The genomic alterations in glioblastoma influence the levels of CSF metabolites

Cerebrospinal fluid (CSF) analysis is underutilized in patients with glioblastoma (GBM), partly due to a lack of studies demonstrating the clinical utility of CSF biomarkers. While some studies show the utility of CSF cell-free DNA analysis, studies analyzing CSF metabolites in patients with glioblastoma are limited. Diffuse gliomas have altered cellular metabolism. For example, mutations in isocitrate dehydrogenase enzymes (e.g., IDH1 and IDH2) are common in diffuse gliomas and lead to increased levels of D-2-hydroxyglutarate in CSF. However, there is a poor understanding of changes CSF metabolites in GBM patients. In this study, we performed targeted metabolomic analysis of CSF from n = 31 patients with GBM and n = 13 individuals with non-neoplastic conditions (controls), by mass spectrometry. Hierarchical clustering and sparse partial least square-discriminant analysis (sPLS-DA) revealed differences in CSF metabolites between GBM and control CSF, including metabolites associated with fatty acid oxidation and the gut microbiome (i.e., carnitine, 2-methylbutyrylcarnitine, shikimate, aminobutanal, uridine, N-acetylputrescine, and farnesyl diphosphate). In addition, we identified differences in CSF metabolites in GBM patients based on the presence/absence of TP53 or PTEN mutations, consistent with the idea that different mutations have different effects on tumor metabolism. In summary, our results increase the understanding of CSF metabolites in patients with diffuse gliomas and highlight several metabolites that could be informative biomarkers in patients with GBM.

Rapid detection of mutations in CSF-cfTNA with the Genexus Integrated Sequencer

PURPOSE

Genomic alterations are fundamental for molecular-guided therapy in patients with breast and lung cancer. However, the turn-around time of standard next-generation sequencing assays is a limiting factor in the timely delivery of genomic information for clinical decision-making.

METHODS

In this study, we evaluated genomic alterations in 54 cerebrospinal fluid samples from 33 patients with metastatic lung cancer and metastatic breast cancer to the brain using the Oncomine Precision Assay on the Genexus sequencer. There were nine patients with samples collected at multiple time points.

RESULTS

Cell-free total nucleic acids (cfTNA) were extracted from CSF (0.1-11.2 ng/μl). Median base coverage was 31,963× with cfDNA input ranging from 2 to 20 ng. Mutations were detected in 30/54 CSF samples. Nineteen (19/24) samples with no mutations detected had suboptimal DNA input (< 20 ng). The EGFR exon-19 deletion and PIK3CA mutations were detected in two patients with increasing mutant allele fraction over time, highlighting the potential of CSF-cfTNA analysis for monitoring patients. Moreover, the EGFR T790M mutation was detected in one patient with prior EGFR inhibitor treatment. Additionally, ESR1 D538G and ESR1::CCDC170 alterations, associated with endocrine therapy resistance, were detected in 2 mBC patients. The average TAT from cfTNA-to-results was < 24 h.

CONCLUSION

In summary, our results indicate that CSF-cfTNA analysis with the Genexus-OPA can provide clinically relevant information in patients with brain metastases with short TAT.

A versatile control program for positioning and shooting targets in laser-plasma experiments

We introduce a LabVIEW-based control program that significantly improves the efficiency and flexibility in positioning and shooting solid targets in laser-plasma experiments. The hardware driven by this program incorporates a target positioning subsystem and an imaging subsystem, which enables us to install up to 400 targets for one experimental campaign and precisely adjust them in six freedom degrees. The overall architecture and the working modes of the control program are demonstrated in detail. In addition, we characterized the distributions of target positions of every target holder and simultaneously saved the target images, resulting in a large dataset that can be used to train machine learning models and develop image recognition algorithms. This versatile control system has become an indispensable platform when preparing and conducting laser-plasma experiments.

Verification of spinwave excitation in coaxial gyromagnetic nonlinear transmission lines

The knowledge of physical mechanism of microwave generation in coaxial gyromagnetic nonlinear transmission lines (GNLTLs) is not complete up until now, especially the action of spinwave excitation during this process. In this paper, control experiments on different groups of GNLTLs with a single variable of NiZn ferrite material spinwave linewidth ΔHk are proposed as an indirect way to demonstrate this microscopic process. Comparative analyses of different groups of GNLTL experimental results are conducted to clarify the existence and effect of spinwave excitation. Theoretical treatment of conditions of spinwave excitation in GNLTLs is derived to explain the experimental results. It is illustrated that spinwave can be excited when the synchronism condition between the working frequency of GNLTL and the spinwave frequency spectrum is satisfied. The unstable spinwave excitation will consume the RF energy of GNLTLs heavily and cause a rapid decrease in RF oscillation.

Effects of saffron and its active constituent crocin on cancer management: A narrative review

Background and Objective

Cancer is a major public health problem in the world, and it dramatically affects the life expectancy of patients and their quality of life. Natural products from botanicals could be beneficial in the prevention or treatment of a variety of cancers. Saffron (the extract of Crocus sativus) includes its major constituent, crocin, have been used as a folk medicine for a long time, and they have shown obvious cancer chemoprevention potential. The objectives of this review are to present the progress of research on the effects of saffron and crocin in cancer management and the underlying mechanisms of action.

Methods

We searched publications in the English language, published between January 1, 1980 and September 30, 2022, of saffron and crocin on cancer through several search engines, i.e., PubMed, SciFinder and Web of Science.

Key Content and Findings

In this article, we first summarize the phytochemical studies of this botanical. Then, we present the anticancer effects of saffron and crocin on different human cancer cells. Saffron and crocin showed obvious antiproliferative effects on human cancer cell lines, including colorectal cancer, breast cancer, lung cancer, prostate cancer, cervical cancer, leukemia, glioblastoma and rhabdomyosarcoma. Finally, the anticancer-related mechanisms of action are summarized, including cell cycle arrest at G0/G1 or G2/M phases, induction of caspase-dependent apoptosis, signaling pathway-linked tumor metabolism regulation, and adaptive immunity regulated inflammation of host immune responses.

Conclusions

Previous studies related to saffron and crocin in cancer management have been reviewed and reported results have been analyzed. Clinical data suggest that saffron and crocin have beneficial effects to improve quality of life in cancer patients. Thus, saffron and crocin can be considered promising candidates for future clinical cancer studies.

[Analysis of clinical prognosis of endoscopic salvage surgery in patients with rT2 recurrent nasopharyngeal carcinoma]

Objective: To investigate the feasibility of endoscopic salvage surgery for patients with rT2 recurrent nasopharyngeal carcinoma (rNPC) and to analyze their prognostic factors. Methods: The clinical data of 33 patients with rT2 rNPC who underwent endoscopic extended nasopharyngectomy in Eye & ENT Hospital Affiliated to Fudan University from January 2015 to July 2020 were analyzed, including 29 males (87.9%) and 4 females (12.1%), aging (51.7±10.6) years. The clinicopathological characteristics of these patients were recorded and analyzed, in terms of gender, sex, alcohol and cigarette use, interval between primary treatment to recurrence, adjuvant therapy, lymph node metastasis, internal carotid artery (ICA) invasion, necrosis, margin and reconstruction materials. Kaplan Meier analysis was used to plot the overall survival rate and progression free survival rate curve, Log-rank test was used to analyze the prognostic factors among patients, and multivariate Cox proportional hazards regression was used to determine the independent risk factors of tumor progression free survival. Results: Among 33 patients with rT2 rNPC, the recurrence interval of 24 patients with rNPC after primary radiotherapy was more than 2 years. A total of 25 patients received primary radiotherapy and adjuvant chemotherapy at the same time. There were 6 cases with cervical lymph node metastasis, 12 cases with ICA invasion, 8 cases with positive surgical margin, 7 cases underwent ICA embolization before operation. A total of 18 cases underwent pedicled tissue flap repairment after operation, including 12 pedicled nasal septal mucosa flaps and 6 temporalis muscle flaps. The median follow-up time was 15 months. Five patients died because of disease progression (in 2 cases), post surgical ICA hemorrhage (in 1 case), liver metastasis (in 1 case) and dysphagia (in 1 case). The 1-year, 2-year and 3-year overall survival rates of all patients were 93.9%, 81.8% and 81.8%, respectively. The 1-year, 2-year and 3-year progression free survival rates were 74.7%, 59.7% and 40.9%, respectively. Log-rank statistical analysis showed that the positive surgical margin (P=0.060) and recurrence interval (P=0.151) were possibly related to the prognosis of rT2 rNPC. Multivariate Cox regression analysis showed that the positive surgical margin was an independent risk factor for patients with rT2 rNPC (P=0.034). Nasopharynx hemorrhage occurred in 4 patients, skull base bone necrosis occurred in 2 patients, trismus occurred in 3 patients, and no obvious brain complications occurred in 7 patients with ICA embolization. Conclusion: Endoscopic salvage surgery for rT2 rNPC is a safe and effective surgical option, but the long-term effect still needs long-term follow-up in bulk cases.

