[Surgical plan selection and efficacy analysis in 32 cases of laryngotracheal stenosis]

Objective: To explore the optimization of surgical procedures for laryngotracheal stenosis and its effect analysis. Methods: The data of 32 patients with acquired laryngotracheal stenosis who received surgical treatment from October 2015 to December 2021 were analyzed retrospectively. The age ranged from 19 to 72 years, with an average of (34.0±9.0) years. The medical history ranged from 1 to 32 months (median 3 months). As for etiology, there were 30 cases of iatrogenic laryngotracheal stenosis, including 20 cases of tracheal intubation and 10 cases of tracheotomy (7 cases of percutaneous tracheotomy and 3 cases of traditional tracheotomy). There were 1 case of laryngotracheal trauma and 1 case of airway Penicillium marneffei infection. According to Myer-Cotton grading system, grade Ⅳ stenosis was found in 14 cases, including 12 cases involving trachea and 2 cases involving trachea and subglottic area.There were 18 cases of grade Ⅲ, all of which involved the cervical trachea 5 cases failed in operation in other hospitals. According to stenosis grading, course of disease, primary disease control and the patient's general condition, the surgical plan was determined individually. The operations of end-to-end anastomosis, circumferential tracheal partial resection, T-tube placement and CO2 laser tracheal scar resection were performed respectively. The recovery of airway function and perioperative complications were observed one year after operation. Results: End-to-end anastomosis was performed in 16 cases, and partial circumferential tracheal resection in 2 cases, and tracheal granulation (scar) resection by CO2 laser in 2 cases and T-tube insertion in 12 cases. Eighteen cases which performed end-to-end anastomosis, partial resection of circumferential trachea in and 2 cases which performed laser tracheal scar resection were all recovered airway function at one stage. After 1 year, 19 cases were cured and 1 case was effective. Of 12 patients with T tube implantation, 11 cases were successfully extubated after 6-12 months, 7 cases were cured after 1 year, 2 cases were effective and 3 cases were ineffective. Among the 3 cases of failure, 2 cases were successfully extubated by sleeve resection and end-to-end anastomosis in the second stage, and the other case refused to accept other treatment methods and the T-tube was placed again, and the tube was blocked and the patient survived. During the follow-up period, the total cure rate was 87.5%, the effective rate was 9.4%, and the total extubation rate was 96.9%.The most common complication was subcutaneous emphysema, accounting for 78% (25/32), but no serious mediastinal emphysema or pneumothorax occurred. In the T-tube implantation group, granulation tissue grew in different degrees around the neck wound after operation, and improved or disappeared after 6-9 months. Anterior cervical tracheal fistula occurred in 4 cases of T-tube implantation group after extubation, which were cured by sealing the stoma. There were no complications such as severe bleeding or perioperative death. Conclusion: When there were various factors, the optimization of the surgical plan according to the degree of stenosis, the course of disease, the control of primary disease and the general condition was an important guarantee to improve the curative effect of laryngotracheal stenosis.

How to enhance the ability of mesenchymal stem cells to alleviate intervertebral disc degeneration

Intervertebral disc (ID) degeneration (IDD) is one of the main causes of chronic low back pain, and degenerative lesions are usually caused by an imbalance between catabolic and anabolic processes in the ID. The environment in which the ID is located is harsh, with almost no vascular distribution within the disc, and the nutrient supply relies mainly on the diffusion of oxygen and nutrients from the blood vessels located under the endplate. The stability of its internal environment also plays an important role in preventing IDD. The main feature of disc degeneration is a decrease in the number of cells. Mesenchymal stem cells have been used in the treatment of disc lesions due to their ability to differentiate into nucleus pulposus cells in a nonspecific anti-inflammatory manner. The main purpose is to promote their regeneration. The current aim of stem cell therapy is to replace the aged and metamorphosed cells in the ID and to increase the content of the extracellular matrix. The treatment of disc degeneration with stem cells has achieved good efficacy, and the current challenge is how to improve this efficacy. Here, we reviewed current treatments for disc degeneration and summarize studies on stem cell vesicles, enhancement of therapeutic effects when stem cells are mixed with related substances, and improvements in the efficacy of stem cell therapy by adjuvants under adverse conditions. We reviewed the new approaches and ideas for stem cell treatment of disc degeneration in order to contribute to the development of new therapeutic approaches to meet current challenges.

[Obstructive sleep apnea and type 2 diabetes: a bidirectional Mendelian randomization study]

Objective: This study aims to explore the causal relationship between obstructive sleep apnea (OSA) and type 2 diabetes (T2D) using bidirectional Mendelian randomization (MR). Methods: The genetic data related to OSA were obtained from the FinnGen Biobank (Ncase=16, 761, Ncontrol=201, 194) in the Genome-wide association study (GWAS). Three single nucleotide polymorphism (SNP) were screened out as instrumental variable (IV) of OSA. The genetic data related to T2D were derived from a large Meta-analysis of GWAS (Ncase=62, 892, Ncontrol=596, 424), 114 SNP were selected as IV of T2D. Multiple MR methods were used for analysis and inverse variance weighted (IVW) was performed as main method. The sensitivity of MR analytic results was analyzed using MR-Egger and other methods, and the IV was evaluated using F-value statistics. Results: MR analysis showed that OSA was significantly associated with increased risk of T2D (OR=2.016, 95%CI: 1.185-3.429, P<0.05). There was no significant relationship between T2D and OSA risk (OR=1.030, 95%CI: 0.980-1.082, P=0.238). There was heterogeneity in both-way results (OSA➝T2D, P=1.808×10-11; T2D➝OSA, P=1.729×10-7), and no horizontal pleiotropy (OSA➝T2D, P=0.477; T2D➝OSA, P=0.349). IV of OSA and T2D-selected in the study were strong instrumental variables (F statistics of OSA=20.543; F statistics of T2D=30.117). Conclusion: Our results supported that OSA was a risk factor for T2D, but T2D had no significant impact on the incidence of OSA. Blood glucose monitoring and diabetes screening in OSA patients might be beneficial to the early detection and intervention of T2D.

[Endometrioid adenocarcinoma with proliferated stromal cells, hyalinization and cord-like formations: A case report]

Corded and hyalinized endometrioid carcinoma (CHEC) is a morphologic variant of endo-metrioid adenocarcinoma. The tumor exhibits a biphasic appearance with areas of traditional low-grade adenocarcinoma merging directly with areas of diffuse growth composed of epithelioid or spindled tumor cells forming cords, small clusters, or dispersed single cells. It is crucial to distinguish CHEC from its morphological mimics, such as malignant mixed mullerian tumor (MMMT), because CHECs are usually low stage, and are associated with a good post-hysterectomy prognosis in most cases while the latter portends a poor prognosis. The patient reported in this article was a 54-year-old woman who presented with postmenopausal vaginal bleeding for 2 months. The ultrasound image showed a thickened uneven echo endometrium of approximately 12.2 mm and a detectable blood flow signal. Magnetic resonance imaging revealed an abnormal endometrial signal, considered endometrial carcinoma (Stage Ⅰ B). On hysterectomy specimen, there was an exophytic mass in the uterine cavity with myometrium infiltrating. Microscopically, most component of the tumor was well to moderately differentiated endometrioid carcinoma. Some oval and spindle stromal cells proliferated on the superficial surface of the tumor with a bundle or sheet like growth pattern. In the endometrial curettage specimen, the proliferation of these stromal cells was more obvious, and some of the surrounding stroma was hyalinized and chondromyxoid, which made the stromal cells form a cord-like arrangement. Immunostains were done and both the endometrioid carcinoma and the proliferating stroma cells showed loss of expression of DNA mismatch repair protein MLH1/PMS2 and wild-type p53 protein. Molecular testing demonstrated that this patient had a microsatellite unstable (MSI) endometrial carcinoma. The patient was followed up for 6 months, and there was no recurrence. We diagnosed this case as CHEC, a variant of endometrioid carcinoma, although this case did not show specific β-catenin nuclear expression that was reported in previous researches. The striking low-grade biphasic appearance without TP53 mutation confirmed by immunohistochemistry and molecular testing supported the diagnosis of CHEC. This special morphology, which is usually distributed in the superficial part of the tumor, may result in differences between curettage and surgical specimens. Recent studies have documented an aggressive clinical course in a significant proportion of cases. More cases are needed to establish the clinical behaviors, pathologic features, and molecular profiles of CHECs. Recognition of the relevant characteristics is the prerequisite for pathologists to make correct diagnoses and acquire comprehensive interpretation.

