[Mid-term clinical outcome of total knee arthroplasty with domestic A3 posterior stabilized prosthesis]

Objective: To observe the mid-term clinical outcome of total knee arthroplasty (TKA) with domestic A3 posterior stabilized prosthesis. Methods: The clinical data of 342 patients (438 knees) who underwent primary TKA by the same surgeon from June 2012 to December 2013 in Peking University Third Hospital were retrospectively collected. The patients were divided into 2 groups according to the type of prosthesis: 107 patients (137 knees) with domestic A3 prosthesis, as domestic group; 235 patients (301 knees) with a kind of imported prosthesis, as the control group. In the end, 311 patients (390 knees) received complete follow-up.The postoperative knee maximum flexion angle, postoperative Hospital for Special Surgery Knee Score (HSS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), postoperative coronal mechanical axis alignment and hospitalization costs were compared between the groups.Paired t-test was used to compare the preoperative and postoperative data in the same group, and independent sample t-test was used to compare the data between the two groups at the same time points. Results: The average follow-up time of all the patients was (5.6±1.1) years, and it was averaged for 64.8 months in the domestic group and 68.2 months in the control group.There was no significant difference in the HSS score and WOMAC score, the knee maximum flexion angle, and coronal mechanical axis alignment at the 3 months postoperatively and at the end of follow-up between the two groups (t=-0.890, -1.610, 1.740, 0.620, all P>0.05). In 2012, the average hospital cost was (24 879±1 627) yuan/knee in the domestic group and it was (49 611±1 589) yuan/knee in the control group (t=-48.902, P<0.01). In 2013, it was (38 393±2 773) yuan/knee in the domestic group, and was (55 931±3 533) yuan/knee in the control group (t=-14.795, P<0.01). Conclusion: It indicates that the domestic A3 posterior stabilized prosthesis brings comparable mid-term results with the imported prothesis and it reduces medical costs remarkably.

Direct and indirect effects of climate on richness drive the latitudinal diversity gradient in forest trees

Climate is widely recognised as an important determinant of the latitudinal diversity gradient. However, most existing studies make no distinction between direct and indirect effects of climate, which substantially hinders our understanding of how climate constrains biodiversity globally. Using data from 35 large forest plots, we test hypothesised relationships amongst climate, topography, forest structural attributes (stem abundance, tree size variation and stand basal area) and tree species richness to better understand drivers of latitudinal tree diversity patterns. Climate influences tree richness both directly, with more species in warm, moist, aseasonal climates and indirectly, with more species at higher stem abundance. These results imply direct limitation of species diversity by climatic stress and more rapid (co-)evolution and narrower niche partitioning in warm climates. They also support the idea that increased numbers of individuals associated with high primary productivity are partitioned to support a greater number of species.

[Individual dose monitoring and health status of radiation workers in some Three A hospitals of Zhejiang province]

Objective: To investigate the individual irridiateddose levelandhealth statusofoccupational externalexposureamong radiationworkers inThreeA hospitals ofZhejiangprovince,andprovideevidence for occupationalhealthmanagement. Methods: 367 different typesof radiationworkerswereexperienced thedose monitoring and health examination from January toDecember, 2015, according to the requirements of"SpecificationsofIndividualMonitoring forOccupationalExternalExposure"and"Specifications forOccupational healthsurveillance forradiationworkers".The resultsofdosemonitoring,chromosomeaberration rate, lensopacity rate,hemogramand thyroid functionwerestatisticallyanalyzed. Results: Theannualeffectivedoseamong radiation workers fromZhejiangprovince in2015was0.13mSv,98.91%of them less than1mSv,whichunder the limit standardofstate(20mSv/a).Thechromosomeaberration(dicentric)detection rateswere7.41%and4.35%, from nuclearmedicinegroupand interventionalgroup respectively,whichhigher thandiagnostic radiologygroup, the differencewasstatisticallysignificant(χ(2)=13.686,8.092,P<0.01).Besides,1caseofsuspiciouschronic radiation dermatitiswas found in the interventiongroup.Radiation lengthhadsignificanteffecton lensopacity rate(P<0.01), lensopacity increasedwith the increasing lengthof the linear trend (χ(2)trend=16.363,P<0.01),and the incidence ofabnormalthyroid function theabnormalrateof lymphocyte ratiohad significantdifferenceamong theagegroups (P<0.05). Conclusion: Although, theoccupationalexternalexposureamong radiationworkersinThreeAhospitals ofZhejiangprovince issafe, long-term lowdosesofionizing radiation stillhascertainhealtheffectson the fieldof nuclearmedicineand interventionalradiologystaff,suchaseye lens,cytogenetics,nailsandskin.

