[Spatial Distribution of Aerobic Bacteria, Sources and Risks of Nitrogen and Phosphorus in Taihu Lake Sediments]

The release of nitrogen and phosphorus from sediments into lake water will exacerbate the eutrophication of lakes and endanger ecological safety and human health. Microorganisms are indispensable in nitrogen and phosphorus conversion, and accurate analysis of the distribution characteristics and sources of nitrogen and phosphorus in sediments as well as their relationship with microorganisms is an important prerequisite for lake eutrophication control. Taking Taihu Lake as the study area, 30 surface sediment samples were collected, and the grain size, pH, organic matter (OM), dissolved organic carbon (DOC), total phosphorus (TP), total nitrogen (TN), nitrate nitrogen (NO3--N), and dissolved organic nitrogen (DON) along with some other index contents were measured and analyzed; accordingly, spatial distribution characteristics were analyzed. While using nutrient agar (NA), the number of aerobic bacteria (AB) was determined by plate counting in the medium. Combined with principal component analysis (PCA) and Pearson correlation analysis, the spatial distribution characteristics and sources of sediments and AB in Taihu Lake were explored. The characteristics of sediment pollution in Taihu Lake were studied using the comprehensive pollution index and the organic pollution index methods. The results revealed that the average sediment indicators of the surface layer of Taihu Lake were as follows:AB was 9.25×104 CFU·g-1, average particle size (MZ) was 17.59 μm, pH was 7.62, ω(OM) was 15.05 g·kg-1, ω(DOC) was 71.60 mg·kg-1, ω(TP) was 598.13 mg·kg-1, ω(TN) was 1113.92 mg·kg-1, ω(NO3--N) was 3.22 mg·kg-1, and ω(DON) was 22.60 mg·kg-1. The comprehensive pollution index (FF) showed that 13% of the Taihu Lake was moderately polluted, while 87% was heavily polluted. Excluding the area in the center of the lake, the southern lake area, and some lakes in the western part of the East Taihu Lake, TN in the rest of the area was moderately and severely polluted. In addition to the heavy pollution of Zhushan Bay, the TP in Taihu Lake was generally at light and moderate pollution. The organic pollution index (OI) showed that the organic pollution of the sediments of Taihu Lake was relatively light, majorly caused by organic nitrogen (ON) pollution. DOC, DON, TN, and OM in Taihu Lake were primarily derived from the influence of aquatic plants, and TP And AB were primarily derived from the influence of the external input of rivers. This research will provide theoretical support for lake eutrophication treatment and also provide new ideas for further analysis of AB to remove nitrogen and phosphorus pollution from sediments.

[A comparative study of the curative effects between butterfly-shaped flap and propeller flap based on the dorsal branch of digital artery in repairing the wound in volar aspect of finger]

Objective: To compare the curative effects of butterfly-shaped flap based on the dorsal branch of digital artery (hereinafter referred to as butterfly-shaped flap) and propeller flap based on the dorsal branch of digital artery (hereinafter referred to as propeller flap) in repairing the wound in volar aspect of finger. Methods: A retrospective cohort study was conducted. From August 2018 to April 2022, 16 patients with finger palmar wounds admitted to Ruijin Hospital of Shanghai Jiao Tong University School of Medicine and 7 patients with finger palmar wounds admitted to General Hospital of PLA Central Theater Command met the inclusion criteria, including 14 males and 9 females, aged 25 to 64 years. After debridement or resection of skin benign tumor, the wounds ranged from 0.5 cm×0.5 cm to 1.5 cm×1.5 cm. According to the different rotation axes of flap pedicle during wound repair, the patients were divided into butterfly-shaped flap group (8 cases) and propeller flap group (15 cases), and their wounds were repaired by butterfly-shaped flap (with area of 0.5 cm×0.5 cm-1.5 cm×1.3 cm) or propeller flap (with area of 0.7 cm×0.5 cm-1.5 cm×1.5 cm) , respectively. In propeller flap group, wounds in the donor sites were repaired by full-thickness skin grafts taken from the palms of wrists or the groin. The surgical time, postoperative complications, flap survival, and wound healing time of patients in the two groups were recorded. Data were statistically analyzed with independent sample t test, Mann Whitney U test, or Fisher's exact probability test. Results: The surgical time and postoperative wound healing time of patients in butterfly-shaped flap group ((43±9) min and (13.1±0.8) d, respectively) were both significantly shorter than those in propeller flap group ((87±16) min and (16.7±4.6) d, respectively, with t values of -7.03 and -2.86, respectively, P<0.05). The postoperative flap survival and complications of patients between the two groups were both similar (P>0.05). Conclusions: For repairing the wound in volar aspect of finger, the butterfly-shaped flap has more advantages in comparison with the traditional propeller flap. The butterfly-shaped flap has a short surgical time and fast postoperative recovery, which is worthy of clinical promotion.

On the use of Monkhorst-Pack scheme to evaluate superconductivity and the issue of umklapp electron-phonon interactions

The Monkhorst-Pack scheme is a method to save time in the days of slow computers. It excludes umklapp phonons with significant consequences. Its widespread application to evaluate superconductivity arises from the desire to reduce phonon contributions to solve a historical difficulty of the BCS theory. An alternative method turns out to be more accurate in Pb and Pd.

