[The impact of the number of previous miscarriages on embryo euploid rate and pregnancy outcomes in patients with unexplained recurrent pregnancy loss]

Objective: To investigate the impact of the number of previous miscarriages on embryo euploid rate and pregnancy outcomes after preimplantation genetic testing for aneuploidies (PGT-A) in patients with unexplained recurrent pregnancy loss (uRPL). Methods: A retrospective cohort study was conducted. 799 women with uRPL who underwent PGT-A for the first time between January 2015 and December 2021 at the Reproductive center of Shandong University were enrolled. These patients were divided into three groups according to the number of previous miscarriages (2, 3, and≥4). Stratified analysis was conducted according to female age (≤37 years and>37 years). The embryo euploidy rate, good-quality blastocyst formation rate, cumulative live birth rate, and cumulative clinical pregnancy loss rate of three groups were compared in younger and older patients, respectively. Meanwhile, the cumulative live birth rate, clinical pregnancy loss rate, and embryo euploidy rate were analyzed by multivariate logistic regression analysis. Results: Patients' age was (34.7±5.1) years old. In the three groups with 2, 3 and ≥4 previous miscarriages, there was no significant difference in the embryo euploidy rate between groups in the younger [48.9% (539/1 103), 50.6% (354/700) and 52.1% (152/292), P=0.567] and older [26.2% (103/393), 28.8% (55/191) and 20.5% (16/78), P=0.377] age population. Compared with 2 and 3 previous miscarriages, the cumulative live birth rate was significantly decreased [52.6% (153/291), 52.8% (93/176) and 34.3% (25/73), P=0.014] and the cumulative clinical pregnancy loss rate was significantly increased [15.8% (31/196), 15.3% (18/118) and 46.9% (23/49), P<0.001] in younger women with ≥4 miscarriages. After adjusting for maternal age, BMI, AMH, endometrial thickness on hCG trigger day and antral follicle count, the number of previous miscarriages ≥4 was a relevant factor for cumulative live birth rate (OR=0.461, 95%CI: 0.263-0.807, P=0.007) and the cumulative clinical pregnancy loss rate (OR=4.382, 95%CI: 2.165-8.873, P<0.001) in younger patients, but it was not significantly correlated with the cumulative live birth rate, cumulative clinical pregnancy loss rate and embryo euploidy rate in patients with advanced age. Conclusion: In uRPL patients,≥4 previous miscarriages decreased cumulative live birth rate and increased cumulative clinical pregnancy loss rate in women aged≤37 years old.

[Impacts of glycemic variability on the relationship between time in range and estimated glycated hemoglobin in patients with type 1 diabetes mellitus]

Objective: This study is to investigate the relationship between time in range (TIR) and glucose management indicator (GMI), and the impact of glycemic variability (GV) on their relationship in patients with type 1 diabetes mellitus (T1DM). Methods: The CGM data were collected from a multicenter randomized clinical trial of adults (≥18 years old) with T1DM, including 83 T1DM patients, respectively from the Third Affiliated Hospital of Sun Yat-sen University (72 cases), Drum Tower Hospital Affiliated to Nanjing University School of Medicine (2 cases), and the First Affiliated Hospital of University of Science and Technology of China (9 cases). All subjects wore the iPro^TM2 system for 14 days at baseline (0-2 weeks), 3 months (12-14 weeks), and 6 months (24-26 weeks). Data derived from iPro^TM2 sensor was used to calculate CGM parameters. Correlation between TIR and GMI was explored according to different stratification of glycemic variability assessed by glucose coefficient of variation (CV). Predicted TIR in the fixed GMI value was calculated via the linear regression equations performed in the respective interquartile group of CV. Results: From November 2017 to June 2021, a total of 233 CGM data were collected with 83 collected from baseline, 80 from the 3-month follow-up, 70 from the 6-month follow-up. Patients including 27 males had a median (Q₁, Q₃) age of 30.69 (25.22, 38.43) years, with a diabetes duration of 10.05(4.46, 13.92) years. The median (Q₁, Q₃) and effective wearing time of available CGM data was 13.92 (13.02, 14.00) days and 91.61% (84.96%, 95.94%), and the value of TIR, GMI and CV was 60.34%±13.03%, 7.14%±0.61% and 41.01%±7.64%, respectively. There was a strong negative correlation between TIR and GMI (r=-0.822, P<0.001). Multiple linear regression analysis showed that the predictive value of TIR calculated from a given GMI was 8.352% higher when CV was up to standard (36%) than that when CV was down to standard. Based on the multiple linear regression equations generated from quartiles of CV, the predicted TIR value was decreased across the ascending quartiles with 69.98 % in the lowest quartile of CV (≤35.91%), 64.57 % in 25^th-50^th quartile of CV (35.91%<CV≤40.08%), 60.96% in 50^th-75^th quartile of CV (40.08%<CV≤45.86%) and 56.44% in the highest quartile of CV (>75^th quartile, CV>45.86%) when GMI was set as 7%. Conclusions: There is a strong correlation between TIR and GMI in adult patients with T1DM in patients with type 1 diabetes mellitus. CV influenced the relationship between TIR and GMI.

[Baseline characteristics of the participants of China National Birth Cohort]

Objective: To explore the effects of environmental, genetic factors as well as the interactions in early life on the short-term and long-term health of offspring and to systematically evaluate the pregnancy outcomes and health of offspring after birth between families with assisted reproductive technology (ART) conception and families with spontaneous conception. Methods: The China National Birth Cohort (CNBC), a multicenter prospective birth cohort study, includes both families with ART conception and families with spontaneous conception. Since 2016, CNBC has recruited families from 24 hospitals located in 12 provinces, municipalities and autonomous regions throughout China. Information and biospecimens were collected before ART treatment, embryo transfer, at early, second, third trimester and delivery, and at 42 days, 6, 12 and 36 months after birth. Results: By June 2020, CNBC had included 27 044 families with ART conception and 29 589 families with spontaneous conception. The majority of the participants are urban residents. Among the families with ART conception, 65.5% of the men and 63.7% of the women had college degrees or higher. The mean age distribution of men and women was (33.83±5.52) and (32.38±4.67) years. 83.2% of women were primiparas, and the prevalence rates of current regular smokers and current alcohol drinkers were 0.8% and 2.1% in women. Among the families with spontaneous conception, 81.5% of the men and 86.5% of the women had college degrees or higher. The mean age distribution of men and women was (32.06±5.09) and (30.40±4.27) years. 67.2% of women were primiparas, and the prevalence rates of current regular smokers and current alcohol drinkers were 0.1% and 2.2% in women. The baseline characteristics were different between the families with ART conception and spontaneous conception in different regions. Conclusion: CNBC provides a powerful and rich resource in studying the impact of genetic, environmental factors and interactions in early life and ART treatment on the health of offspring after birth.

[Profile of China National Birth Cohort]

With the rapid changes in lifestyle, natural and social environment, the reproductive health status of couples in childbearing age continues to decline, and long-term outcomes of the rapidly increasing offspring conceived by assisted reproductive technology (ART) needs to be evaluated urgently. Therefore, the focus of research now needs to be extended from death and severe diseases to full life cycle and full disease spectrum. In order to meet the demand for such research, we launched the China National Birth Cohort (CNBC) study, an ongoing prospective and longitudinal study aiming to recruit 30 000 families underwent ART and 30 000 families with spontaneous pregnancies. Long-term follow-up programs will be conducted for both spouses and their offspring. Data of couples and their offspring, such as environmental exposure, reproductive history, psychological and behavioral status, will be collected during follow-up. Peripheral blood, urine, umbilical blood, follicular fluid, semen were also collected at different follow-up nodes. Based on high-quality data and biological samples, CNBC will play an extremely important supporting role and have a far-reaching impact on maternal and children's health care and reproductive health in China. This paper is exactly a brief introduction to the construction and basic design of CNBC.

