Measurement of the Electron Antineutrino Oscillation with 1958 Days of Operation at Daya Bay

We report a measurement of electron antineutrino oscillation from the Daya Bay Reactor Neutrino Experiment with nearly 4 million reactor ν[over ¯]_{e} inverse β decay candidates observed over 1958 days of data collection. The installation of a flash analog-to-digital converter readout system and a special calibration campaign using different source enclosures reduce uncertainties in the absolute energy calibration to less than 0.5% for visible energies larger than 2 MeV. The uncertainty in the cosmogenic ^{9}Li and ^{8}He background is reduced from 45% to 30% in the near detectors. A detailed investigation of the spent nuclear fuel history improves its uncertainty from 100% to 30%. Analysis of the relative ν[over ¯]_{e} rates and energy spectra among detectors yields sin^{2}2θ_{13}=0.0856±0.0029 and Δm_{32}^{2}=(2.471_{-0.070}^{+0.068})×10^{-3}  eV^{2} assuming the normal hierarchy, and Δm_{32}^{2}=-(2.575_{-0.070}^{+0.068})×10^{-3}  eV^{2} assuming the inverted hierarchy.

[Efficacy and safety of ombitasvir/paritaprevir/ritonavir and dasabuvir combined with ribavirin in Asian adult patients with chronic HCV genotype 1b infection and compensated cirrhosis]

Objective: To evaluate the efficacy and safety of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) 25/150/100 mg once daily and dasabuvir (DSV) 250 mg twice daily combined with ribavirin in adult patients of Mainland China with chronic HCV genotype 1b infection and compensated cirrhosis. Methods: An open-label, multicenter, phase 3 clinical trial study was conducted in mainland China, Taiwan, and South Korea. Adult patients with compensated cirrhosis (Metavir score =F4) who were newly diagnosed and treated for hepatitis C virus genotype 1b infection with ombitasvir/paritaprevir/ritonavir and dasabuvir combined with ribavirin for 12 weeks were included. Assessed SVR rate of patients obtained at 12 and 24 weeks after drug withdrawal. Efficacy and safety were evaluated in patients who received at least one time study drugs. Results: A total of 63 patients from mainland China were enrolled, 62 of whom (98.4%) had a baseline Child-Pugh score of 5 points. The overall rate of SVR12 and SVR24 in patients was 100% (95% CI: 94.3% to 100.0%). Most of the adverse events that occurred were mild. The incidence of common (≥10%) adverse events and laboratory abnormalities included elevated total bilirubin (36.5%), weakness (19.0%), elevated unconjugated bilirubin (19.0%) and conjugated bilirubin (17.5%), and anemia (14.3%). Three cases (4.8%) of patients experienced Grade ≥ 3 adverse events that were considered by the investigators to be unrelated to the study drug. None patients had adverse events leading to premature drug withdrawal. Conclusion: Mainland Chinese patients with chronic HCV genotype 1b infection and compensated cirrhosis who were treated with OBV/PTV/r plus DSV combined with RBV for 12 weeks achieved 100 % SVR at 12 and 24 weeks after drug withdrawal. Tolerability and safety were good, and majority of adverse events were mild.

[Analyzing the mental health status and its impact factors among female nurses in China]

Objective: To analyze the mental health status and its impact factors among nurses, finding ways to improve the mental health of nurses. Methods: A total of 13 425 female healthcare workers aged from 18 to 65 were selected as study objects. The survey was conducted with unified design questionnaire. The survey included the basic situation of the individuals and SCL-90 questionnaire. Comparing the female doctors, the mental health status and its impact factors of nurses were analyzed. Results: The income, age, education and occupation, which include shift work, heavy work load and overtime work are different between nurses and doctors. The main mental health problems of nurses were obsessive-compulsive symptoms, depressive symptoms and somatization. The results of univariate analysis indicated that shift work, overtime work, and heavy work load affected the positive rate of each factor. The results of multivariate analysis showed that occupation, shift work, overtime work, and heavy work load have significant adverse effects on the positive rate of the total score in female healthcare workers (P<0.01) . The positive rate of each dimension of SCL-90 in nurses is significantly higher than that of doctors. Conclusion: The mental health problems of nurses are significantly higher than doctors. The main reasons are low occupational level and adverse workstyles which include shift work, heavy workload and so on. Health administration and hospital management departments should pay much more attention to the mental health of nurses, improving their mental health through a variety of ways.

