[Anterior corneal high-order aberrations in eyes with senile cataract in a Chinese population]

Objective: To investigate the distribution of anterior corneal high-order aberrations (HOAs) in Chinese eyes with cataract and their correlations with age and axial length for the choice of aspheric intraocular lens. Methods: Retrospective study. Six hundred twenty-five Chinese patients with cataract[male: 260, female: 365, age: (71.2±8.0) years] were categorized into 4 groups in accordance with their axial lengths. Anterior corneal HOAs in the central 6- mm zone was measured with an iTrace wavefront analyzer. The correlations between axial length, age and total HOAs, spherical aberration, trefoil aberration, and coma aberration were analyzed using Spearman analysis. The differences in total HOAs, spherical aberration, trefoil aberration, and coma aberration among 4 groups were assessed using the Krusal-Wallis H test. Results: Anterior corneal HOAs showed the nonnormal distribution. The median of corneal total HOAs was 0.666 μm (range 0.246 to 4.115 μm). Medians of coma aberration, spherical aberration and trefoil aberration were 0.313 μm (range 0.015 to 1.879 μm), 0.275 μm (range 0.005 to 1.797 μm) and 0.341 μm (range 0.019 to 2.319 μm), respectively. A significant negative correlation was found between axial length and total HOAs, coma aberration, spherical aberration, trefoil aberration (r=-0.230, -0.235, -0.143, -0.153, P<0.05). But no correlation was found between age and them (r=0.056, 0.045, 0.065, 0.022, P>0.05). Differences in total HOAs, coma aberration, spherical aberration, trefoil aberration were found among various axial groups (H=21.953, 20.665, 15.368, 16.881, P<0.05). Conclusions: Anterior corneal HOAs varied greatly among the majority of the patients. A significant negative correlation was found between axial length and anterior corneal HOAs, but no correlation was found between age and them. (Chin J Ophthalmol, 2017, 53: 828-834).

[The situation and associated factors of satisfaction with follow-up management of HIV/AIDS cases conducted by Community Health Service Center in Hongkou district of Shanghai]

Objective: To analyze satisfaction with follow-up management of HIV/AIDS cases conducted by Community Health Service Center (CHS) and related factors in Hongkou district, Shanghai. Methods: Out of 302 HIV/AIDS cases followed up by CHS in Hongkou district from 2012 to 2016, 263 HIV/AIDS cases were recruited to participate in a cross-sectional study assessed by self-designed questionnaire-based interview during October 1, 2016 and October 20, 2016, with efficiency of 87.1%. Information of basic characteristics including sociodemographic, routes of infection, CD4(+)T cell counts, diagnose of AIDS and status of receiving ART were collected, as well as satisfaction with follow-up management conducted by CHS including service professionalism, service attitude, service environment, referral service, privacy protection, health education, psychological support, and care and assistance. Factors related to satisfaction were analyzed using multiple binary logistic regression. Results: Among 263 HIV/AIDS cases, the average age was 42.0±13.5, 93.2% (245 cases) were male and the proportion of overall satisfaction was 72.2% (190 cases). Out of 8 items of satisfaction, service attitude and health education got the highest score with a total number of 235 (89.4%) answering "very satisfied" or "satisfied" , while care and assistance got the lowest score with a total number of 69 (26.2%) answering "dissatisfied" or "very dissatisfied" . Compared to HIV/AIDS local residents and followed up by CHS <12 months, those who were non-local residents and followed up by CHS ≥12 months were more likely to be satisfied, the OR (95%CI) were 2.66 (1.30-5.44) and 2.52 (1.01-6.29), respectively. Compared to HIV/AIDS ≤30 years old and receiving ART, those who were 31-50 years or >50 years old and not receiving ART were less likely to be satisfied, the OR (95%CI) were 0.36 (0.15-0.89), 0.32 (0.10-0.97) and 0.11 (0.01-0.90), respectively. Conclusion: Satisfaction with follow-up management conducted by CHS in Hongkou district is relatively high. Age, residence, status of receiving ART and cumulative time of following up by CHS are significantly associated with satisfaction, suggesting that CHS should improve their professional abilities during follow-up management, as well as be more targeted and focus on different aspects.

[Research progress and significance of sleep apnea biomarkers]

To review the application of proteomics and metabolomics in the study of OSAHS biomarkers,and to open a new perspective for the study of OSAHS. At present,these studies are still in a very preliminary stage,the results are not always consistent,and far from the clinical application requirements. However,compared with traditional chemical methods,quantitative protein and metabolomics methods still have many advantages and have great clinical potential. Further studies of larger populations for more detailed grouping in the future are necessary to validate these results,and a more structured investigation in cell and animal models is necessary to determine their molecular mechanisms. In addition,the combination of different analytical platforms will be the ideal method for OSAHS biomarker research. In conclusion,the proteomics and metabolomics methods help us to better understand the potential mechanisms of OSAHS and to discover and develop personalized screening,diagnosis,prognostic and therapeutic strategies for future research.

A clip domain serine protease involved in moulting in the silkworm, Bombyx mori: cloning, characterization, expression patterns and functional analysis

Clip domain serine proteases (CLIPs), characterized by one or more conserved clip domains, are essential components of extracellular signalling cascades in various biological processes, especially in innate immunity and the embryonic development of insects. Additionally, CLIPs may have additional non-immune functions in insect development. In the present study, the clip domain serine protease gene Bombyx mori serine protease 95 (BmSP95), which encodes a 527-residue protein, was cloned from the integument of B. mori. Bioinformatics analysis indicated that BmSP95 is a typical CLIP of the subfamily D and possesses a clip domain at the N terminus, a trypsin-like serine protease (tryp_spc) domain at the C terminus and a conserved proline-rich motif between these two domains. At the transcriptional level, BmSP95 is expressed in the integument during moulting and metamorphosis, and the expression pattern is consistent with the fluctuating 20-hydroxyecdysone (20E) titre in B. mori. At the translational level, BmSP95 protein is synthesized in the epidermal cells, secreted as a zymogen and activated in the moulting fluid. Immunofluorescence revealed that BmSP95 is distributed into the old endocuticle in the moulting stage. The expression of BmSP95 was upregulated by 20E. Moreover, expression of BmSP95 was downregulated by pathogen infection. RNA interference-mediated silencing of BmSP95 led to delayed moulting from pupa to moth. These results suggest that BmSP95 is involved in integument remodelling during moulting and metamorphosis.

