Clinical value of glucocorticoids for severe community-acquired pneumonia: A systematic review and meta-analysis based on randomized controlled trials

BACKGROUND

Severe community-acquired pneumonia (sCAP) is characterized by severe symptoms and a poor prognosis, especially with the recent global impact of novel coronavirus in recent years. The use of glucocorticoids in sCAP is currently a subject of debate. To evaluate the clinical efficacy and safety of glucocorticoids and provide guidance for their rational use in clinical practice, we conducted this study.

METHODS

We searched PubMed, Web of Science, and China National Knowledge Infrastructure using the following search terms: "pneumonia", "pneumonias", "Pulmonary Inflammation", "Pulmonary Inflammations", "Lung Inflammation", and "Lung Inflammations". The primary outcomes included mortality and the length of hospital stay. The secondary outcomes included the duration of mechanical ventilation, duration of vasoactive drug use, gastrointestinal bleeding, and multiple infections. The Cochrane Collaboration was used to assess the risk of bias of the included studies. Stata/MP14 was used for meta-analysis.

RESULTS

These studies contained information on 1252 patients who received glucocorticoids and 1280 patients who did not. Meta-analysis showed that there was no difference in terms of mortality [risk ratio (RR) = 0.93, 95% confidence interval (CI): 0.81-1.07, P  > .05], gastrointestinal bleeding (RR = 1.38, 95% CI: 0.83-2.30, P  <  .05), multiple infections (RR = 1.17, 95% CI: 0.90-1.53, P  > .05) and length of hospital stay (mean difference [MD] = -0.87, 95% CI: -2.35 to 0.61, P  > .05) between the hormonal and nonhormonal groups. However, there was a significant difference in the duration of mechanical ventilation (MD = -1.54; 95% CI, -1.89 to -1.12, P  <  .05) and the duration of use of vasoactive drugs (MD = -14.09, 95% CI: -15.72 to -12.46, P < .05).

CONCLUSION

Glucocorticoids reduced the duration of mechanical ventilation duration and vasoactive drug use in sCAP patients without increasing the risk of adverse events including hyperglycemia and multiple infections. However, there was no significant difference in mortality or length of hospital stay in sCAP patients between glucocorticoid and non-glucocorticoid groups. Glucocorticoids could be recommended for patients with sCAP with respiratory failure or hemodynamic instability.

Preliminary results of the 105 GHz collective Thomson scattering system on HL-2A

A 105 GHz collective Thomson scattering (CTS) diagnostic has been successfully developed for fast-ion measurements on the HL-2A tokamak, and it has been deployed during an experimental campaign. Enhanced signals exhibiting synchronous modulation characteristics have been observed across all CTS channels upon the launch of a modulated probe wave. Results show that the intensity of the CTS signal increases with Neutral Beam Injection (NBI) power and is proportional to neutron count, indicating that the scattering signal contains a contribution from fast ions. Compared with the signal without NBI, the enhanced scattering spectrum due to NBI is slightly wider than the predicted fast ion range. Such broadening might be attributed to the heating effects of the gyrotron.

Tumor-Targeting Probe for Dual-Modal Imaging of Cysteine In Vivo

Cysteine (Cys) is a crucial biological thiol that has a vital function in preserving redox homeostasis in organisms. Studies have shown that Cys is closely related to the development of cancer. Thus, it is necessary to design an efficient method to detect Cys for an effective cancer diagnosis. In this work, a novel tumor-targeting probe (Bio-Cy-S) for dual-modal (NIR fluorescence and photoacoustic) Cys detection is designed. The probe exhibits high selectivity and sensitivity toward Cys. After reaction with Cys, both NIR fluorescence and photoacoustic signals are activated. Bio-Cy-S has been applied for the dual-modal detection of Cys levels in living cells, and it can be used to distinguish normal cells from cancer cells by different Cys levels. In addition, the probe is capable of facilitating dual-modal imaging for monitoring changes in Cys levels in tumor-bearing mice. More importantly, the excellent tumor-targeting ability of the probe greatly improves the signal-to-noise ratio of imaging. To the best of our knowledge, this is the first Cys probe to combine targeting and dual-modal imaging performance for cancer diagnosis.

Plasma position measurements by O-mode and X-mode reflectometry systems in tokamak plasmas

Plasma Position Reflectometry (PPR) is planned to provide plasma position and shape information for plasma operation in future fusion reactors. Its primary function is to calibrate the drift of the magnetic signals due to the integral nature of magnetic measurement. Here, we attempt to measure plasma position using ordinary mode (O-mode) and extraordinary mode (X-mode) reflectometry systems on two tokamaks. A new physical model based on the phase shift is proposed to deduce the relative movement of the cut-off layer without density inversion. We demonstrate the plasma position measurements by absolute measurement from density profile inversion and relative measurement from phase shift. The combination of X-mode and O-mode reflectometers can minimize the limitations of single polarization reflectometry and further increase the accuracy of plasma position measurement. These results could provide an important technical basis for the further development of a real-time control system based on PPR.

[Exposure level of neonicotinoid pesticides and their metabolites in pregnant women in the suburb of Shanghai]

In 2021, a total of 151 pregnant women were selected from the suburb of Shanghai. A questionnaire survey was conducted to obtain data about maternal age, gestational week, total annual household income, education level and passive smoking among pregnant women and one spot urine was collected. The concentrations of eight neonicotinoid pesticides and four metabolites in urine were measured by ultra-high performance liquid chromatography-tandem quadrupole time-of-flight mass spectrometry. The differences in detection frequencies and concentrations of neonicotinoid pesticides and their metabolites among pregnant women with different characteristics were compared, and the influencing factors of the detection of neonicotinoid pesticides in urine were analyzed. The results showed that at least one neonicotinoid pesticide was detected in 93.4% (141 samples) of urine samples. The detection frequencies of N-desmethyl-acetamiprid, clothianidin, thiamethoxam, and N-desmethyl-clothianidin were high, about 78.1% (118 samples), 75.5% (114 samples), 68.9% (104 samples), and 44.4% (67 samples), respectively. The median concentration of the sum of all neonicotinoid pesticides was 2.66 μg/g. N-desmethyl-acetamiprid had the highest detection concentration with a median concentration of 1.04 μg/g. A lower urinary detection frequency of imidacloprid and its metabolites was seen in pregnant women aged 30-44 years [OR (95%CI): 0.23 (0.07-0.77)]. A higher detection frequency of clothianidin and its metabolites was seen in pregnant women with per capita annual household income≥100, 000 yuan [OR (95%CI): 6.15 (1.56-24.28)]. There was widespread exposure to neonicotinoid pesticides and their metabolites in pregnant women from the suburb of Shanghai, which might pose potential health risks to pregnant women, and maternal age and household income were potential influencing factors of the exposure to neonicotinoid pesticides.

MHD instability dynamics and turbulence enhancement towards the plasma disruption at the HL-2A tokamak

The evolutions of MHD instability behaviors and enhancement of both electrostatic and electromagnetic turbulence towards the plasma disruption have been clearly observed in the HL-2A plasmas. Two types of plasma disruptive discharges have been investigated for similar equilibrium parameters: one with a distinct stage of a small central temperature collapse ([Formula: see text] 5-10%) around 1 millisecond before the thermal quench (TQ), while the other without. For both types, the TQ phase is preceded by a rotating 2/1 tearing mode, and it is the development of the cold bubble from the inner region of the 2/1 island O-point along with its inward convection that causes the massive energy loss. In addition, the micro-scale turbulence, including magnetic fluctuations and density fluctuations, increases before the small collapse, and more significantly towards the TQ. Also, temperature fluctuations measured by electron cyclotron emission imaging enhances dramatically at the reconnection site and expand into the island when approaching the small collapse and TQ, and the expansion is more significant close to the TQ. The observed turbulence enhancement near the X-point cannot be fully interpreted by the linear stability analysis by GENE. Evidences suggest that nonlinear effects, such as the reduction of local [Formula: see text] shear and turbulence spreading, may play an important role in governing turbulence enhancement and expansion. These results imply that the turbulence and its interaction with the island facilitate the stochasticity of the magnetic flux and formation of the cold bubble, and hence, the plasma disruption.

Grape Seed Extract Attenuates Demyelination in Experimental Autoimmune Encephalomyelitis Mice by Inhibiting Inflammatory Response of Immune Cells

OBJECTIVE

To examine the anti-inflammatory effect of grape seed extract (GSE) in animal and cellular models and explore its mechanism of action.

METHODS

This study determined the inhibitory effect of GSE on macrophage inflammation and Th1 and Th17 polarization in vitro. Based on the in vitro results, the effects and mechanisms of GSE on multiple sclerosis (MS)-experimental autoimmune encephalomyelitis (EAE) mice model were further explored. The C57BL/6 mice were intragastrically administered with 50 mg/kg of GSE once a day from the 3rd day to the 27th day after immunization. The activation of microglia, the polarization of Th1 and Th17 and the inflammatory factors such as tumor necrosis factor- α (TNF- α), interleukin-1 β (IL-1 β), IL-6, IL-12, IL-17 and interferon-γ (IFN-γ) secreted by them were detected in vitro and in vivo by flow cytometry, enzyme linked immunosorbent assay (ELISA), immunofluorescence staining and Western blot, respectively.

