[To compare the efficacy and incidence of severe hematological adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia]

Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.

[Development and thinking of Chinese expert consensus on diagnosis of pleural effusion]

The consensus published in this issue was developed over a period of 1.5 years, and it was discussed and revised by the expertpanel from pleural and mediastinal diseases working group (preparatory) of Chinese Thoracic Society and external experts in several meetings. This article introduced the purpose, process and thinking in the writing of the consensus, hoping to provide a reference for readers to understand the content of this consensus and to make reasonable application in clinical practice.

Non-inductive plasma vertical position measurement for the 1056 s discharge on EAST

Vertical position stability plays a crucial role in maintaining safe and reliable plasma operation for long-pulse fusion devices. In general, the vertical position is measured by using inductive magnetic coils installed inside the vacuum vessel; however, the integration drift effects are inherent for steady-state or long-pulse plasma operation. Developing a non-magnetic approach provides a fusion reactor-relevant steady-state solution that avoids the negative impact of integration drift. In this paper, we compare the non-inductively determined vertical position achieved by line-integrated interferometer and polarimeter measurements to that employing an inductive flux loop for a 1056 s discharge recently achieved on EAST (Experimental Advanced Superconducting Tokamak). Experimental results show that the non-inductive measurement is more robust than flux loops after 300 s if the integrator is not reset to suppress integrator drift. Real-time vertical position control using the non-inductive system is proposed for the next EAST experimental campaign.

[Surgical treatment of papillary thyroid carcinoma involving larynx and trachea]

Objective: To evaluate the efficacy of surgical treatment of papillary thyroid carcinoma (PTC) involving larynx and trachea. Methods: A total of 1 436 cases of thyroid malignant tumors were admitted to the Department of Otolaryngology, Qilu Hospital of Shandong University from 2004 to 2019, including 110 cases of PTC involving larynx and trachea, and of which 105 cases with complete follow-up data were retrospectively analyzed. There were 42 males and 63 females, with a male/female ratio of 1∶1.5, aged from 28 to 81 years. All lesions involved trachea, including 11 cases involving both trachea and larynx. Of those 83 cases underwent laryngeal and airway wall tumor excision, and 22 cases underwent radical tumor excision plus laryngeal and trachea repair. Extubation rate was analyzed and the postoperative survival curve of patients was analyzed by Kaplan-Meier method. Results: Among 105 cases, 16 cases underwent tracheotomy and 12 cases were successfully extubated. The overall 3- 5- and 10-year survival rates were 100.0%, 86.4% and 72.5%, and the disease-free survival rates were 93.1%, 81.6% and 57.7%, respectively. There was significant difference in survival curve between the two groups (χ²=4.21, P=0.040). The 5-year and 10-year survival rates were 94.6% and 77.3% in laryngeal and tracheal tumor exclusion group, and 85.7% and 51.4% in the radical tumor resection group. There was no significant difference in the survival curves between the two groups (χ²=3.50, P=0.061). Conclusion: PTC patients with laryngeal and tracheal involvement can achieve long survival and good quality of life through reasonable surgical treatment.

Combined and interactive effects of alcohol drinking and cigarette smoking on the risk of severe illness and poor clinical outcomes in patients with COVID-19: A multicentre retrospective cohort study

Objectives

Cigarette smoking is an established risk factor for illness severity and adverse outcomes in patients with COVID-19. Alcohol drinking may also be a potential risk factor for disease severity. However, the combined and interactive effects of drinking and smoking on COVID-19 have not yet been reported. This study aimed to examine the combined and interactive effects of alcohol drinking and cigarette smoking on the risk of severe illness and poor outcomes in patients with COVID-19.

Study design

This was a multicentre retrospective cohort study.

Methods

This study retrospectively reviewed the data of 1399 consecutive hospitalised COVID-19 patients from 43 designated hospitals. Patients were grouped according to different combinations of drinking and smoking status. Multivariate mixed-effects logistic regression models were used to estimate the combined and interactive effects of drinking and smoking on the risk of severe COVID-19 and poor clinical outcomes.

Results

In the study population, 7.3% were drinkers/smokers, 4.3% were drinkers/non-smokers and 4.9% were non-drinkers/smokers. After controlling for potential confounders, smokers or drinkers alone did not show a significant increase in the risk of severe COVID-19 or poor clinical outcomes compared with non-drinkers/non-smokers. Moreover, this study did not observe any interactive effects of drinking and smoking on COVID-19. Drinkers/smokers had a 62% increased risk (odds ratio = 1.62, 95% confidence interval: 1.01-2.60) of severe COVID-19 but did not have a significant increase in the risk for poor clinical outcomes compared with non-drinkers/non-smokers.

Conclusions

Combined exposure to drinking and smoking increases the risk of severe COVID-19, but no direct effects of drinking or smoking, or interaction effects of drinking and smoking, were detected.

[Venous thromboembolism risk and prophylaxis status of cancer inpatient]

Objective: To determine the risk profile of venous thromboembolism (VTE) and evaluate VTE prophylaxis implementation of the hospitalized cancer patients in the DissolVE 2 study. Methods: The data of hospitalized cancer patients in the DissolVE 2 study were analyzed. The risk distribution of VTE, preventive measures and in-hospital VTE events of hospitalized patients with tumors were described by percentage and 95% confident interval (CI). Results: A total of 1 535 cancer patients were included. According to the Padua score, 826 (53.8%) patients were at low risk of VTE, while 709 (46.2%) patients were at high VTE risk. VTE events occurred in 4 low-risk patients (0.5%; 95%CI: 0.1%, 1.2%) and 5 high-risk patients (0.7%; 95%CI: 0.2%, 1.6%). The overall incidence was 0.6% (9/1 535, 95%CI: 0.3%, 1.1%). Among patients with high VTE risk, 666 (93.9%) did not receive any VTE prophylaxis, and only 11 (1.6%) patients received appropriate VTE prophylaxis. Among patients who received VTE prevention, no VTE event was observed. Conclusions: Nearly half of the hospitalized cancer patients are at high risk of VTE, but most of them don't receive VTE prophylaxis. The results reflect the insufficient management of VTE risk for hospitalized cancer patients in China, and improvement of awareness and practice of VTE prophylaxis is urgently needed.

[In situ semiconductor laser fenestration of type A aortic dissection during thoracic endovascular aortic repair]

Objective: To investigate the feasibility, efficacy and safety of semiconductor laser in situ fenestration of type A aortic dissection during thoracic endovascular aortic repair. Methods: The clinical data of 68 patients with type A aortic dissection treated by semiconductor laser in situ fenestration from June 2016 to January 2020 in Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University were analyzed retrospectively. Of the patients, 45 were male, 23 were female, the mean age was (52±14) years. The technical success rate and complication rates were assessed. Results: The technical success rate of 68 patients was 92.6% (63/68), only 5 patients failed due to the complex aortic arch type, 3 patients underwent chimney stent implantation, 2 patients underwent artificial vessel bypass. During the perioperative period, 1 patient died due to severe pulmonary infection, 4 patients developed neurological symptoms such as cerebral infarction after surgery, and the remaining patients had no related complications. Postoperative CTA follow-up indicated that the primary intercalation rupture was completely closed, and the main and branch stents were patency, 8 (8.8%) type Ⅰ leakage were occurred. Conclusion: It showed that in situ semiconductor laser fenestration is a feasible, effective and safe method to treat type A aortic dissection.

