[Solitary fibrous tumor/hemangiopericytoma of central nervous system: a clinicopathologic analysis of 71 cases]

Objective: As solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) share the same molecular genetics features, the 2016 WHO classification of central nervous system (CNS) tumors had created the combined term SFT/HPC and assigns three grades. This study aims to investigate the clinicopathologic characteristics, diagnosis, differential diagnosis and prognosis of CNS SFT/HPC. Methods: Seventy-one cases of CNS SFT and HPC were retrospectively reclassified and studied. Histopathological, immunohistochemical and imaging features were analyzed. The follow-up data were analyzed. Results: There were 37 male and 34 female patients. The median age was 48 years (range, 3-77 years). Twelve cases (17%) were WHO grade Ⅰ, 26 (37%) were WHO grade Ⅱ and 33 (46%) were WHO grade Ⅲ. Microscopically the tumor could show traditional SFT phenotype, HPC phenotype or mixed phenotype. Immunochemically, 97%(69/71) were positive for STAT6, with 96%(66/69)showing diffuse strong staining. Approximately 90% were diffusely positive for bcl-2, CD99 and vimentin. The expression rate of CD34 decreased with increasing tumor grade, and the mean expression rate was 78%. SSTR2a was variably expressed in 10% (7/71) of cases including one case showing strong cytoplasmic staining. A few cases expressed EMA, CD57 and S-100 focally. The Ki-67 index ranged from 1% to 50%. Thirty four patients were followed up for 8-130 months; 12 patients(35%)had recurrences, and two (6%) had liver metastases. Conclusions: CNS SFT/HPC is relatively uncommon. There was significant morphological overlap or transition between different grades. STAT6 is a specific marker for the diagnosis of this tumor. Surgical resection is the preferred treatment. WHO grade Ⅱ and Ⅲ SFT/HPC show rates of local recurrence and systemic metastasis, with liver being the most common site of extracranial metastasis.

[A prospective multi-center trial of non-interventional and observational study of lenalidomide in Chinese patients with multiple myeloma]

Objective: To evaluate the efficacy and safety of lenalidomide in a real-world clinical practice in Chinese patients with multiple myeloma (MM). Methods: It was a prospective, multi-center, observational study. A total of 165 consecutive patients with MM treated with lenalidomide-based regimens were enrolled in 12 hospitals from June 2013 to November 2015. Relevant information was recorded, such as baseline clinical data, cytogenetic abnormalities, treatment regimens, and duration of treatment, safety, and survival. Results: (1)There were 126 relapsed and refractory MM (RRMM) patients, 25 newly diagnosed patients and 19 maintenance patients. The evaluable RRMM patients accounted for 120 cases, among which 74 cases(61.7%) reached the partial response (PR) or above, and a very good partial response (VGPR) in 16 patients (13.3%), a complete response (CR) in 14 cases (11.7%), a strictly complete response (sCR) in 4 cases (3.3%). Thus, a VGPR or above in 34 patients accounted for 28.3%. (2)The median follow-up was 13 months, the median time to progression 12 months. The median survival after receiving lenalidomide was 19 months, and the median overall survival (OS) was 62 months. (3) The univariate analysis in 120 RRMM patients suggested that prognostic factors for significant improvement in PFS included normal karyotype, international staging system (ISS) Ⅰ-Ⅱ, t(4; 14) negative (detected by fluorescence in situ hybridization), non-bortezomib resistance and response to previous regimens. As to OS, non-bortezomib resistance, response to previous regimens and non-primary refractoriness were positive factors. Multivariate analysis showed that the response to previous regimens (PR or better) was an independent good prognostic factor for progress-free survival(PFS), non-bortezomib resistance and non-primary refractoriness for OS. (4) Grade 3 or 4 adverse events that occurred in more than 10% of all enrolled patients were neutropenia (12.7%), leukocytosis(11.5%) and thrombocytopenia (12.7%). Owing to intolerance of toxic side effects, 7 cases withdrew lenalidomide. Conclusions: No matter what combination, regimens containing lenalidomide are effective to RRMM patients with overall response rate 61.7%, a time to progression 12 months and an overall survival 62 months.The toxicity is quite tolerable and manageable. In addition, the response to previous treatment (reached PR or above) is the independent good prognostic factor for PFS, non-bortezomib resistance and non-primary refractoriness for OS. Clinical trail registration: Clinicaltrials.gov, NCT01947309.

Spatial and temporal evolution of climatic factors and its impacts on potential evapotranspiration in Loess Plateau of Northern Shaanxi, China

Agriculture is very sensitive to climate change, and correct forecasting of climate change is a great help to accurate allocation of irrigation water. The use of irrigation water is influenced by crop water demand and precipitation. Potential evapotranspiration (ET₀) is a measure of the ability of the atmosphere to remove water from the surface through the processes of evaporation and transpiration, assuming no control on water supply. It plays an important role in assessing crop water requirements, regional dry-wet conditions, and other factors of water resource management. This study analyzed the spatial and temporal evolution processes and characteristics of major meteorological parameters at 10 stations in the Loess Plateau of northern Shaanxi (LPNS). By using the Mann-Kendall trend test with trend-free pre-whitening and the ArcGIS platform, the potential evapotranspiration of each station was quantified by using the Penman-Monteith equation, and the effects of climatic factors on potential evapotranspiration were assessed by analyzing the contribution rate and sensitivity of the climatic factors. The results showed that the climate in LPNS has become warmer and drier. In terms of the sensitivity of ET₀ to the variation of each climatic factor in LPNS, relative humidity (0.65) had the highest sensitivity, followed by daily maximum temperature, wind speed, sunshine hours, and daily minimum temperature (-0.05). In terms of the contribution rate of each factor to ET₀, daily maximum temperature (5.16%) had the highest value, followed by daily minimum temperature, sunshine hours, relative humidity, and wind speed (1.14%). This study provides a reference for the management of agricultural water resources and for countermeasures to climate change. According to the climate change and the characteristics of the study area, farmers in the region should increase irrigation to guarantee crop water demand.

