[Necessities and paths to quality improvement of standardized construction of metabolic and bariatric surgery in China]

Recently, the number of severe obesity in China has now ranked first in the world. The amount of metabolic and bariatric surgery in China is increasing year by year, and has made rapid development. As more and more new hospitals, surgical teams, and physicians join the field of metabolic and bariatric surgery, suboptimal operations and managements will inevitably accompany, causing problems and hidden dangers related to bariatric surgery. To a certain extent, this is in line with the law of development, but it does not mean that we can leave it alone and let it develop. In order to ensure the sustainable, healthy and orderly development of metabolic and bariatric surgery in China in the future, the standardized construction and quality improvement have become an urgent task. This paper reviews the current status of standardized construction of metabolic and bariatric surgery at home and abroad, the necessities and paths to quality improvement of standardized construction of metabolic and bariatric surgery in China, in order to put forward some thoughts and arouse extensive discussions for the development of the subject.

Temporal Structures in Positron Spectra and Charge-Sign Effects in Galactic Cosmic Rays

We present the precision measurements of 11 years of daily cosmic positron fluxes in the rigidity range from 1.00 to 41.9 GV based on 3.4×10^{6} positrons collected with the Alpha Magnetic Spectrometer (AMS) aboard the International Space Station. The positron fluxes show distinctly different time variations from the electron fluxes at short and long timescales. A hysteresis between the electron fluxes and the positron fluxes is observed with a significance greater than 5σ at rigidities below 8.5 GV. On the contrary, the positron fluxes and the proton fluxes show similar time variation. Remarkably, we found that positron fluxes are modulated more than proton fluxes with a significance greater than 5σ for rigidities below 7 GV. These continuous daily positron fluxes, together with AMS daily electron, proton, and helium fluxes over an 11-year solar cycle, provide unique input to the understanding of both the charge-sign and mass dependencies of cosmic rays in the heliosphere.

[Analysis of the direct economic burden of measles cases and its influencing factors in Shanghai from 2017 to 2019]

Objective: To analyze the direct economic burden caused by measles cases in Shanghai from 2017 to 2019 and its influencing factors. Methods: A total of 161 laboratory-confirmed measles cases reported from January 1, 2017, to December 31, 2019, in Shanghai were included in the study through the "Measles Surveillance Information Reporting and Management System" of the "China Disease Surveillance Information Reporting and Management System". Through telephone follow-up and consulting hospital data, the basic information of population, medical treatment situation, medical treatment costs and other information were collected, and the direct economic burden of cases was calculated, including registration fees, examination fees, hospitalization fees, medical fees and other disease treatment expenses, as well as transportation and other expenses of cases. The multiple linear regression model was used to analyze the main influencing factors of the direct economic burden. Results: The age of 161 measles cases M (Q₁, Q₃) was 28.21 (13.33, 37.00) years. Male cases (56.52%) were more than female cases (43.48%). The largest number of cases was≥18 years old (70.81%). The total direct economic burden of 161 measles cases was 540 851.14 yuan, and the per capita direct economic burden was 3 359.32 yuan. The direct economic burden M (Q₁, Q₃) was 873.00 (245.01, 4 014.79) yuan per person. The results of multiple linear regression model analysis showed that compared with other and unknown occupations, central areas and non-hospitalized cases, the direct economic burden of measles cases was higher in scattered children, childcare children, students, and cadre staff in the occupational distribution, suburban areas and hospitalized, with the coefficient of β (95%CI) values of 0.388 (0.150-0.627), 0.297 (0.025-0.569), 0.327 (0.148-0.506) and 1.031 (0.853-1.209), respectively (all P values<0.05). Conclusion: The direct economic burden of some measles cases in Shanghai is relatively high. Occupation, area of residence and hospitalization are the main factors influencing the direct economic burden of measles cases.

[Research on the establishment of standard limits for perfluorooctanoic acid and perfluorooctane sulfonate in the "Standards for Drinking Water Quality（GB5749-2022）"in China]

Perfluorinated compounds, especially Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are widely detected in water environments in China. Considering the potential health risks of drinking water exposure routes, PFOA and PFOS have been added to the water quality reference index of the newly issued "Standards for Drinking Water Quality (GB5749-2022)", with limit values of 40 and 80 ng/L, respectively. This study analyzed and discussed the relevant technical contents for determining the limits of the hygiene standard, including the environmental existence level and exposure status of PFOA and PFOS, health effects, derivation of safety reference values, and determination of hygiene standard limits. It also proposed prospects for the future direction of formulating drinking water standards.

