[Effect of data missing on population based viral load survey in HIV infected men who have sex with men sampled in 16 large cities, China]

Objective: To analyze the effect of missing data in population based viral load (PVL) survey in HIV infected men who have sex with men (MSM) sampled in 16 cities in China. Methods: The database of 3 virus load sampling survey conducted consecutively in HIV infected MSM population in 16 large cities (Beijing, Shanghai, Nanjing, Hangzhou, Wuhan, Chongqing, Kunming, Xi'an, Guangzhou, Shenzhen, Nanning, Urumuqi, Harbin, Changchun, Chengdu and Tianjin) during 2013-2015 was used. SPSS 17.0 software was used to describe distribution of the missing data and analyze associated factors. Results: A total of 12 150 HIV infected MSM were randomly selected for the surveys, in whom, 9 141 (75.2%) received virus load tests, while 3 009 (24.8%) received no virus load tests, whose virus load data missed. The virus load data missing rates in MSM with or without access to antiretroviral therapy (ART) were 11.5% (765/6 675) and 39.4% (2 060/5 223) respectively, and the virus load data missing rates were 21.9% (1 866/8 523) and 28.4% (959/3 374), respectively, in local residents and non-local residents (migrants). Conclusions: The analysis indicated that the data missing occurred in the virus load survey in HIV infected MSM population. ART status and census registering status were the main influencing factors. Data missing could influence the accurate evaluation of community viral load (CVL) and population viral load(PVL) levels in HIV infected MSM in China.

Silicon-on-insulator free-carrier injection modulators for the mid-infrared

Experimental demonstrations of silicon-on-insulator waveguide-based free-carrier effect modulators operating at 3.8 μm are presented. PIN diodes are used to inject carriers into the waveguides, and are configured to (a) use free-carrier electroabsorption to create a variable optical attenuator with 34 dB modulation depth and (b) use free-carrier electrorefraction with the PIN diodes acting as phase shifters in a Mach-Zehnder interferometer, achieving a V_πL_π of 0.052  V·mm and a DC modulation depth of 22 dB. Modulation is demonstrated at data rates up to 125 Mbit/s.

[Associations between milk intake at breakfast and nutritional status of students attending the Nutrition Improvement Program for Rural Compulsory Education Students in 2016]

Objective: To investigate the association between milk intake at breakfast and nutritional status of students attending the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) in 2016, and to provide basic data for improving the nutritional status of the poor rural pupils. Methods: Using the multi-stage stratified random cluster sampling method, 22 315 students from grade three to nine from primary and junior high schools were randomly selected from the 50 key counties under the monitor programs, in 22 provinces of NNIPRCS. Questionnaire was used. Among all the students, with equal number of genders, morning fasting height and weight were measured by trained investigators. Status of nutrition was classified as malnutrition, normal, overweight/obesity, by age-specific height and BMI. Multivariate linear and logistic regression methods were used to analyze the relationship between milk consumption and the status of nutrition of the students. Results: Only 31.4% of the students that were on the monitoring programs would drink milk at breakfast. Proportions of milk intake at breakfast were higher in students from the western regions, in lower grades and in girls (P<0.05). The proportions of malnutrition and overweight/obesity were 11.0% and 10.0% respectively. After controlling factors as gender, age, ethnicity, region of residency and types of parental employment, students who drank milk at breakfast showed an average height of 0.4 cm taller than those who did not drink milk (P=0.001). However, no significant relationships were noticed between milk intake at breakfast and weight, malnutrition or overweight/obesity. Conclusion: Milk intake at breakfast seemed associated with the height of the students under study, suggesting that this program can be promoted, especially in students from the poor rural areas.