Simultaneous measurement of thermal conductivity and heat capacity by flash thermal imaging methods

Thermal properties are important for material applications involved with temperature. Although many measurement methods are available, they may not be convenient to use or have not been demonstrated suitable for testing of a wide range of materials. To address this issue, we developed a new method for the nondestructive measurement of the thermal effusivity of bulk materials with uniform property. This method is based on the pulsed thermal imaging-multilayer analysis (PTI-MLA) method that has been commonly used for testing of coating materials. Because the test sample for PTI-MLA has to be in a two-layer configuration, we have found a commonly used commercial tape to construct such test samples with the tape as the first-layer material and the bulk material as the substrate. This method was evaluated for testing of six selected solid materials with a wide range of thermal properties covering most engineering materials. To determine both thermal conductivity and heat capacity, we also measured the thermal diffusivity of these six materials by the well-established flash method using the same experimental instruments with a different system setup. This paper provides a description of these methods, presents detailed experimental tests and data analyses, and discusses measurement results and their comparison with literature values.

[Cerebrospinal fluid adenosine deaminase and its dynamic changes in tuberculous meningitis]

Objective: To explore the diagnostic value of cerebrospinal fluid (CSF) adenosine deaminase (ADA) level in tuberculous meningitis. Methods: We retrospectively analyzed 139 patients (73 males, 66 females) who visited Beijing Chest Hospital for suspected TBM from January 2010 to June 2015. Of them, 99 patients were diagnosed to have TBM, with 45 males and 54 females, and a mean age of (33±15) years. Forty patients were diagnosed as having Non-TBM, with 28 males and 12 females, and a mean age of (35±18) years. All patients underwent lumbar puncture, and CSF ADA, routine, biochemical and bacteriological tests were performed. Thirty-five TBM patients reviewed CSF ADA test after treatment for 4 weeks, 8 weeks and 6 months. Results: The level of CSF ADA in TBM group was higher than that in the non-TBM group, the difference being statistically significant (5.6 U/L vs 2.3 U/L, P=0.000). When the cut-off value of the CSF ADA was 3.8 U/L , the sensitivity and specificity for diagnosis of TBM were 60.6% (95%CI 50.3%-70.1%) and 87.5% (95%CI 72.4%-95.3%), respectively, and the area under the ROC curve was 0.734.The CSF ADA level was (6.7±4.2) U/L in the 35 cases of TBM before treatment. After 4 weeks, 8 weeks and 6 months of anti-tuberculosis treatment, the CSF ADA levels were (4.5±3.3) U/L, (3.7±2.7) U/L and (2.0±1.5) U/L, respectively; all significantly decreased as compared to that before treatment (P<0.001). There was no significant change in the ADA level between 8 weeks and 4 weeks (P=0.128). After 6 months of treatment, the level of CSF ADA was significantly lower than those after 4 and 8 weeks' treatment (P<0.001). Conclusions: CSF ADA in TBM patients was significantly higher than in non-TBM patients. The sensitivity of CSF ADA level in the diagnosis of TBM was poor, but the specificity was better. CSF ADA was significantly reduced and showed dynamic changes with effective anti-tuberculosis treatment and maybe helpful in evaluating the effect of treatment.

[Isolation of cariogenic Streptococcus mutans and the inhibitory effect of egg yolk antibody on caries]

Objective: To isolate the cariogenic Streptococcus mutans (Sm) strains and study the therapeutical effect of egg yolk antibody (IgY) of the Sm on dental caries development. Methods: Sm strains were isolated from the children's dental plaque samples. Morphological, biochemical and molecular biological methods were applied to identify the serotype, acid producing and adhesion abilities of isolated Sm strains. After inactivation one of the Sm strains was used as antigen to immune laying hens to collect and extract the specific anti-Sm IgY. The rats were infected with Sm (serotype e). After 16 weeks of infection, all the rats were found developing dental caries. The rats were then randomly divided into two groups. The rats in experimental group were supplied with diet containing anti-Sm IgY while the rats in control group with normal IgY. All rats were sacrificed after another 8 weeks' observation. The degree of caries for each rat was assessed using Keyes' method. Results: We isolated 7 Sm strains from the children's dental plaque samples in the present study. The numbers of serotype c, e, f, k were 3, 2, 0 and 2, respectively. All strains showed similar morphological and biochemical characters as standard UA159 Sm strain, and possessed strong capabilities of acid production and adherence. Interestingly, even the same serotypec strains, such as No.3 and No.7 strains, demonstrated significant difference on acid producing and adherence capabilities. After 16 weeks infection with serotype e strain, the rats' mandibular teeth were apparently decayed, and treatment with specific anti-Sm IgY obviously attenuated the development of caries in the experiment group rats (16.4±2.0) compared with that in the control group rats (30.2±9.3) (P<0.05) determined by Keyes' method. Conclusions: Seven cariogenic Sm strains of different serotypes were isolated, which possesses similar morphology and biochemical characters. Although belonging to the same serotype strains they always show significant difference in acid-producing and adherencec apabilities. Further experiment provides evidences that the serotype e strain could obviously induce caries independently, and employment of specific anti-Sm IgY as passive immunotherapy additive might effectively inhibit the further development of dental caries.