[Detection and Analysis of the peripheral lymphocytes micronucleus rate of radiation workers in a city]

Objective: To perform lymphocyte micronucleus analysis on radiation workers with long-term exposure to low doses ionizing radiation, Evaluate the health condition of radiation workers, and provide the evidence for strengthening surveillance of radiation workers. Methods: From January 1, 2013 to December 21, 2016, a statistical analysis and evaluation was conducted of the peripheral lymphocytes micronucleus rate in 5 901 radiation workers who had undergone medical examinations of employees at Chinese Academy of Medical Sciences Institute of Radiation Medicine. Results: The micronucleus rates in radiation workers of the on-job group were higher than the pre-job group (P<0.01) . Significant difference was found among the different sex (t=5.97) , different types (χ(2)=378.69) , different levels of work units (χ(2)=115.48) . Significant difference was found among the micronucleus rates of 672 radiation workers of the on-job group from 2013 to 2016 (χ(2)=92.57, P<0.01) . Conclusion: The peripheral lymphocytes micronucleus rate of radiation workers were significantly higher than non-contact workers. Significant increasing trend of micronucleus rates was noted among the radiation worker with increasing exposure time. The peripheral lymphocytes micronucleus rates of interventional therapy workers were highest. The peripheral lymphocytes micronucleus rates of Private hospitals workers were highest. This phenomenon deserves attention. Protection needs to be strengthened to ensure the health of radiation workers.

[Development and progress of sixty years and stepping firmly to the future]

Since its establishment for 60 years, Department of Burns of the Second Affiliated Hospital of Zhejiang University School of Medicine has grown into a famous regional burn center in China under the leading of the pioneers and through the efforts of several generations. The department has distinctive disciplinary features in burn care, nutritional support, scar prevention and treatments, standard management of chronic wound, and skin tissue engineering research, making positive contribution to the development of burn medicine in China.

The role of breeding system in community dynamics: Growth and mortality in forests of different successional stages

Plant sexual systems appear to play an important role in community assembly: Dioecious species are found to tend to have a higher propensity to colonize communities in early successional stages. Here, we test two demographic hypotheses to explain this pattern in temperate forests. First, we test demographic differences between hermaphrodite and dioecious species in stressful younger successional stages: Previous theory predicts that hermaphrodite seed production is more harmed in stressful environments than that of dioecious populations leading to an advantage for females of dioecious species. Second, in primary forest, we hypothesized that dioecious species would show demographic advantage over monomorphic ones. We used data from two temperate forest plots in Northeast China surveyed over 10 years to compare the rates of growth and mortality of tree species with contrasting breeding systems in both secondary and primary forests. We assessed the effect of breeding system on the growth-mortality trade-off, while controlling for other traits usually considered as correlates of growth and mortality rates. We show that in the secondary forest, dioecious species showed weak advantage in demographic rates compared with monomorphic species; dioecious species showed considerably both lower relative growth and mortality rates compared to the hermaphrodites in the primary forest over 10 years, consistent with a priori predictions. Hermaphrodites showed strong growth-mortality trade-offs across forest stages, even when possibly confounding factors had been accounted for. These results suggest that sexual system influences community succession and assembly by acting on the rates of growth and mortality, and the trade-off between them. As vegetation develops, the demographic differences between breeding systems are much larger. Our results demonstrate the association between breeding system, succession, and community assembly and that this relationship is succession-stage dependent. Our findings support the suggestion that the demographic advantage of dioecious species facilitates the coexistence of sexual systems in primary forest.

Abiotic and biotic determinants of coarse woody productivity in temperate mixed forests

Forests play an important role in regulating the global carbon cycle. Yet, how abiotic (i.e. soil nutrients) and biotic (i.e. tree diversity, stand structure and initial biomass) factors simultaneously contribute to aboveground biomass (coarse woody) productivity, and how the relative importance of these factors changes over succession remain poorly studied. Coarse woody productivity (CWP) was estimated as the annual aboveground biomass gain of stems using 10-year census data in old growth and secondary forests (25-ha and 4.8-ha, respectively) in northeast China. Boosted regression tree (BRT) model was used to evaluate the relative contribution of multiple metrics of tree diversity (taxonomic, functional and phylogenetic diversity and trait composition as well as stand structure attributes), stand initial biomass and soil nutrients on productivity in the studied forests. Our results showed that community-weighted mean of leaf phosphorus content, initial stand biomass and soil nutrients were the three most important individual predictors for CWP in secondary forest. Instead, initial stand biomass, rather than diversity and functional trait composition (vegetation quality) was the most parsimonious predictor of CWP in old growth forest. By comparing the results from secondary and old growth forest, the summed relative contribution of trait composition and soil nutrients on productivity decreased as those of diversity indices and initial biomass increased, suggesting the stronger effect of diversity and vegetation quantity over time. Vegetation quantity, rather than diversity and soil nutrients, is the main driver of forest productivity in temperate mixed forest. Our results imply that diversity effect for productivity in natural forests may not be so important as often suggested, at least not during the later stage of forest succession. This finding suggests that as a change of the importance of different divers of productivity, the environmentally driven filtering decreases and competitively driven niche differentiation increases with forest succession.