[Effect of hyperandrogenism on pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer]

Objective: To explore the effects of hyperandrogenism (HA) on pregnancy outcomes in women with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). Methods: A retrospective study was conducted on infertile women with PCOS undergoing IVF/ICSI-ET from January 2017 to June 2021 in our center. Patients were divided into HA group and NON-HA group according to the levels of testosterone. Propensity score matching (PSM) was used to balance the influence of female age and IVF/ICSI-ET for patients with gonadotropin-releasing hormone (GnRH)antagonist protocol and GnRH agonist protocol, separately. After the PSM procedure, 191 cases in HA group and 382 cases in NON-HA group, were included. Hormone levels and pregnancy outcomes were compared in the two groups. Results: The female age was comparable in two groups [HA: (29.6±3.7) vs NON-HA: (29.5±3.6), P=0.665]. The basal luteinizing hormone [(10.82±6.73) vs (7.76±5.30) IU/L], testosterone [(3.27±0.97) vs (1.60±0.59) nmol/L], free androgen index (7.13 vs 2.77), anti-mullerian hormone [(11.37±5.74) vs (9.67±4.67) ng/ml], fasting glucose [(5.18±0.49) vs (5.06±0.42) mmol/L], 1h glucose [(9.34±2.42) vs (7.99±2.21) nmol/L], 2 h glucose [(7.66±2.17) vs (6.64±1.84) nmol/L], 2 h insulin [(129.81±145.49) vs (97.51±86.92) mU/L], total cholesterol [(5.35±0.89) vs (4.92±0.92) mmol/L], triglycerides [(1.55±1.28) vs (1.33±0.77) mmol/L], and low density lipoprotein cholesterol levels [(3.38±0.66) vs (3.14±0.71) mmol/L] were significantly higher in HA group, compared with NON-HA group (P<0.05). The initiated gonadotropin dose was higher in HA group than that in NON-HA group [(126.96±33.65) vs (137.60±38.12) U, P=0.001], but moderate-severe ovarian hyperstimulation syndrome (OHSS) rate was similar in two groups (P>0.05). The rates of implantation, clinical pregnancy, miscarriage, and live birth were comparable between the two groups (P>0.05). Also, in the subgroups, the rates of implantation, clinical pregnancy, live birth, and miscarriage were similar in HA group and NON-HA group. Conclusions: The risks of hormonal abnormality and glucose-lipid metabolic disorder were higher in PCOS women with HA, whereas satisfactory pregnancy outcomes could be achieved under proper ovarian stimulation undergoing IVF/ICSI-ET.

[Comparative study on imaging and clinical results of patellofemoral joint with kinematic alignment and mechanical alignment in total knee arthroplasty]

Objective: To investigate the changes of imaging parameters of patellofemoral joint after kinematic alignment total knee arthroplasty (KA-TKA) and mechanical alignment total knee arthroplasty (MA-TKA) and the effects on clinical outcomes. Methods: A retrospective analysis was performed on 227 patients diagnosed with knee osteoarthritis, 105 males and 122 females, with the age of (68.6±7.2) years (range: 52 to 86 years). The patients underwent unilateral TKA at the Department of Orthopaedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, from January 2020 to July 2021. The patients were divided into the KA-TKA group (n=102) and the MA-TKA group (n=125) according to the alignment method. The Blackburne-Peel index, lateral patellofemoral angle, patellofemoral tilt angle and patellofemoral index of the two groups were recorded before and 6 months after operation. The frequency of lateral patellar retinaculum release, preoperative and postoperative knee range of motion (ROM), and Oxford knee score(OKS) were also recorded. The differences between preoperative and postoperative measurement data of each group were calculated. If the difference was in line with normal distribution, the independent sample t-test or t'-test was used for comparison between the two groups. If it did not conform to normal distribution, Mann-Whitney U test was used. Paired sample t-test was used for comparison before and after treatment. Chi-square test was used for comparation of categorical data between the two groups. Results: After 6 months of operation, the patellar tilt angles of the KA-TKA group and the MA-TKA group were (14.22±3.26)° and (13.35±2.27)°, and the lateral patellar angles were (9.73±4.86)° and (11.91±3.89)°, respectively. The change of lateral patellofemoral angle in the KA-TKA group was significantly less than that in the MA-TKA group ((1.68±4.86)° vs. (4.15±4.88)°, t=3.805, P<0.01). OKS and ROM were improved in the both groups at 6 months after operation (all P<0.05), but there were no statistic significance in preoperative and postoperative difference between the two groups (all P>0.05). The intraoperative lateral patellar retinacular release rate was 14.4% (18/125) in the MA-TKA group and 6.9% (7/102) in the KA-TKA group, with no statistical difference (χ²=3.256,P=0.071). Conclusions: There are greater patella lateral tilt at 6 months postoperatively in the KA-TKA group compared with the MA-TKA group, but this radiographic difference could not show differences of clinical outcomes and postoperative ROM, the frequency of intraoperative lateral patellar retinacular release wouldn't increase. Therefore, KA-TKA does not increase the difficulty of postoperative patellofemoral joint complications and intraoperative lateral patellar release.

[Clinical characteristics of 21 infertile women with non-classic 21-hydroxylase deficiency]

Objective: To investigate the clinical features of infertile women with non-classic 21-hydroxylase deficiency (21-OHD). Methods: The study enrolled 21 infertile women with non-classic 21-OHD in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2009 to December 2018. The clinical presentation, endocrine hormone, glucolipid metabolism and treatment outcome were retrospectively analyzed. The diagnosis of non-classic 21-OHD was comprehensively based on clinical and hormonal characteristics. Results: Among 21 cases, the age was (29.9±2.9) years, the mean age at menarche was (13.6±2.0) years, body mass index was (22.1±2.9) kg/m², and 38% (8/21) had oligomenorrhea. Hirsutism was diagnosed in 3 cases (14%, 3/21). Clitoromegaly was seen in 14% (3/21) and polycystic ovarian morphology was found in 33% (7/21) of the patients. The mean serum level of basal progesterone was (11.3±21.0) nmol/L, with 48% (10/21) having high basal progesterone level; after therapy by glucocorticoid, the level of progesterone was (1.9±2.0) nmol/L. Serum 17-hydroxyprogesterone concentration was (66.4±123.6) nmol/L; after therapy by glucocorticoid, it was (2.4±1.8) nmol/L. In the study increased testosterone, androstenedione and dehydroepiandrosterone sulfate were present in 62% (13/21), 52% (11/21) and 43% (9/21), respectively; and 52% (11/21) of patients manifested androgen excess and basal progesterone elevation; androgen levels decreased after therapy by glucocorticoid. The pregnancy rate was 76% (16/21). Out of 19 pregnancies, 6/19 ended in spontaneous miscarriages. Conclusions: Infertile women with non-classic 21-OHD are characterized by hyperandrogenism and basal progesterone elevation, whereas gonad axis disorder is not apparent. After no response to conventional therapy, adult infertile women with non-classic 21-OHD could achieve a desirable pregnancy outcome with proper treatment of glucocorticoid.

Mitochondrial DNA Heteroplasmy of Hair Shaft Using HID Ion GeneStudioTM S5 Sequencing System

Objective To study the heteroplasmy of the whole mitochondrial genome genotyping result of hair shaft samples using HID Ion GeneStudio^TM S5 Sequencing System. Methods The buccal swabs and blood of 8 unrelated individuals, and hair shaft samples from different parts of the same individual were collected. Amplification of whole mitochondrial genome was performed using Precision ID mtDNA Whole Genome Panel. Analysis and detection of whole mitochondrial genome were carried out using the HID Ion GeneStudio^TM S5 Sequencing System. Results The mitochondrial DNA sequences in temporal hair shaft samples from 2 individuals showed heteroplasmy, while whole mitochondrial genome genotyping results of buccal swabs, blood, and hair samples from the other 6 unrelated individuals were consistent. A total of 119 base variations were observed from the 8 unrelated individuals. The numbers of variable sites of the individuals were 29, 40, 38, 35, 13, 36, 40 and 35, respectively. Conclusion Sequence polymorphism can be fully understood using HID Ion GeneStudio^TM S5 Sequencing system.