Determination of the Spin and Parity of the Z_{c}(3900)

The spin and parity of the Z_{c}(3900)^{±} state are determined to be J^{P}=1^{+} with a statistical significance larger than 7σ over other quantum numbers in a partial wave analysis of the process e^{+}e^{-}→π^{+}π^{-}J/ψ. We use a data sample of 1.92  fb^{-1} accumulated at sqrt[s]=4.23 and 4.26 GeV with the BESIII experiment. When parametrizing the Z_{c}(3900)^{±} with a Flatté-like formula, we determine its pole mass M_{pole}=(3881.2±4.2_{stat}±52.7_{syst})  MeV/c^{2} and pole width Γ_{pole}=(51.8±4.6_{stat}±36.0_{syst})  MeV. We also measure cross sections for the process e^{+}e^{-}→Z_{c}(3900)^{+}π^{-}+c.c.→J/ψπ^{+}π^{-} and determine an upper limit at the 90% confidence level for the process e^{+}e^{-}→Z_{c}(4020)^{+}π^{-}+c.c.→J/ψπ^{+}π^{-}.

[Predictive values of different critical scoring systems for mortality in patients with severe acute respiratory failure supported by extracorporeal membrane oxygenation]

OBJECTIVE

To investigate the predictive values of different critical scoring systems for mortality in patients with severe acute respiratory failure (ARF) supported by venovenous extracorporeal membrane oxygenation (VV-ECMO).

METHODS

Forty-two patients with severe ARF supported by VV-ECMO were enrolled from November 2009 to July 2015.There were 25 males and 17 females. The mean age was (44±18) years (rang 18-69 years). Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ, Ⅲ, Ⅳ, Simplified Acute Physiology Score Ⅱ (SAPS) Ⅱ, Sequential Organ Failure Assessment (SOFA), ECMO net, PRedicting dEath for SEvere ARDS on VVECMO (PRESERVE), and Respiratory ECMO Survival Prediction (RESP) scores were collected within 6 hours before VV-ECMO support. The patients were divided into the survivors group (n=17) and the nonsurvivors group (n=25) by survival at 180 d after receiving VV-ECMO. The patient clinical characteristics and aforementioned scoring systems were compared between groups. Scoring systems for predicting prognosis were assessed using the area under the receiver-operating characteristic (ROC) curve. The Kaplan-Meier method was used to draw the surviving curve, and the survival of the patients was analyzed by the Log-rank test. The risk factors were assessed for prognosis by multiple logistic regression analysis.

RESULTS

(1) Positive end expiratory pressure (PEEP) 6 hours prior to VV-ECMO support in the survivors group [(9.7±5.0)cmH2O, (1 cmH2O=0.098 kPa)] was lower than that in the nonsurvivors group [(13.2±5.4)cmH2O, t=-2.134, P=0.039]. VV-ECMO combination with continuous renal replacement therapy(CRRT) in the nonsurvivors group (32%) was used more than in the survivors group (6%, χ(2)=4.100, P=0.043). Duration of VV-ECMO support in the nonsurvivors group [(15±13) d] was longer than that in the survivors group [(12±11)d, t=-2.123, P=0.041]. APACHE Ⅱ, APACHE Ⅲ, APACHE Ⅳ, ECMO net, PRESERVE, and RESP scores in the survivors group were superior to the nonsurvivors group (all P<0.05). (2) The areas under the ROC curve of APACHE Ⅳ score for predicting death were largest (0.792±0.076, 95%CI: 0.643-0.940, P<0.05). The best cutoff point was 48 for APACHE Ⅳ score with a sensitivity of 92.0%, specificity of 64.7%, and overall accuracy of 81%. (3) Kaplan-Meier survival analysis showed that 180 d survival rate of the low APACHE Ⅳ score group was higher than the high APACHE Ⅳ score group (χ(2)=11.331, P<0.05). (4) Multiple logistic regression analysis showed that PEEP (OR=1.555, 95%CI: 1.097-2.204, P<0.05), APACHE Ⅳ score (OR=1.152, 95%CI: 1.021-1.301, P<0.05), and PRESERVE score (OR=4.984, 95%CI: 1.531-16.227, P<0.05) were independent risk factors associated with mortality of patients supported by VV-ECMO.

CONCLUSION

The critical scoring systems proved to have good prognostic ability in predicting hospital mortality for severe ARF patients supported by VV-ECMO. Compared to other scoring systems, APACHE Ⅳ score system predicted more accurately, while specific scoring systems in predicting hospital mortality showed no advantage.

Validation of combinatorial probe-anchor ligation-based sequencing as non-invasive prenatal test for trisomy at a central laboratory

OBJECTIVE

To evaluate the clinical validity of a new ultrahigh-throughput non-invasive prenatal test (NIPT) based on combinatorial probe-anchor ligation (cPAL) sequencing of cell-free fetal DNA (cffDNA) using centralized testing.

METHODS

Maternal plasma samples were obtained from 10 594 singleton pregnancies in high-risk populations at 20 centers in China, including 8155 that were collected retrospectively and 2439 prospectively. Fetal outcome data and karyotyping results were documented as gold standard and were double blinded during NIPT. The clinical performance of the ultrahigh-throughput sequencing method, cPAL, for NIPT was validated by evaluating its sensitivity, specificity and positive predictive value (PPV) in detecting trisomies 21, 18 and 13 as the centralized testing mode in the reference laboratory. To ensure stable and reproducible performance of centralized cPAL-based NIPT in detecting trisomies, a series of quality-control systems, including sequencing of two sets of artificial samples, were employed and evaluated.

