[Clinical outcome of combined over-the-top reconstruction with modified Lemaire procedure in one-stage revision anterior cruciate ligament reconstruction]

Objective: To investigate the clinical effect of over-the-top (OTT) reconstruction of the anterior cruciate ligament (ACL) combined with the modified Lemaire technique in one-stage ACL revision. Methods: It's a retrospective study. The clinical data of 37 patients who underwent one-stage revision of ACL using OTT combined with modified Lemaire technique from April 2020 to May 2023 in the Department of Sports Medicine of Xinhua Hospital Affiliated to Dalian University were retrospectively analyzed. There were 28 males and 9 females with a mean age of (32.7±5.7) years. The postoperative knee function and surgical revision effect were evaluated by subjective and objective evaluation indexes of the knee joint before and 3 months and 24 months after surgery. The subjective evaluation indexes included the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score; and the objective evaluation indexes included the anterior-posterior static displacement distance of the tibia, tibia-femur relative rotation angle, the Lachman test, the axial shift test, and the ratio of the loss of muscle strength of the lower limb. Results: At the final follow-up, all patients returned to pre-injury motor level, with significant improvements in IKDC scores (45.3±6.8 preoperatively, 67.5±4.7 and 93.2±2.3 at 3 months and 2 years after the operation, respectively), Lysholm scores (57.2±2.6 preoperatively, 72.6±2.9 and 89.7±3.7 at 3 months and 2 years after the operation, respectively), and Tegner scores (3.1±0.7 preoperatively, 4.9±0.6 and 5.8±1.3 at 3 months and 2 years after the operation, respectively) (all P<0.001). The anterior-posterior static displacement distance of the tibia reduced significantly [from (5.2±0.5) mm before the operation to (1.4±0.5) mm at 2 years postoperatively) (P<0.001)]; and the relative rotation angle of the tibia-femur restored to the normal physiological range, it was reduced from 6.2°±1.2° before the operation to 1.7°±0.3° 2 years after (P<0.001). The Lachman test and axial shift test at 2 years postoperatively were all negative. The muscle strength loss ratio of the affected lower limb was significantly better than that before the operation (P<0.001). Conclusion: The use of OTT reconstruction combined with modified Lemaire technique for revision of ACL in patients with ACL reconstruction failure can circumvent the tunnel problem for one-stage revision and better restore the stability and function of the knee joint, with ideal clinical results.

[Risk factors analysis and the development and validation of a clinical prediction model for acute mesenteric ischemia-induced intestinal infarction]

Objective: To investigate the risk factors of intestinal infarction caused by acute mesenteric ischemia (AMI), and develop and validate a clinical prediction model of Nomogram plot for intestinal infarction caused by AMI. Methods: From January 2014 to December 2020, 201 patients with AMI in the Affiliated Hospital of Yunnan University were selected as the modeling group, and 105 patients with AMI in the First Affiliated Hospital of Kunming Medical University were collected as the validation group. The age of patients in the modeling group was (62±12) years, and there were 70 males and 131 females. The age of patients in the validation group was (62±10) years old, and there were 69 males and 36 females. The clinical data including clinical manifestations, laboratory indicators and imaging indicators of patients in the two groups were retrospectively analyzed, and univariate and multivariate binary logistic regression analyses were performed to screen out risk factors for the progression of AMI to intestinal infarction. A Nomogram plot clinical prediction model for AMI causing intestinal infarction was developed using R software, and the differentiation, calibration and net clinical benefit of this Nomogram plot were evaluated by C-index, calibration curve and clinical decision analysis curve. Results: Shock (OR=13.69, 95%CI: 2.31-88.87), body temperature ≥38.0 ℃ (OR=6.39, 95%CI: 1.85-22.11), white blood cells (WBC) ≥18×10⁹/L (OR=1.19, 95%CI: 1.03-1.37), intestinal changes on CT (OR=0.17, 95%CI: 0.04-0.66), peritoneal irritation (OR=0.06, 95%CI: 0.01-0.26), and pH≤7.34 (OR=0.00, 95%CI: 0.00-0.01) were risk factors for intestinal infarction caused by AMI. Body temperature ≥38.0 ℃ (sensitivity: 81.5%, specificity: 87.0%), WBC ≥18×10⁹/L (sensitivity: 84.0%, specificity: 83.0%) and pH ≤7.34 (sensitivity: 70.4%, specificity: 76.7%) were cut-off values for progression to intestinal infarction in patients with AMI. The Nomogram plot prediction model of intestinal infarction induced by AMI was established by using the above parameters and validated internally and externally. The C index of validation group and modeling group were 0.96 (95%CI: 0.921-0.999) and 0.98 (95%CI: 0.962-0.996), respectively. The calibration curves of the validation group and the modeling group were shaped near the reference line, and the deviation from the reference line was low. The clinical decision analysis curves of validation group and modeling group showed that the clinical prediction model of Nomogram could bring better clinical net benefit for AMI patients. Conclusions: Shock, temperature, white blood cells, intestinal changes on CT, peritoneal irritation sign, and PH are independent risk factors for AMI-induced intestinal infarction. The Nomogram plot established by these factors can effectively predict the probability of AMI patients progressing to intestinal infarction.

Serum immunoglobulin profiles in Chinese children with Henoch-Schönlein purpura

OBJECTIVE

The present study focuses on the associations of serum immunoglobulin with disease activity, relapse/recurrence and renal involvement in Henoch-Schönlein purpura (HSP) children.

METHODS

1683 Chinese children with HSP were recruited from January 2015 to January 2021. Laboratory data of blood samples and urine tests were collected. Renal biopsy was performed by the percutaneous technique. Patients' histories associated with HSP onset were obtained by interviews and questionnaires.