[Angiogenesis and pulmonary fibrosis]

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and irreversible lung interstitial disease characterized by repeated damage and accompanied by fibrotic repair, which ultimately leads to structural disorder and destruction of lung tissue, resulting in honeycomb lung. The exact pathogenesis of IPF has not been fully elucidated, and among the many mechanisms, angiogenesis may also be one of the initiating factors of IPF. Chronic, progressive microvascular remodeling disorder has been proved to exist in IPF. This article reviewed the relationship between angiogenesis and development of pulmonary fibrosis in terms of inducement, regulatory factors, regulatory mechanisms, generate rules and therapeutic targets.

[Epidemiological characteristics and influencing factors of Blastocystis hominis infection among children with diarrhea under five years of age in Guangzhou City]

OBJECTIVE

To investigate the prevalence and influencing factors of Blastocystis hominis infection among children with diarrhea under five years of age in Guangzhou City.

METHODS

Children with diarrhea under 5 years of age admitted to Guangzhou Children's hospital, Guangzhou Maternity and Child Healthcare Hospital and Guangzhou Women and Children's Medical Center during the period between January 1 and December 31, 2020, were enrolled. Participants' demographics, living environments and health status were collected using questionnaire surveys. Stool samples were collected from participants and nucleic acid was extracted. B. hominis infection was identified using PCR assay and sequence alignment, and the factors affecting B. hominis infection among children with diarrhea under 5 years of age were identified using univariate analysis and multivariate logistic regression analysis.

RESULTS

A total of 684 children with diarrhea under 5 years of age were enrolled, including 468 male children and 216 female children, with a mean age of (1.79 ± 1.12) years. The overall prevalence of B. hominis infection was 4.97% [34/684, 95% confidential interval (CI): (3.59%, 6.86%)] among participants, and there was no significant difference in the prevalence of B. hominis infection between children with chronic [7.52% (20/266), 95% CI: (4.92%, 11.33%)] and acute diarrhea [3.35% (14/418), 95% CI: (2.01%, 5.54%)] (χ² = 5.983, P = 0.014). Multivariate logistic regression analysis identified keeping pet [odds ratio (OR) = 6.298, 95% CI: (2.711, 14.633)], drinking non-tap water [OR = 4.522, 95% CI: (1.769, 11.561)], lactose intolerance [OR = 4.221, 95% CI: (1.043, 17.087)], antibiotic use [OR = 0.125, 95% CI: (0.017, 0.944)] and chronic diarrhea [OR = 2.172, 95% CI: (1.018, 4.637)] as factors affecting B. hominis infection among children with diarrhea under 5 years of age in Guangzhou City.

CONCLUSIONS

B. hominis infections is detected in children with diarrhea under five years of age in Guangzhou City. Improving home environments and pet-keeping hygiene is recommended to reduce the likelihood of B. hominis infection among children.

[Effects of bariatric surgery on sex hormones in male patients with obesity]

Objective: To analyze and evaluate the differences in sex hormones after laparoscopic Roux-en-Y Gastric Bypass Surgery (LRYGB) and laparoscopic sleeve gastrectomy (LSG) in male patients with obesity. Methods: This study was a retrospective cohort study. The inclusion criteria were (1) male patients with obesity who met the surgical indications of the "Chinese Guidelines for Surgical Treatment of Obesity and Type 2 Diabetes" (2019 Edition); (2) patients with a body mass index (BMI) of ≥27.5 kg/m2 and obesity-related metabolic diseases, or patients with severe obesity and a BMI of ≥35 kg/m2; and (3) sex hormone levels checked 1 year after surgery. The exclusion criteria included (1) patients with endocrine diseases (thyrotoxicosis, hyperprolactinemia) and hypothalamic-pituitary lesions and (2) those with severe major organ dysfunction who could not tolerate anesthesia or surgery. According to the above criteria, the clinical data of male patients with obesity admitted to the Gastrointestinal Surgery/Bariatric Center of the First Affiliated Hospital of Jinan University from October 2017 to January 2020 were included. A total of 52 male patients with obesity were included in this study. The mean age, body weight, BMI, and total testosterone level were (29.3±10.2) years, (123.6±35.4) kg, (40.1±11.1) kg/m², and 7.6 (5.5, 9.1) nmol/L, respectively. Forty-five patients (86.5%) exhibited testosterone deficiency. Among all the patients, 29 underwent LSG (LSG group) and 23 underwent LRYGB surgery (LRYGB group). The main outcome measure was the change in sex hormone levels before and after bariatric surgery in all the patients. The secondary outcome measures were the comparison of changes in sex hormone levels before and after LSG and LRYGB. Results: Pearson correlation analysis showed that preoperative estradiol was positively correlated with waist circumference (R=0.299, P<0.05), hip circumference (R=0.326, P<0.05), and chest circumference (R=0.388, P<0.05). Testosterone was negatively correlated with BMI (R=-0.563, P<0.01), waist circumference (R=-0.521, P<0.01), hip circumference (R=-0.456, P<0.01), chest circumference (R=-0.600, P<0.01), and neck circumference (R=-0.547, P<0.01). One year following bariatric surgery, the serum testosterone (7.6 [5.5, 9.1] nmol/L vs. 13.6 [10.5, 15.4] nmol/L, Z=-5.910, P<0.001), follicle-stimulating hormone (4.7 [2.7, 5.3] IU/L vs. 6.5 [3.6, 7.8] IU/L, Z=-4.658, P<0.001), and progesterone (1.2 [0.4, 1.5] nmol/L vs. 1.9 [0.8, 1.3] nmol/L, Z=-2.542, P=0.011) levels were significantly higher in all the patients. Both estradiol (172.8 [115.6, 217.5] pmol/L vs. 138.3 [88.4, 168.1] pmol/L, Z=-2.828, P=0.005) and prolactin (11.4 [6.4, 14.6] mIU/L vs. 8.6 [4.8, 7.3] mIU/L, Z=-2.887, P=0.004) levels were decreased. In addition to prolactin levels in the LRYGB group, there were statistically significant differences in the levels of estradiol (P=0.030), follicle-stimulating hormone (P < 0.001), luteinizing hormone (P=0.033), progesterone (P=0.034), and testosterone (P<0.001) compared with their preoperative levels. In the LSG group, there were statistically significant differences in the levels of follicle-stimulating hormone (P=0.011), prolactin (P=0.023), and testosterone (P<0.001) compared with their preoperative levels. Conclusion: The degree of obesity in men was negatively correlated with testosterone levels. Both LRYGB and LSG can significantly improve sex hormone levels in male patients with obesity, and testosterone levels show a significant increase after surgery.

