[Experimental study of GeneXpert(®) system in the diagnosis of extra-pulmonary tuberculosis]

OBJECTIVE

To explore the application value of GeneXpert MTB/RIF for detection of extra-pulmonary tuberculosis and resistance to rifampin.

METHODS

A total of 150 samples were collected, including 33 needle aspirates from lymphoid tuberculosis, 23 needle aspirates from spinal tuberculosis, 49 from tuberculous pleural effusions, 24 from cerebrospinal fluid of tuberculous cephalomeningitis, and 21 urinary sediment samples from renal tuberculosis. Smear microscopy, mycobacterium tuberculosis culture and the MTB/RIF method were used to examine these samples and their positive rates were compared. Rifampin susceptibility tests was performed for culture-positive strains using proportion method, which was compared with the result from GeneXpert MTB/RIF method.

RESULTS

Of the 150 cases of extra-pulmonary tuberculosis, 17 samples were smear-positive, with a sensitivity of 11.3% (17/150); 30 were culture-positive with a sensitivity of 20.0% (30/150); and 96 were positive by MTB/RIF method with a sensitivity of 64.0% (96/150). There was a significant difference between MTB/RIF method and the culture method (χ(2)=59.61, P<0.01). The differences were also significant when the MTB/RIF method was compared with the smear method (χ(2)=88.60, P<0.01) or compared with culture plus smear methods (χ(2)=4.26, P<0.05). Separately, the differences were statistically significant between GeneXpert MTB/RIF method and other 2 methods for diagnosis of lymphoid tuberculosis (n=33, χ(2)=20.56, P<0.01 vs. culture method; χ(2)=27.13, P<0.01 vs. smear results) while no difference was found between culture and smear method (χ(2)=0.67, P>0.05), spinal tuberculosis (n=23, χ(2)=12.74, P<0.01 vs. culture method; χ(2)=14.81, P< 0.01 vs. smear method), tuberculous pleurisy (n=49, χ(2)=32.34, P<0.01 vs.culture method; χ(2)=49.69, P<0.01 vs. smear method) and renal tuberculosis (n=21, χ(2)=4.20, P<0.05 vs. culture method; χ(2) =8.40, P<0.01 vs. smear results). The sensitivity for tuberculous meningitis had no difference among these 3 methods (n=24, P>0.05). Rifampicin-resistance of the strains from the 30 culture-positive cases of extra-pulmonary tuberculosis (20.0%, 6/30) exhibited agreement with GeneXpert MTB/RIF test.

CONCLUSION

The simplicity and high sensitivity of GeneXpert MTB/RIF technology make it a good diagnostic test for rapid detection of extra-pulmonary tuberculosis and resistance to rifampin.

Mucin expression profile of benign and malignant cervical tissues and correlation with clinical-pathologic parameters

PURPOSE

To detect the expression of mucins in diverse benign and malignant cervical tissues of cervical disease.

MATERIALS AND METHODS

158 cases of cervical tissues were collected. Sections were stained with monoclonal antibodies against MUC1, MUC2, MIUC4, MUC5AC, and MUC20 by immunohistochemistry.

RESULTS

Normal cervical epithelium showed high expr ession of MUC1I, MUC4, and MUC5AC, partial expression of MUC20, and no MUC2. With the development from chronic cervicitis, cervical intraepithelial neoplasia (CI7N) to cervical squamous cell carcinoma (SCC), the expression of MUC1, NMUC4, and MUC20 was statistically significant. The expression of MUCl was related with the depth of invasion and clinical stage of SCC. The positive rates of MUC4 and MUC20 were associated with the degree of differentiation and clinical stage of SCC. There was a correlation between the expression of MUC4, MUC 1, and MUC20 in cervical squamous lesions.

CONCLUSION

Mucins may be involved in the development of cervical cancer.

Precision Measurement of the Boron to Carbon Flux Ratio in Cosmic Rays from 1.9 GV to 2.6 TV with the Alpha Magnetic Spectrometer on the International Space Station

Knowledge of the rigidity dependence of the boron to carbon flux ratio (B/C) is important in understanding the propagation of cosmic rays. The precise measurement of the B/C ratio from 1.9 GV to 2.6 TV, based on 2.3 million boron and 8.3 million carbon nuclei collected by AMS during the first 5 years of operation, is presented. The detailed variation with rigidity of the B/C spectral index is reported for the first time. The B/C ratio does not show any significant structures in contrast to many cosmic ray models that require such structures at high rigidities. Remarkably, above 65 GV, the B/C ratio is well described by a single power law R^{Δ} with index Δ=-0.333±0.014(fit)±0.005(syst), in good agreement with the Kolmogorov theory of turbulence which predicts Δ=-1/3 asymptotically.