Femtosecond laser-induced size reduction and emission quantum yield enhancement of colloidal silicon nanocrystals: effect of laser ablation time

Colloidal silicon (Si) nanocrystals (NCs) with different sizes were successfully prepared by femtosecond laser ablation under different laser ablation time (LAT). The mean size decreases from 4.23 to 1.42 nm by increasing the LAT from 30 to 120 min. In combination with structural characterization, temperature-dependent photoluminescence (PL), time-resolved PL and PL excitation spectra, we attribute room-temperature blue emissions peaked at 405 and 430 nm to the radiative recombination of electron-hole pairs via the oxygen-deficient centers related to Si-C-H₂ and Si-O-Si bonds of colloidal Si NCs prepared in 1-octene, respectively. In particular, the measured PL quantum yield of colloidal Si NCs has been enhanced significantly from 23.6% to 55.8% by prolonging the LAT from 30 to 120 min.

[Decision tree analysis in determinants of elderly visits in poor rural areas]

OBJECTIVE

To explore the influencing factors of elderly outpatient visits and to provide evidence for poverty reduction in health in the poor rural areas.

METHODS

Through stratified sampling, a total of 1 271 aged people in four poverty Qi/County of Ulanqabcity were surveyed, including Qahar Right Wing Front Banner, Qahar Right Wing Middle Banner, Qahar Right Wing Rear Banner and Liangcheng County. Their socioeconomic and demographic characteristics, daily consumption, EuroQol five dimensions questionnaire(EQ-5D) and visual analogue scale (VAS),social support, health service needs and utilization were collected through cross-sectional household questionnaires. 1 039 aged people who had experienced physical discomfort in the past 30 days were selected as subjects for the study. The differences between the groups were analyzed by chi-square test. A Logistic regression equation and a decision tree of elderly visits were built to find factors influencing decisionmaking of the aged.

RESULTS

The average age of the research subjects was 71.8 years, with 52.2% being illiterate and 85.8% with middle social support. 58.5% of the subjects living with their spouses, mostly living in 15 min medical circle and without any financial support from their children. The 30-day visiting rate when having physical discomfort was 31.0%. The chi-square test showed that the differences in visit rates among age, ethnic, residence patterns, daily consumption index, housing types, social support scores, grown children's economic assistance, travel time to medical institutions, and health self-assessment scores were statistically significant. Compared with Logistic analysis, the decision tree showed lower error rate of classification. Logistic regression model's error rate of classification was 31.4%, showing that the differences in visit rates among age, ethnic, residence patterns, daily consumption index, social support scores, travel time to medical institutions, and health self-assessment scores were statistically significant. The decision tree model's error rate of classification was 28.6%, showing six main influencing factors, including the travel time to medical institutions, cohabitants, education level, age, whether adult children provide economic support and social support score. The importance of these predictors were 0.42, 0.21, 0.13, 0.11, 0.07 and 0.06, respectively.

CONCLUSION

In poor rural areas, medical resources, economic affordability, family and individual socio-demographic characteristics are the key factors affecting decision-making for the aged. It is necessary to integrate the improvement of the health care of the aged into the overall development of the society. And comprehensive interventions should be adopted to improve the outpatient utilization for aged in poor rural areas.

Association between tobacco smoking and drug-resistant tuberculosis

Background

Tobacco smoking is a risk factor for tuberculosis but little is known about the relationship between tobacco smoking and drug-resistant tuberculosis (DR-TB). We undertook a systematic review and meta-analysis to quantitatively assess the association between DR-TB and tobacco smoking.

Methods

We searched for relevant studies in the Ovid MEDLINE, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WANFANG, and WEIPU data-bases from inception to September 1, 2017. Results were expressed as odds ratios (ORs) with accompanying 95% CIs, and subgroup analyses were performed by study design, smoking type, DR-TB type, and multivariate analysis.

Results

Thirty-three studies related to tobacco smoking and DR-TB were included. We found substantial evidence that tobacco smoking is associated with an increased risk of DR-TB (OR 1.57, 95% CI 1.33–1.86). Associations were also found in subgroup analyses: for multidrug-resistant tuberculosis (OR 1.49, 95% CI 1.19–1.86) and for any DR-TB (OR 1.70, 95% CI 1.3–2.23); the pooled OR was 1.45 (95% CI 1.11–1.90) for current smoking, 2.25 (95% CI 1.46–3.47) for past smoking, and 1.56 (95% CI 1.22–1.98) for smoking history; and similar ORs were also observed in study design and multivariate analysis subgroup analysis.