[Observation on the clinical effect of self-designed modified rhomboid skin flap in facial wound repair]

Objective: To investigate the clinical effect of self-designed modified rhomboid flap in repairing rhomboid, round, and teardrop-shaped wounds on the face. Methods: A retrospective observational study was conducted. From August 2018 to April 2020, 30 patients with facial lesions admitted into Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the People's Hospital of Jianchuan County in Yunnan province met the inclusion criteria, including 16 males and 14 females, aged 23 to 88 years. The wound area ranged from 1.0 cm×1.0 cm to 7.0 cm×5.0 cm, with 10 cases of rhomboid wounds, 12 cases of round wounds, and 8 cases of teardrop-shaped wounds. The self-designed modified rhomboid flaps were applied to repair the wounds and after that, the patients were followed up for 1 to 18 months to record the survival of flaps, wound tension, scar formation and complications after surgery. Results: No necrosis or blackening was observed at the tip of the flaps after surgery. All the flaps survived and the wounds healed well with little tension, minimal scars, and no complications. Conclusions: The self-designed modified rhomboid flap is especially suitable for facial wounds with multiple important organs, multiple anatomical subunits, and areas with large changes in soft tissue tension, which can reduce not only the rotation of the flap, but also unnecessary excision of normal skin and soft tissue.

[Construction of a forecast system for prediction of schistosomiasis risk in China based on the flood information]

OBJECTIVE

To create a model based on meteorological data to predict the regions at risk of schistosomiasis during the flood season, so as to provide insights into the surveillance and forecast of schistosomiasis.

METHODS

An interactive schistosomiasis forecast system was created using the open-access R software. The schistosomiasis risk index was used as a basic parameter, and the species distribution model of Oncomelania hupensis snails was generated according to the cumulative rainfall and temperature to predict the probability of O. hupensis snail distribution, so as to identify the regions at risk of schistosomiasis transmission during the flood season.

RESULTS

The framework of the web page was built using the Shiny package in the R program, and an interactive and visualization system was successfully created to predict the distribution of O. hupensis snails, containing O. hupensis snail surveillance site database, meteorological and environmental data. In this system, the snail distribution area may be displayed and the regions at risk of schistosomiasis transmission may be predicted using the species distribution model. This predictive system may rapidly generate the schistosomiasis transmission risk map, which is simple and easy to perform. In addition, the regions at risk of schistosomiasis transmission were predicted to be concentrated in the middle and lower reaches of the Yangtze River during the flood period.

CONCLUSIONS

A schistosomiasis forecast system is successfully created, which is accurate and rapid to utilize meteorological data to predict the regions at risk of schistosomiasis transmission during the flood period.

[Risk factor analysis on anastomotic leakage after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy and establishment of a nomogram prediction model]