RESULTS

GSE reduced the secretion of TNF-α, IL-1 β and IL-6 in bone marrow-derived macrophages stimulated by lipopolysaccharide (P<0.01), inhibited the secretion of TNF-α, IL-1 β, IL-6, IL-12, IL-17 and IFN-γ in spleen cells of EAE mice immunized for 9 days (P<0.05 or P<0.01), and reduced the differentiation of Th1 and Th17 mediated by CD3 and CD28 factors (P<0.01). GSE significantly improved the clinical symptoms of EAE mice, and inhibited spinal cord demyelination and inflammatory cell infiltration. Peripherally, GSE downregulated the expression of toll-like-receptor 4 (TLR4) and Rho-associated kinase (ROCKII, P<0.05 or P<0.01), and inhibited the secretion of inflammatory factors (P<0.01 or P<0.05). In the central nervous system, GSE inhibited the infiltration of CD45⁺CD11b⁺ and CD45⁺CD4⁺ cells, and weakened the differentiation of Th1 and Th17 (P<0.05). Moreover, it reduced the secretion of inflammatory factors (P<0.01), and prevented the activation of microglia (P<0.05).

CONCLUSION

GSE had a beneficial effect on the pathogenesis and progression of EAE by inhibiting inflammatory response as a potential drug and strategy for the treatment of MS.

[Epidemiological characteristics of two local COVID-19 outbreaks caused by 2019-nCoV Omicron variant in Guangzhou, China]

Objective: To understand the epidemiological characteristics of two local COVID-19 outbreaks caused by 2019-nCoV Omicron variant in Guangzhou, such as incubation period, serial interval, basic reproductive number (R₀) and the influence of gathering places on R₀, and provide evidence for the prevention and control of Omicron variant infection. Methods: The data of daily confirmed cases of Omicron variant infection from April 8 to May 8, 2022 in two COVID-19 outbreaks in Guangzhou were collected for model fitting. Weibull, Gamma and lognormal distribution were used to estimate incubation period and serial interval. Exponential growth method and the maximum likelihood estimation were used to estimate R₀. Results: The median of incubation period was 2.94 (95%CI: 2.52-3.38) days and median of serial interval was 3.32 (95%CI: 2.89-3.81) days. The estimated R₀ in small-size place was 4.40 (95%CI: 3.95-4.85), while the estimated R₀ at airport was 11.35 (95%CI: 11.02-11.67). Conclusion: The incubation period of Omicron variant in two local COVID-19 outbreaks in Guangzhou is significantly shorter than that of delta variant. The higher the gathering degree in a place, the larger the R₀. Due to its rapid transmission, COVID-19 epidemic is prone to occur. Therefore, the COVID-19 prevention and control strategy should be dynamically adjusted in time.

[Research advances on the interaction between Pseudomonas aeruginosa bacteriophages and the host]

Pseudomonas aeruginosa is the most common pathogen of burn wound infection. It can encode a variety of virulence factors and is highly pathogenic, which can lead to poor prognosis and high mortality. In order to research a new method to combat Pseudomonas aeruginosa infection, researchers have observed a wide range of interactions between the bacteriophages and the host. Bacteriophages influence and even dominate the structure, movement, and metabolism of host bacteria through a variety of mechanisms, catalyze the evolution of the host, and are also an important factor in host environmental adaptability and pathogenicity. In this paper, the interaction between Pseudomonas aeruginosa bacteriophages and the host is reviewed from the single cell level and the population level. Understanding these interactions could provide new idea for the treatment of Pseudomonas aeruginosa clinical infections, provides a basis for future development of antimicrobial agents and guides the treatment of burn infections.

Analysis of synthetic electron cyclotron emission from the high field side of HL-2M tokamak plasmas

A synthetic electron cyclotron emission (ECE) diagnostic is used to interpret ECE signals from preset plasma equilibrium profiles, including magnetic field, electron density, and electron temperature. According to the simulation results, the electron temperature (T_e) profile covering the harmonic overlap region can be obtained by receiving ECE signals at the high field side (HFS) of the HL-2M plasma. The third harmonic ECE at the low field side (LFS) cannot pass through the second harmonic resonance layer at the HFS unless the optical thickness (τ) of the second harmonic becomes gray (τ ≤ 2). In addition, the impact of the relativistic frequency down-shift has been evaluated and corrected. The measurable range of the HFS ECE has been calculated by scanning different parameters (electron density, temperature, and magnetic field). Higher plasma parameters allow a wider radial range of electron temperature measurements. The minimum inner measurable position can reach R = 120 cm (r/a = -0.89) when the product of core temperature (T_e0) and density (n_e0) is greater than 35 × 10¹⁹ keV m^-3, which is extended by more than 30 cm inward compared with that of the LFS measurement. The HFS ECE will greatly improve the diagnostic ability of ECE systems on the HL-2M tokamak.

[Analysis on epidemiological characteristics of dengue fever and E gene evolution of dengue virus in Guangzhou, 2020]

Objective: To assess the incidence of dengue fever and E gene evolution of dengue virus in Guangzhou in 2020 and understand the local epidemiological characteristics of dengue fever and spreading of dengue virus. Methods: The information of dengue fever cases in Guangzhou in 2020 was collected from Notifiable Infectious Disease System of Chinese Center for Disease Control and Prevention Information System. Serum samples from the cases were detected by real-time PCR. The E gene was sequenced and analyzed. Maximum likelihood phylogenetic trees were constructed using software MEGA 5.05. The statistical analysis was conducted using software SPSS 20.0. Results: A total of 33 dengue fever cases were reported in Guangzhou in 2020, including 31 (93.94%) imported cases and 2 (6.06%) local cases. Compared with the data during 2016 to 2019, the number of cases, overall incidence and local incidence all decreased with statistically significant differences (all P<0.05). The imported cases from Southeast Asia constituted 90.32% (28/31) of imported cases. The E gene sequences and the phylogenetic trees of imported and local cases demonstrated close relationship with the virus sequences from Southeast Asian, and they were less homologous with the sequences of dengue virus isolated in Guangzhou in previous years. Conclusions: The incidence of dengue in Guangzhou in 2020 was significantly affected by the imported cases, especially those from Southeast Asian countries. The study result demonstrated that dengue fever was not endemic in Guangzhou and it was caused by imported ones.

[Analysis of genomic information and biological characteristics of a bacteriophage against methicillin-resistant Staphylococcus aureus in patients with median sternal incision infection]

Objective: To isolate and purify a bacteriophage against methicillin-resistant Staphylococcus aureus (MRSA), and to analyze its genomic information and biological characteristics. Methods: The experimental research methods were adopted. MRSA (hereinafter referred to as host bacteria) solution was collected from the wound of a 63-year-old female patient with the median sternum incision infection admitted to the Second Affiliated Hospital of Army Medical University (the Third Military Medical University). The bacteriophage, named bacteriophage SAP23 was isolated and purified from the sewage of the Hospital by sewage co-culture method and double-layer agar plate method, and the plaque morphology was observed. The morphology of bacteriophage SAP23 was observed by transmission electron microscope after phosphotungstic acid negative staining. The whole genome of bacteriophage SAP23 was sequenced with NovaSeq PE15 platform after its DNA was prepared by sodium dodecyl sulfonate/protease cleavage scheme, and genomic analysis including sequence assembly, annotation, and phylogenetic tree were completed. The bacteriophage SAP23 solution was co-incubated with the host bacterial solution for 4 h at the multiplicity of infection (MOI) of 10.000 0, 1.000 0, 0.100 0, 0.010 0, 0.001 0, and 0.000 1, respectively, and then the bacteriophage titer was measured by the drip plate method to select the optimal MOI, with here and the following sample numbers of 3. The bacteriophage SAP23 solution was co-incubated with the host bacterial solution at the optimal MOI for 5, 10, and 15 min, respectively, and the bacteriophage titer was measured by the same method as mentioned above to select the optimal adsorption time. After the bacteriophage SAP23 solution was co-incubated with the host bacterial solution at the optimal MOI for the optimal adsorption time, the bacteriophage titers were measured by the same method as mentioned above at 0 (immediately), 5, 10, 15, 20, 30, 40, 50, 60, 80, 100, and 120 min after culture, respectively, and a one-step growth curve was drawn. The bacteriophage SAP23 solution was incubated at 4, 37, 50, 60, 70, and 80 ℃ and pH 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12 for 1 h, respectively, to determine its stability. A total of 41 MRSA strains stored in the Department of Microbiology of Army Medical University (the Third Military Medical University) were used to determine the host spectrum of bacteriophage SAP23. Results: The bacteriophage SAP23 could form a transparent plaque on the host bacteria double-layer agar plate. The bacteriophage SAP23 has a polyhedral head with (88±4) nm in diameter and a tail with (279±21) nm in length and (22.6±2.6) nm in width. The bacteriophage SAP23 has a linear, double-stranded DNA with a full length of 151 618 bp and 11 681 bp long terminal repeats sequence in the sequence ends. There were 220 open reading frames predicted and the bacteriophage could encode 4 transfer RNAs, while no resistance genes or virulence factors were found. The annotation function of bacteriophage SAP23 genes could be divided into 5 groups. The GenBank accession number was MZ427930. According to the genomic collinearity analysis, there were 5 local collinear blocks in the whole genome between the bacteriophage SAP23 and the chosen 6 Staphylococcus bacteriophages, while within or outside the local collinear region, there were still some differences. The bacteriophage SAP23 belonged to the Herelleviridae family, Twortvirinae subfamily, and Kayvirus genus. The optimal MOI of bacteriophage SAP23 was 0.010 0, and the optimal adsorption time was 10 min. The bacteriophage SAP23 had a latent period of 20 min, and a growth phase of 80 min. The bacteriophage SAP23 was able to remain stable at the temperature between 4 and 37 ℃ and at the pH values between 4 and 9. The bacteriophage SAP23 could lyse 3 of the 41 tested MRSA strains. Conclusions: The bacteriophage SAP23 is a member of the Herelleviridae family, Twortvirinae subfamily, and Kayvirus genus. The bacteriophage SAP23 has a good tolerance for temperature and acid-base and a short latent period, and can lyse MRSA effectively. The bacteriophage SAP23 is a new type of potent narrow-spectrum bacteriophage without virulence factors and resistance genes.

