[Enhancing survival outcomes in stage Ⅲ gastric/esophagogastric junction cancer: a retrospective study of immune checkpoint inhibitors and adjuvant chemotherapy based on real-world data]

Objective: To explore the efficacy of immune checkpoint inhibitors combined with adjuvant chemotherapy in patients with phase III gastric cancer and esophagogastric junction cancer. Methods: This study used a retrospective cohort study method based on real-world data. Clinical data of 403 patients with stage III gastric/esophagogastric junction cancer who underwent gastrectomy followed by adjuvant therapy in the Department of Gastric Surgery at Sun Yat-sen University Cancer Center from January 2020 to December 2023 were retrospectively collected. The study cohort comprised 147 (36.5%) patients with stage IIIA, 130 (32.3%) with stage IIIB, and 126 (31.3%) with stage IIIC gastric/esophagogastric junction cancer. Of them, 15 (3.7%) were HER-2 positive, 25 (6.2%) dMMR, and 22 (5.5%) patients Epstein-Barr virus encoding RNA (EBER) positive. Based on treatment plans, the patients were divided into immune checkpoint inhibitor combined with chemotherapy group (immune therapy group, n=110, 71 males and 39 females, median age 59 years old) and chemotherapy alone group (chemotherapy group, n=293, 186 males and 107 females, median age 60 years old). All patients in the immunotherapy group received immune checkpoint inhibitors targeting the programmed cell death protein-1 (PD-1) and its ligand (PD-L1). Of them, 85 received pembrolizumab, 10 received sintilimab, 8 received tislelizumab, 4 received camrelizumab, 2 received toripalimab, and 1 received pabocizumab. The adjuvant chemotherapy regimens used among the chemotherapy alone group includes SOX regimen (132 cases), XELOX (102 cases), S-1 monotherapy (44 cases), and other regimens (15 cases). The 3-year DFS rate of the two groups was compared, and subgroup analysis was conducted based on different ages, molecular phenotypes, pTNM staging, extranodal infiltration, and tumor length. Results: The median follow-up was 20.5 months (range 3.1~46.3), with a 3-year overall DFS rate of 61.4% for the entire 403 patients. The 3-year DFS rate for the immunotherapy group was 82.7%, higher than the chemotherapy alone group (58.8%), with a statistically significant difference (P=0.021). Multivariate analysis showed that postoperative immunotherapy was a protective factor for DFS (HR=0.352, 95%CI: 0.180~0.685). Subgroup analysis showed that stage IIIC (HR=0.416, 95%CI: 0.184~0.940), aged ≥60 years (HR=0.336, 95%CI: 0.121~0.934) and extranodal invasion (HR=0.378, 95%CI: 0.170~0.839) were associated with benefit from the combined immune adjuvant chemotherapy, while no association was observed for MMR, HER-2 or EBER status. Conclusion: Stage III gastric/esophagogastric junction cancer patients may benefite from postoperative immune checkpoint inhibitor combined with adjuvant chemotherapy in real-world settings.

Secondary metabolites in host pears defense against two fruit borers and cytochrome-P450-mediated counter-defense

Herbivorous insects have evolved metabolic strategies to survive the challenges posed by plant secondary metabolites (SMs). This study reports an exploration of SMs present in pears, which serve as a defense against invasive Cydia pomonella and native Grapholita molesta and their counter-defense response. The feeding preferences of fruit borers are influenced by the softening of two pear varieties as they ripen. The content of SMs, such as quercetin and rutin, increases due to feeding by fruit borers. Notably, quercetin levels only increase after C. pomonella feeding. The consumption of SMs affects the growth of fruit borer population differently, potentially due to the activation of P450 genes by SMs. These two fruit borers are equipped with specific P450 enzymes that specialize in metabolizing quercetin and rutin, enabling them to adapt to these SMs in their host fruits. These findings provide valuable insights into the coevolution of plants and herbivorous insects.

Silver Surface-Assisted Dehydrobrominative Cross-Coupling between Identical Aryl Bromides

Cross-coupling reactions represent an indispensable tool in chemical synthesis. An intriguing challenge in this field is to achieve selective cross-coupling between two precursors with similar reactivity or, to the limit, the identical molecules. Here we report an unexpected dehydrobrominative cross-coupling between 1,3,5-tris(2-bromophenyl)benzene molecules on silver surfaces. Using scanning tunneling microscopy, we examine the reaction process at the single-molecular level, quantify the selectivity of the dehydrobrominative cross-coupling, and reveal the modulation of selectivity by substrate lattice-related catalytic activity or molecular assembly effect. Theoretical calculations indicate that the dehydrobrominative cross-coupling proceeds via regioselective C-H bond activation of debrominated TBPB and subsequent highly selective C-C coupling of the radical-based intermediates. The reaction kinetics plays an important role in the selectivity for the cross-coupling. This work not only expands the toolbox for chemical synthesis but also provides important mechanistic insights into the selectivity of coupling reactions on the surface.

Side effects of X-ray irradiation on flight ability of Cydia pomonella moth

BACKGROUND

The sterile insect technique (SIT) has proven to be an effective approach in managing the population of major invasive pests. Our previous studies showed that irradiation of Cydia pomonella males at a dosage of 366 Gy X-rays resulted in complete sterility. However, the mating competitiveness of sterilized males is significantly compromised, which can be attributed to a decline in their ability to fly.

RESULTS

In this study, we examined the flight patterns of both male and female adults of C. pomonella. The results revealed significant variations in the average flight speed of both genders at different stages of maturity, with females displaying longer flight duration and covering greater distances. Effect of irradiation on the flight performance of 3-day-old male moths was further evaluated, as they demonstrated the longest flight distance. The findings indicated a significant decrease in flight distance, duration, and average speed, due to wing deformities caused by irradiation, which also limited the dispersal distance of moths in orchards, as indicated by the mark-and-recapture assay. Reverse-transcription quantitative polymerase chain reaction analysis revealed a down-regulation of flight-related genes such as Flightin, myosin heavy chain, and Distal-less following radiation exposure.

CONCLUSION

These findings demonstrate that X-ray irradiation at a radiation dose of 366 Gy has a detrimental effect on the flight ability of male C. pomonella adults. These insights not only contribute to a better understanding of how radiation sterilization diminishes the mating competitiveness of male moths, but also aid in the development and improvement of SIT practices for the effective control of C. pomonella. © 2023 Society of Chemical Industry.

Quercetin stimulates an accelerated burst of oviposition-based reproductive strategy in codling moth controlled by juvenile hormone signaling pathway

The advantageous characteristics of invasive pests, particularly their ability to reproduce and adapt to the environment, have been observed. However, it remains unclear what specific inherent superiority enables fruit pests to successfully invade and dominate in interactions with other species. In this study, we report that Cydia pomonella (Linnaeus), a notorious invasive pest of pome fruits and walnuts globally, employs unique reproductive strategies in response to quercetin, a plant compound in host fruits. By monitoring adult dynamics and fruit infestation rates, we observed a competitive relationship between C. pomonella and the native species Grapholita molesta (Busck). C. pomonella was able to occupy vacant niches to ensure its population growth. We also found that quercetin had different effects on the reproductive capacity and population growth of C. pomonella and G. molesta. While quercetin stimulated the fecundity and population growth of G. molesta, it inhibited C. pomonella. However, C. pomonella was able to rapidly increase its population after exposure to quercetin by adopting an 'accelerated burst' of oviposition strategy, with each individual making a greater reproductive contribution compared to the control. We further demonstrated that the effect of quercetin on oviposition is regulated by the juvenile hormone (JH) signaling pathway in C. pomonella, allowing it to prioritize survival. The enhanced reproductive fitness of G. molesta in response to quercetin is attributed to the regulation of JH titers and key genes such as Met and Kr-h1, which in turn up-regulate reproduction-related genes Vg and VgR. In contrast, C. pomonella is inhibited. These findings shed light on the mechanisms interspecific competition and help to improve our understanding of the global spread of C. pomonella, which can be attributed to its inherent superiority in terms of reproductive strategy.