[Effects of Meek skin grafting on patients with extensive deep burn at different age groups]

Objective: To investigate the effect of Meek skin grafting on patients with extensive deep burn at different age groups. Methods: Eighty-four patients with extensive deep burns conforming to the study criteria were hospitalized in our unit from April 2011 to April 2015. Patients were divided into children group (C, with age less than 12 years old), young and middle-aged group (YM, with age more than 18 years and less than 50 years old), and old age group (O, with age more than 55 years old) according to age, with 28 patients in each group. All patients received Meek skin grafting treatment. The use of autologous skin area, operation time, wound healing time, and hospitalization time were recorded. The survival rate of skin graft on post operation day 7, complete wound healing rate in post treatment week 2, and the mortality were calculated. Data were processed with one-way analysis of variance, t test, and χ(2) test. Results: The use of autologous skin area of patients in group C was (5.1±1.0)% total body surface area (TBSA), significantly less than (8.3±1.0)%TBSA and (8.3±1.4)%TBSA in groups YM and O, respectively (with t values 32.900 and 52.624, respectively, P values below 0.05). The operation time, wound healing time, and hospitalization time of patients in group C were (1.368±0.562) h, (9.6±0.6) and (32±11) d, significantly shorter than those in group YM [(3.235±0.011) h, (16.9±2.6) and (48±12) d, respectively] and group O [(3.692±0.481) h, (17.3±2.6) and (46±13) d, respectively, with t values from 4.350 to 21.160, P values below 0.05]. The survival rate of skin graft of patients on post operation day 7 in group C was (92±15)%, significantly higher than (81±10)% and (72±12)% in groups YM and O, respectively (with t values 5.509 and 3.229, respectively, P values below 0.05). The above indexes in groups YM and O were similar (with t values from 0.576 to 22.958, P values above 0.05). Complete wound healing rate in post treatment week 2 and the mortality of patients in group C were similar to those in groups YM and O (with χ(2) values 0.365 and 0.122, respectively, P values above 0.05). Conclusions: Meek skin grafting can be used in the treatment of patients with extensive deep burns at different age groups, compared with the young and middle-aged and old patients, the effect in children was better.

Observation of Λ_{c}^{+}→nK_{S}^{0}π^{+}

We report the first direct measurement of decays of the Λ_{c}^{+} baryon involving the neutron. The analysis is performed using 567  pb^{-1} of e^{+}e^{-} collision data collected at sqrt[s]=4.599  GeV with the BESIII detector at the BEPCII collider. We observe the decay Λ_{c}^{+}→nK_{S}^{0}π^{+} and measure the absolute branching fraction to be B(Λ_{c}^{+}→nK_{S}^{0}π^{+})=[1.82±0.23(stat)±0.11(syst)]%. A comparison to B[Λ_{c}^{+}→p(K[over ¯]π)^{0}] provides an important test of isospin symmetry and final state interactions.

Precise Measurement of the e^{+}e^{-}→π^{+}π^{-}J/ψ Cross Section at Center-of-Mass Energies from 3.77 to 4.60 GeV

The cross section for the process e^{+}e^{-}→π^{+}π^{-}J/ψ is measured precisely at center-of-mass energies from 3.77 to 4.60 GeV using 9  fb^{-1} of data collected with the BESIII detector operating at the BEPCII storage ring. Two resonant structures are observed in a fit to the cross section. The first resonance has a mass of (4222.0±3.1±1.4)  MeV/c^{2} and a width of (44.1±4.3±2.0)  MeV, while the second one has a mass of (4320.0±10.4±7.0)  MeV/c^{2} and a width of (101.4_{-19.7}^{+25.3}±10.2)  MeV, where the first errors are statistical and second ones are systematic. The first resonance agrees with the Y(4260) resonance reported by previous experiments. The precision of its resonant parameters is improved significantly. The second resonance is observed in e^{+}e^{-}→π^{+}π^{-}J/ψ for the first time. The statistical significance of this resonance is estimated to be larger than 7.6σ. The mass and width of the second resonance agree with the Y(4360) resonance reported by the BABAR and Belle experiments within errors. Finally, the Y(4008) resonance previously observed by the Belle experiment is not confirmed in the description of the BESIII data.

