Primary assessment of a T. spiralis putative serine protease for early serological detection of experimental trichinellosis

A putative serine protease of T. spiralis (TsSP) was expressed in Escherichia coli and its potential as a diagnostic antigen was primarily assessed in this study. Anti-Trichinella IgG in serum samples from T. spiralis different animal hosts (mice, rats, pigs and rabbits) were detected on Western blot analysis with rTsSP. Anti-Trichinella antibodies were detected in 100% (30/30) of experimentally infected mice by rTsSP-ELISA. Cross-reactions of rTsSPELISA were not found with sera from mice infected with other parasites (S. erinaceieuropaei, S. japonicum, C. sinensis, A. cantonensis and T. gondii) and sera from normal mice. There was no statistical difference in antibody detection rate among mice infected with the encapsulated Trichinella species (T. spiralis, T. nativa, T. britovi, and T. nelsoni) (P>0.05). The results of rTsSP-ELISA showed that serum specific antibody IgG in mice infected with 100 or 500 T. spiralis muscle larvae (ML) were detectable early at 7-8 dpi, but not detected by ML ES antigen-ELISA prior to 10-12 dpi. Specific anti-Trichinella IgG was detected in 100% (18/18) of infected pigs by rTsSP-ELISA and ES-ELISA, but no specific antibodies was not detected in 20 conventionally raised normal pigs by two antigens. The results showed the rTsSP had the potential for early serodiagnosis of animal Trichinella infection, however it requires to be assayed with early infection sera of swine infected with Trichinella and other parasites.

Seasonal variations of NPAHs and OPAHs in PM2.5 at heavily polluted urban and suburban sites in North China: Concentrations, molecular compositions, cancer risk assessments and sources

16 nitrated polycyclic aromatic hydrocarbons (NPAHs) and 5 oxygenated polycyclic aromatic hydrocarbons (OPAHs) in PM_2.5 at two locations in Northern China were analyzed by Gas Chromatography-Mass Spectrometry (GC-MS). Sampling was conducted at an urban site in Shandong University in Jinan (SDU) and a suburban site in Qixingtai in Jinan (QXT) in March, June, September and December in 2016. Overall, the concentrations of NPAHs and OPAHs were higher at SDU (1.88 and 9.49 ng/m³, respectively) than QXT (1.57 and 6.90 ng/m³, respectively), and the NPAHs and OPAHs concentrations were significantly higher during the winter than the other seasons at both sites. The incremental lifetime cancer risk (ILCR) values were lower than 10^-6 for all sites, seasons and age groups (ranging between 1.85E-08 and 2.56E-07), so there was no risk of carcinogenesis due to exposure to these pollutants. Total cancer risk at SDU was higher than QXT and NPAHs have the highest carcinogenic risk for adults aged from 30 to 70 years. The positive matrix factorization (PMF) results revealed that coal/biomass combustion, diesel vehicle emissions, gasoline vehicle emissions and secondary formation were the main sources of NPAHs and OPAHs at SDU and QXT. Coal/biomass combustion contributed more in spring, autumn and winter; diesel vehicle emission contributed the most in summer; secondary formation made greatest contributions in winter; the contributions of gasoline vehicle emission were similar in summer, autumn and winter. Diagnostic ratios clearly demonstrated that secondary formation is more active in winter than in other seasons, and the reactions of PAHs and OH radical were the dominant secondary formation pathway at both SDU and QXT. In addition, the potential source contribution function (PSCF) identified that the Beijing-Tianjin-Hebei region, Shandong province, Bohai Sea, Yellow Sea, Anhui province and Henan province were the main source regions of NPAHs and OPAHs in Jinan.

HtrA1 upregulates the expression of ADAMTS-5 in HNPCs via the ERK/NF-κB/JNK signaling pathway

Intervertebral disc degeneration (IDD) is a form of chronic inflammation and is one of the most common disorders reported to be involved in low back pain (LBP). The pathophysiology of degeneration is not completely understood, but the consensus is that the degradation of extracellular matrix (ECM) proteins in the disc is the leading factor contributing to IDD. High temperature requirement A1 (HtrA1) is serine protease that has been shown to be increased in degenerated intervertebral discs as a result of an increase in the expression of matrix metalloproteinases (MMPs), but no study has focused on the effect of HtrA1 on a disintegrin-like and metalloproteinase with thrombospondin motifs (ADAMTSs). In the present study, we successfully isolated human nucleus pulposus cells (HNPCs) from IDD patients who were our research subjects to elaborate on the potential role of HtrA1 in the pathogenesis of IDD. We confirmed that HtrA1 has the potential to induce the expression of ADAMTS-5 in a dose-dependent manner. Consistently, this was mediated by the ERK, NF-κB and JNK pathways. By using inhibitors of these pathways, the increase in ADAMTS-5 could be reduced. Our findings indicated that HtrA1 can induce the expression of ADAMTS-5 in HNPCs via the ERK/NF-κB/JNK signaling pathway, and our study also elucidated the involved induction mechanisms in HNPCs, which may provide new insights for the treatment of IDD.