Conclusion

This study demonstrated that tobacco smoking is an independent risk factor for DR-TB.

[Clinicpathological features and survival of patients with AIDS related non-Hodgkin's lymphoma]

目的

分析艾滋病相关非霍奇金淋巴瘤（ARL）患者的临床特征及生存状态。

方法

回顾性分析53例ARL患者的临床资料，按1∶2随机配对对照研究方法，以106例普通非霍奇金淋巴瘤（NHL）患者为对照，比较两组患者的生存率。

结果

53例ARL患者的平均年龄为43（11~67）岁，诊断NHL时CD4⁺T细胞中位数为（146±20）个/µl。53例患者中B细胞来源者47例（88.7%），T细胞来源者6例（11.3%）。Ann Arbor分期Ⅲ~Ⅳ期者占52.8%（28/53）；IPI评分中高危组和高危组患者比例分别为45.3%（24/53）和18.9%（10/53）。ARL诊断后放弃治疗者占37.7%（20/53），抗HIV治疗联合放化疗者占62.3%（33/53）。抗NHL治疗采用CHOP（环磷酰胺、长春新碱、表阿霉素、泼尼松）方案。ARL组患者的总生存（OS）时间显著短于对照组[（6.0±1.3）对（48.0±10.0）个月，P<0.05]。接受抗NHL治疗的患者中，ARL组（33例）和对照组（100例）患者的OS时间差异无统计学意义[（48.0±10.9）对（77.0±11.1）个月，P=0.816]；ARL组患者1年OS率低于对照组（60.6%对83.0%，P<0.05），但两组患者的2年（53.5%对60.5%）、3年（48.1%对45.9%）和5年（39.1%对27.5%）OS率差异均无统计学意义（P值均>0.05）。

结论

ARL多见于青壮年，1年内病死率高，抗HIV治疗联合CHOP方案抗NHL治疗能显著改善ARL患者预后。

[Spatial Distribution Study and Pollution Assessment of Pb in Soils in the Xijiang River Drainage of Guangxi]

To obtain data for the accumulation of Pb and its risk in soils in the Xijiang River drainage of Guangxi, 2594 samples were collected from nonferrous metal mining soils, farmland soils (paddy soils and dryland soils), and the background soils in the drainage area. Geostatistical analysis combined with GIS was used to study the soil spatial distribution characteristics and pollution distribution of the soil Pb content. The results showed that the Pb background value of the soil was 51.84 mg ·kg^-1 in the Xijiang River Basin, and the results of the single sample T test showed that the soil background value was significantly higher than that of a previous study (22.08 mg ·kg^-1) and the soil background value (20.50 mg ·kg^-1) in Guangxi province. The geometric mean concentration of Pb in the mining soils, dryland soils, and paddy soils were 655.9, 116.7, and 40.63mg ·kg^-1, respectively, significantly higher than that in other soils. Using GB 15618-1995 and the baseline as the limiting value, the corresponding exceedance rate of the mining soils, dryland soils, and paddy soils were 57.69%, 16.40%, and 8.92% and 54.95%, 8.09%, and 2.03%. The mining soils and farmland soils had an obvious lead accumulation trend. There was an obvious spatial autocorrelation of Pb in the soil, and the structural variation was dominant. The content of Pb in the upper reaches of the Xijiang River reached the middle and lower reaches of the Xijiang River, and the soil Pb was characterized by an obvious decrease. The accumulation of high Pb content in the upper reaches of Diaojiang River is much larger than that in the lower reaches of Diaojiang River. The content of Pb in soil samples in the Xijiang River Basin was mainly rated between mild pollution and moderate pollution, and the pollution was concentrated in the municipal administrative area and the mining activity area. The pollution of the soil in Jinchengjiang and Nandan counties was closely related to the frequent local mining activities.