RESULTS

(1) IgA and IgE were dramatically elevated in HSP patients as compared with their normal values, and subject to a 1.75-3.09 fold and a 1.97-2.61 fold increase, respectively. (2) No significant correlation of the disease activity with IgA and IgE was determined, respectively. (3) The serum IgA levels were significantly lower in patients with relapse/recurrence than that in patients without relapse/recurrence, which may be attributed to the transmission of IgA-mediated immune complexes from blood to vessel walls. (4) No significant correlation was found between serum IgA, IgE levels and the pathological classification.

CONCLUSIONS

HSP children have marked disorders of serum immunoglobulin profiles, characterized by significant increases in IgA and IgE. The detection of serum IgA may be applicable to predict relapse/recurrence of HSP, whereas not associated with disease activity and renal involvement.

[The prognostic value of myocardial infarct size measured by cardiovascular magnetic resonance in patients with acute ST-segment elevation myocardial infarction]

Objective: To investigate the prognostic value of infarct size (IS) in patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PCI). Methods: A total of 104 patients with acute STEMI who underwent primary PCI treatment in Shengjing Hospital of China Medical University from February 2017 to November 2018 were included in the present study. All patients underwent cardiovascular magnetic resonance (CMR) within one week after primary PCI treatment. The subjects were followed up for two years. Major adverse cardiac events (MACE) included new onset congestive heart failure and/or recurrent nonfatal myocardial infarction and/orcardiac death. The optimal IS cutoff value for MACE was determined by receiver operating character (ROC) curve. Based on the IS cutoff value, the patients were divided into the high IS group and the low IS group. Clinical characteristics between the two groups were compared. A cox regression model was used to analyze the prognostic value of IS in acute STEMI patients treated with primary PCI for the adverse events. Results: The IS cutoff value determined by ROC curve was 13.55%. 50 patients were in the high IS group (IS≥13.55%) and 54 patients were in the low IS group (IS<13.55%). More female patients [14 cases (28.0%) vs. 6 cases (11.1%)] were in the IS group, and a higher proportion of patients in the high IS group had anterior myocardial infarction [27 cases (54.0%) vs. 16 cases (29.6%)] or microvascular obstruction [32 cases (64.0%) vs. 16 cases (29.6%)]. White blood cell counts [11.25(8.90, 13.38) ×10⁹/L vs. 9.25(7.58, 11.00) ×10⁹/L], troponin I levels [50.63(16.56, 76.30)μg/L vs. 16.58(2.66, 38.42)μg/L] and brain natriuretic peptide levels [178.10(79.70, 281.95)μg/L vs. 79.60(42.83, 183.90)μg/L] in the high IS group were higher than those in the low IS group (P<0.05), and left ventricular ejection fraction [(45.15±10.65)% vs. (51.95±12.91)%] in the high IS group was lower than that in the low IS group (P<0.05). Multivariate Cox regression analyses showed that IS was independently associated with the risk of cardiac death in patients with acute STEMI two years after primary PCI(P=0.033, HR=1.075, 95%CI1.006-1.148). Every 1% increase in IS was associated with a 7.5% increase in cardiac death. Conclusions: Infarct size, measured by CMR within one week after primary PCI, is strongly associated with cardiac death in patients with acute STEMI two years after primary PCI. IS could be used as an index for the prognosis of patients with acute STEMI.

Near-GeV Electron Beams at a Few Per-Mille Level from a Laser Wakefield Accelerator via Density-Tailored Plasma

A simple, efficient scheme was developed to obtain near-gigaelectronvolt electron beams with energy spreads of few per-mille level in a single-stage laser wakefield accelerator. Longitudinal plasma density was tailored to control relativistic laser-beam evolution, resulting in injection, dechirping, and a quasi-phase-stable acceleration. With this scheme, electron beams with peak energies of 780-840 MeV, rms energy spreads of 2.4‰-4.1‰, charges of 8.5-23.6 pC, and rms divergences of 0.1-0.4 mrad were experimentally obtained. Quasi-three-dimensional particle-in-cell simulations agreed well with the experimental results. The dechirping strength was estimated to reach up to 11  TeV/mm/m, which is higher than previously obtained results. Such high-quality electron beams will boost the development of compact intense coherent radiation sources and x-ray free-electron lasers.

[The influence of XRCC1 gene polymorphism on the prognosis and safety of stage Ⅲ patients with colorectal cancer who received oxaliplatin based adjuvant chemotherapy]

Objective: To investigate the influence of X-ray repair cross complementing 1 (XRCC1) gene polymorphism on the prognosis and safety of stage Ⅲ patients with colorectal cancer (CRC) who received oxaliplatin based adjuvant chemotherapy. Methods: A total of 218 stage Ⅲ patients with CRC after R0 resection and received oxaliplatin based adjuvant chemotherapy in the department of gastrointestinal surgery of the First Affiliated Hospital of Zhengzhou University from March 2012 to December 2019 were included and the baseline characteristics were collected. There were 125 male and 93 female patients, aged from 18 to 78 years. Peripheral blood and peripheral blood mononuclear cell (PBMC) specimens of the colorectal cancer patients were preserved for genotyping of XRCC1 gene genetic variation and mRNA expression of XRCC1, respectively. The association between genotype status and prognosis was analyzed by Kaplan-Meier survival analysis. And the correlation between genotype status and adverse reactions was performed with χ² test. Results: The median follow-up time were 4.9 (0.3-7.3) years. The median disease-free survival (DFS) of the 218 patients with CRC was 4.4 years and the median overall survival (OS) was 5.5 years. The prevalence of rs1799782 in XRCC1 gene among the 218 patients was: GG genotype 62.4% (136/218), GA genotype 33.0% (72/218) and AA genotype 4.6% (10/218), minor allele frequency was 0.21. And the distribution frequencies of the three genotypes were in accordance with the hardy-weinberg equilibrium (P=0.905). GA and AA genotypes were merged in the subsequent analysis. The median DFS [M (95%CI)] of GG genotype and GA/AA genotype was 5.2 (4.5-5.9) years and 3.8 (3.2-4.4) years, which was statistically significant (χ²=6.943, P=0.008). Furthermore, the median OS [M (95%CI)] of the two genotypes were 6.0 (5.3-6.7) years and 4.5 (3.9-5.1) years, which was statistically significant (χ²=5.538, P=0.010). The mRNA expression of XRCC1 in PBMC of the patients with GA/AA genotypes was 3.8±0.6,which was significantly higher than that of the GG genotype patients(2.8±0.7) (t=6.140, P<0.001). Conclusion: The prognosis of patients with CRC who received oxaliplatin based adjuvant chemotherapy may be influenced by XRCC1 rs1799782 through mediating the mRNA expression of XRCC1.