Evidence of Two Resonant Structures in e^{+}e^{-}→π^{+}π^{-}h_{c}

The cross sections of e^{+}e^{-}→π^{+}π^{-}h_{c} at center-of-mass energies from 3.896 to 4.600 GeV are measured using data samples collected with the BESIII detector operating at the Beijing Electron Positron Collider. The cross sections are found to be of the same order of magnitude as those of e^{+}e^{-}→π^{+}π^{-}J/ψ and e^{+}e^{-}→π^{+}π^{-}ψ(2S), but the line shape is inconsistent with the Y states observed in the latter two modes. Two structures are observed in the e^{+}e^{-}→π^{+}π^{-}h_{c} cross sections around 4.22 and 4.39  GeV/c^{2}, which we call Y(4220) and Y(4390), respectively. A fit with a coherent sum of two Breit-Wigner functions results in a mass of (4218.4_{-4.5}^{+5.5}±0.9)  MeV/c^{2} and a width of (66.0_{-8.3}^{+12.3}±0.4)  MeV for the Y(4220), and a mass of (4391.5_{-6.8}^{+6.3}±1.0)  MeV/c^{2} and a width of (139.5_{-20.6}^{+16.2}±0.6)  MeV for the Y(4390), where the first uncertainties are statistical and the second ones systematic. The statistical significance of Y(4220) and Y(4390) is 10σ over one structure assumption.

Influence of Treg cells and HBV genotype on sustained response and drug resistance in the treatment with nucleoside drugs

We aimed to investigate the influence of regulatory T cells including CD4+CD25+, CD8+CD28- and hepatitis B virus (HBV) genotype on sustained virological response and tolerance of nucleoside drugs. One hundred and thirty-seven patients were enrolled. Lamivudine was administered to 84 patients. Entecavir was administered to the other 53 patients. Before treatment, biochemical tests, HBV DNA load, HBV serum level, HBV genotype, PB CD3+, CD4+, CD8+, CD4+CD25+/CD3+, and CD8+CD28-/CD3+ frequencies were measured. Based on HBV DNA loads after 4 weeks of therapy, patients were divided into response group and suboptimal response group. The lamivudine group received treatment continuously, and then patients were categorized into non-resistance group and resistance group. Compared with the suboptimal response and resistance groups for lamivudine, CD4+CD25+/CD3+ levels were higher in the response and non-resistance groups (t=4.372, P=0.046; t=7.262, P=0.017). In the non-resistance group, CD8+CD28-/CD3+ frequency was lower than in the resistance group (t=5.527, P=0.037). Virus load and hepatitis B E antigen (HBeAg)-positive rate were significantly lower than in the response and resistance group (t=2.164, P=0.038; X2=4.239, P=0.040; t=2.015, P=0.044; X2=16.2, P=0.000). Incidence of drug resistance was high in patients with virogene type C. For the virological response to entecavir, CD8+CD28-/CD3+ level was significantly lower than that of the suboptimal response group (t=6.283, P=0.036). Response and suboptimal response groups were compared in CD3+, CD4+, CD8+, CD4+CD25+/CD3+ and virus genotype, and differences were not statistically significant (P>0.05). Baseline regulatory T cells including CD4+CD25+/CD3+ and CD8+CD28-/CD3+ frequencies have a relationship with the incidence of rapid virological response and the resistance to nucleoside drugs. Patients with HBV genotype C receiving lamivudine more often underwent drug resistance. Antiviral efficacy and the resistance to lamivudine were closely correlated with baseline factors; the same cannot be found for entecavir.

[Association between cured meat consumption and risk of colorectal cancer in people with different dietary habits and lifestyles]

OBJECTIVE

To explore the association between the intakes of cured meat and the risk of colorectal cancer, and analyze the role of the interaction between cured meat intake and dietary habit or lifestyle for the risk of colorectal cancer.

METHODS

A well-designed questionnaire were used to collect retrospective information about demography, lifestyle and dietary habit from 400 patients diagnosed with colorectal cancer and 400 controls matched by age and gender. Logistic regression analysis was conducted to examine the possible association between the intake of cured meat and the risk of colorectal cancer. Generalized multifactor dimensionality reduction(GMDR)was used to analyze the interaction between cured meat intake and other dietary habits or lifestyle factors.

RESULTS

Data from conditional logistic regression analysis showed that compared with the people who had <8 times per year of cured meat intake, those had 8-23 times of cured meat intakes(OR=3.480, 95%CI: 2.022-5.991, P<0.001), 24-47 times of cured meat intakes(OR=4.526, 95%CI: 2.553-8.025, P<0.001), ≥48 times of cured meat intakes(OR=5.472, 95% CI: 3.105-9.642, P<0.001)had increased risk of colorectal cancer. There was a multiplied interaction between cured meat intake and pepper intake(OR=0.379, 95% CI: 0.190-0.758, P=0.009). The synergistic effect existed between cured meat intake and pickled vegetable intake; and the antagonism existed between cured meat intake and tea-drinking habit. GMDR analysis showed that interaction among red meat intake, pickled vegetable and cured meat intake on the risk of colorectal cancer might exist(P=0.001).

CONCLUSIONS

With the increase of frequency of cured meat intake, the risk of colorectal cancer increased gradually. The synergistic effect might existed between pickled vegetable intake and cured meat intake. Tea-drinking, pepper intake and cured meat intake might be antagonism in the pathogenesis of colorectal cancer. Red meat intake, pickled vegetable intake and cured meat intake might have combined effect to increase the risk of colorectal cancer.