Properties of Cosmic-Ray Sulfur and Determination of the Composition of Primary Cosmic-Ray Carbon, Neon, Magnesium, and Sulfur: Ten-Year Results from the Alpha Magnetic Spectrometer

We report the properties of primary cosmic-ray sulfur (S) in the rigidity range 2.15 GV to 3.0 TV based on 0.38×10^{6} sulfur nuclei collected by the Alpha Magnetic Spectrometer experiment (AMS). We observed that above 90 GV the rigidity dependence of the S flux is identical to the rigidity dependence of Ne-Mg-Si fluxes, which is different from the rigidity dependence of the He-C-O-Fe fluxes. We found that, similar to N, Na, and Al cosmic rays, over the entire rigidity range, the traditional primary cosmic rays S, Ne, Mg, and C all have sizeable secondary components, and the S, Ne, and Mg fluxes are well described by the weighted sum of the primary silicon flux and the secondary fluorine flux, and the C flux is well described by the weighted sum of the primary oxygen flux and the secondary boron flux. The primary and secondary contributions of the traditional primary cosmic-ray fluxes of C, Ne, Mg, and S (even Z elements) are distinctly different from the primary and secondary contributions of the N, Na, and Al (odd Z elements) fluxes. The abundance ratio at the source for S/Si is 0.167±0.006, for Ne/Si is 0.833±0.025, for Mg/Si is 0.994±0.029, and for C/O is 0.836±0.025. These values are determined independent of cosmic-ray propagation.

Temporal Structures in Electron Spectra and Charge Sign Effects in Galactic Cosmic Rays

We present the precision measurements of 11 years of daily cosmic electron fluxes in the rigidity interval from 1.00 to 41.9 GV based on 2.0×10^{8} electrons collected with the Alpha Magnetic Spectrometer (AMS) aboard the International Space Station. The electron fluxes exhibit variations on multiple timescales. Recurrent electron flux variations with periods of 27 days, 13.5 days, and 9 days are observed. We find that the electron fluxes show distinctly different time variations from the proton fluxes. Remarkably, a hysteresis between the electron flux and the proton flux is observed with a significance of greater than 6σ at rigidities below 8.5 GV. Furthermore, significant structures in the electron-proton hysteresis are observed corresponding to sharp structures in both fluxes. This continuous daily electron data provide unique input to the understanding of the charge sign dependence of cosmic rays over an 11-year solar cycle.

[Paradoxical worsening after treatment of choroidal tuberculoma: a case report]

A young woman who complained of visual acuity decreased in the right eye for 12 days visited the Department of Ophthalmology. A solitary and occupancy lesion was seen in the posterior pole of the fundus of the patient's right eye, accompanied by intracranial and pulmonary tuberculosis. The diagnosis was choroidal tuberculoma, intracranial tuberculoma, and invasive pulmonary tuberculosis. After anti-tuberculosis treatment, the lesions of lung were better, but the lesions in the right eye and brain were paradoxical worsening. Finally, the lesion was calcification and absorption after combined glucocorticoid therapy.

[Effect of closed extension tube on preventing airway leakage during artificial airway clearance]