[Treatment status of tyrosine kinase inhibitors in Chinese patients with chronic myeloid leukemia in 2020]

目的

调查中国慢性髓性白血病（CML）患者的治疗现状。

方法

横断面研究，2020年4月末至5月中旬，以填写调研问卷的形式在全国范围内调研CML患者，分析酪氨酸激酶抑制剂（TKI）一线选择、目前用药、药物转换和获得主要分子学反应（MMR）的比例及其影响因素。

结果

2933份来自全国31个省市自治区CML受访者的问卷可供分析，男性1683例（57.4％），中位年龄38（16～87）岁。一线选择：伊马替尼2481例（84.6％），原创性新药（原研药）1803例（61.5％）。填写问卷时用药：伊马替尼1765例（60.2％），原研药1791例（61.1％）。共1185例（40.4％）受访者曾经历TKI药物转换。1944例初发慢性期受访者TKI中位治疗45（3～227）个月，1417例（72.9％）获得≥MMR的疗效。多因素分析显示，城镇户籍（OR＝0.6，95％CI 0.5～0.8，P<0.001）、≥大学学历（OR＝0.5，95％CI 0.4～0.7，P<0.001）和进展期（OR＝0.5，95％CI 0.3～0.8，P＝0.001）受访者更少首选仿制TKI，而来自中部地区受访者比东部地区更多首选国产仿制TKI（OR＝1.7，95％CI 1.4～2.0，P<0.001）。进展期受访者更多首选二代TKI（OR＝5.4，95％CI 3.6～8.2，P<0.001），≥60岁受访者更少首选二代TKI（OR＝0.4，95％CI 0.2～0.7，P＝0.002）。诊断时处于进展期（OR＝2.2，95％CI 1.6～3.2，P<0.001）、首选伊马替尼（OR＝2.0，95％CI 1.6～2.6，P<0.001）、首选国产仿制药（OR＝1.3，95％CI 1.1～1.6，P＝0.002）、诊断距开始TKI治疗的时间更长（OR＝1.2，95％CI 1.1～1.2，P<0.001）和服用TKI的时间更长（OR＝1.1，95％CI 1.0～1.1，P<0.001）与药物转换比例增高显著相关。城镇户籍（OR＝0.7，95％CI 0.6～0.8，P<0.001）、获≥MMR（OR＝0.6，95％CI 0.5～0.8，P<0.001）和疗效未知（OR＝0.7，95％CI 0.6～0.9，P＝0.003）与药物转换比例低显著相关。女性（OR＝1.4，95％CI 1.1～1.7，P＝0.003）、城镇户籍（OR＝1.6，95％CI 1.3～2.0，P<0.001）、初始服用伊马替尼（OR＝1.4，95％CI 1.1～1.9，P＝0.016）和TKI治疗时间更长（OR＝1.2，95％CI 1.2～1.3，P<0.001）与获得≥MMR显著相关，而年龄≥60岁（OR＝0.7，95％CI 0.4～1.0，P＝0.047）和药物转换（OR＝0.6，95％CI 0.5～0.7，P<0.001）与未获得MMR显著相关。

结论

截至2020年，中国CML患者中大多数首选并持续服用伊马替尼，半数以上服用原研药。社会人口学特征和疾病分期影响了患者的TKI选择、药物转换和治疗反应。

[Spatio-temporal distribution of pulmonary tuberculosis and influencing factors in Beijing, 2008-2018]

Objective: To understand the spatiotemporal distribution of pulmonary tuberculosis (TB) and influencing factors in Beijing from 2008 to 2018. Methods: The incidence data of pulmonary TB in Beijing from 2008 to 2018 were from Tuberculosis Information Management System of Chinese Disease Prevention and Control Information System. Software ArcGIS 10.2 was used to visualize the spatiotemporal distribution of pulmonary TB incidence. Getis's G_i^* statistic was applied to analyze the spatial clustering of pulmonary TB incidence at street/township scale. Bayesian spatiotemporal model was applied to analyze factors affecting its spatiotemporal distribution, including urbanization rate, GDP per capita, number of hospital beds per thousand population, permanent migrant population and population density. Results: The reported pulmonary TB incidence showed a downward trend in the past 11 years in Beijing, from 58.64/100 000 to 30.43/100 000. The incidences were higher in Tongzhou, Changping and other newly developed urban districts, with the hot spots concentrated in local areas of these districts. The incidences of pulmonary TB were lower in Dongcheng, Xicheng and other old urban districts-with the cold spots also concentrated in these area. The risk for the incidence of pulmonary TB was associated with the urbanization rate and the permanent migrant population. For every 1% increase in the urbanization rate, the relative risk of pulmonary TB would increase by 1%. For every 10 000 person increase of permanent migrant population, the relative risk of pulmonary TB would increase by 0.6%. Conclusions: In Beijing, the current pulmonary TB prevention and control needs to be focused on the newly developed urban areas. Due to the accelerated process of urbanization, it is necessary to strengthen TB prevention and control in permanent migrant population to reduce the incidence of TB in Beijing.

[Implication of enhanced recovery after surgery in the surgical management of hypopharyngeal squamous cell carcinoma]

Objective: To investigate the safety and efficacy of enhanced recovery after surgery (ERAS) in the clinical management of hypopharyngeal squamous cell carcinoma (HSCC). Methods: In this retrospective study, a total of 168 patients with pyriform sinus carcinoma in Qilu Hospital of Shandong University from January 2015 to January 2019 were divided into two groups, based on the different perioperative interventions that patients received, i.e. the ERAS group (n=64) and the conventional group (n=104), including 164 males and 4 females, whose ages ranged from 42 to 84 years old. The difference between two groups in the operative time, postoperative nutritional status, incidences of postoperative complications and postoperative hospitalization time were compared using the student's t test, Chi-squared test or Fisher's exact test. Results: Compared with the conventional group, patients in the ERAS group had significantly shorter operative time [(166.8±58.2) min vs. (183.3±39.9) min,t=-2.72, P=0.031], higher levels of postoperative serum albumin [(38.3±4.2) μmol/L vs. (36.6±3.3) μmol/L, t=2.73, P=0.007] and more body weight [(65.4±9.4) kg vs. (62.1±9.4) kg, t=2.22, P=0.028], lower incidences of postoperative subcutaneous infection [7.8% (5/64) vs. 20.2% (21/104), χ²=4.64, P=0.03] and severe pneumonia [4.7% (3/64) vs. 15.4% (16/104), χ²=4.52, P=0.03], and shorter postoperative hospitalization time [(16.5±3.9) d vs. (18.2±4.3) d, t=-2.65, P<0.05]. Conclusion: ERAS is effective and safe in the surgical management of HSCC, with benefits in reducing the operative stress via saving operation time, shortening the hospitalization time, ameliorating nutritional status and decreasing the incidences of complications.