[The role of Tim-3 mRNA in acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation]

目的

探讨T细胞免疫球蛋白黏蛋白结构域分子3(Tim-3）mRNA表达在异基因造血干细胞移植（allo-HSCT）后急性移植物抗宿主病（aGVHD）中的作用。

方法

回顾性分析100例allo-HSCT患者，根据患者aGVHD状态[0（未发生）~Ⅰ度aGVHD组、Ⅱ~Ⅳ度aGVHD治疗前组、Ⅱ~Ⅳ度aGVHD治疗好转组]及移植后不同阶段（+14~＋30 d、+31~＋60 d、+61~＋100 d）比较各组外周血单个核细胞Tim-3 mRNA及血浆IFN-γ、IL-2水平。

结果

0~Ⅰ度aGVHD患者＋31~＋60 d Tim-3 mRNA相对定量（7.24±2.79）明显高于＋14~＋30 d(4.60±1.66）及＋61~＋100 d(3.86±1.36）（P值均<0.05）；+14~＋30 d、+31~＋60 d、+61~＋100 d Ⅱ~Ⅳ度aGVHD治疗前组的Tim-3 mRNA水平分别为9.54±3.05、10.14± 3.28、12.82±4.20，+14~+30 d、+61~＋100 d，均高于0~Ⅰ度aGVHD组及治疗好转组；+31~＋60 d Ⅱ~Ⅳ度aGVHD治疗前组明显高于治疗好转组（2.49±0.89），与0~Ⅰ度aGVHD组（7.24±2.79）相比差异无统计学意义；Ⅱ~Ⅳ度aGVHD组中Tim-3 mRNA水平在不同aGVHD程度、不同脏器之间比较差异均无统计学意义（P>0.05）。Ⅱ~Ⅳ度aGVHD治疗前组血浆IFN-γ、IL-2水平明显高于其他各组，治疗好转组血浆IFN-γ、IL-2水平与0~Ⅰ度aGVHD组比较差异无统计学意义。

结论

Tim-3在aGVHD的发生过程中发挥着重要作用。

Amplitude Analysis of the Decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0}

Based on a sample of 1.31×10^{9}  J/ψ events collected with the BESIII detector, an amplitude analysis of the isospin-violating decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0} is performed. A significant P-wave contribution from η^{'}→ρ^{±}π^{∓} is observed for the first time in η^{'}→π^{+}π^{-}π^{0}. The branching fraction is determined to be B(η^{'}→ρ^{±}π^{∓})=(7.44±0.60±1.26±1.84)×10^{-4}, where the first uncertainty is statistical, the second systematic, and the third model dependent. In addition to the nonresonant S-wave component, there is a significant σ meson component. The branching fractions of the combined S-wave components are determined to be B(η^{'}→π^{+}π^{-}π^{0})_{S}=(37.63±0.77±2.22±4.48)×10^{-4} and B(η^{'}→π^{0}π^{0}π^{0})=(35.22±0.82±2.54)×10^{-4}, respectively. The latter one is consistent with previous BESIII measurements.

[PTPS gene analysis and prenatal diagnosis in patients with 6-pyruvoyl-tetra hydropterin synthase deficiency]

Objective: To analyze the variations of PTPS gene in patients with suspected 6-pyruvoyl-tetra hydropterin synthase deficiency (PTPSD) and to make prenatal diagnosis in high-risk families. Methods: Chemiluminescence was used for phenylalanine detection in blood or dried blood spots.Patients with phenylalanine concentration over 120 μmol/L were detected by urine pterin analysis, and the activity of dihydropteridine reductase (DHPR) was detected. tetrahydrobiopterin loading tests were performed in suspected patients with abnormal urinary pterin profiles. PTPS gene variation analysis was performed by direct Sanger sequencing based on PCR amplification. Prenatal diagnosis in 7 high-risk families was performed by chorionic villus sampling when the genotype was identified. Results: In 656 patients with hyperphenylalanine, 22 cases were diagnosed as PTPSD clinically. 16 variations were detected in the 22 PTPSD cases. The 5 variations, p.Lys77Arg, p.Ile84Phe, c.315-2A>G, c.244-2A>T, c.187-1G>T, were identified as novel variations. Two fetuses carried the same mutation with the proband and therefore were thought to be PTPSD fetuses. Three fetuses carried only one mutant allele and thus were thought to be PTPSD carriers. The other 2 fetuses carried no mutations and were presumed normal. Conclusions: PTPS gene variation analysis is necessary to confirm the diagnosis. Prenatal diagnosis could help avoiding the defect birth in PTPSD families.

[Mutation screening of 433 families with Duchenne/Becker muscular dystrophy]

OBJECTIVE

Mutation analysis of unrelated families with Duchenne/Becker muscular dystrophy (DMD/BMD) was performed to investigate the characteristic of DMD gene mutation, especially the distribution pattern of point mutation of DMD gene in Chinese population.

METHODS

A total of 433 unrelated DMD/BMD families were collected at the Center of Prenatal Diagnosis of the First Affiliated Hospital of Zhengzhou University from March 2010 to December 2014. The deletions or duplications in 79 exons of DMD gene were screened using multiplex ligation-dependent probe amplification (MLPA). Any single-exon deletion detected by MLPA was further validated by PCR amplification. In the 117 unrelated Chinese families in which large-scale deletions and duplications had been excluded by MLPA, the point mutation in 79 exons of DMD gene were tested in the propositus using next-generation sequencing (NGS), and further verified the point mutation using Sanger sequencing.