[Clinical characteristics of 18 children with chronic nonbacterial osteomyelitis]

Objective: To investigate the clinical features of children with chronic nonbacterial osteomyelitis (CNO), and raise awareness among clinicians. Methods: In this retrospective study, 18 patients with CNO who were diagnosed in Children's Hospital of Fudan University from January 2015 to December 2021 were included. Results: Eighteen children with CNO (12 males, 6 females) were identified. Their age at onset was 9 (5, 11) years, the delay in diagnosis was 2 (1, 6) months, and follow-up-was 17 (8, 34) months. The most common symptoms were fever in 14 children, as well as bone pain and (or) arthralgia in 14 children. In terms of laboratory results, normal white blood cell counts were observed at onset in 17 patients; increased erythrocyte sedimentation rate (ESR) in all patients; increased C reactive protein (CRP) over the normal value in 14 patients. Of the 18 patients, 2 had positive antinuclear antibodies, while none had positive human leukocyte antigen-B27 or rheumatoid factor. Imaging examination revealed that all the patients had symmetrical and multifocal skeletal lesions. The number of structural lesions detected by imaging investigation was 8 (6, 11). The most frequently affected bones were tibia in 18 patients and femur in 17 patients. Bone biopsy was conducted in 14 patients and acute or chronic osteomyelitis manifested with inflammatory cells infiltration were detected. Magnetic resonance imaging (MRI) found bone lesions in all the patients and bone scintigraphy were positive in 13 patients. All the patients were treated with nonsteroidal anti-inflammatory drugs, among whom 10 cases also treated with oral glucocorticoids, 9 cases with traditional disease modifying anti-rheumatic drugs, 8 cases with bisphosphonates and 6 cases with tumor necrosis factor inhibitors. The pediatric chronic nonbacterial osteomyelitis disease activity score, increased by 70% or more in 13 patients within the initial 6-month follow-up. Conclusions: The clinical manifestations of CNO are lack of specificity. The first symptom of CNO is fever, with or without bone pain and (or) arthralgia, with normal peripheral blood leukocytes, elevated CRP and (or) ESR. Whole body bone scanning combined with MRI can early detect osteomyelitis at subclinical sites, and improve the diagnostic rate of CNO.

[Genotypes and phenotypes of IQSEC2 gene variants related epilepsy]

Objective: To analyze the genotypes and clinical phenotypes of patients with epilepsy associated with IQSEC2 gene variants. Methods: The genotypes, seizure types, electroencephalogram, neuroimage of 6 patients with IQSEC2 gene variants in the Department of Pediatrics, Peking University First Hospital from July 2019 to October 2021 were analyzed. Results: There were 5 males and 1 female. Six variants were de novo, including 2 frameshift variants (c.3801_3808dup/p.Q1270Rfs*130, c.1459_1460delAT/p.M487Vfs*2), 2 nonsense variants (c.3163C>T/p.R1055*, c.1417G>T/p.E473*), 1 in-frame deletion (c.2295_2297del/p.N765del) and 1 missense variant (c.2293A>G/p.N765D). Age at seizure onset ranged from 3 months to 2 years and 5 months. Multiple seizure types were observed, including epileptic spasms in 5 patients, focal seizures in 5 patients, tonic seizures in 3 patients, myoclonic seizures in 3 patients, atypical absence seizures in 2 patients and atonic seizures in 2 patients. All 6 patients showed global developmental delay before seizure onset. There were other clinical manifestations, including autistic features in 3 patients, microcephaly in 3 patients, dystonia in 2 patients and binocular esotropia in 1 patient. The electroencephalogram showed slow background activity and hypsarrhythmia in all 6 patients. Brain magnetic resonance imaging showed abnormal in 5 patients and normal in 1 patient. Five patients were diagnosed with infantile spasms. Among them, 4 patients had late-onset infantile spasms. One patient was unclassified developmental epileptic encephalopathy. The age of last follow-up ranged from 3 years and 2 months to 7 years and 2 months. All 6 patients still had seizures after multiple anti-seizure medications. Conclusions: The seizure onset of patients with IQSEC2 gene variants usually begins after 1 year of age. The common seizure types include epileptic spasms and focal seizures. Patients usually have a global developmental delay before seizure onset. IQSEC2 variants could be related to developmental and epileptic encephalopathy, and most patients are diagnosed with late onset infantile spasms. Epilepsy associated with IQSEC2 gene variants is usually refractory.

Maternal alcohol consumption and risk of postpartum depression: a meta-analysis of cohort studies

OBJECTIVES

The relationship between maternal alcohol consumption and postpartum depression (PPD) is still controversial. The objective of the present study was to assess the association between maternal alcohol consumption and the risk of developing PPD by means of a meta-analysis of cohort studies.

STUDY DESIGN

This was a meta-analysis.

METHODS

PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases were searched up to February 4, 2021, to identify relevant studies that evaluated the association between maternal alcohol consumption and PPD. Meta-analysis was conducted using RevMan software and Stata software. Subgroup and sensitivity analyses were performed to explore the potential heterogeneity source, and Begg's funnel plots and Begg's linear regression test were conducted to assess the potential publication bias.

RESULTS

A total of 12 studies involving 50,377 participants were identified in our study. Overall, pregnant women who were exposed to alcohol were at a significantly greater risk of developing PPD compared with those who did not consume alcohol (odds ratio = 1.21; 95% confidence interval: 1.04-1.41; P = 0.020).

CONCLUSIONS

Maternal alcohol consumption is significantly associated with the risk of developing PPD. These results emphasize the necessity of enhancing health awareness, improving the public health policies and regulations concerning alcohol use, and strengthening the prevention and intervention of maternal alcohol consumption to promote maternal mental health.

[Internal carotid artery embolization in endoscopic salvage surgery for recurrent nasopharyngeal carcinoma: a single-center retrospective study]

Objective: To evaluate the efficiency of internal carotid artery (ICA) embolization technology in endoscopic salvage surgery for recurrent nasopharyngeal carcinoma (rNPC) invading the ICA. Methods: From January 2016 to March 2021, 83 patients with rNPC who invaded the ICA and underwent endoscopic extended nasopharyngectomy were retrospectively collected from the Eye & ENT Hospital in Fudan University, including 60 males and 23 females. The age of the patients ranged from 27 to 77 years. The standard of ICA invasion was that the distance from the lesion to the ICA on enhanced MRI was ≤ 1.8 mm. The clinical characteristics, ICA management strategy and survival prognosis of patients were analyzed, and the effectiveness of ICA embolization was evaluated. Kaplan-Meier method was used to calculate the survival rate and Log-rank test was used to compare the difference. Results: In 83 patients with rNPC, there were 13 patients with rT2, 38 patients with rT3, 32 patients with rT4, and 16 patients had lymph node metastasis. A total of 37 patients (44.6%) underwent ICA coil embolization before surgery, of which 2 cases underwent external carotid-middle cerebral artery artery bypass grafting and ICA embolization due to positive balloon occlusion test (BOT). Patients with positive surgical margin accounted for 24.1% (20/83). Among them, patients with rT4 and patients without ICA embolization had a higher positive rate of surgical margin (P value was 0.001, 0.043, respectively). The 3-year overall survival (OS) and progression free survival (PFS) rate of all patients was 46.5% and 26.7%, respectively. In addition, the 3-year OS and PFS of patients with ICA embolization was significantly higher than those without ICA embolization, respectively (69.1% vs 27.8%, P=0.003; 33.9% vs 18.9%, P=0.018). Only 2 patients (2/37, 5.4%) had cerebral infarction complications after coil embolization of the affected ICA due to negative BOT. Conclusion: Preoperative ICA embolization can be used to treat patients with rNPC invading the ICA, improve the total removal rate and survival rate of patients, which is an effective salvage treatment.

[The application of temporalis muscle flap in the salvage nasopharyngectomy for advanced recurrent nasopharyngeal carcinoma]

Objective: To summarize the application of temporalis muscle flap in the salvage nasopharyngectomy for advanced recurrent nasopharyngeal carcinoma (rNPC), and to provide guidance for the repair of extensive skull base defects in salvage rNPC. Methods: A total of 54 patients with the application of temporalis muscle flap in the salvage nasopharyngectomy for advanced rNPC were retrospectively analyzed, including 42 males and 12 females, aging from 29 to 71 years. There were 36 patients with rT3 and 18 patients with rT4. The surgical methods of temporalis muscle flap repair were summarized. The general situation, survival time and postoperative complications of patients were recorded, and the advantages and disadvantages of temporalis muscle flap were discussed. Results: The temporal muscle flap could completely cover the defect area of nasopharynx and skull base, without the need for other autologous repair materials. The follow-up period was 2 to 28 months. The survival rate of temporalis flap was 98.1% (53/54). The 1-year overall survival rate was 84.5% while 1-year progression-free survival rate was 49.0%. None of the patients had facial nerve injury. Three patients (5.6%) had necrosis of the cranial membrane required surgical intervention and four patients (7.4%) required a chonoplasty due to severe chonostril stenosis or chonostril atresia. Eleven cases (20.4%) had mouth opening restriction, chewing weakness, dysphagia and other eating difficulties. Conclusions: Temporalis muscle flap is an alternative flap for the salvage nasopharyngectomy for advanced rNPC. Temporal muscle flap shows high survival rate and wide coverage, but the surgeon should apprehend the possible complications and reduce the occurrence of them.