[Effect of imatinib on the height of children with chronic myeloid leukemia in the chronic phase]

目的

评估伊马替尼对慢性髓性白血病慢性期（CML-CP）儿童身高的影响。

方法

2018年7月至2019年7月，在全国范围内对诊断时年龄<18周岁、接受伊马替尼治疗至少3个月的CML儿童或其家长发放问卷，调查受访者伊马替尼治疗前后身高的变化。主要评价指标为身高标准差积分值（HtSDS）以及标准差积分的差值（ΔHtSDS），并分析其相关影响因素。

结果

共有238例受访者符合标准并被纳入研究，男性138例（58.0％），初诊时中位年龄11.0（1.4～17.9）岁，青春期前93例（39.0％），至填写答卷时，中位年龄15.0（2.0～34.0）岁，中位伊马替尼服药时间28（3～213）个月。受访者填写答卷时HtSDS（−0.063±1.361）较治疗前HtSDS（0.391±1.244）显著下降（P<0.001），71.0％的患儿出现身高增长减慢。青春期前服药者治疗后HtSDS下降显著（P<0.05），而青春期开始后服药者HtSDS变化不明显（P>0.05）。多因素分析显示，服药初始年龄较小（偏回归系数为0.122，B＝0.572，t＝10.733，P<0.001）和服药时间较长（偏回归系数为−0.006，B＝−0.211，t＝−4.062，P<0.001）是伊马替尼抑制身高增长的独立影响因素。

结论

伊马替尼引起CML-CP儿童身高增长障碍，服药初始年龄越小、服药时间越长，伊马替尼对身高的影响越明显。

[Efficacy comparison of primary percutaneous coronary intervention by drug-coated balloon angioplasty or drug-eluting stenting in acute myocardial infarction patients with de novo coronary lesions]

Objective: To compare the safety profile, angiographic and clinical outcomes between drug-coated balloon(DCB) only strategy versus drug eluting stent(DES) implantation in primary percutaneous coronary intervention(PCI) for acute myocardial infarction(AMI) patients. Methods: A total of 380 AMI patients who underwent primary PCI in Beijing Chaoyang Hospital from January 2016 to May 2019 were enrolled. They were allocated into DEB group(n=180) or DES group(n=200). The Primary endpoint was the major adverse cardiac events(MACE) in hospital and within 3 months after discharge, the composite event of cardiac death, non-fatal myocardial infarction(MI), target vessel revascularization(TVR) and in stent thrombosis. The secondary endpoints included: (1)TIMI blood flow grade and myocardial perfusion grade (TMP grade) of infarct-related vessels before and after PCI. (2)The degree of ST segment resolution(STR) between half hour and two hours after PCI, and STR was represented by percentage of summed ST-segment reduction between baseline and post-PCI. Using the most significant lead of ST segment elevation, calculating the rate of decline in the ST segment after treatment; or the most significant lead of the ST segment depression, to calculate the rate of recovery in the ST segment after treatment. STR<50% was defined as incomplete STR. (3)The occurrence of coronary artery dissection during operation. (4)The peak value of myocardial enzymes. (5)The incidence of bleeding in hospital and within 3 months after discharge. The inverse probability weighting method based on propensity score (IPTW) was used to compare the effects of the two treatments on MACE occurrence in the logistic regression model. Results: There was no significant difference in sex, age, risk factors of coronary heart disease, type and site of AMI, interventional therapy data(P>0.05) between the two groups. The ratio of bifurcation lesions in DCB group was significantly higher than that in DES group, and the diameter of the DCB was smaller while the length was longer than that of DES (all P<0.05). One death occurred in each group during hospitalization. Compared with the DES group, the incidence of MI ［2.8%(5/180) vs. 0.5% (1/200), P=0.10］ and TVR ［2.8%(5/180) vs. 0.5%(1/200), P=0.10］ in the DCB group during hospitalization showed an increasing trend, and were mostly associated with delayed coronary dissection. The incidence of MACE was similar between the two groups (3.3%(6/180) and 1.0%(2/200), P=0.15) during hospitalization. There was no MACE occurred in the two groups within 3 months after discharge. There was no significant difference between the two groups in TIMI grade, TMP grade, incomplete STR rate and peak value of myocardial enzyme (all P>0.05). The incidence of coronary artery dissection was significantly higher in DCB group than in DES group (8.3%(15/180) and 3.0%(6/200), P=0.02), but most of them were type B or A dissection and did not need special treatment. There was no significant difference in bleeding event between the two groups(P=0.91). Logistic regression analysis showed that there was no difference in the risk of MACE during hospitalization between DES and DCB groups for AMI patients receiving PCI (compared with DCB, OR=0.35, 95%CI 0.08-1.43, P=0.13). Conclusions: The initial safety and efficacy profiles of DCB are similar with those of DES for the AMI patients during PCI. The study highlights that the incidence of coronary dissection (type A or B) is higher post DCB treatment than post DES, but it does not affect blood flow. However, the incidence of in-hospital MI due to delayed coronary dissection trends to be higher post DCB. So we should pay close attention to the risk of delayed coronary dissection after DCB in AMI patients with de novo lesion.

Superconductivity in a unique type of copper oxide

The mechanism of superconductivity in cuprates remains one of the big challenges of condensed matter physics. High-T c cuprates crystallize into a layered perovskite structure featuring copper oxygen octahedral coordination. Due to the Jahn Teller effect in combination with the strong static Coulomb interaction, the octahedra in high-T c cuprates are elongated along the c axis, leading to a 3dx 2-y 2 orbital at the top of the band structure wherein the doped holes reside. This scenario gives rise to 2D characteristics in high-T c cuprates that favor d-wave pairing symmetry. Here, we report superconductivity in a cuprate Ba2CuO4-y , wherein the local octahedron is in a very exceptional compressed version. The Ba2CuO4-y compound was synthesized at high pressure at high temperatures and shows bulk superconductivity with critical temperature (T c ) above 70 K at ambient conditions. This superconducting transition temperature is more than 30 K higher than the T c for the isostructural counterparts based on classical La2CuO4 X-ray absorption measurements indicate the heavily doped nature of the Ba2CuO4-y superconductor. In compressed octahedron, the 3d3z 2-r 2 orbital will be lifted above the 3dx 2-y 2 orbital, leading to significant 3D nature in addition to the conventional 3dx 2-y 2 orbital. This work sheds important light on advancing our comprehensive understanding of the superconducting mechanism of high T c in cuprate materials.

Li(Cd,Mn)P: a new cadmium based diluted ferromagnetic semiconductor with independent spin & charge doping

We report a new diluted ferromagnetic semiconductor Li_1+y(Cd,Mn)P, wherein carrier is doped via excess Li while spin is doped by isovalence substitution of Mn²⁺ into Cd²⁺. The extended Cd 4d-orbitals lead to more itinerant characters of Li_1+y(Cd,Mn)P than that of analogous Li_1+y(Zn,Mn)P. A higher Curie temperature of 45 K than that for Li_1+y(Zn,Mn)P is obtained in Li_1+y(Cd,Mn)P polycrystalline samples by Arrott plot technique. The p-type carriers are determined by Hall effect measurements. The first principle calculations and X-ray diffraction measurements indicate that occupation of excess Li is at Cd sites rather than the interstitial site. Consequently holes are doped by excess Li substitution. More interestingly Li_1+y(Cd,Mn)P shows a very low coercive field (<100 Oe) and giant negative magnetoresistance (~80%) in ferromagnetic state that will benefit potential spintronics applications.

