than 1.54±0.07 of rats in sham injury group (P<0.01). The proliferative activity of CD4(+) T lymphocytes of rats in VNS group was 1.15±0.15, which was significantly higher than that of rats in sepsis group (P<0.01). The proliferative activity of CD4(+) T lymphocytes of rats in VGX group was 0.75±0.06, which was obviously lower than that of rats in sepsis group (P<0.01). (3) In comparison with those of rats in sham injury group, the levels of IL-2 and interferon-γ in CD4(+) T lymphocytes of rats in sepsis group were markedly decreased (P<0.01), while the level of IL-4 was significantly increased (P<0.01). In comparison with those of rats in sepsis group, the levels of IL-2 and interferon-γ in CD4(+) T lymphocytes of rats in VNS group were obviously increased (P<0.01), while the level of IL-4 was markedly decreased (P<0.01). As compared with those of rats in sepsis group, the levels of IL-2 and interferon-γ in CD4(+) T lymphocytes of rats in VGX group were markedly decreased (P<0.01), while the level of IL-4 was significantly increased (P<0.01). (4) As compared with those of rats in sham injury group, expressions of IL-2 and interferon-γ mRNA in CD4(+) T lymphocytes of rats in sepsis group were markedly decreased (P<0.01), while expression of IL-4 mRNA was significantly increased (P<0.01). Expressions of IL-2 and interferon-γ mRNA in CD4(+) T lymphocytes of rats in VNS group were obviously increased when compared with those of rats in sepsis group (P<0.01), while expression of IL-4 mRNA was markedly decreased (P<0.01). In comparison with those of rats in sepsis group, expressions of IL-2 and interferon-γ mRNA in CD4(+) T lymphocytes of rats in VGX group were markedly decreased (P<0.01), while expression of IL-4 mRNA was significantly increased (P<0.01). Conclusions: Electrical stimulation of vagus nerve can significantly improve multiple organ dysfunction and reverse immunosuppression of T lymphocytes in septic rats, while vagotomy of vagus nerve may enhance the susceptibility of rats to sepsis.

[Clinical characteristics of the Wilson disease carrier]

Objective: To study the clinical symptoms, copper metabolism and imaging characteristics of Wilson disease (WD) carriers and to explore the treatment strategy of WD carriers. Methods: Forty WD carriers, 40 WD patients and 20 normal controls from the First Affiliated Hospital of Sun Yat-sen University from July 2007 to May 2018 were included. The modified Young scale was used for neural symptom scoring, and Child grading of liver function, mental symptoms rating scale, magnetic resonance imaging (MRI) scan, susceptibility weighted imaging (SWI) inspection, metal metabolism tests were also applied to all the included subjects. Corrected phase (CP) was measured by SWI. WD carriers were divided into symptomatic group and asymptomatic group. Symptomatic WD carriers were treated with penicillamine for 2 weeks and zinc gluconate for 3 months, then their neurological symptoms, liver function grade, metal metabolism index were rechecked. Results: Six WD carriers presented with some clinical symptoms, including 5 with neurological symptoms and 4 with liver dysfunction. The score of Hamilton anxiety (HAMA) scale of symptomatic WD carriers was higher than that of normal control group (P=0.021). 85% of carriers had ceruloplasmin level less than 0.26 g/L. 80% of carriers had serum copper between normal controls and WD patients. The free copper level of WD carriers was lower than that of WD patients (P=0.012, 0.019). Urinary copper in symptomatic WD carriers was higher than normal controls (P=0.047). The CP values of thalamus, globus pallidus and putamen in symptomatic WD carriers were lower than those in normal control group. After treatment with penicillamine in symptomatic WD carriers, urinary copper was higher than that before treatment (P=0.036). After treatment, the liver enzymes of symptomatic WD carriers returned to normal, and the score of modified Young scale was lower than before treatment (P=0.031). Conclusions: Mild copper metabolism abnormality is seen in WD carriers. A few carriers have neurological symptoms such as limb tremors, or liver symptoms such as abnormal liver enzymes. Abnormal copper metabolism is more serious in symptomatic WD carriers than in asymptomatic WD carriers. Symptomatic WD carriers can be treated with zinc gluconate.