[Analysis of mental state of allergic rhinitis patients in Chengdu city by symptom check list 90 (SCL-90) scale]

Objective: To analyse the mental state of patients with allergic rhinitis (AR) in Chengdu. Methods: One thousand five hundred and thirty-six AR patients from Sichuan Provincial Integrated Traditional Chinese and Western Medicine Hospital, West China Hospital of Sichuan University, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan People's Hospital, Sichuan Second Hospital of Traditional Chinese Medicine were selected from July 2013 to January 2018. Eight hundred and twenty-seven patients were screened into study group by inclusion and exclusion standards. The symptom check list 90 (SCL-90) was used to group and score the mental state of these patients according to nine classification criteria: gender, BMI, age, marital status, monthly salary, disease duration, living environment, education level and working environment. Then, the scores were compared within groups. Inter-group comparison was made between the study group and the Chinese norm, and the positive factors for psychological disorders were extracted. Four symptoms in the study group, i.e. nasal itching, sneezing, clear discharge and nasal congestion, were scored on the visual analogue scale (VAS). SPSS 19.0 software was used to carry out statistical analysis. Partial correlation analysis was performed between the positive factors and the symptom scores by multiple regression statistical method. Results: The total score of SCL-90 in the study group was 2.64±0.25, which was accorded with mild to moderate mental health impairment. There were 124 (15.0%) without mental health damage, 176 (21.3%) with mild damage, 474 (57.3%) with mild to moderate damage, 41 (5.0%) with moderate to severe damage and 12 (1.4%) with severe damage. The in-group comparison showed that the top three categories of different items were the living environment, gender and working environment. The scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, psychosis, other (sleep, diet) and total average score of urban residents were higher than that of country residents (3.29±0.61 vs 2.65±0.50, 2.81±0.77 vs 2.05±0.38, 3.10±0.19 vs 2.49±0.67, 3.40±0.84 vs 2.49±0.70, 3.04±0.64 vs 2.33±0.51, 3.02±0.55 vs 2.40±0.77, 3.40±0.41 vs 2.52±0.77, 2.91±0.11 vs 2.29±0.40, Z value was 4.88, 5.25, 4.57, 5.91, 5.09, 4.63, 5.55, -4.55, respectively, all P<0.05). Women scored higher than man for somatization, interpersonal sensitivity, depression and others (2.66±0.51 vs 2.00±0.45, 3.37±0.47 vs 2.63±0.51, 3.44±0.57 vs 2.85±0.52, 3.47±0.36 vs 2.76±0.45, Z value was -5.10, -5.51, -4.86, -5.28, respectively, all P<0.05). The scores of somatization, interpersonal sensitivity, psychosis and other (sleep, diet) were higher in the indoor group than those in the outdoor group (3.49±0.64 vs 2.78±0.46, 3.33±0.30 vs 2.56±0.68, 3.28±0.60 vs 2.67±0.31, 3.50±0.85 vs 2.85±0.37, Z value was 5.31, 5.79, 4.89, 5.00, respectively, all P<0.05). The outdoor group scored higher on obsessive-compulsive symptoms, anxiety and hostility (3.44±0.40 vs 2.83±0.35, 3.40±0.50 vs 2.57±0.93, 3.34±0.88 vs 2.69±0.56, Z value was 4.96, 6.22, 5.08, respectively, all P<0.05). The inter-group comparison found that depression, anxiety, psychosis and other (sleep, diet) could be partially correlated with VAS scores as 4 positive factors. The results of partial correlation analysis showed that depression was positively correlated with sneezing and nasal runny discharge, anxiety was positively correlated with nasal itching and nasal obstruction, psychosis was positively correlated with nasal itching and sneezing, and other (sleep, diet) was positively correlated with nasal runny discharge and nasal obstruction. Conclusion: AR patients have mild to moderate mental health impairments, which are correlated with AR symptoms.

[Clinical analysis of infective endocarditis with septic pulmonary embolism]

Objective: To analyze the clinical features of infective endocarditis with septic pulmonary embolism, and to improve the diagnosis and treatment of the disease. Methods: Retrospective analysis of clinical manifestations, blood culture, echocardiography, chest CT and diagnosis and treatment of 16 patients with infective endocarditis and septic pulmonary embolism in the First Affiliated Hospital of Zhengzhou University from January 2010 to June 2017 was carried out, and the clinical features of the disease were summarized. Results: Out of the 16 patients, 4 were males and 12 were females, aged (29.5±9.7) years old, 12 patients were with congenital heart disease. The main clinical manifestations were fever, cough, dyspnea, hemoptysis. There were 7 cases with positive blood culture, and 6 of them were Streptococcus. Echocardiography revealed cardiac vegetations, and all were from right heart. Chest CT was characterized by multiple pulmonary lesions, mainly characterized by multiple nodules and small patch shadows. All 16 patients were initially misdiagnosed as pneumonia. All patients were treated with antibiotics intravenously, 13 patients underwent cardiac surgery, 6 patients were cured, 8 patients improved, and 2 patients were discharged automatically. Conclusions: Infective endocarditis with septic pulmonary embolism is easily misdiagnosed. In patients with fever and multiple shadows in the lungs, the possibility of right heart infective endocarditis should be considered. The diagnosis can be confirmed once cardiac vegetations are found by echocardiography, and repeated echocardiographic examinations can be performed if necessary. The prognosis of patients treated with surgery as early as possible on the basis of anti-infection is good.

[The investigation of the positive rate of intrinsic factor antibody and deficiency rate of vitamin B(12) in normal physical examination population]

Objective: To explore the positive rate of intrinsic factor antibody (IFAb) and level of vitamin B(12) (VitB(12)) in normal physical examination population and the possible relation between IFAb, VitB12 and sex, age, number of RBC, HGB and MCV. Methods: A total of 1 427 people who came to Peking Union Medical Colleague Hospital (PUMCH) for physical examination were enrolled. There were 758 males with average age of (52.5±14.5) years-old and 669 females with average age of (50.3±14.3) year-old. Beckman DxI800 automatic biochemical-immune analyzer and corollary reagents were used to analyze the level of serum IFAb and VitB(12). The results in different sex, age were documented and their correlation with the value of whole blood cell count was tested later on. Results: Among the 1 427 normal subjects, 66 (4.63%) were positive for IFAb. The positive rate for IFAb in the population≥40 years-old was higher than those<40 years-old (5.66% vs 1.48%, χ(2)=7.46, P=0.006). The deficiency rate of VitB(12) in the population<40 years-old, 40-59 years-old and ≥60 years-old was 2.22%, 2.51% and 5.50%, respectively (χ(2)=8.55, P=0.014). There were no difference between people with different sex in the positive rate of IFAb (5.15% for males and 4.04% for females, χ(2)=0.99, P=0.320) or in the deficiency rate of VitB(1)2 (3.83% for males and 2.69% for females, χ(2)=1.44, P=0.230). The results of multiple linear regression showed that HGB level of IFAb positive subjects was 3.05 g/L lower on average than those of IFAb negative, but IFAb had no effect on both RBC and MCV. There was no correlation between VitB(1)2 deficiency and HGB, RBC and MCV. Conclusion: The positive rate of IFAb and deficiency rate of VitB(1)2 increase as age increases. But the presence of VitB(12) deficiency is later than the positive findings of IFAb. IFAb showed some effects on the level of HGB, which may compensate the limitations of VitB(12) detection to some extent. It is necessary to check the IFAb and level of VitB(12) in people with middle or old ages.

[Effects of minimally invasive tangential excision in treating deep partial-thickness burn wounds on trunk and limbs in pediatric patients in the early stage post burn]

Objective: To observe the effects of minimally invasive tangential excision in treating deep partial-thickness burn wounds on trunk and limbs in pediatric patients in the early stage post burn. Methods: Clinical data of 40 children with deep partial-thickness burn wounds on trunk and limbs, admitted to our burn ward from January 2016 to June 2017, conforming to the study criteria, were retrospectively analyzed. They were divided into conventional treatment group (CT, n=19) and minimally invasive tangential excision group (MITE, n=21) according to the different treatments. The patients in group CT were treated with eschar-reserving therapy firstly. When tangential excision was performed, the roller knife was used, and no necrotic tissue left on the wound bed was considered the proper depth of excision. Razor-thickness skin grafting was performed to cover the wound when adipose tissue exposed markedly after tangential excision. Dressing change was performed within 48 h after the operation and repeated every 2 days. Unhealed wounds were covered by razor-thickness skin grafting. The patients in group MITE were treated with tangential excision in the early stage post burn. The tangential excision was operated with electric dermatome, and the thickness was set at 0.1 mm to excise the surface of eschar until the sporadic punctate hemorrhage on wound surface was observed and some necrotic tissue was left on the wound bed. Porcine acellular dermal matrix was applied after tangential excision. The first dressing change was often performed about 1 week after the operation. Razor-thickness skin grafting was performed to cover the unhealed wounds. The length of wound healing, high fever, antibiotic usage, and hospital stay, times of later operation, and hospitalization expenses of patients in the 2 groups were recorded. The excisional eschar and wound bed tissue of patients in group MITE were harvested for pathological observation. Data were processed with t test and Fisher's exact probability test. Results: (1) There were no statistically significant differences in length of high fever and length of hospital stay and hospitalization expenses between patients in the 2 groups (t=-1.67, -1.93, 0.31, P>0.05). The lengths of wound healing [(24.8±2.5) d] and antibiotic usage [(4.4±0.7) d] of patients in group MITE were significantly shorter than those in group CT [(33.3±2.5) and (7.0±0.7) d, t=-2.44, -2.44, P<0.05], and times of later operation of patients in group MITE [(0.29±0.14) times] were significantly less than those in group CT [(0.79±0.21) times, t=-2.03, P<0.05]. (2) The thickness of the excisional eschar of patients in group MITE was about 150 μm. The eschar has epidermis and upper dermis. Some necrotic tissue was left on the wound bed. Conclusions: The treatment for pediatric deep partial-thickness burn wounds on trunk and limbs with minimally invasive tangential excision using electric dermatome in the early stage post burn can accelerate wound healing, shorten length of antibiotic usage, and reduce times of later operations.

