[An analysis of the serological characteristics of anti-mitochondrial M2 subtype in patients with drug-induced liver injury and primary biliary cholangitis]

Objective: To analyze the serological characteristics of anti-mitochondrial antibody M2 subtype (AMA-M2) in patients with drug-induced liver injury (DILI) and primary biliary cholangitis (PBC), in order to provide reference for clinical differential diagnosis. Methods: Laboratory data of 2802 DILI cases who visited the hospital between January 2011 and December 2017 were retrospectively collected. AMA-M2 positive patients were analyzed with respect to laboratorical findings, and serum data of 120 patients with primary biliary cholangitis (PBC) at the same period was taken as a control. A chi-square test was used for group comparisons. One-way ANOVA and rank sum tests was used for ALT, AST, ALP, GGT and three groups of immunoglobulin M. Results: Among 2802 DILI patients, AMA-M2 positive rate was 5.1% (144/2 802), 77.1% (111/144) was DILI alone, 22.2% (32/144) was DILI with PBC, and 0.7% (1/144) was DILI with Sjogren's syndrome. An AMA-M2 level in DILI alone group was mostly mild and moderate than the PBC group and the DILI combined with the PBC group. There was significant difference between the two groups (P < 0.05).There was no significant difference in AMA-M2 levels between DILI group combined with PBC group and PBC group (P > 0.05). ALT and AST levels of DILI alone group and DILI combined with PBC were (585.92 ± 653.04) U/L, (501.45 ± 512.67) U/L and (373.47 ± 502.60) U/L, (335.97 ± 513.96) U/L, respectively, which were significantly higher than PBC group [(106.33 + 134.08) U/L, (112.59 + 152.20) U/L]. There were statistically significant differences between the two groups (P < 0.05).The ALP level of DILI alone group was (152.58 + 81.46) U/L, which was lower than PBC group (237.86 + 215.09). The difference was statistically significant (P < 0.05). The level of immunoglobulin M in the DILI alone group was (1.76 ± 1.16) g/L, which was lower than PBC group (4.74 ± 5.74) g/L and the DILI combined with the PBC group (3.31 ± 1.68) g/L. There was significant difference between the two groups. During follow-up, 2.7% of patients with DILI had cirrhosis, 42.3% had lower AMA-M2 titer, 14.4% had lower AMA-M2 titer, 13.5% had higher AMA-M2 titer and five cases developed PBC. Conclusion: AMA-M2 is not only positive in patients with PBC, but also low-to-medium or even high-level AMA-M2 may be detected in DILI patients. For AMA-M2-positive DILI patients, it is necessary to identify whether they are associated with PBC. Secondly, the levels of ALT, AST and ALP should be analyzed, and the patients should be on regular follow up for early and timely detection of drug-induced PBC.

[Study on determination of ethylal in workplace air by gas chromatography]

Objective: A solvent desorption-gas chromatography method for determination of ethylal in workplace air has been established. Methods: Ethylal in workplace air was collected by activated carbon tube and desorbed with carbon disulfide, and the desorption solutions were analysed by capillary column GC with FID detector. Results: The method presented a good linearity in the range of 0.87~34 800.00 mg/L of ethylal in the standard solution, with the correlation coefficient being r=0.999 7. The limit of detection and the limit of quantification of this method were respectively 0.20 mg/L and 0.80 mg/L, and the minimum detectable concentration and the minimum quantification concentration of this method were respectively 0.17 mg/m(3) and 0.60 mg/m(3) per 1.50 L of air.The within-run precision of the method was 2.93%-6.20%, and the between-run precision 3.67%-6.44%. The desorption efficiency between 94.22%-97.27%. Ethylal in activated carbon tube could be kept at least 7 days at room temperature without significant loss. Conclusion: The method could be used for determination of ethylal in workplace air.

[A 5-year follow-up study of pneumoconiosis patients with positive autoantibody]

Objective: To explore the progress of small shadow and the change of lung function in pneumoconiosis with positive autoantibody, so as to provide basis for clinical treatment of pneumoconiosis. Methods: A total of 756 patients were admitted to the pneumoconiosis department of the Guangzhou Occupational Disease Prevention Hospital from January 1, 2013 to June 1, 2019. The patients with combined infection were excluded. According to whether the autoantibody was positive, they were divided into positive group and negative group, 25 cases in each group. Follow-up observation of X-ray chest radiographs, chest CT, forced expiratory volume in one second (FEV(1)) and forced expired flow at 50% of FVC (MEF(50)) of pneumoconiosis patients for 5 years, to analyze the influence of positive autoantibody on the morphology of X-ray chest film, the pneumoconiosis promotion in 5 years and lung function. Results: There were 22 males and 3 females in the autoantibody positive group, aged 53.14±10.51 years. In the autoantibody negative group, there were 23 males and 2 females, aged 53.88±8.10 years. During the 5-year observation period, there was no significant difference of small shadow shape, pneumoconiosis stage, and the pneumoconiosis promotion in 5 years between the autoantibody positive group and the autoantibody negative group (P>0.05). However, the increment of small shadow area in the autoantibody positive group was higher than that in the autoantibody negative group (P<0.05). FEV(1) and MEF(50) of the autoantibody positive group were significantly lower than those of the autoantibody negative group in the fourth and third years, respectively (P<0.05). Positive autoantibody was negatively correlated with FEV(1) and MEF(50) (P<0.05). Conclusion: The positive autoantibody can't promote the progress of X-ray, but show more small shadows on chest CT; the positive autoantibody may aggravate the decline of lung function.