[A clinican linical analysis of 29 cases of chronic pulmonary aspergillosis]

Objective: To improve the understanding of chronic pulmonary aspergillosis (CPA) by analyzing the clinical manifestations, imaging and pathological features, diagnosis, treatment and prognosis of this disease. Methods: Cases of CPA, proven by microbiological evidence based on pathological study in Fuzhou General Hospital of the People's Liberation Army and Affiliated Fuzhou City First Hospital of Fijian Medical University from January 2006 to October 2016 were retrospectively analyzed. Results: The patients consisted of 17 males and 12 females, aged 24 to 75 years, mean (42±16) years. The underlying disorders included post-tuberculosis infection (n=11), bronchiectasis (n=8), chronic obstructive pulmonary disease (n=3) and diabetes mellitus (n=2). The main clinical symptoms included productive cough (n=25), chronic sputum production (n=18) and hemoptysis (n=15). Serum GM antigen tests were performed in 19 cases, and the result was positive in 12 patients. BALF GM antigen tests were performed in 2 cases, both of which were positive. Chest CT showed that the lesions were located predominantly in the upper lobes (n=24). Single cavity with interior irregular intraluminal material (n=16) and multiple cavities with interior irregular intraluminal material (n=10) were the most frequent CT findings, while the "air crescent sign" was found in 13 cases. In the 22 patients who underwent surgical treatment, Aspergillus filaments were found in the cavity (n=20) or the bronchi (n=2) of lung samples, and histological examination didn't show tissue invasion by fungi. Surgical therapy was performed in 22 patients, with complete remission in 19 cases, and death in 3 cases. Anti-fungal therapy was administered in 6 patients, with partial remission in 4, and stable disease in 2 cases. One patient was not treated. Conclusions: CPA is more frequently seen in patients with underlying chronic pulmonary diseases. The common CT findings are single or multiple cavities with interior irregular intraluminal materials. Aspergillus filament in the cavity or bronchi of lung samples, without parenchymal invasion, is the proof of CPA. The surgical cure rate for simple aspergilloma and aspergillus nodule is high, while the risk of operation for chronic cavitary disease is high. GM antigen test may be an evidence for diagnosing CPA.

[Relationship between blood pressure variability and target organ damage in children with essential hypertension]

Objective: To investigate the correlation between blood pressure variability (BPV) and target organ damage in children with essential hypertension. Methods: A retrospective review identified 144 children (104 boys (72.2%) and 40 girls (27.8%), age (11.7±2.5)years) diagnosed with essential hypertension at Children's Hospital Affiliated to Capital Institute of Pediatrics from January 2013 to June 2018. Data on indicators for assessing fundus, cardiac, and renal damages obtained included 24-hour ambulatory blood pressure monitoring, BPV, fundus oculi examination, electrocardiogram, echocardiography, renal function, 24-hour urine protein quantitation, urine microalbumin, serum and urine β(2)-microglobulin. According to the existence of target organ damage, subjects were divided into target organ damage group and non-target organ damage group. Comparison between groups was analyzed using independent sample t test, chi square test and pearson correlation analysis. Results: The study included 144 children. There were 108 children (75.0%) diagnosed with phase 1 hypertension and 36 children (25.0%) diagnosed with phase 2 hypertension. Patients in target organ damage group (n=86, 59.7%) had a higher coefficient of 24 h diastolic BPV (14.5%±3.2% vs. 13.2%±2.5% t=2.558, P=0.012), a higher coefficient of daytime systolic BPV (8.2%±2.1% vs. 7.4%±2.0%, t=2.253, P=0.026) and a higher coefficient of daytime diastolic BPV (12.8%±3.4% vs.11.1%±2.4%, t=3.188, P=0.002) compared with patients in non-target organ damage group (n=58, 40.3%). The coefficients of daytime systolic BPV and daytime diastolic BPV were significantly associated with cardiac damage (r=0.190, P=0.023; r=0.366, P<0.01) and renal damage (r=0.167, P=0.046; r=0.167, P=0.045). The coefficient of daytime diastolic BPV was positively correlated with left ventricular mass index (r=0.366, P<0.01). Conclusions: There is a correlation between BPV and target organ damage in children with essential hypertension. Daytime BPV is strongly associated with cardiac and renal damage, and daytime diastolic BPV may predict early cardiac hypertrophy. As a noninvasive method, daytime BPV can provide evidence for early identification of hypertensive target organ damage.

Role of HMGB1 in Post-traumatic Endoplasmic Reticulum Stress in Rat Lung Tissues

OBJECTIVES

To explore the role of high mobility group B1 （HMGB1） protein in the post-traumatic endoplasmic reticulum stress （ERS） in rat lung tissues.

METHODS

The rat model of acute lung injury was established by crushing the hind limbs of rats with standard weight. The first experiment was to divide rats into postural control group and crush groups （6 h, 18 h and 30 h after crushing）. The second experiment was to divide rats into postural control group, 18 h crush group, HMGB1 inhibitor sodium butyrate （SB） group and 18 h crush+SB group. The protein expression changes of HMGB1 and ERS- related proteins （GRP78, caspase-12, CHOP and IRE1α） in rat lung tissues were detected with Western blotting. Meanwhile, the pathological changes of rat lungs were observed by HE stain.