[Advances in the application of three-dimensional photothermal functionalized scaffold for bone repairation after maxillofacial tumor surgery]

The traditional treatment of maxillofacial tumors includes surgery and chemoradiotherapy. Surgery carries a high risk,and large bone defects are difficult to repair themselves. Besides, chemoradiotherapy can bring serious side effects. Therefore, how to repair the bone defects after maxillofacial tumor surgery and prevent tumor recurrence has become a major clinical challenge. In recent years, photothermal therapy has attracted much attention because of its low invasion, high efficiency, and no side effects. More and more photothermal materials have emerged and been applied in photothermal therapy. In order to treat tumor-related bone defects, many studies use three-dimensional printing technology to prepare photothermal functionalized scaffold to repair bone defects and prevent the recurrence of tumors. Based on photothermal therapy, the review states the photothermal materials, bone repair materials and photothermal functionalized scaffolds in the treatment of maxillofacial tumors at home and abroad, and provides a new way to solve the clinical challenge of bone defect and tumor recurrence after maxillofacial tumor surgery.

Assessment of coronary artery abnormalities and variability of Z-score calculation in the acute episode of Kawasaki disease-A retrospective study from China

BACKGROUND

Accurate classification of coronary artery abnormalities (CAAs) is essential for clinical decision-making and long-term management in Kawasaki disease (KD) patients. To date, there are several echocardiographic criteria of CAA assessment.

MATERIALS AND METHODS

The Japanese Ministry of Health (JMH) criteria and the Z-score criteria from 2004 American Heart Association guidelines were adopted and their detective efficacies for CAAs were compared in 251 Chinese patients with KD Z scores were calculated by 6 published methods.

RESULTS

According to the JMH criteria, 19 (7.57%) KD patients were classified as CAAs during the acute KD episode. However, the detective number of CAAs was highest and had a 0.68-fold increase by the Dallaire et al method with a Z-score cut point of ≥2.5 as compared with the JMH criteria; in contrast, more than 78.95% of patients with CAAs identified by the JMH criteria had a coronary artery Z score ≥2.5. All 6 different Z-score methods had satisfactory accuracies with a range from 93.23% to 97.61% in screening CAAs. For the 19 patients with CAAs identified by the JMH criteria, their Z scores presented the widest variation calculated by the McCrindle et al method.

CONCLUSIONS

The JMH criteria underestimate the prevalence of CAAs as compared with the Z-score criteria. Quantitative assessment of coronary artery luminal dimensions, normalized as Z scores adjusted for body surface, should be recommended. The larger coronary artery luminal dimensions vary, the more heterogeneous Z scores calculated by different methods have.

Long noncoding RNA NNT-AS1 functions as an oncogene in breast cancer via repressing ZFP36 expression

Breast cancer is one of the most common cancers in women. This study focuses on the effects of Long non-coding RNAs (lncRNAs) NNT-AS1 on breast cancer cell growth and metastasis. Fifty-six pairs of breast cancer (BC) tissues and matched paracarcinoma tissues were obtained. The BC cell lines and normal human breast cell line were employed. NNT-AS1 in BC cells was knocked down by shRNA. Cell counting kit-8 assay (CCK-8), colony formation assay, cell cycle analysis, cell apoptosis analysis, cound healing assay, Transwell assay, cioinformatics analysis, Western blot analysis and Xenograft model were used. Quantitative real-time polymerase chain reaction (qRT-PCR) assay indicated that expression of NNT-AS1 was obviously upregulated in breast cancer tissues compared with adjacent tissues (n=56). Knockdown of NNT-AS1 could attenuate breast cancer cell viability, proliferation, invasion and migration, as well as promote cell apoptosis and induce cell cycle arrest at G0/G1 phase. ZFP36 was directly combined with NNT-AS1, and silencing of ZFP36 could rescue tumor suppression role by downregulating NNT-AS1 on cell proliferation and metastasis. Knockdown of NNT-AS1 could suppress cell growth and metastasis via interacting with ZFP36 in vivo. This study demonstrated that knockdown of NNT-AS1 had tumor-suppressive effect on breast cancer progression and metastasis via interacting with ZFP36 in vitro and in vivo, which provides a new insight into the treatment and prognosis evaluation of breast cancer.

Hollow Plasma Acceleration Driven by a Relativistic Reflected Hollow Laser

In order to address the present difficulty in experimentally generating the relativistic Laguerre-Gaussian laser, primarily due to damage caused to optical modulators, a high-reflectivity phase mirror is applied in the femtosecond petawatt laser system to generate a relativistic hollow laser at the highest intensity of 6.3×10^{19}  W/cm^{2} for the first time. A simple optical model is used to verify that the vortex laser may be generated in this new scheme; using such a relativistic vortex laser, the hollow plasma drill and acceleration are achieved experimentally and proven by particle-in-cell simulations. With the development of the petawatt laser, this scheme opens up possibilities for the convenient production of the relativistic hollow laser at high repetition and possible hollow plasma acceleration, which is important for a wide range of applications such as the generation of radiation sources with orbital angular momentum, fast ignition for inertial confinement fusion, and jet research in the astrophysical environment.