[Effects of genetic polymorphisms of GSTT1 and GSTM1 on metabolism of Polycyclic aromatic hydrocarbon in coal tar pitch workers]

Objective: To investigate the influence of genetic polymorphisms of GSTT1 and GSTM1 on metabolism of polycyclic aromatic hydrocarbon (PAHs) in coal tar pitch workers and to explore the effective bio-marker of occupational exposure to coal tar pitch. Methods: 374 cases of workers exposed to coal tar pitch work at the enterprise which use and product coal tar pitch in Shan Dong province named as exposure group.The ad-ministrative and the support staff 135 cases were selected as control group.The concentration of the metabolic product in urine by HPLC/MC.The genetic polymorphisms of GSTT1 and GSTM1 were detected by multiple PCR method. Results: The content of metabolic product in smoke group were significantly higher than workers do not smoke (P<0.05) . The content of metabolic product in exposure group were significantly higher than control group (P<0.05) . The content of metabolic product in workers carry positive GSTT1 and GSTM1 were significantly high-er than workers carry negative one (P<0.05) . The content of metabolic product in different types of labor were significantly different (P<0.05) . The content of metabolic product were significantly higher in urine after work than before work (P<0.05) . The content of metabolic product and workers carry positive GSTT1 and GSTM1 had a positive correlation (P<0.05) . Conclusion: Carrying positive GSTT1 and GSTM1 promote polycyclic aromatic hydrocarbons in the body's metabolism.

[The effect of occupational exposure to coal tar pitch workers' health]

Objective: To investigate the effect of occupational exposure to coal tar pitch on workers' health and metabolism. Methods: 805 workers exposed to coal tar pitch were selected as exposure group from the produce and em-ploy factory. Other people handle administrative and logistical affairs who not exposed to coal tar pitch were selected as control group. Fix-point sample of air were collected to detect the concentration of coal tar pitch. Do physical examination and questionnaire to collect workers' basic and healthy information. To detect the metabolic product of urine samples in laboratory. Results: Anomaly detection rate of the skin in exposure group is 10.61. The lung function indices (FEV_1.0%) in exposure group were significantly lower than control group (P<0.05) . The monocyte count and monocyte rate in expo-sure group were significantly higher than control group (P<0.05) . The metabolic product content of PAHS in urine sam-ples is significantly higher in exposed group than control group (P<0.05) . Conclusion: The metabolic product content of polycyclic aromatic hydrocarbon is higher in exposed workers. Coal tar pitch damage workers' skin and lung function. It can cause pruritus chromatodermatosis and so on.

Genetic diversity and phylogeographic structure of Bactrian camels shown by mitochondrial sequence variations

The Bactrian camel includes various domestic (Camelus bactrianus) and wild (Camelus ferus) breeds that are important for transportation and for their nutritional value. However, there is a lack of extensive information on their genetic diversity and phylogeographic structure. Here, we studied these parameters by examining an 809‐bp mtDNA fragment from 113 individuals, representing 11 domestic breeds, one wild breed and two hybrid individuals. We found 15 different haplotypes, and the phylogenetic analysis suggests that domestic and wild Bactrian camels have two distinct lineages. The analysis of molecular variance placed most of the genetic variance (90.14%, P < 0.01) between wild and domestic camel lineages, suggesting that domestic and wild Bactrian camel do not have the same maternal origin. The analysis of domestic Bactrian camels from different geographical locations found there was no significant genetic divergence in China, Russia and Mongolia. This suggests a strong gene flow due to wide movement of domestic Bactrian camels.

[Magnetic resonance imaging of dystrophinopathy that mimics adductor enthesopathy]

OBJECTIVE

To report thigh muscle magnetic resonance imaging (MRI) tests of four Chinese patients with dystrophinopathy with edema changes in adductor longus muscles that mimics adductor enthesopathy.