[Epidemiological characteristics of three local epidemics of COVID-19 in Guangzhou]

Objective: To understand the epidemiological characteristics of three local COVID-19 epidemics in Guangzhou and provide reference for optimizing strategies and measures of COVID-19 prevention and control. Methods: The data of local COVID-19 cases in Guangzhou reported as of June 18, 2021 were collected from National Notifiable Disease Report System of China. The software Excel 2019 and SPSS 22.0 were applied for data cleaning and statistical analysis. Results: A total of 726 COVID-19 cases were reported in the three local epidemics in Guangzhou. In the epidemic associated with the outbreak of COVID-19 in Hubei province, 366 cases were reported. Most cases were female (51.6%, 189/366), aged 18-65 years (81.4%, 298/366), jobless/unemployed (32.2%, 118/366) and retired persons (20.2%,74/366). The initial symptoms of most cases were fever (71.6%, 250/349) and cough (60.7%, 212/349). In the epidemic associated with the imported COVID-19 cases from Africa, 207 cases were reported. Most cases were aged 18-40 years (72.9%, 151/207), male (69.6%, 144/207), and engaged in commercial services (62.3%,129/207). The initial symptoms of most cases were no obvious discomfort (55.6%, 15/27) and cough (37.0%, 10/27). In the epidemic associated with Delta variant of SARS-CoV-2, 153 cases were reported, in which women accounted for 58.8% (90/153), most cases were over 41 years old (64.7%,99/153), and retired persons accounted for the highest proportion (32.0%,49/153). The initial symptoms of most cases were cough (32.9%, 48/146) and no obvious discomfort (28.1%, 41/146). The household secondary attack rates of the three local epidemics were 11.2%, 5.7% and 11.5%, respectively. The median (P₂₅, P₇₅) of incubation periods were 6.5 (4.0,10.8) d, 4.0 (2.5, 6.0) d and 4.0 (3.0,5.0) d. The serial intervals median (P₂₅, P₇₅) were 4.0 (3.0, 8.0) d, 4.0 (2.5, 6.0) d and 3.0 (2.0,5.0) d. There were significant differences in gender, age, occupation, initial symptoms, household secondary attack rate and incubation period among the three local COVID-19 epidemics (all P<0.05). In the proportion of the case finding way, passive detection in patient treatment were mainly 44.3%(162/366) in the epidemic associated with the outbreak of COVID-19 in Hubei province,but active community case screening [58.5% (121/207) and 27.5% (24/153)] and close contact management in imported case were mostly [33.3% (69/207) and 67.3% (103/153)] in the epidemic associated with the imported COVID-19 cases from Africa and with Delta variant of SARS-CoV-2, respectively. Conclusions: Due to the different sources of infection, strain types and prevention and control strategies, the epidemiological characteristics of the three local COVID-19 epidemics in Guangzhou differed in demographics, clinical symptoms, transmission routes and case finding, which suggested that it is necessary to improve the key population and common symptom monitoring in the routine prevention and control of COVID-19 to prevent the reemerge of the epidemic.

Increased Risk of Postpartum Depression in Women With Allergic Rhinitis During Pregnancy: A Population-Based Case-Control Study

OBJECTIVES

Allergic rhinitis (AR) is associated with increased risk of major depression in the general population, however, no previous study has evaluated its role among pregnant women. We aimed to investigate the potential impact of AR during pregnancy on the development of postpartum depression (PPD).

METHODS

This is a population-based case-control study. Data were retrieved from the National Health Insurance Research Database (NHIRD). Medical records of a total of 199 470 deliveries during 2000 and 2010 were identified. Among which, 1416 women with PPD within 12 months after delivery were classified as the case group, while 198 054 women without PPD after delivery formed the control group. Univariate and multivariate regression analyses were conducted to determine the associations between AR during pregnancies and other study variables with PPD.

RESULTS

AR during pregnancy was found in 9.53% women who developed PPD and 5.44% in women without PPD. After adjusting for age at delivery, income level, various pregnancy and delivery-related conditions, asthma, atopic dermatitis and other medical comorbidities in the multivariate analysis, AR was significantly associated with increased odds of PPD (aOR: 1.498, 95% CI: 1.222-1.836).

CONCLUSION

AR during pregnancy was independently and significantly associated with an approximately 50% increased risk of PPD among women giving birth. Closely monitoring of AR is warranted in the future in order to optimize mother and child outcomes after delivery.

[Epidemiological investigation and analysis of etiological characteristics of infection on 3 067 hospitalized pediatric patients with burns]

Objective: To investigate the epidemiological characteristics and etiological distribution of infection on 3 067 hospitalized pediatric patients with burns, and explore the prevention and treatment strategy of pediatric burns. Methods: A cross-sectional survey was conducted. An analysis was performed on the data of 3 067 hospitalized pediatric patients with burns who met the inclusion criteria and were admitted to the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from January 2012 to December 2020, including gender, age, causative factors, locations and severities of burns, seasons of accidents, and the type, source of tissue or body fluid, and drug resistance of pathogenic bacteria. API bacterial identification batten and automatic microbial identification system were applied for pathogen identification. Drug sensitivities of top 3 consistent ratio pathogen identifed were tested with minimum inhibitory concentration and disk diffusion method. WHONET 5.6 software was applied to analyze the data. Results: There were 3 067 hospitalized pediatric patients with burns, including 1 768 boys and 1 299 girls. The majority of pediatric burn patients were >1 and ≤4 years, accounting for 72.9% (2 236/3 067), and the minority of pediatric burn patients were >8 and ≤12 years, accounting for 4.9% (150/3 067). Moderate burns and severe burns of pediatric burn patients accounted for the majority parts, and the proportions of the two were close. The top cause of pediatric burns was scald, accounting for 81.6% (2504/3 067). Extremities were the most common burn sites in that of entire 3 254. The most pediatric burns occurred in winter, accounting for 29.4% (903/3 067). A total of 1 018 strains of pathogenic bacteria were collected from pediatric burn patients, all of which were non-repeated isolates. The pathogens with top five consistent ratio were Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Enterobacter cloacae, and Escherichia coli, among which Staphylococcus aureus ranked the first every year. The pathogens were mainly isolated from the wound exudate, accounting for 81.34% (828/1 018). Staphylococcus aureus from 2012 to 2020 showed no resistance to vancomycin, linezolid or teicoplanin while Staphylococcus aureus isolated in 2019 was 100% resistant to macrolides, penicillin, aminoglycosides, and quinolones. Pseudomonas aeruginosa was not resistant to polymyxin B. Acinetobacter baumannii showed a high rate of drug resistance to most antibiotics. Conclusions: Among the pediatric burn patients admitted to the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from 2012 to 2020, the majority are male children aged >1 and ≤4 years with moderate burns. Scalds are the leading cause; and extremities are the common burn sites; and the most pediatric burns occurre in winter. Staphylococcus aureus from wound exudate is the primary pathogen of burn wound infections in pediatric patients.

Development of solid state terahertz interferometer for the first plasma on HL-2M tokamak

A solid state terahertz interferometer has been developed on the recent commissioned HL-2M tokamak. It can work in a wide frequency region of 220-325 GHz, and the terahertz wave is generated from a low frequency phase locked voltage controlled oscillator with the frequency multiplying technique. A phase processor based on field programmable gate array (FPGA) technology is designed for the heterodyne interferometer, and it contributes to real-time display of electron density. To extract phase information, a novel numerical algorithm related to fast Fourier transform is written on the FPGA chip and enables one to obtain phase shift without being affected by amplitude variation induced by plasma absorption or frequency modulation from the outer electromagnetic environment. The interferometer achieves minimum measurable electron density in the order of 10¹⁶ m^-3. With the plasma diagnosis, electron density and low frequency tearing mode have been measured during the first experimental campaign.

Identification of the novel KIR3DL1*00702 allele in a Northern Chinese Han individual

The novel KIR3DL1*00702 allele differs from the closest allele KIR3DL1*00701 by a single silent mutation.

Characterization of the novel KIR2DS2*022 allele identified in a northern Chinese Han individual

The novel KIR2DS2*022 allele differs from the closest allele KIR2DS2*00101 by a single nonsynonymous mutation.