[Surgical treatment in 184 patients with supraglottic carcinoma at a single institute]

Objective: To summarize clinical experience in surgical treatment of supraglottic carcinoma and reconstructive techniques. Methods: Medical files of 184 patients (173 men, 11 women) were collected and retrospectively analyzed, who underwent surgeries between January 2008 and December 2012 at Qilu Hospital of Shandong University. Among them, T1, T2, T3 and T4 staging tumors accounted respectively for 14.1% (26/184), 41.9%(77/184), 31.5%(58/184) and 12.5%(23/184). Cervical metastasis was histologically identified in 86 cases (98 for N0, 31 for N1 and 55 for N2). Advanced cases (56 cases at stage Ⅲ and 67 at stage Ⅳ), early cases (22 at stage Ⅰ and 39 at stage Ⅱ) accounted respectively for 66.8% and 33.2%. Supraglottic horizontal laryngectomy or total laryngectomy was performed to allow for tumor excision without compromising margins and the tongue flap or sternohyoidmyofascial flap was subsequently used for repairing the defect after removal of tumor. Survival rates were analyzed by the Kaplan-Meier method. Results: Patients receiving conservation laryngeal surgery accounted for 75.5% (139/184). The 3-year and 5-year survival rates for all cases were 84.2% and 70.7%, respectively. Log-rank test demonstrated that cervical lymph node metastasis, primary tumor staging and clinical TNM staging were significantly associated with prognoses of patients (P=0.003, 0.010, 0.035). Dysphagia was not observed in any case and speech function was maintained in petients with partial laryngectomy. Conclusion: Adequate pre-operative evaluation, individualized treatment, and comprehensive application of flaps for repair are critical to precise tumor excision and reconstruction of laryngeal functions.

Error correction associated with stray light for Faraday-effect polarimetry system on EAST

The polarimeter-interferometer system with 11 double-pass radial-view measurement chords has the ability to provide electron density and plasma current profiles, making it exceptionally useful in daily operation on the Experiment Advanced Superconducting Tokamak. However, due to limited optical access and intrinsic feedback, the stray lights arising from spurious reflections along the optical path (unwanted reflections from various optical components/mounts and transmissive optical elements such as windows, waveplates, and lenses as well as the detectors) distort the Faraday rotation measurements. Furthermore, the feedback light from the retro-reflector which is used to realize the double-pass configuration makes it even worse. A data processing approach to decrease the stray light influence is reported in this paper. Based on the theoretical model developed, the Faraday rotation angle is extracted by subtracting the deviation term which can be calculated with a simplified model. With this approach, the Faraday rotation oscillation during density ramp-up can be reduced from 2°-5° to 0.5°-1.5°, which reduces the Faraday rotation measurement errors significantly.

[Efficacy and safety of domestic dasatinib as second-line treatment for chronic myeloid leukemia patients in the chronic phase]

目的

探讨国产酪氨酸激酶抑制剂（TKI）达沙替尼（商品名：依尼舒）二线治疗慢性髓性白血病慢性期（CML-CP）患者的疗效及安全性。

方法

回顾性分析2016年3月至2018年7月湖北省CML协作组成员医院收治的二线服用国产达沙替尼的CML-CP患者的病例资料，统计患者治疗3、6和12个月时最佳反应率、累积完全细胞遗传学反应（CCyR）率、累积主要分子学反应（MMR）率、无进展生存（PFS）、无事件生存（EFS）情况及不良反应情况。

结果

共纳入83例CML-CP患者，中位随访时间为23（4~45）个月，达沙替尼治疗3、6、12个月最佳反应率分别为77.5%（54/71）、72.6%（61/75）、60.7%（51/69）。至随访截止，累积CCyR率、MMR率分别为65.5%（55/80）、57.1%（48/73），达CCyR和MMR的中位时间均为3个月。随访时间内，PFS率为94.0%（79/83），EFS率为77.4%（65/83）。国产达沙替尼最常见非血液学不良反应为水肿（32.5%），其次为皮疹瘙痒（18.1%）、乏力（13.3%），血液学不良反应主要有血小板减少（31.3%）、白细胞减少（19.3%）和贫血（6.0%）。

结论

国产达沙替尼二线治疗CML-CP患者具有较好的疗效及安全性，可作为CML-CP患者的治疗选择。

[The effect of extending proximal landing zone in thoracic endovascular aortic repair on the prognosis of Stanford type B aortic dissection]

With the continuous development of endovascular surgery, thoracic endovascular aortic repair (TEVAR) has gradually replaced traditional open surgery and has become the preferred treatment strategy for Stanford type B aortic dissection. However, the disadvantage of the short proximal landing zone greatly limited the indication of TEVAR surgery and affected the prognosis. In recent years, many strategies such as hybrid surgery, in vitro fenestrated and branched aortic endo-graft, chimney technique, in-situ fenestration technique, etc., have been developed, which greatly broadens the TEVAR indication and improved the prognosis.

[Series study on the relationship between air quality index and tuberculosis incidence in Beijing]

Objective: To analyze the effect of air quality index (AQI) on the incidence of tuberculosis (TB) in Beijing, and to provide evidence for setting up a better program regarding prevention and control of tuberculosis. Methods: Generalized additive model (GAM) was used to analyze the association between AQI and the incidence of tuberculosis in Beijing, from January 1, 2014 to November 9, 2016. Confounding factors as meteorological conditions and time trends were under control. Results: In Beijing, a total of 14 533 TB cases with definite dates of onset were collected during the study period, with 36 children excluded from the study. Finally, 14 497 cases were included in the study, including 9 513 men and 4 984 women, with 11 290 adults (15-59 years old) and 3 207 elderly (≥60 years old). Data from the optimal single-day lag effect of GAM showed that,with every 10 increase of AQI, the percent of increase on the onsets of overall, male, female and adult; tuberculosis cases were 0.85% (95%CI: 0.26%-1.44%), 0.83% (95%CI: 0.24%-1.42%), 0.93% (95%CI: 0.24%-1.62%) and 0.88% (95%CI: 0.29%-1.46%), respectively. The optimal lag time of the single-day effects were 15 days (lag15), but 16 days (lag16) for male. The optimal cumulative lag effect showed that with every 10 AQI increase, the percent of increase on the onsets of overall, male, female and adult tuberculosis cases were 1.92% (95%CI: 0.23%-3.16%), 1.94% (95%CI:0.15%-3.72%), 2.04% (95%CI: 0.10%-3.97%) and 2.00% (95%CI: 0.30%-3.69%), respectively, with the optimal lag time of cumulative delayed effects as 17 days (lag0_17), 18 days (lag0_18), 16 days (lag0_16) and 17 days (lag0_17), respectively. However, there were no statistical significances noticed in the elderly cases. Conclusion: There was a positive correlation between AQI and the number of TB cases in Beijing, and the effects of AQI on the number of TB cases in different genders and age groups were different.

Bench test of phase measurement on dispersion interferometer for EAST

In recent years, different traditional interferometers have been the necessary diagnostic of electronic density measurement on fusion devices. Until now, two main problems always influence the density measurement: the mechanical vibration and fringe jump in the calculation. The dispersion interferometer (DI) with a long-wavelength infrared wavelength is a good choice because mechanical vibrations can be canceled and the fringe jump can be inhibited. This paper describes the bench test of phase measurement using a wedge instead of plasma on the DI. The results show good agreement with the theoretical calculations. In the background measurement, this DI without a vibration isolation system has good performance, and the drift of the baseline is less than 2 × 10¹⁷ m^-2 in 3 s and less than 5 × 10¹⁷ m^-2 in 400 s. Plasma data will be obtained during the next campaign on EAST (Experimental and Advanced Superconducting Tokamak).