[-a]

Objective: To investigate the clinicopathological features, treatment and prognosis of fibrin-associated diffuse large B cell lymphoma (DLBCL) arising within concurrent atrial myxoma. Methods: Six cases of fibrin-associated DLBCL arising within concurrent atrial myxoma diagnosed at the Department of Pathology, Guangdong General Hospital, from 2006 to 2019 were included. The histology, immunophenotype, treatment and prognoses were analyzed. Results: The patients' age ranged from 46 to 78 years (mean 59 years). There were 3 males and 3 females. The tumors were all discovered incidentally on histological examination of surgical pathology specimens excised for atrial myxoma. All patients appeared to have morphological features of DLBCL, B lineage immunophenotype, high proliferative index and latency type III of Epstein-Barr viral infection. They had complete tumor resections without adjuvant chemotherapy and were healthy at 5- to 120-month follow-ups. Conclusions: Fibrin-associated DLBCL arising within concurrent atrial myxoma is an unusual form of DLBCL associated with chronic inflammation, and its clinical outcome is indolent. The findings suggest that this type of lymphoma does not warrant excessive or unnecessary treatments after complete resection.

[Related factors for microalbuminuria in adult type 1 diabetes patients of short disease duration]

Objective: To investigate related factors for microalbuminuria in adult type 1 diabetes (T1D) patients of short disease duration (less than 5 years), and provide evidence for prevention of early diabetic kidney disease in this population. Methods: All adult patients enrolled in the Guangdong T1D translational medicine study between 2011 and 2017 with a disease duration of less than 5 years were included in this analysis. At enrollment, patients' demographic and clinical data were documented, and blood and urine samples were collected for the measurements of blood lipids, glycated hemoglobin A1c and urine albuminuria. Insulin resistance was evaluated by estimated glucose disposal rate (eGDR). Patients were categorized into groups based on urine albumin creatitine ratio (UACR): normoalbuminuric group (UACR<30 mg/g) and microalbuminuric group (UACR≥30 mg/g). Stepwise multivariate linear regression analysis was used to analyze risk factors for microalbuminuria in adult T1D patients of short disease duration. Results: A total of 384 patients were included in this analysis, and 51.3% (197/384) of which was female. The onset age of patients was (24.6±12.5) years, with a disease duration of 2.1(0.6, 3.5) years, body mass index of (19.8±3.2) kg/m(2), waist hip ratio of 0.85±0.21, and glycated hemoglobin A1c of (9.8±3.3)% at enrollment. Microalbuminuria occurred in 62 patients (16.1%). Multivariate linear analysis showed that higher glycated hemoglobin A1c, higher systolic blood pressure and more severe insulin resistance were related factors for microalbuminuria (t=2.322, 2.868 and -2.373, respectively, all P<0.05). Conclusions: Microalbuminuria was not rare in adult T1D patients of short disease duration. Inadequate glycemic control and insulin resistance were independent related factors for microalbuminuria in this population.

[The effect of mobile application based interactive peer support on glycemic control in patients with type 1 diabetes mellitus]

Objective: To evaluate the effect of mobile application (APP) based interactive peer support on glycemic control in patients with type 1 diabetes mellitus (T1DM). Methods: The data of the present study were from the largest mobile APP platform for patients with T1DM in China, Tangtangquan. Patients with T1DM who has registered in the APP for at least 1 year and had completed data entry were recruited. According to the monthly interaction index during the first year of APP registration (including four indicators: praise, comment, posting and collection), the eligible patients were divided into the high-interaction group and the low-interaction group. The changes from baseline of self-blood glucose monitoring frequency (SMBG), glycosylated hemoglobin (HbA1c), incidence of hyperglycemia and incidence of hypoglycemia were compared between the two groups after one year of using the APP. Results: A total of 238 patients with T1DM with an age of (27±8) years were included. Among them, 77.3% (184/238) were female. The baseline SMBG [the low-interaction group (1.71±1.14) times/day vs. the high-interaction group (1.82±1.15) times/day] and HbA1c [the low-interaction group (6.72±0.99)% vs. the high-interaction group (6.76±1.04)%] were comparable between the two groups. After one year use of the APP, the frequency of SMBG in the high-interaction group was significantly higher than that in the low-interaction group [ΔSMBG (0.59+2.06) times/d vs. (0.08+1.69) times/d, t=4.280, P=0.04), and the reduction of HbA1c was more obvious in the high-interaction group [ΔHbA1c (-0.40+1.10)% vs. (-0.06+1.13)%, t=5.651, P=0.018] than in the lower-interaction group. The incidence of hyperglycemia in the high-interaction group was significantly lower than that in the low-interaction group [13.19(6.22,23.19)% vs. 17.69(10.56,30.49)%, Z=2.850, P=0.005]. There was no significant difference in the incidence of hypoglycemia between the two groups [4.62(2.14, 8.03)% vs. 4.83(2.06, 8.87)%, Z=1.276, P=0.204]. The correlation analysis showed that interaction index was significantly associated with the reduction of HbA1c and incidence of hyperglycemia. Conclusion: Participation in interactive peer education via mobile APP may be beneficent for glycemic control in patients with T1DM.

Assessing the trend of diabetes mellitus by analyzing metformin as a biomarker in wastewater

According to International Diabetes Federation estimates, China has the highest rate of diabetes in the world. To monitor the prevalence of diabetes mellitus (DM) in near real-time, a first-line medication for the treatment of type 2 diabetes, metformin, was used. Wastewater-based epidemiology (WBE) was applied to estimate the consumption of metformin in Dalian from 2015 to 2018. Quantification of metformin was undertaken using solid-phase extraction (SPE) and N-methyl-bis (trifluoroacetamide) derivatization prior to GC-MS analysis. The concentrations of metformin in eleven wastewater treatment plants (WWTPs) ranged from 1.7 μg/L to 239.0 μg/L, with an average value of 68.3 μg/L. For metformin consumption, there was a gradual increase from 12.1 mg/d/capita in 2015 to 28.4 mg/d/capita in 2018. Meanwhile, the prevalence of metformin in the Dalian population ranged from 1.6% in 2015 to 3.8% in 2018. Similarly, the prevalence of DM showed an increasing trend from 12.2% in 2015 to 21.6% in 2018, which is consistent with the data predicted by traditional surveys (15.2-19.8%). Additionally, the prevalence of DM in 2015 estimated based on WBE was 12.2%, which agreed with the results from the traditional survey (12.3%). These results indicated that the proposed method provided a feasible way to reveal the prevalence of DM through metformin monitoring by the WBE approach.

[Awareness of preconceptional care and its related factors in women of child-bearing age with type 1 diabetes]

Objective: To investigate the awareness of preconception care among women of child-bearing age with type 1 diabetes (T1DM) and their self-management status, in order to provide evidence for establishment of management pathway for women with T1DM in pregnancy in China. Methods: This cross-sectional survey recruited female participants of child-bearing age from the cohort of Guangdong Type 1 Diabetes Translational Medicine Study conducted between June 2011 and December 2017. The participants were asked to fill out a questionnaire on the awareness of preconception care, their frequency of self-monitoring of blood glucose (SMBG) and other related variables. Chi-squared test or chi-squared test for trend was used in comparisons of categorical variables, and logistic regression analysis was performed to assess associated factors. Results: Totally, 441 women of child-bearing age with T1DM were investigated. The results show that their awareness of preconception care was poor (15.42%, 68/441). Higher educational level (χ(2trend)=3.990, P=0.046), experience of post-diabetes education evaluation (P<0.001), and better coverage of different modules in diabetes education (survival skills: χ(2)=7.525, P=0.004; basic knowledge: χ(2)=8.598, P=0.002; advanced knowledge: P<0.001) were associated with better awareness of preconception care. The average frequency of SMBG in these participants was 0.29 (0.14, 2.00) times per day, and only 8.5% (37/435) of them reached the frequency (≥4 times per day) recommended by guidelines. Moreover, 21.1% (92/435) of them hardly ever performed SMBG. Conclusion: Child-bearing age women with T1DM in Gunangdong had poor awareness of preconception care, with a much lower SMBG frequency than recommendation.