A remote gain controlled and polarization angle tunable Doppler backward scattering reflectometer

Remote control of the diagnostic systems is the basic requirement for the high performance plasma operation in a fusion device. This work presents the development of the remote control system for the multichannel Doppler backward scattering (DBS) reflectometers. It includes a remote controlled quasi-optical system and a remote intermediate frequency (IF) amplifier gain control system. The quasi-optical system contains a rotational polarizer, its polarization angle is tunable through a remote controlled motor, and it could combine the microwave beams with a wide frequency range into one focused beam. The remote IF gain control system utilizes the digital microcontroller (MCU) technique to regulate the signal amplitude for each signal channel. The gain parameters of amplifiers are adjustable, and the feedback of working status in the IF system will be sent to MCU in real time for safe operation. The gain parameters could be controlled either by the Ethernet remote way or directly through the local control interface on the system. Preliminary experimental results show the effectiveness of the remote controlled multichannel DBS system.

Visible wide-angle view imaging system for the first plasma on the HL-2M tokamak

The wide-angle view imaging system, in terms of a tangential view diagnostic with field of view (FOV) of 56.8° and a downward-looking diagnostic from the top of the machine with FOV of 94.7°, has been newly constructed for the first plasma of the HL-2M tokamak achieved in December 2020. Its mission in this stage is to monitor the plasma evolution during its startup, sustainment, and disruption in the visible spectral range as well as the plasma-wall interaction. For the latter ultrawide view diagnostic, nearly three-quarters of the divertor region and half the area of the inner wall are in the view range. Both the diagnostics are characterized by a similar optical structure, i.e., the light emission from the plasma is collected by a front-end lens and transferred through an imaging fiber bundle to the camera. This optical structure is suitable for application in the complex tokamak environment mainly because the fiber bundle is flexible. Photos of glow discharges are acquired prior to the first plasma for testing the FOVs in the vacuum vessel. The spatial resolution is ∼4mm for the tangential view diagnostic and ∼10mm for the downward-looking diagnostic. The temporal resolutions, ranging from 90 to 360 Hz by changing the region of interest or binning acquisition mode of the color camera, are applied to record the plasma evolutions and/or dust creation events during the first plasma campaign.

Accurate diagnosis of colorectal cancer based on histopathology images using artificial intelligence

BACKGROUND

Accurate and robust pathological image analysis for colorectal cancer (CRC) diagnosis is time-consuming and knowledge-intensive, but is essential for CRC patients' treatment. The current heavy workload of pathologists in clinics/hospitals may easily lead to unconscious misdiagnosis of CRC based on daily image analyses.

METHODS

Based on a state-of-the-art transfer-learned deep convolutional neural network in artificial intelligence (AI), we proposed a novel patch aggregation strategy for clinic CRC diagnosis using weakly labeled pathological whole-slide image (WSI) patches. This approach was trained and validated using an unprecedented and enormously large number of 170,099 patches, > 14,680 WSIs, from > 9631 subjects that covered diverse and representative clinical cases from multi-independent-sources across China, the USA, and Germany.

RESULTS

Our innovative AI tool consistently and nearly perfectly agreed with (average Kappa statistic 0.896) and even often better than most of the experienced expert pathologists when tested in diagnosing CRC WSIs from multicenters. The average area under the receiver operating characteristics curve (AUC) of AI was greater than that of the pathologists (0.988 vs 0.970) and achieved the best performance among the application of other AI methods to CRC diagnosis. Our AI-generated heatmap highlights the image regions of cancer tissue/cells.

CONCLUSIONS

This first-ever generalizable AI system can handle large amounts of WSIs consistently and robustly without potential bias due to fatigue commonly experienced by clinical pathologists. It will drastically alleviate the heavy clinical burden of daily pathology diagnosis and improve the treatment for CRC patients. This tool is generalizable to other cancer diagnosis based on image recognition.

Development of a tunable multi-channel Doppler reflectometer on J-TEXT tokamak

Doppler reflectometer is a powerful diagnostic tool to study the turbulence for tokamak plasmas. It can provide information on the density fluctuation, the poloidal rotation, the radial electric field, its shear, etc. A tunable multi-channel V-band (50-75 GHz) Doppler reflectometer system has been developed on the J-TEXT tokamak for the measurement under various toroidal magnetic fields. A universal serial bus controlled synthesizer is used as a source that can adjust the probing frequency remotely. This Doppler reflectometer can measure the plasma in 0.3 < ρ < 1 . Its radial resolution is <2 cm, and k_⊥ is ∼ 4-12 cm^-1. Based on the Doppler reflectometer, the perpendicular turbulence propagation velocity, the profile of the radial electric field, the geodesic acoustic mode, and some other phenomena have been observed on J-TEXT.

[Epidemic characteristics and dynamic changes of spatio-temporal distribution of hemorrhagic fever with renal syndrome in Guangzhou, 2010-2019]

Objective: To analyze the epidemic characteristics and spatio-temporal distribution of hemorrhagic fever with renal syndrome (HFRS) in Guangzhou from 2010 to 2019 and provide a basis for prevention and control strategies. Methods: The data of HFRS was from National Disease Reporting Information System and the epidemic investigation. A descriptive analysis was used. OpenGeoDa 1.2.0 software was used for global spatial autocorrelation and local spatial autocorrelation analysis. SatScan 9.6 software was used for detecting the hot spot area in time and space. ArcGIS 10.2 software was used for map visualization. Results: 1 298 cases of HFRS were reported, and three patients died in Guangzhou in 2010-2019. The annual incidence rate was 0.99/100 000. The proportion of 21-50 years old cases accounted for 70.88% and the male to female ratio was 2.98∶1. Most patients were house workers or unemployed, accounting for 31.28%, followed by business servants (accounting for 17.33%). The incidence peak in spring and winter accounted for 33.74% and 26.35% of the year. All districts reported cases in recent ten years. A total of 407 cases had been reported in Haizhu district, accounting for 31.36% of the total number of cases in the whole city. The annual incidence rate was 2.52/100 000. The number of reported cases and the annual incidence rate were the highest in Guangzhou. The clustered area showed that there was spatio-temporal clustering in Guangzhou. The aggregation area was mainly concentrated in the urban villages adjacent to Wan-mu orchard and the Haizhu Lake Wetland Park in Haizhu district (logarithmic likelihood ratio was 44.08, P<0.001). Conclusions: The prevalence and concentration of HFRS in winter and spring Guangzhou city from 2010 to 2019, showed a high incidence. Young and middle-aged men engaged in domestic and unemployed, and commercial services appeared the main risk groups. The urban-rural junction with many immigrants and low health environment, streets adjacent to Wan-mu orchard, and the Haizhu Lake Wetland Park in Haizhu district were the important regions for preventing and controlling HFRS. The government should formulate prevention and control measures to curb the rise and spread of the HFRS epidemic.

Understanding colossal barocaloric effects in plastic crystals

Plastic crystal neopentylglycol (NPG) exhibits colossal barocaloric effects (BCEs) with record-high entropy changes, offering exciting prospects for the field of solid-state cooling through the application of moderate pressures. Here, we show that the intermolecular hydrogen bond plays a key role in the orientational order of NPG molecules, while its broken due to thermal perturbation prominently weakens the activation barrier of orientational disorder. The analysis of hydrogen bond strength, rotational entropy free energy and entropy changes provides insightful understanding of BCEs in order-disorder transition. External pressure reduce the hydsrogen bond length and enhance the activation barrier of orientational disorder, which serves as a route of varying intermolecular interaction to tune the order-disorder transition. Our work provides atomic-scale insights on the orientational order-disorder transition of NPG as the prototypical plastic crystal with BCEs, which is helpful to achieve superior caloric materials by molecular designing in the near future.

[Effects of Prrx2 gene silencing on the proliferation of breast cancer and its molecular mechanisms]

Objective: The aim of this study was to investigate the effects of silencing Paired related homoeobox 2 (Prrx2) expression on the proliferation of breast cancer and its molecular mechanisms. Methods: Short hairpin RNA knockdown of Prrx2 was used to examine cellular effects of Prrx2. The level of Prrx2 was verified by Western blot. MTT assay was used to analyze the proliferation of breast cancer cells in vitro. To investigate the effect of Prrx2 depletion on tumor growth in vivo, a nude mouse xenograft model was performed. Results: The expression of Prrx2 decreased 91.2% in MDA-MB-231 cells and 88.7% in MCF-7 cells after transfection with interfering vectors (P<0.05). MTT assay showed that the proliferation of cells in silenced Prrx2 expression group was significantly inhibited compared with the control group (P<0.05). Nude mice transplanted tumors showed that the growth of transplanted tumors was slow after silencing Prrx2 expression, and the weight of the tumors of silenced Prrx2 expression group were smaller than those of the control group ((160.2±26.3)mg vs (365.4±19.7)mg, P<0.05). Western blot showed that silencing Prrx2 expression inhibited the expression of β-catenin in breast cancer cell nucleus and down-regulated the activity of Wnt/β-catenin signaling pathway. Conclusions: Silencing Prrx2 expression can effectively inhibit the proliferation and growth of breast cancer, suggesting that Prrx2 may become a new target for the treatment of breast cancer.