[Analysis on clinical characteristics of 316 patients with hydrofluoric acid burns]

Objective: To investigate the clinical characteristics of patients with hydrofluoric acid (HF) burns. Methods: Clinical data of 316 patients with HF burns admitted to Zhejiang Quhua Hospital from January 2004 to December 2016 were retrospectively analyzed. Patients were divided into non and mild poisoning group (NMP, n=157), moderate poisoning group (MP, n=120), and severe and fatal poisoning group (SFP, n=39) based on the severity of poisoning. Occurrences of hypocalcemia, hypomagnesemia, hypokalemia, and hyperkalemia of patients within 24 hours after admission were recorded. Values of emergency urinary fluoride of patients on admission were recorded. Values of urinary fluoride of patients admitted to hospital in 4 hours post injury in groups MP and SFP at post injury hour 4, 12, and 24 and on post injury day 2, 3, 4, 5, 6, and 7 were also recorded. Electrocardiographic abnormalities of patients within 24 hours after admission were recorded. Data were processed with chi-square test, Kruskal-Wallis H test, and Mann-Whitney U test. Results: (1) Hypocalcemia, hypomagnesemia, and hypokalemia occurred in some patients in each of the three groups, but no patient had hyperkalemia. Taking serum calcium namely total serum calcium as reference, the incidence rate of hypocalcemia of patients in group NMP was close to that in group MP (χ(2)=0.05, P>0.05). The incidence rate of hypocalcemia of patients in group SFP was significantly higher than that in group NMP or group MP (χ(2)=10.53, 7.92, P<0.01). The incidence rates of hypokalemia in the three groups were close (χ(2)=0.63, P>0.05). Taking serum ionized calcium as reference, the incidence ratio of hypocalcemia of patients in group NMP was close to that in group MP (χ(2)=0.01, P>0.05), while there were statistically significant differences in incidence ratio of hypocalcemia of patients between group SFP and each of group NMP and group MP (χ(2)=4.66, 4.47, P<0.05). Taking serum calcium as reference, the incidence rate of hypocalcemia of patients was 7.3% (23/316). Taking serum ionized calcium as reference, the incidence rate of hypocalcemia of patients was 60.0% (42/70), which was significantly higher than that of taking serum calcium as reference (χ(2)=113.74, P<0.01). The incidence rates of hypomagnesemia of patients in groups MP and NMP were close (χ(2)=0.02, P>0.05). The incidence rate of hypomagnesemia of patients in group SFP was significantly higher than that in group NMP or group MP (χ(2)=14.69, 9.94, P<0.01). (2) The urinary fluoride levels were tested in 288 patients, with the value of emergency urinary fluoride of patients on admission 0.2-590.0 mg/L. The values of urinary fluoride of 202 patients were above the normal value. The values of emergency urinary fluoride of patients in groups NMP, MP, and SFP were 2.15 (1.11, 4.30), 5.89 (1.72, 14.25), and 36.0 (13.2, 103.2) mg/L, respectively. The values of emergency urinary fluoride of patients in groups MP and SFP were significantly higher than the value in group NMP (χ(2)=23.28, 66.03, P<0.01). The value of emergency urinary fluoride of patients in group SFP was significantly higher than that in group MP (χ(2)=39.23, P<0.01). The value of urinary fluoride of 33 patients admitted to hospital within 4 hours post injury in groups MP and SFP reached the top at 4 hours post injury and then gradually declined, which returned to normal on about 5 days post injury. The values of urinary fluoride of patients in group SFP at 4, 12, and 24 hours post injury and on 2, 3, 4, 5, 6, and 7 days post injury were significantly higher than those in group MP (Z=-4.28, -4.15, -3.81, -4.21, -2.48, -2.06, -2.31, -2.68, -3.03, P<0.05 or P<0.01). (3) Twenty-seven patients had electrocardiographic abnormality. There were 12 patients with T wave changes (the most common), 8 patients with ST-T changes, 6 patients with ventricular arrhythmias, 6 patients with conduction block, and 1 patient with broadened QRS waveform. There was no patient with prolonged Q-T interval. The ratios of patients with the above electrocardiographic abnormalities in group SFP were higher than those in group NMP and group MP. Conclusions: Clinical manifestations of patients with HF burn are hypocalcemia, hypomagnesemia, hypokalemia, and electrocardiographic abnormality. In addition to routine serum electrolyte and electrocardiogram monitoring, the levels of serum ionized calcium and urinary fluoride can be helpful to evaluate the severity of illness of the patients.