[Analysis of quantitative changes of γδT cells in the peripheral blood of patients with chronic brucellosis]

Objective: To investigate the quantitative changes of γδT cells in peripheral blood before and after anti-Brucella treatment in patients with chronic brucellosis. Methods: A prospective design was used to 88 patients with chronic brucellosis who were admitted to the Second People's Hospital of Tianjin from September 2012 to April 2018. The patients took anti-brucella drugs, And the changes in the number of γδT cell, CD3(+), CD4(+), CD8(+)T lymphocytes and CD4/8 in peripheral blood before treatment, 6 weeks and 12 weeks after treatment were analyzed. Thirty volunteers were selected as the healthy control group from Tianjin Second People's Hospital employee health checkup in 2014. Results: After 6 weeks antibacterial therapy, the counts of CD3(+), CD4(+) and CD8(+)T lymphocytes were significantly lower than before treatment in patients with chronic brucellosis (P<0.05) . After 12 weeks antibacterial therapy, the counts of γδT cell, CD3(+), CD4(+) and CD8(+)T lymphocytes were significantly lower than before treatment (P<0.05) , but CD4/8 was higher than before treatment in patients with chronic brucellosis (P<0.05) . Compared with healthy control group, after 6 weeks antibacterial treatment, the γδT cell count was still significantly higher, but the CD4(+)T lymphocyte count was lower (P<0.05) . After 12 weeks treatment, the γδT cell count was still significantly higher than that of the healthy control group (P<0.01) . Conclusion: γδ T cells, CD4(+), CD8(+) and CD3(+)T lymphocytes may play a role in human body resistance to chronic Brucella infection.

[An investigation of ionizing radiation dose in a manufacturing enterprise of ion-absorbing type rare earth ore]

Objective: To investigate radioactive source term dose monitoring and estimation results in a manufacturing enterprise of ion-absorbing type rare earth ore and the possible ionizing radiation dose received by its workers. Methods: Ionizing radiation monitoring data of the posts in the control area and supervised area of workplace were collected, and the annual average effective dose directly estimated or estimated using formulas was evaluated and analyzed. Results: In the control area and supervised area of the workplace for this rare earth ore, α surface contamination activity had a maximum value of 0.35 Bq/cm² and a minimum value of 0.01 Bq/cm²; β radioactive surface contamination activity had a maximum value of 18.8 Bq/cm² and a minimum value of 0.22 Bq/cm². In 14 monitoring points in the workplace, the maximum value of the annual average effective dose of occupational exposure was 1.641 mSv/a, which did not exceed the authorized limit for workers (5 mSv/a) , but exceeded the authorized limit for general personnel (0.25 mSv/a) . The radionuclide specific activity of ionic mixed rare earth oxides was determined to be 0.9. Conclusion: The annual average effective dose of occupational exposure in this enterprise does not exceed the authorized limit for workers, but it exceeds the authorized limit for general personnel. We should pay attention to the focus of the radiation process, especially for public works radiation.

[Clinical characteristics and prognostic factors of 1 166 patients with uveal melanoma]

Objective: To analyze the clinical characteristics and survival of Chinese uveal melanoma (UM) patients. Methods: It was a retrospective case series study. Clinical data and demography characteristics of 1 166 UM patients who were diagnosed in Beijing Tongren Hospital from January 2004 to January 2020 were collected. The disease was followed up after informed consent was obtained. Kaplan-Meier plots were used to visualize survival outcomes, and the different risk groups were compared using the Log-rank test. The multivariate Cox proportional hazards model was used to select independent prognostic risk factors. Results: A total of 1 166 individuals (598 men, 568 women) were included in this study. The average age was (47.6±12.2) years. Median follow-up time was 38 months. Treatment included episcleral brachytherapy in 881 (75.6%) patients, local tumor resection in 38 (3.2%) patients, laser therapy in 115 (9.9%) patients and primary enucleation in 119 (10.2%) patients. In 120 patients out of the 881 patients with primary brachytherapy, enucleation was performed due to an increasing tumor size or uncontrolled neovascular glaucoma. The Kaplan-Meier survival analysis showed the 5-and 10-year metastasis rates were 18.5% and 26.8%, and the melanoma-related mortality rates were 13.6% and 22.2%, respectively. The Log-rank test showed that patient age (χ²=5.01) and gender (χ²=7.19), as well as tumor grade (χ²=49.11), shape (χ²=34.73), location (χ²=18.60), pathological type (χ²=8.07), presence of subretinal fluid (χ²=15.71) and ciliary body involvement (χ²=19.72) were factors influencing patient prognoses (all P<0.05). In the multivariate Cox analysis, the T2, T3, T4 tumors (compared with the T1 tumor, HR=4.41, 6.82, 10.49), subretinal fluid (HR=1.98), ciliary body involvement (HR=1.79), being male (HR=1.53) and advanced age (greater than 53 years old) (HR=1.83) were independent risk factors for poor prognoses (all P<0.05). Conclusions: UM occurs at a significantly earlier age and non-pigmented tumors represent smaller proportion in Chinese patients. Higher T-stage, presence of subretinal fluid, ciliary body involvement, advanced age, and being male are independent risk factors for poor outcomes.