[Application of RapidHIT™ 200 System in Forensic Medicine]

OBJECTIVES

To validate the analysis capability of RapidHIT™ 200 system for four kinds of routine forensic samples and the recyclable capability of template, template DNA and PCR products in the process of twice duplicate detection.

METHODS

The buccal swabs underwent the test twice by RapidHIT™ 200 system, and the template DNA and PCR products that arose in the system were also tested for two times. After four kinds of routine forensic samples were detected by RapidHIT™ 200 system, the follow-up tests of the template, template DNA and PCR products that arose in the system were performed.

RESULTS

The STR loci could be detected in the buccal swabs by the system for the first time. However, part of the STR loci lost during the second test. And the peak value obtained in the second test was significantly reduced than the one in the first time. The average STR loci detection rates of the template DNA and PCR products were both less than 50% in the second test, which were significantly reduced than that in the first test. In addition, the analysis capability of the system for the tissues and buccal swabs was better than that for the blood and cigarette butts. Compared with the first test, the STR loci detection rate of the tested items, template DNA and PCR products decreased with the numbers of tests.

CONCLUSIONS

RapidHIT™ 200 system is more effective in retesting buccal swabs than other samples, whereas the items, DNA template, PCR products obtained in the first and second time cannot be directly used for the further application and study of forensic medicine.

[The significance of circulating tumor cells in head and neck squamous cell carcinoma: a preliminary study]

Objective: To investigate the significance of circulating tumor cells (CTC) in squamous cell carcinoma of the head and neck (HNSCC). Methods: Twenty-four patients with HNSCC treated between October 2016 and July 2017 in our department were selected (experimental group), including 23 males and 1 females, aged 47-81 years. There were 14 cases of squamous cell carcinoma of larynx and 10 cases of hypopharynx, including I-Ⅱ stage (5 cases) and Ⅲ- Ⅳ stage (19 cases). All patients were primary and/or relapsed after treatment. Nine healthy volunteers were selected as control group. A novel in vivo capture technique (CellCellector system) was used to detect CTC. SPSS23.0 was used for statistical analysis. Results: The total capture rate of CTC in patients with HNSCC before treatment was 70.8% (17/24), with 40% (2/5) for patients at I-Ⅱ stage, and 78.9% (15/19) for patients at Ⅲ- Ⅳ stage, and was 0 in patients of control group. The total capture rate of CTC in patients with HNSCC after treatment was 50% (8/16). There was no significant correlation between CTC and age, sex, location of tumor or lymph node metastasis (P>0.05). CTC was related to tumor staging and tumor differentiation (P<0.05). The positive rate of EGFRVⅢ in CTC was 26.3% (5/19). Conclusions: The CellCollector system is a very efficient way of detecting CTC, and CTC plays an important role in the occurrence, progression and metastasis of HNSCC.

[Preliminary study on the expression of CD4⁺CD25⁺Tregs and Foxp3 in peripheral blood of patients with head and neck squamous cell carcinoma]

Objective:This paper discusses the expression and significance of CD4⁺CD25⁺ Tregs and Foxp3 in peripheral blood of patients with head and neck squamous cell carcinoma. Method:We have collected 40 cases of head and neck squamous cell carcinoma patients with newly diagnosed or relapse after treatment, all of them underwent surgery, 39 males and 1 females, aged 41-79 years, in our department from January 2014 to December 2015. At the same time, 10 healthy volunteers are enrolled as control group. 2 ml peripheral blood has been detected by flow cytometry, and the ratio of CD4⁺CD25⁺/CD4⁺ and CD4⁺CD25⁺Fxop3⁺/CD4⁺ are calculated, respectively. SPSS 23.0 is used for statistical analysis. Result:CD4⁺CD25⁺ Tregs is highly expressed in head and neck tumors, compared with that in the healthy control, and the difference is statistically significant (P<0.01). There is significant difference between the early and late stage (P<0.05). The positive rate of Foxp3+ is higher in CD4⁺CD25⁺ Tregs positive cells than in control group (P<0.01). The difference of positive rate between late stage and early stage head and neck tumors is statistically significant (P<0.05). There is a significant positive correlation between CD4⁺CD25⁺ Tregs and Foxp3 (r=0.95). Conclusion:CD4⁺CD25⁺ Tregs and Foxp3 are highly expressed in the peripheral blood of patients with head and neck squamous cell carcinoma. Through the inhibition of the immune system in patients with head and neck squamous cell carcinoma, the development of carcinoma were promoted.

[Preliminary study on the expression of EGFRvⅢ and CXCR4 in head and neck squamous cell carcinoma]

Objective:The aim of this study is to detect the expression of EGFRvⅢ and CXCR4 in HNSCC and to explore its possible mechanism. Method:We selected 60 cases of HNSCC from May 2013 to November 2016 in our hospital for surgical treatment, including 44 cases of laryngeal squamous cell carcinoma, 14 cases of hypopharyngeal squamous cell carcinoma, and 2 cases of nasal squamous cell carcinoma. pTNM staging according to AJCC 2010, Ⅲ stage 17 cases, Ⅳa stage 40 cases, and Ⅳb stage 3 cases; according to tumor differentiation degree: 13 cases of high differentiation, moderately differentiation in 31 cases, and 16 cases of low differentiated; primary tumor, positive lymph node metastasis as the experimental group, and 10 cases of adjacent tissues are taken as control (control group). The expression of EGFRvⅢ and CXCR4 in primary tumor, metastasis and control group was observed by immunohistochemistry. The immunohistochemical results are semi quantitatively analyzed by Image-Pro Plus. All analyses were conducted using the SPSS 23.0 and Graphpad-Prism 5.0. Result:The expression of EGFRvⅢ and CXCR4 in HNSCC is higher than control, which was not correlated with age, gender, location, degree of differentiation, T grading, and TNM stage (P>0.05). But there was a significant correlation with N grading (P<0.05). The pathology result shows lymph node metastasis in cancer tissues were high expression, but the difference in expression between primary and metastatic tumors are not statistically significant. There is no significant positive correlation between EGFRvⅢ and CXCR4 (r=0.144, P>0.05). Conclusion: Both EGFRvⅢ and CXCR4 promote the invasion and metastasis of advanced HNSCC, however, there may be some synergistic effect between them.

[Association between interleukin-18 gene polymorphisms and hepatocellular carcinoma caused by hepatitis B virus]

OBJECTIVE

To investigate the association between the single nucleotide polymorphisms (SNPs) IL-18-137G/C (rs187238) and IL-18-607A/C (rs1946518) in interleukin-18 (IL-18) gene and hepatocellular carcinoma (HCC) caused by the hepatitis B virus (HBV).

METHODS

The subjects were divided into HBV-related HCC group (109 patients), chronic HBV infection group (113 patients), and healthy control group (127 patients). The polymerase chain reaction-ligase detection reaction (PCR-LDR) was used to determine the alleles and genotypes of the two SNPs IL-18-137G/C and IL-18-607A/C. The t-test and chi-square test were used for baseline data. The chi-square test was used to investigate the differences in genotype and allele frequencies across the three groups. Non-conditional logistic regression analysis was used to compare the odds ratios (ORs) and 95% confidence intervals (CIs) for different genotypes/alleles in predicting the risk of HBV-related HCC.

