[Management of T3 supraglottic carcinoma: a retrospective study]

Objective: To discuss the strategy of therapeutic management of T3 supraglottic carcinoma. Methods: A retrospective analysis of 459 patients with T3 supraglottic carcinoma treated in our hospital was performed. We evaluated the results of different managements, including surgery alone, preoperative radiotherapy, postoperative radiotherapy and radiotherapy alone. The extent of the lesion was also put into analysis. Statistical analysis of the overall survival (OS), cause-specific survival (CSS), local control (LC), regional control(RC), function-conservation (FC) were performed with the statistical package from SPSS. Results: In all patients, the rates of 5-year OS, CSS, LC, RC and FC were 64.2%, 71.2%, 87.8%, 78.8% and 64.5% respectively. The OS, LC and FC of the patients treated by surgery alone, preoperative radiotherapy and postoperative radiotherapy had no significant difference, and were remarkably better than that of patients treated by radiotherapy alone (P<0.001). In 412 patients treated by surgery, 300 patients received function-conservation laryngectomy. 209 patients (50.7%, 209/412) survived and maintained well-function of larynx for 5 years, which was significantly better than those in the radiotherapy alone group (27.7%, 13/47). The patients with the lesion invading the pre-epiglottic space but limited in supraglottic area had better OS (70.2%), LC (93.5%) and FC (85.1%). The rate of 5-year neck lymphatic metastasis was 56.2%(258/459), and the 5-year OS of patients with N0, N1, N2 and N3 stage were 76.0%, 66.2%, 50.5% and 13.0% respectively. Conclusions: Surgical treatment was the best therapeutic approach for T3 supraglottic laryngeal carcinoma. Most patients with T3 lesions are suitable for function-conservation laryngectomy. Surgical procedure was determined by tumor invaded location and extension. The combined therapy of surgery and radiotherapy had no significant advantage.

[Long-term follow-up of multiple myeloma after autologous hematopoietic stem cell transplantation: a single center results]

目的

评价诱导治疗联合自体周血造血干细胞移植（ASCT）治疗、移植后巩固维持治疗的整体方案治疗多发性骨髓瘤（MM）患者的有效性和长期随访结果。

方法

回顾性分析2005年1月1日至2016年2月1日接受整体方案治疗的144例MM患者资料，总结其长期随访结果，分析移植前疗效、移植后缓解深度，以及早期移植、晚期移植、不同预后分期系统等因素对患者生存的影响。

结果

144例患者中获得部分缓解（PR）以上治疗反应率为89.4%[完全缓解（CR）率64.1%]。中位随访47（6~121）个月，患者中位总体生存（OS）和无进展生存（PFS）时间分别为120.9和56.9个月；早期和晚期移植组患者的中位OS分别为120.9和50.1个月，中位PFS时间分别为60.2和16.7个月（P值均<0.001）。127例可进行修订的国际分期系统（R-ISS）分期患者中，Ⅰ期（43例）、Ⅱ期（64例）、Ⅲ期（20例）患者的中位OS时间分别为120.9、88.4、35.6个月，组间差异有统计学意义（P=0.000）。对早期和晚期移植组患者进行亚组生存分析，R-ISS Ⅲ期患者中位OS时间差异有统计学意义（35.6个月对15.8个月，P=0.031）；两组患者各期中位PFS时间差异均有统计学意义（Ⅰ期：72.1个月对18.9个月；Ⅱ期：53.4个月对16.7个月；Ⅲ期：28.5对5.9个月，P值分别为0.000、0.012、0.001）。多因素分析结果显示R-ISS Ⅲ期是影响患者OS的危险因素（HR=8.486，95%CI 2.549~28.255，P=0.003），移植后未获得CR是影响患者PFS的危险因素（HR=2.412，95%CI 1.364~4.266，P=0.002）。

结论

以新药为基础的化疗联合ASCT的整体治疗方案对适合移植的MM患者是有效的，可进一步提高缓解率和缓解深度，延长患者的PFS和OS时间。早期较晚期移植可明显延长患者的OS和PFS时间。R-ISS分期和移植前疗效是影响患者生存的预后因素。

[Outcomes of lenalidomide-based treatment for 57 patients of relapsed or refractory multiple myeloma]

目的

探讨来那度胺（商品名瑞复美）为基础的化疗方案在复发或难治性多发性骨髓瘤（MM）患者中的疗效及安全性。

方法

回顾性分析2013年6月至2016年2月收治的57例应用来那度胺为基础的方案治疗的复发或难治性MM患者资料。

结果

①国际分期系统（ISS）Ⅲ期患者比例为60.4%，修改的国际分期系统（R-ISS）Ⅲ期患者比例为37.9%，53.3%的患者存在高危遗传学异常。②患者应用来那度胺中位疗程为6（1~32）个。治疗的总体缓解率（ORR）为58.9%（33/56），其中完全缓解率为8.9%，非常好的部分缓解率为19.8%，部分缓解（PR）率为30.4%。此外有10.7%（6/56）的患者达到微小缓解，临床获益率69.6%。前期接受一线以上治疗、既往沙利度胺耐药及R-ISS Ⅲ期患者ORR较低。③中位随访27个月，患者中位无进展生存（PFS）时间8个月，中位达PR时间2个月，中位缓解持续时间（DOR）8个月，中位总体生存（OS）时间19个月。单因素分析中，染色体核型异常、R-ISS分期Ⅲ期、疗效未达PR及以上是影响患者PFS和OS的不良因素。多因素分析显示，染色体核型异常、R-ISS分期Ⅲ期具有独立预后意义。④安全性分析显示，最常见的3/4级非血液学不良反应为感染（17.5%）、皮疹（1.8%）、血栓（1.8%）。最常见的3/4级血液学不良反应为中性粒细胞减少（7.0%）和血小板减少（3.5%）。共有3例（5.3%）患者因不良反应停药。共观察到第二肿瘤2例（3.5%）。