[Effect of ABO blood groups on long-term outcome of stable coronary artery disease after percutaneous coronary intervention]

Objective: To evaluate the effect of ABO blood groups on long-term outcome of stable coronary artery disease (CAD) after percutaneous coronary intervention (PCI). Methods: A total of 4 272 patients with stable coronary artery disease and received PCI were consecutively enrolled from January to December 2013 and followed up for 2 years. Patients were divided into O group and non-O group according to their ABO groups. Multivariable COX regression was used to evaluated the relationship between ABO blood groups and prognosis of CAD. The endpoints included all-cause death, cardiac death, myocardial infarction(MI), revascularization, and stroke. Results: There were 1 302 patients in O group and 2 970 patients in non-O group. ABO blood group was not associated with age, sex and blood pressure (P>0.05). The comorbidity rate of hypertension, diabetes mellitus, smoking, family history, previous MI, previous cerebrovascular disease, previous PCI and left ventricular ejection fraction were similar between the two groups (P>0.05). Total cholesterol, low density lipid cholesterol level were significantly higher in non-O group compared with O group [(4.2±1.1)mmol/L vs (4.1±1.1)mmol/L, P=0.027; (2.5±0.9)mmol/L vs (2.4±0.9) mmol/L, P=0.025], while high density lipid cholesterol level was significantly lower[(1.04±0.26) mmol/L vs (1.06±0.28) mmol/L, P=0.035]. As to angiographic results, non-O blood group was not related to the severity of coronary atherosclerosis assessed by SYNTAX score(P=0.277). More cardiac death occurred in non-O group compared with that in O group [21 (0.7%) vs 2(0.1%)] during 2-year follow-up. After adjusted for confounding factors, multivariable COX regression revealed that non-O blood type was not associated with increased cardiac death [HR (95%CI)=7.30(0.97-55.09), P=0.054]. Conclusion: Non-O blood group is associated with 2-year cardiac death in patients with stable coronary artery disease who received PCI, but it is not an independent risk factor for cardiac death.

Overexpression of ERBB3 promotes proliferation, migration, and angiogenesis in nasopharyngeal carcinoma

The purpose of this study is to investigate the role of ERBB3 in nasopharyngeal carcinoma (NPC). We investigated the expression level of ERBB3 in NPC by immunohistochemistry and western blot. CCK-8, cell cycle analysis, transwell assay and wound healing assay were used to detect the effect of ERBB3 on the proliferation and migration of NPC cells. HUVECs were used to study the effects of ERBB3 on angiogenesis in NPC. Our results showed that the expression level of ERBB3 in NPC was much higher than that in normal controls. ERBB3 promoted the proliferation and migration of NPC cells, while suppression of ERBB3 reduced angiogenesis. These results indicated that overexpression of ERBB3 promotes tumorigenesis and angiogenesis in NPC, which may provide an effective target in gene therapy for NPC.

Identification of tRNA-Derived Fragments Expression Profile in Breast Cancer Tissues

Background:

In recent years, tRFs(transfer RNA-Derived Fragments) and transfer RNADerived Stress-induced RNAs (or tRNA halves) have been shown to have vital roles in cancer biology.We aimed to reveal the expression profile of tRNA-derived fragments in breast cancer tissues in the study, and to explore their potential as biomarkers of breast cancer.

Methods:

We characterized the tRNA-derived fragments expression profile from 6 paired clinical breast cancer tissues and adjacent normal samples. Then we selected 6 significantly expressed tRNAderived fragments and screened the genes for validation by using Quantitative Real-time PCR. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes biological pathway were finally analyzed.

Results:

We found 30 differentially expressed tRNA-derived fragments across our dataset, out of which 17 were up-regulated, and 13 were down-regulated. Compared with 16 clinical breast cancer tissues and adjacent normal tissues by qPCR, the results demonstrated that tRF-32-Q99P9P9NH57SJ(FC = -2.6476, p = 0.0189), tRF-17-79MP9PP (FC = -4.8984, p = 0.0276) and tRF-32-XSXMSL73VL4YK (FC = 6.5781, p = 0.0226) were significantly expressed in breast cancer tissues(p < 0.001). tRF-32-XSXMSL73VL4YK was significantly up-regulated, and tRF-32-Q99P9P9NH57SJ and tRF-17-79MP9PP were significantly down-regulated in which the expressionpatterns were similar to the sequencing results. The top ten significant results of GO and KEGG pathways enrichment analysis were presented.