Objective: To investigate the risk factors of anastomotic leakage (AL) after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy and construct a nomogram prediction model. Methods: This study was a retrospective case-control study that collected and reviewed the clinicopathological data of 359 patients who underwent laparoscopic surgery from January 2012 to January 2018, including 202 patients from the Department of General Surgery, Nanfang Hospital of Southern Medical University and 157 patients from the Department of Gastrointestinal Surgery of Fujian Provincial Cancer Hospital. Inclusion criteria: (1) age ≥ 18 years old; (2) diagnosis as rectal cancer by biopsy before treatment; (3) distance from tumor to anus within 12 cm; (4) locally advanced stage (T3-T4 or N+) diagnosed by imaging (CT, MRI, PET or ultrasound); (5) standardized neoadjuvant therapy followed by laparoscopic radical operation. Exclusion criteria: (1) previous history of colorectal cancer surgery; (2) short-term or incomplete standardized neoadjuvant therapy; (3) Miles, Hartmann, emergency surgery, palliative resection; (4) conversion to open surgery. Clinicopathological data, including age, gender, body mass index (BMI), preoperative albumin, distance from tumor to anus, operation hospital, American Society of Anesthesiologists score (ASA score), operation time, T stage, N stage, M stage, TNM stage, pathological complete response (pCR) were analyzed with univariate analysis to identify predictors for AL after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy. Then, incorporated predictors of AL, which were screened by multivariate logistic regression, were plotted by the "rms" package in R software to establish a nomogram model. According to the scale of the nomogram of each risk factor, the total score could be obtained by adding each single score, then the corresponding probability of postoperative AL could be acquired. The area under ROC curve (AUC) was used to evaluate the predictive ability of each risk factor and nomogram on model. AUC > 0.75 indicated that the model had good predictive ability. The Bootstrap method (1000 bootstrapping resamples) was applied as internal verification to show the robustness of the model. The discrimination of the nomogram was determined by calculating the average consistency index (C-index) whose rage was 0.5 to 1.0. Higher C-index indicated better consistency with actual risk. The calibration curve was used to assess the calibration of prediction model. The Hosmer-Lemeshow test yielding a non-significant statistic (P>0.05) suggested no departure from the perfect fit. Results: Of 359 cases, 224 were male, 135 were female, 189 were ≥ 55 years old, 98 had a BMI > 24 kg/m(2), 176 had preoperative albumin ≤ 40 g/L, 128 had distance from tumor to anus ≤ 5 cm, 257 were TNM 0-II stage, 102 were TNM III-IV stage, and 84 achieved pCR after neoadjuvant therapy. The incidence of postoperative AL was 9.5% (34/359). Univariate analysis showed that gender, preoperative albumin and distance from tumor to the anus were associated with postoperative AL (All P<0.05). Multivariate logistic regression analysis revealed that male (OR=2.480, 95% CI: 1.012-6.077, P=0.047), preoperative albumin ≤40 g/L (OR=5.319, 95% CI: 2.106-13.433, P<0.001) and distance from tumor to anus ≤ 5 cm (OR=4.339, 95% CI: 1.990-9.458, P<0.001) were significant independent risk factors for postoperative AL. According to these results, a nomogram prediction model was constructed. The male was for 55 points, the preoperative albumin ≤ 40 g/L was for 100 points, and the distance from tumor to the anus ≤ 5 cm was for 88 points. Adding all the points of each risk factor, the corresponding probability of total score would indicated the morbidity of postoperative AL predicted by this nomogram modal. The AUC of the nomogram was 0.792 (95% CI: 0.729-0.856), and the C-index was 0.792 after internal verification. The calibration curve showed that the predictive results were well correlated with the actual results (P=0.562). Conclusions: Male, preoperative albumin ≤ 40 g/L and distance from tumor to the anus ≤ 5 cm are independent risk factors for AL after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy. The nomogram prediction model is helpful to predict the probability of AL after surgery.

[Clinical research about needle-tract assisted standard percutaneous nephrolithotomy for the treatment of complicated upper urinary tract calculi]

Objective: To investigate the safety and efficacy of needle-tract assisted standard percutaneous nephrolithotomy (PCNL) for the treatment of complicated upper urinary tract calculi. Methods: The clinical data of 1 562 patients with complicated upper urinary calculi who received standard PCNL from December 2013 to December 2017 at Department of Urology, the First Affiliated Hospital of Xiamen University were retrospectively analyzed. There were large residual stones in 256 patients through B-ultrasound exploration after standard PCNL, could't be detected with nephoscope in standard PCNL tracts. 16 F mini PCNL tract were established in 120 cases for treatment of residual stones, while needle-tract were established in order to guide nephroscope to find residual stones in 126 cases. Needle-tract were transferred to 16 F mini PCNL tract for treatment of residual stones in 10 patients if these residual stones could't be detected through needle-tract. Operation time, change of hemoglobin level after operation, incidence of postoperative complications, time of hospitalization and rate of stone clearance were measured in two groups. The statistical methods used included t test, Wilcoxon rank sum test, and χ² test. Results: There were 1 to 3 mini tracts (M(Q_R): 1(1)) established in the mini tracts group and 1 to 7 needle-tracts (M(Q_R): 3(2)) established in the needle-tract group (Z=-10.57, P=0.000). Compared with mini tract group, the operation time ((62.0±18.0) minutes vs. (84.0±15.5) minutes, t=10.242, P=0.000), hospitalization time ((4.40±0.86) days vs. (5.20±0.81) days, t=7.570, P=0.049), hemoglobin dropped ((1.31±0.47) g/L vs. (2.74±0.63) g/L, t=20.12, P=0.000), and incidence of postoperative complications (7.9% (10/126) vs. 19.2% (23/120), χ²=6.674, P=0.01) of needle-tract group were lower, while postoperative stone clearance rate was higher (89.7% vs. 76.7%, χ²=7.497, P=0.006). No perioperative severe complications such as pleural injury, pneumatothorax, perforation of renal, trauma of abdominal organ occurred in two groups. Conclusion: Needle-tract assisted standard PCNL for the treatment of complicated upper urinary calculi can significantly improve stone clearance rate, reduce operation time, decrease risk of kidney and surrounding organs damage.