RESULTS

Ten prospective cases were excluded from the study because of incomplete clinical data. Four prospective samples failed to generate a NIPT result due to assay failure, presenting a failure rate of 0.16% (4/2429). A total of 168 retrospective cases and 47 prospective cases had a positive NIPT result for trisomy, giving respective positive rates of 2.06% and 1.94%. Four false-positive and no false-positive cases were observed in the retrospective and prospective groups, respectively, resulting in PPV of 97.62% (95% CI, 94.02-99.35%) and 100% (95% CI, 92.45-100%), respectively. In the retrospective group, sensitivity and specificity were, respectively, 100% (95% CI, 97.07-100%) and 99.98% (95% CI, 99.94-100%) for trisomy 21, 100% (95% CI, 97.75-100%) and 99.98% (95% CI, 99.94-100%) for trisomy 18, and 100% (95% CI, 15.81-100%) and 100% (95% CI, 99.95-100%) for trisomy 13. In the prospective group, sensitivity and specificity were, respectively, 100% (95% CI, 90.75-100%) and 100% (95% CI, 99.85-100%) for trisomy 21, 100% (95% CI, 63.06-100%) and 100% (95% CI, 99.85-100%) for trisomy 18, and 100% (95% CI, 2.50-100%) and 100% (95% CI, 99.85-100%) for trisomy 13.

CONCLUSION

In this multicenter study with a full quality-control system, NIPT by centralized cPAL-based testing showed high stability and performance comparable to those of previous validation studies in high-risk populations. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

[Endovascular aortic repair of abdominal aortic aneurysm of short neck with Endurant stent graft]

Objective: To evaluate the safety and effectiveness of the Endurant stent graft for abdominal aortic aneurysm cases with proximal neck length <10 mm. Methods: This study was a retrospective analysis. From January 2010 to May 2015, 22 consecutive abdominal aortic aneurysm patients with proximal neck length <10 mm were treated with endovascular aortic repair by Endurant stent graft in Department of Vascular Surgery, Zhongshan Hospital, Fudan University. There were 19 (86.3%) male cases, aging from 57 to 84 years. All patients underwent preoperative CT angiography and the anatomic parameters of abdominal aortic aneurysm were measured. All patients performed standard endovascular aortic repair first and if there was obvious proximal typeⅠ endoleak, the CUFF or the chimney technology were applied to observed the perioperative technical and the clinical success rate. During follow-up, the incidence of adverse events and the reintervention rate were observed. Results: These 22 cases had proximal neck length 5 to 9 mm with the average of (7.2±1.4) mm. Immediate endoleak occurred in 5 patients with 4 cases of proximal typeⅠ endoleak, 3 cases were implanted proximal CUFF, 1 case implanted CUFF and left renal artery chimney. One case died perioperatively, the clinical success rate was 95.4%, the technical success rate was 77.3%. During the follow-up of 6 to 54 months, there was 1 case with delayed proximal type-1 endoleak, during operation the patient had no endoleak, but disappeared 6 months later without further intervention. So the incidence of adverse event was 4.5% and reintervention rate was 0. Conclusion: The Endurant stent graft for abdominal aortic aneurysm cases with proximal neck length < 10 mm is safe and effective.

Measures of and changes in heart rate variability in pediatric heart transplant recipients

Heart rate variability is primarily regulated by the autonomic nervous system. Heart transplant recipients undergo surgical denervation of the graft, which results in interruption of autonomic innervation with resultant diminished heart rate variability although some degree of autonomic control may return. This study aimed to characterize heart rate variability in this population. We report a retrospective review of Holter monitor data from transplanted patients between 2005 and 2013. Studies with significant atrial or ventricular arrhythmias were excluded. We evaluated changes over time and compared standard time domain measures to published pediatric normal values. Data were reviewed from 582 monitors in 152 patients. We found that pediatric heart transplant recipients have lower heart rate variability than age-matched controls and higher average heart rate in recipients older than 3 years. There is an increase in measures of variability through the first 3 years post-transplant with plateau after that time. Surgical technique in regard to interruption of the vagus nerve does not affect variability, nor does underlying congenital vs acquired heart disease.

Lactobacillus plantarum L9 but not Lactobacillus acidophilus LA reduces tumour necrosis factor induced bacterial translocation in Caco-2 cells

Translocation of bacteria across the intestinal barrier is important in the pathogenesis of systemic sepsis and multiple organ dysfunction syndromes. Inflammatory cytokines increase paracellular permeability that allows increased luminal bacteria to translocate across mucosal epithelium and further deteriorate the gut barrier. In order to reduce this risk, the prophylactic use of probiotics has been recently addressed. In this paper, we investigate the protective role toward tumour necrosis factor (TNF)-α induced non-pathogenic Escherichia coli translocation across Caco-2 monolayers of Lactobacillus strains. According to our experimental data, Lactobacillus plantarum L9 and Lactobacillus acidophilus LA have good capacities to adhere to Caco-2 cells. Addition of L. plantarum L9 and L. acidophilus LA to the enterocyte monolayer surface result in significant inhibition of E. coli adhesion and cell internalisation. However, L. plantarum L9 and L. acidophilus LA did not inhibit the growth of the non-pathogenic E. coli B5 after 24 h incubation. Exposure to TNF-α for 6 h caused a dramatic increase in E. coli B5 translocation across Caco-2 cells, which was uncoupled from increases in paracellular permeability. Pretreatment with L. plantarum L9 prevent TNF-α induced transcellular bacterial translocation and IL-8 production in Caco-2 cells. L. plantarum L9 also did not affect the integrity of the monolayers, as indicated by lactate dehydrogenase release, horseradish peroxidase permeability, and transepithelial electrical resistance. L. plantarum L9 showed the potential to protect enterocytes from an acute inflammatory response and therefore could be good potential prophylactic agents in counteracting bacterial translocation.