Identification of G Protein-Coupled Receptors (GPCRs) Associated with Lambda-Cyhalothrin Detoxification in Cydia pomonella

While previous studies have reported G protein-coupled receptor (GPCR)-mediated insecticide resistance in various arthropods, the understanding of GPCR-associated resistance mechanisms in Cydia pomonella remains limited. In this study, a total of 95 CpGPCR genes categorized into four families were identified in C. pomonella. Results revealed high expression levels of the majority of the CpGPCRs during the first larval stage and in the head of C. pomonella. Exposure to lambda-cyhalothrin significantly increased the expression of 15 CpGPCRs, including CpGPCR70, which is highly expressed in all larval stages and shows the highest expression in the midgut. RNA interference (RNAi) demonstrated that downregulation of CpGPCR70 leads to reduced expression of key resistance-related genes and a decreased tolerance of larvae to lambda-cyhalothrin. These findings indicate that CpGPCR70 plays a crucial role in regulating the expression of detoxifying genes involved in lambda-cyhalothrin resistance, offering valuable insights for the development of more effective pest control strategies.

Unprecedented oviposition tactics avoid plant defences and reduce attack by parasitic wasps

Female insects oviposit in sites suitable for the development of their offspring. The Oriental armyworm, Mythimna separata is a serious pest of various crops including wheat and prefers to oviposit on withered leaves rather than on fresh plant material, which is surprisingly different from other insects. Studies here showed that this oviposition tactic enables avoidance of wheat defence against eggs and emerged larvae. Intact plants responded to M. separata egg deposition by releasing oviposition-induced plant volatiles including acetophenone, tetradecene and pentadecane after 24 h. Acetophenone was identified as quantitatively accounting for the attraction of the egg parasitoid wasp (Trichogramma chilonis). Leaf jasmonic acid levels significantly increased after M. separata laid eggs, and primed the plant against emerging larvae. In addition, newly emerged M. separata larvae adopted a fast crawling behaviour and starvation tolerance compared with other noctuid larvae, which enhanced the survival of larvae on the withered leaves. The elucidation of this complex and surprising plant-insect interaction provides the first explanation for a herbivore laying eggs on withered leaves to avoid natural enemies and live-plant defence against emerging larvae.

[Mechanism of podocyte pyroptosis aggravated by up-regulation of phospholipase A2 receptor by hepatitis B virus X protein]

Objective: To explore the effect and underlying mechanism of increased expression of M-type phospholipase A₂ receptor (PLA₂R) on podocyte membrane induced by hepatitis B virus X protein (HBx) on podocyte pyroptosis in hepatitis B virus-associated glomerulonephritis (HBV-GN). Methods: Transfection of the HBx gene into human kidney podocytes was used to mimic the HBV-GN pathogenesis process. Subsequently, podocytes were divided into the following eight groups: normal control plus secretory phospholipase A₂-ⅠB (sPLA₂-ⅠB) group, empty plasmid plus sPLA₂-ⅠB group, HBx group, HBx plus sPLA₂-ⅠB group, HBx plus sPLA₂-ⅠB plus PLA₂R control siRNA group, HBx plus sPLA₂-ⅠB plus PLA₂R-siRNA group, HBx plus sPLA₂-ⅠB plus ROS control siRNA group, and HBx plus sPLA₂-ⅠB plus ROS-siRNA group. Podocyte morphology was observed under a transmission electron microscope, and PLA₂R expression was detected under a fluorescence microscope. Podocyte pyroptosis and reactive oxygen species (ROS) expression were analyzed by flow cytometry, and the mRNA and protein expression of PLA₂R, nucleotide-binding oligomerization domain-like receptor 3 (NLRP3), apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), caspase-1, interleukin (IL)-1β and IL-18 were determined by real-time fluorescence quantitative PCR and Western blot. Results: Compared with the control group, the expression of PLA₂R on podocyte membrane significantly increased after transfection with HBx plasmid in vitro (4.07±0.41 vs 1.01±0.17, P<0.001). Transmission electron microscope and fluorochrome-labeled inhibitor of caspases/propidium iodide (FLICA/PI) double staining suggested that overexpressed PLA₂R combined with sPLA₂-ⅠB caused aggravated podocyte injury and increased pyroptosis (20.22%±0.36% vs 7.86%±0.28%, P<0.001). Moreover, the expression levels of ROS (4 324 515±222 764 vs 12 920±46, P<0.001), NLRP3 (48.30±2.73 vs 1.00±0.11, P<0.001), ASC (4.02±0.84 vs 1.01±0.15, P<0.001), caspase-1 (3.99±0.42 vs 1.00±0.11, P<0.001), IL-1β (9.08±0.75 vs 1.00±0.09, P<0.001) and IL-18 (19.20±0.70 vs 1.00±0.02, P<0.001) increased when PLA₂R was overexpressed. In contrast, with the addition of PLA₂R-siRNA or ROS-siRNA to knockdown the expression of related substances, podocyte injury was alleviated and the degree of pyroptosis decreased, and the expressions of genes related to the downstream signaling pathway (NLRP3, ASC, caspase-1, IL-1β and IL-18) decreased (all P<0.01). Conclusion: HBx may promote podocyte pyroptosis in HBV-GN by targeting the ROS-NLRP3 signaling pathway via the upregulation of PLA₂R.

[Burned-out testicular germ cell tumors: a clinicopathological analysis of three cases]

Objective: To investigate the clinicopathological features and possible mechanisms of burned-out testicular germ cell tumors. Methods: The clinical and imaging data, histology and immunophenotypic characteristics of three cases of burned-out testicular germ cell tumors diagnosed at the Ruijin Hospital, Medical College of the Shanghai Jiaotong University, from 2016 to 2020 were retrospectively analyzed. The relevant literature was reviewed. Results: The mean age of the three patients was 32 years. Case 1 had an elevated preoperative alpha-fetoprotein level (810.18 μg/L) and underwent "radical pancreaticoduodenectomy and retroperitoneal lesion resection" for a retroperitoneal mass. Postoperative pathology showed embryonal carcinoma, which needed to exclude gonadal metastasis. Color Doppler ultrasound showed a solid mass of the right testis, with hypoechoic lesion and scattered calcification in some areas. Case 2 was a "right supraclavicular lymph node biopsy specimen." Chest X-ray showed multiple metastases in both lungs. The biopsy showed metastatic embryonic carcinoma and bilateral testicular color Doppler ultrasound revealed abnormal calcifications in the right testicle. Case 3 showed a cystic mass of the right testis with calcification and solid areas. All 3 patients underwent radical right orchiectomy. Grossly, borders of the testicular scar areas were well defined. Cross sectioning of the tumors showed a gray-brown cut surface and single focus or multiple foci of the tumor. The tumor maximum diameter was 0.6-1.5 cm. Microscopically, lymphocytes, plasma cells infiltration, tubular hyalinization, clustered vascular hyperplasia and hemosiderin laden macrophages were found in the scar. Atrophic and sclerotic seminiferous tubules, proliferation of clustered Leydig cells and small or coarse granular calcifications in seminiferous tubules were present around the scar. Seminoma and germ cell neoplasia in situ were seen in case 1, germ cell neoplasia in situ was seen in case 2 and germ cells with atypical hyperplasia were seen in case 3. Immunohistochemistry showed that embryonic carcinoma expressed SALL4, CKpan(AE1/AE3) and CD30, seminoma and germ cell tumor in situ expressed OCT3/4, SALL4 and CD117, and spermatogenic cells with atypical hyperplasia expressed CD99 and SALL4. The Ki-67 positive index was about 20%, while OCT3/4 and CD117 were both negative. Conclusions: Burned-out testicular germ cell tumors are rare. The possibility of gonad testicular metastasis should be considered first for extragonadal germ cell tumor. If fibrous scar is found in testis, it must be determined whether it is a burned-out testicular germ cell tumor. The burned-out mechanisms may be related to the microenvironment of tumor immune-mediated and local ischemic injury.