[Application of pedicle nasoseptal flap in endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma: an analysis of 39 cases]

Objective: To explore the therapeutic effect and contributing factors of pedicle nasoseptal flap in endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma. Methods: Thirty-nine patients with recurrent nasopharyngeal carcinoma admitted to the Eye, Ear, Nose and Throat Hospital of Fudan University from July 2016 to July 2019 were reviewed, with 19 males and 20 females, aging from 30 to 75 years old. All patients underwent endoscopic nasopharyngectomy, followed by reconstruction with the pedicle nasoseptal flap. The methods of preoperative assessment, mucosal flap preparation and nasopharyngeal reconstruction were summarized, and factors affecting the survival of the pedicle nasoseptal flap were discussed. The rates between groups were compared by Fisher's exact test. Results: Ipsilateral mucosal flap was used in 19 cases while contralateral mucosal flap in 20 cases. After the operation, there were 33 cases with complete epithelialization and 6 cases with flap necrosis. Univariate analysis suggested that the number of radiotherapy courses was an important factor affecting the survival of flap (OR=7.429, 95%CI: 1.120-49.270, P=0.042). However, gender, age, type of transnasal endoscopic nasopharyngectomy, osteonecrosis, side of flap and internal carotid artery resection had no influence on flap survival (all P>0.05). All patients were followed-up for 24 to 60 months. Among them, 8 patients had local recurrence and then operated again, 4 patients survived with systemic metastases and 2 patients died. Conclusion: The pedicle nasoseptal flap is a good material for reconstruction for endoscopic nasopharyngectomy, but it is less effective for patients with multiple course radiotherapy.

Effects of dihydroartemisinin, a metabolite of artemisinin, on colon cancer chemoprevention and adaptive immune regulation

BACKGROUND

Artemisinin (ART) is an anti-malaria natural compound with a moderate anticancer action. As a metabolite of ART, dihydroartemisinin (DHA) may have stronger anti-colorectal cancer (CRC) bioactivities. However, the effects of DHA and ART on CRC chemoprevention, including adaptive immune regulation, have not been systematically evaluated and compared.

METHODS

Coupled with a newly-established HPLC analytical method, enteric microbiome biotransformation was conducted to identify if the DHA is a gut microbial metabolite of ART. The anti-CRC potential of these compounds was compared using two different human CRC cell lines for cell cycle arrest, apoptotic induction, and anti-inflammation activities. Naive CD4⁺ T cells were also obtained for testing the compounds on the differentiation of Treg, Th1 and Th17.

RESULTS

Using compound extraction and analytical methods, we observed for the first time that ART completely converted into its metabolites by gut microbiome within 24 h, but no DHA was detected. Although ART did not obviously influence cancer cell growth in the concentration tested, DHA very significantly inhibited the cancer cell growth at relatively low concentrations. DHA included G2/M cell cycle arrest via upregulation of cyclin A and apoptosis. Both ART and DHA downregulated the pro-inflammatory cytokine expression. The DHA significantly promoted Treg cell proliferation, while both ART and DHA inhibited Th1 and Th17 cell differentiation.

CONCLUSIONS

As a metabolite of ART, DHA possessed stronger anti-CRC activities. The DHA significantly inhibited cell growth via cell cycle arrest, apoptosis induction and anti-inflammation actions. The adaptive immune regulation is a related mechanism of actions for the observed effects.

[CFTR gene variations and phenotypes in seven children]

Objective: To analyze the cystic fibrosis transmembrane conductance regulator (CFTR) gene variations and phenotypes in 7 Chinese children. Methods: In this retrospective study, the data of 7 children with CFTR gene variations admitted to Children's Hospital of Chongqing Medical University from December 2013 to October 2020 were extracted. The general information, clinical manifestations, gene variations, diagnosis and treatment were summarized. Results: Among the 7 children, 2 were males and 5 were females, aged 5.2(0.5-11.3) years. Main clinical manifestations included malnutrition (5 cases), recurrent respiratory infection (4 cases), bronchiectasis (3 cases), steatorrhea (3 cases), vomiting in infancy (2 cases), liver cirrhosis (2 cases), meconium ileus (1 case), metabolic alkalosis and hypochloremia (1 case). A total of 15 variations were found by whole exon sequencing and Sanger sequencing, among which 3 were newly discovered, and 7 were missense mutations. Four children were diagnosed as CF, and the other 3 were diagnosed as CFTR related disease (CFTR-RD). Compared with CF patients, the pancreatic insufficiency and typical CF lung disease were relatively mild in CFTR-RD patients. After treatment, 6 children were clinically improved, while the rest one withdrew treatment due to critical pulmonary infection and disturbance of water-electrolyte metabolism. Conclusions: The loci and phenotypes of CFTR gene variants vary hugely and the pathogenicity of some variations are not clear. Whole exon sequencing can facilitate the identification of CF-and CFTR-RD-causing variaions. For the cases not compatible with CF, CFTR-RD should be considered and evaluated by timely gene detection, so as to carry out appropriate long term management.

[A local case with alveolar echinococcosis in Nanzhang County, Hubei Province]

The diagnosis and treatment of a local case with alveolar echinococcosis was presented. Based on clinical data and epidemiological surveys, this is a rare, local case with alveolar echinococcosis in Nanzhang County, suggesting the possibility of local transmission of echinococcosis. The prevention, control and surveillance of echinococcosis requires to be reinforced in nonendemic areas.

[The endoscopic transnasal approach in management of the sinonasal tumor invading the anterior skull base]

Objective: To evaluate the feasibility of the endoscopic transnasal approach (ETA) and to analyze the outcomes and factors of this surgical technique in the management of the tumor invading the anterior skull base. Methods: A retrospective analysis was performed on 42 patients (31 males and 11 females, with mean age of 49 years) with sinonasal tumor invading the anterior skull base, who underwent ETA from June 2015 to April 2019 in Eye, Ear, Nose and Throat Hospital of Fudan University. Pathologically, there were 15 cases of squamous carcinoma (14 patients with T4bN0M0 and 1 patient with T4bN1M0) and 27 of olfactory neuroblastomas with Kadish stage C. Anterior skull base reconstruction was performed using the vascular pedicled nasoseptal mucoperiosteal flap and fascia lata. Brain non-contrast-enhanced CT was performed on the first postoperative day to exclude massive pneumocephalus, relevant brain edema and subarachnoid hemorrhage. Sinonasal contrast-enhanced MR was performed to assess the extent of the tumor removal. Kaplan-Meier analysis was used to calculate the overall survival (OS) and Cox multivariate regression analysis was used to determine the prognostic factors. Results: The mean duration of the surgery was 452 minutes. Total resection was performed in 36 patients (85.7%), subtotal resection in 2 patients (4.8%) with orbital involvement, partial resection in one patient (2.4%) with injury of the internal carotid artery. One patient (2.4%) underwent the second resection because of the tumor residual, two patients (4.8%) with unsure tumor residual. Mean follow-up was 20 months, with 17 months of median follow-up. One-, two-and three-year overall survival was 86.5%, 76.9% and 64.5%, respectively. For squamous carcinoma, one-, two-and three-year overall survival was 86.2%, 86.2% and 57.4%, respectively. For olfactory neuroblastomas, One-, two-and three-year overall survival was 86.9%, 75.3% and 67.8%, respectively. Multivariate analysis showed that tumor residual (P=0.001) and recurrence (P<0.01) were independent prognostic factors for survival. Conclusions: The ETA is safe and feasible in selected patients with sinonasal tumor invading the anterior skull base. Tumor residual and recurrence are independent prognostic factors for survival.

[Effects of NOX4 on radiosensitivity of nasopharyngeal carcinoma cells by activating the PI3K/AKT pathway]

Objective: To explore the relationship between NOX4 and radiosensitivity of nasopharyngeal carcinoma cells. Methods: Western blot was used to test the expression of NOX4 in nasopharyngeal carcinoma cells (CNE1, CNE2 and HONE1) and normal nasopharyngeal epithelial cells (NP69). The lentiviral vectors for RNA interference and overexpression of NOX4 gene were constructed and nasopharyngeal carcinoma cells were transfected. After treatment with radiation or/and PI3K/AKT inhibitor LY294002, the expressions of related proteins in cells were tested by Western blot, and the cell proliferation was detected by CCK-8 assay and the cell apoptosis was determined by flow cytometry. GraphPad Prism 5 was used for statistical analysis, and P<0.05 was statistically significant. Results: The expressions of NOX4 in nasopharyngeal carcinoma cells were higher than those in normal nasopharyngeal epithelial cells. Compared with the siNC group, the siNOX4 group of nasopharyngeal carcinoma cell had lower proliferation capacity [72 h absorbance (A) value:1.16 vs. 0.75] and higher apoptosis rate (2.9% vs. 10.0%). In contrast,compared with the vector group, the NOX4 group of nasopharyngeal carcinoma cell had higher proliferation capacity [72 h absorbance (A) value: 1.01 vs. 1.32] and lower apoptotic rate (1.7% vs. 1.1%).Treatment with LY294002 for nasopharyngeal carcinoma cells of NOX4 overexpression,compared with the NOX4 group, the proliferation ability of nasopharyngeal carcinoma cells in the NOX4+LY294002 group was reduced (72 h absorbance (A) value: 1.32 vs. 0.77), while the apoptotic rate was increased (1.1% vs. 3.1%).Treatment with radiotherapy, compared with the siNC/Vector group, the proliferation ability of nasopharyngeal carcinoma cells in the siNOX4 group was reduced (72 h absorbance (A) value: 0.72 vs. 0.33), and the apoptotic rate was increased (7.8% vs. 17.3%). However, in the NOX4 group, the proliferation of nasopharyngeal carcinoma cells was enhanced (72 h absorbance (A) value:0.65 vs. 0.78), and the apoptotic rate was reduced (8.1% vs. 3.8%). Compared with the NOX4+radiation group, the proliferation ability of nasopharyngeal carcinoma cells in the NOX4+radiation+LY294002 group was reduced (72 h absorbance (A) value: 0.79 vs. 0.56), while the apoptotic rate was increased (3.8% vs. 8.1%). Conclusion: NOX4 can inhibit radiosensitivity of nasopharyngeal carcinoma cells possibly by activating PI3K/AKT pathway.