METHODS

Four boys, who were from four unrelated families and aged from 5 to 11 years, were investigated because of the clinical manifestations including myalgia or muscle weakness or the incidental findings of elevated serum creatine kinase levels, and were diagnosed with dystrophinopathy by gene test of Duchenne muscular dystrophy (DMD). Their creatine kinase levels were increased from 4 087 IU/L to 32 700 IU/L (Normal range: 75-175 IU/L). The muscle biopsy of three patients all demonstrated a dystrophic pattern including necrosis, regeneration, hypertrophy, atrophy and connective tissue proliferation, with different proportions of dystrophin-negative muscle fibers. The gene test of DMD showed an out-frame deletion of exons in three of the four patients, involving either exons 45 or exons 49-52 deletion or exon 62 duplication, and c.2665 C>T with nonsense mutation in the other one. Muscle MRI tests of the bilateral thighs were performed with T1 weighed sequence and slow tau inversion recovery sequence. The degree of fatty infiltration changes was scored.

RESULTS

MRI of the thigh muscles showed mild to severe fatty infiltration changes in T1 weighed sequence with the total scores from 2 to 13.The most severe fatty infiltration changes were in the long head of biceps femoris and adductor magnus. Obvious hyperintensities appeared mainly in the adductor longus muscles on slow tau inversion recovery (STIR) images in all the patients without any abnormal signals in the attachment of the ligament, indicating edema changes of the adductor longus muscles which mimiced adductor enthesopathy. Two of the four patients presented with edema changes in the bilateral adductor longus muscles, while the other two were with only unilateral changes. Furthermore, other thigh muscles, including adductor magnus, semitendinosus, sartorius and rectus femoris muscles, could also have mild edema changes in two of the four patients.

CONCLUSION

Dystrophinopathy can manifest as edema changes in the adductor longus muscles in thigh muscle MRI tests, which is a typical lesion in adductor enthesopathy. The adductor longus muscles in the dystrophinopathy patients may be easy to be impaired due to traction injury during sports.

[Clinical application of MRI histogram in evaluation of muscle fatty infiltration]

OBJECTIVE

To describe a method based on analysis of the histogram of intensity values produced from the magnetic resonance imaging (MRI) for quantifying the degree of fatty infiltration.

METHODS

The study included 25 patients with dystrophinopathy. All the subjects underwent muscle MRI test at thigh level. The histogram M values of 250 muscles adjusted for subcutaneous fat, representing the degree of fatty infiltration, were compared with the expert visual reading using the modified Mercuri scale.

RESULTS

There was a significant positive correlation between the histogram M values and the scores of visual reading (r=0.854, P<0.001). The distinct pattern of muscle involvement detected in the patients with dystrophinopathy in our study of histogram M values was similar to that of visual reading and results in literature. The histogram M values had stronger correlations with the clinical data than the scores of visual reading as follows: the correlations with age (r=0.730, P<0.001) and (r=0.753, P<0.001); with strength of knee extensor (r=-0.468, P=0.024) and (r=-0.460, P=0.027) respectively. Meanwhile, the histogram M values analysis had better repeatability than visual reading with the interclass correlation coefficient was 0.998 (95% CI: 0.997-0.998, P<0.001) and 0.958 (95% CI: 0.946-0.967, P<0.001) respectively.

CONCLUSION

Histogram M values analysis of MRI with the advantages of repeatability and objectivity can be used to evaluate the degree of muscle fatty infiltration.

Synchronization of Geodesic Acoustic Modes and Magnetic Fluctuations in Toroidal Plasmas

The synchronization of geodesic acoustic modes (GAMs) and magnetic fluctuations is identified in the edge plasmas of the HL-2A tokamak. Mesoscale electric fluctuations (MSEFs) having components of a dominant GAM, and m/n=6/2 potential fluctuations are found at the same frequency as that of the magnetic fluctuations of m/n=6/2 (m and n are poloidal and toroidal mode numbers, respectively). The temporal evolutions of the MSEFs and the magnetic fluctuations clearly show the frequency entrainment and the phase lock between the GAM and the m/n=6/2 magnetic fluctuations. The results indicate that GAMs and magnetic fluctuations can transfer energy through nonlinear synchronization. Such nonlinear synchronization may also contribute to low-frequency zonal flow formation, reduction of turbulence level, and thus confinement regime transitions.