Transcription Factor AhR Regulates Glutathione S-Transferases Conferring Resistance to lambda-Cyhalothrin in Cydia pomonella

Aryl hydrocarbon receptor (AhR) enhances insect resistance to insecticides by regulating the detoxification network. Our previous studies have confirmed that overexpressions of cytochrome P450 monooxygenases (P450s) and glutathione S-transferases (GSTs) are involved in lambda-cyhalothrin resistance in Cydia pomonella. Here, we report that CpAhR regulates the expression of GST and P450 genes, thus conferring resistance. Expression patterns indicated that the expression of CpAhR was highly induced by lambda-cyhalothrin exposure and upregulated in a lambda-cyhalothrin-resistant population. RNA interference (RNAi) of CpAhR decreases the expression of key resistance-related genes (CpGSTe3, CpCYP9A121, and CpCYP9A122) and the activity of the GST enzyme, reducing the tolerance to lambda-cyhalothrin. Furthermore, β-naphthoflavone, a novel agonist of AhR, was first proven to be effective in increasing CpAhR expression and larval tolerance to lambda-cyhalothrin. These results demonstrate that CpAhR regulates the expression of key detoxifying genes and GST activity, resulting in the development of resistance to lambda-cyhalothrin in C. pomonella.

Metabolic functional redundancy of the CYP9A subfamily members leads to P450-mediated lambda-cyhalothrin resistance in Cydia pomonella

BACKGROUND

The evolution of insect resistance to pesticides poses a continuing threat to sustainable pest management. While much is known about the molecular mechanisms that confer resistance in model insects and few agricultural pests, far less is known about fruit pests. Field-evolved resistance to synthetic insecticides such as lambda-cyhalothrin has been widely documented in Cydia pomonella, a major invasive pest of pome fruit worldwide, and the increased production of cytochrome P450 monooxygenases (P450s) has been linked to resistance in field-evolved resistant populations. However, the underlying molecular mechanisms of P450-mediated insecticide resistance remain largely unknown.

RESULTS

Here we found that functional redundancy and preference of metabolism by P450s genes in the CYP9A subfamily confer resistance to lambda-cyhalothrin in Cydia pomonella. A total of four CYP9A genes, including CYP9A61, CYP9A120, CYP9A121, and CYP9A122, were identified from Cydia pomonella. Among these, CYP9A120, CYP9A121, and CYP9A122 were predominantly expressed in the midgut of larvae. The expression levels of these P450 genes were significantly induced by a lethal dose that would kill 10% (LD₁₀ ) of lambda-cyhalothrin and were overexpressed in a field-evolved lambda-cyhalothrin resistant population. Knockdown of CYP9A120 and CYP9A121 by RNA-mediated interference (RNAi) increased the susceptibility of larvae to lambda-cyhalothrin. In vitro assays demonstrated that recombinant P450s expressed in Sf9 cells can metabolize lambda-cyhalothrin, but with functional redundancy and divergence through regioselectivity of metabolism. CYP9A121 preferred to convert lambda-cyhalothrin to 2'-hydroxy-lambda-cyhalothrin, whereas CYP9A122 only generated 4'-hydroxy metabolite of lambda-cyhalothrin. Although possesses a relatively low metabolic capability, CYP9A120 balanced catalytic competence to generate both 2'- and 4'-metabolites.

CONCLUSION

Collectively, these results reveal that metabolic functional redundancy of three members of the CYP9A subfamily leads to P450-mediated lambda-cyhalothrin resistance in Cydia pomonella, thus representing a potential adaptive evolutionary strategy during its worldwide expansion. © 2022 Society of Chemical Industry.

Exposure to lambda-cyhalothrin and abamectin drives sublethal and transgenerational effects on the development and reproduction of Cydia pomonella

The codling moth Cydia pomonella (Lepidoptera: Tortricidae) is a major invasive pest of pome fruits and walnuts worldwide. Lambda-cyhalothrin (LCT) and abamectin (AM) have been frequently used in C. pomonella control, but control of this pest is very difficult because shortly after hatching, larvae of this insect bore tunnels and hide inside host plant fruit. In this study, a simulated field spray bioassay method was developed against neonate larvae of C. pomonella and concentration-response bioassays were conducted to evaluate the susceptibility of the neonate larvae to LCT and AM. Exposure of neonate larvae to sublethal concentration (LC₃₀) of LCT or AM significantly reduced the survival rate of larvae (4th and 5th instars), lowered the mean weight of larvae and pupae, and decreased the daily maximal number of eggs laid and the total number of eggs laid (fecundity) per female. The sublethal effects, including reduced body mass, mean fecundity and net reproductive rate, extended mean generation time, and shortened oviposition period, were also found in transgenerational offspring. Furthermore, the transgenerational maternal effects were more obvious for AM than LCT, in comparison to the control. Additionally, the estimated population size was decreased by exposure to LC₃₀ of LCT and AM, and the observed reduction of fecundity and population size within and across generations was likely the result of the downregulation of the reproduction-related vitellogenin gene (CpVg) after exposure to LC₃₀ of LCT and AM. These results provide a better understanding of the overall effects of LCT and AM on C. pomonella and the transgenerational effects which should be taken into consideration when using insecticides in order to control C. pomonella.

Sterility of Cydia pomonella by X ray irradiation as an alternative to gamma radiation for the sterile insect technique

The codling moth Cydia pomonella is a major pest of global significance impacting pome fruits and walnuts. It threatens the apple industry in the Loess Plateau and Bohai Bay in China. Sterile insect technique (SIT) could overcome the limitations set by environmentally compatible area-wide integrated pest management (AW-IPM) approaches such as mating disruption and attract-kill that are difficult to suppress in a high-density pest population, as well as the development of insecticide resistance. In this study, we investigated the effects of X-ray irradiation (183, 366, 549 Gy) on the fecundity and fertility of a laboratory strain of C. pomonella, using a newly developed irradiator, to evaluate the possibility of X-rays as a replacement for Cobalt⁶⁰ (⁶⁰Co-γ) and the expanded future role of this approach in codling moth control. Results show that the 8^th-day is the optimal age for irradiation of male pupae. The fecundity decreased significantly as the dosage of radiation increased. The mating ratio and mating number were not influenced. However, treated females were sub-sterile at a radiation dose of 183 Gy (20.93%), and were almost 100% sterile at a radiation dose of 366 Gy or higher. Although exposure to a radiation dose of 366 Gy resulted in a significant reduction in the mating competitiveness of male moths, our radiation biology results suggest that this new generation of X-ray irradiator has potential applications in SIT programs for future codling moth control.

[Preliminary study on the effect of fecal microbiota transplantation on neurobehavior and gut microbiota of offspring rats exposed to arsenic]

Objective: To explore the effects of fecal microbiota transplantation (FMT) on neurobehavior and gut microbiota of arsenic-exposed offspring rats. Methods: In April 2021, Thirty-six SPF SD rats aged 8 weeks were seleted, rats were ranked by weight and divided into four groups according to randomized block design, namely control group, arsenic exposure group (As group) , arsenic+normal saline group (As+NaCl group) and As+FMT group, 6 females and 3 males in each group. Fecal microbiota fluid were provided by feces of rats in control group. Rats drank tap water containing 75 mg/L sodium arsenite for one week and then were caged together. The arsenic exposure was terminated until the pups were born. Female rats with vaginal plug were treated with fecal microbiota fluid via gavage during neurodevelopmental teratogenic window period. The volume of gavage was 1 ml/100 g with once every two days, for a total of three times. Weight alterations of offspring rats were recorded every week after weaning, and when offspring rats grew up for 6 weeks, Morris test and open field experiment was used to observe learning and memory abilities, as well as neurobehavioral performance of autonomous exploration and tension, respectively. 16S rDNA sequencing technology was used to detect microbiota diversities in fecal samples of rats in As group and As+FMT group. Results: Compared with the control group, the ratio of swimming distance and staying time in the target quadrant and the times of crossing the platform of rats in As group decreased significantly, and the motor distance, times entering central zone and the number of grid crossing of rats decreased significantly (P<0.05) . Compared with As group, the ratio of swimming distance in target quadrant, the motor distance in central zone and times entering central zone of rats in As+FMT group were evidently increased (P<0.05) . The analysis of fecal microbiota diversities showed that, at the phyla level, the relative abundance of Bacteroidetes in feces of rats in As+FMT group was higher than that in As group (68.34% vs 60.55%) , while the relative abundance of Firmicutes was lower than that in As group (28.02% vs 33.48%) . At the genus level, the relative abundance of Prevotella in As+FMT group was significantly higher than that in As group, becoming the dominant genus (42.08% vs 21.78%) . Additionally, compared with As group, a total of 22 genus were increased with 21 decreased genus in As+FMT group (P<0.05) . LEfSe analysis showed that dominant genuses in As+FMT group were Prevotella and UCG_005, and their relative abundance was significantly higher than that of As group (P<0.05) . Conclusion: FMT may alleviate the impaired learning and memory ability and anxiety like behavior of the offspring rats exposed to arsenic, and improve the disrupted gut microbiota.