Conclusion:

Our studies have demonstrated that there were significantly expressed tRNA-derived fragments in breast cancer tissues. They are hopefully to become biomarkers and would be valuable researches in this area.

Strong and selective isotope effect in the vacuum ultraviolet photodissociation branching ratios of carbon monoxide

Rare isotope (¹³C, ¹⁷O and ¹⁸O) substitutions can substantially change absorption line positions, oscillator strengths and photodissociation rates of carbon monoxide (CO) in the vacuum ultraviolet (VUV) region, which has been well accounted for in recent photochemical models for understanding the large isotopic fractionation effects that are apparent in carbon and oxygen in the solar system and molecular clouds. Here, we demonstrate a strong isotope effect associated with the VUV photodissociation of CO by measuring the branching ratios of ¹²C¹⁶O and ¹³C¹⁶O in the Rydberg 4p(2), 5p(0) and 5s(0) complex region. The measurements show that the quantum yields of electronically excited C atoms in the photodissociation of ¹³C¹⁶O are dramatically different from those of ¹²C¹⁶O, revealing strong isotope effect. This isotope effect strongly depends on specific quantum states of CO being excited, which implies that such effect must be considered in the photochemical models on a state by state basis.

Rotational dependence of the branching ratios and fragment angular distributions for the photodissociation of 12C16O in the Rydberg 4p(2) and 5p(0) complex region (92.84-93.37 nm)

¹²C¹⁶O shows complicated absorption structures in the wavelength range of 92.84-93.37 nm caused by the mutual interactions among the Rydberg 4p(2) and 5p(0) complexes, and several diffuse valence states. Here, we systematically measured the branching ratios and fragment angular distributions for the photodissociation of ¹²C¹⁶O in the wavelength range using our mini-time-slice velocity-map imaging (mini-TSVMI) setup and a tunable vacuum ultraviolet (VUV) laser radiation source generated by the two-photon resonance-enhanced four-wave mixing scheme. Various patterns of rotational dependence for the photodissociation branching ratios have been observed for different vibronic states, and they are found to be consistent with previous spectroscopic investigations, revealing the complicated coupling schemes and predissociation dynamics in this region. Irregular angular distributions of the photofragments have been observed, especially in the Rydberg 5p(0) complex region. This has been attributed to the simultaneous excitation of multiple states with different symmetries in this region. The newly observed underlying continuum in the Rydberg 5p(0) complex region has been directly detected in the present study, and it is found to be of ¹Σ⁺ symmetry and dissociates predominantly into the C(³P) + O(³P) channel. This study generally confirms the results of previous spectroscopic studies from a different perspective, and adds new knowledge for understanding the complicated predissociation dynamics of ¹²C¹⁶O in the titled wavelength range.

PM2.5-bound polycyclic aromatic hydrocarbons (PAHs) and nitrated PAHs (NPAHs) in rural and suburban areas in Shandong and Henan Provinces during the 2016 Chinese New Year's holiday

Eighteen polycyclic aromatic hydrocarbons (PAHs) and fourteen nitrated PAHs (NPAHs) in PM_2.5 samples were collected during the 2016 Chinese New Year's holiday (CNY) at one suburban and three rural sites in Shandong and Henan Provinces. The PAH and NPAH concentrations were highest at the suburban site. The rural PAH concentrations in Qingzhou (QZ), Heze (HZ), and Liaocheng (LC) were higher than those measured at many other urban sites, indicating that PAHs pollution was notably higher in the suburban and rural sites during this festive period. Elevated PAH concentrations were observed during fireworks periods, but fireworks burning was not a significant or direct PAHs or NPAHs source based on molecular profiles and diagnostic ratios. The measured PAHs and NPAHs at the sampling sites mainly originated from coal and biomass burning. The increased concentrations during CNY's Eve may be related to behavioural changes during the period. Secondary formation of NPAHs mainly occurred via OH radical chemistry at all four sites. Fireworks burning did not increase secondary formation of NPAHs. ∑BaP_eq concentrations exhibited strong correlations with PAHs concentrations, and the highest and lowest concentrations were observed in QZ and Xiping (XP), respectively. The incremental lifetime cancer risk (ILCR) was calculated to be between 10^-6 and 10^-4 for 1-70 years old persons, with the highest risks observed in the adult (30-70 years) and the toddler (1-6 years) groups.