[Clinical value of changes of SUVmax in series 18F-FDG PET/CT imaging before and after chemotherapy for non-small cell lung cancer]

Objective: To evaluate the clinical value of changes of maximum standardized uptake value (SUVmax) in series ¹⁸F-FDG PET/CT imaging before and after chemotherapy for non-small cell lung cancer. Methods: From July 2008 to July 2014, a total of 18 patients with pathological confirmed advanced NSCLC who received systemic chemotherapy were enrolled.¹⁸F-FDG PET/CT scans were performed before, 3-4 weeks after 2-4 cycles chemotherapy, 3-4 weeks after the end of chemotherapy for all patients, and added fourth scan for 3 patients 1 year later.The SUVmax of region of interesting was calculated.The histological diagnosis or clinical findings in a 36 months follow-up period served as the standard of control. Results: New metastases foci were found by ¹⁸F-FDG PET/CT scans before chemotherapy in 7 of 18 patients.The plans of chemotherapy for 5 patients were changed as therapeutic responses were evaluated according to changes of SUVmax.Targeted therapy was added for 2 patients after the end of chemotherapy.There was a statistically significant difference in outcome of survival analysis between patients performed PET/CT scans and non-performed (P<0.05). Conclusion: Changes of SUVmax in series ¹⁸F-FDG PET/CT imaging before and after chemotherapy could be used to evaluate therapeutic response and effectively predict survival in patients with advanced NSCLC.

Antiproton Flux, Antiproton-to-Proton Flux Ratio, and Properties of Elementary Particle Fluxes in Primary Cosmic Rays Measured with the Alpha Magnetic Spectrometer on the International Space Station

A precision measurement by AMS of the antiproton flux and the antiproton-to-proton flux ratio in primary cosmic rays in the absolute rigidity range from 1 to 450 GV is presented based on 3.49×10^{5} antiproton events and 2.42×10^{9} proton events. The fluxes and flux ratios of charged elementary particles in cosmic rays are also presented. In the absolute rigidity range ∼60 to ∼500  GV, the antiproton p[over ¯], proton p, and positron e^{+} fluxes are found to have nearly identical rigidity dependence and the electron e^{-} flux exhibits a different rigidity dependence. Below 60 GV, the (p[over ¯]/p), (p[over ¯]/e^{+}), and (p/e^{+}) flux ratios each reaches a maximum. From ∼60 to ∼500  GV, the (p[over ¯]/p), (p[over ¯]/e^{+}), and (p/e^{+}) flux ratios show no rigidity dependence. These are new observations of the properties of elementary particles in the cosmos.

[Effect of application of pulse contour cardiac output monitoring technology on delayed resuscitation of patients with extensive burn in a mass casualty]

OBJECTIVE

To investigate the effect of the application of pulse contour cardiac output (PiCCO) monitoring technology on delayed resuscitation of patients with extensive burn in a mass casualty.

METHODS

The clinical data of 41 patients injured in Kunshan dash explosion hospitalized in the First Affiliated Hospital of Soochow University, the 100th Hospital of the People's Liberation Army, and Suzhou Municipal Hospital were retrospectively analyzed. The patients were divided into traditional monitoring group (T, n=22) and PiCCO monitoring group (P, n=19) according to the monitoring technic during delayed resuscitation. The input volumes of electrolyte, colloids, and water of patients in the two groups within 2 hours after admission, the first, second, and third 8 hours post injury (HPI), and the first 24 HPI were recorded. The fluid infusion coefficients of patients in the two groups within 2 hours after admission, the first, second, and third 8 HPI, and the first, second, third, and fourth 24 HPI were calculated. The urine volume, mean arterial pressure (MAP), and central venous pressure (CVP) of patients in the two groups at post injury hour (PIH) 8, 16, 24, 48, 72, and 96 were recorded. The blood lactate, base excess, hematocrit (HCT), and platelet count of patients in the two groups at PIH 24, 48, 72, and 96 were recorded. Complications and death of patients in the two groups were recorded. Data were processed with analysis of variance for repeated measurement, Chi-square test, t test, and Wilcoxon test. The deviations between figure 2 and the fluid infusion coefficients of the first or second 24 HPI, and the deviations between figure 1 and the fluid infusion coefficients of the second, third or fourth 24 HPI were calculated, and the three groups deviations were analyzed by Pearson correlation analysis.