[Urothelial carcinoma-associated 1 enhances tamoxifen resistance in breast cancer cells through competitively inhibiting miR-18a]

OBJECTIVE

To investigate how urothelial carcinoma-associated 1 (UCA1) and miR-18a modulates acquired tamoxifen resistance and the relevant mechanisms in estrogen receptor (ER) positive cancer cells.

METHODS

qRT-PCR was performed to detect UCA1 and miR-18a expression in breast cancer cells. Dual luciferase assay was performed to detect the binding between miR-18a and UCA1 3'UTR. Tamoxifen sensitive MCF-7 cells were transfected with UCA1 expression vector or miR-18a inhibitors. Tamoxifen resistant LCC9 and BT474 cells were transfected with UCA1 siRNA or miR-18a mimics. CCK-8 assay was performed to detect cell viability. Soft agar assay was performed to assess cell colony formation. Flow cytometric analysis was performed to check cell cycle distribution.

RESULTS

UCA1 was significantly upregulated in tamoxifen resistant LCC2, LCC9, and BT474 cells than in tamoxifen sensitive MCF-7 cells. UCA1 expression was significantly upregulated in MCF-7 cells after treatment with 0.1 μmol/L tamoxifen. UCA1 overexpression enhanced cell viability of MCF-7 cells after tamoxifen treatment, while UCA1 siRNA significantly suppressed viability of LCC9 and BT474 cells after tamoxifen treatment. In MCF-7 cells, compared with vector control+tamoxifen group, the average cell colony number and colony size of the UCA1+tamoxifen group was 19.0% more and 29.0% larger respectively, while the proportions of the cells in G1 phase and in S phase were 7.3% lower and 6.7% higher respectively. In BT474 cells, compared with siRNA control+tamoxifen group, the average cell colony number and colony size of the si-UCA1+tamoxifen group were 54.0% less and 42.0% smaller respectively, while the proportions of the cells in G1 phase and in S phase were 9.0% higher and 6.2% lower respectively. UCA1 directly interacted with miR-18a and reduced its expression in ER positive breast cancer cells. Knockdown of miR-18a increased viability of MCF-7 cells after tamoxifen treatment, while miR-18a overexpression significantly reduced viability of BT474 cells after tamoxifen treatment. In MCF-7 cells, compared with miRNA inhibitor control+tamoxifen group, the average cell colony number and colony size of the miR-18a inhibitor+tamoxifen group were 15.0% more and 33.0% larger respectively, while the proportions of the cells in G1 phase and in S phase were 8.8% lower and 5.3% higher respectively. In BT474 cells, compared with miRNA control+tamoxifen group, the average cell colony number and colony size of the miR-18a mimics+tamoxifen group were 47.0% less and 25.0% smaller respectively, while the proportions of the cells in G1 phase and in S phase were 13.3% higher and 7.9% lower respectively.

CONCLUSION

UCA1 can increase tamoxifen resistance of ER positive breast cancer cells via competitively inhibiting of miR-18a.

Pathologic character and diagnosis of female primary genital system diffuse large B cell lymphoma

OBJECTIVE

We investigated the clinicopathological characteristics and immunophenotype of female genital system diffuse large B-cell lymphoma (DLBCL) in order to improve diagnosis and therapy efficacy.

PATIENTS AND METHODS

The clinicopathologic features of 13 cases with primary DLBCL of the female genital system were studied retrospectively. According to the immunophenotypes, 10 cases were classified as germinal center B-cell-like DLBCL and the other 3 as non-center B-cell-like DLBCL.

RESULTS

The immunohistochemistry data showed that CD20, PAX-5, and CD79a tested positive, while CD3, CD43 and CD45RO tested negative in all 13 cases. In 7 cases EMA was positive, in 9 cases CD10 was positive, in 11 cases bcl-6 was positive, and in 9 cases MUM-1 was tested positive. In one case, the Ki-67 index was less than 59%, in 3 cases Ki-67 index was between 60% to 89% and it was more than 90% in the remaining 9 cases (the median was 90%). All 13 patients underwent hysterectomy, while in 10 of them hysterectomy was followed by chemotherapy. The survival time was 3 to 20 months.

CONCLUSIONS

Primary diffuse large B-cell lymphoma of the primary female genital system is a rare and highly invasive condition that can be easily misdiagnosed. A complete diagnosis is very important because the treatment and prognosis vary in different histological types. Moreover, the immunohistochemistry is an useful diagnostic method for this type of cancer.

Cytoplasmic GPER translocation in cancer-associated fibroblasts mediates cAMP/PKA/CREB/glycolytic axis to confer tumor cells with multidrug resistance

Multiple drug resistance is a challenging issue in the clinic. There is growing evidence that the G-protein-coupled estrogen receptor (GPER) is a novel mediator in the development of multidrug resistance in both estrogen receptor (ER)-positive and -negative breast cancers, and that cancer-associated fibroblasts (CAFs) in the tumor microenvironment may be a new agent that promotes drug resistance in tumor cells. However, the role of cytoplasmic GPER of CAFs on tumor therapy remains unclear. Here we first show that the breast tumor cell-activated PI3K/AKT (phosphoinositide 3-kinase/AKT) signaling pathway induces the cytoplasmic GPER translocation of CAFs in a CRM1-dependent pattern, and leads to the activation of a novel estrogen/GPER/cAMP/PKA/CREB signaling axis that triggers the aerobic glycolysis switch in CAFs. The glycolytic CAFs feed the extra pyruvate and lactate to tumor cells for augmentation of mitochondrial activity, and this energy metabolically coupled in a 'host-parasite relationship' between catabolic CAFs and anabolic cancer cells confers the tumor cells with multiple drug resistance to several conventional clinical treatments including endocrine therapy (tamoxifen), Her-2-targeted therapy (herceptin) and chemotherapy (epirubicin). Moreover, the clinical data from 18F-fluorodeoxyglucose positron emission tomography/computed tomography further present a strong association between the GPER/cAMP/PKA/CREB pathway of stromal fibroblasts with tumor metabolic activity and clinical treatment, suggesting that targeting cytoplasmic GPER in CAFs may rescue the drug sensitivity in patients with breast cancer. Thus, our data define novel insights into the stromal GPER-mediated multiple drug resistance from the point of reprogramming of tumor energy metabolism and provide the rationale for CAFs as a promising target for clinical therapy.