[Clinical characteristics and classification diagnosis of newly diagnosed diabetes onset with ketosis or ketoacidosis in adult patients]

Objective: To describe the clinical characteristics and classification diagnosis of newly diagnosed diabetes onset with ketosis or ketoacidosis in adult patients. Methods: Medical records of newly diagnosed diabetes onset with ketosis or ketoacidosis in the Third Affiliated Hospital of Sun Yat-sen University between January 2011 and August 2016 were reviewed. Patients aged 18 years or older were included, while other diseases that may cause urinary ketoacidosis and special types of diabetes were excluded. Patients were classified as type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) or diabetes mellitus untyped based on discharged diagnosis, and groups were compared for differences in clinical profiles. Then the patient's medication, final diagnosis and outcome within 2 years of discharge were tracked through the inpatient and the outpatient medical record systems. Receiver operating characteristics (ROC) curves were analyzed to check the ability of clinical indicators such as onset age, body mass index (BMI) and C-peptide to discriminate T1DM from T2DM, and to find the best diagnostic cut-off points. Results: A total of 123 patients (88 males) were enrolled [with a mean age of (41.1±13.6) years old], with 37 patients (30.1%) diagnosed as T1DM, 60 patients (48.8%) diagnosed as T2DM and 26 patients (21.1%) diagnosed as Untyped. There was a statistically significant difference in onset age, BMI, blood pressure, blood gas pH and bicarbonate, blood lipids, fasting, 0.5 h and 2 h C-peptide level, any diabetic antibody and anti-glutamic acid decarboxylase antibody (GADA) positive rate, combined fatty liver ratio and family history among the three groups (all P<0.05). ROC curve analysis was performed on patients diagnosed with T1DM (n=36) and T2DM (n=87) after 2 years follow-up, and the area under the curve (AUC) of onset age, BMI, fasting C-peptide, 0.5 h and 2 h C-peptide was 0.735, 0.813, 0.855, 0.898, and 0.882, respectively. Conclusion: The ROC curve analysis indicates that C-peptide, onset age and BMI can provide effective diagnostic value, and the diagnostic value of C peptide is better than BMI and onset age.

Wastewater analysis reveals spatial pattern in consumption of anti-diabetes drug metformin in China

Metformin has been widely used as an oral drug for the treatment of diabetes mellitus. However, its consumption can be influenced by many economic and social factors. In this study, we investigated the spatial consumption pattern of metformin in China through wastewater-based epidemiology (WBE) approach. Influent wastewater samples were collected from 21 wastewater treatment plants (WWTPs) in 19 cities of the northeast China. A method using solid-phase extraction combined with N-Methyl-bis (trifluoroacetamide) derivatization for GC-MS detection was applied for metformin analysis. In 21 days, metformin showed high stability in wastewater at 24 °C and -20 °C. The mean concentrations of metformin in all WWTPs ranged from 2.42 μg L^-1 to 53.6 μg L^-1. The consumption of metformin was 0.66-15.6 mg d^-1 capita^-1 with the mean value of 5.54 ± 4.28 mg d^-1 capita^-1. The prevalence of metformin ranged from 0.09% to 2.10% with an average of 0.74%. Both the consumption and prevalence of metformin displays significant spatial variations in northeast China. A statistical correlation analysis indicated that the consumption of metformin increases with the decrease of per capita disposable income of urban residents. To further predict the use of metformin in China, we developed a regress model and depicted a consumption map. The annual consumption of urban residents in Chinese provinces range from 1085-63,828 kg yr^-1 with mean value of 25,347 kg yr^-1, which would provide a certain reference value for public health care and diabetes control.

Applying a population model based on hydrochemical parameters in wastewater-based epidemiology

Wastewater-based epidemiology combining with a population model based on hydrochemical parameters was applied in 10 wastewater treatment plants (WWTPs) in Jilin province, China. Population of WWTPs served was calculated by the model including three hydrochemical parameters ammonia nitrogen, chemical oxygen demand, and total phosphorus. The population model was constructed by using analytic hierarchy process to calculate weight factors of each hydrochemical parameters equivalent population. The size of population estimated by the model showed the highest correlations with cotinine mass load (r²=0.91, p<0.001), demonstrating better population estimation. Meanwhile daily excretion of cotinine per capita was first estimated about 0.68mg in China through liner regression analysis. In accessing the viability of the population model, the abuse of methamphetamine (METH) was calculated. Prevalence of METH use in Jilin province was calculated with an average of 0.72% based on the population model, which was similar with the result reported by United Nations World Drug Report in 2018. In assessing uncertainty of different population estimations, population model showed lower uncertainty than single hydrochemical equivalent population. These results indicate the population model based on hydrochemical parameters reduces uncertainty in population estimation and is a useful tool in monitoring illicit drug abuse.

[Glycemic control and its associated factors in children and adolescents with type 1 diabetes mellitus]

A higher frequency of SMBG is one of the key factors to achieve sufficient glycemic control among children and adolescents with T1DM treated with CSII.

Diagnostic value of transvaginal four-dimensional hysterosalpingo-contrast sonography combined with recanalization in patients with tubal infertility

Background

A retrospective study was designed to evaluate the diagnostic value of transvaginal four-dimensional hysterosalpingo-contrast sonography (TVS 4D-HyCoSy) combined with recanalization versus laparoscopy for patients with tubal infertility.

Materials and Methods

A total of 195 patients undergoing TVS 4D-HyCoSy were analyzed retrospectively. Of these, 72 patients underwent laparoscopy, which was the gold standard. The endpoints were coincidence rate (defined as a parameter consistent with results arising from TVS 4D-HyCoSy and laparoscopic examination using dye), sensitivity, specificity, positive predictive value, negative predictive value, and Youden index for TVS 4D-HyCoSy.

Results

A total of 385 fallopian tubes were assessed by TVS 4D-HyCoSy, of which 147 (38.2%) were tubal patency, 178 (46.2%) as partial tubal obstruction, and 60 (15.6%) as complete tubal obstruction. Of 195 patients, 72 patients with 144 fallopian tubes underwent laparoscopy and a total coincidence rate of 90.97% compared with TVS 4D-HyCoSy. The sensitivity, specificity, positive predictive value, negative predictive value, and Youden index for 4D-HyCoSy versus laparoscopy were 97.7%, 86.7%, 98.4%, 81.3%, and 0.84, respectively.

Conclusions

TVS 4D-HyCoSy represents a highly useful method for diagnosing tubal patency. However, further large-scale studies are warranted to investigate our findings in patients with tubal infertility.