RESULTS

(1) The input volumes of electrolyte of patients in group P were significantly more than those in group T within the first 8 and 24 HPI (with Z values respectively -3.506 and -2.654, P<0.05 or P<0.01), and the input volumes of electrolyte of patients in the two groups were similar within the other time periods (with Z values from -1.871 to -0.680, P values above 0.05). The input volumes of colloid of patients in group P were significantly less than those in group T within the second, third 8 HPI, and the first 24 HPI (with Z values from -4.720 to -2.643, P<0.05 or P<0.01), and the input volumes of colloid of patients in the two groups were similar within the other time periods (with Z values respectively -2.376 and -2.303, P values above 0.05). The input volumes of water of patients in the two groups were similar within each time period (with Z values from -1.959 to -0.241, P values above 0.05). (2) The fluid infusion coefficients of patients in group T within 2 hours after admission, the first, second, and third 8 HPI, and the first, second, third, and fourth 24 HPI were respectively (0.59±0.18), (0.70±0.23), (0.94±0.24), (0.74±0.14), (2.38±0.44), (1.70±0.56), (1.35±0.67), and (0.92±0.46) mL·kg(-1)·%TBSA(-1,) and the values in group P were respectively (0.59±0.29), (0.82±0.37), (0.86±0.38), (0.59±0.24), (2.27±0.85), (2.13±0.68), (1.59±3.78), and (1.46±0.56) mL·kg(-1)·%TBSA(-1). The fluid infusion coefficients of patients in the two groups were similar within 2 hours after admission, the first, second 8 HPI, and the first, third 24 HPI (with t values from -1.262 to 0.871, P values above 0.05). The fluid infusion coefficient of patients in group P was significantly lower than that in group T within the third 8 HPI (t=2.456, P<0.05), and the fluid infusion coefficient of patients in group P were significantly higher than that in group T within the second and fourth 24 HPI (with t values respectively -2.234 and -3.370, P<0.05 or P<0.01). There was obviously negative correlation between the deviations of figure 2 and the fluid infusion coefficient of the first 24 HPI and that of the second 24 HPI (r=-0.438, P<0.01). There was no obvious correlation between the deviations of figure 1 and the fluid infusion coefficient of the second 24 HPI and that of the third 24 HPI (r=0.091, P>0.05). There was obviously positive correlation between the deviations of figure 1 and the fluid infusion coefficient of the second 24 HPI and that of the fourth 24 HPI (r=0.695, P<0.01). (3) The urine volumes and MAP of patients in the two groups were similar at each time point (with Z values from -1.884 to 0, P values above 0.05). The CVP of patients in group P were significantly higher than that in group T at PIH 16, 24, 48, and 72 (with Z values from -4.341 to -2.213, P<0.05 or P<0.01), and the CVP of patients in the two groups were similar at the other time points (with Z values respectively -0.132 and -1.208, P values above 0.05). The blood lactate of patients in group P was significantly higher than that in group T at PIH 72 (Z= -2.958, P<0.01) , and the blood lactate of patients in the two groups were similar at the other time points (with Z values from -1.742 to -0.433, P values above 0.05). The base excess of patients in group P were significantly lower than that in group T at PIH 24, 48, 72, and 96 (with Z values from -4.970 to -4.734, P values below 0.01). The HCT of patients in the two groups were similar at PIH 24, 48, 72, and 96 (with Z values from -2.239 to -0.196, P values above 0.05). There were significant differences in the platelet count of patients in the two groups at PIH 24, 72, and 96 (with Z values from -4.578 to -2.512, P<0.05 or P<0.01). (4) There were 15 cases in group T accompanied by complications, and 7 cases died, while 13 cases in group P accompanied by complications, and 9 cases died. The occurrence of complications and death of patients in the two groups were similar (with χ(2) values respectively <0.001 and 1.306, P values above 0.05).

CONCLUSIONS

On the basis of traditional burn shock monitoring index, the effect of fluid resuscitation in patients with severe burn monitored by PiCCO technology is not so good and still needs further clinical research.

[Arthroscopic management of lesser arc perilunate injuries]

OBJECTIVE

To evaluate the outcomes of lesser arc perilunate injuries (Perilunate dislocations) treated with arthroscopically assisted mini-invasive reduction and fixation.

METHODS

Between 2012 and 2014, 5 patients who had a perilunate dislocation were treated with arthroscopically assisted reduction and percutaneous fixation. The mean follow-up was 17.8 months (range, 10 to 32 months). Clinical outcomes were evaluated on the basis of range of motion; grip strength; Mayo wrist score; Quick disabilities of the arm, shoulder and hand questionnaire; and patient-rated wrist evaluation score. Radiographic evaluations included carpal alignments and any development of arthritis.