Robust optimization to reduce the impact of biological effect variation from physical uncertainties in intensity-modulated proton therapy

Robust optimization (RO) methods are applied to intensity-modulated proton therapy (IMPT) treatment plans to ensure their robustness in the face of treatment delivery uncertainties, such as proton range and patient setup errors. However, the impact of those uncertainties on the biological effect of protons has not been specifically considered. In this study, we added biological effect-based objectives into a conventional RO cost function for IMPT optimization to minimize the variation in biological effect. One brain tumor case, one prostate tumor case and one head & neck tumor case were selected for this study. Three plans were generated for each case using three different optimization approaches: planning target volume (PTV)-based optimization, conventional RO, and RO incorporating biological effect (BioRO). In BioRO, the variation in biological effect caused by IMPT delivery uncertainties was minimized for voxels in both target volumes and critical structures, in addition to a conventional voxel-based worst-case RO objective function. The biological effect was approximated by the product of dose-averaged linear energy transfer (LET) and physical dose. All plans were normalized to give the same target dose coverage, assuming a constant relative biological effectiveness (RBE) of 1.1. Dose, biological effect, and their uncertainties were evaluated and compared among the three optimization approaches for each patient case. Compared with PTV-based plans, RO plans achieved more robust target dose coverage and reduced biological effect hot spots in critical structures near the target. Moreover, with their sustained robust dose distributions, BioRO plans not only reduced variations in biological effect in target and normal tissues but also further reduced biological effect hot spots in critical structures compared with RO plans. Our findings indicate that IMPT could benefit from the use of conventional RO, which would reduce the biological effect in normal tissues and produce more robust dose distributions than those of PTV-based optimization. More importantly, this study provides a proof of concept that incorporating biological effect uncertainty gap into conventional RO would not only control the IMPT plan robustness in terms of physical dose and biological effect but also achieve further reduction of biological effect in normal tissues.

Reductively dissociable biomimetic nanoparticles for control of integrin-coupled inflammatory signaling to retard atherogenesis

Reductively dissociable biomimetic nanoparticles EC-BSA-MnO₂ were developed for the control of integrin-coupled inflammatory signaling to retard atherogenesis.

A Redox-Responsive Self-Assembled Nanoprobe for Photoacoustic Inflammation Imaging to Assess Atherosclerotic Plaque Vulnerability

Inflammation triggered by oxidative stress is the main determinant of atherosclerotic plaque disruption, which is the leading cause of myocardial infarctions and strokes. Hence, noninvasive mapping of alterations in redox status in vivo is highly desirable for accurate assessment of plaque inflammatory activity and vulnerability. Herein, two types of near-infrared fluorescence probes, specific for glutathione (GSH)/hydrogen peroxide (H₂O₂) redox couple, were used to introduce the self-assembly of bovine serum albumin (BSA), forming a BSA-Cy-Mito nanoprobe for in vivo photoacoustic imaging of redox status. Such BSA-based self-assemblies on one hand processed good biocompatibility and long blood circulation for high EPR effect and plaque accumulation and on the other hand displayed strong GSH- and H₂O₂-dependent absorbance at 765 and 680 nm, which enabled simultaneous photoacoustic detection of GSH/H₂O₂ with high specificity and sensitivity. Using BSA-Cy-Mito as an in vivo GSH/H₂O₂ indicator, accurate detection of the redox-related inflammatory process was realized both in oxidized low-density lipoprotein (ox-LDL)-activated macrophages and high fat diet-fed apolipoprotein E-deficient (ApoE^-/^-) mice. Systemic administration of BSA-Cy-Mito further enabled differentiation of vulnerable plaques from stable ones based on their different redox states. Therefore, this sensitive redox-responsive PA nanoprobe may be a powerful tool for early identification of rupture-prone plaques and help in implementing successful preventative therapeutic strategies.