[Changes of urinary monocyte chemotactic protein 1 and epidermal growth factor and their correlations with clinicopathology in idiopathic membranous nephropathy patients]

Objective: To explore the changes and clinical value of urinary monocyte chemotactic protein 1 (MCP-1), epidermal growth factor (EGF) and their ratio in patients with idiopathic membranous nephropathy (IMN). Methods: A total of 67 IMN patients were enrolled according to kidney biopsy in the Department of Nephrology of the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2018. The patients included 28 males and 39 females, with an average age of (47.6±14.2) years. Eighteen age-and sex-matched healthy controls were also enrolled. Clinical and pathological data, blood and urine samples of all subjects were collected. Urinary MCP-1 and EGF level were detected by enzyme-linked immunosorbent assay (ELISA). And then the levels of urinary MCP-1, EGF and the ratio of EGF/MCP-1 and their correlations with clinicopathology were analyzed. Results: There was no statistical difference of the urine EGF levels between the two groups [8.3(6.0,12.6) vs 8.4(6.5,10.2) ng/mg Cr, P=0.575]. The urine MCP-1 levels of IMN patients were 0.37 (0.21, 0.69) ng/mg Cr, which was statistical significantly higher than those of the control group [0.09 (0.02, 0.19) ng/mg Cr] (P<0.001), while the EGF/MCP-1 ratio was lower than that of the control group [22.2(15.1,36.6) vs 87.6(71.2,132.7), P<0.001]. Urine MCP-1 was negatively correlated with eGFR (r=-0.303, P=0.012), but positively correlated with the urinary ratio of albumin to creatinin (r=0.368, P=0.002). EGF was positively correlated with eGFR (r=0.722, P<0.001), but negatively correlated with the severity of interstitial fibrosis and renal tubular atrophy (IFTA) (r=-0.312, P=0.011). EGF/MCP-1 ratio was positively correlated with eGFR (r=0.693, P<0.001), but negatively correlated with the severity of the urinary ratio of albumin to creatinin and IFTA (r=-0.261, P=0.028 and r=-0.684, P<0.001, respectively). Further multivariate logistic regression analysis showed that EGF/MCP-1 was a protective factor for moderate-to-severe IFTA (OR=0.891, 95%CI: 0.844-0.949, P=0.008). Conclusion: Patients with IMN have elevated urine MCP-1 level and decreased EGF/MCP-1 ratio, which correlate with clinical indicators. In particular, EGF/MCP-1 ratio is independently related to moderate-severe IFTA, and may be a potential clinical biomarker for diagnosis of IMN.

[Olfaction and sinonasal symptoms in CRSwNP patients with or without atopy]

Objective: Olfactory impairment is commonly observed in chronic rhinosinusitis with nasal polyps(CRSwNP) and has a significant impact on quality of life. However, the risk factors for olfactory impairment have not been fully understood, and whether atopy is predisposed to olfactory impairment in CRSwNP patients remains unclear. The present study aims to unveil differences in olfaction and sinonasal symptoms between CRSwNP with and without atopy by means of a hospital-based, cross-sectional survey. Method: In this study, 288 CRSwNP patients ready for sinus surgery were consecutively enrolled, and atopy, olfaction, sinonasal symptoms and CT scores were evaluated. Result: We found 71.3% of CRSwNP patients presented olfactory loss and 34.5% of them presented olfactory complaint in this cohort (In this study, olfactory impairment has been defined when VAS≥1 and olfactory dysfunction has been defined when VAS≥5）.The decreased olfactory function was associated with sinonasal symptoms(nasal congestion and rhino rhea) and total CT scores (P<0.01), but not with atopy. Multivariate logistic regression revealed that nasal congestion score and total CT score were risk factors for olfactory dysfunction (OR, 1.293 and 1.349; P<0.01) in CRSwNP patients. Conclusion: Our findings indicate atopic condition may not directly cause olfactory impairment, and physician should pay attention to the surgical treatment for local disease severity to improve the olfactory function and quality of life..

Cobalt disulfide-modified cellular hierarchical porous carbon derived from bovine bone for application in high-performance lithium-sulfur batteries

Improving the insulating nature of sulfur and retaining the soluble polysulfides in sulfur cathodes are crucial for realizing the practical application of lithium-sulfur batteries (LSBs). Biomass-based carbon is becoming increasingly popular for fabricating economical and efficient cathodes for LSBs owing to its unique structure. Herein, we report a facile strategy to transform bovine bone with an organic-inorganic structure into cellular hierarchical porous carbon via carbonization and KOH activation, followed by CoS₂ modification through hydrothermal treatment. The synthesized composite can load abundant sulfur and produce a dual effect of "physical confinement and chemical entrapment" on polysulfides. The conductive carbon frame with the developed porous structure provides adequate space to accommodate sulfur and physically suppress the shuttle effect of polysulfides. The embedded half-metallic CoS₂ sites can chemically anchor the polysulfides and enhance the electrochemical reaction activity as well. Owing to the multifunctional structure and dual restraint effect, the designed electrode exhibits enhanced electrochemical properties including high initial capacity (1230.9 mAh g^-1 at 0.2 C), improved cycling stability and enhanced rate capability.

[Retrospective analysis of 188 cases of parapharyngeal space tumors]

Objective:To explore the diagnosis,treatment,surgical approach and prognosis of parapharyngeal space tumors.Method:The clinical data of 188 patients with parapharyngeal space tumor who were treated from January 2007 to December 2016 were analyzed retrospectively.All patients underwent imaging examination before operation.Surgical approach was as follows:transcervical approach applied in 159 cases,endoscopic-assisted transnasal approach in 9 cases,transcervical-transmandibular approach in 8 cases,transcervical-transparotid approach in 8 cases,transoral approach in 7 cases,and infratemporal fossa approach in 4 case.Result:Of the 188 cases,the tumor was benign in nature in 168 cases(89%)and malignant in 20 cases(11%).Complications occurred in 28(15%)patients,with the most common symptom being hoarseness.168 cases of benign tumors were followed up for 10 months to 10 years,and 3 cases were lost and 4 cases had recurrence.All cases underwent re-operation.Patients with malignant tumors received combined treatment after surgery,and 3 cases were lost to follow-up,1 case died of recurrence 9 months after surgery,the rest survived.Conclusion:Surgery is the preferred method for treating parapharyngeal space tumors and postoperative recurrence rate is pretty low.Endoscopy provides a new surgical management method,helping to reduce postoperative complications and recurrence rate.

[One case report of subglottic schwannomaresected with CO₂ laser]

A 26 years female patient was in hospital with repeated asthma, hoarseness and dyspnoea. Fiber laryngoscope examination showed that a mass in subglottic area. The tumor was completelyresected with CO₂ laser and finally diagnosed as subglottic schwannomaby pathological examination. The characteristics of subglottic schwannoma and the resection methods of CO₂ laser were discussed. There was no recurrence in three months follow.

Supplementation with CTGF, SDF1, NGF, and HGF promotes ovine in vitro oocyte maturation and early embryo development

The strategies for improving the in vitro maturation (IVM) of domestic animal oocytes focus on promoting nuclear and cytoplasmic maturation. The identification of paracrine factors and their supplementation in the culture medium represent effective approaches for oocyte maturation and embryo development. This study investigated the effects of paracrine factor supplementation including connective tissue growth factor (CTGF), nerve growth factor (NGF), hepatocyte growth factor (HGF), and stromal derived factor 1 (SDF1) on ovine oocytes and early parthenogenetic embryos using an in vitro culture system. First, we identified the optimal concentrations of CTGF (30 ng/mL), SDF1 (10 ng/mL), NGF (3 ng/mL), and HGF (100 ng/mL) for promoting oocyte maturation, which combined, induced nuclear maturation in 94.19% of oocytes. This combination also promoted cumulus cell expansion and inhibited oocyte/cumulus apoptosis, while enabling a larger proportion (33.04%) of embryos to develop into blastocysts than in the controls and prevented embryo apoptosis. These novel findings demonstrate that the paracrine factors CTGF, SDF1, NGF, and HGF facilitate ovine oocyte and early parthenogenetic embryo development in vitro. Thus, supplementation with these factors may help optimize the IVM of ovine oocytes and early parthenogenetic embryo development strategies.