RESULTS

The range of flexion-extension motion of injured wrist averaged 84% of the values for contralateral wrist. The grip strength of the injured wrist averaged 90% of the values for the contralateral wrists. The mean Quick Disabilities of the arm, shoulder and hand score was 1, and the mean Patient-Rated Wrist Evaluation score was 5. According to the Mayo wrist scores, the overall functional outcomes were rated as excellent in all the patients. Reduction obtained during the operation was maintained within normal ranges in all the patients. Arthritis had not developed in any patient at the end of the follow-up.

CONCLUSION

Arthroscopic mini-invasive reduction with percutaneous fixation is a reliable and favorable alternative in the treatment of perilunate dislocations according to our early results.

Association between ERCC1 and ERCC2 gene polymorphisms and susceptibility to pancreatic cancer

We conducted a study to investigate the association between ERCC1 (rs3212986) and ERCC2 (rs13181) gene polymorphisms and the risk of pancreatic cancer in a Chinese population. A total of 217 pancreatic cancer patients and 244 control subjects were recruited from the Nuclear Industry 215 Hospital of Shaanxi Province between February 2013 and December 2014. Genomic DNA was extracted from peripheral blood samples using a TIANamp Blood DNA Kit (Tiangen, Beijing, China) according to the manufacturer's instructions. The ERCC1 rs3212986 and ERCC2 rs13181 polymorphisms were genotyped by polymerase chain reaction-restriction fragment length of polymorphism. Unconditional logistic regression analyses showed that subjects with the CC genotype of ERCC1 rs3212986 were susceptible to the development of pancreatic cancer when compared with subjects with the AA genotype (OR = 2.57, 95%CI = 1.34-5.02). The ERCC1 rs3212986 gene polymorphism was associated with increased risk of pancreatic cancer in the dominant (OR = 1.54, 95%CI = 1.05-2.28) and recessive (OR = 2.22, 95%CI = 1.20-4.19) models. However, no significant difference was found between the ERCC2 rs13181 polymorphism and the risk of pancreatic cancer in the codominant, dominant, and recessive models. We suggest that the ERCC1 rs3212986 polymorphism increases susceptibility to pancreatic cancer in the codominant, dominant, and recessive models, although further studies are needed to confirm our findings.

Precision Measurement of the Helium Flux in Primary Cosmic Rays of Rigidities 1.9 GV to 3 TV with the Alpha Magnetic Spectrometer on the International Space Station

Knowledge of the precise rigidity dependence of the helium flux is important in understanding the origin, acceleration, and propagation of cosmic rays. A precise measurement of the helium flux in primary cosmic rays with rigidity (momentum/charge) from 1.9 GV to 3 TV based on 50 million events is presented and compared to the proton flux. The detailed variation with rigidity of the helium flux spectral index is presented for the first time. The spectral index progressively hardens at rigidities larger than 100 GV. The rigidity dependence of the helium flux spectral index is similar to that of the proton spectral index though the magnitudes are different. Remarkably, the spectral index of the proton to helium flux ratio increases with rigidity up to 45 GV and then becomes constant; the flux ratio above 45 GV is well described by a single power law.

Effects of exogenous protease supplementation on endogenous trypsin activity and gene expression in broilers

Two hundred and forty one-day-old male broiler chickens (Ross-308) were fed corn-soybean basal diets with 0, 40, 80, or 160 mg/kg of an acid protease preparation from 1 to 42 days of age, in order to investigate the effects of an exogenous enzyme on growth performance, pancreatic trypsin activity and mRNA expression. Average daily gain (ADG) was greatest in the 160-mg/kg treatment group at 1-21 days, which was significantly higher than that in the control. After 42 days, average daily feed intake (ADFI) and ADG had significantly increased in the 80- and 160-mg/kg treatments (P < 0.05), with the 80-mg/kg treatment group having the highest ADFI and ADG values. The feed conversion ratio was not affected. Dietary acid protease at 80 and 160 mg/kg significantly decreased trypsin activity in the pancreas (relative to the control group) by 35.71 and 47.29%, respectively (P < 0.05). After 42 days, trypsin mRNA expression in the pancreas had significantly decreased by 19.5% in the 80-mg/kg treatment group relative to the control (P < 0.05). After 21 and 42 days, the diet supplemented with 160 mg/kg acid protease significantly decreased pancreatic trypsin mRNA by 19.6 and 37.7%, respectively, compared to the control. There were the 40-mg/kg treatment group and the control. Our results suggest that the amount of acid protease in the diet significantly affects trypsin activity and mRNA expression in broilers.