[Role of aquaporin-4 in the change of interstitial fluid drainage in Alzheimer's disease]

OBJECTIVE

To observe the characteristics of the interstitial fluid (ISF) drainage in the Alzheimer's disease (AD) rats through magnetic resonance imaging (MRI) tracer gadolinium-diethylene triamine pentacetic acid (Gd-DTPA)spread in the brain extracellular space (ECS) and to discuss the role of aquaporin-4 (Aqp4) in the AD.

METHODS

Wild type SD rats (300-350 g) and Aqp4 gene knock out (Aqp4^-/-) SD rats (300-350g) were divided into Sham group, AD group, Aqp4^-/--Sham group and Aqp4^-/--AD group. Sham group and Aqp4^-/--Sham group were injected with saline by intraperitoneal each day for 6 weeks, and the AD group and Aqp4^-/--AD group were injected with D-galactose by intraperitoneal each day for 6 weeks. MRI tracer Gd-DTPA (10 mmol/L, 2 μL) was injected into the hippocampus of the rats. MRI scan was performed at the end of 0.5 h, 1.5 h, 1 h, 2 h, and 3 h to observe the dynamic distribution of the Gd-DTPA in the hippocampus and the diffusion rate D^*, clearance rate k' and half-life t_1/2 measured.

RESULTS

The diffusion rate D* in Sham group was (2.66±0.36)×10^-6 mm2/s, the diffusion rate D^* in AD group was (2.72±0.62)×10-6 mm²/s, the diffusion rate D^* in Aqp4^-/--Sham group was (2.75±0.47)×10^-6 mm²/s, the diffusion rate D^* in Aqp4^-/--AD group was (2.802±0.55)×10^-6 mm²/s, and there was no statistically significant difference in the four groups (One-Way ANOVA, P>0.05).The clearance rate k' in Sham group was (4.57±0.14)×10^-4/s, the clearance rate k' in AD group was (3.68±0.22)×10^-4/s, the clearance rate k' in Aqp4^-/--Sham group was (3.17±0.16)×10^-4/s, the clearance rate k' in Aqp4^-/--AD group was (2.59±0.19)×10^-4/s, and there was significant difference in the four groups (One-Way ANOVA, P<0.05). The half-life t_1/2 in Sham group was (0.67±0.12) h, the half-life t_1/2 in AD group was (0.88±0.08) h, the half-life t_1/2 in Aqp4^-/--Sham group was (1.12±0.15) h, the half-life t_1/2 in Aqp4^-/--AD group was (1.58±0.11) h, and there was significance difference in the four groups(one-way ANOVA,P<0.05).

CONCLUSION

The ISF drainage is slow after AD and the loss of Aqp4 in the AD makes the ISF drainage obviously slow down, Aqp4 plays an important role in AD to remove the metabolism of waste out of the brain.

[Accumulation of Cd and Its Risks in the Soils of the Xijiang River Drainage Basin in Guangxi]

To understand the distribution and risk of soil cadmium (Cd) in the Xijiang River drainage basin in Guangxi, a total of 2512 soil samples were collected nonferrous metal mining area, farmland (paddy soils and dryland soils) and the background soils, in the Xijiang River drainage basin in Guangxi.The results showed that Cd concentration was 0.514 mg·kg^-1 in background soils significantly higher than previously resulted(0.148 mg·kg^-1)and that in Guangxi background soil(0.267 mg·kg^-1). The geometric average concentration of Cd in dryland soils, paddysoils and mining soils was 0.559, 0.787, 5.71 mg·kg^-1, respectively, which were significantly higher than background soils. The Cd concentration exceeded the background soils and baseline by 51.2% and 35.2% in dryland soil, 66.7% and 39.6% in paddy soil, 77.8% and 71.4% in mining soil, high Cd concentration occurred in the Nandan County, Dahua County, Duan County, Huanjiang County and Yizhou City, as well as Liujiang County, These regions have developed severe and even extremely serious pollution, medium-high pollution accumulation and higher-extremely high potential ecological risks. The Cd-pollution in soils in agricultural and mining soils in upstream of Xijiang River in Guangxi is serious, due to mining activities and high Cd geological background. People in the mining area and surrounding areas who live on local crops, vegetables, may expose to the Cd-pollution. It is recommended to further develop a Cd risk assessment through a soil-plant-human system, taking appropriate measures to control risk.