Objective: To explore the role of closed extension tube in preventing airway leakage during artificial airway clearance. Methods: The test lung was connected with a ventilator for mechanical ventilation. The pressure parameters were set as 16/5, 20/6, 24/7, 28/8, 32/9 and 36/10 cmH₂O(1 cmH₂O=0.098 kPa), respectively. The circuit was connected with an open extension tube or a closed extension tube. The ventilator was set with different pressure parameters to observe the changes of airway pressure and tidal volume during airway clearance. Results: (1) The pressure parameters were set as 16/5, 20/6, 24/7, 28/8, 32/9 and 36/10 cmH₂O, and the airway pressures (in cmH₂O) of circuit connected with open extension tube were (15.94±0.27)/(4.81±0.04), (20.09±0.23)/(6.05±0.16), (23.89±0.41)/(6.94±0.06), (27.90±0.22)/(7.71±0.18), (31.92±0.13)/(8.74±0.12)and(35.65±0.31)/(9.72±0.07), respectively.Under the same ventilator pressure parameters, the airway pressures (in cmH₂O) of circuit connected with close extension tube were (16.36±0.06)/(4.85±0.04), (20.54±0.26)/(6.44±0.12), (24.36±0.24)/(7.01±0.33), (28.69±0.25)/(8.07±0.08), (32.97±0.33)/(8.93±0.09), (37.34±0.29)/(9.75±0.08), respectively. The airway pressure of circuit connected with open extension tube was lower than that connected with closed extension tube(P<0.05);with the increase of the pressure setting of the ventilator, the difference of the airway pressure between the two extended tubes gradually increased. When the maximum inspiratory pressure of the ventilator was set 36 cmH₂O, the difference reached 1.69 cmH₂O. (2) The airway pressures (in cmH₂O) dropped from (15.94±0.27)/(4.81±0.04), (20.09±0.23)/(6.05±0.16), (23.89±0.41)/(6.94±0.06), (27.90±0.22)/(7.71±0.18), (31.92±0.13)/(8.74±0.12), (35.65±0.31)/(9.72±0.07) to (13.42±0.4)/(3.15±0.14), (16.81±0.6)/(4.30±0.14), (20.22±0.5)/(5.48±0.45), (23.73±1.4)/(6.25±0.22), (24.78±0.7)/(7.13±0.21), (20.83±0.4)/(6.61±0.19)when the suction port of the open extension tube was opened (P<0.05);and the tidal volume (in L) also decreased from 0.328±0.004, 0.580±0.012, 0.621±0.003, 0.626±0.003, 0.615±0.003, 0.603±0.002 to 0.272±0.008, 0.416±0.051, 0.487±0.047, 0.396±0.116, 0.507±0.022, 0.508±0.079, respectively (P<0.05). The decrease of airway pressure and tidal volume gradually increased with the increase of ventilator setting pressure. When the ventilator setting parameter was 36/10 cmH₂O, the decrease of airway inspiratory pressure was (14.82±0.51) cmH₂O and the maximum reduction of tidal volume was (0.164±0.021)L. (3)The airway pressure (in cmH₂O) was increased to(15.70±0.23)/(4.80±0.33), (19.01±0.81)/(5.71±0.34), (22.27±0.62)/(6.85±0.44), (25.35±2.09)/(7.94±0.16), (28.38±0.46)/(8.96±0.23), (33.34±0.71)/(9.71±0.25) when the suction tube was inserted from the suction port of the open extension tube in the open state, and the tidal volume (in L) was increased to 0.340±0.016, 0.563±0.020, 0.571±0.030, 0.556±0.026, 0.514±0.021, 0.512±0.031 as well.The airway pressure and tidal volume of the ventilation circuit were higher than those in the open state, but still lower than those in the closed state. Compared with the closed state of the suction port, the maximum pressure drop and tidal volume decrease were (3.53±0.46) cmH₂O and (0.101±0.011) L, respectively. (4) The pressure of the ventilator was set between 16/5 cmH₂O to 36/10 cmH₂O. The airway pressure (in cmH₂O) was decreased from (16.26±0.04)/(4.85±0.04), (20.74±0.15)/(6.42±0.11), (25.09±0.31)/(7.10±0.13), (29.38±0.24)/(8.17±0.09), (33.80±0.16)/(9.02±0.17), (37.89±0.19)/(9.83±0.07) to(16.36±0.06)/(4.85±0.04), (20.54±0.26)/(6.44±0.12), (24.36±0.24)/(7.01±0.33), (28.69±0.25)/(8.07±0.08), (32.97±0.33)/(8.93±0.09), (37.34±0.29)/(9.75±0.08), respectively during the insertion of the suction tube from the suction port of the closed extension tube, and the tidal volume (in L) was decreased from0.361±0.005, 0.592±0.003, 0.631±0.001, 0.642±0.007, 0.633±0.007, 0.626±0.08 to 0.335±0.005, 0.588±0.008, 0.631±0.002, 0.638±0.004, 0.628±0.004, 0.618±0.005.The maximum pressure change of the ventilation circuit was (0.83±0.27) cm H₂O and the maximum tidal volume change was (0.008±0.006)L. The changes of airway pressure and tidal volume were significantly lower than those of ventilation circuit connected with open extension tube under the same pressure parameters. Conclusion: The connection of closed extension tube in mechanical ventilation circuit can reduce the airway leakage during artificial airway clearance, which is worthy of clinical recommendation.