[Epidemiological characteristics of a case infected with avian influenza A (H5N6) virus associated with exposure to aerosol]

Objective: To investigate the epidemiological and clinical characteristics of a case infected with avian influenza A (H5N6) virus associated with exposure to aerosol and provide evidence for the prevention and control of human infection with avian influenza virus. Methods: Epidemiological investigation was conducted to identify the history of exposure, infection route, and disease progression. Real-time fluorescent quantitative RT-PCR was used to test the samples collected from the case, close contacts, environment and poultry market. Results: The case had no history of exposure to live poultry and poultry market. But before the onset the case had a history of exposure to the live poultry placed in a car with doors and windows closed. The samples collected from the case's lower respiratory tract and the remaining frozen chicken meat were all influenza A (H5N6) virus positive. Conclusions: The source of infection was the live poultry, and the infection route might be the exposure to aerosol in a car with doors and windows closed, where the poultry were temporarily stored. It is necessary to promote centralized poultry slaughtering, cold chain distribution and fresh poultry sale, as well as strengthen health education and establish the concept of consuming fresh poultry.

Improvement in Psychological Condition of Patients With Persistent Moderate-Severe Allergic Rhinitis by Drug Therapy Combined With Psychological Intervention

OBJECTIVE

To investigate the effect of drug treatment combined with psychological intervention on mental disorders in patients with persistent moderate-severe allergic rhinitis.

METHODS

Sixty patients with persistent moderate-severe allergic rhinitis who met the criteria were randomly divided into 2 groups: control group and experimental group. The control group was only given medication, whereas the experimental group was given psychological intervention on the basis of the same medication. Cognitive behavioral therapy was used for psychological intervention. After 12 weeks of treatment, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) were used to evaluate the changes in anxiety, depression, and quality of life before and after treatment.

RESULTS

The SAS and SDS scores of the control group after treatment were lower than those before treatment, and the difference was statistically significant. Similarly, the SAS and SDS scores of the experimental group after treatment were lower than those before treatment with statistically significant difference. In addition, after treatment, the SAS and SDS scores of the experimental group were statistically lower than those of the control group. The results of RQLQ showed that the scores of each dimension in the control group after treatment were lower than those before treatment, and the difference was statistically significant. Similar results were found in the experimental group. After treatment with these 2 different schemes, the RQLQ scores of sleep, nonnasal/eye symptoms, and emotion in the experimental group were statistically lower than those in the control group.

CONCLUSION

Drug therapy or drug therapy combined with psychological intervention can alleviate anxiety and depression of patients with persistent moderate-severe allergic rhinitis and improve their quality of life. Moreover, based on the effect of improving mental disorder and quality of life of patients, drug therapy combined with psychological intervention is better than drug treatment alone.

[Spatial distribution of cancer-related burden in Guangzhou from 2010 to 2013]

Objective: To evaluate the burden and to describe the characteristics of spatial distribution caused by malignant tumors among different administrative areas in Guangzhou from 2010- 2013. Methods: Based on data from the Cancer Registry system and population in Guangzhou in 2010- 2013, disability-adjusted life year (DALY) was assessed on the disease burden of cancer, in accordance with the method used in the Global Burden of Disease study. Results: The crude incidence rates of cancer appeared as 256.22/10(5) in 2010-2011 and 270.04/10(5) in 2012-2013, with the crude mortality rates as 143.17/10(5) and 148.01/10(5), respectively, in Guangzhou. Cancers caused 606 238.95 DALYs in 2010-2011 and 623 763.80 DALYs in 2012-2013 for both sexes and 37.63 and 37.81 person year per 1 000 persons, with the standardized DALY rates as 34.51‰, 34.00‰ respectively. Three administrative districts (Yuexiu, Haizhu and Liwan) were with the largest disease burden of cancers that accounted for 45% of the DALYs for the whole Conghua district, with liver cancer was the leading cancer on DALYs, and tracheal, bronchus and lung cancer ranked the first in the other districts. Conclusions: In Guangzhou, disease burden caused by cancers was both prominently seen in the newly developed urban area and the old districts. It remains an arduous task to continue programs on control and prevention of cancers in this city.

[Advances in the research of application of immune modulation of phage in treatment of sepsis]

Phages are traditionally deemed to lyse host bacteria, while new evidences have convinced their immunomodulation effects in metazoan hosts during period of anti-infection treatment. For sepsis induced by bacteria, phage therapy has attracted widespread attention of researchers at home and abroad for its lytic and immunoregulation functions. Clinical and basic researches in mechanism, usage, dosage, and safety of phages in China are inadequate and urgent to be carried out in depth and strengthened. Here we review overall anti-inflammation functions of phages in the treatment of sepsis, influence of phages in human immune cells, and clinical advances in present researches of phage therapy for sepsis.

An eight-channel correlation electron cyclotron emission diagnostic for turbulent electron temperature fluctuation measurement in HL-2A tokamak

A new correlation electron cyclotron emission (CECE) diagnostic has recently been installed on the HL-2A tokamak in order to study electron temperature fluctuations. Eight radial locations are measured simultaneously through eight pairs of correlated channels. Multiplexers are employed in the intermediate frequency section instead of the conventional separated filter banks to meet strict cross-isolation specifications and lower insertion loss. Relative electron temperature fluctuations are observed by CECE for the first time on the HL-2A by using the spectral decorrelation method. The achieved minimum detectable fluctuation level is up to (T̃_e/T_e)_min∼0.5%. When studying electron temperature fluctuations in the core region with gas puffing, the cross-power spectra show that the amplitude of the electron temperature fluctuation increases in a high temperature and low density plasma. Further analysis demonstrates that the electron temperature gradient ∇T_e drives the electron temperature fluctuations together with electron heat transport.

[Effects of vitamin D3 on intestinal mucosal barrier of mice with severe burns]

Objective: To explore the effects of vitamin D₃ on intestinal mucosal barrier of mice with severe burns. Methods: Forty-two C57BL/6C male mice aged eight to twelve weeks were divided into vitamin D₃ vehicle+ sham injury group of seven mice, vitamin D₃ vehicle+ burn injury group of fourteen mice, vitamin D₃+ sham injury group of seven mice, and vitamin D₃+ burn injury group of fourteen mice according to random number table. Mice in vitamin D₃ vehicle+ sham injury group and vitamin D₃ vehicle+ burn injury group were injected with vehicle of vitamin D₃ at a dose of 0.1 mL intraperitoneally at 1, 24, and 48 h before burn experiment. Mice in vitamin D₃+ sham injury group and vitamin D₃+ burn injury group were injected with vitamin D₃ at a dose of 100 ng/kg dissolved in 0.1 mL vehicle intraperitoneally at the same time points. Mice in vitamin D₃ vehicle+ burn injury group and vitamin D₃+ burn injury group were inflicted with 30% total body surface area full-thickness dermal scald (hereinafter referred to as burn) on the back by 98 ℃ hot water for 3 to 4 seconds. And mice in vitamin D₃ vehicle+ sham injury group and vitamin D₃+ sham injury were treated with 37 ℃ water on the back for 3 to 4 seconds to simulate injury. Seven mice in vitamin D₃ vehicle+ sham injury group and seven mice in vitamin D₃+ sham injury group at post injury hour (PIH) 24, and seven mice in vitamin D₃ vehicle+ burn injury group and seven mice in vitamin D₃+ burn injury group at PIH 6 and 24 were sacrificed respectively to collect mesentery lymph nodes, spleens, livers, and intestinal tissue. The mesentery lymph nodes, spleens, and livers of mice in each group were collected to observe growth of bacteria, and number of bacteria was counted. Intestinal tissue of mice in each group was collected to detect protein expressions of zonal occludin 1 (ZO-1) and occludin by immunohistochemistry staining method, distribution of ZO-1 by immunofluorescence staining method, and expression of occludin by Western blotting. Data were processed with Kruskal-Wallis H test, Nemenyi test, one-way analysis of variance, t test, and Bonferroni correction. Results: (1) At PIH 6 and 24, bacterial counts of mesentery lymph nodes, livers, and spleens of mice in vitamin D₃ vehicle+ burn injury group were significantly higher than those of mice in vitamin D₃ vehicle+ sham injury group (P<0.05). At PIH 6, bacterial counts of livers and spleens of mice in vitamin D₃+ burn injury group were significantly lower than those of mice in vitamin D₃ vehicle+ burn injury group (P<0.05). At PIH 24, bacterial counts of mesentery lymph nodes and livers of mice in vitamin D₃+ burn injury group were significantly lower than those of mice in vitamin D₃ vehicle+ burn injury group (P<0.05). (2) At PIH 6 and 24, expressions of ZO-1 and occludin of intestinal tissue of mice in vitamin D₃ vehicle+ burn injury group were significantly lower than those of mice in vitamin D₃ vehicle+ sham injury group, and expressions of ZO-1 and occludin of intestinal tissue of mice in vitamin D₃+ burn injury group were close to those of mice in vitamin D₃+ sham injury group. At PIH 6 and 24, expressions of ZO-1 and occludin of intestinal tissue of mice in vitamin D₃+ burn injury group were significantly higher than those of mice in vitamin D₃ vehicle+ burn injury group. (3) At PIH 6 and 24, compared with that of mice in vitamin D₃ vehicle+ sham injury group, distribution of ZO-1 of intestinal mucosal epithelium of mice in vitamin D₃ vehicle+ burn injury group was discontinuous. Distribution of ZO-1 of intestinal mucosal epithelium of mice in vitamin D₃+ sham injury group was normal, and the distribution of ZO-1 of intestinal mucosal epithelium of mice in vitamin D₃+ burn injury group was with good continuity. (4) At PIH 6 and 24, expressions of occludin of intestinal tissue of mice in vitamin D₃ vehicle+ burn injury group were 0.720±0.003, 0.638±0.052 respectively, significantly lower than 0.918±0.003 of mice in vitamin D₃ vehicle+ sham injury group (t=57.33, 5.36, P<0.05). At PIH 6 and 24, expressions of occludin of intestinal tissue of mice in vitamin D₃+ burn injury group were 0.994±0.058, 1.064±0.060, close to 0.938±0.023 of mice in vitamin D₃+ sham injury group (t=0.91, 1.96, P>0.05). At PIH 6 and 24, expressions of occludin of intestinal tissue of mice in vitamin D₃ vehicle+ burn injury group were significantly lower than those of mice in vitamin D₃+ burn injury group (t=4.75, 5.35, P<0.05). Conclusions: Intestinal bacterial translocation can occur in the early stage of severe burn. And vitamin D₃ plays a protective role in the intestinal mucosal barrier post severe burn to reduce the bacterial translocation by protecting tight junction proteins of intestinal epithelium.