RESULTS

Compared with the postural control group, the expression levels of ERS-related proteins （GRP78, caspase-12, CHOP and IRE1α） and HMGB1 protein in rat lung tissues by crushing the hind limbs of rats were obviously increased. The protein levels reduced at 30 h after crushing but were still higher than those of postural control group and obvious pathological changes of acute lung injury were observed simultaneously in rats. Compared with the 18 h crush group, the expression levels of the ERS-related proteins and HMGB1 protein in rat lung tissues were attenuated in 18 h crush+SB group, and the pathological changes of rat lung injury began to alleviate.

CONCLUSIONS

HMGB1-ERS pathway activated by traumatic stress can lead to acute lung injury in rats.

[Mechanism of lung injury of rats induced by inhalation of white smoke from burning smoke pot]

Objective: To explore mechanism of lung injury of rats induced by inhalation of white smoke from burning smoke pot. Methods: Forty-eight Sprague Dawley rats were divided into control group (n=12) and injury group (n=36) according to the random number table. Rats in injury group were placed in smoke-induced injury experimental equipment fulled with white smoke from burning smoke pot for 5 minutes to make lung injury, and rats in control group were placed in smoke-induced injury experimental equipment fulled with air for 5 minutes to make sham injury. Six rats in injury group at post injury hour (PIH) 6, 24, and 72 and six rats in control group at PIH 72 were collected to observe pathological changes of lung tissue and pathological score of rats in the two groups by hematoxylin-eosin staining, to detect expression of nuclear factor-κB (NF-κB) p65 mRNA in lung tissue of rats by reverse transcriptional polymerase chain reaction, and to detect content of tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and IL-6 in lung tissue of rats by enzyme-linked immunosorbent assay. Data were processed with one-way analysis of variance and t test. Results: At PIH 72, lung tissue structure of rats in control group was clear and complete, with no inflammatory cell infiltration. At PIH 6, there was edema, hemorrhage, and inflammatory cell infiltration in lung tissue of rats in injury group. At PIH 24, edema, hemorrhage, and inflammatory cell infiltration in lung tissue of rats in injury group aggravated. At PIH 72, area of edema in lung tissue of rats in injury group was enlarged, with obvious hemorrhage and inflammatory cell infiltration. At PIH 6, 24, and 72, pathological score of lung tissue of rats in injury group was (3.43±0.86), (5.39±0.93), and (9.99±0.84) points, respectively, obviously higher than that of rats in control group at PIH 72 [(2.11±0.20) points, t=3.659, 8.450, 22.355, P<0.05]. As time post injury prolonged, pathological scores of lung tissue of rats in injury group were significantly increased (F=121.244, P<0.01). At PIH 6, 24, and 72, expression of NF-κB p65 mRNA in lung tissue of rats in injury group was 15.5±4.3, 25.9±1.8, 30.9±3.5 respectively, significantly higher than that of rats in control group at PIH 72 (7.8±0.8, t=4.315, 20.445, 14.408, P<0.01). As time post injury prolonged, expression of NF-κB p65 mRNA in lung tissue of rats in injury group gradually increased (F=32.691, P<0.01). At PIH 6, 24, and 72, content of TNF-α, IL-1β, and IL-6 in lung tissue of rats in injury group was significantly higher than that of rats in control group at PIH 72, respectively (t=7.650, 8.968, 6.827, 6.726, 8.978, 3.460, 5.420, 13.289, 16.438, P<0.01). At PIH 24, content of TNF-α and IL-1β in lung tissue of rats in injury group was higher than that of rats in the same group at PIH 6 and 72, respectively (t=3.409, -2.549, 4.047, -4.100, P<0.05). At PIH 24 and 72, content of IL-6 in lung tissue of rats in injury group was respectively higher than that of rats in the same group at PIH 6 (t=8.273, 9.711, P<0.05). Conclusions: After inhaling white smoke from burning smoke pot, rats are inflicted with lung injury by increasing expression of NF-κB p65 mRNA and content of TNF-α, IL-1β, and IL-6, and induce pathological changes of edema, hemorrhage, and inflammatory cell infiltration of lung tissue.

[The effection of white matter abnormality to auditory and speech rehabilitation after cochlear implantation in prelingual deafness children]

Objective:To investigatethe effection of white matter abnormality to auditory and speech rehabilitation after cochlear implantation in prelingual deafness children.Method:Thirty-five children with white matter abnormality were included in this study. The degree of leukoaraiosis was evaluated by Scheltens scale based on MRI.The hearing and speechrecovery level was rated by auditory behavior grading standards(CAP) and speech intelligibility grading standards(SIR) at 6 months, 12 months, and 24 months post operation. Result:The CAP scores and SIR scores of the children with white matter abnormality were lower than those of the control group at 6 months after operation (P<0.05).The SIR scores of the children with white matter abnormality at 12 months and 24 months post operation were significantly lower than those of the control group.There was no statistically significant difference between the CAP scores of the two groups at 12 and 24 months after operation(P>0.05).Schelten classification had a greater impact on SIR scores than on CAP scores. Conclusion:The effect of white matter abnormality on auditory and speech rehabilitation after cochlear implantation was related to the degree of leukoencephalopathy. When the lesion of white matter abnormality was larger, the level of hearing and verbal rehabilitation was lower, and the speech rehabilitation was more significantly impacted by white matter lesions degree.