[A multicenter epidemiological study of acute bacterial meningitis in children]

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.

Aromatic Ring Fusion to Benzoporphyrin via γ-ortho Cyclodehydrogenation on a Ag(111) Surface

Aromatic ring fusion to porphyrins and their derivatives represents an attractive route to tune the molecular conjugation and thus expand their functionalities. Here, we report the expansion of the aromatic π-system of palladium tetraphenyltetrabenzoporphyrins (Pd-TPTBP) via surface-assisted γ-ortho cyclodehydrogenation on Ag(111). The chemical transformation of Pd-TPTBP into different products at an elevated temperature of 600 K was revealed at the single-molecule level using bond-resolved scanning tunneling microscopy with a CO-functionalized tip. We captured a series of γ-ortho cyclodehydrogenation products, wherein the maximum extent to which the reaction can progress is associated with 7-fold C-C formation to afford nearly planar γ-ortho fused porphyrins with 66 conjugated π-electrons. In addition, a small number of molecules undergo C-C bond dissociation of meso-phenyl at elevated temperature, producing fully planar γ-ortho fused products lacking one or two phenyl moieties. Scanning tunneling spectroscopy measurements and DFT calculations suggest the electronic gap of the γ-ortho fused porphyrin decreases compared to that of the precursor. The HOMO and LUMO of the planar γ-ortho fused products are localized on the partially fused benzo moieties and the meso-position, respectively.

Effects of X-ray irradiation on the fitness of the established invasive pest fall armyworm Spodoptera frugiperda

BACKGROUND

Spodoptera frugiperda has spread to Africa, Asia, and Oceania, posing a serious threat to global agriculture. We estimated the appropriate dose of X-ray sterilization for S. frugiperda using an X-ray irradiation instrument to investigate environmentally acceptable control techniques, laying the framework for future applications of sterile insect technology (SIT) to manage the pest environmentally-friendly.

RESULTS

This study is the first to investigate the effects of X-ray irradiation on the growth, development, survival, reproduction, and flight of S. frugiperda. The results showed that irradiation with 50-400 Gy had no significant effect on pupal eclosion, but females were more sensitive than males in terms of reproductive parameters, especially when doses of radiation were > 350 Gy. After irradiation with a sub-sterilizing dose of 250 Gy, the parental sterility rate was > 85%, and the sterility traits could be passed on to their offspring, resulting in a continuous decrease in the population of F₁ and F₂ generations.

CONCLUSION

Our laboratory experiments theoretically confirmed the feasibility of SIT for controlling S. frugiperda in the field using X-ray radiation. This study provides a theoretical basis for future regional pest management strategies. © 2022 Society of Chemical Industry.

[Application status and prospect of single-cone obturation technique with bioceramic sealers]

Compared with cold lateral condensation and continuous wave of condensation which are classically used in clinical, newly emerging single-cone obturation technique is easy-to-operate as well as time-saving. Especially when combined with bioceramic root canal sealers of improved physicochemical and biological properties, single-cone obturation technique showed satisfactory short-term outcomes in clinical observations. However, difficulties still exist in avoiding the root canal overfilling and in operating the retreatment. Besides, the long-term effects of single-cone obturation with bioceramic sealers still remain unclear. This article makes an overview on the history and development of single-cone obturation ,and provides analysis of its pros and corns. Furthermore, we would also like to summarize its clinical application and look into its future improvements.

Glutathione S-Transferase Genes are Involved in Lambda-Cyhalothrin Resistance in Cydia pomonella via Sequestration

Pest management is mostly accomplished by the use of insecticides. However, the overuse of insecticides has led to the development of resistance. Glutathione S-transferases (GSTs) are vital detoxification enzymes involved in insecticide resistance in insects. In this study, we report the involvement of GSTs in insecticide resistance to lambda-cyhalothrin in Cydia pomonella, a globally quarantined fruit pest. A total of 25 GST, including 22 cytosolic genes and 3 microsomal genes, are identified from the genome database of C. pomonella. These cytosolic genes are further classified into six classes, including four in delta, eight in epsilon, three in omega, three in sigma, one in theta, and one in zeta class, as well as two unclassified genes. The real-time quantitative polymerase chain reaction (RT-qPCR) shows that the majority of these genes are mainly expressed throughout the larval stage and in the midgut of the fourth-instar larvae. Exposure to an LD₁₀ dose of lambda-cyhalothrin resulted in the upregulation of 17 GST genes. Moreover, mRNA levels of most GST genes, with the exception of CpGSTe6, CpGSTd2, CpGSTd4, and CpGSTz1, are considerably higher in a lambda-cyhalothrin-resistant population (ZW_R) than those of susceptible strains. Recombinant CpGSTd1, CpGSTd3, CpGSTe3, and CpGSTs2 can bind and metabolize lambda-cyhalothrin, with the highest metabolic rate observed for CpGSTd3 but no metabolite(s) was detected, supporting the role of GSTs in sequestration of lambda-cyhalothrin. Molecular dynamics simulation analysis indicates that key residues of hydrophobic pocket-derived lipophilic energy S(lipo) interactions with a hydrophobic pharmacophore of lambda-cyhalothrin are crucial for metabolism by CpGSTd3 and further lead to resistance. Our study is the first to experimentally confirm the involvement of GSTs in lambda-cyhalothrin resistance via sequestration and provides new insights into resistance management in C. pomonella.

[Clinical characteristics of paroxysmal nocturnal hemoglobinuria (PNH) complicated with ischemic bowel disease]

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematopoietic stem cell disease. Gastrointestinal involvement is rarely seen in PNH. This study aims to analyze the clinical features in PNH patients complicated with ischemic bowel disease. Clinical date of 6 patients were collected at Peking Union Medical College Hospital from January 2010 to December 2020. The clinical manifestations, laboratory tests,imaging, endoscopic,and histopathological features and treatment were analyzed.Five in 6 patients were men, with a median age of 31 years old at onset. Most of disease course were recurrent episodes of chronic disease, with abdominal pain (5/6) and gastrointestinal bleeding (5/6). Laboratory examinations showed pancytopenia, reticulocytosis, elevated serum lactate dehydrogenase, high D-dimer and C-reactive protein levels in all patients. Multiple segments of small intestine were the most commonly involved and colon was also affected. Abdominal CT scan showed thickening and roughness or exudation of the intestinal wall (6/6), increased mesenteric density or "comb sign"(4/6), and cholestasis or gallbladder stones (5/6). Endoscopic manifestations included irregular shallow ulcers in the annular cavity (5/6), swelling mucosa with well-defined margins (6/6). Pathological biopsy revealed chronic inflammation of mucosa. The efficacy of steroids combined with anticoagulant therapy was better than that of steroids alone. Ischemic bowel disease in PNH patients is different from typical ischemic enteritis. Young patients, involvement of intestine with multiple segments are common characteristics. The anticoagulant is an essential agent for these patients.

[Mini-incision with endoscope-assisted surgery for bilateral congenital second branchial cleft fistula and a pedigree report]

Objective: To investigate the feasibility and efficacy of mini-incision with endoscope-assisted resection for bilateral congenital second branchial cleft fistula, and to report on a rare pedigree. Methods: The clinical data of 5 patients with bilateral congenital second branchial fistula admitted in Fujian Provincial Hospital from April 2007 to December 2018 were retrospectively reviewed, including 2 males and 3 females, aged from 3 to 31 years old. The surgical strateges and clinical experience of single mini-incision with endoscope-assisted fistulectomy were summarized, and a rare pedigree was reported. Results: In five patients, Case 1 to Case 4 were treated with bilateral endoscopic-assisted fistula high ligation with titanium clips and removal through a single small incision under general anesthesia. No obvious complications occurred after the operation. The patients were followed up for 40-164 months with no fistula recurrence. Case 5 gave up surgical resection and was followed up for 24 months with acute infection attack once. Case 2 and Case 4 came from the same family. In this family, 7 out of 31 members of four generations had second branchial cleft fistulas, of which 4 were bilateral and 3 were right. Pedigree analysis was consistent with autosomal dominant inheritance. No deafness, preauricular tag, external and middle ear deformity and kidney malformation were found in the family members. Conclusions: Bilateral congenital second branchial cleft fistula is rare. Surgical resection is the preferred treatment. Mini-incision with endoscopic-assisted fistula high ligation with titanium clip and resection has clear operative field, ideal cosmetic effect and definite curative effect.