C-type natriuretic peptide stimulates osteoblastic proliferation and collagen-X expression but suppresses fibroblast growth factor-23 expression in vitro

BACKGROUND

The effects of C-type natriuretic peptide (CNP) and fibroblast growth factor (FGF)-23 appear to oppose each other during the process of bone formation, whereas few studies exist on the interaction between CNP and FGF-23. The main objective of the present study is to probe whether CNP is directly responsible for the regulation of osteoblast or via antagonizing FGF-23.

METHODS

Osteoblasts were cultured in the absence or presence of CNP (0, 10, and 100 pmol/L) for 24 h, 48 h and 72 h, respectively.

RESULTS

The findings of the present study indicated that: (1) CNP significantly stimulated osteoblastic proliferation and collagen (Col)-X expression; (2) both osteoblastic (osteocalcin, procollagen type I carboxy-terminal propeptide, total alkaline phosphatase and bone-specific alkaline phosphatase) and osteolytic (tartrate-resistant acid phosphatase and cross-linked carboxyterminal telopeptide of type I collagen) bone turnover biomarkers were up-regulated by CNP in osteoblasts; (3) FGF-23 mRNA and protein were significantly down-regulated at 24 h by CNP in osteoblasts, but the expression of FGF receptor-1/Klotho had no significant change.

CONCLUSIONS

CNP stimulates osteoblastic proliferation and Col-X expression via the down-regulation of FGF-23 possibly in vitro. However, the specific mechanisms of the interaction between CNP and FGF-23 in osteoblasts are still unclear according to our findings. A further study on osteoblasts cultured with CNP and FGF-23 inhibitor will be undertaken in our laboratory.

[Features of gut microbiota in patients with idiopathic Parkinson's disease]

Objectives: To investigate whether the fecal microbiome of Parkinson's disease patients differs from that of healthy population and explore the pathogenesis and new treatment of idiopathic Parkinson's disease. Methods: A total of 30 patients diagnosed as idiopathic Parkinson disease (PD group) in Beijing Friendship Hospital between April 2017 and June 2018 were enrolled and 30 healthy controls (NC group) were recruited at the same time.Medical records and score of unified Parkinson's disease rating scale (UPDRS) were collected and fresh fecal samples were obtained and stored in refrigerator (-80℃). The microbial compositions of fecal samples were investigated by 16S rRNA gene sequencing targeting the V3-V4 region. The taxa abundance and microbial composition were tested. Results: There was no difference of age and sex in PD and NC groups. Chao1 and Shannon indexes tended to be higher in PD group, yet failed to reach statistic significance (P=0.115 and 0.052). Relative abundance of gut microbiota differed in each taxonomic category. The relative abundance of Firmicutes in PD group was 53.6%(41.7%-64.8%), while that of Bacteroidetes in NC group was 51.7%(31.7%-65.3%). The ratios of Firmicutes to Bacteroidetes were significantly different between the two groups (1.6(0.9-3.4) vs 0.7(0.5-1.4), P=0.001). In Clostridia, Bacilli and Erysipelotrichia of Firmicutes, the relative abundances of Clostridiales, Christensenellaceae, Peptoclostridium, Lactobacillus and Erysipelatoclostridium were higher in PD group (P=0.024, 0.046, 0.036, 0.022 and 0.037). The relative abundance of Prevotella of Bacteroidales, was lower in PD group, yet failed to reach statistic significance (P=0.121). The relative abundances of Alistipes of Rikenellaceae and Butyricimonas of Marinilabiliales in PD group were significantly higher than those in NC group (P=0.047 and 0.033). The relative abundance of Bifidobacterium of Actinobacteria was significanly higher in PD group when compared with NC group (P=0.009). Despite the relatively low abundance, Akkermansia of Verrucomicrobia was significantly higher in PD group than in NC group (P=0.025). Conclusion: The structures of the fecal microbiota differ significantly between PD patients and healthy controls.

[Trends of female reproductive health status in Bangladesh from 1999 to 2018]

Objective: To analyze the changes of relevant indicators in reproductive health status among Bangladeshi women from 1999 to 2018 and to assess whether the 2030 Sustainable Development Goals (SDGs) can be achieved. Methods: Data were obtained from both the Bangladesh Demographic and Health as well as from the Maternal Mortality and Health Care Surveys. The trends of SDGs indicators related to reproductive health from 1999 to 2018 were analyzed and compared, and the average annual rate of change was calculated. Development index was used to assess the difficulty of achieving the SDGs. Results: The maternal mortality rate increased first and then leveled off from 2001 to 2016. From 1999 to 2018, the coverage of reproductive health care services and the proportion of women who had the right to make the decision on their own health care service, were generally increasing. Proportion of the following areas as: "contraceptive needs, women who consider that partner violence is justified, the rate of early marriage, and the rate of early childbearing etc.", were declining at various degrees. Development index of the antenatal care coverage, rate of delivery in medical facilities, percentage of live births attended by medically trained providers and the rate of postnatal care etc., were less than 1. The development indices of the maternal mortality rates were close to 1, while all the other indicators were greater than 1. Conclusions: The reproductive health-related SDGs indicators in Bangladesh appeared somehow degrees of progress from 1999 to 2018. However, for most indicators, the average annual rate of change was still lower than the expected to achieve the 2030 target which called for acceleration in the next few years.