[Efficacy and safety of endoscopic papillectomy of major duodenal papilla neoplasms]

Objective: To discuss the efficacy and safety of endoscopic papillectomy of major duodenal papilla neoplasms. Methods: The clinical-pathological data of 21 patients who were admitted to the Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and underwent endoscopic papillectomy of major duodenal papilla neoplasms from January 2014 to January 2020 were retrospectively studied, their postoperative outcomes and complication were also analyzed. Results: Tweenty-one patients were successfully performed endoscopic papillectomy of major duodenal papilla neoplasms. The resected lesions varied between 0.5-2.8 cm. Completed lesion was resected in 19 cases and lesion blocks in 2 cases. The incidence of postoperative complication was 52.4% (11/21), including 8 cases of postoperative bleeding (38.1%). Five patients stopped bleeding after endoscopic hemostasis and 3 patients stopped after interventional embolization. Two patients experienced perforation (9.5%) and recovered after conservative treatment including anti-inflammatory treatment and abdominal drainage. Five patients had pancreatitis (23.8%) and recovered after treatment with pre-somatostatin and anti-inflammatory rectal suppository. Preoperative pathological results of 21 patients suggested that 11 were high-grade intraepithelial neoplasia and 8 were low-grade intraepithelial neoplasia, and 2 were chronic inflammation. Postoperative pathological results suggested that 4 were adenocarcinoma, and the rest 17 were adenoma. The coincidence rate of preoperative biopsy results and postoperative pathology was 38.1%(8/21), and underestimate of the pathological stage occurred in 11 patients (52.4%) during the preoperative biopsy, overestimate occurred in two patients (9.5%). Four cases had a positive incisal margin. All patients had good prognoses and no death event occurred during the follow-up period. Conclusions: Early-stage major duodenal papilla neoplasms should be treated with aggressive resection. Endoscopic papillectomy of duodenal papilla neoplasms is safe, effective, and can be recommended as the preferred procedure for major duodenal papilla neoplasms.

[Analysis of risk factors for delayed bleeding after endoscopic submucosal dissection of gastric epithelial neoplasm]

Objective: To determine the potential risk factors of delayed hemorrhage after endoscopic submucosal dissection (ESD) in patients with early gastric carcinomas or precancerous lesions. Methods: The clinical data of 637 patients with early gastric carcinomas (EGC) who treated with ESD in Department of Endoscopy at Cancer Hospital, Chinese Academy of Medical Sciences, from August 2013 to August 2019, were retrospectively analyzed. Univariate analysis and multivariate logistic analysis were conducted to evaluate the risk factors associated with delayed bleeding. Results: A total of 699 lesions in 637 patients, of which 696 lesions were resected enbloc, the curative resection rate was 92.1% (644/699). The pathological diagnosis after ESD showed that 46 cases were low-grade intraepithelial neoplasia, 71 were high-grade intraepithelial neoplasia, and 582 were cancer. Delayed bleeding occurred in 74 lesions, while other 625 lesions without postoperative bleeding. The incidence was 10.6%. Compared with the non-bleeding group, there were statistically significant differences in the maximum length of the lesion, the gross shape of the lesion, the control of intra operative bleeding, and the operation time in the delayed bleeding group (P<0.05). Multivariate logistic regression analysis showed that the maximum length of the lesion and the gross shape of the lesion were independent factors of delayed bleeding after ESD. Delayed bleeding was inclined to occur in patients with lesion size ≥3.0 cm (OR=1.958, 95% CI: 1.162-3.299) and the superficial and flat lesion (OR=10.598, 95% CI: 1.313-85.532) after ESD. Conclusions: The maximum length of the lesion and the gross shape of the lesion are independent impact factors of delayed bleeding occurring in patients with EGC and precancerous lesions after ESD. Patients with lesion size≥3 cm, or superficial flat lesion should be paid attention after ESD operation. It needs to take timely measures to prevent the very likely bleeding in order to ensure postoperative recovery and improve the quality of life for postoperative patients.