Properties of Daily Helium Fluxes

We present the precision measurement of 2824 daily helium fluxes in cosmic rays from May 20, 2011 to October 29, 2019 in the rigidity interval from 1.71 to 100 GV based on 7.6×10^{8} helium nuclei collected with the Alpha Magnetic Spectrometer (AMS) aboard the International Space Station. The helium flux and the helium to proton flux ratio exhibit variations on multiple timescales. In nearly all the time intervals from 2014 to 2018, we observed recurrent helium flux variations with a period of 27 days. Shorter periods of 9 days and 13.5 days are observed in 2016. The strength of all three periodicities changes with time and rigidity. In the entire time period, we found that below ∼7  GV the helium flux exhibits larger time variations than the proton flux, and above ∼7  GV the helium to proton flux ratio is time independent. Remarkably, below 2.4 GV a hysteresis between the helium to proton flux ratio and the helium flux was observed at greater than the 7σ level. This shows that at low rigidity the modulation of the helium to proton flux ratio is different before and after the solar maximum in 2014.

Fe-Mn doped powdered activated carbon pellet as ozone catalyst for cost-effective phenolic wastewater treatment: Mechanism studies and phenol by-products elimination

A novel bimetallic doped PAC (Fe-Mn/PAC) pellet was prepared with a facile sol-gel method and used as an ozone catalyst for phenolic wastewater (PWW) treatment. Adoption of Fe-Mn/PAC pellet in microbubble ozonation enhanced the 1-h chemical oxygen demand (COD) and phenol removal in PWW to 79% and 95%, respectively. With ozone dosage of 10 mg/L, 1 g/L Fe-Mn/PAC pellet exhibited ozone conversion of 92%. In comparison to microbubble ozonation process, Fe-Mn/PAC induced microbubble-catalytic ozonation process promoted ozone decomposition rate by 1.9 times. In terms of ^•OH production, Fe-Mn/PAC pellet enhanced ^•OH exposure by 10 times, with a R_ct value of 2.92 × 10 ^-8. R_ct kinetic model also suggested that Fe-Mn/PAC pellet obtained higher kinetic rate constants for initiating and promoting ^•OH generation. Usage of Fe-Mn/PAC pellet in microbubble ozonation for phenolic wastewater treatment also reduced the total ozone consumption by 70%. In Fe-Mn/PAC induced microbubble-catalytic ozonation process, the ratio between ozone consumption and COD removal (ΔO₃/ΔCOD) was 0.91. Fe-Mn/PAC pellet characterization with X-ray photoelectron spectroscopy (XPS), Fourier-transform infrared (FT-IR) and X-ray powder diffraction (XRD) analysis revealed successful doping of Fe-Mn on PAC substrate and larger numbers of carbon-oxygen/hydroxyl surface groups, which played key roles in ozone decomposition and ^•OH production.

Periodicities in the Daily Proton Fluxes from 2011 to 2019 Measured by the Alpha Magnetic Spectrometer on the International Space Station from 1 to 100 GV

We present the precision measurement of the daily proton fluxes in cosmic rays from May 20, 2011 to October 29, 2019 (a total of 2824 days or 114 Bartels rotations) in the rigidity interval from 1 to 100 GV based on 5.5×10^{9} protons collected with the Alpha Magnetic Spectrometer aboard the International Space Station. The proton fluxes exhibit variations on multiple timescales. From 2014 to 2018, we observed recurrent flux variations with a period of 27 days. Shorter periods of 9 days and 13.5 days are observed in 2016. The strength of all three periodicities changes with time and rigidity. The rigidity dependence of the 27-day periodicity is different from the rigidity dependences of 9-day and 13.5-day periods. Unexpectedly, the strength of 9-day and 13.5-day periodicities increases with increasing rigidities up to ∼10  GV and ∼20  GV, respectively. Then the strength of the periodicities decreases with increasing rigidity up to 100 GV.

[Enlightment of routine vaccination under the prevention and control of COVID-19 based on the circulating event of type Ⅲ vaccine-derived poliovirus in Shanghai]

Since the Global Polio Eradication Initiative was launched by the World Health Assembly in 1988, significant progress has been made in global polio prevention and control. But the occurrence of vaccine-associated paralytic poliomyelitis cases and vaccine-derived poliovirus related cases have become a major challenge during the post-polio era. While coronavirus disease 2019(COVID-19) has brought serious disease burden and economic burden to all countries in the world, prevention and control of vaccine-preventable infectious diseases such as polio should not be neglected under the background of the global common fight against COVID-19. Taking the type Ⅲ VDPV cycle event in Shanghai as an example, the paper discussed how to do a good job of routine inoculation under the prevention and control of COVID-19 to strictly prevent the outbreak of vaccine-preventable infectious diseases.