[Influencing factors and clinical significance of severe hypocalcemia in patients with extremely severe burns in early stage]

Objective: To analyze the influencing factors and clinical significance of severe hypocalcemia in patients with extremely severe burns in early stage. Methods: Clinical data of 142 patients with extremely severe burns admitted to our wards from January 2010 to July 2015, conforming to the study criteria, were retrospectively analyzed. (1) The incidence of hypocalcemia and severe hypocalcemia on admission were calculated. (2) Patients were divided into the male group (n=113) and the female group (n=29) according to gender. The levels of serum calcium of patients whose age more than 55 years old and less than or equal to 55 years old in the two groups were compared with t test. (3) Patients were divided into severe hypocalcemia group (n=52) and non-severe hypocalcemia group (n=90) according to the level of serum calcium on admission. The data including gender, age, flame burn, total burn area, inhalation injury, admission time, the pH value, and the albumin level of patients on admission between two groups were compared with chi-square test or t test. Indexes with P<0.1 between two groups were selected, and multivariate logistic regression analysis was conducted to screen the influencing factors of severe hypocalcemia in patients with extremely severe burns in early stage. (4) According to the prognosis, patients were divided into survival group (n=112) and non-survival group (n=30). The data including gender, age, flame burn, total burn area, inhalation injury, admission time, the level of serum calcium, the pH value, and the albumin level of patients on admission between two groups were compared with chi-square test or t test. Indexes with P<0.1 between two groups were selected, and multivariate Cox regression analysis was conducted to screen the influencing factors of prognosis of patients with extremely severe burns. Results: (1) The incidence of hypocalcemia on admission was 97.2% (138/142), and patients diagnosed as severe hypocalcemia accounted for 36.6% (52/142). (2) In the male group, the level of serum calcium of patients with age more than 55 years old was (1.84±0.19) mmol/L, which was close to (1.88±0.21) mmol/L of patients with age less than or equal to 55 years old within the same group and (1.96±0.13) mmol/L of patients with age more than 55 years old in the female group (t=0.833, 1.560, P>0.05). In the female group, the level of serum calcium of patients with age less than or equal to 55 years old was (1.78±0.19) mmol/L, which was significantly lower than that of patients with age less than or equal to 55 years old in the male group and that of patients with age more than 55 years old in the female group (t=-2.197, -2.472, P<0.05). (3) Compared with those of patients in severe hypocalcemia group, the total burn area and the proportion of inhalation injury of patients in non-severe hypocalcemia group were obviously smaller (t=2.379, χ(2) =13.410, P<0.05 or P<0.01), and the admission time was obviously earlier (t=2.675, P<0.01), while the albumin level was obviously higher (t=-6.163, P<0.01). There were no statistically significant differences between patients of the two groups in gender, flame burn, age, and the pH value on admission (χ(2)=1.869, 2.850, t=-0.578, 0.645, P>0.05). Multivariate logistic regression analysis showed that only the albumin level on admission was the independent influencing factor of severe hypocalcemia in patients with extremely severe burns (with odds ratio 1.179, 95% confidence interval 1.092-1.273, P<0.01). (4) Compared with those of patients in non-survival group, the total burn area and the proportion of inhalation injury in survival group were smaller (t=-5.515, χ(2)=27.573, P<0.05 or P<0.01), while the pH value and the albumin level on admission were higher (t=2.208, 3.321, P<0.05 or P<0.01). There were no statistically significant differences between patients of the two groups in gender, flame burn, age, admission time, and the level of serum calcium on admission (χ(2)=0.198, 2.545, t=-1.316, -1.397, 1.857, P>0.05). Multivariate Cox regression analysis showed that total burn area and inhalation injury were the independent risk factors to predict prognosis of patients with extremely severe burns (with relative risk 1.066 and 4.081, 95% confidence interval 1.023-1.110 and 1.144-14.559, P<0.05 or P<0.01), but the pH value and levels of albumin and serum calcium were not independent risk factors to predict prognosis of patients with extremely severe burns (with relative risk 0.003, 1.025, and 0.634, 95% confidence interval <0.001-1.183, 0.956-1.099, and 0.055-7.321, P>0.05). Conclusions: The level of serum calcium of the majority of patients with extremely severe burns on admission is decreasing significantly, especially the female patients less than or equal to 55 years old. Compared with non-severe hypocalcemia patients, patients with severe hypocalcemia are with larger total burn area, higher proportion of inhalation injury, later admission time, and lower albumin level on admission. However, only the albumin level on admission is the independent influencing factor of severe hypocalcemia in patients with extremely severe burns. And the level of serum calcium on admission can not predict the prognosis of patients with extremely severe burns.

[Significance of evaluating the severity of patients with extremely severe burn by platelet count recovery in the early stage post burn]