Plasmonic nanoparticles embedded in single crystals synthesized by gold ion implantation for enhanced optical nonlinearity and efficient Q-switched lasing

We report on the synthesis of embedded gold (Au) nanoparticles (NPs) in Nd:YAG single crystals using ion implantation and subsequent thermal annealing. Both linear and nonlinear absorption of the Nd:YAG crystals have been enhanced significantly due to the embedded Au NPs, which is induced by the surface plasmon resonance (SPR) effect in the visible light wavelength band. Particularly, through a typical Z-scan system excited by a femtosecond laser at 515 nm within the SPR band, the nonlinear absorption coefficients of crystals with Au NPs have been observed to be nearly 5 orders of magnitude larger than that without Au NPs. This giant enhancement of nonlinear absorption properties is correlated with the saturable absorption (SA) effect, which is the basis of passive Q-switching or mode-locking for pulsed laser generation. In addition, the linear and nonlinear absorption enhancement could be tailored by varying the fluence of implanted Au⁺ ions, corresponding to the NP size and concentration modulation. Finally, the Nd:YAG wafer with embedded Au NPs has been applied as a saturable absorber in a Pr:LuLiF₄ crystal laser cavity, and efficient pulsed laser generation at 639 nm has been realized, which presents superior performance to the MoS₂ saturable absorber based system. This work opens an avenue to enhance and modulate the nonlinearities of dielectrics by embedding plasmonic Au NPs for efficient pulsed laser operation.

[Spatial Variability and Contamination of Arsenic in Soils of Xijiang River Basin]

In this study, 2585 soil samples were collected in the Xijiang River Basin in Guangxi Zhuang Autonomous Region and the spatial variability and contamination of Arsenic in soils were evaluated using geostatistical and GIS tools. The results showed that the concentrations of As in surface soils (23.82 mg·kg^-1) were higher than the background values of the Guangxi and Xijiang Rivers in natural soils; the upstream values (Diaojiang River and Huanjiang River) (30.22 mg·kg^-1) were significantly higher than those in other regions. Concentrations of As in soil samples were in the order of soil in mining areas > soil in dryland > natural soil > paddy soil. As in mining areas were significantly higher than in other areas; high As concentrations were measured in the upstream of the Diaojiang River basin and the downstream of the Huanjiang River Basin. Low concentration clusters were in the six villages of Nandan, which are far from the mine, and in the upper reaches of the Dahuanjiang River and Xiaohuanjiang River Basin. Spatial autocorrelations of arsenic in the watershed soil were evident and the structural variability was dominant. The concentration of As in the upper reaches decreased from the northwest to the southeast. High As concentrations were distributed naturally along the river basin; concentrations in the middle and lower reaches of the basin were between 0.44 mg·kg^-1 and 40 mg·kg^-1. The concentration levels of As in total soil samples ranged from no-pollution to slight pollution, and the pollution was mainly distributed in the administrative areas of the city and the intensive areas of mining activities, among which the soil pollution in Jinchengjiang River and Nandan counties was more prominent. Effective measures should be taken to strengthen the safety level of tailings reservoirs during the rainy season, so as to maintain the production levels while protecting living standards of local residents.

Electric field tuned MoS2/metal interface for hydrogen evolution catalyst from first-principles investigations

Understanding the interfacial properties of catalyst/substrate is crucial for the design of high-performance catalyst for important chemical reactions. Recent years have witnessed a surge of research in utilizing MoS₂ as a promising electro-catalyst for hydrogen production, and field effect has been employed to enhance the activity (Wang et al 2017 Adv. Mater. 29, 1604464; Yan et al 2017 Nano Lett. 17, 4109-15). However, the underlying atomic mechanism remains unclear. In this paper, by using the prototype MoS₂/Au system as a probe, we investigate effects of external electric field on the interfacial electronic structures via density functional theory (DFT) based first-principles calculations. Our results reveal that although there is no covalent interaction between MoS₂ overlayer and Au substrate, an applied electric field efficiently adjusts the charge transfer between MoS₂ and Au, leading to tunable Schottky barrier type (n-type to p-type) and decrease of barrier height to facilitate charge injection. Furthermore, we predict that the adsorption energy of atomic hydrogen on MoS₂/Au to be readily controlled by electric field to a broad range within a modest magnitude of field, which may benefit the performance enhancement of hydrogen evolution reaction. Our DFT results provide valuable insight into the experimental observations and pave the way for future understanding and control of catalysts in practice, such as those with vacancies, defects, edge states or synthesized nanostructures.