The performance of magnetic resonance imaging in the detection of triangular fibrocartilage complex injury: a meta-analysis

The aim of this study was to evaluate the accuracy of magnetic resonance imaging in the detection of triangular fibrocartilage complex injury through a meta-analysis. A comprehensive literature search was conducted before 1 April 2014. All studies comparing magnetic resonance imaging results with arthroscopy or open surgery findings were reviewed, and 25 studies that satisfied the eligibility criteria were included. Data were pooled to yield pooled sensitivity and specificity, which were respectively 0.83 and 0.82. In detection of central and peripheral tears, magnetic resonance imaging had respectively a pooled sensitivity of 0.90 and 0.88 and a pooled specificity of 0.97 and 0.97. Six high-quality studies using Ringler's recommended magnetic resonance imaging parameters were selected for analysis to determine whether optimal imaging protocols yielded better results. The pooled sensitivity and specificity of these six studies were 0.92 and 0.82, respectively. The overall accuracy of magnetic resonance imaging was acceptable. For peripheral tears, the pooled data showed a relatively high accuracy. Magnetic resonance imaging with appropriate parameters are an ideal method for diagnosing different types of triangular fibrocartilage complex tears.

Precision Measurement of the Proton Flux in Primary Cosmic Rays from Rigidity 1 GV to 1.8 TV with the Alpha Magnetic Spectrometer on the International Space Station

A precise measurement of the proton flux in primary cosmic rays with rigidity (momentum/charge) from 1 GV to 1.8 TV is presented based on 300 million events. Knowledge of the rigidity dependence of the proton flux is important in understanding the origin, acceleration, and propagation of cosmic rays. We present the detailed variation with rigidity of the flux spectral index for the first time. The spectral index progressively hardens at high rigidities.

Differential gene expression of epigenetic modifying enzymes between Tibet pig and Yorkshire in high and low altitudes

Epigenetic modifying enzymes play important roles in the adaptation to hypoxia, although no studies have examined their expression levels in Tibet pigs. The lung is an important functional organ in hypoxia adaptation. In this study, we examined the mRNA expression level of 5 enzymes in the lung of Tibet pigs using real-time polymerase chain reaction to determine the epigenetic performance of hypoxia adaptation. We selected four groups of pig as the study object, which were Tibet pig in highland (TH), Yorkshire in highland (YH), Tibet pig in lowland (TL), Yorkshire in lowland (YL). Expression of Dnmt1 in Tibet pig was higher than that in Yorkshire (P < 0.01), although there was no significant difference between different altitudes within each breed. Expression of Dnmt3a was higher in Tibet pig than that in Yorkshire (P < 0.01), and higher in pigs from highland than that in lowland areas (P < 0.05). Expression of Hdac1 was higher in group TH than in Yorkshire (P < 0.01). Expression of Kdm3a was higher in group TH than in the rest of the groups (P < 0.01). Expression of Uhrf1 was higher in Tibet pig than in Yorkshire (P < 0.01). In conclusion, the expression levels of the 5 epigenetic modifying genes were higher in group TH than in group YH. Under conditions of oxygen deficiency, breed was the most important factor affecting DNA methylation and gene expression.

Serious anaphylactic shock induced by hemocoagulase agkistrodon during anesthesia in a 5-year-old child

We report a case of serious anaphylactic shock in a 5-year-old child undergoing scheduled surgery blank space of a right femoral intramedullary nail removal. The boy had undergone right femoral elastic intramedullary nail fixation surgery 14 months prior, but had no history of allergies. Within 5 minutes of intravenous bonus injection of hemocoagulase agkistrodon (HCA) 1 unit, a widespread transient diffuse erythema was seen on the front of his chest. After 20 minutes, sudden, profound cardiovascular collapse occurred. The child was treated effectively and sent to a ward 5 hours later. In this period, he received intravenously infused 200 ml hydroxyethyl starch solution and epinephrine at a rate of 0.05-0.01 μg kg(-1) min(-1). Total amount of dexamethasone sodium phosphate 14 mg was used. To the best of our knowledge, few case reports of HCA-induced anaphylactic shock in children exist. Our report will, therefore, increase awareness of the allergic potential of HCA among pediatric anesthesiologists.