Hepatic dysfunction secondary to Kawasaki disease: characteristics, etiology and predictive role in coronary artery abnormalities

Coronary artery abnormalities (CAAs) are prominent during the acute Kawasaki disease (KD) episode and represent the major contributors to the long-term prognosis. Several meta-analysis and published scoring systems have identified hepatic dysfunction as an independent predictor of CAA risks. The medical records of 210 KD children were reviewed. Blood samples were collected from all subjects at 24 h pre-therapy and 48 h post-therapy, respectively. Liver function test (LFT) and inflammatory mediators were detected. Multivariate logistic regression analysis was conducted to identify the reliable biomarkers predicting whether CAAs existed or not in KD patients. 90.95% of KD patients had at least 1 abnormal LFT. Hypoalbuminemia was the most prevalent type of hepatic dysfunction, followed by elevated aspartate aminotransferase, low TP, low A/G and hyperbilirubinemia, respectively. The elevated inflammatory mediators (procalcitonin and C-reactive protein) and moderate dose of aspirin played a synthetic role in hepatic dysfunction secondary to KD. However, LFT presented no significant differences between infectious and noninfectious conditions. By a multivariate analysis, a lower albumin/globulin ratio (A/G, OR 13.50, 95% CI 3.944-46.23) served as an independent predictor of CAAs and had a sensitivity of 56.25%, and a specificity of 61.11% at a cutoff value of < 1.48. In conclusion, hepatic dysfunction is a common complication during the acute KD episode, characterized by elevated serum liver enzymes, hypoalbuminemia and hyperbilirubinemia. Systemic inflammation and aspirin, rather than infectious agents, are both the major contributors of hepatic dysfunction secondary to KD. A lower A/G serves as an independent predictor of CAAs.

P1693The longitudinal associations between telomere attrition and the effects of blood pressure lowering and antihypertensive treatment

Background

Leukocyte telomere length, as an emerging marker of biological age, has been shown to associate with hypertension. However, it has not been studied whether telomere attrition rate in patients with hypertension is related to the heterogeneity of blood pressure (BP) response to antihypertensive therapy.

Purpose

Our aim is to investigate the relationship between telomere attrition rate and BP lowering in a longitudinal Chinese hypertensive cohort. We also aim to explore the potential association between telomere attrition rate and the differences in antihypertensive treatment response.

Methods

A community-based, prospective study was conducted at BenXi county, Liaoning province, in the northern China. A total of 3,671 hypertensive patients were recruited from 2013 t 2015 and of whom 1,382 provided blood samples at baseline. After a median follow-up period of 2.2 (range 1.5–2.4) years, the blood samples were collected from 1,197 patients again in 2016, and 185 patients were not reached to obtain blood sample because of immigration. In addition, 89 blood samples were excluded due to insufficient quality. Finally, 1,108 patients who are available for blood samples both at baseline and at follow-up, were included in the analysis for telomeres change. Annual telomere attrition rate was calculated as (follow-up telomere length-baseline telomere length)/follow-up year, and then categorized into two groups: the shorten (annual telomere attrition rate <0) and the lengthen (annual telomere attrition rate >0). Multivariable linear regression model was used to examine the association of annual telomere attrition rate with blood pressure lowering and antihypertensive treatment. Cox Proportional Hazards model was used to examine the association between annual telomere attrition rate and cardiovascular disease risk.

Results

In multivariable linear regression models, the telomere lengthening was significantly associated with decrease in systolic blood pressure (SBP) (β: −4.13; p=0.006) and pulse pressure (PP) (β: −3.22; p=0.007) during the follow-up, but not associated with diastolic blood pressure (DBP) change. And the associations were observed age- and gender-specific difference. The lengthen was significantly associated with ΔSBP and ΔPP in women and younger patients (age ≤60 years old). Furthermore, the associations were observed in patients who treated with calcium channel blocker (CCB) and angiotensin receptor blocker (ARB), but not in diuretics. Then we found no significant association between annual telomere attrition rate and incident cardiovascular events during the follow-up.

Conclusion(s)

Our data showed that the increasing of leukocyte telomere length is associated with the decreasing of SBP and PP, particularly for the patients who received CCB and ARB therapy. These data showed that annual telomere attrition rate could be a marker of treatment response and will help in clinical management.

Acknowledgement/Funding

the National Science and Technology Pillar Program during the Twelfth Five-year Plan Period (No. 2011BAI11B04)

Attenuating effect of melatonin on lipopolysaccharide-induced chicken small intestine inflammation

Enriched melatonin (MEL) has been found in the mammalian intestine and has been recently demonstrated to alleviate rodent colitis. In this study, the effect of MEL on lipopolysaccharide (LPS)-induced intestinal inflammations was investigated in new chicken hatchlings. The chicks were fed with a diet supplemented with MEL (12.5 mg/day) from D1 to D10. Meanwhile, the chicks in the LPS or MEL + LPS groups were injected with LPS (10 mg/kg BW, i.p.) at D10. LPS treatment for 6 h increased the expression of IL-6, IL-4, caspase-3 mRNAs and TUNEL-positive cell populations, but decreased populations of the goblet and PCNA+ cells, IgA production and the expression of MUC2 mRNA in the duodenum. Compared with the LPS group, MEL pre-feeding alleviated duodenal inflammation and decreased the expression of TNF-α mRNAs by 23.6% (P = 0.004), IL-6 mRNAs by 69.4% (P = 0.001), IL-4 mRNAs by 4.1% (P = 0.824) and caspase-3 mRNAs by 45.8% (P < 0.001). Conversely, MEL pre-feeding attenuated the LPS-induced changes of IgA production by 161.6% (P = 0.013) and PCNA+ cell populations by 172.1% (P < 0.001) in the duodenum. TLR4 mRNA was also up-regulated by LPS treatment but down-regulated by MEL pre-feeding. In conclusion, dietary MEL could attenuate LPS-induced chick duodenal inflammation by down-regulating the expression of inflammatory cytokines, promoting epithelial cell proliferation, improving the immunological barrier and inhibiting epithelial apoptosis via the mediation of TLR4.