CeO2 Nanowire-BODIPY-Adenosine Triphosphate Fluorescent Sensing Platform for Highly Specific and Sensitive Detection of Arsenate

Effective and sensitive monitoring of arsenate in drinking water is significant for risk management of public health. Here, we demonstrated that a CeO₂ nanowire acted as an efficient quencher for small fluorescent molecules with a phosphate group, BODIPY-adenosine triphosphate (BODIPY-ATP) and riboflavin-5'-phosphate (Rf-P), and developed a CeO₂ nanowire-BODIPY-ATP platform for highly selective and sensitive detection of arsenate. The response strategy was based on the competitive coordination chemistry of CeO₂ nanowire between arsenate and phosphate group of BODIPY-ATP. Arsenate displaced adsorbed BODIPY-ATP to enhance fluorescence, allowing detection of arsenate down to 7.8 nM, which is lower than the WHO-defined limit of 130 nM. An excellent linear range of 20-150 and 150-1000 nM was obtained. Importantly, this system was simple in design and convenient in operation. Also, the platform exhibited excellent selectivity for arsenate without the interference of phosphate ions. Finally, the proposed method had been successfully employed for determination of arsenate in real water samples.

[The clinical characteristics of immunocompetent adults with chronic active Epstein-Barr virus associated enteritis]

Objective: To investigate the clinical and pathological characteristics of chronic active Epstein-Barr virus associated enteritis (CAEAE) . Methods: The clinical data of 6 CAEAE patients in Peking Union Medical College Hospital were retrospectively analyzed from January 2010 to November 2017, including clinical manifestations, endoscopic, pathological features, medications and clinical outcome. Results: The male∶female ratio was 4∶2 and the average age was 34 years old. All patients did not have personal and family history of immunodeficiency. The common symptoms consisted of fever (6/6), abdominal pain (6/6), hematochezia (6/6) and diarrhea (5/6). The most frequently affected sites were colorectum (5/6), followed by small intestine (3/6). Further serologic tests revealed a high load of serum Epstein-Barr virus(EBV) DNA. The main manifestations under endoscopy were multifocal or diffuse irregular ulcers. There was inflammation in the ulcer bases and surrounding areas, where EBV-encoded small RNA (EBER) was positive by in situ hybridization (6/6). The common complications were massive hemorrhage (3/6) and intestinal perforation (2/6). None of treatment agents including glucocorticoid, ganciclovir, foscarnet sodium and cytotoxic drugs was effective. All patients died within 0.5 to 13 months after diagnosis. Conclusions: CAEAE in immunocompetent individuals is a rare disorder with poor prognosis. It is difficult to differentiate CAEAE from inflammatory bowel disease due to similar clinical and endoscopic manifestations.

[Central venous-arterial carbon dioxide tension to arterial-central venous oxygen content ratio combined with lactate clearance rate as early resuscitation goals of septic shock]