HBV/HCV co-infection is associated with a high level of HCV spontaneous clearance among drug users and blood donors in China

Understanding the biology of spontaneous clearance of hepatitis C virus (HCV) infection could lead to improved strategies to prevent the sequelae associated with chronic HCV infection. Chronic infections with hepatitis virus are very common in China, but the factors associated with spontaneous clearance of HCV have not been adequately studied. We evaluated the spontaneous clearance of HCV among 1918 drug users and 1526 HCV-seropositive blood donors in Guangzhou, China. Among participants who were co-infected with hepatitis B virus (HBV), 41.38% of drug users and 39.47% of blood donors had cleared their HCV infection without antiviral therapy compared to 9.41% of drug users and 16.73% of blood donors who were mono-infected with a single virus (P<.01). The proportion of subjects who had cleared their HCV infection was significantly greater in the co-infected subjects whose serum HBV DNA was greater than 2000IU/mL than those with lower levels. A multiple logistic regression analysis found female gender, IL28B rs8099917 TT genotype, HBV co-infection and blood donors (vs drug users) associated with increased spontaneous clearance of HCV infection. Although acute HCV infections are common in China, the incidence of chronic HCV may be reduced among the high prevalence of chronic HBV and IL28B genotypes associated with spontaneous clearance of HCV in Chinese populations.

Observation of Λ_{c}^{+}→nK_{S}^{0}π^{+}

We report the first direct measurement of decays of the Λ_{c}^{+} baryon involving the neutron. The analysis is performed using 567  pb^{-1} of e^{+}e^{-} collision data collected at sqrt[s]=4.599  GeV with the BESIII detector at the BEPCII collider. We observe the decay Λ_{c}^{+}→nK_{S}^{0}π^{+} and measure the absolute branching fraction to be B(Λ_{c}^{+}→nK_{S}^{0}π^{+})=[1.82±0.23(stat)±0.11(syst)]%. A comparison to B[Λ_{c}^{+}→p(K[over ¯]π)^{0}] provides an important test of isospin symmetry and final state interactions.

Precise Measurement of the e^{+}e^{-}→π^{+}π^{-}J/ψ Cross Section at Center-of-Mass Energies from 3.77 to 4.60 GeV

The cross section for the process e^{+}e^{-}→π^{+}π^{-}J/ψ is measured precisely at center-of-mass energies from 3.77 to 4.60 GeV using 9  fb^{-1} of data collected with the BESIII detector operating at the BEPCII storage ring. Two resonant structures are observed in a fit to the cross section. The first resonance has a mass of (4222.0±3.1±1.4)  MeV/c^{2} and a width of (44.1±4.3±2.0)  MeV, while the second one has a mass of (4320.0±10.4±7.0)  MeV/c^{2} and a width of (101.4_{-19.7}^{+25.3}±10.2)  MeV, where the first errors are statistical and second ones are systematic. The first resonance agrees with the Y(4260) resonance reported by previous experiments. The precision of its resonant parameters is improved significantly. The second resonance is observed in e^{+}e^{-}→π^{+}π^{-}J/ψ for the first time. The statistical significance of this resonance is estimated to be larger than 7.6σ. The mass and width of the second resonance agree with the Y(4360) resonance reported by the BABAR and Belle experiments within errors. Finally, the Y(4008) resonance previously observed by the Belle experiment is not confirmed in the description of the BESIII data.

Evidence of Two Resonant Structures in e^{+}e^{-}→π^{+}π^{-}h_{c}

The cross sections of e^{+}e^{-}→π^{+}π^{-}h_{c} at center-of-mass energies from 3.896 to 4.600 GeV are measured using data samples collected with the BESIII detector operating at the Beijing Electron Positron Collider. The cross sections are found to be of the same order of magnitude as those of e^{+}e^{-}→π^{+}π^{-}J/ψ and e^{+}e^{-}→π^{+}π^{-}ψ(2S), but the line shape is inconsistent with the Y states observed in the latter two modes. Two structures are observed in the e^{+}e^{-}→π^{+}π^{-}h_{c} cross sections around 4.22 and 4.39  GeV/c^{2}, which we call Y(4220) and Y(4390), respectively. A fit with a coherent sum of two Breit-Wigner functions results in a mass of (4218.4_{-4.5}^{+5.5}±0.9)  MeV/c^{2} and a width of (66.0_{-8.3}^{+12.3}±0.4)  MeV for the Y(4220), and a mass of (4391.5_{-6.8}^{+6.3}±1.0)  MeV/c^{2} and a width of (139.5_{-20.6}^{+16.2}±0.6)  MeV for the Y(4390), where the first uncertainties are statistical and the second ones systematic. The statistical significance of Y(4220) and Y(4390) is 10σ over one structure assumption.