Culture and characterization of chicken small intestinal crypts

The integrity and normal function of the small intestinal epithelium depends critically on the rapid renewal of epithelial cells from basal stem cells. The intensive proliferation that fuels this self-renewal process is confined to the intestinal crypts. Establishment of suitable protocols for crypt isolation and culture is pivotal for the studies of intestinal self-renewal mechanisms. In this study, chicken small intestinal crypts were isolated, purified, and further cultured in a Matrigel 3-D culture system. The growth factor concentration assay on the fourth d of culture showed that Group C (50 ng/mL epidermal growth factor (EGF), 100 ng/mL Noggin, and 500 ng/mL R-spondin 1) supplement in culture medium could significantly enlarge the diameter of organoids when compared with Group A (5 ng/mL EGF, 10 ng/mL Noggin, 50 ng/mL, and R-spondin 1) and Group B (10 ng/mL EGF, 20 ng/mL Noggin, and 100 ng/mL R-spondin 1) by 188.4% (P = 0.026) and 176.9% (P = 0.034), respectively. Transmission electron microscopy, neutral red staining, and 5-ethynyl-2΄-deoxyuridine incorporation demonstrated the integrated structure, high viability, and proliferative activity in cultured chicken intestinal organoids. In addition, intestinal stem cell marker genes (Olfm4, Znrf3, Hopx, and Lgr5) also could be detected in cultured intestinal organoids. Furthermore, CHIR99021 (a glycogen synthase kinase 3β inhibitor) could enhance the expression of Olfm4, Znrf3, Hopx, and Lgr5 by 750% (P = 0.001), 467% (P < 0.001), 450% (P < 0.001), and 333% (P = 0.008), respectively, indicating the responsiveness of the cultured chicken intestinal organoids to exogenous stimulus. This study modified a murine culture model and optimized it to provide a chicken intestinal organoid model for use as a physiological or pathological research platform in vitro.

Collisionless Shock Acceleration of High-Flux Quasimonoenergetic Proton Beams Driven by Circularly Polarized Laser Pulses

We present experimental studies on ion acceleration using an 800-nm circularly polarized laser pulse with a peak intensity of 6.9×10^{19}  W/cm^{2} interacting with an overdense plasma that is produced by a laser prepulse ionizing an initially ultrathin plastic foil. The proton spectra exhibit spectral peaks at energies up to 9 MeV with energy spreads of 30% and fluxes as high as 3×10^{12}  protons/MeV/sr. Two-dimensional particle-in-cell simulations reveal that collisionless shocks are efficiently launched by circularly polarized lasers in exploded plasmas, resulting in the acceleration of quasimonoenergetic proton beams. Furthermore, this scheme predicts the generation of quasimonoenergetic proton beams with peak energies of approximately 150 MeV using current laser technology, representing a significant step toward applications such as proton therapy.

[Analysis and comprehensive evaluation on cold resistance of six varieties of Michelia]

Taking six varieties of Michelia as test materials, their responses under cold situation in the field were investigated and the semilethal low temperatures were calculated by fitting Logistic equation. The nine structure indexes of leaf tissue were observed by paraffin section, and a comprehensive evaluation on cold resistance of different varieties was given according to subordinate function value analysis. The results showed that the relative electrical conductivity of six varieties of Michelia was significantly positively correlated with the semilethal low temperature (LT₅₀) of 3 h 0-25 ℃ treatment. From high to low, the order of LT₅₀, which ranged between -20.48 ℃and -8.67 ℃, was M. maudiae ＞ M. maudiae var. rubicunda ＞ M. wilsonii ＞ M. 'liubanhanxiao' ♀× M. shiluensis ♂ ＞ M. platypetala ＞ M. 'liubanhanxiao'. The epidermal anticlinal walls of six varieties of Michelia leaves had 1-2 layers and showed slightly sinuated shape. The leaf had 1-3 layers of palisade tissue cells and the differences among the indexes of nine anatomical structures were extremely significant. The thickness of palisade tissue, ratio between palisade tissue and spongy tissue, and thickness of the vein were the key factors affecting cold resistance. The order of cold resistance of six varieties of Michelia, from the strong to the weak, was M. 'liubanhanxiao' ＞ M. platypetala ＞ M. 'liubanhanxiao' ♀× M. shiluensis ♂＞M. wilsonii ＞ M. maudiae var. rubicunda ＞ M. maudiae, which was basically consistent with the result of field investigation.

[Comparison of surface characteristics and cytocompatibility of Ti-6Al-4V alloy fabricated with select laser melting and electron beam melting]

Objective: To evaluate the surface characteristics and cytocompatibility of Ti-6Al-4V alloy fabricated using select laser melting (SLM) and electron beam melting (EBM) technique. Methods: Ti-6Al-4V alloy specimens were fabricated with SLM and EBM. A wrought form of Ti-6Al-4V alloy was used as a control. Its properties were evaluated using component analysis, contact angle test, surface roughness, surface topography, cell ultrastructure, cell attachment and proliferation observation, metal ion precipitation examination. Results: The roughness of SLM and EBM specimens was suitable for cell attachment but not the best. The character of SLM and EBM specimens was hydrophobic (>65°). The surface topography of EBM and SLM specimens were similar, but were not the best type for cell attachment. The components of Ti-alloy oxide film were detected in all the specimens. The content of Ti, Al, V ions of EBM, SLM and wrought specimens were very low and did not affect the cell attachment and proliferation. The ultrastructure of cell was normal, and the cytomembrane was intact. The number of cells was similar to each other among the three kinds of specimens and increased obviously with the culture time. Conclusions: The results of the study suggested that EBM and SLM Ti-6Al-4V specimens possessed good surface characteristics. However, the surface modification are needed further.

[A preliminary study on the mechanical characteristics of the titanium scaffolds with three-dimensional mesh structure fabricated by electron beam melting]

Objective: To examine the biomechanical properties of three-dimensional(3D) printed electron beam melting(EBM) Ti-6Al-4V mesh as scaffold for mandibular repairment. Methods: We fabricated Ti-6Al-4V samples of different structures with strut, sheet and 3D mesh scaffolds(a controllable diameter 0.35, 0.50, 0.70 mm, distribution density: intensive sparse) by EBM process. The mechanical properties of these structures were examined by X-ray energy dispersive spectrum(EDS), uniaxial tensile test, three-point bending test, under compression load and compared with their different microstructure and mechanical properties. Results: Compressive deformation behavior of these cellular structures exhibited brittle character that had a typical irregular plateau region in the stress-strain curves. The mesh of larger diameter(d=0.70 mm) showed higher specific strength than the meshs of small diameter(d=0.35 mm) did, and the other 3D mesh under the same condition showed identical specific stiffness. Conclusions: EBM was successfully used to fabricate novel 3D mesh Ti-6Al-4V structures for applications. By optimizing the buckling and bending deformation, Ti-6Al-4V cellular solids with high strength, low modulus. Furthermore, the results of mechanical property and chemistry composition showed that the scaffold could completely satisfy the requirement of hard tissue repairment.