Objective: To retrospectively analyze the prognostic value of platelet count recovery in the early stage post burn for patients with extremely severe burn, so as to evaluate their severity. Methods: A study involving 244 adult patients with extremely severe burn admitted to our hospital from January 2006 to December 2015, conforming to the inclusion criteria, was conducted. Data of their demography, injury, transmission, disease change in hospital, and platelet count from post injury day (PID) 1 to 10 were collected. (1) Patients were divided into survival group (n=212) and non-survival group (n=32) according to whether death or not. The dynamic change characteristic of platelet count in patients of two groups from PID 1 to 10 was analyzed and compared. (2) Patients were divided into return to normal group (RN, n=163) and non-return to normal group (NRN, n=81) according to whether platelet count returned to normal within one week post burn. The proportion of patients who received mechanical ventilation and mortality in groups RN and NRN, and length of stay in ICU between patients with platelet count that returned to normal and that did not return to normal in the early stage post burn in survival group were compared. Data were processed with independent samples t test , analysis of variance of repeated measurement, chi-square test, and binomial distribution test. Correlation was analyzed between data of sex, age, weight, total burn area, full-thickness burn area, inhalation injury, length of hospital stay, receiving mechanical ventilation, platelet count recovery condition within one week post burn and death of patients using the univariate and multivariate Cox regression analysis. Receiver operating characteristic (ROC) curve of platelet count on PID 8 was drawn to evaluate predicting value for death of 244 patients. Results: (1) The platelet count kept declining from PID 1 to 4, declined to below the normal low limit on PID 2, and reached its lowest level on PID 4 both in survival group and non-survival group. The platelet count both in survival group and non-survival group rose gradually from PID 4 to 10, and returned to normal on PID 8 and 10, respectively. There was no significant difference in platelet count of patients in two groups on PID 1 (t=1.01, P>0.05), while platelet count of patients in non-survival group was obviously lower than that in survival group from PID 2 to 10 (with t values from 2.64 to 7.17, P values below 0.01). The daily increment of platelet count in survival group from PID 4 to 10 was (26±13)×10(9)/L, obviously higher than that in non-survival group [(19±11)×10(9)/L, t=2.76, P<0.01]. (2) The proportion of patients who received mechanical ventilation was obviously lower than that of patients who did not receive mechanical ventilation in group RN (P<0.01), while the proportion of patients who received mechanical ventilation was obviously higher than that of patients who did not receive mechanical ventilation in group NRN (P<0.05). The proportion of patients who received mechanical ventilation in group NRN was obviously higher than that in group RN (χ(2)=32.93, P<0.01). The mortality of patients in group NRN was obviously higher than that in group RN (χ(2)=20.99, P<0.01). The length of stay in ICU of patients whose platelet count did not return to normal in the early stage was significantly longer than that of patients whose platelet count returned to normal in the early stage in survival group (t=4.20, P<0.01). (3) Total burn area, receiving mechanical ventilation, and platelet count did not return to normal within one week post burn were independent risk factors for death of patients with extremely severe burn (with hazard ratio respectively 1.073, 16.552, and 2.249, 95% confidence interval respectively 1.033-1.115, 2.147-127.580, and 0.993-5.096, P<0.05 or P<0.01). (4) The area under the ROC curve of platelet count on PID 8 to predict death of 244 patients with extremely severe burn was 0.745 (with 95% confidence interval 0.645-0.845, P<0.01), and 150×10(9)/L was chosen as the optimal threshold value, with sensitivity of 71.4% and specificity of 71.0%. Conclusions: Platelet count recovery in the early stage post burn of patients with extremely severe burn was significantly associated with their prognosis and could be used as an important indicator to evaluate the severity of illness.

Synchronous primary pulmonary lymphoma presenting with pulmonary adenocarcinoma: A case report and literature review

The incidence of synchronous lung tumors is rare, as reported in various clinical series, ranging from 0.2% to 8%. Most reported cases of synchronous tumors were shown to have the same histologic types of lung cancer. Among possible combinations, squamous cell carcinoma was by far the most common. Primary pulmonary lymphoma (PPL) is very rare in clinics accounting for only 0.5-1% of primary lung tumors. There is no report about synchronous primary pulmonary adenocarcinoma presenting with lung lymphoma. It can be easily misdiagnosed or missed. Although the treatment of PPL and synchronous pulmonary tumors has controversial, surgery with/without postoperative adjuvant radio-chemotherapy are used for most patients in present. We describe a case of synchronous primary lung tumors presenting with lymphoma and adenocarcinoma, in which expression of the cell surface antigens were evaluated immunohistochemically. By taking into consideration of the reported experiences, the author discusses the clinical features, prognostic criteria and therapeutic management of synchronous lung cancer and PPL.

Avian sarcoma and leukosis virus gag gene in the Anser anser domesticus genome

Endogenous retroviruses are regarded as ideal genetic markers for evolutionary analyses. Birds were some of the initial vertebrates found to contain endogenous retroviruses. However, few studies have investigated the presence and distribution of endogenous retroviruses in goose. In this study, we detected the avian sarcoma and leukosis virus gag gene in the genomic DNA of 8 Chinese native breeds using polymerase chain reaction method. The results indicated that a 1.2-kb avian sarcoma and leukosis virus gag sequence was integrated into all 8 goose breeds. The mean genetic pairwise distance was 0.918% among the investigated geese. To the best of our knowledge, this is the first report demonstrating the presence of the endogenous retroviruses in the domestic goose genome. The genetic structure should be further examined in the domestic goose.

Differential expression of Toll-like receptor genes in lymphoid tissues between Marek's disease virus-infected and noninfected chickens

Toll-like receptors (TLR) are trans-membrane sensors recognizing invading microbes. Toll-like receptors play a central role in initiating immune responses against several pathogens. In this study, we investigated the response of TLR and downstream genes to Marek's disease virus (MDV) infection. Forty 1-d-old chicks were randomly divided into 2 groups, with 20 chicks infected with MDV and 20 chicks mock-infected. Four chickens were euthanized respectively from infected and age-matched noninfected groups at 4, 7, 14, 21, and 28 d postinfection (dpi). Bursas, spleens, and thymuses were removed. The differential expression of TLR genes, including TLR3, TLR5, TLR7, TLR15, and TLR21, and downstream genes of TLR7, including MyD88, TRAF3, TRAF6, IFNA, IFNB, and IL6, in lymphoid tissues of MDV-infected and noninfected chickens was determined by real-time PCR. The results showed that the change of TLR genes was different in 3 lymphoid tissues. Expression of TLR7 and MyD88 was upregulated at 14 dpi and downregulated at 28 dpi in MDV-infected compared with noninfected spleens. The TRAF6 and IFNB were upregulated, and TRAF3, IFNA, and IL6 genes showed increasing trends in MDV-infected compared with noninfected spleens at 14 dpi. The expression of TLR3 and TLR15 genes was downregulated in MDV-infected compared with noninfected spleens at 28 dpi. The results indicated that TLR7 and its downstream genes were a response to MDV infection at 14 dpi. However, the function of TLR was impaired when the infection entered the tumor transformation phase. In bursas, TLR3 and TLR15 genes were upregulated at 7 and 4 dpi, respectively. It indicated that TLR3 and TLR15 might be involved in response to MDV infection in bursa at early phases. However, no differential expression of TLR genes was observed between MDV-infected and noninfected thymuses, which indicated that the thymus had little response to MDV infection mediated by TLR.