结论

来那度胺为基础的化疗方案在复发或难治性MM患者中有效率高、耐受性良好。预后因素分析显示，在这一患者群体中染色体核型异常、R-ISS分期Ⅲ期是独立预后不良因素。

Genetic diversity of mtDNA D-loop sequences in four native Chinese chicken breeds

1. To explore the genetic diversity of Chinese indigenous chicken breeds, a 585 bp fragment of the mitochondrial DNA (mtDNA) region was sequenced in 102 birds from the Xichuan black-bone chicken, Yunyang black-bone chicken and Lushi chicken. In addition, 30 mtDNA D-loop sequences of Silkie fowls were downloaded from NCBI. The mtDNA D-loop sequence polymorphism and maternal origin of 4 chicken breeds were analysed in this study. 2. The results showed that a total of 33 mutation sites and 28 haplotypes were detected in the 4 chicken breeds. The haplotype diversity and nucleotide diversity of these 4 native breeds were 0.916 ± 0.014 and 0.012 ± 0.002, respectively. Three clusters were formed in 4 Chinese native chickens and 12 reference breeds. Both the Xichuan black-bone chicken and Yunyang black-bone chicken were grouped into one cluster. Four haplogroups (A, B, C and E) emerged in the median-joining network in these breeds. 3. It was concluded that these 4 Chinese chicken breeds had high genetic diversity. The phylogenetic tree and median network profiles showed that Chinese native chickens and its neighbouring countries had at least two maternal origins, one from Yunnan, China and another from Southeast Asia or its surrounding area.

[Effect of Liangge powder on expression of inflammatory mediators and hepatic and renal function in rats with sepsis]

Objective: To investigate the effect of Liangge powder on the expression of inflammatory mediators and hepatic and renal function in rats with sepsis via a preliminary analysis. Methods: A total of 195 Wistar rats were randomly divided into sham-operation group (15 rats) , model group (90 rats) , and treatment group (90 rats) using a random number table, and according to the time point after modeling, the model group and the treatment group were further divided into 24, 48, and 72 hour subgroups, with 30 rats in each subgroup. Cecal ligation and puncture (CLP) was performed to establish a rat model of sepsis, and solid-phase sandwich enzyme-linked immunosorbent assay was used to measure the expression of interleukin-10 (IL-10) , interleukin-1 (IL-1) , interleukin-4 (IL-4) , and lipopolysaccharide (LPS) at 24, 48, and 72 hours after CLP. An automatic biochemical analyzer was used to measure the levels of alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , blood urea nitrogen (BUN) , and creatinine (Cr) . Results: Compared with the sham-operation group, the model group had significant increases in the serum levels of IL-1, IL-4, IL-10, LPS, BUN, Cr, AST, and ALT at 24, 48, and 72 hours after CLP (P<0.05) . Compared with the model group, the treatment group had a significant reduction in the serum level of IL-1 at 24, 48, and 72 hours after CLP, a significant increase in the serum level of IL-4 at 24 and 48 hours after CLP, and a significant increase in the serum level of IL-10 and a significant reduction in the serum level of LPS at 24 and 72 hours after CLP (P<0.05) . Compared with the model group, the treatment group had a significant reduction in ALT at 24 hours after CLP, significant reductions in BUN and Cr at 48 hours after CLP, and a significant reduction in AST at 72 hours after CLP (P<0.05) . Conclusion: In the early stage of sepsis, imbalance between pro-inflammation and anti-inflammation and immunosuppression may cause hepatic and renal impairment in rats with sepsis. The traditional Chinese medicine Liangge powder can regulate inflammatory response, restore the balance between pro-inflammation and anti-inflammation, and improve hepatic and renal function in rats with sepsis.

[Analysis on the causes of unscheduled suspensions of knee and hip arthroplasty]

OBJECTIVE

To analyze and summarize the causes of unscheduled suspension of knee and hip arthroplasty and to provide the method for optimizing the patient's preoperative management and improving the efficiency of medical resources as well as the patient's satisfaction.

METHODS

The data for this report was retrospectively collected from September 2013 to August 2014 in our hospital, from cases of knee and hip arthroplasty that were suspended before the scheduled operation time. Acquisition data from the collected cases including the patients' gender, age and the surgical procedure. At the same time, the suspension reasons were recorded and analyzed. All the decisions of suspension was made by the surgeons and the anesthesiologists according to the abnormal result of preoperative examinations, after communicating with the patients and their families and obtaining their understandings.

RESULTS

In the collecting period, our department scheduled 1 146 cases of knee and hip arthroplasty, among which 1 003 were completed, 143 suspended (12.5% suspension rate). Among the causes of suspension, the top four common causes were cardiovascular disease (44/143, 31%), other infections (20/143, 14%), bacteriuria (18/143, 13%) and inappropriate surgical indication (16/143, 11%). Other causes include surgeon's reason, Blood system abnormalities, high inflammatory index, deep vein thrombosis, other diseases uncontrolled, abnormal liver function and poor diabetes mellitus control, etc. For the rate of suspension, there was no significant difference between the patients with different genders (male: 15.0%, and female: 11.7%, P=0.149), or age (≤50 years: 13.0%; 51-65 years: 11.6%; 66-80 years 13.3%; >80 years 11.1%; P=0.864). However compared with knee arthroplasty, hip arthroplasty had a higher suspension rate (knee arthroplasry 11.1%, hip arthroplasry 16.1%, P=0.021).