[Analysis of clinical and prognostic characteristics of newly diagnosed multiple myeloma with myelofibrosis patients]

Objective: To investigate the clinical and prognostic characteristics of newly diagnosed multiple myeloma (NDMM) patients with myelofibrosis (MF). Methods: The clinical data of 160 NDMM patients admitted to Henan Provincial People's Hospital from January 2012 to July 2022 were analyzed retrospectively. They were divided into MF group(n=74) and non-MF group(n=86) according to whether combined with MF. Patients in MF group were further splited into MF-1 group (n=47) and MF-2/3 group (n=27). All patients were treated with bortezomib and immunomodulatory-based combination therapy. The efficacy was evaluated after 4 courses, and the clinical features and prognosis between the two groups were compared. The deadline for follow-up was December 30, 2022 and the median follow-up period [M (Q1, Q3)] was 23.5 (14.4, 40.5) months. Kaplan-Meier method was used for survival analysis, and Cox regression model was used to analyze the influencing factors of survival. Results: Among 160 patients with NDMM, 91 were males and 69 were females, with a median age [M (Q1, Q3)] of 59 (54, 69) years. In MF group, the bone marrow immature plasma cell percentage, total plasma cell percentage were 9.6% (3.2%, 28.5%) and 36.4% (18.5%, 51.1%), respectively, which were higher than 6.0% (1.2%, 17.2%) and 24.0% (12.0%, 46.0%) of the non-MF group (both P<0.05). Hb level was 84.0(74.5, 100.5)g/L and PLT was (151.99±90.68) ×109/L in the MF group, which were lower than 96.0 (81.0, 112.0)g/L and (180.38±85.32) ×109/L of non-MF group (both P<0.05). But there were no significant differences in ISS stage, karyotypic and fluorescence in situ hybridization (FISH) high-risk genetic abnormalities between the two groups (all P>0.05). Objective response rate (ORR), overall survival (OS) and progression-free survival (PFS) were not significantly different between the two groups (all P>0.05). The rate of 17p- was 25.9% (7/27) in MF-2/3 group, which was higher than 8.1% (7/86) of non-MF group (P=0.049). The median OS of the MF-2/3 group was 25.0 (95%CI: 23.6-26.4) months, which was shorter than that of the non-MF group (54.0 months, P=0.031). Multivariate Cox regression analysis showed that grade MF-2/3 was not a risk factor for OS in NDMM patients (HR=1.507, 95%CI: 0.624-3.993, P=0.425). Conclusions: The ratio of bone marrow immature plasma cells and total plasma cells in NDMM patients with MF are higher than that in patients without MF, and the Hb and PLT are lower than that in patients without MF. NDMM patients with grade 2/3 MF have shorter survival than those without MF.

[Development and validation of predictive models for esophageal squamous cell carcinoma and its precancerous lesions using terminal motif analysis in circulating cell-free DNA]

Objectives: To develop and validate predictive models for esophageal squamous cell carcinoma (ESCC) using circulating cell-free DNA (cfDNA) terminal motif analysis. The goal was to improve the non-invasive detection of early-stage ESCC and its precancerous lesions. Methods: Between August 2021 and November 2022, we prospectively collected plasma samples from 448 individuals at the Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences for cfDNA extraction, library construction, and sequencing. We analyzed 201 cases of ESCC, 46 high-grade intraepithelial neoplasia (HGIN), 46 low-grade intraepithelial neoplasia (LGIN), 176 benign esophageal lesions, and 29 healthy controls. Participants, including ESCC patients and control subjects, were randomly assigned to a training set (n=284) and a validation set (n=122). The training cohort underwent z-score normalization of cfDNA terminal motif matrices and a selection of distinctive features differentiated ESCC cases from controls. The random forest classifier, Motif-1 (M1), was then developed through principal component analysis, ten-fold cross-validation, and recursive feature elimination. M1's efficacy was then validated in the validation and precancerous lesion sets. Subsequently, individuals with precancerous lesions were included in the dataset and participants were randomly allocated to newly formed training (n=243), validation (n=105), and test (n=150) cohorts. Using the same procedure as M1, we trained the Motif-2 (M2) random forest model with the training cohort. The M2 model's accuracy was then confirmed in the validation cohort to establish the optimal threshold and further tested by performing validation in the test cohort. Results: We developed two cfDNA terminal motif-based predictive models for ESCC and associated precancerous conditions. The first model, M1, achieved a sensitivity of 90.0%, a specificity of 77.4%, and an area under the curve (AUC) of 0.884 in the validation cohort. For LGIN, HGIN, and T1aN0 stage ESCC, M1's sensitivities were 76.1%, 80.4%, and 91.2% respectively. Notably, the sensitivity for jointly predicting HGIN and T1aN0 ESCC reached 85.0%. Both the predictive accuracy and sensitivity increased in line with the cancer's progression (P＜0.001). The second model, M2, exhibited a sensitivity of 87.5%, a specificity of 77.4%, and an AUC of 0.857 in the test cohort. M2's sensitivities for detecting precancerous lesions and ESCC were 80.0% and 89.7%, respectively, and it showed a combined sensitivity of 89.4% for HGIN and T1aN0 stage ESCC. Conclusions: Two predictive models based on cfDNA terminal motif analysis for ESCC and its precancerous lesions are developed. They both show high sensitivity and specificity in identifying ESCC and its precancerous stages, indicating its potential for early ESCC detection.