A genome-wide SNP scan reveals two loci associated with the chicken resistance to Marek's disease

Marek's disease (MD) is a neoplastic disease in chickens, caused by the Marek's disease virus (MDV). To investigate host genetic resistance to MD, we conducted a genome-wide association study (GWAS) on 67 MDV-infected chickens based on a case and control design, including 57 susceptible chickens in the case group and 10 resistant chickens as controls. After searching 38 655 valid genomic markers, two SNPs were found to be associated with host resistance to MD. One SNP, rs14527240, reaching chromosome-wide significance level (P < 0.01) was located in the SPARC-related modular calcium-binding 1 (SMOC1) gene on GGA5. The other one, GGaluGA156129, reaching genome-wide significance (P < 0.05), was located in the protein tyrosine phosphatase, non-receptor type 3 (PTPN3) gene on GGA2. In addition, expression patterns of these two genes in spleens were detected by qPCR. The expression of SMOC1 was significantly up-regulated (P < 0.05), whereas the expression of PTNP3 did not show significance when the case group was compared with the control group. Up-regulation of SMOC1 in susceptible spleens suggests its important roles in MD tumorigenesis. This is the first study to investigate MD-resistant loci, and it demonstrates the power of GWASs for mapping genes associated with MD resistance.

Low-density lipoprotein receptor-related protein 2 gene is associated with egg-quality traits in dwarf layers

Some members of the low-density lipoprotein receptor (LDLR) family play important roles in the regulation of lipoprotein metabolism and egg quality traits. Low-density lipoprotein receptor-related protein 2 (LRP2) gene belongs to the LDLR super family, and widely expresses in many tissues. This work identified and genotyped 1 single-nucleotide polymorphism (SNP), T14347C, at 3'-UTR of the LRP2 using matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS), and analyzed the effects of the SNP (T14347C) on egg-quality traits in 544 dwarf hens from 44 sire families. Frequencies of this SNP in the studied population did not agree with the Hardy-Weinberg equilibrium (P < 0.0001). Egg weight, albumen weight, albumen height, and albumen ratio of the TT genotype were significantly higher than those of the CC genotype (P < 0.05), whereas eggshell ratio of the TT genotype was significantly lower than that of the CC genotype (P < 0.05). The relative expression level of the LRP2 gene in the magnum was determined by real-time quantitative PCR. The gene expression of genotype CC individuals was significantly higher than that of TT and CT birds (P < 0.05). By combining both genetic effects and expression analyses results, we propose that the LRP2 gene is a good candidate gene, exhibiting a key role in albumen formation processes.

Subdural haematoma due to dural metastases from bronchogenic carcinoma in a previously well patient: an unusual cause of non-traumatic recurrent intracranial haematomata

Subdural haematomata (SDH) are usually traumatic in aetiology. Non-traumatic instances of SDH are uncommon, and can rarely be due to metastases involving the dura. Computed tomography or magnetic resonance imaging can be misleading, as the underlying aetiology may be masked by the SDH, or the appearance can simulate meningiomas. A high index of suspicion for SDH is thus required. Under such circumstances, when no overt cause is identified, dural tissue should be sent for histological analysis and blood clot for cytology, even if the appearances are grossly normal at surgery. We present a rare case of a 42-year-old woman who was previously well, but presented with progressive weakness due to acute spontaneous SDH. She required repeated surgical evacuations for SDH and for subsequent recurrent extradural haematomata. After extensive investigations, the cause was identified to be secondary dural metastases from a primary lung carcinoma.

Effect of myofiber characteristics and thickness of perimysium and endomysium on meat tenderness of chickens

The objective of the present study was to evaluate the role of myofiber characteristics and the thickness of 2 major muscle membranes, perimysium and endomysium, in determining the breast meat tenderness of chickens. Birds from 2 breeds (White Leghorn and a line of broiler) were chosen. Chicks were sexed and wing-banded at hatch and were grown in separate cages in a single house. Sixty broilers and 60 White Leghorns were harvested at 6 wk of age, respectively, whereas another 60 White Leghorns were slaughtered at 18 wk of age. An equal number of males and females was maintained for each group. Body weight, breast muscle weight, pH, drip loss, cooking loss, Warner-Bratzler shear force value (SFV), total energy of shear force, fiber diameter, sarcomere length, myofiber density, and the thickness of endomysium and perimysium of the breast were determined for each bird. At 6 wk of age, histological examination indicated that the size of myofiber and thickness of endomysium and perimysium of broilers were larger than that those of White Leghorns (P < 0.01), whereas the SFV, drip loss, and cooking loss of broilers were smaller (P < 0.01). A comparison between the White Leghorns at 18 wk and the broilers at 6 wk, which were at similar BW but different ages, showed that the breast muscle weight of broilers was larger (P < 0.01) than that of White Leghorns. For breast muscle, the endomysium of broilers at 6 wk was thicker than that of White Leghorns at 18 wk (P < 0.01), whereas the perimysium was thinner (P < 0.01). The SFV, drip loss, and the cooking loss of broilers were smaller than those of White Leghorns at similar BW (P < 0.01). Meat tenderness was negatively correlated with myofiber density (-0.27) and the thickness of endomysium (-0.29) and positively correlated with the thickness of perimysium (0.20). It is suggested that muscle membrane should be considered in evaluating meat tenderness of the chicken.