[All levels miniplate fixation and a modified hybrid fixation method in expansive open-door cervical laminoplasty: a retrospective comparative study]

OBJECTIVE

To retrospectively compare the effect of alternate levels miniplate and anchor fixation with the effect of all levels miniplate fixation in expansive open-door cervical laminoplasty (EOLP).

METHODS

Patients with cervical spondylosis underwent EOLP between July 2015 and June 2016 were included in the study. There were 33 patients in the alternate group (alternate levels miniplate and anchor fixation group) and 34 patients in the miniplate group (all levels miniplate fixation group). Neurological function was evaluated with the Japanese Orthopedic Association (JOA) score and degree of pain was assessed with the visual analogue scale (VAS) score. Basic clinical and surgical data, complication rates and medical costs of the two groups were compared. In addition, radiological examinations were performed pre- and post-operatively and at the final follow-up. Relative imaging data such as anteroposterior diameter (APD), cervical curvature index (CCI) and open angle were collected and compared.

RESULTS

(1) The mean follow-up time was 18.6 months in the alternate group and 18.9 months in the miniplate group. There were no significant differences in operation time, intraoperative blood loss, perioperative complication rates, post-operative hospital stays, VAS scores and neurological recovery rates preoperatively and at the final follow-up between the two groups. (2) Additionally, no obvious differences were observed about CCIs and APDs at the three follow-up time points between the two groups. Post-operative open angles at C4 and C6 in the alternate group were significantly smaller than those in the miniplate group. However, there were no significant differences in C3, C5 and C7 open angles between the two groups post-operatively. Notably, no significant differences were detected about the open angles at all levels between the two groups at the final follow-up. (3) When comparing radiologic data at different time points in each group, CCIs and open angles at each level had no significant differences, but APDs after surgery and at the final follow-up were significantly larger than pre-operative APDs. (4) Total costs in the alternate group were significantly lower than those in the miniplate group.

CONCLUSION

The two surgical methods showed almost the same neurological recovery rates and complication rates. However, use of alternate levels miniplate and anchor fixation in EOLP can reduce medical expenses.

[Efficacy analysis of psychological intervention on the basis of medication for the treatment of moderate-severe persistent allergic rhinitis]

Objective:To observe the effect of psychological intervention on the basis of drug therapy for moderate-severe persistent allergic rhinitis.Method:Sixty patients with moderate-severe persistent allergic rhinitis were randomly divided into two groups: control group and study group. The control group was only given pure drug therapy. The study group was given drug treatment and psychological intervention. Both groups were treated for 12 weeks. Before and after the treatment, the patients were graded by SAS, SDS and RQLQ to assess their anxiety and depression, as well as changes in the quality of life. Finally, a statistical analysis was performed.Result:After the treatment, the SAS and SDS scores of the control group and the study group were lower than those scores before treatment, and the difference was statistically significant (P<0.05). The SAS and SDS scores were lower in the study group than in the control group after treatment, and the difference was statistically significant (P<0.05).After the treatment, the scores of RQLQ in the control group and the study group were lower than those scores before treatment. and the difference was statistically significant (P<0.05). After treatment with two regimens, the scores of the sleep, the non-nose/eye symptoms, and the emotion were lower in the study group than those scores in the control group, and the difference was statistically significant (P<0.05).Conclusion:To improve the mental disorder and the quality of life of the moderate-severe persistent allergic rhinitis patients, on the basis of drug treatment along with psychological intervention is more effective than using medical treatment.

[Recalling the 60 years' glory of burn medicine in China]

Chinese burn medicine began in the " Great Leap Forward" movement, with the mark of the successful rescue of Qiu Caikang in Guangci Hospital (now known as Ruijin Hospital Affiliated to the Medical School of Shanghai Jiao Tong University), Shanghai. With the fading of the " Great Leap Forward" movement in 1962, medical staff of some burn bases such as Southwest Hospital of the Seventh Military Medical University (now known as the First Affiliated Hospital of Army Medical University) made a comprehensive summary on burn treatment, forming a set of original effective treatment protocols, which led to the improvement of burn treatment level. The stamp-like auto-allo intermingled skin grafting was created during that period, followed by the creation of an approach called " to embed small pieces of autogenic skin into the holes of a large sheet of allogenic skin" in Guangci Hospital, Shanghai. Owing to these approaches, the eschar of extensive burns was excised in multiple times, which led to the improvement of the cure level for extensive deep burn. Since then, the cure rate of burns of China continued to be the first in the world. Unfortunately, with the beginning of the " Great Cultural Revolution" , the development of Chinese burn medicine was interrupted and stopped. With the founding of the " Revolutionary Committee" in 1969, the Chinese burn medicine just started to recover. After 1978, the Chinese burn medicine began to rise rapidly again. Since then, the theoretic research on burns has been conducted in China, just as a follower at the beginning, and then as a runner in 1990s', but as a leader in 2000s' in some fields such as inhalation injury, sepsis, and wound healing, etc. At present, the clinical cure rate of burns in China is ranked in the leading position in the world, and the theoretical research on burns is also among the advanced ranks in the world.

[A case of human infection with highly pathogenic avian influenza A (H7N9) virus through poultry processing without protection measure]

Objective: To investigate the infection pattern and etiological characteristics of a case of human infection with highly pathogenic avian influenza A (H7N9) virus and provide evidence for the prevention and control of human infection with highly pathogenic avian influenza virus. Methods: Epidemiological investigation was conducted to explore the case's exposure history, infection route and disease progression. Samples collected from the patient, environments and poultry were tested by using real time reverse transcriptase-polymerase chain reaction (RT-PCR). Virus isolation, genome sequencing and phylogenetic analysis were conducted for positive samples. Results: The case had no live poultry contact history, but had a history of pulled chicken processing without taking protection measure in an unventilated kitchen before the onset. Samples collected from the patient's lower respiratory tract, the remaining frozen chicken meat and the live poultry market were all influenza A (H7N9) virus positive. The isolated viruses from these positive samples were highly homogenous. An insertion which lead to the addition of multiple basic amino acid residues (PEVPKRKRTAR/GL) was found at the HA cleavage site, suggesting that this virus might be highly pathogenic. Conclusions: Live poultry processing without protection measure is an important infection mode of "poultry to human" transmission of avian influenza viruses. Due to the limitation of protection measures in live poultry markets in Guangzhou, it is necessary to promote the standardized large scale poultry farming, the complete restriction of live poultry sales and centralized poultry slaughtering as well as ice fresh sale.

MicroRNA-135a Inhibits Nasopharyngeal Carcinoma Cell Proliferation Through Targeting Interleukin-17

BACKGROUND/AIMS

The objective of this study was to investigate the potential role of IL-17 in the development of nasopharyngeal carcinoma (NPC) and to screen microRNAs (miRNAs) that potentially target IL-17 in NPC cells.

METHODS

Blood was collected from NPC patients and normal subjects, and plasma IL-17 concentration was quantified by enzyme-linked immunosorbent assay. An immortalized normal human nasopharyngeal epithelial cell line, NP69, was treated with or without human IL-17 (15 ng/mL) for various times, and expression of IL-1ß, IL-6, IL-12, and TNF-α mRNA was assessed by real-time reverse transcription PCR. The candidate miRNAs that potentially target IL-17 were predicted by a bioinformatics strategy. The selected miR-135a mimic was transfected into primary NPC cells, and cell proliferation was assessed by MTT assay.

RESULTS

The concentration of plasma IL-17 was significantly higher in the NPC patients (92.5 ± 7.3 pg/mL) than in the control subjects (56.8 ± 2.9 pg/mL). In response to IL-17 treatment, the mRNA expression of IL-1ß and IL-6 was significantly upregulated and reached a peak at 12 h, followed by a slight decrease at 24 h, while the mRNA expression of IL-12 and TNF-α was significantly upregulated at 12 h and remained high even at 48 h after exposure to IL-17. Moreover, miR-135a specifically targets IL-17 and was dramatically downregulated in NPC cells compared with NP69 cells. Transfection of exogenous miR-135a mimic resulted in significant suppression of IL-17 secretion and subsequent inhibition of NPC cell proliferation.