RESULTS

The HBV-related HCC group showed significantly higher AA genotype and A allele frequencies of the SNP IL-18-607A/C than the healthy control group (AA genotype frequency: 29.4% vs 18.1%, χ (2) = 4.152, P < 0.05; A allele frequency: 54.6% vs 44.1%, 5.169, P < 0.05), which were positively correlated with the risk of HBV-related HCC (AA genotype frequency: OR = 1.879, 95% CI: 1.020-3.464; A allele frequency: OR = 1.524, 95% CI: 1.059-2.193). The chronic HBV infection group had a significantly higher A allele frequency of the SNP IL-18-607A/C than the healthy control group (54.0% vs 44.1%, χ (2) = 4.680, P < 0.05), which was positively correlated with the risk of chronic HBV infection (OR = 1.487, 95% CI: 1.037-2.132). The genotype and allele frequencies of the SNP IL-18-607A/C showed no significant differences between the HBV-related HCC group and the chronic HBV infection group (P > 0.05). The genotype and allele frequencies of the SNP IL-18-137G/C showed no significant differences between any two groups of the three groups (P > 0.05).

CONCLUSION

The AA genotype and A allele frequencies of the SNP IL-18-607A/C are positively correlated with the morbidity of HBV-related HCC, and the A allele frequency of the SNP IL-18-607A/C is positively correlated with the morbidity of chronic HBV infection.

[Clinical analysis of fourteen cases with neuromyelitis optica spectrum disorders]

Objective: To analysis the clinical manifestation, radiological data, laboratory findings of neuromyelitis optica spectrum disorders (NMOSD) to help physicians have a deeper understanding of the disease. Methods: The clinical manifestations, radiological data, laboratory findings of NMOSD patients from People's Hospital of Zhengzhou University between June 2015 and June 2016 were retrospectively analyzed. Results: Fourteen patients with NMOSD were enrolled, consisting of 3 males and 11 females. The onset age ranged from 15 to 62 years, in average 39.64. Among them, there was 1 case with history of hyperthyroidism, 3 cases with Sjögren syndrome (SS). Major clinical manifestations were vision loss in 4 cases, nausea and vomiting in 4 cases, limbs numbness and weakness in 6 cases. All the 14 patients were received the cerebrospinal fluidcell surface antigen antibody detection, and the results were strong positive 6 cases (6/14), positive 7 cases (7/14), weak positive 1 case (1/14). Abnormal signals in the thirdventricle, midbrain aqueduct, oblongata, pons and cervical, thoracic spinal cord were found by Magnetic Resonance Imaging (MRI). Fourteen patients were treated with glucocorticoid, among them 8 received immunosuppressive therapy. All the 14 patients were followed up, and 9 patients had different degrees of sequelae, including vision decline in 4 cases, numbness and weakness in 5 cases. Conclusions: Neuromyelitis optica spectrum disorders frequently occur in young female. Clinicians need to consider the possibility of NMOSD for acute or subacute blurred vision, nausea, vomiting, numbness and weakness of limbs or trunk and psychiatric symptoms. NMOSD can not be easily excluded for those special patients with atypical clinical manifestations, and relevant inspections should be performed as far as possible in order to make the correct diagnosis.

[DOTAP liposome-mediated transfection of human adipose-derived stemcells with pIRES2-EGFP-VEGF plasmid and target gene expression]

Objective:To explore liposome-mediated transfection of human adipose-derived stem cells (hASCs) with vascular endothelial growth factor(VEGF) gene and to investigate the expression of VEGF after transfection.Method:Lipoaspirate was digested using collagenase.Cell pellet was harvested and subcultured to passage 4.Phenotype was detected with flow cytometry and multilineage differentiation was induced for the identification of hASCs.hASCs was transfected with pIRES2-EGFP-VEGF plasmid using DOTAP liposome.The intracellular expression of VEGF was detected by immunofluorescent staining and the VEGF concentration in supernatant was analyzed by ELISA.Result:1 ml lipoaspirate yielded(4.38±0.21)×10⁵ cells.hASCs on passage 4 showed high expression of CD90(81.49%) and low expression of CD19(6.37%),CD31(14.91%),CD34(17.56%) and CD45(15.39%).GFP and VEGF were observed in transfected hASCs.The transfection efficiency was(43.69±18.53)%.Untransfected hASCs did not express GFP but low level of VEGF.The optical density of VEGF intransfected hASCs is 2.13 fold of untransfected hASCs.The VEGF concentration in supernatant of transfected hASCs significantly increased over time and exhibit statistic differences compared with untransfected hASCs(P<0.05).Conclusion:hASCs were successfully transfected with pIRES2-EGFP-VEGF plasmid using DOTAP liposome.The post-transfection expression and secretion of VEGF remarkably increased.

Microstructures, mechanical properties and corrosion resistances of extruded Mg-Zn-Ca-xCe/La alloys

Magnesium alloys are considered as good candidates for biomedical applications, the influence of Ce/La microalloying on the microstructure, mechanical property and corrosion performance of extruded Mg-5.3Zn-0.6Ca (wt%) alloy has been investigated in the current study. After Ce/La addition, the conventional Ca2Mg6Zn3 phases are gradually replaced by new Mg-Zn-Ce/La-(Ca) phases (T1'), which can effectively divide the Ca2Mg6Zn3 phase. The Ca2Mg6Zn3/T1' structure in Mg-Zn-Ca-0.5Ce/La alloy is favorably broken into small particles during the extrusion, resulting in an obvious refinement of secondary phase. The dynamic recrystallized grain size is dramatically decreased after 0.5Ce/La addition, and the tensile yield strength is improved, while further addition reverses the effect, due to the grain coarsening. However, the corrosion resistance of extruded Mg-Zn-Ca alloy deteriorates after Ce/La addition, because the diameter of secondary phase particle is remarkably decreased, which increases the amount of cathodic sites and accelerates the galvanic corrosion process.

Association between interleukin-21 gene polymorphisms (rs12508721) and HBV-related hepatocellular carcinoma

Interleukin-21 (IL-21), as a multifunctional cytokine, plays an important role in many diseases, such as cancer, inflammatory and autoimmune diseases. We aimed to investigate the relationship between polymorphisms of IL-21 gene and susceptibility of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) in a Chinese population. Studied subjects were divided into three groups: 100 patients with HBV-related HCC, 115 patients with chronic HBV infection and 127 healthy controls. Genomic DNA was isolated from peripheral blood, and the polymerase chain reaction-ligase detection reaction (PCR-LDR) method was used to genotype the SNPs (rs2221903, rs907715 and rs12508721) within IL-21 gene. Our results showed that IL-21 polymorphisms were associated with the risk of HCC and chronic HBV infection when compared with healthy controls. The rs2221903A/G AG genotype was associated with a higher risk of chronic HBV infection when compared with healthy controls [AG versus AA + GG, P = 0.036, OR = 1.898, 95%CI = 1.038-3.471]. The rs12508721C/T TT genotype was related with a lower risk of chronic HBV infection and HBV-related HCC than in healthy controls [TT versus CT + CC, P = 0.026, OR = 0.451, 95%CI = 0.221-0.920; P = 0.049, OR = 0.482, 95%CI = 0.231-1.005]. No significant difference in the genotype and allele distrubutions of rs907715G/A SNP was observed in the HBV-related HCC group, chronic HBV-infected group and the healthy control group when compared to each other. Our findings suggest that the rs12508721T/C and rs2221903A/G polymorphisms of IL-21 gene are associated with the susceptibility of HBV-related HCC and chronic HBV infection. The genetic variant may in fact cause protection against the HBV-related HCC. However, the function in these SNPs of IL-21 gene needs to clarify the mechanisms involved in the pathogenesis of HBV-related HCC further.

[Predictive value of deubiquitination enzymes USP37 in the prognosis of breast cancer]

OBJECTIVE

To explore the expression of Ubiquitin-specific processing enzyme 37(USP 37)in breast cancer and its association with the prognosis of breast cancer.

METHODS

In this study, the method of Western blot was utilized to examine the expression of USP37 protein in breast cancer fresh tissue. Immunohistochemistry (IHC) was used to determine the expression of USP37 in 533 cases of breast cancer. Receive operating characteristic (ROC) curve analysis was employed to determine a cut-off score for USP37 expression. For validation, the ROC-derived cut-off score was subjected to analysis the association of USP37 expression with cancer patient outcome and clinical characteristics.

RESULTS

USP37 protein was mainly located in cytoplasm of the cell, occasionally in nucleus by immunohistochemistry. In the normal breast tissue, USP37 was not expressed or with low expression level, while in the 533 cases of breast cancer, the high USP37 expression was detected in 50.7% samples (270/533) with corresponding low or negative expression rate 49.3% (263/533). We found that USP37 was highly expressed in primary breast cancer tissues compared to paired adjacent non-cancerous tissues. High expression of USP37 was associated with breast cancer node classification, molecular classification and proliferation biomarker Ki67. Both univariate and multivariate analyses further revealed that USP37 expression was an independent poor prognostic parameter for overall survival (OS), recurrence-free survival (RFS) and metastasis-free survival (MFS) in breast cancer. Furthermore, USP37 expressions divided the luminal and triple negative breast cancer into different prognosis subgroups.