[Chest wall hamartoma of infancy: a clinicopathologic observation of five cases]

Objective: To study the clinicopathologic features, diagnosis and differential diagnosis of chest wall hamartoma of infancy. Methods: The clinical data, histopathologic features and immunophenotype of five chest wall hamartomas were analyzed, and the relevant literature was reviewed. Results: The patients' age ranged from seven months and eight days to 20 months at time of resection, although the lesions were detected in the neonatal period. The male-to-female ratio was 4∶1. Three cases were unilateral, two presented with multiple lesions; and four were located on the right side. CT-scan of the chest showed expansile soft tissue masses with heterogeneous density containing calcifications or ossifications in one or more ribs showing partial bone destruction. Patients were all treated by complete resection. Grossly, the lesions comprised solid and cystic areas, the latter showing hemorrhage. Microscopic examination revealed the solid areas were composed of islands of multilobulated hyaline cartilage interspersed within spindle or oval mesenchymal cells, waved bone and collagen fibers. Around the chondroid tissue, there were focal endochondral ossification and mucus-like background. In addition, there were areas of aneurysmal bone cyst-like changes formed by hemorrhagic dilated cystic spaces. Immunohistochemistry was generally not necessary to establish the diagnosis. Conclusions: Chest wall hamartoma is a rare but benign lesion of infancy, showing characteristic clinicopathologic features. The prognosis are excellent after complete surgical excision.

Epidemiological investigation and risk factors of Peste des petitis ruminants (PPR) in yaks (Bos grunniens) and cattle in five regions of China

To investigate the prevalence of Peste des petitis ruminants in yaks and cattle in poorly studied areas of China. A total of 1202 and 560 blood samples were collected from yaks and cattle, respectively and processed using a commercial ELISA kit. Multivariable logistic regression model was piloted to find the variables, potentially associated with exposure of PPR infection in yaks and cattle. Results indicated that the overall prevalence of PPR in yaks was 11.2%. A total 66 (11.8%) out of 560 were examined out to be positive to PPR in cattle in Jiangxi province. According to conditional stepwise logistic regression, region, age and gender were found to be the more influencing risk factors in yaks, while region and age were found to be the potential risk factors in cattle. The current results reported the prevalence and associated risk factors of PPR in bovine for the first time in China.

[Knowledge, related behavior and on AIDS/HIV infection among rural adults with Derung minority, in Yunnan province, 2016]

Objective: To understand the related risk behaviors, knowledge and status of HIV/AIDS infection among rural adults of Derung minority, to provide relevant messages for the development of HIV/AIDS intervention strategy in this minority group. Methods: We used system sampling method to conduct a cross-sectional survey in 6 administration villages of Derung Township, Gongshan Derung and Nu Autonomous County in Nujiang Lisu Autonomous Prefecture of Yunnan Province, with a sample size estimated as 383. Adult residents with Derung minority in six villages of Gongshan County were involved, with relevant information collected through door-to-door visit. HIV antibody was tested and SPSS 17.0 was used for statistical analysis. Results: Information on 394 valid respondents was collected, with age as between 18 and 65 (34.39±9.74), 80.7% (318/394) as married, 54.0% (213/394) having had primary school education, 13.2% (52/394) as migrant workers. In this population, the overall HIV infection rate appeared as 0.5% (2/400), mainly through sexually transmission. The rate of awareness on HIV/AIDS was 69.8% (275/394), mainly through free publicized materials 50.0% (197/394). Rates on premarital sexual behavior on multiple sexual partners in the past year, on temporary sexual partners in the past year, having commercial sexual experiences in the past year and ever used condoms when engaging in casual sex, were 6.4% (60/366), 18.0%(66/366), 5.7%(21/366), 1.9%(7/366) and 8.0%(25/311), respectively. Conclusions: Few numbers of HIV infections were identified among the migrating workers with Derung minority, with sexual transmission as the major route, along with the increased number of rural migrant workers and the low rates both on AIDS knowledge and condom use, accompanied by the high risk sexual behavior appeared in this rural adult residents of Derung minority. Relative strategies on HIV/AIDS intervention and control should be developed.