[Comprehensive treatment of 335 patients with pyriform sinus carcinoma by surgery via the paraglottic space approach]

Objective: To report the experience in comprehensive surgical treatment of pyriform sinus carcinoma via the paraglottic space approach. Methods: Three hundred and thirty-five cases with pyriform sinus carcinoma (according to UICC 2012 criteria, stage Ⅰ, 12 cases; Ⅱ, 36; Ⅲ, 79; Ⅳ, 208; T1, 26; T2, 139; T3, 121; T4, 49; cN0, 83; cN1, 61; cN2a-b, 118; cN2c, 71; cN3, 2) treated between 2006 and 2013 were retrospectively reviewed. There were 323 males and 12 females. Age aged from 36 to 80 years old with a median of 60 years old. There was no case with distant metastasis. All patients received modified neck dissection, including unilateral in 240 patients and bilateral in 95 patients. Pharyngoesophageal defects were reconstructed with directly suture in 246 cases, pectoralis major musculocutaneous flaps in 74 cases, and laryngotracheal flaps in 15 cases. Three hundred and nineteen patients received postoperative radiotherapy (55-65 Gy). Results: The overall 3 and 5 year survival rates were 68.6% (230/335) and 52.1%(139/267), respectively. The cervical lymph node metastases were found in 265 (79.1%) patients. Pathologic findings showed that all patients had squamous cell carcinoma. Laryngeal functions (voice, respiration and deglutition) were completely restored in 277 (82.7%) patients. Conclusions: The oncological efficacy of surgery via the paraglottic space approach is sure for pyriform sinus carcinoma, especially suitable for the early and medium-term lesions. The function of the larynx can retain after surgery, with the decreased incidences of cough and pharynx fistula.

Effects of stray lights on Faraday rotation measurement for polarimeter-interferometer system on EAST

A double-pass radially view 11 chords polarimeter-interferometer system has been operated on the experimental advanced superconducting tokamak and provides important current profile information for plasma control. Stray light originating from spurious reflections along the optical path (unwanted reflections from various optical components/mounts and transmissive optical elements such as windows, waveplates, and lens as well as the detectors) and also direct feedback from the retro-reflector used to realize the double-pass configuration can both contribute to contamination of the Faraday rotation measurement accuracy. Modulation of the Faraday rotation signal due to the interference from multiple reflections is observable when the interferometer phase (plasma density) varies with time. Direct reflection from the detector itself can be suppressed by employing an optical isolator consisting of a λ/4-waveplate and polarizer positioned in front of the mixer. A Faraday angle oscillation during the density ramping up (or down) can be reduced from 5°-10° to 1°-2° by eliminating reflections from the detector. Residual modulation arising from misalignment and stray light from other sources must be minimized to achieve accurate measurements of Faraday rotation.

The adverse effects of perinatal exposure to nonylphenol on carbohydrate metabolism in male offspring rats

BACKGROUND

We sought to investigate the adverse effects of perinatal exposure to nonylphenol (NP) on carbohydrate metabolism of male offspring rats.

METHODS

Thirty-two healthy pregnant Sprague Dawley rats were randomly divided into four groups, control normal diet group (C), NP normal diet group (NPN), control high-energy diet group (CH), and NP high-energy diet group (NPH). Both of the control groups were received a gavage of corn oil and the NP-groups were received NP (200 mg/kg/day) from gestational days 6 to post-natal day (PND) 21. The concentrations of NP in pancreatic tissues were measured by high-performance liquid chromatography (HPLC). The key genes of glucose metabolism expression were detected by reverse transcription-polymerase chain reaction (RT-PCR). The pancreatic tissues were stained with hematoxylin/eosin (HE).

RESULTS

On PND 1, the body weights of male pups in the NPN and NPH groups were lower than those of the CH group (p = 0.012 and 0.001, respectively). On PND 30, the body weight of male pups from the NPH group was elevated compared with the C group (p = 0.019), while the body weights of male pups in the NPN and NPH groups were elevated compared to the CH group (p = 0.034 and 0.004, respectively). On PND 60, the body weights of NPN and NPH pups were higher than those in the C (p < 0.001) and CH groups (p < 0.001). The levels of fasting blood glucose (FBG) were increased significantly in the animals treated with NP compared to control animals (F = 29.14, p < 0.001). The FBG levels in the treatment groups are ranked as follows: NPH > NPN > CH > C (p < 0.05). The concentrations of NP in pancreas tissues in both the NPN (2045.0 ± 130.1 μg/L) and NPH groups (2038.0 ± 104.2 μg/L) were higher than those in the C (499.5 ± 27.4 μg/L) and CH groups (494.2 ± 22.4 μg/L; p < 0.05). Morphological examination of tissues from rats exposed to NP shown that the NP-treated groups appeared to have a higher degree of inflammatory injury, edema, and focal necrotic cells in the pancreatic tissues. Compared with C group, expression of glucokinase (GCK) was down-regulated, while Uncoupling protein-2 (UCP-2) was up-regulated in the NP-treated groups (F_GCK = 218.89, p < 0.001; F_UCP-2 = 18.82, p < 0.001).

CONCLUSIONS

Prenatal exposure to NP could induce glucose metabolism disorder in male F1 rats, which may be due to the fact that NP induces abnormal expression patterns of GCK and UCP-2.

[Implantation of the irradiation stent system intoportal vein: studies on normal beagles]

Objective: To assess the feasibility and safety of the irradiation stent system in portal vein on normal beagles. Methods: A portal vein irradiation stent system was composed of an Iodine-125 seeds-carrier and a conventional stent.Twenty beagle dogs were randomly assigned to receive treatment with a conventional stent (5 beagle dogs) or an irradiation stent system (15 beagle dogs in three groups received 11.1, 22.2, 33.3 MBq radioactivity, n=5 in each dose group). Follow-up methods included blood biochemical test, color Doppler sonographyand CT scan at 0, 15, 30, 60, and 120 days after implantation of irradiation stent system.Pathological tissues were obtained from sacrificed beagle dogs on the 120th day. Results: The portal vein irradiation stent systems and the conventional stents were successfully deployed into the targeted portal vein segment in all beagles, none was dislodged during the deployment or the follow-up period.Differences of blood biochemical indexes and portal vein flow volume measured by color Doppler sonography were not significant (P>0.05). Stent systems were morphologically intact and patent.None of the peripheral organs had hemorrhage, necrosis or perforation.Pathological tissues revealed that the systems were surrounded by fibrous tissues and a few inflammatory cells, but with no significant differences in all groups. Conclusion: It indicates that portal veinirradiation stent system is safe in all dose groups, and it is feasible to design a special irradiation stent system for each patient according to the size of the portal vein tumor thrombus.