[Analysis on effects of modified dosage of calcium gluconate on patients with hydrofluoric acid burns not in hands or feet]

Objective: To retrospectively explore the effects of modified dosage of calcium gluconate (CG) on the patients with hydrofluoric acid burns not in hands or feet. Methods: One hundred and sixty patients with hydrofluoric acid burns not in hands or feet were hospitalized in our burn ward from January 2004 to December 2017. Based on the dosage of CG at different admission time, 76 patients hospitalized from January 2004 to December 2012 were included in traditional group, and 84 patients hospitalized from January 2013 to December 2017 were included in modified group. For patients in the two groups, subcutaneous injection of CG solution at one time was immediately conducted on admission in topical treatment. In traditional group, the injection was CG solution with mass concentration of 100 g/L. For wounds of superficial partial-thickness and above degree, CG solution was prescribed at the dosage of 50 mg/cm(2). Wounds of superficial-thickness or mass fraction of hydrofluoric acid less than 20.0% did not receive injection. In modified group, the mass concentration of CG solution for injection was diluted with normal saline to 25 g/L. For wounds of deep partial-thickness and above degree, CG solution was prescribed at the dosage of (50×mass fraction of hydrofluoric acid) mg/cm(2). For wounds of superficial partial-thickness, CG solution was prescribed at the dosage of (25×mass fraction of hydrofluoric acid) mg/cm(2). For wounds of superficial-thickness, CG solution was prescribed at the dosage of 2.5 mg/cm(2). For systemic treatment, the injection velocity of CG solution via venous access was adjusted according to the level of serum calcium namely total serum calcium of patients in traditional group. In modified group, serum ionized calcium was additionally detected through automatic blood gas analyzer by the bed to regulate the injection velocity of CG via venous access. The incidence rate of hypercalcemia and mortality of patients after treatment in the two groups, and the situation about treatment of survivors in the two groups were analyzed. Data were processed with chi-square test, Fisher's exact probability test, t test, and Mann-Whitney U test. Results: (1) After treatment, 9 patients (11.8%) had hypercalcemia, while the other 67 patients (88.2%) did not have hypercalcemia in traditional group. Two patients (2.4%) had hypercalcemia, while the other 82 patients (97.6%) did not have hypercalcemia in modified group. The incidence rate of hypercalcemia of patients in traditional group was significantly higher than that in modified group (χ(2)=5.579, P=0.02). (2) There were two deaths (2.6%) and 74 survivors (97.4%) in traditional group, while there were two deaths (2.4%) and 82 survivors (97.6%) in modified group. The mortalities of patients in the two groups were close (P>0.05). (3) The ratios of eschar excision and skin grafting and hyperplastic scar formation, wound healing time, and ratio of esophageal scar stenosis of survivors in the two groups were close (χ(2)=0.002, 0.054, Z=0.66, P>0.05). Conclusions: Hydrofluoric acid is highly dangerous. The early management of patients with hydrofluoric acid burns emphasizing specialized dosage of CG for treatment can be helpful to reduce incidence of complications and improve the safety of treatment.

[Advances in the research of application of three-dimensional bioprinting in skin tissue engineering]

Deep skin wounds require skin grafts for coverage. Current treatments such as tissue engineered skin or skin substitutes can not meet the needs of clinical application due to the technical problems involving preservation, transportation, and a lengthy preparation process. In comparison with traditional methods such as freeze-drying, three-dimensional bioprinting can precisely dispense living cells, nucleic acid, growth factor, and phase-changing hydrogels according to the wound form, while maintaining high cell viability. Besides, it has excellent performance in high resolution, flexibility, reproducibility, and high throughput, showing great potential in the fabrication of tissue engineered skin. This review mainly introduces the common techniques of three-dimensional bioprinting, and their application in skin tissue engineering, focusing on the latest research progress, and summarizes the current challenges and future development of three-dimensional skin printing.

Global signal of top-down control of terrestrial plant communities by herbivores

The theory of "top-down" ecological regulation predicts that herbivory suppresses plant abundance, biomass, and survival but increases diversity through the disproportionate consumption of dominant species, which inhibits competitive exclusion. To date, these outcomes have been clear in aquatic ecosystems but not on land. We explicate this discrepancy using a meta-analysis of experimental results from 123 native animal exclusions in natural terrestrial ecosystems (623 pairwise comparisons). Consistent with top-down predictions, we found that herbivores significantly reduced plant abundance, biomass, survival, and reproduction (all P < 0.01) and increased species evenness but not richness (P = 0.06 and P = 0.59, respectively). However, when examining patterns in the strength of top-down effects, with few exceptions, we were unable to detect significantly different effect sizes among biomes, based on local site characteristics (climate or productivity) or study characteristics (study duration or exclosure size). The positive effects on diversity were only significant in studies excluding large animals or located in temperate grasslands. The results demonstrate that top-down regulation by herbivores is a pervasive process shaping terrestrial plant communities at the global scale, but its strength is highly site specific and not predicted by basic site conditions. We suggest that including herbivore densities as a covariate in future exclosure studies will facilitate the discovery of unresolved macroecology trends in the strength of herbivore-plant interactions.