RESULTS

In the 433 unrelated DMD/BMD families, 316 families with DMD deletions/duplications were identified by MLPA. Out of 57 single-exon deletions detected by MLPA, 3 were found as point mutations by PCR and Sanger sequencing, including 2 nonsense mutation (c.1729G>T [p.Glu577X], c. 3346A>T [p.Lys1116X]) and 1 frame-shift mutation (c.8605_8606delGT [p.Val2869ThrfsX25]). Direct sequencing with Ion PGM and Sanger sequencing in 117 families with negative results in MLPA detected 92 different point mutations in 96 families, including 46 novel mutations, 42 previously reported ones, and 4 possible polymorphisms (rs189143447, rs202008454, rs200213555, rs187617705). The 46 novel mutations consisted of 16 nonsense mutations (c.100A>T [p.Lys34X], c. 1201C>T [p.Gln401X], c. 1707C>A [p.Cys569X], c. 1831G>T [p.Glu611X], c. 1912C>T [p.Gln638X], c. 2213C>G [p.Ser738X], c. 3673_3673delA [p.Ile1225X], c. 3774C>A [p.Cys1258X], c. 4858G>T [p.Glu1620X], c. 5764A>T [p.Lys1922X], c. 6035T>G [p.Leu2012X], c. 6408G>A [p.Trp2136X], c. 7717C>T [p.Gln2573X], c. 7864G>T [p.Glu2622X], c. 8184_8185insT [p.Lys2729X], c. 8215C>T [p.Gln2739X]), 5 missense mutations (c.139G>A [p.Gly47Arg], c. 238G>C [p.Ala80Pro], c. 335G>T [p.Trp112Leu], c. 804A>C [p.Leu268Phe], c. 1149G>T [p.Glu383Asp]), 6 splice-site mutations (c.2293-3C>A, c. 2380+ 1G>T, c. 3277-1G>C, c.4519-7A>G, c. 5740-15G>T, c. 7661-1G>C), 16 small deletions (c.688_688delA [p.Met230CysfsX14], c.1760_1791del32 [p.Thr587IlefsX37], c. 2271_2271delA [p.Asp774ThrfsX22], c. 2281_2285delGAAAA [p.Glu761SerfsX10], c. 2527_2527delG [p.Glu843SerfsX3], c. 3405_3405delC [p.Asn1135LysfsX18], c. 4450_4450delC [p.His1484ThrfsX14], c. 4770_4770delA [p.Thr1590ThrfsX5], c. 4937_4937delA [p.Glu1646GlyfsX11], c. 5253_5256delATTA [p.Lys1751LysfsX2], c. 5654_5654delA [p.Gln1885ArgfsX6], c. 7441_7441delG [p.Glu2481AsnfsX13], c. 7860_7860delC [p.Ile2620IlefsX18], c. 8668-8668delG /c.8668+ 1-8668+ 1delG, c. 9009_9009delC [p.Thr3003ThrfsX18], c. 9021_9021delT [p.Ile3007IlefsX14]), and 3 small insertions (c.305_306insG [p.Gly102GlyfsX4], c. 3116_3117insA [p.His1039GlufsX11], c. 9197_9198insATCTC [p.Ser3066SerfsX25]). And 87.4% (83/95) of the pathologic point mutations disrupted the translational reading frame (46 nonsense mutations, 24 frame-shift mutations, and 13 splice-site mutations).

CONCLUSIONS

Inexpensive and efficient genetic/prenatal diagnosis of DMD/BMD may be plausible by MLPA analysis, NGS, and Sanger sequencing. Most of the mutations identified in this study led to a predictable premature stop codon or splicing defects, resulting in defective function of dystrophin.

[The clinical characteristics and surgical treatment strategy of acute gangrenous cholecystitis after biliary tract stenting]

Objective: To analysis of the possible cause and surgical diagnosis and treatment strategies of acute gangrenous cholecystitis (AGC) after biliary stent drainage. Methods: The clinical data of 273 patients who received biliary stent drainage in Beijing Chaoyang Hospital from January 2015 to March 2016 were analyzed retrospectively. Among them, 22 patients who underwent surgical treatment were divided into two groups: 9 cases of AGC group and 13 cases of non-AGC group. The risk factors of AGC and surgical approach were analyzed. Result: All 22 patients underwent laparoscopic surgery. In AGC group, 1 patient with toxic shock died of multiple organ viscera function failure caused by infection, and 1 patient with gallbladder triangle inflammatory adhesion suffered from biliary leakage. The postoperative pathology of 2 patients was acute gangrenous cholecystitis. Non-AGC group had no death, bile duct injury and bleeding, with postoperative pathology of chronic cholecystitis. Patients were followed up for 2 month to restore well, without biliary calculi residual. Operation time, intraoperative blood loss, hospitalization days and hospitalization expenses of AGC group were higher than those of non-AGC group. Conclusion: The advocated AGC after biliary stent drainage should actively surgery after early diagnosis and endoscopic therapy should not be repeated. Laparoscopic surgery is a safe and effective treatment for AGC after carotid stenting.