[Discriminatory power of variable number on tandem repeats loci for genotyping Mycobacterium tuberculosis strains in China]

Objective: Using the standard genotype method, variable number of tandem repeats (VNTR), we constructed a VNTR database to cover all provinces and proposed a set of optimized VNTR loci combinations for each province, in order to improve the preventive and control programs on tuberculosis, in China. Methods: A total of 15 loci VNTR was used to analyze 4 116 Mycobacterium tuberculosis strains, isolated from national survey of Drug Resistant Tuberculosis, in 2007. Hunter-Gaston Index (HGI) was also used to analyze the discriminatory power of each VNTR site. A set combination of 12-VNTR, 10-VNTR, 8-VNTR and 5-VNTR was respectively constructed for each province, based on 1) epidemic characteristics of M. tuberculosis lineages in China, with high discriminatory power and genetic stability. Results: Through the completed 15 loci VNTR patterns of 3 966 strains under 96.36% (3 966/4 116) coverage, we found seven high HGI loci (including QUB11b and MIRU26) as well as low stable loci (including QUB26, MIRU16, Mtub21 and QUB11b) in several areas. In all the 31 provinces, we found an optimization VNTR combination as 10-VNTR loci in Inner Mongolia, Chongqing and Heilongjiang, but with 8-VNTR combination shared in other provinces. Conclusions: It is necessary to not only use the VNTR database for tracing the source of infection and cluster of M. tuberculosis in the nation but also using the set of optimized VNTR combinations in monitoring those local epidemics and M. tuberculosis (genetics in local) population.

Superconductivity in HfTe5 across weak to strong topological insulator transition induced via pressures

Recently, theoretical studies show that layered HfTe₅ is at the boundary of weak & strong topological insulator (TI) and might crossover to a Dirac semimetal state by changing lattice parameters. The topological properties of 3D stacked HfTe₅ are expected hence to be sensitive to pressures tuning. Here, we report pressure induced phase evolution in both electronic & crystal structures for HfTe₅ with a culmination of pressure induced superconductivity. Our experiments indicated that the temperature for anomaly resistance peak (Tp) due to Lifshitz transition decreases first before climbs up to a maximum with pressure while the Tp minimum corresponds to the transition from a weak TI to strong TI. The HfTe₅ crystal becomes superconductive above ~5.5 GPa where the Tp reaches maximum. The highest superconducting transition temperature (Tc) around 5 K was achieved at 20 GPa. Crystal structure studies indicate that HfTe₅ transforms from a Cmcm phase across a monoclinic C2/m phase then to a P-1 phase with increasing pressure. Based on transport, structure studies a comprehensive phase diagram of HfTe₅ is constructed as function of pressure. The work provides valuable experimental insights into the evolution on how to proceed from a weak TI precursor across a strong TI to superconductors.

[Effects of tetrahydrobiopterin on the angiogenesis in hepatocellular carcinoma]

Objective: To investigate the effect and mechanism of tetrahydrobiopterin (BH4) on the angiogenesis in hepatocellular carcinoma (HCC). Methods: BALB/c-nu mice were subcutaneously injected with HepG-2 cells and randomly divided into control and BH4 groups. The BH4 group and control group received 20 mg/kg BH4 or saline by intraperitoneal injection daily for two weeks, respectively. The level of BH4 was measured by high performance liquid chromatography (HPLC), the level of nitric oxide (NO) was measured by Griess test array, the transcriptional level of K-ras was measured by quantitative RT-PCR, and the protein expressions of guanosine triphosphate cyclohydrolase Ⅰ(GTPCH), endothelial nitric oxide synthase (eNOS), phospho-Akt and Akt were determined by Western blot. Results: BH4 level in the tumor tissues of BH4 group was (0.24±0.02) μg/ml, significantly higher than the (0.17±0.01) μg/ml in the control group (P<0.01). The level of NO in the tumor tissues of BH4 group was (51.44±2.90) mmol/L, significantly higher than the (24.77±0.54) mmol/L in the control group (P<0.01). The tumor volume of BH4 group was (191.05±8.70) mm3, significantly higher than the (103.10±5.03) mm3 in the control group (P<0.01). The expressions of CD34, K-ras, phospho-eNOS, phospho-Akt and GTPCH were significantly up-regulated in the tumor tissues of BH4 group when compared with those of the control group (P<0.01). Conclusions: BH4 recognized as an essential cofactor of eNOS can increase tumor-produced NO by activating the wild-type Ras-PI3K/Akt pathway, thus induces angiogenesis. This might provide a novel and promising way to control the progression of hepatocellular carcinoma through targeting BH4 synthesis pathway and inhibiting angiogenesis.

Initial measurements of plasma current and electron density profiles using a polarimeter/interferometer (POINT) for long pulse operation in EAST (invited)

A double-pass, radially viewing, far-infrared laser-based POlarimeter-INTerferometer (POINT) system utilizing the three-wave technique has been implemented for diagnosing the plasma current and electron density profiles in the Experimental Advanced Superconducting Tokamak (EAST). POINT has been operated routinely during the most recent experimental campaign and provides continuous 11 chord line-integrated Faraday effect and density measurement throughout the entire plasma discharge for all heating schemes and all plasma conditions (including ITER relevant scenario development). Reliability of both the polarimetric and interferometric measurements is demonstrated in 25 s plasmas with H-mode and 102 s long-pulse discharges. Current density, safety factor (q), and electron density profiles are reconstructed using equilibrium fitting code (EFIT) with POINT constraints for the plasma core.

Optical configuration optimization and calibration for the POINT system on EAST

Calibration of the polarimeter system is one of the key elements to determine the overall measurement accuracy. The anisotropic reflection and transmission properties of the mesh beam splitters can easily distort the polarization state of the circularly polarized beams. Using a rotating crystal quartz λ/2-waveplate to replace the plasma can effectively allow us to obtain the ratio of the measured Faraday rotation angle to the known rotation angle of the waveplate. This ratio is used to estimate the calibration factor for each chord to be accurately determined and help to minimize distortions introduced by the wire-mesh beam splitters. With the novel configuration optimization, the distortion of polarization state is effectively eliminated.

[The effect and safety of tirofiban on acute ST segment elevation myocardial infarction patients receiving no early reperfusion therapy]

OBJECTIVE

To study the efficacy and safety of tirofiban on acute ST segment elevation myocardial infarction (STEMI) in patients who do not receive early reperfusion therapy.

METHODS

A total of 153 STEMI patients without early reperfusion therapy were randomly distributed into tirofiban group (therapeutic group, n=78) and non-tirofiban group (control group, n=75). Coronary angiography was performed on the 5(th) and 10(th) day after treatment, and percutaneous coronary intervention (PCI) was conducted when necessary. The differences of initial patency of the infarct related artery (IRA), bleeding complication and clinic events within 30 days between these two groups were compared.

RESULTS

Tirofiban did not increase the percentage of patients with initial patency of IRA (60.3% vs 64.0%, P=0.63). The percentage of patients with thrombolysis in myocardial infarction (TIMI) 3 after PCI was 100.0% in tirofiban group and 97.1% in the control group (P=0.09). However, application of tirofiban significantly decreased poor myocardial perfusion rate after PCI (1.4% vs 8.8%, P=0.04). No significant differences were observed in major adverse cardiovascular events (MACE) (3.8% vs 2.7%, P=0.68) between therapeutic and control group. The same is true for mild (5/78 vs 4/75 cases, P=0.78) and severe hemorrhage (2/78 vs 1/75 cases, P=0.58), and severe thrombocytopenia (2/78 vs 0/75 cases, P=0.10) between these two groups within 30 days.