Spatially Explicit Metrics of Species Diversity, Functional Diversity, and Phylogenetic Diversity: Insights into Plant Community Assembly Processes

Spatial processes underlie major species coexistence mechanisms. A range of spatial analysis techniques are increasingly applied to data of fully mapped communities to quantify spatial structures in species and phylogenetic and functional diversity at some given spatial scale with the goal of gaining insights into processes of community assembly and dynamics. We review these techniques, including spatial point pattern analysis, quadrat-based analyses, and individual-based neighborhood models, and provide a practical roadmap for ecologists in the analysis of local spatial structures in species and phylogenetic and functional diversity. We show how scale-dependent metrics of spatial diversity can be used in concert with ecological null models, statistical models, and dynamic community simulation models to detect spatial patterns, reveal the influence of the biotic neighborhood on plant performance, and quantify the relative contribution of species interactions, habitat heterogeneity, and stochastic processes to community assembly across scale. Future works should integrate these approaches into a dynamic spatiotemporal framework.

Microbial Taxa Distribution Is Associated with Ecological Trophic Cascades along an Elevation Gradient

The elevational pattern of soil microbial diversity along mountain slopes has received considerable interest over the last decade. An increasing amount of taxonomic data on soil microbial community composition along elevation gradients have been collected, however the trophic patterns and environmental drivers of elevational changes remain largely unclear. Here, we examined the distribution patterns of major soil bacterial and fungal taxa along the northern slope of Changbai Mountain, Northeast China, at five typical vegetation types located between 740 and 2,691 m above sea level. Elevational patterns of the relative abundance of specific microbial taxa could be partially explained by the oligotrophic-copiotrophic theory. Specifically, two dark-coniferous forests, located at mid-elevation sites, were considered to be oligotrophic habitats, with relatively higher soil C/N ratio and [Formula: see text]-N concentrations. As expected, oligotrophic microbial taxa, belonging to the bacterial phyla Acidobacteria and Gemmatimonadetes, and fungal phylum Basidiomycota, were predominant in the two dark-coniferous forests, exhibiting a mid-elevation maximum pattern. In contrast, the broad leaf-Korean pine mixed forest located at the foot of the mountain, Betula ermanii-dominated forest located below the tree line, and alpine tundra at the highest elevation were considered more copiotrophic habitats, characterized by higher substrate-induced-respiration rates and [Formula: see text]-N concentrations. Microbial taxa considered to be so called copiotrophic members, such as bacterial phyla Proteobacteria and Actinobacteria, and fungal phylum Ascomycota, were relatively abundant in these locations, resulting in a mid-elevation minimum pattern. At finer taxonomic levels, the two most abundant proteobacterial classes, alpha- and beta-Proteobacteria, along with Acidobacteria Gp1, 2, 3, 15, and the Basidiomycotal class of Tremellomycetes were classified with the copiotrophic group. Gamma- and delta-Proteobacteria, Acidobacteria Gp4, 6, 7, 16, and Basidiomycotal class of Agaricomycetes were classified as oligotrophic taxa. This work uses the oligotrophic-copiotrophic theory to explain the elevational distribution pattern of the relative abundance of specific microbial taxa, confirming some of the existing trophic classifications of microbial taxa and expanding on the theory to include a broader range of taxonomic levels.

[Analysis on on-site rescue and traumatic features of victims involved in gas explosion accident in Hangzhou]

Objective: To investigate the situations of on-site rescue and traumatic features of victims involved in gas explosion accident in Hangzhou, so as to provide more data support for emergency medical rescues of the similar incidents of massive casualty. Methods: Two medical workers with a certain clinical experience were sent to Hangzhou 120 emergency medical centers to collect data of the on-site rescue on 21st July, 2017, including ambulance call-outs, on-site command and traffic conditions, and on-site triage and evacuation of the victims. They were then sent to the hospitals receiving the victims to investigate the situations of these victims including the general information (such as gender, age, admitted hospitals, and number of admission, discharge, and transferring in the first two weeks after the accident) and injury assessment [such as injury position and type, injury severity evaluation by New Injury Severity Scoring (NISS), and burn severity evaluation for victims with burns]. Results: (1) A total of 15 ambulances reached the accident site for rescue. The traffic and transportation were jammed and interrupted after this accident. On-site triage and distribution were disorderly conducted. (2) Clinical data of 53 victims were collected, including 24 males and 29 females, with the age of 8 to 70 (34±14) years old. They were sent into 6 hospitals in Hangzhou. Two victims died on the day of accident. Up to two weeks after this accident, 28 (52.8%) victims were discharged from the hospitals and received follow-up in outpatient department. Five victims with severe injuries were transferred to the other hospitals. (3) Based on the results of NISS, the injury severities were mild in 29 (54.7%) cases, moderate in 9 (17.0%) cases, serious in 3 (5.7%) cases, and severe in 12 (22.6%) cases. Those 2 dead victims were classified into the severe category due to the highest NISS score of 75. For all of the victims, skin and soft tissue defects were most common. Six (11.3%) victims were combined with burns. According to the classification of burn severity, there were one case of mild, one case of serious, and 4 cases of severe. Conclusions: The gas explosion accident in Hangzhou caused massive casualties with complex injuries. The local emergency medical rescue responded quickly, but during the rescue process, lots of aspects should be further improved.