Feasibility and safety of peroral endoscopic myotomy for achalasia after failed endoscopic interventions

With advances in natural orifice transluminal endoscopic surgery, peroral endoscopic myotomy (POEM) has become a novel treatment for esophageal achalasia. In this study, we investigated the feasibility and safety of POEM in patients with achalasia after failed endoscopic interventions. Data on all patients undergoing POEM treatment of achalasia were collected prospectively. We enrolled 61 patients who underwent POEM for achalasia between July 2011 and January 2014. The preoperative intervention group included patients who had undergone botulinum toxin injection or pneumatic balloon dilation before POEM. The preoperative, operative, and short-term outcome data between the groups were compared. Among preoperative intervention group, 22 patients received endoscopic therapy before being referred for operation (18 dilation only, 2 botulinum toxin only, and 2 both treatments). Procedure time in the preoperative intervention group was similar to the nonpreoperative intervention group (60.8 ± 30.9 vs. 62.0 ± 21.0 minutes, P = 0.863). Both groups demonstrated significant improvement in Eckardt scores and manometric outcomes at 1-year follow-up. There were no significant differences in pretreatment and posttreatment D-values of symptom scores and lower esophageal sphincter pressures between groups (6.2 ± 2.2 vs. 6.1 ± 1.8, P = 0.840; 27.9 ± 17.6 vs. 24.9 ± 15.2; P = 0.569). There was also no significant difference in the incidence of intraoperative complications (P = 0.958) and gastroesophageal reflux rate (23.5% vs. 20.0%, P = 0.771) between the two groups. Our study demonstrated that POEM is safe and effective, even for treating achalasia in the setting of failed endoscopic interventions.

Amplitude Analysis of the Decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0}

Based on a sample of 1.31×10^{9}  J/ψ events collected with the BESIII detector, an amplitude analysis of the isospin-violating decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0} is performed. A significant P-wave contribution from η^{'}→ρ^{±}π^{∓} is observed for the first time in η^{'}→π^{+}π^{-}π^{0}. The branching fraction is determined to be B(η^{'}→ρ^{±}π^{∓})=(7.44±0.60±1.26±1.84)×10^{-4}, where the first uncertainty is statistical, the second systematic, and the third model dependent. In addition to the nonresonant S-wave component, there is a significant σ meson component. The branching fractions of the combined S-wave components are determined to be B(η^{'}→π^{+}π^{-}π^{0})_{S}=(37.63±0.77±2.22±4.48)×10^{-4} and B(η^{'}→π^{0}π^{0}π^{0})=(35.22±0.82±2.54)×10^{-4}, respectively. The latter one is consistent with previous BESIII measurements.

Treatment of Type 2 diabetes mellitus in Chongqing of China: unaffordable care for the poor

AIM

This study aims to investigate the medical expenditure of people with Type 2 diabetes mellitus in Chongqing, China; to explore factors that contribute to the expenditure; and to examine the financial burden placed on households, particularly poor households.

METHODS

A cross sectional survey was conducted with a sample of people diagnosed with Type 2 diabetes mellitus in 2014. Of the 664 people eligible, 76% were interviewed. Descriptive statistics and log-linear regression were used to examine respondents' age, sex and level education, location of residence, income and type of health insurance associated with out-of-pocket expenditure on accessing diabetes mellitus care.

RESULTS

In a year, average out-of-pocket expenditure on the purchase of drugs from pharmacies and having outpatient care were US $333 and US $310, respectively. The average out-of-pocket expenditure on accessing inpatient care was 3.7 times (US $1159) that of accessing outpatient care. After adjusting for age and sex, out-of-pocket expenditure on diabetes care was significantly higher for people covered by the Urban Employee Basic Medical Insurance programme and those enrolled in the identified priority diseases reimbursement programme, which provided higher reimbursement rates for outpatient and (or) inpatient care. Out-of-pocket expenditures on the purchase of drugs from pharmacies, having outpatient and inpatient care, respectively, were 9.8%, 16.2% and 62.6% of annual household income in low-income group.

CONCLUSION

Even with health insurance coverage, poor people with Type 2 diabetes mellitus suffered from significant financial hardship. This has significant implications for models of care and healthcare financing in China with the growing burden of diabetes.

Measurement of Singly Cabibbo Suppressed Decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}

Using 567  pb^{-1} of data collected with the BESIII detector at a center-of-mass energy of sqrt[s]=4.599  GeV, near the Λ_{c}^{+}Λ[over ¯]_{c}^{-} threshold, we study the singly Cabibbo-suppressed decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}. By normalizing with respect to the Cabibbo-favored decay Λ_{c}^{+}→pK^{-}π^{+}, we obtain ratios of branching fractions: [B(Λ_{c}^{+}→pπ^{+}π^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(6.70±0.48±0.25)%, [B(Λ_{c}^{+}→pϕ)/B(Λ_{c}^{+}→pK^{-}π^{+})]=(1.81±0.33±0.13)%, and [B(Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(9.36±2.22±0.71)×10^{-3}, where the uncertainties are statistical and systematic, respectively. The absolute branching fractions are also presented. Among these measurements, the decay Λ_{c}^{+}→pπ^{+}π^{-} is observed for the first time, and the precision of the branching fraction for Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-} and Λ_{c}^{+}→pϕ is significantly improved.

Review of remediation practices regarding cadmium-enriched farmland soil with particular reference to China

Cadmium-enrichment of farmland soil greatly threatens the sustainable use of soil resources and the safe cultivation of grain. This review paper briefly introduces the status of farmland soil as well as grain, which are both often polluted by cadmium (Cd) in China, and illustrates the major sources of Cd contaminants in farmland soil. In order to meet soil environmental quality standards and farmland environmental quality evaluation standards for edible agricultural products, Cd-enriched farmland soil is frequently remediated with the following prevailing techniques: dig and fill, electro-kinetic remediation, chemical elution, stabilisation and solidification, phytoremediation, field management and combined remediation. Most remediation techniques are still at the stage of small-scale trial experiments in China and few techniques are assessed in field trials. After comparing the technical and economical applicability among different Cd-enriched farmland soil remediation techniques, a novel ecological and hydraulic remediation technique has been proposed, which integrated the advantages of chemical elution, solidification and stabilisation, phytoremediation and field management. The ecological and hydraulic remediation concept is based on existing irrigation and drainage facilities, ecological ditches (ponds) and agronomic measures, which mainly detoxify the Cd-enriched soil during the interim period of crop cultivation, and guarantee the grain safety during its growth period. This technique may shift the challenge from soil to water treatment, and thus greatly enhances the remediation efficiency and shortens the remediation duration. Moreover, the proposed ecological and hydraulic remediation method matches well with the practical choice of cultivation while remediation for Cd-enriched soil in China, which has negligible impacts on the normal crop cultivation process, and thus shows great potential for large area applications.