CONCLUSIONS

Tirofiban did not increase initial patency in STEMI patients without early reperfusion therapy. However, it can improve myocardial perfusion after PCI.

Self-priming on the plant viral RNAs during reverse transcription-PCR

The occurrence of the primer-independent cDNA synthesis during RT-PCR analysis of human and animal RNA viruses has been well documented. Conversely, there is scant knowledge about this event in plant RNA viruses. Here we show that the primer-independent cDNA synthesis occurs in all eight different plant RNA viruses tested in this study, suggesting a common phenomenon for RT-PCR analysis of plant RNA viruses. Additional experiments indicate that the event is likely contributed to by RNA self-priming, and can be effectively reduced or eliminated through increasing temperature of the RT reaction.

Faraday-effect polarimeter-interferometer system for current density measurement on EAST

A multichannel far-infrared laser-based POlarimeter-INTerferometer (POINT) system utilizing the three-wave technique is under development for current density and electron density profile measurements in the EAST tokamak. Novel molybdenum retro-reflectors are mounted in the inside wall for the double-pass optical arrangement. A Digital Phase Detector with 250 kHz bandwidth, which will provide real-time Faraday rotation angle and density phase shift output, have been developed for use on the POINT system. Initial calibration indicates the electron line-integrated density resolution is less than 5 × 10(16) m(-2) (∼2°), and the Faraday rotation angle rms phase noise is <0.1°.

Ketamine-induced ventricular structural, sympathetic and electrophysiological remodelling: pathological consequences and protective effects of metoprolol

BACKGROUND AND PURPOSE

Growing evidence suggests that long-term abuse of ketamine does harm the heart and increases the risk of sudden death. The present study was performed to explore the cardiotoxicity of ketamine and the protective effects of metoprolol.

EXPERIMENTAL APPROACH

Rats and rabbits were divided into control, ketamine, metoprolol alone and ketamine plus metoprolol groups. Ketamine (40 mg·kg(-1) ·day(-1), i.p.) and metoprolol (20 mg·kg(-1) ·day(-1), p.o.) were administered continuously for 12 weeks in rats and 8 weeks in rabbits. Cardiac function, electrophysiological disturbances, cardiac collagen, cardiomyocte apoptosis and the remodelling-related proteins were evaluated.

KEY RESULTS

Rabbits treated with ketamine showed decreased left ventricular ejection fraction, slowed ventricular conduction velocity and increased susceptibility to ventricular arrhythmia. Metoprolol prevented these pathophysiological alterations. In ketamine-treated rats, cardiac collagen volume fraction and apoptotic cell number were higher than those of control animals; these effects were prevented by co-administration of metoprolol. Consistently, the expressions of poly (ADP-ribose) polymerases-1, apoptosis-inducing factor and NF-κB-light-chain-enhancer of activated B cells were all increased after ketamine treatment and sharply reduced after metoprolol administration. Moreover, ketamine enhanced sympathetic sprouting, manifested as increased growth-associated protein 43 and tyrosine TH expression. These effects of ketamine were prevented by metoprolol.

CONCLUSIONS AND IMPLICATIONS

Chronic treatment with ketamine caused significant ventricular myocardial apoptosis, fibrosis and sympathetic sprouting, which altered the electrophysiological properties of the heart and increased its susceptibility to malignant arrhythmia that may lead to sudden cardiac death. Metoprolol prevented the cardiotoxicity of ketamine, indicating a promising new therapeutic strategy.

Isolation and characterization of the organ-specific and light-inducible promoter of the gene encoding rubisco activase in potato (Solanum tuberosum)

Constitutive promoters have been widely used in crop biotechnology applications. Tissue-specific or inducible promoters, however, have advantages in some cases. We isolated the 731-bp 5' flanking sequence of a potato (Solanum tuberosum) gene, encoding ribulose-1,5-bisphosphate carboxylase/oxygenase (rubisco) activase (RCA), which was isolated by genome walking. By using GUS as a reporter and with Northern blot analysis, the 702-bp fragment (referred to as StRCAp), ranging from nt -731 to -30 relative to the initiation code of the RCA gene, was analyzed in transgenic tobacco plants. The activity of StRCAp in leaves was 0.4-fold less than that of cauliflower mosaic virus 35S promoter, and was expressed throughout the green part of the light-grown transgenic T(1) seedlings, including cytoledons, leaves and young stems, but not roots. Further deletion analysis revealed that a shorter fragment (nt -249 to -30, StRCAp2) retained light-inducible features in cytoledons and leaves, but showed no detectable activity in young stems and roots. Although the activity of StRCAp2 in leaves was reduced significantly compared with that of StRCAp, the overall data indicated that cis-elements sufficient to regulate organ-specific and light-inducible transcription are within the 220-bp fragment. There is potential for application of StRCAp in plant genetic engineering.

Sex ratio bias in early-dead embryos of chickens collected during the first week of incubation

According to Mendelian heredity laws, the sex ratio of a given chicken population during hatching is expected to be 1:1. In this study, we collected 432 chicken embryos that died during the first week of incubation from 5 different breeds. The sexes of the early-dead embryos were determined by using the previously described molecular sexing technique of double PCR. The female-to-male sex ratio was analyzed for departure from the expected 1:1 sex ratio by chi(2) testing. These results showed that the number of female dead embryos was significantly greater than that of males in the Hubei local breeding stock, Zhusi, and Hy-line Variety Brown (P < 0.05, P < 0.01, P < 0.01 respectively), with observed female-to-male sex ratios of 1.40:1, 2.03:1, and 2.22:1, respectively. Two other Chinese local breeds (the Yellow chicken and the Aijiaohuang chicken) also showed altered sex ratios, although the differences were not significant. Altogether, these results indicated that female chickens were more likely than male chickens to die at the early stages of incubation.

East meets West in the search for Alzheimer's therapeutics - novel dimeric inhibitors from tacrine and huperzine A

Alzheimer's disease (AD) is linked to cholinergic deficiency and the overactivation of glutamate receptors. The acetylcholinesterase (AChE) inhibition treatment approach has produced the most encouraging results in clinical practice, and memantine, a moderate antagonist of N-methyl-D-aspartate (NMDA) receptors, has been approved for treating AD. However, AChE inhibitors have limited success as they only improve memory in mild dementia but cannot stop the process of neurodegeneration; while memantine possesses neuroprotective effects only with a little ability in memory enhancement. There has been a major rush among neuroscience research institutions and pharmaceutical firms worldwide to search for safer and more effective therapeutic agents for AD. The novel dimers, derived from tacrine and the fragment of huperzine A (HA'), have been demonstrated to be potent and selective reversible inhibitors of AChE. Bis(7)-tacrine, bis(12)-hupyridone (E12E) and HA'(10)-tacrine, are representatives of three series of novel dimers. According to the preclinical studies, these compounds have been shown to have low toxicity and high efficacy for improving cognitive deficits in several animal models. More interestingly, bis(7)-tacrine, similar to memantine, prevents glutamate-induced neurotoxicity by moderately blocking glutamate receptor NMDA subtype. Furthermore, bis(7)-tacrine, as well as E12E, possesses multiple neuroprotective effects in vitro and in vivo. Taking together, these dimeric AChE inhibitors, especially bis(7)-tacrine, E12E and HA'(10)-tacrine, may provide beneficial effects in AD and other neurodegenerative diseases.