[Advances in the research of negative-pressure wound therapy inducing the vascularization of dermal substitute]

In clinical practice, skin defects resulted from various acute and chronic diseases occur frequently. Dermal substitute (DS), known as dermal regenerative template, is used more and more widely, but the slow process of vascularization limits its clinical application. At present, there are many strategies developed to enhance the process of vascularization, such as modifying the structure of dermal scaffolds, prevascularization by seeding stem cells and/or endothelial cells. Recently, negative-pressure wound therapy (NPWT) emerged and rapidly became popular in promoting wound healing due to its intrinsic advantages. Furthermore, some researchers introduced this technique to accelerate the vascularization process of DS. This paper represents a comprehensive overview on the efficiency of NPWT in different combination models, and the related mechanism.

[Brief disserting on the balance of internal environment in burn disease]

The essential internal environment in human being involves water, electrolyte, and acid-base balance, which is the basis of balance and stability of internal environment in other systems. For burn patients, the balance of internal environment, referring to metabolism, nutrition, inflammatory response, and immunoreaction, is one of the most important aspects in burn disease. This paper aims to briefly elaborate the balance of internal environment after burn, with the purpose to promote the basic and clinical research in this field.

[The author of Yi du (Medicine Reading) and source and history of its editions]

Yi du (Medicine Reading)was a primer of traditional Chinese medicine. The original author was Wang Ji of the Ming Dynasty, and the book was block-printed and published, after the supplement made by Cheng Yingmao of the Qing Dynasty during the reign of Kangxi Emperor of the Qing Dynasty. The editions of the book preserved in Nanjing Library and China Institute for History of Medicine and Medical Literature of China Academy of Chinese Medical Sciences was the original version in the reign of Kangxi Emperor. The edition in Shanghai University of Traditional Chinese Medicine was the amended version of original version in the reign of Kangxi Emperor. The version of Edo Period in the Cabinet Library of National Archives of Japan was the reprinted edition of the amended version of original version in the reign of Kangxi Emperor. The transcript of Mr. Wang Shishan's Medicine Reading of the Qing Dynasty in Nanjing Library and Suzhou Library was the hand-copied version of the original one, with 75 syndromes, including external contraction, internal injuries, woman miscellaneous diseases etc. and all sorts of prescriptions. Cheng Yingmao added his preface, 14 syndromes of children diseases and prescription verse, supplemented general notices, properties of materia medica, pulse manifestations, and revised some texts of pathogenesis to form the 7 volumes. The former 5 volumes of Yi du were in 4-character verses, the 6(th)~7(th) volumes were in 7-character verses, and the pill prescriptions were in prose, which made more convenient for beginners to read, remember, and for recitation.

[The role of HuR in mediating snail expression in human small airway epithelium induced by cigarette smoke extract]

Objective: To investigate the abundance of human antigen R (HuR) in small airway epithelial cells stimulated by cigarette smoke extract (CSE) as well as the role of HuR in mediating snail which is recognized as a key transcription factor in regulating epithelial-mesenchymal transition (EMT). Methods: Human small airway epithelial cells (HSAEpiC) cultured in vitro were exposed to cigarette smoke extract (CSE) to model COPD status. Real-time PCR and western blotting analysis were used in detecting HuR protein and mRNA expression in cells with CSE which were divided into 5 groups: a control group, a 1%-24 h group, a 3%-24 h group, a 1%-48 h group and a 3%-48 h group. Small interfering RNA (siRNA) transfection was used to decrease HuR abundance. HuR expression at both mRNA and protein levels was detected using Real-time PCR and Western blotting analysis respectively, and the experiment was divided into 3 groups: a control group, a transfection control group and a transfection group. Snail, E-cadherin and vimentin levels were determined using Western blotting test in cells with both CSE exposure and HuR siRNA transfection which were divided into three groups: control group, CSE group and CSE + transfection group. Results: After CSE stimulation, HuR expression was increased at both mRNA and protein levels [mRNA 1%-24 h group (1.12±0.04), 3%-24 h group (1.41±0.06), 1%-48 h group (1.26±0.05), 3%-48 h group (1.49±0.06), protein 3%-24 h group (1.35±0.08), 1%-48 h group (1.17±0.06), 3%-48h group (1.42±0.06) all P<0.05]. Compared with the control siRNA, after HuR siRNA transfection, HuR mRNA and protein levels were significantly reduced [mRNA level (0.33±0.06) vs (1.02±0.10), protein level (0.46±0.07) vs (0.97±0.06), all P<0.01]. Control siRNA transfection had no effect on HuR expression [mRNA level (1.02±0.10), protein level (0.97±0.06), all P>0.05]. After 48 h stimulation with 3% CSE, the expression of HuR (1.47±0.11), snail (1.46±0.05) and vimentin (1.56±0.05) increased and the expression of E-cadherin (0.49±0.05) decreased. After transfection and CSE stimulation, the expression of HuR (0.84±0.06), snail (1.22±0.06) and vimentin (1.11±0.09) decreased and the expression of E-cadherin (0.73±0.06) increased. (All P>0.05). Conclusions: CSE promoted the expression of HuR in human small airway epithelial cells. HuR participated in the regulation process of EMT key transcription factor snail and might regulate EMT process by this action.