Bacteremia in patients with hematologic malignancies

The decision regarding the appropriate empirical antibiotic therapy for bacteremia in patients with hematologic malignancies must be individualized in each institution, by taking into account variations in the patterns of microbial isolates and their resistance profiles. Microbial isolates and antibiotic resistance patterns must be taken into account at each hospital. A shift from bacteremia due to infections caused by predominantly gram-negative organisms to predominantly gram-positive organisms in patients with hematologic malignancies has been noted in reports from other countries. We investigated bacterial isolates and their antibiotic sensitivities in patients with hematologic malignancies in the Veterans General Hospital-Taipei. A total of 185 episodes of bacteremia in 140 patients with hematologic malignancies were recorded during the period from 1995 to 1996. Unlike foreign reports, our investigation shows that gram-negative organisms still predominate, accounting for 72.7% of isolates, followed by gram-positive organisms, accounting for 26.3% of isolates, and anaerobes, accounting for 1% of isolates. Escherichia coli was the most commonly isolated organism, accounting for 23.9% of isolates, followed by Klebsiella pneumoniae (18.5%), Pseudomonas aeruginosa (12.2%), Enterobacter cloacae (7.3%), and methicillin-resistant Staphylococcus aureus (7.3%). A high mortality rate was observed in gram-negative bacteremia: 31% for E. coli, 26% for K. pneumoniae, 24% for P. aeruginosa, and 33% for E. cloacae. If methicillin-resistant S. aureus bacteremia occurred, mortality was high (47%). The antibiotic sensitivity profiles of the four most common gram-negative isolates (E. coli, K. pneumoniae, P. aeruginosa, and E. cloacae) indicated that, in our hospital, amikacin with either cefoperazone, ceftazidime, ciprofloxacin, or imipenem, would be an ideal combination for empirical therapy for bacteremia in patients with hematologic malignancies.

[Protective effect of Angelica on ECV(304) from injury induced by hyperlipidemic serum in vitro]

The aim of this article was to examine the protective effect of Chinese traditional medicine Angelica on human umbilical vein endothelial cells (HUVECs, ECV(304)) from injury induced by hyperlipidemic serum (HLS) and to study the underlying mechanisms. Microstructures of HUVECs were observed by a scanning electron microscope. Spectrophotometer and immunocytochemical methods were used to detect the content of NO in the suspension and expression of ICAM-1, TGFbeta(1), bFGF on the cell surface, respectively. After being incubated with HLS for 24 hours, HUVECs exhibited pronounced morphological changes, such as disappearance of microvilli on the endothelial cell (EC) surface, rupture of cell membranes, etc. Expression of ICAM-l and bFGF in ECs was significantly increased, while expression of TGFbeta(1) and the release of NO from ECs were significantly decreased. All these effects of HLS on ECs can be reversed by Angelica significantly. The above effects of Angelica may be related to its anti-atherosclerotic action.

Spinal cord changes after the evacuation of a spinal subdural haematoma

Spinal subdural haematoma is a rare entity. Only a few cases have been reported, mainly in patients with coagulopathies or bleeding diathesis, and also in patients undergoing anticoagulant therapy following surgery, trauma, or lumbar puncture. Symptoms of spinal cord compression produced by spinal subdural haematoma may progress rapidly causing complete and irreversible deficits. However, rapid diagnosis and surgical intervention can result in a good functional outcome for the patient. We report on a 41-year-old woman with a normal coagulation profile who developed a spinal subdural haematoma after a minor motor vehicle accident. Although initially asymptomatic, she developed a dense quadriparesis over a 36-h period. A magnetic resonance imaging study demonstrated a subdural mass compressing the spinal cord, and at surgery a spinal subdural haematoma was found. She was discharged to an inpatient rehabilitation facility. Follow-up at 1 year showed significant improvement in motor function, but absence of posterior column function. A follow-up magnetic resonance study demonstrated widening of the spinal cord, advanced myelomalacia and a large, central, multi-loculated syrinx.