Effects of Periploca forrestii Schltr on wound healing by Src meditated Mek/Erk and PI3K/Akt signals

ETHNOPHARMACOLOGICAL RELEVANCE

Periploca forrestii Schltr. (PF) is a traditional folk medicine in China that has been used widely for treating rheumatoid arthritis and traumatic injuries for a long history. Previously, we have roughly demonstrated that the ethanol extract of PF possessed in vitro wound healing potential, and more in depth research deserves to be conducted.

AIM OF THE STUDY

The present study is aiming to fully evaluate the wound healing activity of PF in vitro and in vivo, clarify the mechanism of actions and the primary constituents responsible for wound healing.

MATERIALS AND METHODS

The total extract of Periploca forrestii Schltr. (EPF) and its fraction (65% ethanol fraction, EPFE65) were obtained and evaluated on in vitro wound healing properties using mouse dermal fibroblasts (L929). Cell proliferation was tested by MTT and EdU assay, confirmed by cell cycle analysis, cell migration was evaluated by scratch and transwell assay and collagen production was also determined. Then EPFE65 was tested on in vivo wound healing activity using the excision rat models. The wounded skin of rats was topically applied with 0.1% EPFE65 once daily for 6 days with hydrogel as the carrier and the recombinant bovine basic fibroblast growth factor hydrogel (rbFGF) as positive control. Histopathology of the wounded skin on day 6 and day 12 was studied via hematoxylin and eosin (HE) staining. The expression of phosphorylation of Src, Akt and Erk1/2 was determined after the treatment with EPFE65 by western blot. In order to figure out whether the activation of Src, Akt and Erk1/2 was directly in conjunction with wound healing process promoted by EPFE65, cell proliferation and migration were tested in the presence of three inhibitors of Src, Akt and Erk1/2. Finally, the chemical composition of the effective fraction EPFE65 was analyzed by HPLC-Q-TOF-MS/MS.

RESULTS

In vitro experiments suggested that EPFE65 was comparable to EPF that had potent effect on promoting L929 fibroblasts proliferation, migration and increasing collagen production. 0.1% EPFE65 hydrogel also exhibited significant effect on promoting wound healing in rats. The wound closure was significantly faster in EPFE65 and positive rbFGF group than that in negative control group since the third day post wounding (p < 0.05). Specifically, on day10-12, the wounds in EPFE65 and rbFGF group were almost healed as the wound areas diminished into 13.3-5.3% and 7.7-4.0%, while the wound in control group was still apparent with 36.8-22.1% wound area. HE staining demonstrated that EPFE65 and rbFGF group could advance re-epithelialization in the early days and promote the transition of granulation tissue into complete dermis tissue with more skin appendages resembling those of normal skin in the last days. Western blot results suggested that the active fraction EPFE65 could increase the phosphorylation of Src, Akt and Erk1/2 in both dose-dependent and time-dependent manner, whereas Akt and Erk1/2 phosphorylation caused by EPFE65 could be abolished by Src inhibition. Inhibition experiments confirmed that the activation of Src, Akt and Erk1/2 were involved in cell proliferation and migration. All of these demonstrated that EPFE65 promoted wound healing at least in part via Src mediated Mek/Erk and PI3K/Akt signaling pathways. Analysis of chemical composition of EPFE65 revealed that cardiac glycosides were major components in EPFE65, among which periplocin showed effectiveness on promoting fibroblasts proliferation indicating that cardiac glycosides in EPFE65 maybe the active compounds responsible for wound healing.

CONCLUSION

The present study confirmed that EPFE65, ethanol extract of Periploca forrestii Schltr. could accelerate wound healing in vitro and in vivo through Src meditated Mek/Erk and PI3K/Akt signaling pathways.

Potential biodegradation of phenanthrene by isolated halotolerant bacterial strains from petroleum oil polluted soil in Yellow River Delta

The Yellow River Delta (YRD), being close to Shengli Oilfield, is at high risk for petroleum oil pollution. The aim of this study was to isolate halotolerant phenanthrene (PHE) degrading bacteria for dealing with this contaminates in salinity environment. Two bacterial strains assigned as FM6-1 and FM8-1 were successfully screened from oil contaminated soil in the YRD. Morphological and molecular analysis suggested that strains FM6-1 and FM8-1 were belonging to Delftia sp. and Achromobacter sp., respectively. Bacterial growth of both strains was not dependent on NaCl, however, grew well under extensive NaCl concentration. The optimum NaCl concentration for bacterial production of strain FM8-1 was 4% (m/v), whereas for strain FM6-1, growth was not affected within 2.5% NaCl. Both strains could use the tested aromatic hydrocarbons (naphthalene, phenanthrene, fluoranthene and pyrene) and aliphatic hydrocarbons (C12, C16, C20 and C32) as sole carbon source. The optimized biodegradation conditions for strain FM6-1 were pH 7, 28 °C and 2% NaCl, for strain FM8-1 were pH 8, 28 °C and 2.5% NaCl. The highest biodegradation rate of strains FM6-1 and FM8-1 was found at 150 mg/L PHE and 200 mg/L, respectively. In addition, strainsFM8-1 showed a superior biodegradation ability to strain FM6-1 at each optimized condition. The PHE biodegradation process by both strains well fitted to first-order kinetic models and the k₁ values were calculated to be 0.1974 and 0.1070 per day. Strain FM6-1 metabolized PHE via a "phthalic acid" route, while strain FM8-1 metabolized PHE through the "naphthalene" route. This project not only obtained two halotolerant petroleum hydrocarbon degraders but also provided a promising remediation approach for solving oil pollutants in salinity environments.