Correlation between luminescence and structural evolution of colloidal silicon nanocrystals synthesized under different laser fluences

We present a detailed investigation of the structural evolution and photoluminescence (PL) properties of colloidal silicon (Si) nanocrystals (NCs) synthesized through femtosecond laser ablation at different laser fluences. It is shown that the mean size of colloidal Si NCs increases from ∼0.97-2.37 nm when increasing laser fluence from 1.0-2.5 mJ cm^-2. On the basis of structural characterization, temperature-dependent PL, time-resolved PL, and PL excitation spectra, we identify that the size-dependent spectral shift of violet emission is attributed to the quantum confinement effect. The localized excitons' radiative recombination via the oxygen-related surface states on the surface of the colloidal Si NCs is employed to explain the origin of the blue emission.

[Correlation between the parameters of acoustic cardiography and BNP, LVEF and cardiac function grading in patients with chronic heart failure]

Objective: To explore the correlation between the parameters of the new generation of Acoustic Cardiography and brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and cardiac function grading in the diagnosis of heart failure. Methods: One hundred and sixty-eight inpatients, who were hospitalized in Department of Cardiology, Haikou People's Hospital from May 2016 to July 2017, were enrolled as heart failure group, including NYHA class Ⅰ(n=29), NYHA class Ⅱ(n=40), NYHA class Ⅲ(n=64), NYHA class Ⅳ (n=35). And eighty-seven patients with normal cardiac function were selected as healthy control group. The data of the two groups were analyzed after the Acoustic Cardiography test, BNP determination and LVEF examination. Results: The differences in QRS duration, electromechanical activation time (EMAT), EMAT%, systolic dysfunction index (SDI), third heart sound (S3) and other indicators among the groups with different levels of cardiac function were statistically significant (P<0.05). The difference in left ventricular systolic time (LVST) between the cardiac function grade Ⅰ and healthy group was not significant (P>0.05), while the differences among the rest groups were significant. There was a positive correlation between QRS duration, EMAT%, SDI, S3 and BNP (t=9.46, 11.38, 12.14, 9.67, respectively, P<0.05); LVST and BNP were negatively correlated (t=-14.27, P<0.05). There was a negative correlation between QRS duration, EMAT%, SDI, S3 and LVEF (t=11.24, -8.764, -2.393, -0.579, respectively, P<0.05). There was a positive correlation between LVST and LVEF (t=23.48, P<0.05). There was a positive correlation between QRS duration, EMAT%, SDI, S3 and cardiac function grading (β=0.003, 0.234, 0.419, 0.352, respectively, P<0.05). There was a negative correlation between LVST and cardiac function grade (β=-0.021, P<0.05). Conclusion: The parameters of the Acoustic Cardiography test (EMAT%, EMAT, SDI, S3 ) are closely related to BNP, LVEF and cardiac function grading, and can be used as assistant indexes for the diagnosis and evaluation of heart failure.

[Clinical features and prognostic factors of squamous cell carcinoma of the base of tongue：an analysis of 124 cases]

Objective:To summarize the clinicopathological characteristics and prognostic factors of squamous cell carcinoma (SCC) of the base of tongue (BOT). Method:Review the clinical data of 124 cases of patients with BOT tumors. HPV-DNA was detected using SPF10-DNA enzyme immunoassay and LiPA genotyping method. Survival rates and prognostic factors was calculated with SPSS 19.0 software using the Kaplan-Meier method and multivariate Cox model survival analysis. Result:5-year disease-specific survival (DSS), 5-year overall survival and median survival time for patients with SCC BOT were 54.5%, 48.5% and 45.2 months, respectively. HPV infection rate was 18.3%(11/60), the HPV-16 subtype in 10 cases, accounting for 90.9%(10/11). Univariate analysis results showed that smoking history (P=0.028), drinking history (P=0.001), tumor stage (P=0.009) and p16 protein expression (P=0.015) significantly affected the prognosis. The prognosis of patients with HPV positive BOT cancers was better than the HPV negative patients (5-year DSS was 80.8% compared to 54.5%), but not statistical difference (P=0.138). Multivariate analysis revealed that independent prognostic factors of BOT tumors were drinking history (P=0.006) and tumor stage (P=0.035). Conclusion:The prognosis of BOT tumor was relatively poor. Smoking history, drinking history, tumor staging and the expression of p16 protein significantly affected the prognosis. Drinking history and tumor stage were independent prognostic factors for BOT cancers.