CONCLUSION

It is important to educate and manage the patients before their knee and hip arthroplasty. Through clear diagnosis, detailed medical history analysis careful physical examination, and targeted outpatient examinations and tests for which priority was focused on cardiovascular or other system diseases we could minimize the occurrence of operative suspension post hospitalization, therefore improving the efficiency of the use of medical resources.

[Epidemiological analysis of the deaths of malaria in China, 2005-2014]

OBJECTIVE

To explore the epidemiological features of deaths of malaria from 2005 to 2014, so as to provide the evidence for subsequently more effective strategic planning of malaria elimination in China.

METHODS

The data of individual malaria cases (including probable and confirmed cases, population data, geographic distribution, diagnosis and reporting information) were obtained from the National Notifiable Infectious Disease Reporting Information System from 2005 to 2014 and the epidemiological investigation information (including the clinical systems and the imported and indigenous cases) was extracted from Parasite Disease Prevention and Control Information System from 2011 to 2014. All of the data didn't include Hongkong, Macao, Taiwan and foreign cases. The population characteristics, clinical systems, geographic distribution, diagnosis and reporting and sources of infections of deaths were analyzed.

RESULTS

From 2005 to 2014, a total of 228 deaths of malaria were reported, with 203 (89.0%) of P. falciparum malaria, 13 (5.7%) of P. vivax malaria, 1 (0.5%) of P. malariae malaria and 11(4.8%) other cases. The fatality rate of malaria increased since 2010. Among the deaths, 48 (81.4% ) had serious complications, which included cerebral lesion, coma, severe renal and hepatic injuries and hemolysis and so on. In 2005-2010, the geographical distribution of malaria deaths was mainly in Yunnan (78 deaths, 56.1%), Sichuan (13 deaths, 9.4%), Henan (7 deaths, 5.0%), Shandong (6 deaths, 4.3%) and Zhejiang (5 deaths, 3.6%) province. However, since the initiation of malaria elimination program in 2010, the areas with malaria deaths have changed, which mainly distributed in Henan (10 deaths, 11.2%), Sichuan (9 deaths, 10.1%), Shandong (8 deaths, 9.0%), Jiangsu (7 deaths, 7.9%) and Hunan province (7 deaths, 7.9%). Besides there were nine deaths (10.0%) reported in non-endemic areas of malaria (Beijing, Inner Mongolia, Jilin, and Ningxia) in 2011-2014. The median time from illness onset to diagnosis for deaths was 5.5 (P25-P75: 3.0-8.5) d, which was longer than 3.0 (2.0-6.0)d for survivors. Moreover, for deaths, the median P50 (P25-P75)(6.0, 4.0-9.0 d) from illness onset to diagnosis in 2011-2014 was longer than that in 2005-2010 (5.0, 3.0-9.0 d). Among imported deaths, 77 deaths (90.6%) originated from Africa and 8 deaths (9.4%) from Southeast Asia.

CONCLUSION

Although the reported deaths of malaria were stable in 2005-2014, the geographical distribution of malaria deaths changed significantly and the time from illness onset to the diagnosis was longer since 2010. Special attention should be paid to the diagnosis and treatment of imported cases to reduce the fatality at the malaria elimination stage.

[The progression of parenteral and enteral nutrition based on new guidelines]

As people are getting a better understanding of organism's metabolism and the concept of disease treatment is being continuously updated, parenteral and enteral nutrition become an inter discipline subject that serves for the clinic and involves a number of disciplines. Just in the past five years, related guidelines at home and abroad have been published as much as more than 40. In order to better serve the clinical decision making, this text attempts to give a carding and interpretation from the three aspects of nutrition screening and assessment, the implementing of nutritional intervention and the progress of special nutrition support. It is observed that the standard clinical nutrition diagnosis and treatment process has been formed consensus. But in the practical application, there are still many details need to confirm and further study.

[Monitoring and research on pathogen spectrum in patients with acute diarrhea from sentinel hospital of Zhejiang Province during 2009 to 2014]