Plasma Mitochondrial DNA Levels as a Biomarker of Lipodystrophy Among HIV-infected Patients Treated with Highly Active Antiretroviral Therapy (HAART)

Lipodystrophy is a common complication in HIV-infected patients taking highly active antiretroviral therapy. Its early diagnosis is crucial for timely modification of antiretroviral therapy. We hypothesize that mitochondrial DNA in plasma may be a potential marker of LD in HIV-infected individuals. In this study, we compared plasma mitochondrial DNA levels in HIV-infected individuals and non-HIV-infected individuals to investigate its potential diagnostic value. Total plasma DNA was extracted from 67 HIV-infected patients at baseline and 12, 24 and 30 months after initiating antiretroviral therapy. Real-time quantitative PCR was used to determine the mitochondrial DNA levels in plasma. Lipodystrophy was defined by the physician-assessed presence of lipoatrophy or lipohypertrophy in one or more body regions. The mitochondrial DNA levels in plasma were significantly higher at baseline in HIV-infected individuals than in non-HIV-infected individuals (p<0.05). At month 30, 33 out of 67 patients (49.2%) showed at least one sign of lipodystrophy. The mean plasma mitochondrial DNA levels in lipodystrophy patients were significantly higher compared to those without lipodystrophy at month 24 (p<0.001). The receiver operating curve analysis demonstrated that using plasma mitochondrial DNA level (with cut-off value <5.09 log10 copies/ml) as a molecular marker allowed identification of patients with lipodystrophy with a sensitivity of 64.2% and a specificity of 73.0%. Our data suggest that mitochondrial DNA levels may help to guide therapy selection with regards to HIV lipodystrophy risk.

[Expression of chemokine like factor-like myelin and lymphocyte and related proteins for vesicle trafficking and membrane link transmembrane domain-containing protein 2 in rats with varicocele]

OBJECTIVE

To investigate whether chemokine like factor (CKLF)-like myelin and lymphocyte and related proteins for vesicle trafficking and membrane link (MARVEL) transmembrane domain-containing protein 2 (CMTM2) is involved in spermatogenesis in varicocele induced subfertility rats and to discuss the possible mechanisms.

METHODS

Forty male SD rats (body weight: 220-330 g, age: 6-7 weeks) were randomly divided into 4 groups: varicocele for 4 weeks, varicocele for 12 weeks, sham operation for 4 weeks and sham operation for 12 weeks, with 10 rats in each group. These rats were introduced by partially ligating left kidney veins for the experimental groups, and the sham surgery groups as controls were executed with exactly the same surgery as in the experimental groups except for the ligation. The rats in control and experimental groups for 4 and 12 weeks were killed after laparotomy at the end of 4 and 12 weeks, respectively, the left testes and epididymis were taken out for counting the sperm, observing the seminiferous tubule change and immunochemistry for CMTM2. The changes included sperm density and motility, the outer diameter and inner diameter change and the changes of epithelium and the CMTM2 expression in immunochemistry.

RESULTS

Compared with the control groups, the sperm density [(63.9±7.1)×10⁶/mL vs.(74.3±5.0)×10⁶/mL] and motility [(58.7%±7.9%) vs.(66.1%±4.3%)] were reduced slightly in group of varicoele for 4 weeks, respectively (t=1.432, 1.563; P=0.076, 0.059, respectively). Varicocele significantly caused a decrease in sperm concentration [(40.5±7.2) ×10⁶/mL vs.(71.1±4.5)×10⁶/mL] and motility [(35.2%±8.5%)vs. (63.4%±4.1%)] at 12 weeks, compared with the related sham groups (t=3.754, 3.933; P=0.004, 0.002, respectively). Additionally, testis CMTM2 exhibited the same disparity, that is, the CMTM2 protein expression in varicocele group was significantly reduced, with the ratio of sham group to varicocele group at the end of 12 weeks 2.3±0.4 (t=1.978; P=0.039). In the evaluation of seminiferous tubules diameter, the external [(198.2±10.2) μm vs. (255.8±12.7) μm, t=2.125, P=0.003] and epithelium diameter [(54.1±1.5) μm vs. (75.5±4.1) μm, t=2.246, P=0.021] were decreased compared with the sham-related groups and previous varicocele groups. In all the varicocele groups, all types of sperm motility decreased compared with the related sham-operated group (P<0.05).

CONCLUSION

This study suggests varicocele has a detrimental effect on CMTM2 levels and decreases spermatogonia cell number, seminiferous tubules diameter, and sperm indices. CMTM2 is associated with sperm changes in rats with varicocele, and further studies are needed to study the mechanism.

A weighted scoring system to differentiate malignant liposarcomas from benign lipomas

PURPOSE

To construct a scoring system to differentiate malignant liposarcomas from benign lipomas by comparing their clinical and magnetic resonance imaging (MRI) features.

METHODS

Clinical and MRI features of 33 women and 33 men aged 17 to 83 (mean, 53) years who underwent resection of malignant liposarcomas (n=32) or benign lipomas (n=34) were reviewed.

RESULTS

The 5 strongest predictors of liposarcoma were male gender, larger tumour maximum dimension, deep to fascia, thick non-fatty septum or nodule, and internal cystic change. A weighted scoring system was constructed using the 5 strongest predictors as: Z score=10X1+X2+12X3+15X4+10X5, respectively. A cut-off score of 35 was used; all 32 malignant liposarcomas and 4 of 34 benign lipomas scored >35. The cut-off score of ≤35 could predict 30 of 66 lipomatous tumours as benign with a negative predictive value of 100% (p<0.0001).