[Effect of high glucose-based peritoneal dialysis fluids on NLRP3-IL-1β in human peritoneal mesothelial cells]

OBJECTIVE

To explore the effect of high glucose-based peritoneal dialysis fluids on NLRP3-IL-1β in human peritoneal mesothelial cells.

METHODS

HMrSV5 cells (SV40 immortalized human peritoneal mesothelial cell line) were grown in type I collagen-coated dishes in DMEM/F12 containing 10% fetal calf serum (FCS). All experiments on HMrSV5 cells were performed between passages 5 and 10. The cells were divided into 7 groups: control, 1.5% dextrose, 2.5% dextrose, 4.25% dextrose, rotenone, thenoyltrifluoroacetone (TTFA), and antimycin A. Immunoblotting was used to evaluate the expression of IL-1β. Small interfering RNA (siRNA) targeting NLRP3 was used to downregulate the expression of NLRP3 and Western blot was used to evaluate the expression of IL-1β in human peritoneal mesothelial cells exposed to 4.25% dextrose. In the meanwhile, resveratrol (RSV) was used to induce autophagy, 3-methyladenine (3-MA) and siRNA against Beclin 1 or ATG5 were used to block auto-phagy, flow cytometric was used to analyze the respiring (mitotracker deep red), total (mitotracker green) and reactive oxygen species (ROS)-generating mitochondria (mitoSOX); Western blot was used to evaluate the expression of IL-1β.

RESULTS

The IL-1β relative expressions were 0, 0.175±0.082, 0.418±0.163, 2.357±0.288, 2.642±0.358, 3.271±0.462, and 0.123±0.091, indicating that the cells exposed to high glucose-based peritoneal dialysis fluids and cells treated with mitochondria respiratory chain key enzyme complex I, and complex III inhibitors increased the IL-1β expression. And we found that NLRP3 knock-down significantly blocked the upregulation of IL-1β. In addition, the fluorescence intensity of total mitochondria and ROS-generating mitochondria in the following groups: control, negative control, RSV, 3-MA, ATG5 siRNA, Beclin1 siRNA were 1.76±0.42, 1.83±0.55, 1.85±0.62, 7.36±0.92, 5.35±0.77, 5.06±0.62 and 821.68±95.12, 868.15±102.82, 723.39±92.56, 1 660.08±113.65, 1 433.01±107.24, 1 562.36±112.88 respectively. The increased concentrations of mitochondrial ROS and IL-1β upregulation were confirmed in the inhibition but not the induction of auto-phagy. We also found that downregulation of ATG5 and Beclin1 sensitized cells for the release of IL-1β induced by MSU (monosodium urate) or nigericin which was the NLRP3 inflammasome activator. RSV treatment attentuated this effect.

CONCLUSION

Long-term application of high glucose-based peritoneal dialysis fluids can trigger the consistent activation of NLRP3-IL-1β in peritoneal mesothelial cells. Timely initiation of autophagy may block the NLRP3-IL-1β activation and provide a basis for the further development of a potential therapeutic strategy for delay of chronic inflammation and peritoneal fibrosis associated with peritoneal dialysis.

Metabolic Pathway of Icotinib In Vitro: The Differential Roles of CYP3A4, CYP3A5, and CYP1A2 on Potential Pharmacokinetic Drug-Drug Interaction

Icotinib is the first self-developed small molecule drug in China for targeted therapy of non-small cell lung cancer. To date, systematic studies on the pharmacokinetic drug-drug interaction of icotinib were limited. By identifying metabolite generated in human liver microsomes and revealing the contributions of major cytochromes P450 (CYPs) in the formation of major metabolites, the aim of the present work was to understand the mechanisms underlying pharmacokinetic and pharmacological variability in clinic. A liquid chromatography/UV/high-resolution mass spectrometer method was developed to characterize the icotinib metabolites. The formation of 6 major metabolites was studied in recombinant CYP isozymes and human liver microsomes with specific inhibitors to identify the CYPs responsible for icotinib metabolism. The metabolic pathways observed in vitro are consistent with those observed in human. Results demonstrated that the metabolites are predominantly catalyzed by CYP3A4 (77%∼87%), with a moderate contribution from CYP3A5 (5%∼15%) and CYP1A2 (3.7%∼7.5%). The contribution of CYP2C8, 2C9, 2C19, and 2D6 is insignificant. Based on our observations, to minimize drug-drug interaction risk in clinic, coprescription of icotinib with strong CYP3A inhibitors or inducers must be weighed. CYP1A2, a highly inducible enzyme in the smoking population, may also represent a determinant of pharmacokinetic and pharmacological variability of icotinib, especially in lung cancer patients with smoking history.