High-Brightness High-Energy Electron Beams from a Laser Wakefield Accelerator via Energy Chirp Control

By designing a structured gas density profile between the dual-stage gas jets to manipulate electron seeding and energy chirp reversal for compressing the energy spread, we have experimentally produced high-brightness high-energy electron beams from a cascaded laser wakefield accelerator with peak energies in the range of 200-600 MeV, 0.4%-1.2% rms energy spread, 10-80 pC charge, and ∼0.2  mrad rms divergence. The maximum six-dimensional brightness B_{6D,n} is estimated as ∼6.5×10^{15}  A/m^{2}/0.1%, which is very close to the typical brightness of e beams from state-of-the-art linac drivers. These high-brightness high-energy e beams may lead to the realization of compact monoenergetic gamma-ray and intense coherent x-ray radiation sources.

A comprehensive, prospective study of penile dimensions in Chinese men of multiple ethnicities

This study aimed to establish a reference range of penile length and circumference of adult males in China, and to compare the penile dimensions of different ethnical backgrounds. To do this, penile length and circumference measurements were obtained from 5196 healthy males attending the Urology Counseling Clinic. The mean value of penile dimensions was a flaccid length of 6.5 ± 0.7 cm, a stretched length of 12.9 ± 1.2 cm and a flaccid circumference of 8.0 ± 0.8 cm. In the subgroup of 311 males, the mean erectile length was 12.9 ± 1.3 cm and the mean erectile circumference was 10.5 ± 0.9 cm, the mean flaccid and erectile glans lengths were 2.7 ± 0.3 and 3.4 ± 0.4 cm, respectively, and the mean flaccid and erectile glans diameters were 2.6 ± 0.2 and 3.4 ± 0.4 cm, respectively. We found that flaccid penile length and circumference varied among different ethnicities. This study established a reference range for penile dimensions, which will help when counseling patients worried about their penile size or seeking penis enlargement surgery. We also found that penile dimensions are different in different ethnicities, but further investigations are needed to validate this.

All-optical cascaded laser wakefield accelerator using ionization-induced injection

We report on near-GeV electron beam generation from an all-optical cascaded laser wakefield accelerator (LWFA). Electron injection and acceleration are successfully separated and controlled in different LWFA stages by employing two gas cells filled with a He/O2 mixture and pure He gas, respectively. Electrons with a Maxwellian spectrum, generated from the first LWFA assisted by ionization-induced injection, were seeded into the second LWFA with a 3-mm-thick gas cell and accelerated to be a 0.8-GeV quasimonoenergetic electron beam, corresponding to an acceleration gradient of 187  GV/m. The demonstrated scheme paves the way towards the multi-GeV laser accelerators.

Heparin-functionalized collagen matrices with controlled release of basic fibroblast growth factor

Tissue engineering scaffolds with controlled long-term release of growth factors are constructed in an attempt to mimic the intelligent ability of the extracellular matrix (ECM) to release endogenous growth factors. In this study, collagen sponges (Collagen group) were modified by N-(3-dimethylaminopropyl)-N-ethylcarbodiimide hydrochloride (EDC) and N-hydroxysuccinimide (NHS) crosslinking (EDC/NHS group) and heparin immobilization (EDC/NHS-H group), and subsequently seeded with human umbilical vein endothelial cells (HUVECs). Native and modified sponges were pre-adsorbed with basic fibroblast growth factor (bFGF) to evaluate the sustained release and bioactive maintenance of bFGF from the sponges. We found that modified collagen matrices permitted HUVECs to proliferate and migrate well and to distribute uniformly. The EDC/NHS-H group exhibited an excellent sustained-release profile and bioactive maintenance of the pre-adsorbed bFGF as compared with the Collagen and EDC/NHS groups. These results suggest that heparin-functionalized collagen matrices can support a controlled release of bFGF and thus, have potential as a tissue engineering scaffold.

Transverse evolution of a plasma channel in air induced by a femtosecond laser

We investigate the evolution of filamentation in air by using a longitudinal diffraction method and a plasma fluorescence imaging technique. The diameter of a single filament in which the intensity is clamped increases as the energy of the pump light pulse increases, until multiple filaments appear.

Optical breakdown for silica and silicon with double femtosecond laser pulses

The optical breakdown thresholds (OBTs) of typical dielectric and semiconductor materials are measured using double 40-fs laser pulses. By measuring the OBTs with different laser energy and different time delays between the two pulses, we found that the total energy of breakdown decrease for silica and increase for silicon with the increase of the first pulse energy.

Phase dependence of relativistic electron dynamics and emission spectra in the superposition of an ultraintense laser field and a strong uniform magnetic field

The phase dependence of the dynamics and emission spectra of a fully relativistic electron in the superposition of an ultraintense plane wave laser field and a strong uniform magnetic field has been investigated. It is found that the effect of changing the initial laser phase is quite different for circularly and linearly polarized laser fields. For circular polarization only the axis of the helical trajectory is changed with variation of the initial laser field phase. However, for linear polarization, the effect of changing the initial phase is opposite in the two parameter regions divided by the resonance condition r=1 (r stands for the ratio between the reduced cyclotron frequency and laser frequency). When r<1, with increase in the initial laser field phase eta(0) from 0 to pi/2, both the radius of the electron's helical trajectory and the height of the peak related to the uniform magnetic field are decreased, and these two physical values are increased with an increase in the laser initial phase when r>1. The phase dependence of the electron's energy and velocity components was also studied. Some beat structure is found when eta(0)=0 and this structure is absent when eta(0)=pi/2.