CONCLUSION

The 5 strongest clinical and MRI features were identified to construct a scoring system to differentiate malignant from benign lipomatous tumours. Further validation in independent populations is required.

[Composition of potassium channels in normal rat coronary smooth muscle cells and activation effects of docosahexaenoic acid]

OBJECTIVE

To investigate the composition of potassium channels in normal rat coronary smooth muscle cells (CASMCs) and the activation effects of docosahexaenoic acid (DHA).

METHODS

CASMCs were isolated by enzyme digestion.Effects of different types of potassium channel blockers and/or DHA on potassium channels currents were studied by whole-cell patch clamp technique.

RESULTS

Potassium currents were significantly increased with 5 μmol/L DHA perfusion (P<0.05). The current density was increased from (52.80±6.68) pA/pF to (110.09±13.39) pA/pF (P<0.05) after DHA perfusion when the stimulation voltage was 100 mV.Compared with baseline, potassium currents were significantly decreased by various inhibitor perfusion (tetraethylammonium: (49.63±5.75) pA/pF vs. (13.96±2.18) pA/pF; ibritoxin: (50.67±7.89) pA/pF vs. (26.53±4.68) pA/pF; TRAM-34: (52.60±7.02) pA/pF vs. (46.05±7.60) pA/pF; apamin: (51.97±3.83) pA/pF vs. (44.89±5.04) pA/pF; 4-aminopyridine: (51.19±3.44) pA/pF vs. (29.92±2.81) pA/pF; glyburide: (49.67±1.77) pA/pF vs. (49.61±1.87) pA/pF, all P<0.05). In presence of different inhibitors, potassium channel current densities were increased after DHA perfusion except tetraethylammonium (tetraethylammonium: ( 12.79±1.89) pA/pF; ibritoxin: (67.08±5.54) pA/pF; TRAM-34: (117.91±21.79) pA/pF; apamin: (108.33±7.06) pA/pF; 4-aminopyridine: (127.73±20.56) pA/pF; glyburide: (121.53±13.83) pA/pF, all P<0.05 compared with baseline).

CONCLUSIONS

Large-conductance calcium-activated potassium channel and voltage-gated potassium channel are the major constituents of potassium channels in CASMCs.DHA can activate potassium channels in CASMCs, mainly the large conductance calcium-activated potassium channel, thus dilate coronary arteries.

Observation of an Anomalous Line Shape of the η^{'}π^{+}π^{-} Mass Spectrum near the pp[over ¯] Mass Threshold in J/ψ→γη^{'}π^{+}π^{-}

Using 1.09×10^{9} J/ψ events collected by the BESIII experiment in 2012, we study the J/ψ→γη^{'}π^{+}π^{-} process and observe a significant abrupt change in the slope of the η^{'}π^{+}π^{-} invariant mass distribution at the proton-antiproton (pp[over ¯]) mass threshold. We use two models to characterize the η^{'}π^{+}π^{-} line shape around 1.85  GeV/c^{2}: one that explicitly incorporates the opening of a decay threshold in the mass spectrum (Flatté formula), and another that is the coherent sum of two resonant amplitudes. Both fits show almost equally good agreement with data, and suggest the existence of either a broad state around 1.85  GeV/c^{2} with strong couplings to the pp[over ¯] final states or a narrow state just below the pp[over ¯] mass threshold. Although we cannot distinguish between the fits, either one supports the existence of a pp[over ¯] moleculelike state or bound state with greater than 7σ significance.

[Docosahexaenoic acids activate large conductance calcium-activated potassium channels via phospholipase C- inositol triphosphate- calcium pathway in normal rat coronary smooth muscle cells]

OBJECTIVE

To investigate the mechanisms of docosahexaenoic acids (DHA) on activating large conductance calcium-activated potassium channels (BK channels) in normal rat coronary smooth muscle cells.

METHODS

Normal coronary smooth muscle cells were isolated by enzyme digestion from Sprague-Dawley rats. BK currents were recorded by patch clamp in whole cell and single channel configurations, respectively. The effects of DHA on cytosolic calcium concentrations were examined by recording the changes of fluorescence intensity ratios.

RESULTS

DHA (1 μmol/L) could activate BK channels. Open probabilities (NP0) of BK channels at test potential 60 mV, and calcium concentrations in external solution at 0, 0.01, 0.1, 1, 3, 10, 50 and 100 μmol/L were 0.002 7±0.000 4, 0.006 0±0.001 4, 0.097 2±0.010 6, 0.137 9±0.032 9, 0.468 7±0.163 7, 2.097 1±0.310 4 and 3.120 4±0.242 7, respectively (P<0.05, n=4). Before DHA perfusion, the fluorescence intensity ratio was 0.51±0.01, and the ratios were 0.53±0.02 and 0.55±0.01 after 0.001 and 0.01 μmol/L DHA perfusion, respectively (P>0.05, n≥5). The ratios were 0.64±0.01, 0.65±0.01, 0.70±0.01, 0.69±0.01, 0.68±0.01 and 0.67±0.02 after 0.1, 0.3, 1, 3, 5 and 10 μmol/L DHA perfusion, respectively, and EC50 was (0.04±0.02) μmol/L(P<0.05, n≥4). They were all higher than that before DHA perfusion. After incubating with phospholipase C (PLC) blocker U73122 and inositol triphosphate (IP3) blocker 2-APB, the ratios were 0.52±0.01 and 0.49±0.02 on the setting of 0.1 μmol/L DHA, respectively. Compared with control group(0.64±0.01), the ratios decreased after incubating with blockers (P<0.05, n≥4).

CONCLUSIONS

Docosahexaenoic acids can activate large conductance calcium-activated potassium channels by the pathway of PLC-IP3-Ca(2+) to increase cytosolic calcium concentration in normal coronary smooth muscle cells, dilate the coronary vessels and bestow protective effects on cardiovascular system.