Objective: To investigate the prognostic significance of central venous-arterial carbon dioxide tension to arterial-venous oxygen content ratio (Pcv-aCO(2)/Ca-cvO(2)) combined with lactate clearance rate (LCR) as early resuscitation goals of septic shock. Methods: One hundred and forty-five septic shock patients admitted to Second Department of Critical Care Medicine of Lanzhou University Second Hospital from March 2013 to May 2017 were enrolled in this study.All septic shock patients received an initial resuscitation therapy according to early goal-directed therapy.The arterial and central venous blood gases were measured simultaneously at baseline (T0) and 6 hours after resuscitation (T6). Pcv-aCO(2)/Ca-cvO(2) and LCR were calculated.Patients were classified into four groups according to Pcv-aCO(2)/Ca-cvO(2) and LCR at T6: group A, Pcv-aCO(2)/Ca-cvO(2)>1.8 and LCR<30%; group B, Pcv-aCO(2)/Ca-cvO(2)>1.8 and LCR≥30%; group C, Pcv-aCO(2)/Ca-cvO(2)≤1.8 and LCR<30%; group D, Pcv-aCO(2)/Ca-cvO(2)≤1.8 and LCR≥30%.General demographics, hemodynamic parameters, oxygen metabolism parameters, acute physiology and chronic health evaluation (APACHE Ⅱ) scores, sequential organ failure assessment (SOFA) scores, length of intensive care unit (ICU) stay, and 28-day mortality rate were compared among the 4 groups.A Kaplan-Meier curve showed the survival probabilities at day 28 using a log-rank test for multiple comparisons.Parameters were introduced into a Cox's proportional hazards regression model to analyze the prediction of 28-day mortality.Receiver operating characteristics (ROC) curves were constructed to evaluate the ability of Pcv-aCO(2)/Ca-cvO(2), LCR, Pcv-aCO(2)/Ca-cvO(2) combined with LCR at T6 to predict 28-day mortality. Results: Compared with patients in group A, patients from group D had the lower APACHE Ⅱ and SOFA score at day 3 (t=-2.909, -3.630, both P<0.05), shorter ICU stay (t=-2.575, P=0.011), and lower mortality rate at day 28 (χ(2)=3.124, P=0.011). Survival curves up to day 28, illustrated by Kaplan-Meier method, showed that group A had the shortest median survival time (χ(2)=10.332, P=0.016), difference between group A and group D was statistically significant (χ(2)=8.304, P=0.004). The Cox regression analysis revealed that Pcv-aCO(2)/Ca-cvO(2) (RR=3.888, 95%CI: 2.443-6.189, P<0.001) and LCR (RR=0.073, 95%CI: 0.008-0.640, P=0.018) at T6 were independent predictors of 28-day mortality.The area under ROC curve for Pcv-aCO(2)/Ca-cvO(2) combined with LCR (0.919, 95%CI: 0.862-0.958) was significantly greater than whether Pcv-aCO(2)/Ca-cvO(2) (0.862, 95%CI: 0.795-0.914) or LCR (0.820, 95%CI: 0.748-0.879) alone (Z=2.032, 2.364, both P<0.05). Conclusion: Combination of Pcv-aCO(2)/Ca-cvO(2) and LCR is better than single parameter to predict the risk of adverse outcomes of septic shock patients, and may provide useful information for assessing the adequacy of resuscitation at early stage of septic shock.

[Relationship between expression level of sex-determining region Y box 9 and metastasis of oral squamous cell carcinoma]

Objective: To investigate the effects of sex-detemining region Y box9 (SOX9) expression levels on the proliferation, migration and metastasis in oral squamous cell carcinoma (OSCC). Methods: A total of 74 OSCC pathological specimens were collected from Shanghai OSCC Tissue and Biological Informations Bank, and clinicopathological information of these specimens were collected. Immunohistochemistry assay was used to examine the expression levels of SOX9 in OSCC and to analyze their relationship with clinicopathological features. Cell counting kit-8 assay and cloning formation was used to observe the relationship between the expression levels of SOX9 and the proliferation of OSCC. Transwell experiment and scratch test were used to detect the difference of the ability of OSCC in cell lines with different expression levels of SOX9. Results: The risk of lymph node metastasis in patients with high expression of SOX9 was significantly increased (P=0.010). In the Transwell experiment, the number of HN6 cells (671.0±57.4, P=0.000) migrated to the lower chamber more than that of CAL27 cells (172.0±13.9). In the scratch experiment, HN6 cells [0 h: (93.7±2.1) μm; 6 h: (56.7±2.5) μm; 12 h: (29.7±3.1) μm] migrated faster than CAL27 [0 h: (93.7±1.5) μm; 6 h: (78.0±2.0) μm; 12 h: (42.0±3.0) μm](P<0.05). The migration ability of the cell line (HN6) with high-expression of SOX9 was significantly higher than that in cell line (CAL27) with low-expression SOX9 (P<0.05). The expression levels of SOX9 in OSCC were no significant on cell proliferation (P>0.05). Conclusions: High expression of SOX9 can promote the migration and lymph node metastasis of OSCC. SOX9 is a candidate gene target for the diagnosis and intervention of lymph node metastasis in OSCC.