[Probiotics enhance the efficacy of fecal microbiota transplantation in severe acute liver injury]

Objective: To observe the changes of gut flora in mice, and explore the outcome of fecal microbiota transplantation combined with probiotics in the intervention of severe acute liver injury. Methods: Forty male BALB/c mice were selected and randomly divided into blank control group (10 mice), model group (10 mice), ordinary fecal microbiota transplantation group (10 mice), and fecal microbiota + probiotics transplantation group (10 mice). An intraperitoneal injection of d-galactosamine (D-GalN 3.0g/kg) was given to every group except the blank control group to induce severe acute liver injury model. Simultaneously, ordinary fecal microbiota transplantation group and fecal microbiota + probiotics transplantation group and modeling group were given enema solutions (once a day). After 48 hours, fetched serum was taken to detect alanine transaminase, aspartate transaminase and total bilirubin, and liver tissue was taken for pathological detection. The colonic content was used to extract DNA for 16S V3-V4 high-throughput sequencing. The results of sequencing were analyzed by using bioinformatics analysis; including OTU cluster analysis, α diversity analysis, β diversity analysis, and linear discriminant analysis effect size (Lefse) to find the bacteria with different colonic content characteristics in different groups of mice. Differences in clinical biochemical indicators between groups were compared using t-test, and the differences between 16S V3-V4 region sequencing results were compared using Wilcoxon test. Results: Model group mice serum biochemical parameters were higher than the other three groups, and the difference was statistically significant (P < 0.05). HE staining of liver sections showed severe inflammatory changes under the microscope in the model group. Ordinary fecal microbiota transplantation group and fecal microbiota + probiotic microbiota transplantation group had low levels of inflammation than the model group. The analysis results of 16S rRNA high-throughput sequencing showed that there was no statistically significant difference in Shannon's index between the blank control and the other three groups. Observed Species difference was statistically significant, and the gut flora composition varied greatly. Species number in the mice gut flora was increased with fecal microbiota transplantation. The results of β - diversity analysis showed that the difference between the blank control group and the other three groups was greater than that between the disease groups. The difference in the structure of the gut flora of the diseased mice in the fecal microbiota + probiotic transplantation group was mostly butyrate-producing bacteria. Conclusion: Fecal microbiota + probiotics enhance the therapeutic effect of fecal microbiota transplantation, improve liver inflammation, and increase the number of butyrate-producing bacteria in the gut.

[Analysis of treatment response and prognostic factors of T-LBL patients treated with pediatric-like ALL therapy following HSCT]

目的

探讨经急性淋巴细胞白血病（ALL）儿童方案治疗达到完全缓解（CR）和部分缓解（PR）的T淋巴母细胞淋巴瘤（T-LBL）患者应用造血干细胞移植巩固治疗的疗效及预后因素。

方法

收集2013年1月至2017年1月于唐都医院血液病中心接受治疗的T-LBL患者的临床资料，将达到CR或PR的患者纳入研究，进行回顾性分析。

结果

①48例患者接受了ALL儿童方案治疗，经2个疗程的诱导化疗后39例达CR，9例达PR。其中接受自体造血干细胞移植（auto-HSCT）者14例，接受异基因造血干细胞移植（allo-HSCT）者7例，21例患者移植后造血功能均顺利重建。②中位随访时间31（9～16）个月。3年总生存（OS）率为61.0%（95% CI 53.7%～68.3%），3年无进展生存（PFS）率为54.8%（95% CI 47.1%～62.2%）。③移植组和未移植组3年OS率分别为84.7%和42.8%（P＝0.006），两组3年PFS率分别为75.4%和38.9%（P＝0.004）。④auto-HSCT组与allo-HSCT组患者的OS率、PFS率差异均无统计学意义（P值分别为0.320、0.597）。⑤骨髓侵犯、未接受造血干细胞移植是影响患者长期预后的独立危险因素［ HR＝5.804（95% CI 1.140～29.549），P＝0.034；HR＝5.871（95% CI 1.711～20.140），P＝0.005］。

结论

ALL儿童方案化疗序贯造血干细胞移植治疗T-LBL疗效确切，安全性好。auto-HSCT与allo-HSCT患者的OS率及PFS率差异均无统计学意义。骨髓侵犯、未接受造血干细胞移植是影响T-LBL患者长期预后的独立危险因素。

[Implant restoration on folded fibular graft for the repair of mandibular defect]

Objective: To discuss the key points of implant restoration on folded fibular graft for mandibular defect. Methods: Fifteen patients with mandibular ameloblastoma were treated by segmental resection of the mandible.The mandibular defect was reconstructed with vascularized folded fibular graft. Implant restoration on the graft was conduced 6-9 months after operation.The results were evaluated. Results: All patients had no tenderness in the temporomandibular joint region. The mouth opening reached 3.1-3.9 cm and the occlusion relationship was good. There was no obvious abnormality in masticatory and swallowing function. After 12-48 months of follow-up, the implants were all survived. Conclusions: The application of folded fibula for both mandible defect repair and postoperative implant restoration could achieve satisfactory results in restoration of the facial appearance and physiological function of oral cavity.

[Results analysis of occupational physical examination for silica dust, benzene and noise-exposed laborer in 2016 in Guangzhou City]

Objective: To analyze the results of occupational physical examination for silica dust, benzene and noise-exposed laborer in 2016 in Guangzhou, to provide basis for occupational health supervise. Methods: The data were derived from "occupational disease and health information surveillance system" and the summary data reported by all the occupational physical examination agencies, and analyzed by descriptive epidemiology method. Results: 77506 data from 21 agencies of 12 district were collected, and 63 suspected occupational disease were detected, which including 1 silicosis, 8 benzene poisoning, 54 noise deafness. Conclusion: Noise exposure was distributed widely, noise deafness had to be focused on, occupational chronic benzene poisoning and silicosis should be monitored continuously. Small, foreign economy and manufacturing industry should be supervised firstly.