[Diagnostic and prognostic implications of MAML2 gene translocation in primary pulmonary mucoepidermoid carcinoma]

Objective: To investigate MAML2 gene-translocation in primary pulmonary mucoepidermoid carcinoma (PMEC) and pulmanary adenosquamous carcinoma, and the optimal diagnostic immunohistiochemical (IHC) panel in distinguishing PMEC from adenosqumous carcinoma. Methods: Twenty-four cases of PMEC and 44 adenosqumous carcinoma diagnosed in the Guangdong General Hospital were tested for MAML2 translocation by fluorescent in-situ hybridization (FISH) using tissue array. An IHC panel including TTF1, Napsin A, CK5/6, p63, p40 and Ki-67 was performed on the cohort. The clinical data for all cases were collected and all PMEC patients had follow-up information. Results: The patients' age ranged form 6 to 73 years, with a median age of 32 years. The male to female ratio was 1.4∶1.0. MAML2 translocation was found in 16/24 (66.7%) cases of PMEC whereas all 44 cases adenosqumous carcinoma were negative for translocation. All the cases of the PMEC were negative for TTF1 and Napsin A but positive for CK5/6, p63 and p40 in the intermediate cells and epidermal-like cells. In most PMEC cases, the Ki-67 expression index was lower than 10%. In contrast, most cases of adenosqumous carcinomas expressed TTF1 and Napsin A in the adenomatous component and CK5/6, p63 and p40 in the squamous component, which expression pattern was different from that of PMEC. Based on IHC staining, 2 cases of highly invasive ALK-positive adenocarcinoma mimicing PMEC were also found in the study. Conclusions: MAML2 gene translocation can be detected in about two-third of PMEC. Translocation of MAML2 gene and lower morphology grading are associated with good prognosis. The combined use of IHC antibodies panel is helpful to distinguish PMEC from the adenosqumous carcinoma and adenocarcinoma mimicing PMEC.

[Pathological features of duodenal-type follicular lymphoma]

Objective: To investigate the clinicopathological features, treatment and prognosis of duodenal-type follicular lymphoma. Methods: Four cases of duodenal-type follicular lymphoma diagnosed at Guangdong General Hospital from 2014 to 2015 with detailed clinical data were included. The histomorphology, immunophenotype, treatment and prognoses were analyzed. Results: The patients' age ranged from 51 to 57 years (mean 54 years), and there were 2 males and 2 females. The involved sites were gastric fundus in one case, second portion of the duodenum in two cases and terminal ileum in one case. All patients presented with multiple mucosal granules or nodules at endoscopy. Microscopically, there were multiple mucosal neoplastic follicles, constituting grade 1-2 disease based on nodal follicular lymphoma grading system. The tumor cells were positive for CD20, CD10, bcl-6 and bcl-2. CD21 highlighted the follicular dendritic meshwork mainly at the periphery of the follicles. Proliferation index was low. Three patients received rituximab monotherapy for 4 cycles, leading to complete remission. One patient refused therapy and the disease progressed to systemic lymphoma 15 months after the initial diagnosis. Conclusions: Duodenal-type follicular lymphoma is a special variant of follicular lymphoma with indolent clinical course. The tumor exhibits morphology of low grade follicular lymphoma with characteristic dendritic meshwork at the periphery of the follicles and a low proliferation index. Prognosis is excellent. Rituximab monotherapy is treatment of choice, but a small minority of patients may progress to systemic disease.

Reduction in methamphetamine consumption trends from 2015 to 2018 detected by wastewater-based epidemiology in Dalian, China

BACKGROUND

Wastewater-based epidemiology (WBE) has become a useful tool in long-term or short-term continuous monitoring of illicit drugs consumption over the world.

METHODS

We investigated the trend of methamphetamine (METH) use between 2015 and 2018 through WBE in Dalian, a typical Chinese city. Samples were collected in 11 municipal wastewater treatment plants (WWTPs). An analytical method, solid-phase extraction combined with trifluoroacetic anhydride derivatization prior to gas chromatography-mass spectrometry (GC-MS) analysis was applied to detect METH concentrations.

RESULTS

During the sampling period, the METH concentrations increased slowly from 315 ± 243 ng/L in 2015 to 523 ± 549 ng/L in 2016, followed by a significant decrease with the concentrations 188 ± 187 ng/L in 2017 and 54.6 ± 42.9 ng/L in 2018. Ammonium nitrogen (NH₄-N) was applied to estimate population size. The average coefficient of variation for population in 11 WWTPs was 35.3 ± 8.9%, reflecting the dynamic variations of population effectively. For METH consumption, there was a gradual increase from 2015 (231 mg/day/1000 people) to 2016 (414 mg/day/1000 people) and a significant linear decrease to 2017 (206 mg/day/1000 people) and 2018 (53.9 mg/day/1000 people). The prevalence of METH increased from 2015 (0.78%) to 2016 (1.06%), then decreased to 2017 (0.55%) and 2018 (0.17%), showed similar trends with the consumption.

CONCLUSIONS

The obvious reduction trends of METH consumption via WBE over the period in Dalian provides objective evidence for declined METH consumption in local population. The reduction is probably due to the severe crack-down of illicit drugs by the government.

[Role of aquaporin-4 in the change of interstitial fluid drainage in Alzheimer's disease]

OBJECTIVE

To observe the characteristics of the interstitial fluid (ISF) drainage in the Alzheimer's disease (AD) rats through magnetic resonance imaging (MRI) tracer gadolinium-diethylene triamine pentacetic acid (Gd-DTPA)spread in the brain extracellular space (ECS) and to discuss the role of aquaporin-4 (Aqp4) in the AD.

METHODS

Wild type SD rats (300-350 g) and Aqp4 gene knock out (Aqp4^-/-) SD rats (300-350g) were divided into Sham group, AD group, Aqp4^-/--Sham group and Aqp4^-/--AD group. Sham group and Aqp4^-/--Sham group were injected with saline by intraperitoneal each day for 6 weeks, and the AD group and Aqp4^-/--AD group were injected with D-galactose by intraperitoneal each day for 6 weeks. MRI tracer Gd-DTPA (10 mmol/L, 2 μL) was injected into the hippocampus of the rats. MRI scan was performed at the end of 0.5 h, 1.5 h, 1 h, 2 h, and 3 h to observe the dynamic distribution of the Gd-DTPA in the hippocampus and the diffusion rate D^*, clearance rate k' and half-life t_1/2 measured.

RESULTS

The diffusion rate D* in Sham group was (2.66±0.36)×10^-6 mm2/s, the diffusion rate D^* in AD group was (2.72±0.62)×10-6 mm²/s, the diffusion rate D^* in Aqp4^-/--Sham group was (2.75±0.47)×10^-6 mm²/s, the diffusion rate D^* in Aqp4^-/--AD group was (2.802±0.55)×10^-6 mm²/s, and there was no statistically significant difference in the four groups (One-Way ANOVA, P>0.05).The clearance rate k' in Sham group was (4.57±0.14)×10^-4/s, the clearance rate k' in AD group was (3.68±0.22)×10^-4/s, the clearance rate k' in Aqp4^-/--Sham group was (3.17±0.16)×10^-4/s, the clearance rate k' in Aqp4^-/--AD group was (2.59±0.19)×10^-4/s, and there was significant difference in the four groups (One-Way ANOVA, P<0.05). The half-life t_1/2 in Sham group was (0.67±0.12) h, the half-life t_1/2 in AD group was (0.88±0.08) h, the half-life t_1/2 in Aqp4^-/--Sham group was (1.12±0.15) h, the half-life t_1/2 in Aqp4^-/--AD group was (1.58±0.11) h, and there was significance difference in the four groups(one-way ANOVA,P<0.05).

CONCLUSION

The ISF drainage is slow after AD and the loss of Aqp4 in the AD makes the ISF drainage obviously slow down, Aqp4 plays an important role in AD to remove the metabolism of waste out of the brain.