Insecticide resistance in the Cydia pomonella (L): Global status, mechanisms, and research directions

The codling moth, Cydia pomonella (Lepidoptera: Tortricidae) is a major pest of pome fruit and walnuts worldwide. Although environmentally compatible integrated control strategies, such as mating disruption, attract-kill strategy, and sterile insect technique have been conducted for management of this notorious pest, effects to control of codling moth have mainly relied on insecticides. In consequence, different levels of insecticide resistance towards organophosphates, neonicotinoids, hydrazines, benzoylureas, pyrethroids, diamides, spinosyns, avermectins, JH mimics, carbamates, oxadiazines and C. pomonella granulovirus (CpGVs) have developed in codling moth in different countries and areas. Both metabolic and target-site mechanisms conferring resistance have been revealed in the codling moth. In this review, we summarize the current global status of insecticide resistance, the biochemical and molecular mechanisms involved, and the implications for resistance management.

[Inflammatory myofibroblastic tumors of the urinary bladder: a clinicopathological study of ten cases]

0bjective To investigate the clinicopathological features,immunohistochemical phenotypes, molecular genetic alterations,diagnosis and differential diagnosis of inflammatory myofibroblastic tumor (IMT) of the urinary bladder. Methods: Ten cases of IMT of the urinary bladder (three cases at Ningbo Diagnostic Pathology Center from September 2011 to December 2020, five in-house diagnosed cases and two consultation cases at Shanghai Rui Jin Hospital from June 2011 to December 2020) were collected retrospectively. The clinicopathologic features and immunophenotypic profiles were studied by light microscopy and immunohistochemistry (EnVision method). The translocation of ALK gene was detected by fluorescence in situ hybridization (FISH). Results: Of the 10 patients, eight were male and two were female. The patients' age range was 16 to 62 years (median 36 years).The main clinical presentation was hematuria and urinary irritation. Three cases were located at the dome of the urinary bladder, four cases were in the left lateral wall and the remaining three cases were in the right lateral wall. The tumor size ranged from 1.5 cm to 8.5 cm. In eight cases, the tumors were mainly submucosal, and in some cases extending to the muscular layer of the urinary bladder. In two cases, the tumors were mainly located in the muscular layer and focally extended to the submucosa and adventitia. Histologically, four cases had the nodular fasciitis-like pattern, three cases had fibrohistiocytoma-like pattern, two cases had mixed histologic patterns and the remaining case showed leiomyosarcoma-like histologic features. Immunohistochemically, the tumor cells expressed SMA (10/10),calponin (9/10),desmin (6/10) and CKpan (9/10). Cytoplasmic staining for ALK1 and ALK (5A4) was detected in 7 of 10 cases and 8 of 10 cases, respectively. Nuclear and cytoplasmic staining for ALK (D5F3) was detected in 7 of 10 cases. Among eight cases with material available for FISH analysis, ALK rearrangement was present in five cases. Follow-up data were available in eight patients and none had local recurrence nor distant metastasis. Conclusion: IMT of the urinary bladder is an uncommon mesenchymal neoplasm with intermediate malignant potential.It has special clinicopathologic features, and a minority of cases have local tumor recurrence.

Identification and Functional Characterization of a Sigma Glutathione S-Transferase CpGSTs2 Involved in λ-Cyhalothrin Resistance in the Codling Moth Cydia pomonella

The codling moth, Cydia pomonella (L.), is a quarantine pest of global significance impacting pome fruits and walnuts. It has evolved resistance to many commonly used insecticides including λ-cyhalothrin. Glutathione S-transferases (GSTs) are multifunctional enzymes playing a crucial role in the detoxification of insecticides in insects. However, the role of specific GST gene in λ-cyhalothrin resistance in C. pomonella is unclear. In this study, we identified three sigma-class genes (CpGSTs1, CpGSTs2, and CpGSTs3). These genes were ubiquitously expressed at all developmental stages, and of these, the expression level of CpGSTs2 in the larval stage was significantly higher than in the egg, pupal, and adult stages. Moreover, CpGSTs2 was predominantly expressed in the fat body while lower levels in the cuticle. In addition to exposure of larvae to LD₁₀ of λ-cyhalothrin elevating the expression level of CpGSTs2, mRNA levels of CpGSTs2 in a field population (ZW_R) from northeast China, which has developed moderate level resistance to λ-cyhalothrin, was significantly higher than that of susceptible strains. In vitro inhibition assays demonstrated that λ-cyhalothrin inhibited the conjugating activities of recombinant CpGSTs2, and metabolic assays indicated that λ-cyhalothrin could be depleted by recombinant CpGSTs2. These results bring evidence for the involvement of CpGSTs2 in C. pomonella in resistance to λ-cyhalothrin.

[Long-term effect of anal fistula plug treatment on postoperative anal function in patients with trans-sphincteric perianal fistula and risk factors associated with anal function]

Objective: To evaluate the long-term effects of anal fistula plug treatment on postoperative anal function in patients with trans-sphincteric perianal fistula, and identify risk factors associated with anal function. Methods: A case-control study was conducted. Clinical and follow-up data of 123 patients with trans-sphincteric perianal fistula receiving anal fistula plug treatment in Beijing Chaoyang Hospital from August 2008 to September 2012 were retrospectively analyzed. The follow-up deadline was April 30, 2020. The Wexner score for incontinence was used to evaluate pre-and postoperative anal function (range from 0 to 20, with higher score representing worse function). The potential risk factors affecting postoperative anal function, including gender, age, fasting blood glucose, diabetes, smoking, alcoholism, location of external opening of anal fistula, surgeon expertise and operation time, were statistically analyzed. Results: Among the 123 patients, 114 were male and 9 were female, the median age was 39 (15-69) years, body mass index (BMI) was (26.2±3.9) kg/m(2), and the median distance between the external opening of anal fistula and the anal verge was 2.6 (1.0-5.0) cm. The median operation time was 30.4 (15.0-60.0) minutes. The median follow-up time was 120 (93-141) months. Sixty-nine patients (56.5%) were healed. The assessment of anal function by Wexner incontinence score showed that 33 (26.8%) patients had anal functional decline after surgery, and the postoperative median Wexner score was 1.34 (0-8), which was significantly higher than preoperative score of 0.17 (0-4) (Z=-5.057, P<0.001). Compared with preoperative levers, postoperative subscores of flatus incontinence, liquid incontinence, solid incontinence and alteration in lifestyle were increased significantly (all P<0.05). Subgroup analysis showed that both in the healed and unhealed groups, the postoperative Wexner scores were higher than those before surgery [healed group: 1.22 (0-8) vs. 0.17 (0-1), Z=-3.796, P<0.001; unhealed group: 1.5 (0-8) vs.0.17 (0-3), Z=-3.422, P=0.001]. Univariate analysis revealed that 33 patients with postoperative anal functional decline had higher BMI, higher fasting blood glucose, higher proportion of alcoholism, longer distance between external opening of anal fistula and the anal verge, and longer operation time (all P<0.05). Multivariate logistic regression analysis testified that higher BMI (OR=1.485, 95% CI: 1.220-1.807, P<0.001) and longer distance between external opening and anal verge (OR=2.207, 95% CI: 1.276-3.220, P=0.003) were independent risk factors for postoperative anal functional decline. Conclusions: The treatment for trans-sphincteric anal fistula with anal fistula plug leads to long-term postoperative anal function decline. For patients with obesity and longer distance between external opening of anal fistula and the anal verge, this procedure should be performed with particular caution, and the anal sphincter should be preserved as much as possible during the operation.