Clinical significance of epithelial-mesenchymal transition-related molecules in lung adenocarcinoma

Background

Epithelial-mesenchymal transition (emt) refers to the biologic process in which epithelial cells are transformed into interstitial phenotypes by specific pathways. This transition plays an important biologic role in the process by which epithelium-derived malignant tumour cells acquire the ability to migrate and invade. We explored the relationship between emt-associated molecules and patient-related clinical factors to determine whether any clinical characteristics could be used as biomarkers for emt-related protein alterations in lung cancer-especially lung adenocarcinoma.

Methods

Tumour specimens were collected from 80 patients with lung adenocarcinoma who underwent surgery or lung biopsy, with 4 patients being evaluated a 2nd time after re-biopsy. Expression of emt-related proteins, including E-cadherin and vimentin, was evaluated by immunohistochemistry. We analyzed the relationship between clinicopathologic characteristics and expression level of the emt markers.

Results

Positive expression of E-cadherin was observed in 63 patients (79%), and vimentin, in 46 patients (57.5%). No significant relationships between E-cadherin or vimentin expression and smoking history, sex, age, driving gene mutations, or cell differentiation were identified. A significant correlation was observed between vimentin expression and pathologic stage. Of the 4 patients who were evaluated a 2nd time after re-biopsy, 3 showed the same emt-related protein expression status as in the first analysis. In the remaining patient, E-cadherin had changed completely.

Conclusions

Clinicopathologic factors in cancer patients did not help to diagnose emt status in lung adenocarcinoma; however, TNM stage might be associated with vimentin expression.

Periplocin promotes wound healing through the activation of Src/ERK and PI3K/Akt pathways mediated by Na/K-ATPase

BACKGROUND

Periploca forrestii(PF) is mainly utilized for treatment of arthritis and traumatic injury historically. We had previously demonstrated that a fraction rich in cardiotonic steroids isolated from PF had the potential to facilitate wound healing. However, the exact material basis and mechanism of action responsible for wound healing is still unclear. Periplocin(PP) is the highest level of cardiotonic steroid included in PF. The present study aims to evaluate the efficacy of periplocin on wound healing systematically in vitro and in vivo.

MATERIALS AND METHODS

The L929 proliferation was determined by both MTT and EdU assay. Cell migration was tested by both scratch and transwell assay. The total amount of soluble collagen was assessed using a Sircol Collagen Assay Kit. The wound healing activity was evaluated in vivo using the excision rat models. Histopathology of the wounded skin on day 9 was studied via hematoxylin and eosin staining (HE) for general morphological observations and masson's trichrome staining for collagen deposition, respectively. The alteration in Src/ERK and PI3K/Akt pathways mediated by Na/K-ATPase was determined by western blot after the treatment with periplocin. The interaction between Na/K-ATPase and Src was tested by immunoprecipitation and immunostaining analysis.

RESULTS

The results revealed that periplocin could significantly boost proliferation, migration and stimulate collagen production in fibroblast L929 cells, which is dependent on activation of Src/ERK and PI3K/Akt pathways mediated by Na/K-ATPase, and thus promoting wound healing. Indeed, inhibition of Na/K-ATPase/Src complex receptor by Src specific inhibitor or knocking down the Na/K-ATPase expression would abolish the subsequent activation of Src/ERK and PI3K/Akt pathways and attenuate periplocin-induced beneficial effects on wound healing. Additionally, the wound healing activity is also confirmed in a rat excisional wound model as evidenced by increased rate of wound closure, reepithelization, formation of granulation tissue and collagen accumulation.

CONCLUSIONS

Collectively, we lay the rationale for traditional usage for traumatic injury, suggesting that periplocin and periploca forrestii is a promising candidate for management of chronic wounds.