[Optimal energy supply in different age groups of critically ill children on mechanical ventilation]

Objective: To analyze the resting energy expenditure and optimal energy supply in different age groups of critically ill children on mechanical ventilation in pediatric intensive care unit (PICU). Methods: Patients on mechanical ventilation hospitalized in PICU of Beijing Children's Hospital from March 2015 to March 2016 were enrolled prospectively. Resting energy expenditure of patients was calculated by US Med Graphic company critical care management (CCM) energy metabolism test system after mechanical ventilation. Patients were divided into three groups:<3 years, 3-10 years, and >10 years. The relationship between the measured and predictive resting energy expenditure was analyzed with correlation analysis; while the metabolism status and the optimal energy supply in different age groups were analyzed with chi square test and variance analysis. Results: A total of 102 patients were enrolled, the measured resting energy expenditure all correlated with predictive resting energy expenditure in different age groups (<3 years (r=0.3, P=0.0) ; 3~10 years (r=0.6, P=0.0) ;>10 years (r=0.5, P=0.0) ) . A total of 40 cases in < 3 years group, including: 14 cases of low metabolism (35%), 14 cases of normal metabolism (35%), and 12 cases of high metabolism (30%); 45 cases in 3-10 years group, including: 22 cases of low metabolism (49%), 19 cases of normal metabolism (42%), 4 cases of high metabolism (9%); 17 cases in>10 years group, including: 12 cases of low metabolism (71%), 4 cases of normal metabolism (23%), 1 case of high metabolism (6%). Metabolism status showed significant differences between different age groups (χ(2)=11.30, P<0.01, r=-0.01). Infants had higher metabolic status, which lessened with aging. The total average actual energy requirement was (210±84) kJ/ (kg⋅d) . There were significant differences in actual energy requirement between age groups (F=46.57, P<0.001), with (277±77) kJ/ (kg⋅d) in<3 years group, (184±53) kJ/ (kg⋅d) in 3-10 years group, and (120±30) kJ/ (kg⋅d) in>10 years group. Conclusion: The resting energy metabolism of the critically ill children on mechanical ventilation is negatively related to the age. The actual energy requirement should be calculated according to different ages.

Protective effect of erythropoietin against lipopolysaccharide induced inflammation and mitochondrial damage in liver

Recent studies have shown that liver dysfunction is an early event in sepsis. Pre-existing liver dysfunction is a risk factor for progression of infection to sepsis. However, the mechanism of the liver immune response in promoting sepsis and the importance of liver function are not completely understood. In the present study, we investigated the protective effect of erythropoietin (EPO) against mitochondrial dysfunction in a lipopolysaccharide (LPS)-induced sepsis model, and examined the underlying signaling mechanisms. Enzyme linked immunosorbent assay (ELISA) and reactive oxygen species (ROS) analysis were used to evaluate the levels of interleukin (IL)-1β and ROS. The effects of EPO on hepatic mitochondrial function were studied by detecting the mitochondrial DNA (mtDNA) copy number using real-time PCR (RT-PCR). To explore the mechanism of action of EPO in sepsis, protein expressions of IL-1β, caspase-1 and NLRP3 were assessed by Western blotting; liver histopathology and ultrastructure of liver mitochondria was examined by transmission electron microscopy. We found that LPS treatment increased serum IL-1β and ROS levels, the effect of which was attenuated by EPO. Moreover, LPS treatment also increased the mtDNA copy number and the protein expressions of IL-11β, caspase-1, and NLRP3, which were suppressed by EPO. Histological examination of liver showed LPS-induced cellular edema in hepatic lobules, lymphocytic infiltration and hepatocellular necrosis; these changes were also alleviated by EPO treatment. On electron microscopy, the size of hepatocellular mitochondria in the LPS group was smaller than that in the control group, and the changes were reversed by EPO in the LPS+EPO group. Our results suggest that EPO alleviated liver and mitochondrial damage induced by LPS, possibly via inhibition of NLRP3 signaling.

Coniella vitis sp. nov. Is the Common Pathogen of White Rot in Chinese Vineyards

Grape white rot is a common disease and causes considerable yield losses in many grape-growing regions when environmental conditions are favorable. We surveyed grape white rot in five provinces in China and collected 27 isolates from diseased grape tissues. Multigene phylogenetic analyses of the internal transcribed spacer region (ITS1-5.8S-ITS2), the 28S large subunit of nuclear ribosomal RNA (LSU), partial translation elongation factor 1-alpha gene (TEF 1-α), and partial histone 3 gene (HIS), coupled with genealogical concordance phylogenetic species recognition and morphological observations, revealed that Coniella vitis sp. nov. and C. diplodiella are the causal agents of grape white rot in China. Koch's postulates were performed on Vitis vinifera cv. Summer Black in a greenhouse. These results confirmed the pathogenicity on grapes, as symptoms were reproduced, and also indicated significant variations in the virulence among C. vitis isolates. This work provides evidence that C. vitis is the main pathogen of grape white rot in China and also provides an optimized multigene backbone for resolving Coniella species.