A Bayesian network meta-analysis comparing concurrent chemoradiotherapy followed by adjuvant chemotherapy, concurrent chemoradiotherapy alone and radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma

BACKGROUND

Given the lack of studies, whether the addition of adjuvant chemotherapy (AC) to concurrent chemoradiotherapy (CCRT) is superior to CCRT alone for locoregionally advanced nasopharyngeal carcinoma (NPC) remains unclear. The main objective of this Bayesian network meta-analysis was to determine the efficacy of CCRT + AC when compared with CCRT alone.

PATIENTS AND METHODS

We systematically searched databases and extracted data from randomized, controlled trials involving NPC patients randomly assigned to receive CCRT + AC, CCRT, or radiotherapy (RT). Overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) with hazard ratios (HRs) were investigated. A Bayesian network for different outcomes was established to incorporate all evidence. Multiple treatment comparisons based on the network integrated the efficacy of CCRT + AC, CCRT, and RT.

RESULTS

Eight studies involving 2144 patients were analyzed. In the network meta-analysis, CCRT + AC and CCRT were both significantly better than RT alone for all outcomes, except that no significant difference was found between CCRT and RT for LRFS. Though ranking probabilities showed that CCRT + AC was ranked superior to CCRT for OS, LRFS, and DMFS, no significant differences were found between CCRT+AC and CCRT for all outcomes [OS: HR = 0.86, 95% credible interval (CrI) 0.60-1.16; LRFS: HR = 0.72, 95% CrI 0.43-1.15; DMFS: HR = 0.86, 95% CrI 0.62-1.16].

CONCLUSIONS

No significant improvement was found following CCRT + AC compared with CCRT alone. Whether the omission of additional AC can reduce toxic effects without adversely affecting survival in patients with locoregionally advanced NPC should be further explored, in addition to the precise patient status that would benefit from AC following CCRT.

Precision Measurement of the (e^{+}+e^{-}) Flux in Primary Cosmic Rays from 0.5 GeV to 1 TeV with the Alpha Magnetic Spectrometer on the International Space Station

We present a measurement of the cosmic ray (e^{+}+e^{-}) flux in the range 0.5 GeV to 1 TeV based on the analysis of 10.6 million (e^{+}+e^{-}) events collected by AMS. The statistics and the resolution of AMS provide a precision measurement of the flux. The flux is smooth and reveals new and distinct information. Above 30.2 GeV, the flux can be described by a single power law with a spectral index γ=-3.170±0.008(stat+syst)±0.008(energy scale).

Design of vibration compensation interferometer for Experimental Advanced Superconducting Tokamak

A vibration compensation interferometer (wavelength at 0.532 μm) has been designed and tested for Experimental Advanced Superconducting Tokamak (EAST). It is designed as a sub-system for EAST far-infrared (wavelength at 432.5 μm) poloarimeter/interferometer system. Two Acoustic Optical Modulators have been applied to produce the 1 MHz intermediate frequency. The path length drift of the system is lower than 2 wavelengths within 10 min test, showing the system stability. The system sensitivity has been tested by applying a periodic vibration source on one mirror in the system. The vibration is measured and the result matches the source period. The system is expected to be installed on EAST by the end of 2014.

Optical layout and mechanical structure of polarimeter-interferometer system for Experimental Advanced Superconducting Tokamak

A Far-InfaRed (FIR) three-wave POlarimeter-INTerferometer (POINT) system for measurement current density profile and electron density profile is under development for the EAST tokamak. The FIR beams are transmitted from the laser room to the optical tower adjacent to EAST via ∼20 m overmoded dielectric waveguide and then divided into 5 horizontal chords. The optical arrangement was designed using ZEMAX, which provides information on the beam spot size and energy distribution throughout the optical system. ZEMAX calculations used to optimize the optical layout design are combined with the mechanical design from CATIA, providing a 3D visualization of the entire POINT system.

Faraday-effect polarimeter-interferometer system for current density measurement on EAST

A multichannel far-infrared laser-based POlarimeter-INTerferometer (POINT) system utilizing the three-wave technique is under development for current density and electron density profile measurements in the EAST tokamak. Novel molybdenum retro-reflectors are mounted in the inside wall for the double-pass optical arrangement. A Digital Phase Detector with 250 kHz bandwidth, which will provide real-time Faraday rotation angle and density phase shift output, have been developed for use on the POINT system. Initial calibration indicates the electron line-integrated density resolution is less than 5 × 10(16) m(-2) (∼2°), and the Faraday rotation angle rms phase noise is <0.1°.