Overexpression of Glutathione S-Transferase Genes in Field λ-Cyhalothrin-Resistant Population of Cydia pomonella: Reference Gene Selection and Expression Analysis

Analysis of the glutathione S-transferase (GST) gene expression in an insecticide-resistant strain of Cydia pomonella using real-time quantitative polymerase chain reaction is a key step toward more mechanism studies that require suitable reference genes with stable expression. Here, nine commonly used reference genes were selected, and their expression stabilities were analyzed. Results showed that EF-1α was the most stable reference gene in all of the experimental sets. The combinations of EF-1α and 18S, EF-1α and RPL12, and EF-1α and GAPDH were sufficient for normalization of gene expression analysis accurately in developmental stages, tissues, and larvae exposed to sublethal dose of λ-cyhalothrin, respectively. Additionally, the suitability of particular reference genes was verified by analyzing the spatiotemporal and insecticide-induced expression profiles of CpGSTe3, CpGSTd3, and CpGSTd4, which were overexpressed in a λ-cyhalothrin-resistant population from northeast China. These genes were used to confer the practicability of reference genes chosen in this study.

Application of Eye Tracker in Lie Detection

Objective To investigate the application value of eye tracking in lie detection. Methods The 40 subjects were randomly divided into two groups. The pupil diameter, fixation duration, points of fixation and blink frequency of the subjects in the experimental group in observing target stimulation and non-target stimulation were recorded with eye tracker after they accomplished the mock crime. The eye movement parameters of subjects in the control group were directly collected. The differences in eye movement parameters of the experimental group and the control group in observing target stimulation and non-target stimulation were analyzed by t-test. Pearson coefficient analysis of correlation between eye movement parameters that had differences was conducted. The effectiveness of eye movement parameters to distinguish between the experimental group and the control group was calculated by the receiver operator characteristic （ROC） curve. Results Participants from the experimental group had shorter average pupil diameter, longer average fixation duration and fewer fixation points （P<0.05）, but the differences in blink frequency had no statistical significance. The differences in the above indicators of the control group in observing target stimulation and non-target stimulation had no statistical significance. The average fixation duration showed a negative correlation with fixation points （r=-0.255, P<0.05）; the average fixation duration showed a negative correlation with average pupil diameter （r=-0.218, P<0.05）; the fixation points showed a positive correlation with average pupil diameter （r=0.09, P<0.05）. The area under the curve of average pupil diameter, average fixation duration and fixation points was 0.603, 0.621 and 0.580, respectively. Conclusion The average pupil diameter, average fixation duration and fixation points obtained by the eye tracker under laboratory conditions can be used to detect lies.

Construction of 2D extended cocrystals on the Au(111) surface via IOaldehyde halogen bonds

2D extended organic cocrystals were constructed using 1,4-diiodotetrafluorobenzene and aromatic aldehydes via IOaldehyde halogen bonds on an Au(111) surface. The competition and synergy of halogen bonds and hydrogen bonds in 2D co-crystallization were revealed by scanning tunneling microscopy.

Functional characterization of a novel λ-cyhalothrin metabolizing glutathione S-transferase, CpGSTe3, from the codling moth Cydia pomonella

BACKGROUND

Recent work has shown that two codling moth (Cydia pomonella) glutathione S-transferase genes (GSTs), CpGSTd1 and CpGSTd3, can metabolize λ-cyhalothrin, one of the recommended insecticides for C. pomonella control worldwide. However, systematical characterization of delta and epsilon GSTs, especially their potential contributions in the metabolism of λ-cyhalothrin, is currently still lacking in C. pomonella.

RESULTS

In this study, a total of nine cDNA sequences were identified in C. pomonella, including four in the delta and five in the epsilon subclasses. RT-qPCR showed that seven GSTs were ubiquitously expressed at all developmental stages, and CpGSTe2, CpGSTe3, and CpGSTe4 were mainly expressed in larvae. The mRNA levels of CpGSTd2, CpGSTd4, and CpGSTe5 were significantly higher in male than in female adults. Tissue-specific expression analysis revealed that the CpGSTe2, CpGSTe3, and CpGSTe4 were highly expressed in the midgut while CpGSTd2 and CpGSTd4 were predominantly expressed in the Malpighian tubules. The transcripts of these GSTs (except CpGSTe1) were co-expressed following exposure to LD₁₀ of λ-cyhalothrin for 3 h. Recombinant CpGSTd4, CpGSTe2, and CpGSTe3 proteins expressed in Escherichia coli displayed glutathione-conjugating activity toward 1-chloro-2,4-dinitrobenzene. In addition, λ-cyhalothrin could inhibit the activity of recombinant CpGSTd4, CpGSTe2, and CpGSTe3 enzymes, but only recombinant CpGSTe3 showed λ-cyhalothrin metabolic capacity, with 21.88 ± 1.09% of parental compound being depleted within 1 h.

CONCLUSION

These data show that CpGSTe3 is a third GST gene, encoding an enzyme that metabolizes λ-cyhalothrin in C. pomonella. © 2019 Society of Chemical Industry.

[Long-term efficacy of bioprosthetic anal fistula plug in the treatment of transsphincteric anal fistula]

Objective: To evaluate the long-term healing rate of transsphincteric anal fistula treated with anal fistula plug procedure and the risk factors affecting the healing of anal fistula. Methods: A retrospective case-control study was conducted to analyze the clinical data of 207 patients with transsphincteric anal fistulas who received anal fistula plug procedure at the Department of General Surgery, Beijing Chaoyang Hospital of Capital Medical University from August 2008 to September 2012. Inclusion criteria: (1) consistent with the diagnosis of transsphincteric anal fistula: the anal fistula passed through the internal and external sphincter; (2) complete data; (3) initial treatment with anal fistula plug procedure. Exclusion criteria: (1) acute rectal or perianal infection or poorly controlled focal infection; (2) recent incision and drainage of perianal abscess or spontaneous rupture of abscess; (3) patients with malignant tumor; (4) patients with Crohn's disease or ulcerative colitis; (5) patients with heart, liver, brain, lung or renal insufficiency; (6) cachexia due to various chronic wasting diseases; (7) patients could not tolerate surgery. Patients were followed up for anal fistula healing. The cumulative healing rate of patients with transsphincteric anal fistula was plotted using the Kaplan-Meier method, and the factors affecting anal fistula healing were explored by univariate and multivariate logistic regression analysis. Results: There were 186 males and 21 females with age of 15 to 69 (mean 38) years. The duration of anal fistula was 3-60 (mean 15) months. Three patients had a history of previous episodes of perianal abscess and underwent incision and drainage of perianal abscess (all more than 3 months). During follow-up ending on October 31, 2018, 72 patients (34.8%) were lost to follow-up. Among 135 patients who were successfully followed up, the average follow-up period was 96 (75-124) months. Seventy-five patients had anal fistula healing, with healing rate of 55.6%. Kaplan-Meier survival curve showed that the healing time of anal fistula was prolonged and finally stabilized at 55.6%. In the patients who failed initial treatment with anal fistula plug packing, there were 6 cases whose anal fistula healed spontaneously without other treatment. Among them, 3 cases healed spontaneously 2 years and 3 cases 3 years after operation without recurrence. From 2008 to 2012, the annual healing rates of anal fistula plug treatment were 3/6, 61.5% (24/39), 42.1% (24/57), 12/15 and 12/18, respectively. Multivariate logistic regression analysis showed that the duration of anal fistula≥6 months (OR=3.187, 95% CI: 1.361-7.466, P=0.008) was an independent risk factor for anal fistula healing after treatment with anal fistula plug. Conclusion: The long-term efficacy of anal fistula plug procedure in the treatment of transsphincteric anal fistula is positive, and this procedure should be implemented as soon as possible.