CONCLUSIONS

Blood IL-17 was significantly higher in NPC patients compared with normal subjects. Expression of miR-135a in the cancer cells isolated from nasopharyngeal tumors was significantly lower than that in NP69 cells, and suppression of IL-17 by miR-135a mimic resulted in significant inhibition of NPC cell proliferation. These findings suggested that downregulation of miR-135a may contribute to the development of NPC via the mechanism of IL-17 stimulation of proinflammatory cytokine expression.

Sculpting nanoparticle dynamics for single-bacteria-level screening and direct binding-efficiency measurement

Particle trapping and binding in optical potential wells provide a versatile platform for various biomedical applications. However, implementation systems to study multi-particle contact interactions in an optical lattice remain rare. By configuring an optofluidic lattice, we demonstrate the precise control of particle interactions and functions such as controlling aggregation and multi-hopping. The mean residence time of a single particle is found considerably reduced from 7 s, as predicted by Kramer’s theory, to 0.6 s, owing to the mechanical interactions among aggregated particles. The optofluidic lattice also enables single-bacteria-level screening of biological binding agents such as antibodies through particle-enabled bacteria hopping. The binding efficiency of antibodies could be determined directly, selectively, quantitatively and efficiently. This work enriches the fundamental mechanisms of particle kinetics and offers new possibilities for probing and utilising unprecedented biomolecule interactions at single-bacteria level.

Optical trapping is a versatile tool for biomedical applications. Here, the authors use an optofluidic lattice to achieve controllable multi-particle hopping and demonstrate single-bacteria-level screening and measurement of binding efficiency of biological binding agents through particle-enabled bacteria hopping.

[Willingness and influencing factors related to "centralized slaughtering, fresh poultry listing and marketing" strategy among the household chefs in Guangzhou]

Objective: To study the willingness and influence factors related to "centralized slaughtering, fresh poultry listing and marketing" strategy, among the household chefs, and provide reference for government to adjust and optimize the strategy on avian influenza prevention. Methods: According to the geographical characteristics and regional functions, 6 'monitoring stations' were selected from 12 residential districts of Guangzhou, respectively. Another 21 meat markets which selling live poultry, were selected in each station and 5 household chefs of each market were invited to attend a face to face interview. Basic information, personal cognitive, willingness and influencing factors to the policy were under study. Univariate and multivariate logistic regression methods were used. Results: A total of 664 household chefs underwent the survey and results showed that the rate of support to the "centralized slaughtering, fresh poultry listing and marketing" strategy was 44.6% (296/664). Results from the multi-factor logistic regression showed that those household chefs who were males (OR=1.618, 95% CI: 1.156-2.264, P=0.005), having received higher education (OR=1.814, 95% CI: 1.296-2.539, P=0.001), or believing that the existence of live poultry stalls was related to the transmission of avian influenza (OR=1.918, 95% CI: 1.341-2.743, P<0.001) were factors at higher risk. These household chefs also intended to avoid the use of live poultry stalls (OR=1.666, 95%CI: 1.203-2.309, P=0.002) and accept the "centralized slaughtering, fresh poultry listing and marketing" strategy. Conclusion: Detailed study on this subject and, setting up pilot project in some areas as well as prioritizing the education programs for household chefs seemed helpful to the implementation of the 'freezing-fresh poultry' policy.

High-resolution and multi-range particle separation by microscopic vibration in an optofluidic chip

An optofluidic chip is demonstrated in experiments for high-resolution and multi-range particle separation through the optically-induced microscopic vibration effect, where nanoparticles are trapped in loosely overdamped optical potential wells created with combined optical and fluidic constraints. It is the first demonstration of separating single nanoparticles with diameters ranging from 60 to 100 nm with a resolution of 10 nm. Nanoparticles vibrate with an amplitude of 3-7 μm in the loosely overdamped potential wells in the microchannel. The proposed optofluidic device is capable of high-resolution particle separation at both nanoscale and microscale without reconfiguring the device. The separation of bacteria from other larger cells is accomplished using the same chip and operation conditions. The unique trapping mechanism and the superb performance in high-resolution and multi-range particle separation of the proposed optofluidic chip promise great potential for a diverse range of biomedical applications.

[Phylogenetic analysis of envelope gene of dengue virus serotype 2 in Guangzhou, 2001-2015]

Objective: To investigate the molecular characteristics of dengue virus serotype 2 (DENV2) in Guangzhou during 2001-2015, and analyze the E gene of the strains isolated, the phylogenetic tree and molecular clock were constructed to know about the evolution of the strains. Methods: The serum samples of the patients were detected by real time PCR, and positive samples were used to isolate dengue virus by using C6/36 cells. The E gene of the isolated strains were sequenced. The phylogenetic tree was constructed by using software Mega 4.0, and the molecular clock was drawn by using software BEASTv1.8.2. Results: Twenty-six dengue virus strains were isolated between 2001 and 2015. They were all clustered into 2 genotypes, i.e. cosmopolitan genotype and Asian genotype Ⅰ. The strains isolated in Guangzhou shared high homology with Southeast Asian strains. The cosmopolitan genotype was divided into 2 sub-genotype at about 46 and 35 years ago. The substitution rate of dengue virus serotype 2 in Guangzhou was 7.1 × 10(-4) per year per site. Conclusions: There were close relationship between the Guangzhou strains and Southeast Asian strains. Guangzhou was at high risk of imported dengue fever, outbreak of dengue hemorrhagic fever and dengue shock syndrome. There might be two ways of introduction of cosmopolitan genotype. The substitution rate of the strains in Guangzhou was similar to that in the neighbor countries.

[Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis]

OBJECTIVE

To describe the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis.

METHODS

Observation group included 14 cases of degenerative lumbar diseases with osteoporosis received polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws from November 2014 to July 2015, control group included 12 cases of degenerative lumbar diseases with osteoporosis received polymethylmethacrylate augmentation with traditional pedicle screws.The operation time, blood loss, number of pedicle screws and number of augmented pedicle screws in the two groups were compared. The bone cement leakage and pulmonary bone cement embolism in the two groups were also compared. The fusion rate and pedicle screws loosening by lumbar X ray and dynamic X ray were evaluated. The clinical results were assessed by visual analog scale (VAS) of pain on lumbar and lower limbers, lumbar Japanese Orthopaedic Association scores (JOA), Prolo functional scores and Oswestry disability (ODI) scores.

RESULTS

Differences of operation time and blood loss in the two groups were not statistically significant. The average number of pedicle screws was 9.9±4.7 and the average number of augmented pedicle screws was 5.9±2.6 in observation group while the average number of pedicle screws was 7.1±2.8 and the average number of augmented pedicle screws was 3.0±1.9 in control group. The ratio of augmented pedicle screws was higher in observation group than in control group (0.69±0.30 vs.0.47±0.30,P<0.05). The bone cement leakage rate was lower in observation group than in control group (5/83 vs. 12/42, P<0.01). All the cases in observation group were without leakage to the interspinal canal while one case in control group suffered from bone cement leakage to the interspinal canal with augmentation of 3 pedicle screws. The follow up period was (10.6±2.3) months in observation group and (36.5±7.2) months in control group. In final follow up, no case with non-fusion or pedicle screws loosening was found in both groups. Lumbar VAS, lower limbers VAS, lumbar JOA scores, Prolo functional scores and ODI scores were all better than pre-operation (P<0.01).

CONCLUSION

Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis was effective, with simple working processes and lower risk of bone cement leakage. The short-term clinical result was good.

[Inventory building of phages against extensively drug-resistant Acinetobacter baumannii isolated from wounds of patients with severe burn and related characteristic analysis]

OBJECTIVE

To build inventory of phages against extensively drug-resistant Acinetobacter Baumannii isolated from wounds of inpatients of burn ICU and analyze related characteristics.

METHODS

In 2014 and 2015, 131 strains of extensively drug-resistant Acinetobacter Baumannii were isolated from wounds of inpatients of burn ICU from one hospital in Chongqing. In 2015, 98 strains of extensively drug-resistant Acinetobacter Baumannii were isolated from wounds of inpatients of burn ICU from 6 hospitals in Guangdong province. Above-mentioned 229 strains were collected for conducting experiments as follows: (1) Multilocus sequence typing (MLST) of strains isolated from Chongqing and Guangdong province was analyzed. (2) Sewage co-culture method was applied for isolation of phages with above-mentioned strains and sewage from Chongqing and Guangdong province. Numbers of isolated phages and times of successful isolation and unsuccessful isolation were recorded. (3) The most prevalent subtypes of strains from Chongqing and Guangdong province in 2015 were collected, and their phages respectively underwent cross infection with all strains from Chongqing and those from Guangdong province. The lysis ability of phage was observed when phage underwent cross infection with the same subtype of strain or not the same, and the lytic ratio was calculated. (4) Fluid of phage in one type was randomly selected and equally divided into 3 parts, and its titer was determined by double dilution method. Then each part of phage fluid was subdivided into 3 small parts, which were cultured with LB fluid medium and respectively stored under the condition of -20 ℃, 4 ℃, and room temperature. After being stored for 1 month and 2 months, the titer of phage was determined for evaluating stability of phage. Data were processed with Fisher's exact test, chi-square test, and one-way analysis of variance.