[Application of semi-quantitative risk assessment method in occupational health risk assessment of wooden furniture manufacturing enterprises]

Objective: To explore the applicability of semi-quantitative risk assessment methods in wood furniture manufacturing companies. Methods: Two medium-sized wooden furniture manufactures were randomly selected as research objects, namely A company and B company. Used the Semi-Quantitative risk assessment method (the ratio method, the index method and the comprehensive method) in the "Guidelines for occupational health risk assessment of chemicals in the workplace" (GBZ/T 298-2017) to conduct occupational hygiene survey, occupational hazard factor testing and occupational health risk assessments for two wood furniture manufacturers from January to October 2018, and compared and analyzed the applicability of these three semi-quantitative risk assessment methods in wooden furniture manufacturing enterprises. Results: The occupational health status of A enterprises was worse than that of B enterprises, and the occupational health risk level was higher than that of B enterprises, and the risk level of A enterprise is 3~4, and the risk level of B enterprise is 2~3. The occupational health risk level obtained by the index method was consistent with the comprehensive method, while the risk level of some occupational disease hazards used the ratio method was inconsistent with the results of the index method and the comprehensive method. Compared with the index method and the comprehensive method, when E/OEL<0.5 or E/OEL≥2, there might be a certain fluctuation in the occupational health risk level obtained by the ratio method. Conclusion: The semi-quantitative risk assessment is more objective, comprehensive and flexible in the application of occupational health risk assessment, and can assess the occupational health risk level of chemical poisons in wood furniture manufacturing enterprises.

Molecular characterization and phylogenetic analysis of porcine epidemic diarrhea virus samples obtained from farms in Gansu, China

Porcine epidemic diarrhea poses significant sanitation problems in the porcine industry, and has negatively affected the economy in recent years. In this study, 48 fecal specimens were collected from piglets from four intensive swine farms located in the Gansu Province of China. The molecular diversity and phylogenetic relationships between porcine epidemic diarrhea viruses (PEDV) prevalent in Gansu were probed, and the resultant proteins were characterized. Sequence analysis of the spike protein (S) genes showed that each specimen had unique characteristics, and that the PEDV1/S/4 strain could be differentiated from the others via a unique mutation of the S gene. The phylogeny of S glycoprotein showed that all strains were clustered into two major groups. The four Gansu PEDV field strains were characterized into different groups; this finding was consistent with the results of the protein characterization prediction. This analysis additionally revealed the unique characteristics of each specimen. The results of this study could be used to elucidate the prevalence of PEDV and contribute to the prevention of PEDV in Gansu.

[Role of CTGF and PI3K/Akt signaling pathway in paraquat-induced mesenchymal changes in alveolar epithelial cells]

Objective: To investigate the role of connective tissue growth factor (CTGF) and PI3K/Akt signaling pathways in paraquat (PQ) -induced alterations in alveolar epithelial cell mesenchymalization (EMT) . Methods: In February 2023, RLE-6TN cells were divided into 2 groups, which were set as uncontaminated group and contaminated group (200 μmol/L PQ), and cellular EMT alteration, CTGF and PI3K/Akt signaling pathway related molecules expression were detected by cell scratch assay, qRT-PCR and western-blot assay. Using shRNA interference technology to specifically inhibit the expression of CTGF, RLE-6TN cells were divided into four groups: control group, PQ group (200 μmol/L PQ), interference group (transfected with a plasmid with shRNA-CTGF+200 μmol/L PQ), and null-loaded group (transfected with a plasmid with scramble- CTGF+200 μmol/L PQ), qRT-PCR and western blot were used to examine the alteration of the cellular EMT and the expression of molecules related to the activity of PI3K/Akt pathway. The PI3K/Akt signaling pathway was blocked by the PI3K inhibitor LY294002, and the expression of EMT-related molecules in cells of the control group, PQ group (200 μmol/L PQ), and inhibitor group (200 μmol/L PQ+20 μmol/L LY294002) was examined by qRT-PCR and western blot.The t-test was used to compare the differences between the two groups, while the analysis of variance (ANOVA) was applied to compare the differences among multiple groups. For further pairwise comparisons, the Bonferroni method was adopted. Results: The results of cell scratch test showed that compared with the uncontaminated group, RLE-6TN cells in the contaminated group had faster migration rate, lower mRNA and protein expression levels of E-Cadherin, and higher mRNA and protein expression levels of α-SMA, CTGF, PI3K and Akt, with statistical significance (P<0.05). After specific inhibition of CTGF expression, the mRNA and protein expression of CTGF, PI3K, Akt, and α-SMA in the cells of the interference group were significantly lower than that of the PQ group and the null-loaded group (P<0.05/6), whereas that of E-Cadherin was higher than that of the PQ group and the null-loaded group (P<0.05/6). Specifically blocking the PI3K/Akt signaling pathway, the mRNA and protein expression of PI3K, Akt and α-SMA in the cells of the inhibitor group was decreased compared with that of the PQ group (P<0.05/3), while the expression of E-Cadherin was elevated compared with that of the PQ group (P<0.05/3) . Conclusion: CTGF may promote PQ-induced alveolar epithelial cell EMT through activation of the PI3K/Akt signaling pathway. Inhibition of CTGF expression or blockade of PI3K/Akt signaling pathway activity can alleviate the extent of PQ-induced alveolar epithelial cell EMT.