[Clinical value of intraoperative parathyroid hormone determination in secondary hyperparathyroidism operation]

Objective:To investigate the clinical value of intraoperative parathyroid hormone monitoring in operation of patients with secondary hyperparathyroidism（SHPT）. Method:A retrospective analysis was carried out and enrolled， including 100 primary surgery and 14 second surgery. The data of 100 patients with primary surgery and 14 patients with reoperation were retrospectively analyzed. The criterion, predicting the success of surgery, is that the measured iPTH level declines by more than 80% compared with that before surgery, 20 minutes after the last parathyroid gland removed. Serum calcium, serum phosphorus and iPTH tested pre-and post-operation were statistically analyzed. Result:112 cases（98 cases in the first operation and 14 cases in the second operation） were cured by operation and the cure rate is 98.2%. In 109 cases（97 cases of first operation and 12 cases of reoperation）, the intraoperative determination of parathyroid hormone was up to standard, and the sensitivity of predicting the success of surgery was 97.0% and 85.7%, respectively. Postoperative clinical symptoms such as joint pain and skin itching, etc. were significantly improved or disappeared. Postoperative iPTH, serum calcium and serum phosphorus were significantly different from those before surgery, and the difference was statistically significant（P<0.05）. Conclusion:Intraoperative parathyroid hormone monitoring has vital clinical guiding value for SHPT, and can improve the success rate significantly. A more than 80% reduction in iPTH at 20 min after the last parathyroidectomy was a good predictor of successful surgery.

2D Co-crystallization of molecular homologues promoted by size complementarity of the alkyl chains at the liquid/solid interface

Co-crystallization of organic molecules is an important strategy for the fabrication of molecular materials. In this contribution, we investigated the mixing behavior of 5-(benzyloxy)-isophthalic acid homologues (BIC-Cn, n = 6, 8, 10, 12, and 14) at the liquid/solid interface using a scanning tunneling microscope. Deposition of the single component of BIC-Cn always results in typical honeycomb networks, whereas co-deposition of two BIC-Cn homologues leads to hybrid double-walled honeycomb networks or phase separation depending on the difference in the length of their alkyl chains. 2D co-crystallization can only be realized for BIC-C6/BIC-C10 or BIC-C8/BIC-C12 which have a four-methyl unit difference in their alkyl chains. The size complementarity of the alkyl chains in the two components suggests that it is responsible for the 2D co-crystallization, though hydrogen bonding contributes a lot both to the pristine honeycomb network and to the hybrid co-crystal. This result is of importance for understanding the role of van der Waals interaction and its interplay with hydrogen bonding in 2D co-crystallization.

Tri-Stable Structural Switching in 2D Molecular Assembly at the Liquid/Solid Interface Triggered by External Electric Field

A tri-stable structural switching between different polymorphisms is presented in the 2D molecular assembly of a 5-(benzyloxy)isophthalic acid derivative (BIC-C12) at the liquid/solid interface. The assembled structure of BIC-C12 is sensitive to the applied voltage between the STM tip and the sample surface. A compact lamellar structure is exclusively observed at positive sample bias, while a porous honeycomb structure or a quadrangular structure is preferred at negative sample bias. Selective switching between the lamellar structure and the honeycomb structure or the quadrangular structure is realized by controlling the polarity and magnitude of the sample bias. The transition between the honeycomb structure and the quadrangular structure is, however, absent in the assembly. This tri-stable structural switching is closely related to the molecular concentration in the liquid phase. This result provides insights into the effect of external electric field on molecular assembly and benefits the design and construction of switchable molecular architectures on surfaces.

Cytochrome P450-Mediated λ-Cyhalothrin-Resistance in a Field Strain of Helicoverpa armigera from Northeast China

Resistance to pyrethroid and organophosphate insecticides has been a growing problem in the management of cotton bollworm Helicoverpa armigera (Hübner) populations in the Yangtze River and Yellow River valleys of China, but resistance status and mechanisms of H. armigera populations from northeast China are less documented. In this study, a field strain collected from Shenyang in northeast China (SYR) is up to 16-fold more resistant than a susceptible strain (SS) to λ-cyhalothrin, while the resistance level to phoxim remained low (2.6-fold). Synergist tests and enzymatic assays show that increased cytochrome P450 monooxygenase (P450) activity is the main mechanism for λ-cyhalothrin resistance. Eight out of 10 genes from CYP6 and CYP9 subfamilies were significantly overexpressed in the SYR strain, and CYP6AE11 was the mostly overexpressed P450 (59-fold). These results suggest that overexpression of multiple P450 enzymes contributes to λ-cyhalothrin resistance in the SYR strain of H. armigera from northeast China.

CpGSTd3 is a lambda-Cyhalothrin Metabolizing Glutathione S-Transferase from Cydia pomonella (L.)

Little is known about the role of specific delta GST genes in the detoxification of lambda-cyhalothrin in the global quarantine fruit pest codling moth, Cydia pomonella (L.). Real-time quantitative PCR shows that CpGSTd3 was ubiquitously expressed at all developmental stages and is most abundant in the larval stage and lowest in the egg stage; the mRNA level of CpGSTd3 is higher in the midgut and Malpighian tubules of fourth-instar larvae and abdomens of adults than in other tissues. Exposure of fourth-instar larvae to an LD₁₀ dosage of lambda-cyhalothrin significantly induced the transcript of CpGSTd3 at 3 h, but the mRNA level was down-regulated after 12 h of treatment. Recombinant CpGSTd3 expressed in Escherichia coli was able to catalyze the conjugation of 1-chloro-2,4-dinitrobenzene (CDNB) and with an IC₅₀ value of 0.65 mM for lambda-cyhalothrin. Metabolism assays indicate that recombinant CpGSTd3 could metabolize lambda-cyhalothrin. These results suggest that CpGSTd3 is probably a lambda-cyhalothrin metabolizing GST in C. pomonella.

LC50 of lambda-cyhalothrin stimulates reproduction on the moth Mythimna separata (Walker)

Lambda-cyhalothrin has long been recommended as an effective insecticide to control the oriental armyworm, Mythimna separata (Walker), a notorious migratory pest of agricultural plants. Previous researches have suggested that survival, development, and reproduction of insects are influenced by sublethal concentrations of insecticides. However, the effects of sublethal concentrations of lambda-cyhalothrin on M. separata are less known. In this study, we determined the toxicity and effects of LC₂₀ and LC₅₀ concentration of lambda-cyhalothrin on development and reproduction of M. separata. Results indicate that LC₂₀ of lambda-cyhalothrin tends to decrease the life traits of M. separate, with a shortening larvae period of offspring and oviposition period, whereas LC₅₀ of lambda-cyhalothrin stimulates daily maximal fecundity and forwards the oviposition peak, suggesting a stimulation of reproduction by LC₅₀ of lambda-cyhalothrin. The M. separata population was increased by an LC₅₀ concentration of lambda-cyhalothrin, resulting in a net reproductive rate (R₀) and intrinsic rate of increase (r_m) significantly higher than that of the control. Transcripts of vitellogenin (MsVg) and vitellogenin receptor (MsVgR) genes were suppressed at day 1 after emergence of moth which developed from the larvae exposed to LC₂₀ and LC₅₀ of lambda-cyhalothrin, but were significant induced when the moth begin to lay eggs (day 4), with a more remarkable induction by LC₅₀ of lambda-cyhalothrin than those of LC₂₀ of lambda-cyhalothrin. Our results indicate that the observed stimulation of reproduction is therefore the results of up-regulation of MsVg and MsVgR by LC₅₀ of lambda-cyhalothrin.

Spontaneous coronary artery dissection in a middle-aged woman with acute anterior myocardial infarction: A case report

RATIONALE

Spontaneous coronary artery dissection is a highly unusual cause of acute coronary disease. It is a result of a hematoma formation within the outer third of the tunica media,with subsequent expansion leading to compression of the true lumen and resultant myocardial ischemia.

PATIENT CONCERNS

We present a case of a middle-aged woman presenting with chest pain with acute anterior myocardial infarction, who did not reveal any of the cardiovascular risk factors. Finally,when pressed further about her past history, the patient revealed she had been taking oral contraceptives for the past 2 years.

DIAGNOSES

The diagnosis is usually confirmed by coronary angiography, but it has some limitations. If necessary, intravascular ultrasound (IVUS) may help in further examinations to reduce the incidence of erroneous diagnosis or missed diagnosis.