Reverse osmosis concentrate treatment by microbubble ozonation-biological activated carbon process: Organics removal performance and environmental impact assessment

Reverse osmosis (RO) is being used in many water reclamation facilities to produce high quality water that can be reused for different purposes. As a part of the RO process, a reject stream is produced as the reverse osmosis concentrate (ROC), which contains elevated levels of contaminants compared to the source water. Effective treatment and safe disposal of ROC via cost-effective means is very challenging. This study aims to develop a robust microbubble ozonation-biological process for industrial ROC treatment with a target effluent chemical oxygen demand (COD) lower than 60 mg/L. As compared to macrobubble ozonation, microbubble ozonation exhibited better ozone dissolution and 29% higher COD removal efficiency with the same ozone dosage. Under the optimum operating conditions with ozone dosage of 30 mg/L, ROC natural pH of 8.67 and ozonation duration of 1 h, microbubble ozonation achieved 42% COD removal efficiency while increasing the BOD₅/COD ratio (ratio of biological oxygen demand over 5 days to the corresponding chemical oxygen demand) in ROC from 0.042 to 0.216. A biological activated carbon (BAC) column with an empty bed contact time (EBCT) of 120 min was combined with microbubble ozonation for continuous ROC treatment. Over the 100-day operation, the combined system performed consistent organics removal with an average effluent COD of 45 mg/L. Both LC-OCD data and fluorescence EEM spectra confirmed humic substances were the dominant organic species in ROC. Ozone pre-treatment could achieve significant removal of humic substances in raw ROC. ATP analysis found that ozone pre-treatment enhanced BAC biofilm activity by around 5 folds. 5 min acute toxicity assessment with Aliivibrio fischeri showed 4 times reduction of bioluminescence inhibition in ozone treated ROC. From the environmental point of view, Life cycle assessment (LCA) results demonstrated that Ozone-BAC system had significant environmental burdens on climate change and human toxicity due to the electricity production process. These environmental impacts can be mitigated by optimizing the ozonation process with reduced ozone dosage or utilizing renewable energy sources for electricity generation.

Erratum: Properties of a New Group of Cosmic Nuclei: Results from the Alpha Magnetic Spectrometer on Sodium, Aluminum, and Nitrogen [Phys. Rev. Lett. 127, 021101 (2021)]

This corrects the article DOI: 10.1103/PhysRevLett.127.021101.

Simulation of FBR-Fenton/GAC process for recalcitrant industrial wastewater treatment with a computational fluid dynamics-kinetic model framework

An integrated computational fluid dynamics (CFD)-kinetic model framework was developed to numerically describe the hydrodynamic and kinetic phenomena in a liquid-solid two phases Fluidized-bed reactor Fenton/granular activated carbon (FBR-Fenton/GAC) system. The model obtained excellent accuracy for predicting chemical oxygen demand (COD) removal in reverse osmosis concentrate (ROC) treatment under different operation conditions. Hydrodynamic evaluation demonstrated that under the quasi-steady state, the GAC particles were uniformly circulated in the bed region with two pairs of counter-rotating recirculation cells, and a clear interface layer formed between the solid and the liquid phases. Superficial liquid velocity highly affected the fluidized bed expansion and solid volume fraction, while its impact on the overall COD removal efficiency was negligible. Chemical evaluation revealed that GAC/H₂O₂ catalytic reaction enhanced the ^•OH production in FBR-Fenton/GAC process by 2.7 folds as compared to homogenous Fenton process. Fenton reaction mainly occurred in the upper liquid region and its kinetics for ^•OH generation significantly diminished by 75% within the first 10 min. GAC/H₂O₂ reaction took place in the fluidized bed region for continuous ^•OH generation with a relatively stable rate from 1.21 × 10^-6 to 0.60 × 10^-6 M/s. Along the ROC treatment with FBR-Fenton/GAC process, the simulated COD degradation rate decreased along the reaction time with 2.05 × 10^-6 M/s and 2.93 × 10^-7 M/s at 2 min and 60 min, respectively. Faster COD removal was attained in the fluidized bed region due to combining effects of ^•OH oxidation and GAC adsorption. The overall predicted COD concentration reduced from 122 to 35 mg/L, ^•OH oxidation and GAC adsorption contributed 59% and 41%, respectively, to the total COD removal.