Conspecific density dependence and community structure: Insights from 11 years of monitoring in an old-growth temperate forest in Northeast China

Forest community structure may be influenced by seedling density dependence, however, the effect is loosely coupled with population dynamics and diversity in the short term. In the long term the strength of conspecific density dependence may fluctuate over time because of seedling abundance, yet few long‐term studies exist. Based on 11 years of seedling census data and tree census data from a 25‐ha temperate forest plot in Northeast China, we used generalized linear mixed models to test the relative effects of local neighborhood density and abiotic factors on seedling density and seedling survival. Spatial point pattern analysis was used to determine if spatial patterns of saplings and juveniles, in relation to conspecific adults, were in accordance with patterns uncovered by conspecific negative density dependence at the seedling stage. Our long‐term results showed that seedling density was mainly positively affected by conspecific density, suggesting dispersal limitation of seedling development. The probability of seedling survival significantly decreased over 1 year with increasing conspecific density, indicating conspecific negative density dependence in seedling establishment. Although there was variation in conspecific negative density dependence at the seedling stage among species and across years, a dispersed pattern of conspecific saplings relative to conspecific adults at the local scale (<10 m) was observed in four of the 11 species examined. Overall, sapling spatial patterns were consistent with the impacts of conspecific density on seedling dynamics, which suggests that conspecific negative density dependence is persistent over the long term. From the long‐term perspective, conspecific density dependence is an important driver of species coexistence in temperate forests.

[Etiological analysis on patients in department of vertigo and dizziness oriented outpatient]

Objective: We aimed to explore the spectrum of causes for patients in department of vertigo and dizziness oriented outpatient, in order to provide a reference for diagnosis and treatment of patients with vertigo or dizziness. Methods: Retrospective analysis were carried out with clinical data of patients in our department of vertigo and dizziness oriented outpatient. The target group under study was diagnosed based on the uniform diagnostic criteria, and re-visiting patients were excluded. Results: This clinical study was conducted on 5 348 cases, who visited our vertigo and dizziness oriented outpatient from December 2012 to July 2015. The ratio of male to female was 1∶1.48, the age range was between 16 and 93. The frequencies of different etiology were: benign paroxysmal positional vertigo 1 902(35.56%), Chronic subjective dizziness 1 329(24.85%), vestibular migraine 624(11.67%), Meniere's disease 378(7.07%), multi-sensory neuropathy 231(4.32%), vestibular paroxysmia 177(3.31%), benign recurrent vestibulopathy 171(3.20%), presyncope 66(1.23%), posterior circulation ischemia 57(1.07%), vestibular neuritis 54(1.01%), sudden deafness complicated vertigo 36(0.67%), other reasons 68(1.27%), unknown 255(4.77%). Conclusions: Our study indicates that the precedent three causes for vertigo or dizziness are benign paroxysmal positional vertigo, chronic subjective dizziness and vestibular migraine, followed by Meniere's disease、multi-sensory neuropathy, vestibular paroxysmia and benign recurrent vestibulopathy. Presyncope, posterior circulation ischemia, vestibular neuritis and sudden deafness complicated vertigo are relatively infrequent. There are still a certain proportion of patients undetermined.