[Early physical growth and disease analysis among children born delivered by HBsAg-positive mothers]

Objective: To estimate the early physical growth and disease in children born to HBsAg-positive mothers. Methods: This was a retrospective cohort study. Three areas as Xihu in Hangzhou, Lanxi in Jinhua, and Haiyan in Jiaxing in Zhejiang province were selected by cluster sampling. The growth outcomes of children born to HBsAg-positive mothers (exposure group) and matched 1∶1 women uninfected with HBV (control group) in 2014 were investigated and compared at birth, 6, 9, 12, and 18 months, respectively. There were totally 342 children in each group. Results: The incidences of low birth weight (LBW) for children born to exposure and control group were 1.8% (6/342), and 2.6% (9/342), respectively (P=0.433); and, rates of preterm birth were 2.3% (8/342), and 2.0% (7/342), respectively (P=0.794). The mean birth weight of children born to mothers without HBV infection (3.4±0.4) kg was dramatically higher than children in exposure group (3.3±0.4) kg (P=0.019). At 18 months, the average head circumference was significantly greater among children in control group (47.3±1.3) cm than children in exposure group (47.0±2.0) cm (P=0.038). Additional, mean birth weeks, height, weight, increases in height/weight/head circumference each month, weight/height/head circumference for age Z scores, proportion of growth retardation and low weight, disease prevalence were not observed statistically differences between two groups (P>0.05). All children born to HBsAg-positive mothers were received three-dose HBV vaccination. The rate of hepatitis B immunoglobulin for births born to HBsAg-positive was 98.8% (338/342). Mother to children transmission of HBV at 18 months was 1.0% (1/97). Conclusion: No significant differences in growth development and disease prevalence were found among children born to HBsAg-positive women and women without HBV infection.

[Measurement and analysis of tracheal inner diameter in Chinese adults using multi-slice spiral CT, multi-planar reconstruction and special window technique]

Objective: To measure the inner diameter of tracheal(TD) in Chinese adults by multi-slice spiral CT(MSCT), multi-planar reconstruction(MPR) with special window technique and analyze its influencing factors. Methods: A total of 824 normal adults(male 435, female 389) and 16 patients with small peripheral pulmonary nodules(SPN) receiving chest multi-slice spiral CT (MSCT) in the physical examination at the First Affiliated Hospital of Guangzhou Medical University between January, 2014 and December, 2015 were included and their records were retrospectively analyzed. The 16 patients with SPN received bronchoscopy and the images were recorded followed by measurement of tracheal diameter using software. MSCT and MPR images were obtained by the 3Dview software, and the inner diameter of the trachea at 4 horizontal positions were measured by special window technique (window width 500 Hu, window level 100 Hu): thoracic entrance (TD(1)), aortic arch (TD(2)), 2 cm higher than the carina of trachea (TD(3)) and the narrowest trachea (TD(4)). Results: The results of bronchoscopy and software measurement in 16 patients were consistent with those of MSCT and MPR combined with special window technique (P>0.05). The TD at 4 positions in adult males were larger than those of adult females (P<0.01). The TD values at each position for males and females were as follows: (18.9±1.7) and (15.6±1.3) mm (t=30.9, P<0.01) for TD(1), (18.8±1.6) and (16.1±1.2) mm (t=28.0, P<0.01) for TD(2), (19.0±1.6) and (16.3±1.3) mm (t=26.5, P<0.01) for TD(3), (18.4±1.5) and (15.5±1.1) mm (t=31.3, P<0.01) for TD(4), respectively. The age, weight and BMI were not significantly correlated with the tracheal diameter (P>0.05). The height was linearly correlated with the tracheal diameter: for males, TD(1)=0.071× height (cm) + 6.964 (r=0.249, P<0.05), TD(2)=0.064 × height (cm) + 7.898 (r=0.246, P<0.05), TD(3)=0.074 × height (cm) + 6.533 (r=0.279, P<0.05), TD(4)=0.056 × height(cm) + 8.811(r=0.226, P<0.05); while for females, TD(1)= 0.046× height (cm) + 8.331 (r=0.183, P<0.05), TD(2) = 0.058 × height (cm)+ 6.950(r=0.248, P<0.05), TD(3)=0.059 × height (cm)+ 7.052 (r=0.235, P<0.05), TD(4) =0.044× height (cm) + 8.520 (r=0.208, P<0.05). Conclusion: MSCT and MPR combined with special window technique are accurate and feasible for the measurement of adult tracheal diameter. The diameter of the trachea in males is larger than that in females, and it is positively correlated with height, but not with age, body weight and BMI. The tracheal diameter can be evaluated by linear regression equation.