[Research and development of an air sampling tube for chlorobenzene compounds and its supporting determination method]

Objective: To establish a GDH-3 air sample tube for simultaneous determination of twelve kinds of chlorobenzene compounds (CBs) in workplace air by gas chromatography. And to established a matching determination method. Methods: In October 2020, the vapor and aerosol CBs in workplace air were collected by GDH-3 air sampling tube, and desorption and elution with 3.00 ml toluene for 15 min, then the solution separated by DB-23 capillary column, and finally detected with microcell electron capture detector. Results: The quantitative determination ranges of twelve isomers of CBs were 0.71×10(-3)-2000.00 mg/L, with the correlative coefficients were 0.99967-0.99998. The minimum detectable concentrations were 0.04-112.63 μg/m(3), and the minimum quantification concentrations were 0.14-375.42 μg/m(3) (15.00 L sample, 3.00 ml sample solution) . The average elution efficiencies were 96.00%-104.00%. The within-run relative standard deviations (RSDs) were 2.54%-6.12%, and the between-run RSDs were 3.85%-7.87%. Sealed samples could be stable at room temperature for at least 15 days. Conclusion: GDH-3 air sample tube can be used for simultaneous determination of twelve kinds of CBs in workplace air by gas chromatography. The established supporting measurement method meets the measurement requirements of the occupational health standard detection method, and the it's suitable for the simultaneous determination of 12 kinds of CBS in the air.

Structural changes of potato starch and activity inhibition of starch digestive enzymes by anthocyanin from lingonberry (Vaccinium uliginosum L.) retarded starch digestibility

The effects of anthocyanins on in vitro and in vivo digestibility of potato starch were evaluated in this study. Then the influence of anthocyanins on physicochemical property of potato starch and the activity of starch digestive enzymes (α-amylase and α-glucosidase) were also investigated to understand the mechanism of anthocyanins on starch digestibility. Results have shown that dietary anthocyanins could effectively inhibit the biological activities of α-amylase and α-glucosidase to delay the peak of postprandial blood glucose. Characterization of physicochemical properties of potato starch indicates a structural change due to the presence of anthocyanins, hindering its access to starch digestive enzymes. Among all anthocyanins, lingonberry anthocyanin significantly promoted the retrogradation of potato starch (7.153 % to 25.913 %) and exert promising inhibition on α-amylase and α-glucosidase. Lingonberry anthocyanins mainly interacted with potato starch through hydrogen bonds, which reduce the amount of amylose molecules leached from potato starch and loosen the three-dimensional (3D) network structure of starch gel. This study could provide theoretical evidence for utilization of anthocyanins in diabetic-management function food.

[Interpretation of Ergonomic Principle for the Prevention of Work-Related Musculoskeletal Disorders Part 1: General Principles (T/WSJD 14.1-2020)]

Ergonomic Principle for the Prevention of Work-Related Musculoskeletal Disorders Part 1: General Principles (T/WSJD 14.1-2020) is the first guideline standard for the prevention of work-related musculoskeletal disorders provided to employers and occupational health technical service institutions in China, which covers ergonomic risk factors and their hazard definition, ergonomic prevention principles, risk assessment process, risk control process and risk evaluation principles. The standard specifically clarify the specific types of adverse ergonomic risk factors and control strategies and the standard process of systematic ergonomic risk assessment, providing implementation paths and practical guidance for eliminating/reducing adverse ergonomic risks and enhance workplace environments to prevent work-related musculoskeletal disorders. This paper interprets and analyzes the background of standard establishment, formulation process, fundamental basis, and main content, etc., to provide scientific and accurate technical support for enterprise managers, labours and technical personnel of occupational health institutions to optimize the use of this standard.

Dynamic pupillary response to positive differential of light stimulus

Under low background illumination, the pupil responds only to an increase in light intensity by a transient constriction when the extent and rate of the increase exceed a certain values. We term this response the dynamic papillary response in order to differentiate it from the much more sluggish and much less pronounced response moiety that governs the static pupil size according to the level of light adaptation. The characteristics of the dynamic response are studied in some detail. This virtually unidirectional rate sensitivity of pupil to light renders it difficult to be subjected to frequency-response analysis even by small signal approximation. Analysis of the experimental results suggests that this transient response is a light-precipitated confluence of few consecutive hippus.