[The surgical management of nasal skull base schwannoma under endonasal endoscope: a retrospective review of 52 cases]

Objective: To discuss the surgical technique and outcome of nasal skull base schwannoma treated under endonasal endoscope. Methods: Fifty-two patients with nasal skull base nonvestibular schwannoma were treated under endonasal endoscope from May 2006 to June 2017 in Shanghai E&ENT Hospital. Of the patients, there were 21 men and 31 women. The age of the patients ranged from 33 to 71 years.Schwannoma mainly came from trigeminal nerve.Clinical symptoms included facial numbness, facial pain, nasal obstruction, headache, hypopsia, diplopia and tinnitus. Surgical approaches included pure endonasal endoscope approach (18 cases) and endoscopic endonasal resection asissted with sublabial transmaxillary approach (34 cases). Results: Total tumor resection was achieved in 42 patients(80.8%), subtotal resection in 8 patients, and partial resection in 2 patients. The relief rate of facial numbness, facial pain, nasal obstruction, headache, hypopsia, diplopia and tinnitus were 68.8%, 45.5%, 100.0%, 90.0%, 60.0%, 40.0% and 100.0%, respectively. During surgery, cerebrospinal fluid leakage was observed in 5 cases. All cases were successfully repaired with a nasoseptal flap or autologous fascia lata and fat obtained from thigh. Four cases with recurrence were observed in the follow-up period (6-134 months). Conclusion: Endonasal endoscopic approach is a safe and feasible procedure for schwannoma in nasal cavity, paranasal sinus, orbital apex, pterygopalatine fossa, infratomporal fossa, cavernous sinus and Meckel cave.

A cardioid oscillator with asymmetric time ratio for establishing CPG models

Nonlinear oscillators are usually utilized by bionic scientists for establishing central pattern generator models for imitating rhythmic motions by bionic scientists. In the natural word, many rhythmic motions possess asymmetric time ratios, which means that the forward and the backward motions of an oscillating process sustain different times within one period. In order to model rhythmic motions with asymmetric time ratios, nonlinear oscillators with asymmetric forward and backward trajectories within one period should be studied. In this paper, based on the property of the invariant set, a method to design the closed curve in the phase plane of a dynamic system as its limit cycle is proposed. Utilizing the proposed method and considering that a cardioid curve is a kind of asymmetrical closed curves, a cardioid oscillator with asymmetric time ratios is proposed and realized. Through making the derivation of the closed curve in the phase plane of a dynamic system equal to zero, the closed curve is designed as its limit cycle. Utilizing the proposed limit cycle design method and according to the global invariant set theory, a cardioid oscillator applying a cardioid curve as its limit cycle is achieved. On these bases, the numerical simulations are conducted for analyzing the behaviors of the cardioid oscillator. The example utilizing the established cardioid oscillator to simulate rhythmic motions of the hip joint of a human body in the sagittal plane is presented. The results of the numerical simulations indicate that, whatever the initial condition is and without any outside input, the proposed cardioid oscillator possesses the following properties: (1) The proposed cardioid oscillator is able to generate a series of periodic and anti-interference self-exciting trajectories, (2) the generated trajectories possess an asymmetric time ratio, and (3) the time ratio can be regulated by adjusting the oscillator's parameters. Furthermore, the comparison between the simulated trajectories by the established cardioid oscillator and the measured angle trajectories of the hip angle of a human body show that the proposed cardioid oscillator is fit for imitating the rhythmic motions of the hip of a human body with asymmetric time ratios.

[Clinical research of anxiety and depression state among patients suffered from sudden deafness with vertigo]

Objective:To offer the objective evidences for the diagnosis by analyzing anxiety and depression among patients with sudden deafness and vertigo and their possible causes. Method:Eighty patients with sudden deafness and vertigo of single ear as the observation group; 80 patients with sudden deafness without vertigo and 60 healthy people as control group.Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD) are used for quantitative analysis and compare the results of each group score. Result:①The HAMA score of the deafness group with vertigo was significantly higher than that of the group without vertigo and the healthy group (P<0.01). The HAMD score of the deafness group with vertigo was significantly higher than that of the group without vertigo and the healthy group (P<0.01). ②There was correlation between HAMA and sex, age, duration of dizziness, tinnitus, DHI and efficacy grading (P<0.05). There was no correlation between HAMA and the mean hearing threshold, urban and rural distribution, ear fullness (P> 0.05). There was a correlation between HAMD and sex, age, tinnitus, DHI and efficacy grading (P<0.05). There was no correlation between HAMD and the mean hearing threshold, duration of dizziness, urban and rural distribution, ear fullness (P>0.05). Conclusion:There are anxiety and depression in patients with deafness and vertigo. It is mainly related to sex, age, dizziness duration, tinnitus, DHI and grade of efficacy. It is necessary to pay attention to the mental state of patients in clinical treatment. Psychological counseling or treatment can be used to improve clinical efficacy.

Observational evidence of a long-term increase in precipitation due to urbanization effects and its implications for sustainable urban living

Although projected precipitation increases in East Asia due to future climate change have aroused concern, less attention has been paid by the scientific community and public to the potential long-term increase in precipitation due to rapid urbanization. A ten-year precipitation dataset was analysed for both a rapidly urbanized megacity and nearby suburban/rural stations in southern China. Rapid urbanization in the megacity was evident from satellite observations. A statistically significant, long-term, increasing trend of precipitation existed only at the megacity station (45.6mm per decade) and not at the other stations. The increase was attributed to thermal and dynamical modifications of the tropospheric boundary layer related to urbanization, which was confirmed by the results of our WRF-SLUCM simulations. The results also suggested that a long-term regional increase in precipitation, caused by greenhouse gas-induced climate change, for instance, was not evident within the study period. The urbanization-induced increase was found to be higher than the precipitation increase (18.3mm per decade) expected from future climate change. The direct climate impacts due to rapid urbanization is highlighted with strong implications for urban sustainable development and the planning of effective adaptation strategies for issues such as coastal defenses, mosquito-borne disease spread and heat stress mortality.

[Characterization and uncertainty evaluation of aqueous reference materials for cholesterol]

Objective: Characterization and evaluation of the uncertainty of the reference materials of cholesterol in aqueous solution. Methods: The certified reference material GBW09203b was weighed accurately and dissolved into methyl cyclodextrin aqueous solution to prepare six kinds of candidate reference materials of cholesterol according to the concentration. The materials were tested for homogeneity and stability using routine methods and were evaluated the uncertainty derived from the inhomogeneity and instability. The uncertainty due to measurement was derived from the purity of the raw material, the weighing and the density measurement. The certified values and expanded uncertainties were calculated according to the ISO Guide. The expanded uncertainty of the certified value was the combination of standard uncertainty of measurement, inhomogeneity and instability. The coverage factor, k, was determined from the Student's t-distribution corresponding to the calculated effective degrees of freedom and 95% level of confidence. Results: It showed that the six candidate reference materials were homogeneous and were tested to be stable for at least 1 year at -70 ℃ and -20 ℃ using the isochronous stability study. The relative uncertainties due to the inhomogeneity were 0.14%, 0.11%, 0.13%, 0.47%, 0.39% and 0.11%. The relative uncertainty due to the instability was 0.25% at -70 ℃. The uncertainties of measurement were 0.06%, 0.05%, 0.05%, 0.05%, 0.05% and 0.05%.The certified values (reference value ± expanded uncertainty, mmol/L) were as follows: (0.651±0.004), (1.310 ±0.007), (2.574±0.015), (5.210±0.055), (7.710±0.072), (10.242±0.056) mmol/L. Conclusions: Six kinds of certified reference materials for cholesterol in aqueous solution have been prepared, which were homogeneity, stable and reliable. It showed that the uncertainty of measurement was very small compared with the uncertainty due to inhomogeneity and instability.