[Correlation between aspiration and long-term survival of inpatients with chronic obstructive pulmonary disease]

Objective: To retrospectively analyze the high risk factors of death in patients with chronic obstructive pulmonary disease (COPD) and to explore the influence of aspiration on the long-term survival rate of COPD patients. Methods: A retrospective analysis of clinical data of inpatients, who were admitted to the First Affiliated Hospital of Guangzhou Medical University from April 2012 to December 2013 due to COPD exacerbations and had radionuclide aspiration test, was conducted. Meanwhile, we phoned the patients' family members, whose phone numbers were recorded in the electronic patient record system, to follow up the patients' survival status, and learn the causes of death from their death records if patients died during follow-up period. Inquired the resident administration patients belonging to according to their original address to get patient's current contact information if changed. Besides, if family members of patients failed to provide death record, we should look up information concerned from the medical records room of the hospital where they died. Results: The follow-up for the last patient was performed on February 20, 2017.The time span of this study is 58 months, starting from the radionuclide aspiration test for the first patient and ending with the follow-up for the last patient. 16 of the 53 patients(16/53, 30.2%)were tested positive whose average age was slightly higher than patients without aspiration (76.0±6.8 vs 70.9±9.9), but there was no significant difference between them(P=0.064). The aspiration rates among patients over and under the age of seventy were 14/35 and 2/18 respectively, and there was a significant difference between them(P = 0.03). Compared to the aspiration-negative patients, the aspiration-positive patients had higher incidence rate of pneumonia in COPD exacerbations (11/16 vs 9/37, χ²= 9.383, P = 0.002).The major cause of death in the patients with and without aspiration were respectively severe pneumonia and pulmonary encephalopathy(P<0.05 in both cases).Among COPD patients who took radionuclide aspiration test, the median survival time of the patients with and without aspiration were about 3 and 5 years respectively. The high-risk factors influencing long-term survival of the COPD patients with aspiration included ICU-involved medical history and accompanying pneumonia. Conclusions: The incidence rate of aspiration is relatively high in COPD patients over 70 years old. Compared to COPD patients without aspiration, COPD patients with aspiration have higher incidence rate of pneumonia and shorter median survival time. ICU-involved medical history and severe pneumonia are the two high-risk factors influencing long-term survival of COPD patients with aspiration.To improve the survival time of COPD patients with aspiration, we need to attach importance to the prevention and treatment of aspiration.

[Pay attention to the mental disorders related dry eye]

The number of patients suffering from both dry eye and mental disorders (especially anxiety and depression) has risen rapidly in ophthalmic clinics. However, the mental disorders related dry eye has not received enough attention. At present, it lacks related information of basic data, and there is no standard for the clinical diagnosis and treatment. To this end, this article aims to determine the role of mental factors in the pathogenesis of dry eye, to strengthen the relevant basic and clinical research, to standardize its clinical diagnosis and treatment, and thus to promote the prevention and treatment of the mental disorder related dry eye in China.

Properties of a New Group of Cosmic Nuclei: Results from the Alpha Magnetic Spectrometer on Sodium, Aluminum, and Nitrogen

We report the properties of sodium (Na) and aluminum (Al) cosmic rays in the rigidity range 2.15 GV to 3.0 TV based on 0.46 million sodium and 0.51 million aluminum nuclei collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. We found that Na and Al, together with nitrogen (N), belong to a distinct cosmic ray group. In this group, we observe that, similar to the N flux, both the Na flux and Al flux are well described by the sums of a primary cosmic ray component (proportional to the silicon flux) and a secondary cosmic ray component (proportional to the fluorine flux). The fraction of the primary component increases with rigidity for the N, Na, and Al fluxes and becomes dominant at the highest rigidities. The Na/Si and Al/Si abundance ratios at the source, 0.036±0.003 for Na/Si and 0.103±0.004 for Al/Si, are determined independent of cosmic ray propagation.