[Comparison of preoperative planning of radioactive seed implantation for pelvic wall recurrent gynecological malignant tumors between 3D-printing non-coplanar template and 3D-printing coplanar template]

Objective: To compare the difference of preoperative planning parameters between 3D-printing non-coplanar template (3D-PNCT) and 3D-printing coplanar template (3D-PCT) in the treatment of pelvic wall recurrent gynecological malignant tumor with radioactive seeds implantation, and to guide the clinical application. Methods: From January 2016 to March 2018, 33 patients with pelvic wall recurrent gynecological malignant tumor were treated with radioactive seeds implantation assisted by 3D-printing template and in Peking University Third Hospital. All patients underwent 3D-PNCT and 3D-PCT preoperative planning. The D(90) of target remained similar for the same patient. The parameters were compared with Wilcoxon test or Kruskal-Wallis test. Results: D(90) was similar between the two groups (P>0.05). The number of inserting needles through intestine and bone in 3D-PNCT group was less than that in 3D-PCT group (0 (0-13), 0 (0-25), Z=-2.941, P<0.05;0 (0-3), 0 (0-25), Z=-2.232, P<0.05). Conclusion: For patients with gynecological malignancies with pelvic recurrence, both of the two peroperative plans could achieve prescription dose, but 3D-PNCT is more safer.

[Safety and efficacy of second generation drug eluting stents in diabetic and non-diabetic patients]

Objective: To investigate the long-term prognosis of Second generation drug-eluting stents(G2-DES) in diabetic mellitus(DM) and non-DM patients. Methods: Patients with coronary heart disease(CHD) in Fuwai Hospital from January 2013 to December 2013 who had exclusively G2-DES implantation, were consecutively included the follow-up period was 2 years. Results: A total of 6 094 patients with CHD were implanted with G2-DES, of which 1 862 patients with DM, and 4 232 patients without DM.The proportion of DM patients receiving G2-DES implantation with the following characteristics: advanced age, female, hypertension, hyperlipidemia, history of previous stroke, history of peripheral artery disease, previous history of PCI, and with triple vessel, high preoperative Syntax score, high number of target lesions, B2 or C type lesions, severe calcification lesions, and chronic occlusive disease were significantly higher than those of non-DM patients(P<0.05). The incidence of major adverse cardiac and cerebral vascular events(MACCE), target vascular revascularization(TVR) and target lesion revascularization(TLR) were higher in DM patients than in non-DM patients during 2 year's follow-up(P<0.05). The univariate COX regression analysis showed that diabetes was risk factor for MACCE in patients with CHD implanting G2-DES(HR=1.241, 95%CI: 1.053-1.463, P=0.010). However, multivariable COX analysis showed that DM was not an independent risk factor for MACCE in CHD patients with G2-DES(HR=1.125, 95%CI: 0.952-1.330, P=0.167). While age, female, preoperative Syntex score, triple vessel, B2 or C lesion were independent risk factors for poor clinical prognosis in CHD patients with G2-DES. Conclusions: (1) CHD patients with DM often accompany more clinical risk factors and complicated coronary lesions; (2) the incidence of MACCE, TVR and TLR in DM patients is significantly higher than non-DM patients with G2-DES during the 2 year's follow-up; (3) after multivariate adjustment, DM is not an independent risk factor for poor clinical prognosis in CHD patients with G2-DES, while traditional risk factors and complex coronary lesions are independent risk factors for poor clinical prognosis.

[Seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China]

Objective: To understand the seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China. Methods: This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout 7 geographic areas in the mainland of China (northeast, north, central, east, south, northwest and southwest). The numbers of asthmatic patients and total inpatients of the respiratory department of each hospital were recorded. The monthly ratio of asthmatic patients to the total inpatients in every area was calculated and compared. Results: During the study period, 6 480 patients were admitted for asthma exacerbation, accounting for 3.14% of all the 206 135 patients admitted to the respiratory departments in the 29 hospitals. The ratio of asthmatic patients to total inpatients in the northeast area (5.61%) was highest, and the ratio in east area was lowest (1.97%). Statistical analysis showed that the difference among different areas was significant (P<0.000 1). In most areas, both the number and proportion of hospitalized asthmatic patients peaked in spring (February-April) and autumn (September-October). In the northeast area, east area and south area, the peaks in spring were more obvious, while in the north area and southwest area, the peaks in autumn were more obvious. In the northwest area the peaks occurred in winter (December-January) and summer (June-August), respectively. The differences in hospitalization due to asthma among different months were significant in the northeast, north, and southwest areas (P<0.005). Conclusion: The number of patients hospitalized for asthma exacerbation fluctuated with season in different areas in China. In most areas, more asthmatic patients were admitted to hospitals in spring and autumn.