Objective: To explore pathogen spectrum constitution of acute diarrhea in outpatient and emergency of Zhejiang Province, and provide basis for treatment, prevention and control of the disease. Methods: During January 2009 to December 2014, we selected seven sentinel hospitals in different regions of Zhejiang, monitored and researched on pathogen spectrum in patients with acute diarrhea from outpatient and emergency. We recorded patients' personal basic information, the main symptoms and signs, and collected stool samples (5 g). Eight kinds of bacteria (Vibrio cholerae, Shigella spp., Salmonella spp., Diarrheagenic E. coli, Vibrio parahaemolyticus, Aeromonas hydrophila, Yersinia enterocolitica and Plesiomonas shigelloides) and five kinds of viruses (Rotavirus, Norovirus, Sappovirus, Astrovirus and Adenovirus) were detected. Chi-square test and Fisher's exact probability method were used to compare different characteristics of patients with single bacterial infection, single virus infection and multiple infection (bacteria-bacteria, bacteria-viruses, virus-virus). Results: During 2009 to 2014, 9 364 fecal samples from acute diarrhea patients were collected and tested, among which 3 500 cases were tested positive, with total positive rate of 37.38%. Positive rates of bacteria and viruses were 13.14% (1 230 cases) and 20.75% (1 943 cases), respectively. Mixed infection positive rate of multiple pathogens was 3.49% (327 cases). Positive rate of Vibrio parahaemolyticus (5.96% , 558 cases) was the highest among bacterial pathogens, followed by pathogenic Escherichia coli (3.86%, 361 cases). Viruses were mainly Norovirus (10.73%, 1 005 cases) and rotavirus (8.35%, 782 cases). A big difference existed in diarrheogenic pathogen spectrum between patients less than 15 years old and patients equal or older than 15 years old. Pathogens for patients less than 15 years old were mainly virus, with the positive rate of 32.69% (1 014 cases). However, the positive rate of bacteria was 16.86% (1 056 cases) in patients equal or older than 15 years old. Single bacterial infection was highest in age group of 25-34 years old (18.62%, 302 cases) , single virus infection was highest in age group of 1-4 years old (41.12%, 435 cases) , and mixed infections of multiple pathogens were mainly existed in age group of 1-4 years old (7.37%, 78 cases) . Pathogen positive rate were increasing year by year. Pathogen positive rate of patients with acute diarrhea has obvious seasonality, with single bacterial infection being highest during July to September and single virus infection being highest during December to March. Pathogen spectrum of outpatient and emergency patients with acute diarrhea in Zhejiang Province changed a little from 2009 to 2014, mainly rotavirus (22.34% (782/3 500)), norovirus (28.71% (1 005/3 500)), vibrio parahaemolyticus (15.92% (558/3 500)) and Escherichia coli (10.31% (361/3 500)). However, pathogen spectrums in different years owned different features. Conclusion: Common pathogens in outpatient and emergency patients with acute diarrhea in Zhejiang Province were tested with significant seasonal epidemic law. The composition of pathogenic spectrum was variant in different age group. Constitutes of major pathogen spectrum in different years differed a little.

Promoter analysis and tissue expression of the chicken ASB15 gene

1. This study was conducted to explore the promoter region of the chicken ASB15 gene by detecting the activities of the dual luciferase reporter gene and to assess expression profiles of the ASB15 gene in 10 different tissues from Gushi chickens. 2. Five dual luciferase reporter gene vectors were constructed and transfected into DF1 cells. The activities of recombined plasmids were measured and the core promoter was confirmed by bioinformatic analysis. Total RNA was extracted and the relative expression of the ASB15 gene was examined. 3. Data analysis indicated that the promoter was located from -955 to -212 bp. Results showed that the chicken ASB15 gene was expressed in heart, breast muscle and leg muscle. 4. This study has confirmed the promoter region and the expression profile of the chicken ASB15 gene, which provides a foundation for further exploring its transcriptional regulation and function.

[Value of endobronchial ultrasound-guided transbronchial needle aspiration of enlarged mediastinal lymph nodes and analysis of false negative results]

Objective: To explore the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results of EBUS-TBNA. Methods: A retrospective analysis of the clinical and imaging data of 389 patients who underwent EBUS-TBNA for sampling enlarged hilar and mediastinal lymph nodes from October 2009 to October 2015 in Shandong Tumor Hospital, to evaluate its significance in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results. Results: Among the 389 collected cases, positive biopsy results were obtained in 362 cases, and false negative results in 27 cases. The sensitivity, specificity, positive predictive value and negative predictive value were 92.9%, 100%, 100% and 25.0%, respectively. There was a positive correlation between the size of lymph node and biopsy positive rate (P=0.021). The subcarinal lymph nodes had the highest positive rate (97.7%), followed by the paratracheal lymph nodes (91.2%), with a statistically significant difference (P=0.006). The positive rates obtained by cytology (88.7%) and pathology (92.5%, ) showed no significant difference (P=0.065). The positive rate of EBUS-TBNA was not correlated with pathological types (P=0.932). Needle types (21G, 22G) had no significant effect on diagnosis accuracy (P=0.142). Conclusions: EBUS-TBNA is a practical technology for diagnosis of enlarged mediastinal lymph nodes, with unique characteristics such as minimally invasiveness, local anesthesia, good safety and repeatability. Along with the accumulation of surgical experience, improvement of operative skills, more close cooperation between surgeons, cytologists and pathologists, false negative results will be reduced and positive rate of EBUS-TBNA examination will be further improved.

Polymorphisms of Flanking Region of the ASB15 Gene and Their Associations with Performance Traits in Chicken

Research on the identity of genes and their relationship with traits of economic importance in chickens could assist in the selection of poultry. In this study, an F₂ resource population of Gushi chickens crossed with Anka broilers was used to detect single-nucleotide polymorphisms (SNPs) in the flanking region of the ASB15 gene by DNA sequencing and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). One SNP of -1271 C>T in 5' flanking region of the chicken ASB15 gene and two SNPs of the 10618 A>G and 10716 G>A in 3' flanking region were identified. Furthermore, the 10618 A>G and 10716 G>A in 3' flanking region were in complete linkage. Association analysis results showed that -1271 C>T was not associated with performance traits, while the 10618 A>G and 10716 G>A were significantly associated with BW2, 4, 6, 8, 10, 12, SL12, CD8, CW4, 8, 12, BSL4, 8, 12, and SEW, EW, WW, BMW, LW, CW, SFT. Our results suggest that the ASB15 gene profoundly affects chicken performance traits.