[Expression of βF1 and T cell receptor γ in T lymphoblastic lymphoma/leukemia]

Objective: To evaluate the expression of βF1 and T cell receptor (TCR)γ in T lymphoblastic lymphoma/leukemia(T-LBL/ALL), and investigate the clinicopathological features. Methods: Fifty-one cases of T-LBL/ALL were collected at Guangdong General Hospital from 2010 to 2016, the expression of βF1 and TCRγ was assessed by immunohistochemistry. Results: There were 13 cases of children and adolescents, and 38 cases of adults. The expression rates of βF1 and TCRγ were 27.5%(14/51) and 15.7%(8/51) respectively. The proportion of adults in αβ T-LBL/ALL, TCR-silent T-LBL/ALL and γδ T-LBL/ALL was 7/14, 79.3%(23/29)and 8/8 respectively, and the difference was significant (P=0.023). There was no statistical difference in sex, LDH, bone marrow involvement and Ann arbor stage among these three groups(P>0.05). γδ T-LBL/ALLs included 6 cases of CD4(-)/CD8(-) phenotype, whereas αβ T-LBL/ALL included 7 cases of CD4(+) /CD8(+) phenotype. There was significant difference in CD4/CD8 expression among these three groups(P<0.01). Conclusions: γδ T-LBL/ALL occurred only in adults, with predominantly CD4(-)/CD8(-) phenotype. αβ T-LBL/ALL occurred more common in children and adolescents, with predominantly CD4(+) /CD8(+) phenotype.

[Insulin regimes and impact on glycemic control in patients with type 1 diabetes]

Objective: To describe the insulin regimens and their associations with glycemic control and to explore factors associated with intensive insulin therapy. Methods: Patients with type 1 diabetes (T1DM) were recruited from Guangdong Type 1 Diabetes Mellitus Translational Medicine Study which was conducted in 16 centers in Guangdong province. The demographic and clinical data were collected. Patients were grouped according to different insulin regimens: insulin pump (R1), basal insulin plus regular insulin or short-acting insulin (R2), insulin injection 1-3 times per day (R3). Distribution of insulin regimens and the relationships between insulin regimens and hemoglobin A1c (HbA1c) were described. Multivariate logistic regression was used to identify factors associated with intensive insulin therapy. Results: A total of 1 421 patients with the age of 27.8 (19.4, 38.3) years and a duration of T1DM of 3.3 (0.5, 7.1) years were recruited. There was 12.3% of patients in R1 (n=175), 35.5% in R2 (n=504), and 52.2% in R3 (n=742), respectively. HbA1c was 8.0 (6.8, 9.3)%, 8.9 (7.1, 11.8)%, and 9.2 (7.5, 11.4)% in R1, R2, R3, respectively, and it was associated with insulin regimens (P<0.001). HbA1c target rate was 32.3%, 21.1%, 17.8% in R1, R2, R3, respectively (P=0.002). Older age (OR=1.01, P=0.027), higher education level (college or above) (OR=1.56, P=0.003), and higher household income (>30 000 yuan per year per person)(OR=1.45, P=0.009) were associated with intensive insulin therapy in adult patients. Conclusions: The study suggested that insulin therapy need to be optimized in patients with T1DM. The optimization of insulin regimens and diabetes education may be helpful for improvement of glycemic control.

Second harmonic generation from an individual amorphous selenium nanosphere

Among the numerous nonlinear optics effects, second harmonic generation (SHG) is always a hotspot and it is extensively used for optical frequency conversion, biomedical imaging, etc. However, SHG is forbidden in a medium with inversion symmetry under the electric-dipole approximation. Here, we demonstrated SHG from a single amorphous selenium (a-Se) nanosphere under near-infrared femtosecond pulse excitation. It was found that SH spectra are tunable with the size of a-Se nanospheres and the SHG efficiency of a single a-Se sphere with a diameter over 300 nm is estimated at 10(-8). We also established two physical mechanisms of SHG from the amorphous nanospheres. There is an electric-dipole contribution to the second-order nonlinearity in view of the inevitable structural discontinuity at the surface. The discontinuity of the normal component of the electric field strength leads to the quadrupole-type contributions arising from the large electric field gradient. The SHG process can be enhanced by resonance near the fundamental wavelength, giving rise to the detectable second harmonic (SH) spectra of a single a-Se nanosphere (d > 300 nm) or two small a-Se nanospheres (d = 200 nm) aggregated into a dimer, while the single nanosphere with smaller size (d > 300 nm) is undetectable. As an essential trace element for animals, a-Se features unique biological compatibility and has specific properties of optical nonlinearity within the optical window in biological tissue. This discovery makes a-Se nanospheres promising both in nonlinear optics and biomedicine.

Reducing dioxin formation by adding hydrogen in simulated fly ash

In this study, simulated fly ash containing CuO/CuCl2 was heated at 350 °C in a flow of N2 and also in a nitrogen flow containing 10 vol% H2, to evaluate the influence of hydrogen adding on dioxin formation. The total polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) output derived from the CuO sample under N2 and 10 % H2 was 7.382 and 0.708 ng/g, respectively. As for CuCl2, it was 589 and 46.1 ng/g, respectively. The results show that the hydrogen adding has a good inhibition effect on PCDD/F formation; the inhibition rate was higher than 90 % for PCDD/Fs. HCl and NH3 were detected by Gasmet in the flue gas; the probable inhibition mechanism of hydrogen reaction was proposed, based on our measurements and others' researches.

A miniature surface tension-driven robot using spatially elliptical moving legs to mimic a water strider's locomotion

The highly agile and efficient water-surface locomotion of the water strider has stimulated substantial interest in biomimetic research. In this paper, we propose a new miniature surface tension-driven robot inspired by the water strider. A key feature of this robot is that its actuating leg possesses an ellipse-like spatial trajectory similar to that of a water strider by using a cam-link mechanism. Simplified models are presented to discuss the leg-water interactions as well as critical conditions for a leg penetrating the water surface, and simulations are performed on the robot's dynamic properties. The final fabricated robot weighs about 3.9 g, and can freely and stably walk on water at different gaits. The maximum forward and turning speeds of the robot are measured as 16 cm s(-1) and 23°/s, respectively. Furthermore, a similarity analysis with Bond number and Weber number demonstrates that the locomotion of this robot is quite analogous to that of a real water strider: the surface tension force dominates the lifting force and plays a major role in the propulsion force. This miniature surface tension-driven robot might have potential applications in many areas such as water quality monitoring and aquatic search and rescue.

Magnetically induced forward scattering at visible wavelengths in silicon nanosphere oligomers

Electromagnetically induced transparency is a type of quantum interference that induces near-zero reflection and near-perfect transmission. As a classical analogy, metal nanostructure plasmonic ‘molecules' produce plasmon-induced transparency conventionally. Herein, an electromagnetically induced transparency interaction is demonstrated in silicon nanosphere oligomers, wherein the strong magnetic resonance couples with the electric gap mode effectively to markedly suppress reflection. As a result, a narrow-band transparency window created at visible wavelengths, called magnetically induced transparency, is easily realized in nearly touching silicon nanospheres, exhibiting low dependence on the number of spheres and aggregate states compared with plasmon induced transparency. A hybridization mechanism between magnetic and electric modes is proposed to pursue the physical origin, which is crucial to build all-dielectric metamaterials. Remarkably, magnetic induced transparency effect exhibiting near-zero reflection and near-perfect transmission causes light to propagate with no extra phase change. This makes silicon nanosphere oligomers promising as a unit cell in epsilon-near-zero metamaterials.

A weak and narrow electric dipole has limited the use of silicon nanospheres in nanophotonic applications requiring strong interaction between electric and magnetic modes. Here, Yan et al. demonstrate effective coupling between the magnetic resonance and the electric gap mode in nearly touching silicon nanospheres.