[Risk factors for lower extremity amputation in patients with diabetic foot]

Objective: To explore the risk factors for lower extremity amputation in patients with diabetic foot. Methods: The clinical data of 1 771 patients with diabetic foot at the Air Force General Hospital of PLA from November 2001 to April 2015 were retrospectively analyzed. The patients were divided into the non-amputation and amputation groups. Within the amputation group, subjects were further divided into the minor and major amputation subgroups. Binary logistic regression analyses were used to assess the association between risk factors and lower extremity amputation. Results: Among 1 771 patients with diabetic foot, 323 of them (18.24%) were in the amputation group (major amputation: 41; minor amputation: 282) and 1 448 (81.76%) in the non-amputation group. Compared with non-amputation patients, those in the amputation group had a longer hospital stay and higher estimated glomerular filtration rate(eGFR)levels. Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), C-reaction protein (CRP), ESR, ferritin, fibrinogen and WBC levels of the amputation group were higher, while hemoglobin albumin, transferrin, TC, TG, HDL-C and LDL-C were lower than those of the non-amputation group (all P<0.05). The proportion of hypertension(52.48% vs 59.98%), peripheral vascular disease (PAD)(68.11% vs 25.04%), and coronary heart disease(21.33% vs 28.71%)were different between the amputation and non-amputation groups (all P<0.05). Multivariable logistic regression analyses showed that Wagner's grade, PAD and CRP were the independent risk factors associated with lower extremity amputation in hospitalized patients with diabetic foot. Conclusion: Wagner's grade, ischemia of lower limbs and infection are closely associated with amputation of diabetic foot patients.

Age-Related Response of Rumen Microbiota to Mineral Salt and Effects of Their Interactions on Enteric Methane Emissions in Cattle

Mineral salt bricks are often used in cow raising as compensation for mineral losses to improve milk yield, growth, and metabolic activity. Generally, effects of minerals are partially thought to result from improvement of microbial metabolism, but their influence on the rumen microbiota has rarely been documented to date. In this study, we investigated the response of microbiota to mineral salt in heifer and adult cows and evaluated ruminal fermentation and enteric methane emissions of cows fed mineral salts. Twelve lactating Holstein cows and twelve heifers fed a total mixed ration (TMR) diet were randomly allocated into two groups, respectively: a treatment group comprising half of the adults and heifers that were fed mineral salt and a control group containing the other half fed a diet with no mineral salt supplement. Enteric methane emissions were reduced by 9.6% (P < 0.05) in adults ingesting a mineral salt diet, while concentrations of ruminal ammonia, butyrate, and propionate were increased to a significant extent (P < 0.05). Enteric methane emissions were also reduced in heifers ingesting a mineral salt diet, but not to a significant extent (P > 0.05). Moreover, the concentrations of ammonia and volatile fatty acids (VFAs) were not significantly altered in heifers (P > 0.05). Based on these results, we performed high-throughput sequencing to explore the bacterial and archaeal communities of the rumen samples. Succiniclasticum and Prevotella, two propionate-producing bacteria, were predominant in samples of both adults and heifers. At the phylotype level, mineral salt intake led to a significant shift from Succiniclasticum to Prevotella and Prevotellaceae populations in adults. In contrast, reduced abundance of Succiniclasticum and Prevotella phylotypes was observed, with no marked shift in propionate-producing bacteria in heifers. Methanogenic archaea were not significantly abundant between groups, either in adult cows or heifers. The shift of Succiniclasticum to Prevotella and Prevotellaceae in adults suggests a response of microbiota to mineral salt that contributes to higher propionate production, which competes for hydrogen utilized by methanogens. Our data collectively indicate that a mineral salt diet can alter interactions of bacterial taxa that result in enteric methane reduction, and this effect is also influenced in an age-dependent manner.

Application values of detection of serum CA199, CA242 and CA50 in the diagnosis of pancreatic cancer

Pancreatic cancer is characterized by rapid onset, high malignancy and high mortality, thus its early diagnosis is effective for improving the survival rate of patients. To discuss the values of detection of carbohydrate antigen (CA) 50, CA242 and CA199 in the diagnosis of pancreatic cancer, this study randomly selected 112 patients who were confirmed as having stage Ia~IIb pancreatic ductal adenocarcinoma (PDAC) in the Shandong Provincial Hospital, China, from May 2012 to May 2013 as a malignant group. One hundred patients with benign pancreatic lesions and 90 healthy people were selected in the same period as a benign group and a healthy control group, respectively. The levels of serum CA199, CA242 and CA50 were detected using electrochemiluminescence. Results demonstrated that the levels of serum CA199, CA242 and CA50 of the malignant group were significantly higher than those of the benign group and the healthy control group (P=0.001; P=0.003; P=0.000). The positive rate of the tumor markers of the malignant group was higher than that of the benign group and the healthy control group, and the differences had statistical significance (P=0.006; P=0.004; P=0.005). In the malignant group, sensitivity of CA199 was the highest (81.42%) as was the specificity of CA242 (80.14%). The detection of two or more markers could improve sensitivity (joint detection based on parallel tests) and specificity (joint detection based on serial tests). Thus the levels of serum tumor markers including CA199, CA242 and CA50 could be used as the assisted indicators for the diagnosis of early-stage PDAC. Joint detection of the three tumor markers is of great significance to improve the diagnostic sensitivity and accuracy of early PDAC.