[Gastric pull-up reconstruction after pharyngoesphagectomy for advanced hypopharyngeal or cervical esophageal squamous cell carcinoma]

Objective: To analyze the clinical results of gastric pull-up reconstruction following total pharyngoesophagectomy. Methods: A total of 90 patients with hypopharyngeal or cervical esophageal cancinoma who underwent gatric pull-up reconstruction after pharyngoesophagectomy between June 2006 and June 2015 were reviewed retrospectively. Clinical data were analyzed. Rates of survival, recurrence and complicates were calculated with SPSS software. Results: Of 90 patients, 8 patients had hypopharyngeal cancinoma invading cervical esophagus, 51 patients had cervical esophageal carcinoma, and 31 patients had hypophageal and esophageal multiple parimary carcinomas. Forty patients were treated with surgery alone, 29 patients with planned surgery, and 21 patients with salvage surgery. After follow up of 6-104 months with a median of 22 months, 54 patients died and the total 3-year survival rate was 36.3%. Seventeen patients developed local recurrences and 10 patients cervical or mediastinal lymph node metastasis (LNM). The 3-year survival rates of patients with and without recurrence or LNM were respectively 5.9%, and 45.7% (χ²=11.564, P=0.001). Twenty-three patients developed distant metastasis. The 3-year survival rate of patients with and without distant metastasis were respectively 22.9% and 41.8% (χ²=4.534, P=0.033). Multivariate analysis showed local recurrence and distant metastasis as predictors for poor survival. The rates of perioperative mortality and anastomotic fistula were 3.3% (3/90) and 13.3%(12/90), respectively. Conclusions: Gastric pull-up reconstruction is a relatively safe and effective method for esophageal reconstruction after removal of hypopharyngeal or cervical esophageal carcinoma. Some patients could achieve good survival with low mortality and acceptable morbidity after multidisciplinary treatments.

[Using (1)H-nuclear magnetic resonance metabolomics and gene ontology to establish pathological staging model for esophageal cancer patients]

OBJECTIVES

By combining the metabolomics and computational biology, to explore the relationship between metabolic phenotype and pathological stage in esophageal cancer patients, to find the mechanism of metabolic network disturbance and develop a new method for fast preoperative clinical staging.

METHODS

A prospective cohort study (from April 2013 to January 2016) was conducted. The preoperative patients from Sichuan Provincial People's Hospital, who were diagnosed with esophageal cancer from May 2013 to April 2014 were included, and their serum samples were collected to detect (1)H-nuclear magnetic resonance (NMR) metabolomics for the purpose of drawing the metabolic fingerprinting in different stages of patients with esophageal cancer. The data were processed with these methods-principal components analysis: partial least squares regression and support vector machine, for the exploration of the enzyme-gene network regulatory mechanism in abnormal esophageal cancer metabolic network regulation and to build the quantitative prediction model of esophageal cancer staging in the end. All data were processed on high-performance computing platforms Matalab. The comparison of data had used Wilcoxon test, variance analysis, χ(2) test and Fisher exact test.

RESULTS

Twenty patients with different stages of esophageal cancer were included; and their serum metabolic fingerprinting could differentiate different tumor stages. There were no difference among the five teams in the age (F=1.086, P>0.05), the body mass index (F=1.035, P>0.05), the distance from the incisors to tumor (F=1.078, P>0.05). Among the patients with different TNM stages, there was a significant difference in plasma metabolome. Compared to ⅡB, ⅢA, Ⅳstage patients, increased levels of butanone, ethanol amine, homocysteine, hydroxy acids and estriol, together with decreased levels of glycoprotein, creatine, choline, isobutyricacid, alanine, leucine, valine, were observed inⅠB, ⅡA stage patients. Four metabolic markers (ethanol amine, hydroxy-propionic acid, homocysteine and estriol) were eventually selected. gene ontology analysis showed that 54 enzymes and genes regulated the 4 key metabolic markers. The quantitative prediction model of esophageal cancer staging based on esophageal cancer NMR spectrum were established. Cross-validation results showed that the predicted effect was good (root mean square error=5.3, R(2)=0.47, P=0.036).

CONCLUSIONS

The systems biology approaches based on metabolomics and enzyme-gene regulatory network analysis can be used to quantify the metabolic network disturbance of patients with advanced esophageal cancer, and to predict preoperative clinical staging of esophageal cancer patients by plasma NMR metabolomics.

[Isolation and biological characteristics on Yersinia pestis phage YP060]

OBJECTIVE

To isolate and identify the characteristics of Yersinia pestis phage YP060 from mice nests in Yunnan plague focus.

METHODS

Phage YP060 was isolated from Yunnan plague focus by double-layer agar plate method with attenuated vaccine Yersinia pestis strain EV76 as the host bacterium. Phage particle was observed under the electron microscope while biological properties of phage YP060 including lytic capacity, host spectrum, optimal multiplicity of infection (MOI), one-step growth curve, sensitivity to temperature, pH, ultraviolet ray and chloroform etc. were identified.

RESULTS

The particles of phage YP060 presented tadpoles-like features, with optimal multiplicity of infection as 0.1. Latent period and burst period appeared as 50 min and 80 min, respectively. The phage endured the temperature between 30-50 ℃, and it contained a stronger lysis activities in a range of pH 5 to 10. Phage YP060 was sensitive to ultraviolet rays but insensitive to chloroform while presented special lysic ability to Yersinia pestis.