Analysis of volatile species kinetics during typical medical waste materials pyrolysis using a distributed activation energy model

The complex reactions of typical medical waste materials pyrolysis and the evolution of different volatile species can be well represented by a Distributed Activation Energy Model (DAEM). In this study, A thermogravimetric analyser (TGA), coupled with Fourier transform infrared analysis of evolving products (TG-FTIR), were used to perform kinetic analysis of typical medical waste materials pyrolysis. A simple direct search method was used for the determination of DAEM kinetic parameters and the yield of individual pyrolysis products under any given heating condition. The agreement between the model prediction and the experimental data was generally good. The results can be used as inputs to a pyrolysis model based on first-order kinetic expression with a Gaussian Distribution of Activation Energies as a sub-model to CFD code.

Degradation of gas-liquid gliding arc discharge on Acid Orange II

The effects of pH value, initial concentration of dye solution and temperature on the degradation efficiency of Acid Orange II (AO7) using gas-liquid gliding arc discharge were investigated. The influences of pH value and temperature on degradation efficiency were not apparent. Increasing initial solution concentration caused the decrease of degradation rate and the increase of absolute degradation quantity. Considering energy efficiency and absolute degradation quantity, the gas-liquid gliding arc discharge is fit for treating high concentration organic wastewater. A possible mineralization pathway was proposed through the analysis of intermediate products detected by gas chromatograph coupled with mass spectrophotometer (GC-MS) and ion chromatograph (IC). Hydroxyl radicals reacted with the azo linkage-bearing carbon of a hydroxy-substituted ring, leading to the cleavage of -C-N- and degradation of AO7. The solution biodegradability was significantly improved (BOD(5)/COD from 0.02 to 0.43). The toxicity of intermediate products was lower than that of the initial Acid Orange II.

Study on pyrolysis of typical medical waste materials by using TG-FTIR analysis

Pyrolysis of certain medical waste materials was studied using thermogravimetric analyzer coupled with Fourier transform infrared spectroscopy (TG-FTIR). Pyrolysis characteristics of three common materials were discussed. The pyrolysis of absorbent cotton turned out to be the most concentrative, followed by medical respirator and bamboo stick. From TG and DTG curves, pyrolysis of these three materials occurred in single, two and three stages respectively. Evolved volatile products from all these three materials included 2-butanone, benzaldehyde, formic acid, acetic acid, hydrocarbon, carbon dioxide, carbon monoxide, and water; whereas no sulphur dioxide, ammonia and hydrogen cyanide was detected. There are several differences in yield among them. However, the study in this paper is essential for medical waste pyrolysis model, the TG-FTIR approach is potential to provide valuable inputs for predictive modeling of medical waste pyrolysis. More studied are needed to get the kinetic parameters and pyrolysis models that can predict yields and evolution patterns of selected volatile products for CFD applications.

PCDD/F concentrations of agricultural soil in the vicinity of fluidized bed incinerators of co-firing MSW with coal in Hangzhou, China

The concentrations of 17PCDD/F congeners as well as tetra- to octa-homologues were determined in 33 soil samples collected within a radius of 7 km from a municipal solid waste (MSW) incineration plant that is equipped with three fluidized bed incinerators (FBIs) of co-firing MSW with coal in Hangzhou, China. The total PCDD/F concentrations ranged from 0.39 to 5.04 pg I-TEQ g(-1) (54-285 pg g(-1)), with an average and a median value of 1.22 and 0.84 pg I-TEQ g(-1) (105 and 86 pg g(-1)), respectively. A systematic decrease of PCDD/F levels was observed with the increasing distances and with the decreasing downwind frequencies from the plant. The comparisons of homologue and congener patterns and multivariate analysis of soil and flue gas samples strongly indicated that most of the soil samples were influenced by the FBIs. Apart from the incineration plant, historical PCDD/F emissions of hazardous waste incinerator (HWI) and motor vehicles as well as the application of 1,3,5-trichloro-2-(4-nitrophenoxy) benzene (CNP) seemed to play an important role in soil samples adjacent to these potential sources.

Characteristic of polychlorinated dibenzo-p-dioxins and dibenzofurans in fly ash from incinerators in china

Fly ash from municipal solid waste (MSW), medical waste (MW) and electrical power plant (EPP) incinerators were analyzed for polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). The study showed that the PCDD/F levels in fly ash were EPP<MSW<MW. The homologue profiles of PCDD/Fs in fly ash produced from waste incinerators were similar. However, the homologue profiles of PCDD/Fs in fly ash from electrostatic precipitator (ESP) of electrical power plant were different from that from waste incinerator. The strong correlation was found between the concentration of 2,3,4,7,8-PeCDF and the I-TEQ value of fly ash regardless of the different fly ashes sources.

Effects of calcium-based sorbents on PCDD/F formation from pentachlorophenol combustion process

Calcium-based sorbents are widely employed to reduce the acidic gases emission from combustion processes, and also have effects on trace organic pollutants formation and emission. Batch experiments were conducted to investigate the effects of calcium-based sorbents on pentachlorophenol (PCP) forming PCDDs/Fs during high temperature combustion processes. The results indicated that highly chlorinated PCDD/F homologues were the predominant dioxin products from PCP thermo decomposition, and only minor increasing of PCDDs happened when Ca/Cl ratio was lower than 1, while a major jump occurred when Ca/Cl ratio increased from 1 to 2. The CaO addition clearly promoted the production of all chlorinated dibenzo-p-dioxins homologue and 4-7DFs homologue. Comparison of total PCDD/F emission and its I-TEQ for three different calcium-based sorbents addition (CaO, CaCO3, basic fly ash) indicated that CaO and fly ash containing CaO had almost the same promotion effects on PCDDs/Fs originated from PCP, while CaCO3 inhibit PCDD/F formation greatly with inhibition efficiency up to 70%. Such effects may be partly proved by the observed clearly different micro-surface structures of their reaction residues. The mechanism of CaO on condensation and dechlorination reactions for PCP forming PCDDs and acid-base interaction were proposed to speculate the promotion effects of CaO, and the reaction precedence was used to speculate the inhibition effects of CaCO3 on PCDDs/Fs originated from PCP. The results of the present paper might be useful for the industrial application of calcium-based sorbents to control PCDD/F emission.

Degradation of PCDD/Fs by mechanochemical treatment of fly ash from medical waste incineration

The potential of mechanochemical treatment (MC) to degrade PCDD/Fs contained in fly ash was tested via grounding with and without calcium oxide (CaO) under atmospheric pressure. Three types of fly ash collected from medical waste incineration were compared, originating either from rotary kiln fluidized bed multi-stage incinerator using activated carbon spray (FA1, FA2), or a simple stoker incinerator without activated carbon spray (FA3). In test I: CaO to FA1 mixed at ratio of 6-60% was milled at rotational speed of 350 rpm; in test II: FA2 and FA3 without CaO were milled at rotational speed of 400 rpm. The duration of the tests was 2h. The results from the present study indicate that (1) under two test conditions of with and without CaO, PCDD/Fs contained in real fly ash both can be degraded by mechanochemical treatment, (2) under condition of blending with CaO, the degradation efficiency of PCDD/Fs increased with increasing ratio of CaO, (3) the degradation efficiency of PCDD/Fs may increase with rotational speed increasing and (4) the destruction and dechlorination are major mechanism for PCDD/Fs degradation. These results show that mechanochemical treatment is a high potential technology for PCDD/Fs degradation in fly ash.