CONCLUSION

Our findings first provide evidences that high expression of USP37 served as an independent molecular biomarker for poor prognosis in breast cancer.

Functional calcium imaging in zebrafish lateral-line hair cells

Sensory hair-cell development, function, and regeneration are fundamental processes that are challenging to study in mammalian systems. Zebrafish are an excellent alternative model to study hair cells because they have an external auxiliary organ called the lateral line. The hair cells of the lateral line are easily accessible, which makes them suitable for live, function-based fluorescence imaging. In this chapter, we describe methods to perform functional calcium imaging in zebrafish lateral-line hair cells. We compare genetically encoded calcium indicators that have been used previously to measure calcium in lateral-line hair cells. We also outline equipment required for calcium imaging and compare different imaging systems. Lastly, we discuss how to set up optimal imaging parameters and how to process and visualize calcium signals. Overall, using these methods, in vivo calcium imaging is a powerful tool to examine sensory hair-cell function in an intact organism.

Cloning and characterization of a benzoic acid/salicylic acid carboxyl methyltransferase gene involved in floral scent production from lily (Lilium 'Yelloween')

In lily flowers, the volatile ester methyl benzoate is one of the major and abundant floral scent compounds; however, knowledge regarding the biosynthesis of methyl benzoate remains unknown for Lilium. In this study, we isolated a benzoic acid/salicylic acid carboxyl methyltransferase (BSMT) gene, LiBSMT, from petals of Lilium 'Yelloween'. The gene has an open reading frame of 1083 base pairs (bp) and encodes a protein of 41.05 kDa. Sequence alignment and phylogenetic analyses of LiBSMT revealed 40-50% similarity with other known benzenoid carboxyl methyltransferases in other plant species, and revealed homology to BSMT of Oryza sativa. Heterologous expression of this gene in Escherichia coli yielded an enzyme responsible for catalyzing benzoic acid and salicylic acid to methyl benzoate and methyl salicylate, respectively. Quantitative real-time polymerase chain reaction analysis showed that LiBSMT was preferentially expressed in petals. Moreover, the expression of LiBSMT in petals was developmentally regulated. These expression patterns correlate well with the emission of methyl benzoate. Our results indicate that LiBSMT plays an important role in floral scent methyl benzoate production and emission in lily flowers.

Association between PAI-1 polymorphisms and plasma PAI-1 level with sepsis in severely burned patients

We investigated the association between plasminogen activator inhibitor-1 (PAI-1) polymorphisms and plasma PAI-1 level with sepsis in severely burned patients. A total of 182 patients with burn areas lager than 30% of the body surface area were enrolled in this study. Peripheral blood samples were obtained from 103 patients with sepsis (sepsis group) and 79 patients without sepsis (control group). An allele-specific polymerase chain reaction assay was used to determine PAI-1 polymorphism 4G/5G distribution. Plasma PAI-1 levels were detected using an enzyme-linked immunosorbent assay. The frequency of the 4G/4G genotype and the 4G allele frequency in the sepsis group were 42.7 and 62.1% respectively, which were significantly higher than those in the control group (P < 0.05). Sepsis patients had a significantly higher plasma PAI-1 level than the control group (P < 0.05). Compared with the 5G/5G genotype, PAI-1 concentrations were significantly higher in the 4G/4G genotype (P < 0.05). The study indicates that the 4G/5G promoter polymorphism of PAI-1 gene may be related to the susceptibility to burn sepsis and that the 4G/4G genotype may be an important genetic risk factor of burn sepsis. Additionally, PAI-1 concentrations in the serum are increased in patients with burn sepsis.

Development of expressed sequence tag-simple sequence repeat markers for Chrysanthemum morifolium and closely related species

With the development of chrysanthemum breeding in recent years, an increasing number of wild species in genera related to Chrysanthemum were introduced to extend the genetic resources and facilitate the genetic improvement of chrysanthemums via hybridization. However, few simple sequence repeat (SSR) markers are available for marker-assisted breeding and population genetic studies of chrysanthemum and closely related species. Expressed sequence tags (ESTs) in public databases and cross-species transferable markers are considered to be a cost-effective means for developing sequence-based markers. In this study, 25 EST-SSRs were successfully developed from Chrysanthemum EST sequences for Chrysanthemum morifolium and closely related species. In total, 4164 unigene sequences were assembled from 7180 ESTs of chrysanthemum in GenBank, which were subsequently used to screen for the presence of microsatellites with the SSRIT software. The screening criteria were 8, 5, 4, and 3 repeating units for di-, tri-, tetra-, and penta- and higher-order nucleotides, respectively. Moreover, 310 SSR loci from 296 sequences were identified, and 198 primer pairs for SSR amplification were designed with the Primer Premier 5.0 software, of which 25 SSR loci showed polymorphic amplification in 52 species and varieties belonging to Chrysanthemum, Ajania, and Opisthopappus. The application of EST-SSR markers to the identification of intergeneric hybrids between Chrysanthemum and Ajania was demonstrated. Therefore, EST-SSRs can be developed for species that lack gene sequences or ESTs by utilizing ESTs of closely related species.

Screening of molecular markers linked to dwarf trait in crape myrtle by bulked segregant analysis

Plant height is one of the most important traits of plant architecture as it modulates both economic and ornamental values. Crape myrtle (Lagerstroemia indica L.) is a popular ornamental woody plant because of its long-lasting mid-summer bloom, rich colors, and diversified plant architecture. These traits also make it an ideal model of woody species for genetic analysis of many ornamental traits. To understand the inheritance of plant height and screen for genes modulating plant height in Lagerstroemia, segregation of the plant height trait was analyzed using the F1 population of L. fauriei (standard) x L. indica 'Pocomoke' (dwarf) with 96 seedlings, while dwarf genes were screened using the bulked segregant analysis method, combined with 28 amplified fragment length polymorphism primers and 41 simple sequence repeat primers. The results showed that the dwarf trait of crape myrtle was controlled by a major gene and modified by minor genes. An amplified fragment length polymorphism marker, M53E39-92, which was 23.33 cM from the loci controlling the dwarf trait, was screened. These results provide basic information for marker-assisted selection in Lagerstromia and cloning of dwarf genes in future studies.

Safety of recombinant human granulocyte-macrophage colony-stimulating factor in healing pediatric severe burns

We explored the safety of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) for healing burns in children. Subjects were randomly assigned to two groups: the experimental group received external rhGM-CSF gel, and the control group received rhGM-CSF gel matrix components, applied to the burn surface. Neither group was given any other drugs that promote wound healing. Each day we recorded the pulse, body temperature, and respiration status in the two groups. We detected the blood routine, urine routine, and hepatic and renal function before the patients received drug treatment and after 72 h. The wound scab and healing states in the two groups were recorded every 4 days to evaluate wound healing rate and time taken for complete healing. Adverse reactions and their rate of occurrence were also recorded. The median time of healing was 15 days in the experimental group and 19 days in the control group (log-rank χ(2) = 5.139, P < 0.05). After 10 days, the experimental group healing rate was consistently higher than that of the control group (significantly different using intuitive analysis), suggesting the experimental group method was more effective. There were no obvious adverse reactions. There was no significant difference between the blood routine, urine routine, and liver and kidney function in the two groups before the treatment and after 3 days (P > 0.05). Compared with saline treatment of severe burns, rhGM-CSF can effectively shorten the healing time without significant adverse reactions, and is an effective and safe treatment for burns in children.

Treatment with hydrogen molecules prevents RANKL-induced osteoclast differentiation associated with inhibition of ROS formation and inactivation of MAPK, AKT and NF-kappa B pathways in murine RAW264.7 cells

The bone protective effects of the hydrogen molecule (H2) have been demonstrated in several osteoporosis models while the underlying molecular mechanism has remained unclear. Osteoclast differentiation is an important factor related to the pathogenesis of bone-loss related diseases. In this work, we evaluated the effects of incubation with H2 on receptor activator of NFκB ligand (RANKL)-induced osteoclast differentiation. We found that treatment with H2 prevented RANKL-induced osteoclast differentiation in RAW264.7 cells and BMMs. Treatment with H2 inhibits the ability to form resorption pits of BMMs stimulated by RANKL. Treatment with H2 reduced mRNA levels of osteoclast-specific markers including tartrate resistant acid phosphatase, calcitonin receptor, cathepsin K, metalloproteinase-9, carbonic anhydrase typeII, and vacuolar-type H(+)-ATPase. Treatment with H2 decreased intracellular reactive oxygen species (ROS) formation, suppressed NADPH oxidase activity, down-regulated Rac1 activity and Nox1 expression, reduced mitochondrial ROS formation, and enhanced nuclear factor E2-related factor 2 nuclear translocation and heme oxygenase-1 activity. In addition, treatment with H2 suppressed RANKL-induced expression of nuclear factor of activated T cells c1 and c-Fos. Furthermore, treatment with H2 suppressed NF-κB activation and reduced phosphorylation of p38, extracellular signal-regulated kinase, c-Jun-N-terminal kinase, and protein kinases B (AKT) stimulated with RANKL. In conclusion, hydrogen molecules prevented RANKL-induced osteoclast differentiation associated with inhibition of reactive oxygen species formation and inactivation of NF-κB, mitogen-activated protein kinase and AKT pathways.