[Seasonal characteristics of patients hospitalized for asthma exacerbation in China]

Objective: To study the seasonal characteristics of patients hospitalized for asthma exacerbation in China. Methods: This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout mainland China during 2013-2014. The number of patients hospitalized for asthma exacerbation in each hospital was calculated, as well as the ratio of asthmatic patients to all the hospitalized patients. The analysis by month was conducted. The number and ratio of asthmatic patients in the northern and southern cities were calculated respectively. Results: During the study period, there were 6 480 patients hospitalized for asthma exacerbation, accounting for 3.14% (6 480/206 135) of all the hospitalized patients of the respiratory department in 29 hospitals. The analysis by month showed that the ratio of patients hospitalized for asthma exacerbation was highest in March (3.49%), then declined from April to June, then rose again from July, reaching a second peak at September (3.28%), and then declined again from October to December. The ratio of asthmatic patients in every month was higher in northern cities than in southern cities. Conclusions: The ratio of patients hospitalized for asthma exacerbation in China fluctuates with the changes of seasons, and March and September are the two peak months. Northern cities have a higher ratio of asthmatic patients than southern cities.

[Warning symptoms of asthma attack and asthma self-management: a national asthma control survey from China]

Objective: To investigate warning symptoms of asthma attack and evaluate asthma self-management status of asthma patients in urban China. Methods: A multi-center, cross-sectional, questionnaire-based survey was carried out from 30 general hospitals dispersed in 30 provinces of mainland China (except for Tibet) during Oct 2015 to May 2016. Information of frequency and warning symptoms of asthma attack, the time from warning symptoms to asthma attack, the impact of asthma attack and asthma self-management were collected from asthma patients of outpatient department. Results: Altogether 3 875 asthmatic outpatients were recruited. 78.1% (3 026/3 875) of the patients reported restriction of exercise and daily activities during asthma exacerbation. 82.5% (3 160/3 829) of the patients had warning symptoms before asthma attack, the most common warning symptoms were cough, chest tightness and shortness of breath. The median time from warning symptoms to asthma attack was 2 h, the mean time was 90 h. Only 4.4% (167/3 829) of the patients had definite confidence to control asthma when symptoms deteriorated. 76.7% (2 937/3 828) of the patients used medications to control asthma when asthma symptoms deteriorated. Medication choice: inhaled corticosteroid (ICS) + formoterol 45.8% (1 776/3 875), short-acting beta-agonist (SABA) 23.9% (927/3 875). Conclusions: Most asthma patients have warning symptoms before asthma attack, the most common symptoms are cough, chest tightness and shortness of breath. The proportion of patients conducting effective asthma self-management remains low.

Design of a high-Q fiber cavity for omnidirectionally emitting laser with one-dimensional topological photonic crystal heterostructure

Designing a cavity with a high quality factor for omnidirectionally emitting laser (OEL) can extend its potential applications in optical communication and biomedical detection. We demonstrate a method including five steps to design a high-Q cavity for OEL using a one-dimensional topological photonic crystal heterostructure. A Si/SiO₂ fiber cavity for OEL with solid gain medium Er-doped SiO₂ is designed following our design steps. The designed fiber can axially transmit the pump energy at low confine loss and act as a cavity for the radial emission of the exited beam, simultaneously. The quality factor of this fiber cavity is on the order of magnitude of 10⁸. Moreover, a method of further improving the Q-factor is proposed. The results in this paper are not restricted to the solid gain medium, and they also can be applied to designing a cavity for optofluidic OEL or quantum dot OEL. Our study may provide not only the reference for OEL manufacture, but also a route for improving the performance of OEL.

[Predictive value of neutrophil to lymphocyte ratio on long-term outcomes of acute myocardial infarction patients with multivessel disease]