Evaluation of PCDD/Fs emission from fluidized bed incinerators co-firing MSW with coal in China

The levels and homologue profile of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) from stack gas of three typical fluidized bed incinerators co-firing municipal solid waste (MSW) with Chinese coal were measured. The PCDD/Fs emission was in the range of 0.0054-0.1961 ng I-TEQ/N m(3). Comparison of PCDD/Fs detection results by HRGC/HRMS and HRGC/LRMS suggested that it was feasible to detect fly ash with high PCDD/Fs concentration by HRGC/LRMS. Several factors on PCDD/Fs emission were discussed. The primary reason for the lower PCDD/Fs emission was the inhibition mechanism of relatively high sulfur in feeding coal on PCDD/Fs formation. The emission results also showed that there was no directly correlation between PCDD/Fs levels and CO, O(2) and HCl concentration in flue gas. It was estimated that about 0.1034 g I-TEQ was annually emitted to atmosphere from the tested three MSW incinerators (total daily treatment capacity is 800 tonnes MSW).

Properties of pyrolytic chars and activated carbons derived from pilot-scale pyrolysis of used tires

Used tires were pyrolyzed in a pilot-scale quasi-inert rotary kiln. Influences of variables, such as time, temperature, and agent flow, on the activation of obtained char were subsequently investigated in a laboratory-scale fixed bed. Mesoporous pores are found to be dominant in the pore structures of raw char. Brunauer-Emmett-Teller (BET) surfaces of activated chars increased linearly with carbon burnoff. The carbon burnoff of tire char achieved by carbon dioxide (CO2) under otherwise identical conditions was on average 75% of that achieved by steam, but their BET surfaces are almost the same. The proper activation greatly improved the aqueous adsorption of raw char, especially for small molecular adsorbates, for example, phenol from 6 to 51 mg/g. With increasing burnoff, phenol adsorption exhibited a first-stage linear increase followed by a rapid drop after 30% burnoff. Similarly, iodine adsorption first increased linearly, but it held as the burnoff exceeded 40%, which implied that the reduction of iodine adsorption due to decreasing micropores was partially made up by increasing mesopores. Both raw chars and activated chars showed appreciable adsorption capacity of methylene-blue comparable with that of commercial carbons. Thus, tire-derived activated carbons can be used as an excellent mesoporous adsorbent for larger molecular species.

Mechanism of action of Tripterygium Wilfordii polyglycoside on experimental endometriosis

PURPOSE OF INVESTIGATION

This study was designed to examine the therapeutic effectiveness and mechanism of action of Tripterygium Wilfordii polyglycoside (TWP) in the treatment of endometriosis.

METHODS

An experimental endometriosis model was developed using New Zealand White rabbits where endometrial tissue was autotransplanted into the peritoneum. Six weeks after transplantation, a total of 22 rabbits were randomly placed into two groups: Group I (n=17) was treated with TWP (10 mg/kg/day) and Group 2 (n=5) served as the water-fed control for three successive months. The volume of endometrial implants was measured before and after administration of TWP and water. Immune and endocrine systems were investigated in the normal phase, six weeks after induction of endometriosis, and three months after TWP treatment and water administration.

RESULTS

After treatment with TWP, the average volume of endometrial implants significantly decreased (p < 0.0001), and the antiendometrial antibody (EmAb) level decreased (p < 0.05) to near normal levels, but it did not decrease in the untreated controls. Serum FSH and LH levels also decreased after TWP treatment. Furthermore, electron microscopic examination of the pituitary ultrastructure revealed morphological changes in gonadotropic cells (G-cell) after treatment with TWP, and changes gradually disappeared four weeks after withdrawal of TWP.

CONCLUSION

This study indicates that TWP has both hormonal and immune system action that is effective as a medical treatment for experimental endometriosis by modulating both reproductive endocrine functions and immunosuppression that results in remission of the disease.

Effects of aging on linear and curvilinear aiming arm movements

This research was designed to test the hypothesis that seniors may have deficits in their movement planning and execution of rapid target oriented arm movements. Twenty senior adults (M = 81.2 years, SD = 1.8) and 20 young adults (M = 25.2 years, SD = 2.5) performed two types of fast aiming arm movements (linear and curvilinear) on a digitizer in a counterbalanced order. Age effects on the variables of movement time, movement jerk, as well as on the profiles of movement displacement, velocity, and acceleration were examined. The outcomes of analysis of variance (ANOVA) with repeated measures indicated that the seniors executed both movement tasks more slowly and had higher movement jerk than the young adults. This suggests that aging is not only associated with slower but less smooth movements. In addition, the examination of movement profiles indicated that the young adults implemented the curvilinear task as one smooth and integrated motion, whereas the seniors executed the task in two segments. One possible reason of this "segmental" execution of curvilinear movement is that seniors may compensate for their deficits in movement planning by adopting a control strategy that reduces movement complexity. The aging effects on rapid aiming arm movements are discussed from the perspectives of motor planning, the "speed-accuracy trade-off," and task complexity.

Developmental features of rapid aiming arm movements across the lifespan

Using a lifespan approach, the authors investigated developmental features of the control of ballistic aiming arm movements by manipulating movement complexity, response uncertainty, and the use of precues. Four different age groups of participants (6- and 9-year-old boys and girls and 24- and 73-year-old men and women, 20 participants in each age group) performed 7 types of rapid aiming arm movements on the surface of a digitizer. Their movement characteristics such as movement velocity, normalized jerk, relative timing, movement linearity, and intersegment intervals were profiled. Analyses of variance with repeated measures were conducted on age and task effects in varying movement complexity (Study 1), response uncertainty (Study 2), and precue use (Study 3) conditions. Young children and senior adults had slower, more variant, less smooth, and less linear arm movements than older children and young adults. Increasing the number of movement segments resulted in slower and more variant responses. Movement accuracy demands or response uncertainty interacted with age so that the 6- and 74-year-old participants had poorer performances but responded similarly to the varying treatments. Even though older children and young adults had better performances than young children and senior adults, their arm movement performance declined when response uncertainty increased. The analyses suggested that young children's and senior adults' performances are poorer because less of their movement is under central control, and they therefore use on-line adjustments. In addition, older children and young adults use a valid precue more effectively to prepare for subsequent movements than do young children and senior adults, suggesting that older children and young adults are more capable of organizing motor responses than are young children and senior adults.

Movement substructures change as a function of practice in children and adults

An experiment is reported in which participants at 6 (n = 20), 9 (n = 20), and 24 years (n = 20) of age either received or did not receive practice on a rapid aiming task using the arm and hand. The purpose of the experiment was to document the changes in movement substructures (in addition to movement time) as a function of practice. After receiving 10 baseline trials, subjects in the practice groups received 30 practice trials followed by 10 retention trials on each of 5 days, while subjects in the no-practice group had only baseline and retention trials. Retention-only trials were divided into primary (reflecting the ballistic controlled part of the movement) and secondary (reflecting corrective movement adjustments) submovements. In addition, jerk (the 3rd derivative of movement displacement) was calculated as an estimate of the smoothness of the movement. Participants increased the primary submovement as a function of practice; however, the increases were substantially larger in the children (25-30%) than in the adults (10%). Participants also decreased jerk as a function of practice and the decreases were greater in children than in adults. The results suggest that with practice the primary submovement is lengthened so that it ends nearer the target, especially in children. Associated with the primary submovement covering a larger percentage of the movement length and time, movements became smoother.

Tai chi practice reduces movement force variability for seniors

BACKGROUND

The purpose of this study was to examine whether Tai Chi practice can reduce the inconsistency of arm movement force output in older adults.