CONCLUSION

Yersinia pestis phage YP060 was isolated for the first time from mice nests in plague natural focus in China. Our findings related to narrow host spectrum and stronger lysis activities.

[Effects of forsythia suspense on the liver gene expression levels of rats with sepsis model]

OBJECTIVE

To study the effects of forsythia extract on the liver gene expression levels of rats with sepsis model.

METHODS

The 90 Wistar rats were randomly divided into three groups: sham operation group (n=30) , sepsis model group (n=30) and forsythia group (n=30). The survival rates at 48 h and 72 h were observed for all groups. The sepsis model and forsythia group rats were prepared by "CLP" method. 72 h later the rats were sacrificed by removed the vertebra. Under sterile conditions,cut the size of about 10 mm×10 mm×3 mm rat liver tissue and placed in liquid nitrogen for use. The same with the sham operation group. The gene expression levels of livers in all groups were detected by the Applications Rat Genome 230 2.0 microarray,and the relative strength of both the fluorescence signal ratio>2 or <-2 screening significantly different genes, by the US National Center for Biotechnology Information (NCBI) database query gene function and classify.

RESULTS

Forsythia group 48 h, 72 h rat mortality rates were 30% and 50%, the sepsis model group 48 h, 72 h rat mortality rates were 46.7% and 70%, two groups 48 h, 72 h mortality rates were compared, the differences were statistically significant (P<0.05). 72 hours after CLP, the genes with up-regulation in sepsis model group/sham operation group and with down-regulation in Forsythia group/sepsis model group were 14. The genes with down-regulation in sepsis model group/sham operation group and with up-regulation in Forsythia group/sepsis model group were 11. The genes involves immune-related genes 8, metabolism genes 5, material transport two related genes, cell adhesion two related genes, cell proliferation, differentiation and apoptosis related genes 4, transcriptional regulation genes 2and other related gene.

CONCLUSION

Forsythia can reduce the 48, 72 h mortality of rats with sepsis and can regulate abnormal sepsis liver genes which associated with tissue immunity, inflammation, metabolism occur regression expression.

Toll-like receptor-4-dependence of the lipopolysaccharide-mediated inhibition of osteoblast differentiation

Bone fractures or bones subjected to open conduction and internal fixation are easily infected by bacteria; bacterial lipopolysaccharide (LPS) has been recognized as an important pathogenic factor affecting bone fracture healing. Therefore, the effect of LPS on bone metabolism is relevant for bone healing. In this study, we investigated the effect of LPS on the expression of Toll-like receptor (TLR)-4 (an LPS receptor) by using real-time quantitative PCR and western blotting. We also examined the regulatory role of LPS in osteoblast differentiation by measuring the ALP activity, matrix mineralization, and ALP, OCN, and Runx2 mRNA (essential factors affecting osteoblast differentiation) expression in LPS-treated mouse osteoblast MC3T3-E1 cells. We also evaluated the effect of TLR-4 on LPS-mediated inhibition of osteoblast differentiation using RNA interference. LPS promotes TLR-4 mRNA and protein expression in MC3T3-E1 cells (P < 0.05, P < 0.01 or P < 0.001), and inhibits osteoblast differentiation by downregulating matrix mineralization and ALP activity (P < 0.05, P < 0.01 or P < 0.001), and suppressing the expression ALP, OCN, and Runx2 mRNA in MC3T3-E1 cells (P < 0.05 or P < 0.01). Conversely, RNAi-mediated TLR-4 knockdown abrogates the LPS-mediated inhibition of osteoblast differentiation (P < 0.05 or P < 0.01). In summary, LPS was shown to inhibit osteoblast differentiation by suppressing the expression of ALP, OCN, and Runx2 in a TLR-4-dependent manner. The results of this study may provide insights into the signal pathway of LPS-induced bone loss or delayed bone fracture healing.

[Clinical analysis of lymphocytic thyroiditis coexistent with papillary thyroid carcinoma]

OBJECTIVE

To analyse the clinical features and treatment strategies of papillary thyroid carcinoma(PTC) coexistent with lymphocytic thyroiditis (LT).

METHODS

A total of 292 patients including 25 males and 267 females with LT and thyroid nodules treated in the department of head and neck surgery between Sep 2011 and Sep 2014 was analysed retrospectively and divided into two groups according to pathological results, of them 262 patients, with a median age of 47 years old, were LT with PTC and 30 patients, with a median age of 54 years old, were LT with benign nodules. Among 262 patients having LT with PTC, 259 were diagnosed as having malignant or suspicious malignant nodules and 3 having benign nodules with ultrasound before surgery, 98 cases were considered multifocal malignant nodules by preoperative ultrasound, and 112 cases were positive in cervical lymph nodes, including bilateral positive in 37 cases. Of 30 patients having LT with benign nodules, 14 were diagnosed malignant or suspicious malignant nodules and 16 benign nodules.

RESULTS

The mean age in 262 patients with PTC was less significantly than that in 30 patients with benign nodules (P<0.05). Ultrasound showed a high proportion of calcification and microcalcification in patients with PTC (34%) compared to patients with benign nodules(13%)(P<0.05). There were not significant differences in the mean levels of serum thyroid stimulating hormone(TSH) (2.80 vs 2.99 mU/L, P=0.233), thyroglobulin(TG) (27.14 vs 18.60 μg/L, P=0.747), and anti-thyroglobulin antibodies(ATG)(417.3 vs 378.7 U/ml, P=0.834) between patients with PTC and those with benign nodules. In patients with PTC, multifocal tumor accounted for 42%. The central and lateral lymph node metastasis rates were respectively 50% and 24%, and the occult metastasis rate of lateral neck lymph node was 16%. Univariate analysis showed that age less than 45 years old, multifocal tumor, tumor diameter more than or equal to 2cm and extrathyroidal extension were associated with central lymph node metastasis (P<0.05), but not with lateral neck metastasis. Multivariate analysis showed a closed correlation only between the lymph node metastases in central and lateral neck levels (P<0.05).