Responses of Blood Pressure and Renal Sympathetic Nerve Activity to Colorectal Distension in Anesthetized Rats

We investigated the effects of visceral stimulation by colorectal distension (CRD) on mean arterial blood pressure (MAP) and renal sympathetic nerve activity (RSNA), the latter being an index of vasoconstrictor activity, in anesthetized central nervous system (CNS)-intact and C2 spinalized rats. The CRD stimulation was induced by the distention of a balloon inserted into the colorectum. In CNS-intact rats, there were significant reductions in MAP and RSNA in response to intraballoon pressures of 60 and 80 mmHg, but not to 20 and 40 mmHg. However, spinalized rats demonstrated significant increases in MAP in response to intraballoon pressures of 60 and 80 mmHg and increases in RSNA in response to intraballoon pressures of 40, 60, and 80 mmHg. These results suggest that noxious visceral stimulation at lower spinal levels reduces MAP by inhibiting sympathetic output in CNS-intact anesthetized rats. On the other hand, noxious visceral stimulation results in an increase in sympathetic-induced MAP in spinalized anesthetized rats.

Reflex Inhibition of Heart Rate and Efferent Cardiac Sympathetic Outflow Induced by Colorectal Distension in Anesthetized Rats

Colorectal distensions of 60 and 80 mmHg significantly reduced heart rate (HR) and cardiac sympathetic nerve activity in anesthetized rats. This bradycardiac response was not influenced by the intravenous administration of atropine, but was abolished by propranolol, suggesting that it was elicited by sympathetic but not vagal efferent nerves.

Analgesic effect of electroacupuncture on complete Freund's adjuvant-induced inflammatory pain in mice: a model of antipain treatment by acupuncture in mice

Electroacupuncture (EA) was applied bilaterally to the acupoints of Zu-san-li (ST-36) and Kun-lun (BL-60) in the hindlimbs of mice. The therapeutic effect of EA on inflammatory pain induced by an ipsilateral injection of complete Freund's adjuvant (CFA) into the right paw of the mouse was investigated in this study. The time of paw-withdrawal latency (PWL) was used as an indicator for judging the intensity of the pain induced by the CFA injection. The EA effects were divided into immediate (PWL tests within 2 h after EA treatment) and cumulative (PWL tests during and after repetitive EA treatments for 3 weeks) effects. As immediate effects, PWL was significantly shortened in the CFA-injected paw, but was again prolonged 20 min after an EA treatment and lasted until 30 min after. As cumulative effects, PWL was significantly shortened in the CFA-injected paw, but recovered from the 2nd to the 8th day during repetitive EA treatments. No such effects could be observed after sham EA treatment, which resulted in behavior similar to that in untreated animals. These results demonstrate that the CFA-induced inflammatory pain in mice is an ideal model system for the investigation of EA effects and may serve as a valuable reference for the clinical treatment of inflammatory pain in human beings. Furthermore, the mouse pain model opens the possibility to apply the investigation also to transgenic mice.

Molecular epidemiology of Mycobacterium tuberculosis in China: a nationwide random survey in 2000

OBJECTIVE

To determine the contribution of the Mycobacterium tuberculosis (TB) Beijing genotype to the population structure of M. tuberculosis complex in China.

DESIGN

Genotypes of 441 mycobacterial isolates were determined by spoligotyping and IS6110 restriction fragment length polymorphism (RFLP). The isolates were from a nationwide random survey for the epidemiology of TB conducted in 2000, and the drug susceptibility patterns and epidemiological data were known.

RESULT

A total of 408 samples contained M. tuberculosis as determined by spoligotyping. Of the M. tuberculosis strains, 64.9% (265/408) were of the Beijing genotype. Using the chi-squared test, no statistically significant differences were observed in the proportion of Beijing genotype TB in patients of different sex, age or living in different areas of the country, but a significant difference was observed with multidrug-resistant (MDR) TB: 77.8% (42/ 54) of MDR isolates were of the Beijing genotype vs. 60.2% (213/354) of the drug-susceptible isolates. In the multivariate logistic regression model, the Beijing genotype was significantly associated with region and not with MDR.

CONCLUSION

The M. tuberculosis Beijing genotype has prevailed in China for at least five decades and is associated with region.

Electro-acupuncture relieves chronic visceral hyperalgesia in rats

Acupuncture treatment is one of the most desirable choices for the management of pain including chronic visceral pain, but its scientific evidence and laws of action are not very clear at this point. In this study, we examined the immediate and cumulative effects of electro-acupuncture (EA) on chronic visceral pain induced by colorectal distention (CRD) stimuli in rats using an irritable bowel syndrome (IBS) model (a chronic visceral hypersensitivity model). The results demonstrated that EA could significantly depress both abnormally increased abdominal withdrawal reflex (AWR) scores and the magnitude of electromyograms (EMGs) recorded from the rectus abdominis in response to CRD stimulation at strengths of 20, 40, 60, and 80 mmHg. Repeated EA treatment for 14 days showed that the effects of EA on both abnormal AWRs and EMGs appeared 2-4 days after the start of the EA application session, gradually enhanced to its maximum within 8-12 days, and lasted 5 days after EA treatment stopped. These data provide evidence that visceral pain associated with the rat IBS model can be effectively treated by EA and opens up the possibility of clinical treatment of chronic visceral pain with acupuncture.

Risk assessment of exposure to volatile organic compounds in different indoor environments

The lifetime cancer risks of exposure of cooks and food service workers, office workers, housewives, and schoolchildren in Hong Kong to volatile organic compounds (VOCs) in their respective indoor premises during normal indoor activities were assessed. The estimated cancer risk for housewives was the highest, and the second-highest lifetime cancer risk to VOC exposure was for the groups of food service and office workers. Within a certain group of the population, the lifetime cancer risk of the home living room was one to two orders of magnitude higher than that in other indoor environments. The estimated lifetime risks of food service workers were about two times that of office workers. Furthermore, the cancer risks of working in kitchen environments were approximately two times higher than the risks arising from studying in air-conditioned classrooms. The bus riders had higher average lifetime cancer risks than those travelling by Mass Transit Railway. For all target groups of people, the findings of this study show that the exposures to VOCs may lead to lifetime risks higher than 1 x 10(-6). Seven indoor environments were selected for the measurement of human exposure and the estimation of the corresponding lifetime cancer risks. The lifetime risks with 8-h average daily exposures to individual VOCs in individual environments were compared. People in a smoking home had the highest cancer risk, while students in an air-conditioned classroom had the lowest risk of cancer. Benzene accounted for about or more than 40% of the lifetime cancer risks for each category of indoor environment. Nonsmoking and smoking residences in Hong Kong had cancer risks associated with 8-h exposures of benzene above 1.8 x 10(-5) and 8.0 x 10(-5), respectively. The cancer risks associated with 1,1-dichloroethene, chloroform, methylene chloride, trichloroethene, and tetrachloroethene became more significant at selected homes and restaurants. Higher lifetime cancer risks due to exposure to styrene were only observed in the administrative and printing offices and air-conditioned classrooms. Higher lifetime cancer risks related to chloroform exposures were observed at the restaurant and the canteen.