[Value analysis of preoperative and intra-operative ultrasound in diagnosis and treatment of parathyroid adenoma]

Objective:To explore the value characteristics of preoperative and intra-operative ultrasound in the diagnosis and treatment of parathyroid adenoma,and to further clarify the value of ultrasound in the diagnosis and treatment of parathyroid adenoma.Method:A total of 62 cases of parathyroid adenoma confirmed by postoperative pathology from March 2016 to November 2017 were collected, and the pre-operative ultrasound parameters were analyzed;and 26 cases were detected by intra-operative ultrasound.Result:In 62 cases of parathyroid adenoma, 58 cases of parathyroid adenoma were diagnosed by ultrasound before operation,and the sensitivity was 93.54%. Among the 26 cases,the lesions of 24 cases were detected by intra-operative ultrasound,and the sensitivity was 92.31%.Conclusion:Preoperative ultrasonography has a high diagnostic value for the qualitative diagnosis and location diagnosis of parathyroid adenoma, and intra-operative ultrasound can help to detect lesions quickly and safely, which is of great significance to shorten the operation time and improve the safety of operation. It is an important development space of ultrasound in the diagnosis and treatment of parathyroid glands.

The Src homology and collagen A (ShcA) adaptor protein may participate in the pathogenesis of membranous lupus nephritis

The Src homology and collagen A (ShcA) adaptor protein that binds to tyrosine kinase receptors. ShcA plays a role in insulin signaling, stress resistance and energy metabolism. The 66-kDa Src homology 2 domain-containing protein (p66shc) belongs to the ShcA family and has been associated with reactive oxygen species (ROS); increased ROS is involved in the pathology of lupus nephritis (LN). However, whether ShcA can act as a biomarker for oxidative injury in LN is unknown. This study is aimed to investigate the ShcA expression in kidney tissues from patients presenting with LN and the association between ShcA expression and clinical parameters. Renal biopsy tissues were obtained from 62 LN, 20 primary membranous nephropathy (MN) and 10 other secondary MN patients. ShcA was measured by immunofluorescence. The expression of ShcA in the membranous lupus nephritis (class V) group showed a higher trend but there were no significant differences compared with pure mesangial disease (class II) and proliferative (Class III/IV) lupus nephritis. ShcA deposits were negative in primary and other secondary MN. ShcA might act as a new biomarker and a diagnostic tool to identify membranous lupus nephritis with other MN.

[Relationship between UGT1A1 gene polymorphisms and irinotecan-induced severe adverse events]

Objective: To investigate the relationship between UGT1A1*6, UGT1A1*28, UGT1A1*60 and UGT1A1*93 polymorphisms and irinotecan-induced severe adverse reactions(grade 3-4 delayed diarrhea and neutropenia) in Chinese cancer patients. Methods: A total of 141 cancer patients treated with irinotecan were enrolled in this study. Peripheral venous blood was collected and genomic DNA was extracted. The genetic polymorphisms of UGT1A1*6, UGT1A1*28, UGT1A1*60 and UGT1A1*93 were analyzed by PCR and direct sequencing. The adverse reactions during chemotherapy were observed and recorded. The incidence of severe adverse reactions was compared among patients with different genotypes. Results: Among 141 patients, the cases with UGT1A1*6 GG, GA and AA genotypes were 71, 54 and 16, while those with UGT1A1*28 TA6/6, TA6/7 and TA7/7 genotypes were 105, 33 and 3, respectively. The cases with UGT1A1*60 AA, AC and CC genotypes were 52, 80 and 9, while those with UGT1A1*93 GG, GA and AA genotypes were 105, 32 and 4, respectively. The patients with grade 3-4 delayed diarrhea and neutropenia were 23 and 56, respectively. Multivariate logistic regression analysis showed that UGT1A1*6 and UGT1A1*60 genetic polymorphisms were independent factors influencing the occurrence of grade 3-4 delayed diarrhea. The risk of grade 3-4 delayed diarrhea in homozygous AA carriers of UGT1A1*6 increased 3.79 times compared with that in wild-type GG carriers (95%CI: 1.35-10.67). Moreover, the risk of grade 3-4 delayed diarrhea in homozygous CC carriers of UGT1A1*60 was 20.42 times compared with that in wild-type AA carriers (95%CI: 3.52-118.33). In addition, UGT1A1*28 genetic polymorphism was an independent factor of the occurrence of grade 3-4 neutropenia. The patients with homozygous TA7/7 carriers of UGT1A1*28 had an 1.61 times higher risk of grade 3-4 neutropenia compared with those with wild-type TA6/6 carriers (95%CI: 1.44-12.65). There was no correlation between UGT1A1*93 genetic polymorphism and severe adverse reactions caused by irinotecan. Conclusion: The cancer patients who carried UGT1A1*6, UGT1A1*28 and UGT1A1*60 gene polymorphisms have high risk of severe adverse events caused by irinotecan-based chemotherapy.