Electron acceleration and high-order harmonic generation by an intense short pulse laser in a magnetic field

Electron acceleration and short-wavelength radiation generation by an intense, short, linearly polarized laser pulse in an external magnetic field parallel to that of the light wave is investigated classically. It is found that enhanced electron acceleration by the laser can occur. After the pulse has passed, much of the energy gained by the electron is retained in its relativistic cyclotron motion. The electron emits radiation at high harmonics of the cyclotron frequency until the static magnetic field decays.

Phylogeny and ontogeny of the lymphatic stomata connecting the pleural and peritoneal cavities with the lymphatic system--a review

This paper reviews the phylogeny and ontogeny of "lymphatic stomata" through which fluids and cells in the pleural and peritoneal cavities enter the lymphatic system. In amphibians, the pleuroperitoneal cavity is connected through numerous pores with the wide subvertebral lymphatic sinus corresponding to the thoracic duct in mammals. In reptiles, direct connections of the pleural and peritoneal cavities with the lymphatic system have been reported. In mammals, the pleural and peritoneal cavities are directly connected with lymphatics through lymphatic stomata. How do lymphatic stomata develop in mammals? In the rat, distinct lymphatics are noted in the subpleural space of the diaphragm periphery in 16 days old embryo. With age, the supleural lymphatics increase and form a polygonal network. They show a tubular appearance and possess many valves. Some of them become endowed with smooth muscle cells. In 19 days old embryos, some lymphatics appear in the subperitoneal space of the diaphragm. They extend centripetally and form many lateral projections that later elongate and connect with those from adjacent lymphatics, thus forming a lattice-like network or "lymphatic lacunae". During early postnatal days, the lymphatic lacunae project many bulges that subsequently come into contact with the pores among mesothelial cells lining the diaphragmatic peritoneum, thus forming lymphatic stomata. They increase until postnatal week 10. The lymphatic stomata in the costal pleura also develop during early postnatal days.

Structural studies of initial lymphatics adjacent to gastric and colonic malignant neoplasms

Invasion and metastases are the main causes of death from cancer, and prognosis is best correlated with invasion of malignant cells into initial lymphatics and dissemination to regional lymph nodes. Using both light and transmission electron microscopy, we examined human gastric and colonic cancers and their relation to initial lymphatics. Invasion of malignant tumor cells into the initial lymphatics was characterized by interdigitating and overlapping endothelium giving way to open junctions as lymphatic endothelial cells were apparently dissolved and destroyed. Cytoplasmic vesicles, mitochondria, and rough endoplasmic reticulum were qualitatively increased as demonstrated by image analysis.

[A clinical analysis of intramuscular hemangioma in oral and maxillofacial regions: Report of 59 cases]

From 1978 to 1992,the clinical data of 59 patients with intramuscular hemangioma in oral and maxillofacial regions were reviewed and analysed.The average age and the duration were 23 years old and eight years respectively.All patients were treated surgically,53 cases (89.83%)were completely resected and those of other 6 cases(10.1%) partially resected without any complications,Follow-up for 11 months to 12 years showed that 2 cases relapsed,and thus the cure rate was 96.6%(57/59),The author affirmed the significance of surgical operation in treatment and put forward the view of classification of hemangioma the vascular deformities.

[The effect of dosage on oral fluorescein angiography of the fundus]

105 patients were orally given fluorescein of different dosage and concentration for fundus angiography. The results indicated that the dosage of 30mg/kg at 2% concentration produced more distinct angiograms.

Shedding of human neuroblastoma gangliosides

Gangliosides shed by tumor cells are implicated in modulating tumor formation. For example, rapid progression of human neuroblastoma tumors is associated with high circulating levels of shed GD2 ganglioside. To elucidate the kinetic and qualitative characteristics of tumor cell ganglioside shedding, which is difficult to accomplish in vivo, we examined this process in LAN-5 human neuroblastoma cells in vitro. Three major gangliosides, GD2, GM2 and GT1b, comprise 82% of the mean total of 38 nmol LBSA/10(8) cells. These molecules are shed very rapidly (1-3 pmol/10(6) cells per h, or approx. 0.5% of the total cell gangliosides per h). Quantitative and qualitative characteristics of ganglioside shedding are remarkably constant over a 40-fold range of cell density. Not only GD2, but every major carbohydrate species is shed, in proportion to its concentration in the cell, with slightly greater shedding of ceramide subspecies containing shorter chain fatty acids. These findings were confirmed in three other neuroblastoma cell lines, LAN-1, IMR and KCNR. We suggest that the high expression and rapid generalized shedding of human neuroblastoma tumor gangliosides results in significant in vivo accumulation of these biologically active molecules during tumor growth.

[Antigen signature analysis of dengue-2 viruses strains in Hainan China]

In this paper, we try to define the extent of antigenic variation between dengue-2 viruses from Hainan province, which had been isolated over a period of 3 years (1985-1987). The dengue-2 viruses were compared with the prototype New Guinea B strain and were subjected to antigen signature analysis. Eight strains of dengue-2 virus were analyzed by three monoclonal antibodies: flavivirus group, subcomplex dengue-2 type-specific reactive epitopes, over a range of antigen concentration. Five out of eight dengue-2 virus strains showed them to be antigenically homogeneous, and the remaining three strains showed them to be heterogeneous. Signature analysis provides a rapid and simple means to different strains derived from different sources, thus permit monitoring changes or introductions of hew dengue virus populations in certain geographic region.

Compositional analysis of the three main gangliosides from adult human myometrium by a rapid capillary gas chromatographic method

A new capillary GC method is described for the compositional analysis of the three main gangliosides isolated from adult human myometrium. The sample was subjected to methanolysis, acetylation and trimethylsilylation which allows all the constituents to be analyzed simultaneously. The predominant ganglioside was found to be GD3, with GM3 and GT1b the next most abundant.