[Clinical application of hybrid surgery for the treatment of cerebral arteriovenous malformations]

Objective: To investigate the application of hybrid technique for the treatment of cerebral arteriovenous malformations (CAVMs) and to assess the value of hybrid technique. Methods: The cases of CAVMs treated in Qilu hospital and People's Hospital of Xinjiang Uygur Autonomous Region from July 2011 to July 2016 were analyzed retrospectively.Two modes of hybrid surgery, "angiographic diagnosis-craniotomy lesion resection or/and hematoma clearance-intraoperative angiography evaluation" and "angiographic diagnosis-intraoperative embolization-craniotomy lesion resection or/and hematoma clearance-intraoperative angiography evaluation" were applied for all the cases.We placed an aneurysm clip as marker in surgery field during real-time angiography.If CAVMs residues occurred during surgery, we re-resected the residue according to the guidance of the marker (clip) and DSA imaging. Intra-operative angiography evaluated the results of CAVMs resection one more time.Postoperatively, follow-up CT scan was performed for all the patients. Results: Of all the cases with CAVMs, there were 8 cases of scale Ⅰ, 13 cases of scale Ⅱ, 10 cases of scale Ⅲ and 6 cases of scale Ⅳ according to Spetzler-Martin Scale.There were 28 cases of acute hemorrhagic CAVMs and 9 cases of chronic hemorrhagic CAVMs or no-hemorrhagic CAVMs.Intra-operative angiography showed CAVMs residues in 6 cases of acute hemorrhagic CAVMs and only one in chronic group.About 18.92% residual rate of CAVMs were found for the first time intra-operative assessment angiography.With the guidance of intra-operative angiography and aneurysm clip as Marker, all residues of CAVMs were resected totally.Follow up CT showed the hematomas disappeared in all the cases of acute hemorrhagic cases.The cure rate of CAVMs with hybrid surgery was 100% according to the final intra-operative assessment angiography. Conclusions: (1)Hybrid surgery for the treatment of CAVMs in one session could evaluate the results of CAVMs resection and instruct the surgical procedure according to real-time angiography.This model could improve the treatment safety and efficacy for patients with CAVMs.(2)Patients with higher Spetzler-Martin Scale (Ⅲ-Ⅳ) who need intra-operative embolization and patients with hemorrhagic CAVMs are more suitable for hybrid surgery.

[Managements and prognostic analyses in patients with invasive fungal rhinosinusitis]

OBJECTIVE

To evaluate the survival outcomes of invasive fungal rhinosinusitis by analyzing the clinical features.

METHODS

A retrospective analysis was performed for cases of invasive fungal sinusitis proved by histological analysis between March 2006 and November 2015. All relevant factors including interval from the onset of symptoms to initiation of diagnosis, clinical characteristics, features of CT and MRI, treatment and prognosis were collected. A total of 18 patients (10 males; 8 females) were identified. The median age was 54 years old. Three patients suffered from acute invasive fungal sinusitis, while the other 15 suffered from chronic invasive fungal sinusitis.

RESULTS

The mean duration between onset of symptoms and diagnosis was 5 months. The most common symptom was headache (10/18), followed by visual disturbance (7/18), nasal obstruction (4/18), facial numbness and pain (2/18) and diplopia(2/18). Two patients had diabetes mellitus; one patient had ankylosing spondylitis receiving immunosuppressive drugs treatment for one year. Four patients had the disease confined in the sinus. Complications of this disease included orbital apex involvement in 6 patients, intraorbital and optic nerve involvement in 3 patients, cavernous sinus involvement in 5 patients, pterygopalatine fossa and infratemporal fossa involvement in 5 patients, intracranial extension involvement in 3 patients. Fungal species included aspergillus (15 cases) and mucor (3 cases). Seventeen patients received intravenous antifungal therapy after surgery. The duration of follow-up ranged from 1 to 60 months. Two patients reoccurred and one patient died of the disease.

CONCLUSION

Endoscopic debridement combined with intravenous antifungals is efficacious in the management of invasive fungal sinusitis.

Application of combined intraperitoneal and intravenous neoadjuvant chemotherapy in senile patients with advanced ovarian cancer and massive ascites

OBJECTIVE

The aim of this study was to explore the effects of neoadjuvant chemotherapy in senile patients with advanced ovarian can- cer and ascites.

MATERIALS AND METHODS

One hundred eight senile patients with advanced ovarian cancer and ascites were randomly di- vided into two groups: experimental and control groups. Patients in the experimental group were treated with two courses of intraperitoneal combined with intravenous neoadjuvant chemotherapy, followed by cytoreductive surgery, and six courses of intravenous chemotherapy, while the patients in the control group only received cytoreductive surgery and six to eight courses of intravenous chemotherapy.

RESULTS

The operation duration, blood loss, ideal success rate of cytoreductive surgery, and prognosis of the two groups were then compared. Thirty-eight patients in the experimental group successfully received cytoreductive surgery, accounting for 74.14%, while only 23 patients in the control group received cytoreductive surgery successfully, accounting for 46%, showing signifinificantly less than those in the control group (p < 0.001). However, the median survival and the median progression-free survival showed no statistical difference between the two groups (p > 0.05).

CONCLUSIONS

Neoadjuvant chemotherapy can obviously shorten the operation duration, reduce the intraoperative blood loss, and improve the ideal success rate of cytoreductive surgery, but does not obviously improve the prognosis.

[KAP research and intervention effects of health education on prevention and control of occupational diseases in occupational groups in Jinzhou, China]

OBJECTIVE

To investigate the current status of knowledge, attitude, and practice (KAP)on the prevention and control of occupational diseases in occupational groups in Jinzhou, China, and to evaluate the intervention effects of health education.

METHODS

Using the cluster random sampling method, 1000 workers who underwent occupational health examination in Jinzhou Center for Disease Control and Prevention from September 2014 to April 2015 were enrolled in this study. They were equally and randomly divided into intervention group and control group. The intervention group received health education for 6 months through bulletin board, promotion materials, expert lecture, Q&A session, and other relevant educational events. The questionnaire survey was performed before and after intervention. The control group received the questionnaire survey but not the health education.

RESULTS

The overall awareness rate of prevention and control knowledge was 75.34% in 990 workers in Jinzhou, China. After the intervention, the intervention group had a significantly higher awareness rate of prevention and control knowledge than the control group (89.87%~98.86% vs 71.25%~80.82%, P<0.05); the intervention group had a significantly higher attitude accuracy for" whether occupational health examination is necessary or not" and " is willing to received the training on occupational health knowledge" than the control group(χ(2)=57.857, P<0.05; χ(2)=70.683, P<0.05); and the intervention group had a significantly higher rate of correct behavior for" whether help the business management personnel to carry out the prevention and control of occupational diseases or not" and"whether actively understand the occupational hazards of job" (χ(2)=102.186, P<0.05; χ(2)=91.159, P<0.05).

CONCLUSION

Health education can significantly increase the awareness rate of prevention and control knowledge on occupational diseases in occupational groups in Jinzhou, China. However, the more structured and longterm comprehensive intervention is necessary for improving their attitude and behavior.

[Clinical significance of the preoperative neutrophil lymphocyte ratio in the evaluation of the prognosis of laryngeal carcinoma]

OBJECTIVE

To explore the effect of preoperative neutrophil lymphocyte ratio (NLR) on the prognosis of patients with laryngeal carcinoma.

METHODS

Clinical data of 202 patients with laryngeal carcinoma treated from January 2004 to October 2009 were retrospective analyzed to determine the optimal critical value of NLR. To study whether NLR is an independent factor affecting the recurrence and 5-year survival rate of patients with laryngeal cancer after surgery, single factor and multivariate analyses were performed. The factors included age, gender, T stage, pathological differentiation, lymph node metastasis, primary tumor site and NLR value. The relationship between NLR and cervical lymph node metastasis was analyzed.

RESULTS

The optimal critical value of NLR was 2.85, by which cases were divided into high NLR group (NLR≥2.85) and low NLR group (NLR<2.85). Single factor and multivariate analyses indicated that T staging, lymph node metastasis, primary tumor location, and NLR were the independent factors affecting the recurrence of laryngeal carcinoma. T stage and lymph node metastasis were the independent factors affecting 5-year survival rate of laryngeal carcinoma. The increase of NLR value increased the rate of cervical lymph node metastasis.

CONCLUSION

Preoperative NLR level influences the recurrence and cervical lymph node metastasis of laryngeal carcinoma and can be considered a prognosis factor of laryngeal cancer.

Electric field modification of magnetism in Au/La2/3Ba1/3MnO3/Pt device

The La_2/3Ba_1/3MnO₃ film is deposited in a CMOS-compatible Pt/Ti/SiO₂/Si substrate with the oxygen pressure of 10 Pa for investigating magnetoelectric effect. Bipolar resistive switching effect with excellent endurance and retention is observed in this Au/La_2/3Ba_1/3MnO₃/Pt device. Through this effect, a significant nonvolatile change of magnetization is obtained in this device as well. The change of magnetization can be understood by the break and repair of the -Mn³⁺-O²⁻-Mn⁴⁺- chains induced by the electric field through the oxygen vacancies migration. The resistance and magnetization of the Au/La_2/3Ba_1/3MnO₃/Pt device can be simultaneously manipulated by the electric field, which makes it to be a promising candidate for the multifunctional memory devices.

Marker of lipid peroxidation related to diabetic nephropathy in Indonesian type 2 diabetes mellitus patients

OBJECTIVE

Even though diabetes patients exhibit an increased oxidative stress, its correlation with diabetic nephropathy is not fully understood. The purpose of this study was to determine whether lipid peroxidation marker correlates well with eGFR and UACR in type 2 diabetes mellitus patients.

METHODS

We collected urine and serum samples of Indonesian type 2 diabetes mellitus outpatients with normo- and microalbuminuria at a Local Government Clinic (from ages: 39-74 years). Urinary 8-iso-PGF2α was measured by ELISA, the serum malondialdehyde by TBARS assay, and urinary albumin by BCG albumin assay. eGFR was calculated using the corrected-Cockcroft-Gault (CG), MDRD, and CKD-EPI equation. Other necessary data were obtained through questionnaires.