Effect of selenium supplementation on pigeon reproductive performance, selenium concentration and antioxidant status

The effects of dietary supplementation of sodium selenite (SS) on the reproductive performance and the concentration of selenium, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and malondialdehyde (MDA) were determined, and expression of glutathione peroxidase 4 (GPx4) and bone morphogenic protein 15 (BMP15) was evaluated. Paired pigeons (n = 864) were fed: T1 received no SS, while T2, T3, and T4 received 0.5, 1.0, and 1.5 mg of SS/kg of dry matter (DM), respectively. Treatments were performed in triplicate with 72 pairs in each replicate. The results showed that selenium supplementation significantly affected pigeon reproductive performance. Birds fed 1.0 mg of SS/kg displayed higher egg production (P > 0.05), higher birth rate, and lower dead sperm rate than the control group (P < 0.05). Selenium and biochemical analyses revealed a higher selenium concentration in the 1.5 mg of SS/kg group than in the control group (P < 0.05), while GSH-Px was higher in the 0.5 mg of SS/kg group than in the control group (P < 0.05). Neither the MDA nor the SOD content were affected significantly in liver, chest muscle, or leg muscle (P > 0.05); however, in plasma, MDA was lower in the control group (P < 0.05), while SOD was higher in the control group (P < 0.05). qRT-PCR results revealed up-regulation of GPx4 in hypothalamus, pituitary and testis tissues in supplemented groups (P < 0.05). However, expression in ovary differed; GPx4 mRNA levels were lower in the 1.5 mg of SS/kg and control groups than in the 1.0 or 0.5 mg of SS/kg groups (P < 0.05). Expression of BMP15 in the hypothalamus, pituitary, and testis tissues was unaffected (P > 0.05), while in ovary, BMP15 was down-regulated in the 1.5 mg of SS/kg group (P < 0.05). These results suggest pigeons supplemented with SS up-regulated GPx4, 1.0 mg of SS/kg exhibited superior reproductive performance, while 1.5 mg of SS/kg increased the selenium concentration, and 0.5 mg of SS/kg up-regulated GSH-Px activity.

First detection of foot-and-mouth disease virus O/ME-SA/Ind2001 in China

Foot-and-mouth disease (FMD) is endemic in China and is predominantly due to foot-and-mouth disease virus (FMDV) serotype O Mya-98 lineage. In recent years, FMDV O/ME-SA/Ind2001 lineage has spread from the Indian subcontinent to South-East Asia, Middle East and Africa, which may pose potential threats for future trans-regional livestock movements. In this study, we identified the appearance of FMDV O/ME-SA/Ind2001 in China; the first time that this virus lineage has been found there. Sequencing and phylogenetic analysis of VP1 sequences revealed that this newly determined strain belongs to O/ME-SA/Ind2001 sublineage d and is closely related to strains that have caused recent outbreaks of FMD in Nepal, Myanmar, Russia and South Korea. The results suggest extensive movements of the current O/ME-SA/Ind2001 sublineage d viruses and provide essential information for an effective national FMDV control programme in China.