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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

BACKGROUND

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

PATIENTS AND METHODS

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

RESULTS

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

CONCLUSION

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

CLINICAL TRIAL NUMBER

NCT00941538.

Complete Measurement of the Λ Electromagnetic Form Factors

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

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

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

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

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

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

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

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

[Clinical characteristics of patients with delayed hepatolenticular degeneration]

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

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

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

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

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

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

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

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

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

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

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

[Clinical characteristics of the Wilson disease carrier]

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