RESULTS

The results showed that the increasing level of malondialdehyde was mildly correlated with the decline in eGFR (MDRD). In contrary, there was a significant positive correlation between 8-iso-PGF2α concentration and eGFR based on the corrected-CG, MDRD study, and CKD-EPI equation (r=0.457, p<0.001; r=0.424, p<0.001; r=0.443, p<0.001). This relationship still persisted in the normoalbuminuric subjects (n=43) (r=0.491, p=0.001; r=0.461, p=0.002; r=0.455, p=0.002). The multivariate analysis showed that 8-iso-PGF2α together with fasting plasma glucose was the most predictive factor for the high 2-quantile eGFR (adjusted OR 1.001, (95% CI, 1.000-1.001)). However, there was no significant correlation between UACR with malondialdehyde (r=0.268, p=0.050) and 8-iso-PGF2α(r=-0.030, p=0.808). UACR itself was inversely correlated with eGFR based on the corrected-CG, the MDRD, and CKD-EPI (r=-0.232, p<0.05; r=-0.228, p<0.05; r=-0.232, p<0.05).

CONCLUSIONS

Increased 8-iso-PGF2α and malondialdehyde in type 2 diabetes mellitus patients may play a role in the pathophysiologic significance of diabetic nephropathy, even while considering the effect of potential confounders.

First Report of Geosmithia pallida Causing Foamy Bark Canker, a New Disease on Coast Live Oak (Quercus agrifolia), in Association with Pseudopityophthorus pubipennis in California

Declining coast live oak (Quercus agrifolia) trees have been observed since 2012 throughout urban landscapes in Los Angeles, Orange, Riverside, Santa Barbara, Ventura, and Monterey counties in California. Symptoms causing branch dieback and tree death included a cinnamon-colored gum seeping through multiple 0.95-mm-diameter entry holes on the bole, followed by a prolific, cream-colored foamy liquid. Beneath the outer bark was phloem and xylem necrosis. Fifty 1- to 2.5-mm adult and larval beetles were collected. Adults fit the morphological description of Pseudopityophthorus pubipennis (western oak bark beetle) (R. Rabaglia, personal communication), and ~800 bp of the mitochondrial COI gene was amplified for three beetles using primer pairs and methods previously described (2,3). All three sequences were identical (GenBank Accession Nos. KJ831289 to 91) and a BLAST search confirmed the closest match (94%) as P. pubipennis. Necrotic wood tissues collected from two trees in each county were cultured on potato dextrose agar amended with 0.01% tetracycline (PDA-tet), and incubated at 25°C for 1 week. Ochre-colored cultures with plane or radially furrowed velutinous mycelium were consistently produced. Fifty conidia each measured from two isolates were 3.66 ± 0.04 μm × 1.77 ± 0.03 μm, and arranged in non-persistent conidial chains, at first roughly parallel, becoming tangled with age. These fungal colonies were observed within gallery walls. The rDNA internal transcribed spacer (ITS) was amplified using primer pairs and methods previously described (5). Three isolates were sequenced and matched 100% to known sequences of Geosmithia pallida in GenBank; sequences of two isolates (UCR2208 and UCR2210) were deposited in GenBank (KJ468687 and KJ468688). Pathogenicity tests were performed by inoculating twelve 27.0-cm detached coast live oak shoots for each isolate with a spore suspension of G. pallida (UCR2208 and UCR2210) and sterile distilled water for controls. A 2-mm-wide, 3-mm-deep hole was drilled into the center of each shoot, 20 μl of a 10⁶ conidia/ml spore suspension was pipetted into the hole, and sealed with Vaseline and Parafilm. The experiment was repeated twice. After 4 weeks in a moist chamber at 25°C, lesions produced by G. pallida averaged 8.3 cm and was significantly longer (ANOVA; P < 0.0001) from the control (average 0.4 cm). G. pallida was re-isolated from all inoculated plants and identified by colony morphology. P. pubipennis is a native beetle, common as a secondary agent, and previously not associated with disease. However, cryptic species may be common among bark and ambrosia beetles (4). A larger sample (i.e., populations and loci) is needed to determine the precise taxonomic status of P. pubipennis. G. pallida was shown to inhibit root growth of Q. petraea by 25% in Europe (1), appears to have affinities with a range of subcorticolous insects, and is widely distributed (5), but there is no published record of the fungus occurring in the United States. This is the first report of G. pallida causing foamy bark canker in association with P. pubipennis on Q. agrifolia in California. Results suggest this new disease complex is causing decline of Q. agrifolia throughout the state. References: (1) D. Cizková et al. Folia Microbiol. 50:59, 2005. (2) A. I. Cognato and F. A. H. Sperling. Mol. Phylogenet. Evol. 14:445, 2000. (3) A. I. Cognato et al. Mol. Phylogenet. Evol. 36:494, 2006. (4) B. H. Jordal and M. Kambestad. Mol. Ecol. Res. 14:7, 2014. (5) M. Kolarík et al. Mycol. Res. 108:1053, 2004.

Large magnetoelectric coupling in Co4Nb2O9

Magnetoelectric materials which simultaneously exhibit electric polarization and magnetism have attracted more and more attention due to their novel physical properties and promising applications for next-generation devices. Exploring new materials with outstanding magnetoelectric performance, especially the manipulation of magnetization by electric field, is of great importance. Here, we demonstrate the cross-coupling between magnetic and electric orders in polycrystalline Co₄Nb₂O₉, in which not only magnetic-field-induced electric polarization but also electric field control of magnetism is observed. These results reveal rich physical phenomenon and potential applications in this compound.

Identification of Species of Botryosphaeriaceae Causing Bot Gummosis in Citrus in California

Members of the Botryosphaeriaceae family are known to cause Bot gummosis on many woody plants worldwide. To identify pathogens associated with Bot gummosis on citrus in California, scion and rootstock samples were collected in 2010 and 2011 from five citrus-growing counties in California. Symptoms observed on citrus included branch cankers, dieback, and gumming. Various fungal species were recovered from necrotic tissues of branch canker and rootstock samples. Species were identified morphologically and by phylogenetic comparison as 'Eureka' lemon, 'Valencia', 'Washington Navel', 'Fukumoto', grapefruit, 'Satsuma', and 'Meyer' lemon. Species were identified morphologically and by phylogenetic comparison of the complete sequence of the internal transcribed spacer regions, β-tubulin gene, and elongation factor α-1 genes with those of other species in GenBank. A consensus-unrooted most parsimonious tree resulting from multigene phylogenetic analysis showed the existence of three major clades in the Botryosphaeriaceae family. In total, 74 isolates were identified belonging to the Botryosphaeriaceae family, with Neofusicoccum spp., Dothiorella spp., Diplodia spp., (teleomorph Botryosphaeria), Lasiodiplodia spp., and Neoscytalidium dimidiatum (teleomorphs unknown) accounting for 39, 25, 23, 10, and 3% of the total, respectively. On inoculated Eureka lemon shoots, lesion length was significantly different (P < 0.05) among 14 isolates recovered from portions of cankered tissues of the original trees. Lesion lengths were significantly longer (P < 0.05) for shoots inoculated with isolates of Neofusicoccum luteum and shorter for shoots inoculated with isolates of Dothiorella viticola (P < 0.05) than those of other species. Identifying the distribution and occurrence of these fungal pathogens associated with Bot gummosis is useful for management applications during occasional outbreaks in California.

Identification and Pathogenicity of Fungal Pathogens Associated with Stem-End Rot of Avocado in California

Stem-end rot of harvested avocado fruit commonly occurs wherever the crop is cultivated. Multiple fungal species have been described as causal agents. To determine the causal pathogens of stem-end rot in California, fungal isolations were conducted from symptomatic fruit, and fungi were identified by morphological and molecular techniques. In 2010 and 2011, a total of 177 isolates were recovered from 290 avocado fruit collected from seven orchards in one of the major avocado growing areas in Southern California. The majority of isolates was identified as Neofusicoccum luteum (65%), with the remainder either as Colletotrichum gloeosporioides (33%) or Phomopsis sp. (2%). In a pathogenicity test, N. luteum caused significantly (P < 0.05) more severe stem-end rot than either C. gloeosporioides or Phomopsis sp. No significant (P > 0.05) differences in stem-end rot severity were observed between inoculations with N. luteum isolated from fruit stem-end rot and N. luteum or N. parvum isolated from branch cankers. This confirms that stem-end rot of avocado can be initiated by fungi causing branch cankers. Although low humidity and rainfall during much of the growing and harvest seasons in California are considered unfavorable conditions for the development of avocado stem-end rot, the identification of the causal pathogens is of value when decays have to be managed during outbreaks, and it stresses the importance of managing branch cankers.