CONCLUSIONS

Calcification and microcalcification have the same importance in the ultrasonic diagnosis for PTC in patients with LT. Total thyroidectomy and prophylactic central lymph node should be a choice for LT with PTC. Lymph node metastasis in level Ⅵ indicates the possibility of lateral cervical lymph node metastasis in the patients having LT with PTC.

[Epidemic features and impact factors on hospitalization of Plasmodium vivax in China 2011-2014]

OBJECTIVE

To investigate the epidemiological characteristics and impact factors on hospitalization of Plasmodium vivax (P.vivax) since initiation of national malaria elimination program, so as to facilitate the adjustment of technical guideline in response to the epidemic changing of malaria in China.

METHODS

The data of individual P. vivax case (probable and confirmed) and population during 2011-2014 were collated from China National Notifiable Infectious Disease Reporting Information System, and the data of epidemiological investigation for individual P. vivax case (imported and indigenous) during 2011-2014 were collected from China Parasite Disease Prevention and Control Information System. All of the data didn't include China's Hongkong, Macao, Taiwan and foreign cases. The risk factors on hospitalization were explored by multiple factors variable binary classification unconditioned logistic regression model.

RESULTS

During study period of four years, a total of 5 656 Plasmodium vivax cases were detected. Among them, 69.9% (3 951 cases) were imported cases and 30.1% (1 705 cases) were autochthonous cases. The male cases accounted for 82.7% of all cases. Among the autochthonous cases, 535 cases (31.4%) occurred in the cross-bordering areas, and 577 cases (33.8%) were reported in the junction of difference provinces. The amount of autochthonous cases decreased from 1 363 cases in 2011 to 53 cases in 2014, and the county affected by autochthonous cases was shrunk from 185 counties to 10 counties. The proportion of autochthonous cases introduced by domestic migrants increased constantly, which reached 41.5% in 2014. The imported cases were detected from 614 counties of 30 provinces, who were originated from 57 overseas countries of 4 continents, with Southeast Asia being the leading origins (2 772 cases, 70.2%). There were 1 494 cases hospitalized for treatment, with the male (OR=1.41, 95%CI: 1.16-1.71), 14 years old and younger (OR=2.26, 95%CI: 1.44-3.56), and oversea imported cases (OR=2.73, 95%CI: 2.30-3.25) were the high risk group for hospitalization.

CONCLUSION

The scale and scope of P. vivax occurrence decreased dramatically since initiation of malaria elimination grogram in 2010. However, the risk of P. vivax introduction by the overseas imported cases and domestic migrants should be highlighted.

[Comparison of demographical characteristics of malaria cases from malaria control to elimination in China]

OBJECTIVE

To further identify the high-risk population at malaria elimination phase, and to provide the scientific evident for targeted prevention and control measures, we compared the demographical feature and its change trend for malaria cases between malaria control stage and elimination stage in China.

METHODS

The data of individual case (probable and confirmed) and population during 2007-2014 were collected from China National Notifiable Infectious Disease Reporting Information System, and the data of epidemiological investigation for malaria case (imported and indigenous) during 2011-2014 were collected from China Parasite Disease Prevention and Control Information System. All of the data didn't include China's Hongkong, Macao, Taiwan and foreign cases. We described the demographic features of malaria cases, e.g. sex, age, occupation and mobility, to compare the differences of cases between malaria control stage (2007-2010) and the elimination phase (2011-2014).

RESULTS

From 2007 to 2014, a total of 108 076 malaria cases were reported nationwide, which 13 355 cases were reported at the elimination stage. The proportion of male cases considerably increased from 65.1% (6 1625 cases) at the control stage to 91.4% (12 209 cases) at the elimination phase, with the cases aged 15-64 years among male cases dramatically rose from 74.3% (45 793 cases) to 97.2% (11 870 cases). In terms of occupation, the proportion of children and students decreased from 17.8% (16 891 cases) to 2.7% (356 cases), while the percentage of migrant workers, workers and other professional cases increased from 8.5% (8 031 cases), 3.5% (3 319 cases) and 3.6% (3 435 cases) to 13.1% (1 757 cases), 11.5% (1 534 cases) and 11.4% (1 517 cases), respectively. During the elimination stage,P. faliparium cases have higher proportion of male (96.4%, 7 179 cases) and adult aged 15-64 year (99.4%, 7 399 cases) than that of P. vivax cases , 83.9% (4 344 cases) and 90.3% (4 679 cases), respectively. Moreover, the proportion of imported cases rose from 63.6% (2 599 cases) in 2011 to 97.7% (2 854 cases) in 2014, and the proportion of the migrants in indigenous cases also showed an increasing trend from 13.5% (201 cases) in 2011 to 28.4% (19 cases) in 2014.

CONCLUSION

Compared with the control stage, great changes of demographical characteristics of malaria cases occurred at the elimination stage. Male adults aged 15-64 year-old, imported cases and domestic migrants were the high-risk population for targeted control and prevention at the malaria elimination stage.