METHODS

Twenty seniors took part in the 8-week-long exercise intervention program (12 in Tai Chi practice, M = 79.3 years, SD = 2.4; and 8 in a locomotor activity group, walking or jogging, M = 79.5 years, SD = 1.9). Linear and curvilinear manual aiming movements were tested at the beginning (pretest), during 4th week (retest), and the end of the exercise program (post-test). The measure of vertical pressure on the surface of a tablet served as the dependent variable.

RESULTS

The findings suggest that the Tai Chi participants significantly reduce more pressure variability than the participants in locomotor activity group after 8 weeks of practice. Additionally, seniors produced higher pressure variability in the curvilinear task than in the linear task.

CONCLUSIONS

Evidence from this study proposes that Tai Chi practice may serve as a better real world exercise for reducing force variability in older adults' manual performance.

Locomotion improves children's spatial search: a meta-analytic review

This meta-analysis quantitatively summarized the developmental influence and the effects of locomotor experience as well as the benefits of locomotor practice, locomotor assistance, and active searching patterns on children's search performance. Based on specific criteria, a search of a database and reference lists identified 19 studies, including 1,029 children (510 boys and 519 girls) from 4 to 144 months of age. Outcome measures of spatial performance were converted to 83 effect sizes that reflected the effects of specific experimental characteristics. Analyses of variance indicated that with older children, locomotor activities are more important to their spatial searching. Locomotor status, searching patterns, locomotor assistance, test conditions, and test reliability were identified as moderator variables. In addition, locomotor training significantly improved children's spatial search. The results supported the hypothesis that children's development of spatial search skills is influenced by locomotor experience.

Aging and rapid aiming arm movement control

The authors explored the motor control of target-oriented arm movements across 3 age groups: 20 20- to 30-year-olds, 2 groups (n = 38) of older adults (54 to 64, and 65 to 80). Each individual completed 2 arm movement tasks that had the same movement difficulty but different movement directions. A mixed design was used to examine the differences among age groups and movement directions in reaction time (RT), variability in RT, movement time (MT), timing variability, and inter-segment-interval (ISI). Comparing to the young participants, the senior adults initiated movement tasks slower (RT) and with more RT variability, and executed the arm movements slower and less consistently. The two older groups had greater timing variability in their movements, showed more delays (longer ISI) when reversing arm movement direction, and had lower correlations among segments of the movements than the younger group. The quality of the elderly's control of rapid aiming arm movements showed a regression, which suggests a lack of movement planning, resulting in greater use of visual feedback during movement execution.

Stereoselective in vivo and in vitro studies on the metabolism of doxepin and N-desmethyldoxepin

1. Doxepin is marketed as an irrational mixture of geometric isomers such that the more active Z-isomer comprises only 15% of the total doxepin whereas the less active E-isomer makes up the remaining 85%. 2. The ratio of isomers of the doxepin remains approximately Z:E = 15:85 in the plasma of depressed patients whereas plasma levels of the active Z-N-desmethyl metabolite are similar to those of E-N-desmethyldoxepin. 3. After examination of four animal species (dog, rabbit, guinea pig, rat), rat was closest to human in terms of the Z:E ratio of the geometric isomers of N-desmethyldoxepin excreted in the 0-24-h urine. 4. Changes in the urinary Z:E ratio of the metabolite were observed after oral but not after intravenous or intraperitoneal administration of commercial doxepin to rat. 5. There was no evidence of Z/E interconversion after administration of the pure isomers to rat in vivo, or after incubation of rat or human liver homogenates with pure isomers. 6. In vitro data suggested that the distortion of the Z:E ratio of N-desmethyldoxepin was a consequence of faster metabolism of the E-isomer in comparison with Z-N-desmethyldoxepin rather than 'enrichment' of the Z-isomer at the expense of the E-isomer.

[Pathological study on placenta from pregnancies with systemic lupus erythematosus]

Pathological study on the placenta of 18 cases of pregnancy complicated with systemic lupus erythematosus (SLE) and 23 cases of normal pregnancy was done. The average weight and placenta-villi area ratio of the placenta from pregnancy with SLE were significantly lower than those of the normal (P < 0.05). Scanning under electron microscope showed the placental villi of the SLE group slender and branching little, with their ends bean-sprout looking and the surface covered with pin-point holes, even slitted masses. Immunohistologic examination indicated deposition of IgG, IgA, IgM, C3 on the villi capillary wall surface, which suggested damage of the placental function of the SLE gravidae by the immunologic compounds.

Billings natural family planning in Shanghai, China

With cervical mucus, or Billings, method of family planning, a woman learns to recognize the characteristics of her cervical mucus that identify the fertile phase in her menstrual cycle. She and her partner abstain from sexual activity during a period from the first indication of mucus until four days after the mucus peak day, which includes ovulation. They also abstain during menses, because mucus can be confused with menstrual bleeding. This method of family planning is used widely, worldwide, by couples seeking a natural, reliable method of family planning. Between July 1988 and May 1990, 688 couples of child-bearing age, most of whom were parous, used the Billings method for contraception. Five hundred and fifty of these couples used the method for more than 12 months. Efficacy, continuation rates, and discontinuation rates were analyzed using life-table analysis for 10,175 woman-months of data collected. The net cumulative discontinuation rates per 100 women at 12 and 18 months were 19.85 and 34.58, respectively, resulting in continuation rates of 80.15 and 65.42. The discontinuation rates per 100 women for method-related reasons at 12 and 18 months were 1.61 and 2.84, respectively, while the discontinuation rates for unintended pregnancy were 1.02 and 1.18. During the study, 67 subjects volunteered to have vaginal smears taken from the upper part of the vaginal wall for cytologic examinations, and among them serum and urine LH levels were measured in 10 subjects and urinary estrogen and progesterone were assayed in 35 cases. These tests related other indications of the menstrual cycle to the ability of the women to judge ovulation by cervical mucus. Our research suggests that further investigation of the Billings method is warranted and that careful planning and organization are needed to disseminate the method more broadly.

Preliminary experience in HDR brachytherapy for 72 nasopharyngeal carcinoma patients

From April 1989 to July 1991, 72 patients with residual or recurrent nasopharyngeal carcinoma (NPC) were treated by MSH Ir-192 brachytherapy or combined external radiation therapy. All were proven histologically. 39 patients with residual disease and 6 with recurrent lesion at the primary site were identified after one or more courses of radical external radiation. Eleven patients had received brachytherapy for boost therapy after one or more courses of external radiation. Sixteen were treated with a planned protocol of external irradiation combined with intracavitary brachytherapy. The overall local control rate was 93.3%; the local control rate for residual and recurrent disease was 100% and 50%, respectively. Soft palate perforation was observed in 3 patients. Brachytherapy is believed to be a useful treatment for residual or recurrent NPC following radical external radiation.

Generation of monoclonal antibodies to bovine follicle-stimulating hormone and application in an enzyme immunoassay

Twenty monoclonal antibodies (MAbs) to bovine follicle-stimulating hormone (bFSH) were generated by using the hybridoma technique. Twelve of the MAbs have been shown to bind specifically to bFSH and seven of them were purified from the respective ascitic fluids with the methods of caprylic acid precipitation and hydroxylapatite column chromatography. The purity of the MAbs was in the range of 86-95%. Three of the purified MAbs have been coupled to horseradish peroxidase (HRP). By using a matrix cross-matching procedure, two MAbs reacted with discrete antigenic determinants are selected for a double antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA). The designed ELISA procedure could be performed within 60 min in a two-stage incubation and has a minimum sensitivity of 1ngFSH/ml. For serum samples, its mean intra- and inter-assay coefficients of variation were 3.4% and 7.3% respectively. The DAS-ELISA can be used to establish a complete FSH profile in the field of in vitro diagnosis.