Effect of the Insecticide Dinotefuran on the Ultrastructure of the Flight Muscle of Female Sogatella furcifera (Hemiptera: Delphacidae)

Sogatella furcifera Horváth (Hemiptera: Delphacidae), is a major migratory pest of rice crops in Asia. The ultrastructure of the flight muscle directly affects the flight ability of insects. The ultrastructure of the flight muscle of some insects can be affected by insecticides. However, the ultrastructure of the flight muscle of S. furcifera and the effect of insecticides on the flight muscle of S. furcifera are not well understood. The present study was conducted to determine the effect of the insecticide dinotefuran on the ultrastructure of the flight muscle of S. furcifera females. In this study, the cross-sectional area and the diameter of the myofibril cross-sections of dinotefuran-treated S. furcifera females increased with the number of days after emergence (DAE), and they were higher than in untreated females. The sarcomere length of myofibrils increased with the number of DAE, and it differed from that of the untreated females. On the first day after emergence, the higher the concentration of dinotefuran, the smaller was the extent of decrease. On the third day after emergence, the higher the concentration of dinotefuran, the larger was the extent of enhancement. For the percentage of mitochondria, those of LC10 and LC20 dinotefuran-treated S. furcifera females increased with the number of DAE and were higher than in untreated females. LC10 dinotefuran-treated S. furcifera females exhibited the largest increase. Thus, our results suggest that the flight ability of S. furcifera increased with time. Some concentrations of dinotefuran can enhance the flight capacity of S. furcifera.

[Influence of collagen/fibroin scaffolds containing silver nanoparticles on dermal regeneration of full-thickness skin defect wound in rat]

Objective: To explore the influence of collagen/fibroin scaffolds containing silver nanoparticles on dermal regeneration of full-thickness skin defect wound in rat. Methods: Eighty-one collagen/fibroin scaffolds containing silver nanoparticles (with the mass concentration of silver nanoparticles as 10 mg/L) and 81 collagen/fibroin scaffolds without silver nanoparticles were produced respectively with freeze-drying method and enrolled as silver nanoparticles scaffold group (SNS) and control scaffold group (CS). Nine scaffolds in each group were cultured with human fibroblasts. At post culture hour (PCH) 2, 12, and 24, the human fibroblasts adherent to the scaffolds (n=3) in two groups were counted. Four full-thickness skin defect wounds were reproduced on the back of each one of the 36 SD rats. The rats were divided into groups SNS (wounds were transplanted with collagen/fibroin scaffolds containing silver nanoparticles) and CS (wounds were transplanted with collagen/fibroin scaffolds without silver nanoparticles) according to the random number table, with 18 rats in each group. In post surgery week (PSW) 1, 2, and 4, 6 rats in each group were sacrificed respectively for general observation, observation of histological structure, inflammatory cell infiltration, and collagen deposition with HE staining, count of CD68 positive cells with immunohistochemical staining, and mRNA expressions of interleukin-6 (IL-6) and IL-10 with real-time fluorescent quantitative reverse transcription polymerase chain reaction. Data were processed with analysis of variance of factorial design, t test, and Bonferroni correction. Results: (1) At PCH 2, 12, and 24, the numbers of human fibroblasts adherent to the scaffolds in the two groups were close (with t values from 1.77 to 2.60, P values above 0.05). (2) In PSW 1, no obvious symptom of infection was observed in wound or wound edge of rats in group SNS with obvious vascularization of scaffolds, while obvious symptoms of infection were observed in wounds of rats in group CS with some scaffolds exfoliated. In PSW 2, the scaffolds were firmly attached to the wounds of rats in group SNS, while obvious contracture was observed in the wounds of rats in group CS with a lot of scaffolds exfoliated. In PSW 4, the scaffolds covered the wounds of rats in group SNS with obvious epithelization on the surface of the scaffolds, while all the scaffolds exfoliated, leaving obvious contracture of residual wounds of rats in group CS. (3) In PSW 1 and 2, compared with those in group CS, more collagen secretion and tissue regeneration and less inflammatory cell infiltration in the scaffolds were observed in the wounds of rats in group SNS. In PSW 4, obvious epithelization was observed in the wounds of rats in group SNS, while inflammatory cell infiltration was observed without obvious epithelization in the wounds of rats in group CS. (4) In PSW 1, the number of CD68 positive cells in the wounds of rats in group SNS [(54±10) /mm(2)] was similar to that in group CS [(78±7) /mm(2,) t=1.52, P>0.05]. In PSW 2 and 4, the numbers of CD68 positive cells in the wounds of rats in group SNS [(154±10) and (77±7) /mm(2)] were significantly less than those in group CS [(268±16) and (136±13) /mm(2,) with t values respectively 7.31 and 3.83, P values below 0.01] respectively. (5) Except for the expression in PSW 4 (t=1.23, P>0.05), the mRNA expressions of IL-6 in the wounds of rats in group SNS in PSW 1 and 2 were significantly lower than those in group CS (with t values respectively 13.12 and 4.65, P values below 0.01). Except for the expression in PSW 1 (t=3.08, P<0.05), the mRNA expressions of IL-10 in PSW 2 and 4 in the wounds of rats in the two groups were similar (with t values respectively 2.14 and 0.49, P values above 0.05). Conclusions: Besides good biocompatibility, collagen/fibroin scaffolds containing silver nanoparticles have obvious effect in modulating inflammation, thus they can accelerate dermal regeneration induced by collagen/fibroin scaffolds for wound repair.