Association of serum arginase I with L-arginine, 3-nitrotyrosine, and exhaled nitric oxide in healthy Japanese workers

The associations of serum arginase I with serum L-arginine, serum 3-nitrotyrosine, and fractional exhaled nitric oxide (FENO) were evaluated cross-sectionally in healthy Japanese workers. The serum median (minimum-maximum) levels of arginase I, 3-nitrotyrosine, and FENO in healthy people (n = 130) were 14.6 (0.94-108.1) ng/mL, 81.0 (0.27-298.6) pmol/mg protein, and 14.0 (5.0-110.0) parts per billion, respectively. Significant correlations of arginase I with FENO, L-arginine, 3-nitrotyrosine, and percent predicted forced expiratory volume in 1 s (FEV1 (% predicted)) were observed, and correlations of FENO with immunoglobulin E (IgE), NOx, arginase I, and sex and allergy were also observed. By multiple regression analysis, arginase I showed positive associations with FENO and 3-nitrotyrosine, and a negative association with L-arginine; and FENO showed positive associations with IgE and NO2(-) + NO3(-) (NOx), and a negative association with L-arginine, as well as an association with sex. Moreover, logistic regression analysis showed linear inverse associations of arginase I and 3-nitrotyrosine with L-arginine, and showed linear positive associations of FENO with IgE and NOx. It was concluded that serum arginase I might regulate serum L-arginine and 3-nitrotyrosine via L-arginine, and that IgE or NOx might regulate FENO in a healthy Japanese population.

Effect of Fungicide Application on the Management of Avocado Branch Canker (Formerly Dothiorella Canker) in California

Members of the Botryosphaeriaceae family have been associated with branch cankers of avocado trees (Persea americana) in California. Canker infections are initiated by spores entering the host plant through fresh wounds such as pruning wounds. With high-density planting becoming more common in the California avocado industry, more intensive pruning may increase the occurrence of branch canker. The objective of this study was to evaluate the preventive ability of some commercial fungicides belonging to different chemical families against fungal pathogens associated with avocado branch canker. Initially, 12 fungicides were tested in vitro for their effect on the inhibition of mycelial growth of three isolates of Dothiorella iberica and isolates (five per species) of Neofusicoccum australe, N. luteum, N. parvum, and Phomopsis sp. Subsequently, azoxystrobin, fludioxonil, metconazole, and pyraclostrobin, selected because of their low effective concentrations that reduce 50% of mycelial growth (EC₅₀ values), and myclobutanil, selected for its high EC₅₀ value, were tested in two field experiments. Azoxystrobin and fludioxonil were used in a premix with propiconazole and cyprodinil, respectively, in field trials. Significant differences (P < 0.05) were observed among fungicides in field trials. Azoxystrobin + propiconazole had the highest percent inhibition at 52 and 62% (internal lesion length) in trial 1 and trial 2, respectively, although this level of inhibition was not significantly different from that of metconazole. A significant correlation (r = 0.51, P < 0.05) was observed between internal lesion length data in the field experiment and EC₅₀ data from in vitro fungicide screening. Application of azoxystrobin + propiconazole and metconazole can play a key role in protecting Californian avocado against fungi causing avocado branch canker.

Bilateral prediction and intersection calculation autofocus method for automated microscopy

In this paper, a bilateral prediction and intersection calculation autofocus method for automated microscopy, which obtains the in-focus position by calculating the intersection of the predicted left and right focus measure curves located respectively in the left and right sides of the peak position of the focus measure curve, is proposed and performed. According to the autofocus method, the area including the peak position of the focus measure curve and its left and right neighbourhoods should be determined firstly, and the left and right neighbourhoods are considered as the left and right sampling areas. The left and right focus measure curves are predicted by appropriate predicting models according to the two sample sequences, which comprise the focus values by evaluating the sampled images in the left sampling area and right sampling area, respectively and their corresponding sampling positions. The intersection of the predicted left and right focus measure curves is calculated and can be considered as the in-focus position. The autofocus can be realized by moving the focus plane of the microscope to the intersection of the predicted left and right focus measure curves. The proposed bilateral prediction and intersection calculation autofocus method is experimentally verified in an automated light microscopy for implementing microassembly and micromanipulation. The theoretical analyses have shown that the proposed bilateral prediction and intersection calculation autofocus method can not only effectively avoid the principle error caused by assuming the symmetrical focus measure curve in the autofocus methods based on curve fitting, but also eliminate the possible waver search near the peak position in the modified fast climbing servo method. The experimental results have shown that the proposed bilateral prediction and intersection calculation autofocus method possesses the merits as follows: (1) the focusing accuracy is high and slightly affected by the sampling step size and (2) the focusing speed is higher than those of the 7-point hill-climbing search method and the quadratic curve fitting method with a determinate focusing accuracy.

First Report of a Fusarium sp. and Its Vector Tea Shot Hole Borer (Euwallacea fornicatus) Causing Fusarium Dieback on Avocado in California

Per capita consumption of avocado in the United States has nearly doubled between 2000 and 2010. The California avocado industry supplies almost 40% of U.S. demand and the remaining 60% is supplied by imports from Latin America and New Zealand. The Tea Shot Hole Borer (TSHB) is an ambrosia beetle from Asia that forms a symbiosis with a new, yet undescribed Fusarium sp. and is a serious problem for the Israeli avocado industry (3). The beetle also causes severe damage on the branches of tea (Camelia sinensis) in Sri Lanka and India (1). In California, TSHB was first reported on black locust (Robinia pseudoacacia) in 2003, but there are no records of fungal damage (4). In 2012, nine backyard avocado trees (cvs. Hass, Bacon, Fuerte, and Nabal) exhibiting branch dieback were observed throughout the residential neighborhoods of South Gate, Downey, and Pico Rivera in Los Angeles County. Upon inspection, symptoms of white powdery exudate, either dry or surrounded by wet discoloration of the outer bark in association with a single beetle exit hole, were found on the trunk and main branches of the tree. Examination of the cortex and wood under the exit hole revealed brown discolored necrosis. The TSHB was also found within galleries that were 1 to 4 cm long going against the grain. Symptomatic cortex and sapwood tissues were plated onto potato dextrose agar amended with 0.01% tetracycline (PDA-tet). The TSHB was dissected and plated onto PDA-tet after surface disinfestation following methods described by Kajimura and Hijii (2). After 5 days of incubation at room temperature, regular fungal colonies with aerial mycelia and reddish brown margins were produced. Single spore isolations were used to establish pure culture of the fungus. Fifty conidia were hyaline, clavate with a rounded apex, and initially aseptate (4.1 to 12.0 × 2.4 to 4.1 μm) becoming one- to three-septate (7.6 to 15.1 × 2.8 to 4.5 μm, 9.2 to 17.2 × 3.4 to 4.8 μm, and 13.5 to 17.6 × 4.3 to 4.7 μm, respectively). Identity of the fungal isolates was determined by amplification of the rDNA genes with primers ITS4/5 and EF1/2, respectively. Sequences were deposited into GenBank under Accession Nos. JQ723753, JQ723760, JQ723756, and JQ723763. A BLASTn search revealed 100% similarity to Fusarium sp. (Accession Nos. JQ038020 and JQ038013). Detached green shoots of healthy 1-year-old avocado were wounded to a depth of 1 to 2 mm and 5-mm mycelial plugs from 5-day-old cultures (UCR 1781 and UCR 1837) were placed mycelial side down onto the freshly wounded surfaces and then wrapped with Parafilm. Control shoots were inoculated with sterile agar plugs and five replicates per treatment were used. Shoots were incubated at 25 ± 1°C in moist chambers for 3 weeks. Lesions were observed on all inoculated shoots except for the control. Mean lesion lengths were 10.7 and 12.8 cm for UCR1781 and UCR1837, respectively, and were significantly different (P ≤ 0.05) from the control. Both isolates were reisolated from 100% of symptomatic tissues of inoculated shoots to complete Koch's postulates. This experiment was conducted twice and similar results were obtained. To our knowledge, this is the first report of Fusarium sp. and its vector E. fornicatus causing Fusarium dieback on Avocado in California. References: (1) W. Danthanarayana. Tea Quarterly 39:61, 1968. (2) H. Kajimura and N. Hijii. Ecol. Res. 7:107, 1992; (3) Mendel et al., Phytoparasitica, DOI 10.1007/s12600-012-0223-7, 2012. (4) R. J. Rabaglia. Annals Entomol. Soc. Amer. 99:1034, 2006.

In-line silica capillary tube all-silica fiber-optic Fabry-Perot interferometric sensor for detecting high intensity focused ultrasound fields

Aiming at detecting high intensity focused ultrasound (HIFU) fields, this letter reports on a novel in-line silica capillary tube all-silica fiber-optic Fabry-Perot (ILSCT-ASFP) interferometric sensor fabricated by splicing a commercially available silica capillary tube to two single-mode fibers. The experimental results show that such a novel ILSCT-ASFP interferometric sensor with a cavity length of ∼60.76 μm has an excellent fringe visibility of up to ∼20 dB, and the fringe visibility is still good when the cavity length extends up to ∼1031.07 μm. The measured wavelength-temperature sensitivity of 0.000858 nm/°C shows that the wavelength drift of the fabricated ILSCT-ASFP interferometric sensor towards temperature is extremely low. Meanwhile, the measurement of HIFU fields by this novel sensor is demonstrated, and the experimental results indicate that the signal-to-noise ratio of the sensing system for sensing a 0.93 MHz HIFU field with a pressure of 2.69 MPa in the focus area can reach 42.8 dB. The corresponding noise equivalent pressure is 0.0194 MPa, and the calculated acoustic sensitivity is 65.4 mV/MPa over a 2.5 MHz measurement bandwidth.