RESULTS

(1) The major type of strains from Chongqing in 2014 was ST368 (45%, 31/69), and major types of strains from Chongqing in 2015 were ST75 (26%, 16/62) and ST195 (24%, 15/62), while that from Guangdong province in 2015 was ST977 (46%, 45/98). (2) For strains from Chongqing, isolation effect of phage with sewage of Chongqing (8 times of successful isolation with 9 strains of phages and 1 time of unsuccessful isolation) was better than that with sewage of Guangdong province (1 time of successful isolation with 1 strain of phage and 7 times of unsuccessful isolation). For strains from Guangdong province, isolation effect of phage with sewage of Guangdong province (8 times of successful isolation with 6 strains of phages) was better than that with sewage of Chongqing (7 times of unsuccessful isolation with no phage). These differences were statistically significant (P<0.05 or P<0.01). There was no obvious difference in isolation effect of phage between strains from Chongqing with sewage of Chongqing and strains from Guangdong province with sewage of Guangdong province (P>0.05). (3) The ratios of phages of ST75 and ST977 extensively drug-resistant Acinetobacter Baumannii strains lysing the strains with the same type were respectively 13/16 and 8/9, which were obviously higher than those lysing the strains with different type (respectively 11/115 and 3/53, with χ(2) values respectively 48.23 and 68.46, P values below 0.001). (4) Compared with that before storage, titer of phage under storage condition of -20 ℃, 4 ℃, and room temperature for 1 month decreased by approximately 1 order of magnitude, and that for 2 months decreased by approximately 2 orders of magnitude. After being stored for 1 month and 2 months, there were no statistically significant differences in titer of phage among 3 storage conditions (with F values respectively 1.29 and 1.07, P values above 0.05).

CONCLUSIONS

This study has successfully built an inventory covering 229 strains of phages of extensively drug-resistant Acinetobacter Baumannii. MLST of extensively drug-resistant Acinetobacter baumannii varies in different area and different time. Phage can be well isolated using sewage with the same source as that of strain. The lysis ability of phage is closely related to the MLST of strains. Inventory of phages should be built according to regional division. Moreover, phage cultured with LB fluid medium shows good stability without special requirements for storage conditions.

Observation of Double Impurity Critical Gradients for Electromagnetic Turbulence Excitation in Tokamak Plasmas

The impact of impurity ions on a pedestal has been investigated in the HL-2A Tokamak, at the Southwestern Institute of Physics, Chengdu, China. Experimental results have clearly shown that during the H-mode phase, an electromagnetic turbulence was excited in the edge plasma region, where the impurity ions exhibited a peaked profile. It has been found that double impurity critical gradients are responsible for triggering the turbulence. Strong stiffness of the impurity profile has been observed during cyclic transitions between the I-phase and H-mode regime. The results suggest that the underlying physics of the self-regulated edge impurity profile offers the possibility for an active control of the pedestal dynamics via pedestal turbulence.

[Clinical application of iodine solution staining in the diagnosis of early laryngeal cancer with electronic endoscope]

Objective:To discuss the feasibility and clinical application value of the laryngeal iodine staining under the electronic fiber laryngoscope.Method:Will meet the inclusion criteria of 90 patients, randomly divided into three groups, set to a, b, c group.a ,all patients in the a group were examined by electronic fiber mirror, NBI mode and 0.5% Lugol liquid iodine staining method in three ways. b, all patients in the b group were examined by electronic fiber mirror, NBI mode and 1.0% Lugol liquid iodine staining method in three ways. c,all patients in the c group were examined by electronic fiber mirror, NBI mode and 1.5% Lugol liquid iodine staining method in three ways. The location and range of positive lesions were recorded in each person of the three groups, positive lesions were biopsy, if the positive lesion is repeated, the site can only take a biopsy. As a diagnostic gold standard, the results of the other tests were compared with the results of other tests. And to observe the color of iodine in the throat, all patients were followed up for 24 hours in the presence of dyspnea, severe pain in the throat and other symptoms, and 24 hours after the examination again electronic fiber optic examination. Biopsy was performed in all patients, as gold standard. Using chi square test, inspection standardP <0.05.Result:As the solution of the iodine concentration increased, the rate of the laryngeal was cancer gradually increased. Ninety people take part in the experiment, no one has serious complications. All the patients have no significant inflammation on the mucous membrane of the throat and the subglottic airway afer 24 hours, by the electronic fiber laryngoscope. 1% and the following concentration of Lugol solution for iodine staining, sensitivity to the diagnosis of early laryngeal cancer was higher than that of electronic fiber,the two methods were compared, and the statistical analysis was performed(P >0.05). No statistical significance. There was no significant difference in the diagnosis of early laryngeal cancer. Contrast between iodine stain with 1.5% Lugol solution and electronic fiber sus pension, after statistical calculation(P <0.05);both are statistically significant, and the difference is significant.Comparison of iodine stain with 1.5% Lugol solution and NBI examination, make statistical analysis,P >0.05, there was no significant difference between the both.Conclusion:The 1.5% and below the concentration of the iodine staining under the electronic fiber laryngoscope can be safely applied to inspect the throat, and 1.5% Lugol iodine solution in the diagnosis of laryngeal cancer in the early stage of laryngeal cancer is better than using electronic, and has a certain value in clinical application.

Note: Upgrade of electron cyclotron emission imaging system and preliminary results on HL-2A tokamak

The electron cyclotron emission imaging system on the HL-2A tokamak has been upgraded to 24 (poloidally) × 16 (radially) channels based on the previous 24 × 8 array. The measurement region can be flexibly shifted due to the independence of the two local oscillator sources, and the field of view can be adjusted easily by changing the position of the zoom lenses. The temporal resolution is about 2.5 μs and the achievable spatial resolution is 1 cm. After laboratory calibration, it was installed on HL-2A tokamak in 2014, and the local 2D mode structures of MHD activities were obtained for the first time.

Evidence of b-jet quenching in PbPb collisions at √(s(NN))=2.76 TeV

The production of jets associated to bottom quarks is measured for the first time in PbPb collisions at a center-of-mass energy of 2.76 TeV per nucleon pair. Jet spectra are reported in the transverse momentum (p(T)) range of 80-250  GeV/c, and within pseudorapidity |η|<2. The nuclear modification factor (R(AA)) calculated from these spectra shows a strong suppression in the b-jet yield in PbPb collisions relative to the yield observed in pp collisions at the same energy. The suppression persists to the largest values of p(T) studied, and is centrality dependent. The R(AA) is about 0.4 in the most central events, similar to previous observations for inclusive jets. This implies that jet quenching does not have a strong dependence on parton mass and flavor in the jet p(T) range studied.

Transmission of avian influenza A(H7N9) virus from father to child: a report of limited person-to-person transmission, Guangzhou, China, January 2014

We investigated a possible person-to-person transmission within a family cluster of two confirmed influenza A(H7N9) patients in Guangzhou, China. The index case, a man in his late twenties, worked in a wet market that was confirmed to be contaminated by the influenza A(H7N9) virus. He developed a consistent fever and severe pneumonia after 4 January 2014. In contrast, the second case, his five-year-old child, who only developed a mild disease 10 days after disease onset of the index case, did not have any contact with poultry and birds but had unprotected and very close contact with the index case. The sequences of the haemagglutinin (HA) genes of the virus stains isolated from the two cases were 100% identical. These findings strongly suggest that the second case might have acquired the infection via transmission of the virus from the sick father. Fortunately, all 40 close contacts, including the other four family members who also had unprotected and very close contact with the cases, did not acquire influenza A(H7N9) virus infection, indicating that the person-to-person transmissibility of the virus remained limited. Our finding underlines the importance of carefully, thoroughly and punctually following-up close contacts of influenza A(H7N9) cases to allow detection of any secondary cases, as these may constitute an early warning signal of the virus's increasing ability to transmit from person-to-person.

Observation of the associated production of a single top quark and a W boson in pp collisions at sqrt[s] = 8 TeV

The first observation of the associated production of a single top quark and a W boson is presented. The analysis is based on a data set corresponding to an integrated luminosity of 12.2 fb(-1) of proton-proton collisions at sqrt[s] = 8 TeV recorded by the CMS experiment at the LHC. Events with two leptons and a jet originating from a b quark are selected. A multivariate analysis based on kinematic and topological properties is used to separate the signal from the dominant tt background. An excess consistent with the signal hypothesis is observed, with a significance which corresponds to 6.1 standard deviations above a background-only hypothesis. The measured production cross section is 23.4 ± 5.4 pb, in agreement with the standard model prediction.

Measurement of inclusive W and Z boson production cross sections in pp collisions at sqrt[s] = 8 TeV

A measurement of total and fiducial inclusive W and Z boson production cross sections in pp collisions at sqrt[s] = 8 TeV is presented. Electron and muon final states are analyzed in a data sample collected with the CMS detector corresponding to an integrated luminosity of 18.2 ± 0.5 pb(-1). The measured total inclusive cross sections times branching fractions are σ(pp → WX)×B(W → ℓν) = 12.21 ± 0.03(stat) ± 0.24(syst) ± 0.32(lum) nb and σ(pp → ZX) × B(Z → ℓ+ℓ-) = 1.15 ± 0.01(stat) ± 0.02(syst) ± 0.03(lum) nb for the dilepton mass in the range of 60-120 GeV. The measured values agree with next-to-next-to-leading-order QCD cross section calculations. Ratios of cross sections are reported with a precision of 2%. This is the first measurement of inclusive W and Z boson production in proton-proton collisions at sqrt[s] = 8 TeV.