Developmental phenotypic-genotypic associations of tyrosinase and melanocortin 1 receptor genes with changing profiles in chicken plumage pigmentation

The tyrosinase (TYR) and melanocortin 1 receptor (MC1R) genes have been accepted as major genes involved in the plumage pigmentation of chickens. The co-segregation of plumage coloration and sequence polymorphism in TYR and MC1R genes were investigated using an intercross between black and white plumage color types of the Dongxiang blue-shelled chicken. Profiles of plumage color changing and genes expression levels of TYR and MC1R were observed from hatch to 112 d of age using quantitative real-time reverse transcription-PCR. Intercrossed offspring were classified by phenotypes of plumage colors. The phenotypes of black and amber chicks with genotypes of E_C_ exhibited a black feather pattern, whereas white, gray, and buff chicks with genotypes of E_cc and eecc belonged to the white feather pattern. Although TYR in cooperation with MC1R determined the coloration feather patterns, the different phenotypes did not correspond completely with the genotypes. During the period studied, plumage phenotype changed dramatically, and the buff and gray down were gradually replaced by whiteness feathers. Real-time reverse transcription-PCR studies showed that 1) expression levels of TYR declined dramatically with age, and expression at hatch was highest (P<0.01) during the ages studied; 2) expression level of MC1R was higher at 28 d than at younger and older ages; and 3) expression of TYR in chickens carrying E/E and E/e alleles on MC1R loci were higher than those carrying e/e alleles from hatch to 28 d.

Low-density lipoprotein receptor-related protein 8 gene association with egg traits in dwarf chickens

Low-density lipoprotein receptor-related protein 8 (LRP8), a member of the low-density lipoprotein receptor gene family with a role in clusterin processing, was investigated as a candidate gene for egg quality-related traits. One SNP from C to T at position 1623 of the open reading frame of LRP8 was identified and genotyped by a high-throughput genotyping method, matrix-assisted laser desorption-ionization time-of-flight mass spectrometry in 747 egg-type dwarf layers from 44 sire families. There were no significant differences among genotypes for any interior egg traits measured, except for yolk color, in which color was deeper for the TT genotype than CC or CT (P < 0.05). For shell traits, strength and thickness were greater for TT than CC (P < 0.05), with CT intermediate and not different from either. Shape index was lower for CT than either TT or CC, which did not differ, whereas for shell color, CT was intermediate to the homozygotes, which differed (CC > TT). The present results indicated that LRP8, as a new member of eggshell matrix protein, may be a candidate gene associated with eggshell traits.

Deficiency of Growth Hormone Receptor Does Not Affect Male Reproduction in Dwarf Chickens

Sex-linked dwarf chickens caused by the mutation of the growth hormone receptor gene are characterized by normal growth hormone (GH), very low insulin-like growth factor I (IGF-I) level in the blood, and reduced growth. It has been demonstrated that the sex-linked dwarfing gene has negative effects on female reproduction. In the current study, dwarf cocks and their phenotypic normal siblings were used to investigate the effects of dwarf gene on male reproduction. Dwarf cocks grew slower than the normal cocks did, and at 20 wk of age, their BW were 36.4% smaller. However, all parameters for semen quality, including volume, sperm concentration, viability, mobility, pH, and percentage of abnormal sperms, examined at 30 wk of age showed no significant difference between normal and dwarf cocks. The fertility of dwarf cocks was 95.2%, and the normal was 92.4%. The concentrations of GH and IGF-I in serum and seminal plasma were measured with RIA and ELISA, respectively. The serum GH in the dwarf cocks was significantly higher than their normal siblings (P < 0.05), whereas the serum IGF-I in the dwarf cocks was very low. However, the concentration of seminal IGF-I in dwarf cocks was similar to that of their normal siblings, indicating that IGF-I might be produced and acted independently in testis. In conclusion, the deficiency in GH receptor did not affect the male reproduction in dwarf chickens, and the fertility of dwarf cocks could be satisfactory for production when artificial insemination was adopted.

[215 cases of diffuse pulmonary disease diagnosed with transbronchial lung biopsy via bronchofibroscope]

215 cases of diffuse pulmonary disease diagnosed with transbronchial lung biopsy (TBLB) via bronchofibroscope were reported. The incidence of successful biopsy was 96.7%. The total diagnostic rate was 80.5%. There were no other serious complications except for bloody or blood-streaking sputum, but the amount rarely exceeded 50 ml, and pneumothorax occurred occasionally. It was suggested that TBLB is an easy, safe and useful method for diagnosing diffuse pulmonary disease.

[The diagnosis and treatment in 39 cases of sarcoidosis]

The diagnosis, treatment and follow-up in 39 cases of sarcoidosis were reported. The authors believed that (1) diagnosis of this disease would be made by analysing clinical and pathological manifestations carefully, (2) treatment was given when the disease was active, and (3) in order to find complications as early as possible, follow-up was very important during treatment.