Treatment with exogenous hydrogen sulfide attenuates hyperoxia-induced acute lung injury in mice

The aim of this work was to test the effect of treatment with hydrogen sulfide (H2S) on hyperoxia-induced acute lung injury in mice. Mice were exposed to room air or 95 % O2, and treated with NaHS (intraperitoneal injection of 0.1 ml/kg/day of 0.56 mol/l NaHS). Treatment with H2S partly restored the reduced H2S levels in plasma and lungs of mice exposed to hyperoxia. Treatment with H2S attenuated hyperoxia-induced acute lung injury marked by reduced ratio of lung weight to body weight, ratio of lung wet weight to dry weight, and cell numbers and protein content in bronchoalveolar lavage (BAL) and decreased apoptosis. Treatment with H2S markedly prolonged the survival of mice under oxygen exposure. Treatment with H2S abated hyperoxia-induced oxidative stress marked by reduced malondialdehyde and peroxynitrite formation, reduced NADPH oxidase activity, enhanced translocation of nuclear factor E2-related factor (Nrf2) into nucleus and increased activity of HO-1. Treatment with H2S decreased IL-1β, MCP-1, and MIP-2, and increased IL-10 expression in lungs of mice exposed to hyperoxia. Treatment with H2S decreased NFκB activity and iNOS expression in lungs, and reduced NOx content in BAL of mice exposed to hyperoxia. Treatment with H2S reduced lung permeability and suppressed VEGF release and VEGFR2 expression in lungs of mice under oxygen exposure. Treatment with exogenous H2S attenuated hyperoxia-induced acute lung injury through abating oxidative stress, suppressing inflammation, and reducing lung permeability in mice.

Genetic diversity of Lagerstroemia (Lythraceae) species assessed by simple sequence repeat markers

Lagerstroemia (crape myrtle) are famous ornamental plants with large pyramidal racemes, long flower duration, and diverse colors. However, little is known about the genetic structure and diversity of germplasm in Lagerstroemia. We genotyped 81 L. indica cultivars, five other species of Lagerstroemia, and 10 interspecific hybrids using 30 simple sequence repeat markers; 275 alleles were generated with a mean of nine alleles per locus. The mean polymorphism information content value, a measure of gene diversity, was 0.63, with a range from 0.25 to 0.86. The mean observed heterozygosity (0.51) tended to be lower than the mean expected heterozygosity (0.67). The mean F-statistics (F(ST), F(IS), and F(IT)) were 0.05, 0.20, and 0.24, respectively, indicating a high level of genetic variation among cultivars. Clustering analysis based on genetic distance divided the 96 genotypes into three distinct groups, which corresponded with their genetic backgrounds and geographic regions. L. indica cultivars and the other five L. species were grouped into different sub-clusters. Chinese and North American cultivars were divided into different clusters. These data about the genetic relationship among cultivars demonstrated the potential value of L. indica cultivars and other Lagerstroemia species for widening the genetic basis of breeding programs for this ornamental flower.

Observation of electron-antineutrino disappearance at Daya Bay

The Daya Bay Reactor Neutrino Experiment has measured a nonzero value for the neutrino mixing angle θ(13) with a significance of 5.2 standard deviations. Antineutrinos from six 2.9 GWth reactors were detected in six antineutrino detectors deployed in two near (flux-weighted baseline 470 m and 576 m) and one far (1648 m) underground experimental halls. With a 43,000 ton-GWth-day live-time exposure in 55 days, 10,416 (80,376) electron-antineutrino candidates were detected at the far hall (near halls). The ratio of the observed to expected number of antineutrinos at the far hall is R=0.940±0.011(stat.)±0.004(syst.). A rate-only analysis finds sin(2)2θ(13)=0.092±0.016(stat.)±0.005(syst.) in a three-neutrino framework.

Influence of consumption of probiotics on the plasma lipid profile: a meta-analysis of randomised controlled trials

AIMS

Human clinical studies have yielded mixed results on the effects of consumption of probiotics on the plasma lipid profile. We conducted a meta-analysis of randomised controlled trials that evaluated the effects of probiotics consumption on blood lipids.

DATA SYNTHESIS

A systematic literature search of Embase, Web of Science, PubMed and Cochrane Controlled Trials Registry was conducted for studies that investigated the efficacy of probiotics on the plasma lipid profile of subjects. With the help of Review Manager 4.2, data from 13 trials, which included 485 participants with high, borderline high and normal cholesterol levels, were examined. The pooled mean net change in total cholesterol for those treated with probiotics compared to controls was -6.40 mg dl(-1) (95% confidence interval (CI), -9.93 to -2.87), mean net change in low-density lipoprotein (LDL) cholesterol was -4.90 mg dl(-1) (95% CI, -7.91 to -1.90), mean net change in high-density lipoprotein (HDL) cholesterol was -0.11 mg dl(-1) (95% CI, -1.90-1.69) and mean net change in triglycerides was -3.95 mg dl(-1) (95% CI, -10.32-2.42).

CONCLUSION

These results indicate that a diet rich in probiotics decreases total cholesterol and LDL cholesterol concentration in plasma for participants with high, borderline high and normal cholesterol levels.

Genetic diversity of Aquilegia (Ranunculaceae) species and cultivars assessed by AFLPs

Species of the genus Aquilegia are exceptionally diverse in their floral morphology and color, commonly known as columbine. They are widely planted ornamentals and are highly attractive for hummingbirds. However, little is known about their genetic diversity. We examined the genetic diversity of the species and cultivars using amplified fragment length polymorphism (AFLP) markers. Sixteen EcoRI/MseI AFLP primer combinations produced 327 informative polymorphic bands, with a mean of 20.4 bands scored per primer. Jaccard's coefficient of similarity varied from 0.61 to 0.93, indicative of high levels of genetic variation. Cluster analysis using the unweighted pair group method with arithmetic mean algorithm placed the 64 accessions into two main clusters, each divided into two sub-clusters. The AFLP variability was significantly associated with the geographic origins, as the Asian species and the North American species grouped into two distinct clusters. The genetic diversity found among Aquilegia demonstrated the potential value of Chinese germplasm for cultivar improvement and for widening the genetic basis of breeding programs and breeding material selection. We concluded that AFLPs are informative and can provide significant insights for genetic diversity research in columbine species.

A micromachined tunable coupled-cavity laser for wide tuning range and high spectral purity

This paper presents the design and experimental study of a coupled-cavity laser based on the micromachining technology for wide tuning range and improved spectral purity. The core part of this design utilizes a deep-etched movable parabolic mirror to couple two identical Fabry-Pérot chips and thus allows the active adjustment of the cavity gap so as to optimize the mode selection and to increase the tuning range as well. In experiment, the laser achieves the single longitudinal mode output over 51.3 nm and an average side-mode-suppression ratio of 22 dB when the tuning current varies from 5.7-10.8 mA. The measured wavelength tuning speed is 1.2 micros and the single mode output is stable at any wavelength when the tuning current is varied within +/- 0.06 mA. Compared with the conventional fixed cavity gap coupled-cavity lasers, such design overcomes the phase mismatching and mode instability problems while maintaining the merit of high-speed wavelength tuning using electrical current.

A comparative study on Pb2+, Zn2+ and Cd2+ sorption onto zirconium phosphate supported by a cation exchanger

In the present study, a novel hybrid sorbent ZrP-001 was prepared by loading zirconium phosphate (ZrP) onto a strongly acidic cation exchanger D-001. Sorption behavior of Pb(2+), Zn(2+), and Cd(2+) onto ZrP-001 was experimentally examined by comparing with the host exchanger D-001. ZrP-001 was characterized by scanning electron micrograph (SEM), X-ray diffraction (XRD), thermogravimetric analysis (TGA), pH-titration and pore size distribution analysis. Sorption of the heavy metals onto ZrP-001 was found to be pH-dependent due to the ion exchange mechanism. Compared to D-001, a smaller pore size of ZrP-001 due to the ZrP dispersion consequently resulted in a lower sorption rate. Competitive effect of Ca(2+) on sorption of heavy metals onto ZrP-001 and D-001 was compared to elucidate sorption preference of the hybrid sorbent towards heavy metals. More favorable sorption of ZrP-001 than D-001 was observed for all the three metals and their sorption preference onto ZrP-001 followed the order Pb(2+)>>Zn(2+) approximately Cd(2+). Fixed-bed sorption results and its efficient regeneration property further demonstrated that ZrP-001 is a potential candidate for removing heavy metals from contaminated water.