[The radiologic study of the nasolacrimal duct decompression surgery for treatment of chronic]

Objective:To explore the possibility of endoscopic nasolacrimal duct decompression surgery for the treatment of chronic dacryocystitis.Method:①Twenty-two eyes with chronic dacryocystitis were treated with 30% iohexol injection for lacrimal sac lithography. Contrast agents were taken from the lacrimal canal reflux to stop the injection. The CT scan for the lacrimal passage was performed immediately. ②Three-dimensional reconstruction of lacrimal duct and its surrounding structures was performed with Sinuses Trachea Ⅰ software. ③The lacrimal sac and nasolacrimal canal were cut and depressed using this software simulation.Result:①The incidence of lacrimal duct obstruction were 4.5% (1/22, in lacrimal duct), 22.7%(5/22, in lacrimal sac), 13.6%(3/22, transition section), 36.4%(8/22, in nasocrimal duct), and 22.7%(5/22, in Hasner valve) separately. The transitional section, nasolacrimal duct, Hasner valve section 72.7%(16/22) totally. ②The lateral wall of the nasolacrimal duct in 3D visual model is constructed of maxillary lacrimal process. The interior wall of the nasolacrimal duct is made of drop process of lacrimal bone and ascending lacimal process of the inferior turbinate. ③Observed from the inferior meatus, hard nasolacrimal duct is surrounded by inferior turbinate bone, and forms the inside wall of openings of the lacrimal duct. ④The removal of the front parts of the inferior turbinate attached to the lateral nasal can lead to the deperession of the membranous nasolacrimal duct sufficiently, and create the efficient space to eliminate nasolacrimal duct obstruction. Conclusion:Endoscopic nasolacrimal duct decompression surgery is efficacy for the treatment of chronic dacryocystitis. The integrity of the membranous lacrimal duct was reserved, and the complication such as lacrimal sac granulation hyperplasia, lacrimal duct obstruction again caused by scar formation was avoided.

[Incidence and trend of occupational diseases in Ningbo, China, from 2006 to 2015]

Objective: To investigate the incidence, distribution features, and incidence trend of occupational diseases in Ningbo, China, from 2006 to 2015. Methods: In February 2016, the data on occupational disease report cards in the occupational disease and occupational health information system from 2006 to 2015 were collected to perform a comprehensive analysis of the types, incidence trend, population characteristics, and enterprise characteristics of occupational diseases. Results: There were 845 new cases of occupational diseases in Ningbo from 2006 to 2015, among which 596 (70.53%) were pneumoconiosis; there were 445 (74.66%) cases of stage I pneumoconiosis, 73 (12.25%) cases of stage II pneumoconiosis, and 78 (13.09%) cases of stage III pneumoconiosis; silicosis (59.76%) was the most common type of pneumoconiosis. Of all patients with occupational diseases, 84.97% were male, 64.50%were aged 35-55 years, and 63.67% had 5-20 working years. Most of the patients with occupational diseases worked in small and medium-sized private (or foreign) enterprises; the most common industries were black metal smelting and rolling (38.76%) , construction (17.11%) , and non-metallic ore mining (13.09%) . A total of 51.28%, 10.26%, and 7.69% of the patients with occupational poisoning worked in the electric apparatus manufacturing industry, furniture manufacturing industry, and chemical raw material and chemical product manufacturing industry, respectively. The cases of occupational diseases are mainly distributed in Yuyao City (24.62%) , Yinzhou District (23.91%) , and Ninghai County (15.62%) . Conclusion: Pneumoconiosis is the most common type of occupational disease in Ningbo and most of these patients work in small and medium-sized private (or foreign) enterprises. The supervision of small and medium-sized private enterprises should be enhanced to protect workers' health.

Terahertz generation from laser-driven ultrafast current propagation along a wire target

Generation of intense coherent THz radiation by obliquely incidenting an intense laser pulse on a wire target is studied using particle-in-cell simulation. The laser-accelerated fast electrons are confined and guided along the surface of the wire, which then acts like a current-carrying line antenna and under appropriate conditions can emit electromagnetic radiation in the THz regime. For a driving laser intensity ∼3×10^{18}W/cm^{2} and pulse duration ∼10 fs, a transient current above 10 KA is produced on the wire surface. The emission-cone angle of the resulting ∼0.15 mJ (∼58 GV/m peak electric field) THz radiation is ∼30^{∘}. The conversion efficiency of laser-to-THz energy is ∼0.75%. A simple analytical model that well reproduces the simulated result is presented.