Objective: Patients with acute coronary syndrome due to multivessel disease (MVD) were at the highest risk of adverse cardiovascular events. Neutrophil to lymphocyte ratio (NLR) was proposed as a marker of cardiovascular risk. Present study evaluated the independent predictive value of NLR for acute myocardial infarction (AMI) patients with MVD. Methods: AMI patients with MVD (n=1 433) underwent percutaneous coronary intervention (PCI) between January 2013 and December 2013 were followed up for 2 years. Patients were divided into 2 sub-groups based on an optimal cut off value of NLR to predict 2-year all-cause mortality. The primary endpoint was all-cause death. The secondary endpoint was long-term major adverse cardiovascular and cerebrovascular events (MACCE). Results: By receiver operating characteristics curve analysis, the optimal cut-off value of admission NLR to predict 2-year all-cause mortality was 3.39 (area under the curve 0.765, sensitivity 71%, specificity 73%). The high NLR group(n=396) had higher prevalence of prior myocardial infarction, prior PCI and intra-aortic balloon pump use (IABP)(P<0.01). Compared to the low NLR group (n=1 037), patients in the high NLR group were older, had higher level of neutrophil count and high-sensitivity C-reactive protein (hs-CRP) (P<0.001), but lower level of lymphocyte count, estimated glomerular filtration rate (eGFR) and ejection fraction (P<0.001). During the follow-up period, rate of long-term all-cause death was significantly higher in the high NLR group than in the low NLR group (5.1% (20/396) vs. 0.8% (8/1 037), P<0.001). Cardiac death (4.0% (16/396) vs. 0.7% (7/1 037), P<0.001) and MACCE (21.7% (86/396) vs. 12.6% (131/1 037), P<0.001) were also significantly higher in the high NLR group than in the low NLR group. Multivariate Cox analysis showed that NLR ≥ 3.39 was determined as an independent predictor of 2-year all-cause mortality (HR=3.23, 95%CI 1.38-7.54, P=0.007) and MACCE (HR=1.58, 95%CI 1.19-2.10, P=0.002) in this patient cohort after adjusting for other risk factors. Correlation analysis showed that the NLR was positively correlated with hs-CRP levels (r=0.241, P<0.001). Conclusion: Our study demonstrates that admission NLR ≥ 3.39 is an independent predictor of long term all cause death and MACCE in AMI patients with MVD post PCI.

[The level of asthma control in China from a national asthma control survey]

Objective: To assess the overall asthma control level in urban China. Methods: A multi-center, cross-sectional, questionnaire-based survey was carried out in 30 provinces in China (except Tibet). Asthmatic outpatients who met the inclusion criteria were recruited consecutively from 30 sub-centers from October 2015 to May 2016. Data of demographic characteristics, asthma control, asthma management, asthma exacerbations and self-management, and disease perception were collected by face-to-face interviews. Results: Totally 3 875 asthmatic outpatients were recruited. Asthma control level was assessed according to GINA 2015. The prevalence of asthma control was 28.5%(1 099/3 854). Among 10 cities, which were also involved in the asthma control survey in 2008, the level of asthma control improved from 28.7% in 2008 to 39.2%(533/1 361) in 2016. The rate of hospitalizations due to asthma exacerbations was 26.4%(1 017/3 858) and the rate of emergency visits was 22.4%(864/3 858). Among adult patients, 18.4%(568/3 092) of them had been absent from work while 63.6%(63/99) adolescent patients had been absent from school because of asthma attacks in the previous year. Conclusion: Although the level of asthma control in China is still far from ideal at present, the status has been improved in some cities. Poorly controlled asthma resulted in increase of hospitalizations, emergency department visits and work/school absences.

[A multi-center retrospective study of clinical characteristics and hospitalization costs of patients hospitalized for asthma exacerbation in China during 2013-2014]

Objective: To study the characteristics of patients hospitalized for asthma exacerbation in 29 teaching hospitals in China and to evaluate the hospitalization costs of these patients. Methods: This was a retrospective study and involved patients hospitalized for asthma exacerbation in 29 hospitals throughout China during 2013-2014. Information about the demographic features, conditions before the admission, the outcome, the complications, and the costs was collected using the pre-designed case report form. The influencing factors of the hospitalization costs were analyzed. Results: 3 240 asthmatic patients (1 369 males and 1 871 females) were included and data were analyzed. There were 41.5% (1 346/3 240) patients who had a history of previous hospitalization or emergency department visits during the last year. Only 28.0% (907/3 240) patients had used asthma-controlling medications regularly before the admission. Seventy-three(2.3%) patients were admitted to ICU and used mechanical ventilation. Mortality among these patients hospitalized for asthma exacerbation was 0.25% (8/3 240). The median hospitalization costs was 9 045(6 431, 13 035) RMB. The costs of medications, examinations and treatment accounted for 52.1%, 27.6%, and 9.6% respectively. The costs of asthma medications accounted for only 22.7% of the total medication costs, while the costs of antibiotics accounted for 44.0%. The patients who were admitted to ICU, used mechanical ventilation, complicated with pneumonia, or had a history of hospitalization or emergency department visits during the last year due to asthma exacerbations tended to cost more. Conclusion: In this study, we demonstrated that only a minority of the patients had used asthma controllers regularly before the admissions with exacerbations. The in-hospital mortality of asthma patients in this study was much lower than that reported in other countries. The average cost of hospitalization was much higher than the yearly cost of maintenance therapy. Medication was the predominant component of the total hospitalization costs, and the costs of antibiotics made up the major part of the total medication costs.