INTERVENTIONS

There is no guiding suggestion for the treatment of SCAD. The main treatment methods are 3 aspects: conservative internal medical treatment, stent implantation, coronary artery bypass grafting. The treatment strategy depends mainly on the patienst' clinical symptoms, the hemodynamic state, and the position and quantity of the dissection. In this case,we used stent implantation treatment originally and then we resorted to medical treatment.

OUTCOMES

After careful review and analysis, coronary arteriography results was able to prove the existence of the spiral shaped dissection. We then resorted to medical treatment and her symptoms were gradually relieved.

LESSONS

SCAD should be suspected in young to middle-aged women with chest pain symptoms, particularly during the perinatal period or for subjects who use oral contraceptives. Doctors should be able to obtain a detailed past history and analyze coronary angiography results carefully.

[Comparison between continuous noninvasive hemoglobin monitoring and venous blood hemoglobin monitoring in children with kidney disease]

OBJECTIVE

To assess the correlation and consistency between continuous noninvasive hemoglobin detection and venous blood hemoglobin detection in children with kidney disease, and try to analyze the affecting factors. Try to provide a reference for the monitoring of hemoglobin in children with kidney disease by continuous noninvasive hemoglobin detection technique.

METHODS

Eighty-five inpatient children with kidney disease, 50 boys (58.8%) and 35 girls (41.2%), aged from 3 years old to 18 years old (9.35±4.29) were included finally. Noninvasive hemoglobin monitoring by spectrophotometry (SpHb) was stably read by PRONTO-7, selecting the ring finger of the non handedness as the detection site. And then the venous blood hemoglobin of the same patient was collected in 5 minutes as the true hemoglobin (tHb) by Beckman coulter DXH-800. The data of SpHb and tHb were compared and analyzed using SPSS 17.0 and MedCalc.

RESULTS

Correlation analysis showed data of SpHb and tHb were with significant correlation, the correlation coefficient between SpHb and tHb was 0.85 (P<0.05). Bland-Altman plot points suggested that the mean of differences between SpHb and tHb was -1.3 g/dL. The 95% CI of agreement of SpHb-tHb was -4.2-1.5 g/dL, suggesting that the average measurement result of SpHb was lower than that of tHb. The mean of differences as percent between SpHb and tHb was -9.8%, 95% CI of agreement was (-35.9%, 16.2%) exceeding the acceptable range of true value ±6%. The consistent rate of non-invasive hemoglobin detection and venous blood hemoglobin detection was 31.8%, the 95% CI of consistent rate was (21.7%, 41.9%). The chi square test of the fourfold table showed that the diagnosis of anemia with SpHb was of high sensitivity, but the specificity was low, the false positive rate was high, and the difference was statistically significant (P=0.000).

CONCLUSION

There was a significant correlation between SpHb and tHb in the children with kidney disease. Noninvasive hemoglobin measurement can be used for monitoring of changes of hemoglobin in children with kidney diseases. But the consistency between SpHb and tHb needs to be improved. Noninvasive hemoglobin measurement could not replace the venous hemoglobin measurement. It could not be used for the diagnosis of anemia, and the accuracy of hemoglobin concentration measurement in children with kidney disease should be further explored.

[Three combined imaging studies' diagnostic value for preoperative position of hyperthyroidism]

Objective:To investigatethe diagnostic value of three combined imaging studies' preoperative localization for secondary hyperparathyroidism.Method:This study lies on the retrospective analysis about 72 patients with secondary hyperparathyroidism who had parathyroid gland resection in our hospital from 2010 to 2017. All of 72 cases are examined by color doppler ultrasound,99mTC-MIBI nuclide imaging and magnetic resonance imaging. According to the gold standard pathological diagnosis after surgery, we compute the sensitivity and the specificity of various imaging examination and analyse these statistics by rate card square test with SPSS 19.0 software.Result:The parathyroid gland number of pathological diagnosis is 282. The sensitivities of magnetic resonance imaging, 99mTC-MIBI nuclide imaging, color doppler ultrasound and three combined imaging are 72.70%, 47.52%, 44.33% and 82.27%, respectively. The specificities of the examinations are 78.16%, 91.75%, 95.14% and 67.96%, respectively. The sensitivity of the combined three imaging studies is greater than the sensitivity of each single imaging studies, and there is a statistical significance between them. The specificity of the combined three imaging studies is smaller than the sensitivity of single imaging studies. There is a statistical significance,either.Conclusion:Three combined imaging studies' preoperative localization for secondary hyperparathyroidism has higher diagnostic value for the preoperative localization about secondary hyperparathyroidism. It can be a effective way to SHPT's surgery.

Development of stable Pickering emulsions/oil powders and Pickering HIPEs stabilized by gliadin/chitosan complex particles

In this paper, we demonstrate the use of gliadin/chitosan complex particles (GCCPs) as particulate stabilizers of oil-in-water emulsions of natural oils and water. For this purpose, we fabricated GCCPs through a facile anti-solvent procedure and demonstrated their usage in the formation of Pickering emulsions and Pickering high internal phase emulsions (HIPEs). The GCCPs can be used to produce surfactant-free o/w Pickering emulsions and Pickering HIPEs; unfortunately these emulsions were labile to coalescence. NaCl addition and/or pH regulation, and the combination were used to modify the surface wettability of the complex particles to achieve stable emulsions. The microstructures, e.g., interfacial frameworks, GCCP partition between the continuous phase and interfacial region, and the state of the droplets, of Pickering emulsions were visualized by confocal laser scanning microscopy (CLSM), confirming that the inclusion of NaCl and slightly adjusting pH toward 4.0 and/or 5.0 benefited the adsorption and accumulation of colloid particles at the droplet surface to form an engineered interfacial structure, bridging droplets together through a percolating layer of colloidal particles at the oil/water interface. A schematic representation for the formation route of the emulsions is proposed to relate the physical performance and rheological property with the interfacial structures and aggregate behaviors in the Pickering system stabilized by the complex particles. Interestingly, direct freeze-drying of the emulsions transformed unstable Pickering emulsions into stable oil powders. This study opens a promising route based on Pickering HIPEs or oil powders to structure liquid oils into solid-like fats without artificial trans-fat, which outlines new directions for future fundamental research.

[Effects of apolipoprotein E deficiency on sphingosine-1-phosphate distribution in plasma and lipoproteins of mice]

Objective: To investigate the effects of apolipoprotein E deficiency (Apo E(-/-)) on plasma and lipoprotein distribution of sphingosine-1-phosphate (S1P) in mice. Methods: Five male or female Apo E(-/-) or wild type (WT) mice were fed with chow diet and sacrificed at 32-week-age and plasma was collected. The constituents of lipoprotein(very low density lipoprotein (VLDL), low density lipoprotein (LDL), high density lipoprotein (HDL)) were separated by ultracentrifuge. The protein concentration of constituents was detected by BCA protein quantitative kit, and the S1P concentration in plasma and various lipoprotein constituents was detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Western blot was used to determine the plasma, liver, and kidney protein expression of apolipoprotein M(Apo M), which is considered as specific ligand of S1P.The S1P concentration in plasma and various constituents of lipoprotein in the Apo E(-/-) mice was compared to respective WT mice. Results: (1)Plasma S1P content was significantly higher in the Apo E(-/-) groups than that of WT groups (male: (535.7±78.5)nmol/L vs. (263.3±22.0)nmol/L; female: (601.1±64.0)nmol/L vs. (279.0±33.9)nmol/L; all P<0.01). (2) Compared with WT mice, S1P content in non-HDL(LDL+ VLDL) was significantly higher in Apo E(-/-) mice (male: (504.9±52.8)nmol/L vs. (28.7±9.0)nmol/L; female: (427.7±27.4) vs. (27.8±4.7)nmol/L; after standardization of protein concentration, male: (385.0±41.2)pmol/mg protein vs. (71.4±6.6)pmol/mg protein; female: (330.2±22.0)pmol/mg protein vs. (67.2±12.1)pmol/mg protein; all P<0.01). (3) The expression of Apo M in plasma, liver and kidney was significantly higher in Apo E(-/-) groups than that of WT groups(all P<0.05). Conclusion: The deficiency of Apo E could lead to upregulated S1P expression in the non-HDL, the underlying mechanism might be the increased transfer of HDL into the non-HDL by Apo M-S1P.