Measurement of Singly Cabibbo Suppressed Decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}

Using 567  pb^{-1} of data collected with the BESIII detector at a center-of-mass energy of sqrt[s]=4.599  GeV, near the Λ_{c}^{+}Λ[over ¯]_{c}^{-} threshold, we study the singly Cabibbo-suppressed decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}. By normalizing with respect to the Cabibbo-favored decay Λ_{c}^{+}→pK^{-}π^{+}, we obtain ratios of branching fractions: [B(Λ_{c}^{+}→pπ^{+}π^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(6.70±0.48±0.25)%, [B(Λ_{c}^{+}→pϕ)/B(Λ_{c}^{+}→pK^{-}π^{+})]=(1.81±0.33±0.13)%, and [B(Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(9.36±2.22±0.71)×10^{-3}, where the uncertainties are statistical and systematic, respectively. The absolute branching fractions are also presented. Among these measurements, the decay Λ_{c}^{+}→pπ^{+}π^{-} is observed for the first time, and the precision of the branching fraction for Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-} and Λ_{c}^{+}→pϕ is significantly improved.

[Progress in the study of central auditory processing disorders]

Summary With the development of artifical ossicular and cochlear implant，the treatment of refractory hearing loss acquire significant breakthrough，thus central auditory processing disorders are becoming the major cause of refractory hearing loss.In this paper，research progress of central auditory processing disorders in clinical and fundamental are reviewed.

[Effect of expanded lateral thoracic abdominal flap transferred with pedicle on repairing large area of hypertrophic scar after burn of the upper extremity]

Objective: To observe the effect of expanded lateral thoracic abdominal flap transferred with pedicle on repairing large area of hypertrophic scar after burn of the upper extremity. Methods: Twelve patients with large area of secondary hypertrophic scar 8 month to 3 years after healing of burn wound on the upper extremity were hospitalized in Zhengzhou First People's Hospital from October 2008 to October 2015, with scar area ranging from 11 cm×7 cm to 20 cm×10 cm. Five patients were with limited straightening and bending of elbow. The scars were reconstructed with ipsilateral expanded lateral thoracic abdominal flap or that combined with expanded upper extremity flap according to the area of scar. Lateral thoracic abdominal incision was located near the anterior axillary line, and upper extremity incision was located near scar edge. A capsule cavity was formed by blunt dissection in the superficial fascia layer. Expander with suitable capacity was implanted with the injection pot being built-in. Volume of water reaching 1 time to 3 times of the capacity of expander was injected for excessive expanding. The expanded lateral thoracic abdominal flap supplied by lateral thoracic cutaneous artery and expanded upper extremity flap were dissected after the completion of expanding. The expanded upper extremity flap was advanced locally to cover the surrounding secondary wound after resection of hypertrophic scar. The expanded lateral thoracic abdominal flap was transferred with pedicle to reconstruct scar, with pedicle being sutured in skin tube-like shape, and the flap donor site was sutured directly. Flap pedicle separation was carried out 3 weeks after surgery. Anti-scar treatment was carried out after healing of sutured area. Results: Totally 18 expanders were implanted, without complications such as infection, exposure of expander, and so on. The areas of expanded lateral thoracic abdominal flaps were from 11 cm×7 cm to 16 cm×11 cm. The combined application of expanded upper extremity flaps with area ranging from 8 cm×4 cm to 9 cm×6 cm was used in 6 patients. All the flaps survived with incision healed. The color, texture, and thickness of skin area repaired by flap were close to those of the normal skin of upper extremity after 6 months to 2 years' follow-up afer discharge. The limited straightening and bending of elbow in 5 patients were rectified. Obvious linear scar was observed in the sutured area of surgery in 3 patients, while light linear scar was observed in the sutured area of surgery in 9 patients. Conclusions: Expanded lateral thoracic abdominal flap has constant blood vessel and is easy to be dissected. It can achieve well reconstruction of appearance and function in repairing large area of hypertrophic scar after burn of the upper extremity.

[Association and interaction of heat shock proteins B1 gene and tumor-suppressor protein p53 gene with chromosome damage levels among coke oven workers]