Highly effective removal of heavy metals by polymer-based zirconium phosphate: A case study of lead ion

Zirconium phosphate (ZrP) has recently been demonstrated as an excellent sorbent for heavy metals due to its high selectivity, high thermal stability, and absolute insolubility in water. However, it cannot be readily adopted in fixed beds or any other flowthrough system due to the excessive pressure drop and poor mechanical strength resulting from its fine submicrometer particle sizes. In the present study a hybrid sorbent, i.e., polymer-supported ZrP, was prepared by dispersing ZrP within a strongly acidic cation exchanger D-001 and used for enhanced lead removal from contaminated waters. D-001 was selected as a host material for sorbent preparation mainly because of the Donnan membrane effect resulting from the nondiffusible negatively charged sulfonic acid group on the exchanger surface, which would enhance permeation of the targeted metal ions. The hybrid sorbent (hereafter denoted ZrP-001) was characterized using a nitrogen adsorption technique, scanning electron microscope (SEM), and X-ray diffraction (XRD). Lead sorption onto ZrP-001 was found to be pH dependent due to the ion-exchange mechanism, and its sorption kinetics onto ZrP-001 followed the pseudo-first-order model. Compared to D-001, ZrP-001 exhibited more favorable lead sorption particularly in terms of high selectivity, as indicated by its substantially larger distribution coefficients when other competing cations Na(+), Ca(2+), and Mg(2+) coexisted at a high level in solution. Fixed-bed column runs showed that lead sorption on ZrP-001 resulted in a conspicuous decrease of this toxic metal from 40 mg/L to below 0.05 mg/L. By comparison with D-001 and ZrP-CP (ZrP dispersion within a neutrally charged polymer CP), enhanced removal efficiency of ZrP-001 resulted from the Donnan membrane effect of the host material D-001. Moreover, its feasible regeneration by diluted acid solution and negligible ZrP loss during operation also helps ZrP-001 to be a potential candidate for lead removal from water. Thus, all the results suggested that ZrP-001 offers excellent potential for lead removal from contaminated water.

Modeling synergistic adsorption of phenol/aniline mixtures in the aqueous phase onto porous polymer adsorbents

The adsorption equilibria of phenol and aniline on nonpolar polymer adsorbents (NDA-100, XAD-4, NDA-16 and NDA-1800) were investigated in single- and binary-solute adsorption systems at 313 K. The results showed that all the adsorption isotherms of phenol and aniline on these adsorbents can be well fitted by Freundlich and Langmuir equations, and the experimental uptake of phenol and aniline in all binary-component systems is obviously higher than predicted by the extended Langmuir model, arising presumably from the synergistic effect caused by the laterally acid-base interaction between the adsorbed phenol and aniline molecules. A new model (MELM) was developed to quantitatively describe the synergistic adsorption behavior of phenol/aniline equimolar mixtures in the binary-solute systems and showed a marked improvement in correlating the binary-solute adsorption of phenol and aniline by comparison with the widely used extended Langmuir model. The newly developed model confirms that the synergistic coefficient of one adsorbate is linearly correlated with the adsorbed amount of the other, and the larger average pore size of adsorbent results in the greater synergistic effect of phenol/aniline equimolar mixtures adsorption.

Mycelium cultivation, chemical composition and antitumour activity of a Tolypocladium sp. fungus isolated from wild Cordyceps sinensis

AIMS

To examine and illustrate the morphological characteristics and growth kinetics of Cs-HK1, a Tolypocladium fungus, isolated from wild Cordyceps sinensis in solid and liquid cultures, and the major chemical constituents and antitumour effects of Cs-HK1 mycelium.

METHODS AND RESULTS

The Cs-HK1 fungus was isolated from the fruiting body of a wild C. sinensis and identified as a Tolypocladium sp. fungus. It grew rapidly at 22-25 degrees C on a liquid medium containing glucose, yeast extract, peptone and major inorganic salts, with a specific growth rate of 1.1 day(-1), reaching a cell density of 23.0 g dw l(-1) in 7-9 days. Exopolysaccharides accumulated in the liquid culture to about 0.3 g l(-1) glucose equivalent. In comparison with natural C. sinensis, the fungal mycelium had similar contents of protein (11.7-microg) and carbohydrate (654.6-microg) but much higher contents of polysaccharide (244.2 mg vs 129.5 mg), adenosine (1116.8-microg vs 264.6 microg) and cordycepin (65.7 microg vs 20.8 microg) (per gram dry weight). Cyclosporin A, an antibiotic commonly produced by Tolypocladium sp., was also detected from the mycelium extract. The hot water extract of mycelium showed low cytotoxic effect on B16 melanoma cells in culture (about 25% inhibition) but significant antitumour effect in animal tests, causing 50% inhibition of B16 cell-induced tumour growth in mice.

CONCLUSIONS

The Tolypocladium sp. fungus, Cs-HK1, can be easily cultivated by liquid fermentation. The mycelium biomass contained the major bioactive compounds of C. sinensis, and the mycelium extract had significant antitumour activity.

SIGNIFICANCE AND IMPACT OF THE STUDY

The Cs-HK1 fungus may be a new and promising medicinal fungus and an effective and economical substitute of the wild C. sinensis for health care.

Genetic diversity of avian infectious bronchitis coronavirus strains isolated in China between 1995 and 2004

Twenty-six avian infectious bronchitis (IB) viruses (IBV) were isolated from outbreaks in chickens in China between 1995 and 2004. They were characterized by comparison with twenty-six Chinese reference strains and five other IBV strains. Chinese IBVs, which were mainly nephropathogenic, were placed into seven genotypes. Fourteen Chinese IBV isolates were placed in genotype I, having small evolutionary distances from each other. Genotype II included 6 strains that were isolated in the 1990s in China. Genotype III consisted of eight Chinese isolates that showed close relationship with Korean IBV isolates. Another eight IBV isolates clustered in genotype IV and showed larger evolutionary distances. The Massachusetts serotype was present in China in 1990s and was in a separate genotype. Two isolates, HN99 and CK/CH/LHN/00I, which might be a reisolation of vaccine strains, clustered into genotype VI. Four Chinese IBV isolates formed another genotype and showed larger evolutionary distances from other Chinese IBV genotypes (genotype VII). IBVs in same genotypes showed more than 90% amino acid sequence similarities, whereas most of the viruses in different genotypes showed less than 90%. The results showed that IBVs in China came from genetic changes both in IBV populations that existed before the advent of vaccination and in the viruses that were introduced through live vaccines. IBVs showing various genetic differences are cocirculating in China.

Application of an effective method in predicting breakthrough curves of fixed-bed adsorption onto resin adsorbent

Removal of many organic pollutants including phenolic compounds from industrial wastewater can always be achieved by fixed-bed adsorption onto the polymeric resin adsorbent, and the relevant breakthrough curves would provide much valuable information to help to design a fixed-bed adsorption process in field application. In the present study, a model developed based on the constant-pattern wave approach theory and the Freundlich model was adopted to describe the breakthrough curves of phenol and p-nitrophenol adsorption onto a macroreticular resin adsorbent NDA-100 from aqueous solution. Column experiments were performed at different conditions to verify the model and the results proved that the model would describe the breakthrough curves well. Effect of the operation parameters on breakthrough curves was also discussed to get helpful information in choosing the adsorption process.

Adsorption of phenolic compounds from aqueous solution onto a macroporous polymer and its aminated derivative: isotherm analysis

Adsorption of phenolic compounds from aqueous solution to a macroporous polymeric adsorbent (CHA-111), its animated derivative (MCH-111) and a reference weakly anion exchanger (ND-900) was studied. Experimental results indicated that amino functional groups on the polymeric matrix play an important role in phenol adsorption by MCH-111 and ND-900, which was attributed to the formation of hydrogen bonding between the phenol molecule and the amino group on the polymeric matrix. The semi-empirical Freundlich isotherm equation and its reduced form were employed to interpret the adsorption behavior. A site energy distribution model based on the Polanyi adsorption potential theory can elucidate the adsorption mechanism reasonably.