[Epidemiologic characteristics of Plasmodium ovale in China in 2011-2014]

OBJECTIVE

To investigate the epidemiological characteristics of Plasmodium ovale in 2011-2014 for malaria control policy making during the phase of malaria elimination in China.

METHODS

The data of individual Plasmodium ovale case (probable and confirmed) and population during 20011-2014 were collated from China National Notifiable Infectious Disease Reporting Information System, and the data of epidemiological investigation for individual Plasmodium ovale case (imported and indigenous) during 2011-2014 were collected from China Parasite Disease Prevention and Control Information System. All of the data didn't include China's Hongkong, Macao, Taiwan and foreign cases. The epidemiological characteristics, diagnosis and reporting were compared and analyzed.

RESULTS

During study period of 2011-2014, a total of 373 Plasmodium ovale imported cases were reported, with male being 98.4% and median age being 40 years old. Jiangsu (100 cases), Guangxi (76 cases), Henan (55 cases), Anhui (28 cases) and Shandong(18 cases) reported Plasmodium ovale imported cases ranked the top 5 place in the list. Totally 182 counties from 21 provinces were reported Plasmodium ovale imported cases. 94.6% of ovale malaria imported cases (353/373) got infected from African countries and comprehensive hospitals, CDCs and hospital of infectious disease reported 40.0%, 37.8%, and 16.6% of Plasmodium ovale imported cases, respectively. 4 days of median time lag of Plasmodium ovale imported cases from date of onset to diagnosis was longer than 3 days.

CONCLUSION

From 2011 to 2014, the rising number of Plasmodium ovale imported cases reported from wilder scope of China. Diagnosis time lag of Plasmodium ovale was longer than that of other Plasmodium. Diagnosis and prompt treatment of Plasmodium ovale imported cases and relapse case should be highlighted.

[Epidemiologic characteristics of noroviruses isolated in outpatients with acute gastroenteritis in Hangzhou area, from 2014 to 2015]

OBJECTIVE

To explore the epidemiologic characteristics of noroviruses isolated in patients with acute gastroenteritis in Hangzhou between March 2014 and April 2015.

METHODS

Stool specimens and clinical data were collected from 1 109 patients with acute gastroenteritis. Specimens were detected for noroviruses with GⅠand GⅡsubtypes by one-step double real-time RT-PCR. Some of the positive specimens were then randomly selected and amplified by multiplex RT-PCR. Those positive PCR products were sequenced and analyzed phylogenetically for testing the partial capsids of noroviruses.

RESULTS

Of the 1 109 stool specimens, positive rate of noroviruses was 26.87% (298/1 109). GⅡgenotype was the major viruses with the proportion as 25.52% (283/1 109), while 1.35% (15/1 109) belonged to GⅠgenotypes. There was no significant difference in the noroviruses detection rate of the different genders (P>0.05). However, in different age groups, GⅡgenotypes were predominant types of noroviruses, and the positive rates of GⅡgenotypes were 16.94% (<5 years-old), 19.45% (5-18 years-old) and 32.26% (≥18 years-old), respectively. In different seasons, noroviruses could be detected all year round, with positive rate as 29.67%-37.08% in the highly epidemic seasons (between December and March of the following year). The distribution trends were seen certain difference between noroviruses-GⅡand GⅠtypes. Additionally, results from the sequence analysis demonstrated that GⅡ-4 genotype was the prevalent strain of GⅡ genotypes, clustered into GⅡ-4/Sydney (46.43%, 13/28) and GⅡ-4/2006b (25.0%, 7/28), while GⅠstrains clustered into GⅠ-1.

CONCLUSION

Noroviruses appeared one of the major pathogens, leading to acute gastroenteritis. G Ⅱgenotypes of noroviruses, especially the G Ⅱ-4/Sydney variant strains and GⅡ-4/2006b variant strains, were considered to be the prevalent strains prevailed in Hangzhou areas from 2014 to 2015.

Assessment of correlation between pre-miRNA-1757 polymorphism and chicken performance traits

Single nucleotide polymorphism in microRNAs (miRNA) may influence their target gene selection and regulation efficiency, leading to animal phenotypic variation. The aim of this study was to evaluate the possible effect of single nucleotide polymorphisms in the miRNA-1757 gene precursor region (pre-mir-1757) on economic-related traits in chicken. Genotyping was performed using Sequenom MassArray® iPLEX GOLD System. Association analysis was performed using SPSS19.0. The data showed that the G/C polymorphism was significantly correlated with semi-evisceration weight, evisceration weight, carcass weight, body weight at 10 weeks of age, shank length at 4 weeks of age, pectoral angle at 8 weeks of age, and body slanting length and pelvis breadth at 12 weeks of age (P < 0.05), and led to the alteration of the RNA secondary structure of pre-mir-1757. Our results provide useful information for further annotation studies of miRNA function.

Single-point position and transition defects in continuous time quantum walks

We present a detailed analysis of continuous time quantum walks (CTQW) with both position and transition defects defined at a single point in the line. Analytical solutions of both traveling waves and bound states are obtained, which provide valuable insight into the dynamics of CTQW. The number of bound states is found to be critically dependent on the defect parameters, and the localized probability peaks can be readily obtained by projecting the state vector of CTQW on to these bound states. The interference between two bound states are also observed in the case of a transition defect. The spreading of CTQW probability over the line can be finely tuned by varying the position and transition defect parameters, offering the possibility of precision quantum control of the system.