Objective: To investigate the association and interaction of heat shock proteins B1(HSPB1)gene rs2868371 and tumor-suppressor protein p53(TP53)gene rs1042522 polymorphisms with chromosome damage levels among coke oven workers. Methods: We recruited 1 333 male workers from a state-run coke oven plant in Wuhan in September-October 2010. Among them, 949 who had worked in coke oven workplaces, including auxiliary facilities and bottom, side, and top ovens, were nominated as coke oven workers(i.e., exposed), and 384 administrative or medical staff whose workplaces were offices were used as controls. General characteristics and 5 ml of venous blood were collected from each participant. The plasma concentrations of benzo[a]pyrene-diolepoxide(BPDE)-albumin adducts and the lymphocytic micronucleus(MN)frequencies for each individual were detected by ELISA and cytokinesis-block micronucleus assay, respectively. Gene polymorphisms were genotyped using TaqMan assays via quantitative PCR(ABI Prism 7900HT), and the corresponding frequency ratios(FR)with 95% confidence intervals(CI)were computed for all assays. Results: In the exposed group, the MN frequencies were higher in HSPB1 rs2868371 GC, CC, and GC+ CC genotype carriers((3.88 ± 2.88)‰,(4.00 ± 2.66)‰, and(3.91 ± 2.83)‰, respectively)than in rs2868371 GG genotype carriers((3.52±2.67)‰; FR=1.10, 1.13, and 1.11; 95% CI: 1.02-1.19, 1.02-1.25, and 1.03-1.19, respectively), and the HSPB1 rs2868371C allele was associated with increased MN frequency(P_trend=0.006). Further, in the exposed group, the MN frequencies were lower in TP53 rs1042522 CG and CG+GG genotype carriers((3.63±2.61)‰ and(3.66±2.61)‰, respectively)than in TP53 rs1042522 CC genotype carriers(3.95±3.06)‰(FR=0.87 and 0.90; 95% CI: 0.83-0.96 and 0.84-0.97, respectively). The effect of gene-gene interaction between HSPB1, rs2868371, and TP53 rs1042522 on MN frequency was significant among coke oven workers(P=0.001). Further stratified analyses showed that the effects of the HSPB1 rs2868371C allele in increasing MN frequencies were robust in subjects aged >40 years(FR=1.07, 95% CI: 1.01-1.12), those working >20 years(FR=1.08, 95% CI: 1.02-1.14), those with BMI ≤24 kg/m²(FR=1.07, 95% CI: 1.01-1.13), drinkers(FR=1.09, 95% CI: 1.02-1.16), and workers with higher BPDE-albumin adduct levels(FR=1.07, 95% CI: 1.01-1.13)(P_trend=0.023, 0.013, 0.029, and 0.020, respectively). The decreasing effect of the TP53 rs1042522 G allele on MN frequencies was robust in subjects aged >40 years(FR=0.94, 95% CI: 0.89-0.99), those with BMI ≤24 kg/m²(FR=0.94, 95% CI: 0.88-0.99), and drinkers(FR=0.94, 95% CI: 0.88-1.00)(P_trend=0.031, 0.023, and 0.038, respectively). In addition, there were interactions between HSPB1 rs2868371 and age and between HSPB1 rs2868371 and working years in terms of MN frequency(P=0.030 and 0.013, respectively). Conclusion: In coke oven workers, the HSPB1 rs2868371 C and TP53 rs1042522 G alleles were associated with increased and decreased chromosome damage levels, respectively, and their interaction effect on chromosome damage levels was significant.

[Preliminary evaluation on self-developed dentin porcelain color prediction system]

OBJECTIVE

To apply the self-developed dentin porcelain color prediction system in the fabrication of porcelain-fused-to-metal-crown(PFMC), and to evaluate its accuracy in color-matching.

METHODS

Twenty upper central incisors were recruited according to preset criteria, and three PFMC were made for each tooth using three shade-matching techniques. Group A: PFMC were made according to the result of visual color selection; Group B: an spectrophotometer-based color-matching technique was used; Group C: PFMC were fabricated with dentin porcelain powder calculated by the prediction system according to the L(*), a(*), b(*) value measured by a spectrophotometer. Color differences(ΔE) (measured by spectrophotometer) of three groups of crowns were calculated in the cervical, middle, and incisal regions. The results were analyzed using one-way ANOVA.

RESULTS

Mean color differences in body regions were: Group A: 3.53±1.80, Group B: 2.86±1.63, Group C: 3.77±1.40(P>0.05), and those in incisal regions were: Group A: 2.70 ± 1.13, Group B: 2.80 ± 0.90, Group C: 3.04 ± 1.03(P>0.05). In cervical region, Group C had greater color difference than Group B(2.78±1.14)(P<0.05). Group A(3.80±2.02) and Group B, Group A and Group C had similar color difference(P>0.05).

CONCLUSIONS

PFMC fabricated using self-developed dentin porcelain color prediction system had similar color matching compared with conventional and instrument-based methods.

Effect of compound Maqin decoction on TGF-β1/Smad proteins and IL-10 and IL-17 content in lung tissue of asthmatic rats

In this research, compound Maqin decoction (CMD) has been shown to positively affect in airway inflammation of asthma models. We evaluated the effects of CMD on the expression of transforming growth factor (TGF)-β1/Smad proteins, interleukin (IL)-17, and IL-10 in lung tissue of asthmatic rats. Asthma was induced in a rat model using ovalbumin. After a 4-week treatment with CMD, rats were killed to evaluate the expression of TGF-β1 and Smad proteins in lung tissue. IL-10 and IL-17 levels in lung tissue homogenates were determined by ELISA. The expression of TGF-β1 and Smad3 protein increased, whereas expression of Smad7 protein decreased upon high-dose or low-dose treatment with CMD or by intervention with dexamethasone, compared to the control. There was a significant difference between treatment with a high dose CMD and the control treatment, but no significant difference was found between high-dose CMD treatment and dexamethasone intervention. The expression of TGF-β1 and Smad7 protein increased, whereas the expression of Smad3 protein decreased in the model group compared to other groups. In the CMD high-dose group, low-dose group, and dexamethasone intervention group, the IL-17 concentrations in lung tissue homogenates were decreased, while IL-10 levels were increased. Again, there was a significant difference between CMD high-dose and control treatment, but not between CMD high-dose treatment and dexamethasone intervention. Thus, positive effects of CMD against asthmatic airway remodeling may be due to its regulatory effect on TGF-β1, Smad3, and Smad7 protein levels and on cytokines such as IL-10 and IL-17.