[Free medial thigh perforator flaps with various pedicle origins for the reconstruction of defect after buccal mucosa squamous cell carcinoma resection]

Objective: To explore investigate the application of free medial thigh perforator flaps with different pedicle origins in the reconstruction of defect after radical resection of buccal mucosa squamous cell carcinoma. Methods: From January 2015 to December 2016, 32 cases with buccal mucosa squamous cell carcinoma underwent radical resection and buccal mucosa defect after surgery was reconstructed by free medial thigh perforator flap at the same stage. The patients included 32 males and 5 females, ranged in age from 36 to 71 years (45.2 years on average). According to UICC stage: T4N0M0 13 cases, T4N1M0 12 cases, T3N1M0 5 cases, T3N2M0 2 cases. The course ranged from 1 to 30 months (9.6 months on average). Results: The perforator flaps ranged from 8.0 cm×3.5 cm to 15.5 cm×6.0 cm in size, from 2.0 to 4.5 cm in thickness.The mean length of pedicles from gracilis muscle was (8.7±0.4) cm in 19 cases, the mean length of pedicles from adductor magnus muscle was (9.5±0.4) cm in 9 cases and the length of pedicles from femoral artery was (6.9±0.5) cm in 4 cases.All 44 perforator flaps survived uneventfully. The donor sites in the medial thigh were closed directly and healed well in all cases. Patients were followed up for 8 to 32 months with satisfied esthetic and functional results in reconstructed tongue, with no local recurrence. Only linear scars left in the donor sites, the functions of thighs were not affected. Conclusion: The free medial thigh perforator flap is an idea choice to reconstruct the defect after radical resection of buccal mucosa squamous cell carcinoma.

Renin-angiotensin system regulates pulmonary arterial smooth muscle cell migration in chronic thromboembolic pulmonary hypertension

Pulmonary arterial smooth muscle cell (PASMC) migration plays a key role in vascular remodeling, which occurs during development of chronic thromboembolic pulmonary hypertension (CTEPH). Activation of the renin-angiotensin system (RAS) contributes to vascular remodeling observed in many diseases, including idiopathic pulmonary arterial hypertension. However, the role of RAS imbalance in CTEPH has not been characterized. Here, we hypothesize that RAS imbalance regulates vascular remodeling by promoting PASMC migration in CTEPH. Serum renin and angiotensin II levels in patients with CTEPH were quantified by ELISA. The pulmonary endarterectomy tissues were stained and analyzed by immunohistochemistry. PASMCs were isolated and verified by immunofluorescence staining. PASMC migration was determined by Transwell assay. Phosphorylation and protein level were detected by Western blotting. Serum levels of renin and angiotensin II were increased in patients with CTEPH {renin [median (25th percentile, 75th percentile) in pg/ml], 1,199.94 [690.85, 1,656.90] vs. 595.43 [351.48, 936.43], P < 0.001; angiotensin II [in pg/ml], 63.97 [45.97, 345.24] vs. 56.85 [11.20, 90.37], P < 0.05}. The migration of PASMCs isolated from patients with CTEPH was enhanced compared with control. Angiotensin II promoted the migration of PASMCs via activation of angiotensin II receptor 1 and phosphorylation of ERK1/2, whereas angiotensin-(1-7) counteracted this effect through activation of the Mas receptor and ERK1/2. These results demonstrate that the renin-angiotensin system regulates migration of PASMCs from patients with CTEPH via the ERK1/2 pathway. Our findings suggest that angiotensin-(1-7) or reagents targeting the renin-angiotensin system will be beneficial in the development of novel therapies for CTEPH.

[Efficacy and safety of pegylated interferon α-2b injection (Y shape, 40 kD) in treatment of patients with genotype 1/6 chronic hepatitis C]

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion: In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.