Warm perches: a novel approach for reducing cold stress effect on production, plasma hormones, and immunity in laying hens

Cold temperature is a common environmental stressor that induces pathophysiological stress in birds with profound economic losses. Current methods used for preventing cold stress, such as reducing ventilation and using gas heaters, are facing challenges due to poor indoor air quality and deleterious effects on bird and caretaker health. The aim of this study was to examine if the novel designed warmed perch system, as a thermal device, can reduce cold stress-associated adverse effects on laying hens. Seventy-two 32-week-old DeKalb hens were randomly assigned to 36 cages arranged to 3 banks. The banks were assigned to 1 of 3 treatments: cages with warmed perches (WP; perches with circulating water at 30°C), air perches (AP, regular perches only), or no perches (NP) for a 21-d trial. The room temperature was set at 10°C during the entire experimental period. Rectal temperature and body weight were measured from the same bird of each cage at d 1, 8, 15, and 21 during the cold exposure. Egg production was recorded daily. Feed intake, egg and eggshell quality were determined during the 1st and 3rd wk of cold stress. Plasma levels of corticosterone, thyroid hormones (3, 3’, 5-triiodothyronine and thyroxine), interleukin (IL)-6 and IL-10, were determined after 1 d and 21 d of cold exposure. Compared to both AP and NP hens, WP hens were able to maintain their body temperature without increasing feed intake and losing BW. The eggs from WP hens had thicker eggshell during the 3rd wk of cold exposure. Warmed perch hens also had a lower thyroxine conversion rate (3, 3’, 5-triiodothyronine/thyroxine) at d 1, while higher plasma concentrations of IL-6 at d 21. Plasma levels of corticosterone, 3, 3’, 5-triiodothyronine, and IL-10 were not different among treatments. Our results indicate that the warmed perch system can be used as a novel thermal device for preventing cold stress-induced negative effects on hen health and welfare through regulating immunity and metabolic hormonal homeostasis.

Properties of Heavy Secondary Fluorine Cosmic Rays: Results from the Alpha Magnetic Spectrometer

Precise knowledge of the charge and rigidity dependence of the secondary cosmic ray fluxes and the secondary-to-primary flux ratios is essential in the understanding of cosmic ray propagation. We report the properties of heavy secondary cosmic ray fluorine F in the rigidity R range 2.15 GV to 2.9 TV based on 0.29 million events collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. The fluorine spectrum deviates from a single power law above 200 GV. The heavier secondary-to-primary F/Si flux ratio rigidity dependence is distinctly different from the lighter B/O (or B/C) rigidity dependence. In particular, above 10 GV, the F/Si/B/O ratio can be described by a power law R^{δ} with δ=0.052±0.007. This shows that the propagation properties of heavy cosmic rays, from F to Si, are different from those of light cosmic rays, from He to O, and that the secondary cosmic rays have two classes.

Fluidized-bed Fenton technologies for recalcitrant industrial wastewater treatment-Recent advances, challenges and perspective

In recent years, fluidized-bed Fenton (FBR-Fenton) process has gained more attention in treating recalcitrant industrial wastewater. FBR-Fenton combines the effectiveness of homogeneous Fenton and sludge reduction of heterogeneous Fenton. Comparing to other modified Fenton processes, FBR-Fenton has greater economical and scaling up potential. However, large consumption of Fenton reagents and strict pH control are still the bottlenecks hampering the full-scale application of FBR-Fenton. While prior reviews mainly focused on the operation and performance of FBR-Fenton process, the present study critically discussed the challenges and bottlenecks for its full-scale industrial application. This study also comprehensively reviewed the development strategies for tackling these drawbacks, mainly over the recent five years. Homogeneous FBR-Fenton, heterogeneous FBR-Fenton and heterogeneous FBR-photo-Fenton processes were classified for the first time according to their reaction mechanisms and system designs. Important operational and design parameters affecting the cost-effectiveness of all FBR-Fenton technologies were reviewed, including the fundamentals, common practices and even innovative steps for enhancing the process performance. Up-to-date applications of FBR-Fenton technologies in recalcitrant wastewater/compounds treatment were also summarized, and it was found that upscaling of heterogeneous FBR-Fenton and heterogeneous FBR-photo-Fenton processes was still very challenging. Strategies to overcome the key technical limitations and enhance process cost-effectiveness were discussed in the future perspective part. Furthermore, modelling techniques such as computational fluid dynamics model and artificial neural network were suggested to be promising modelling techniques for speeding up the full-scale applications of FBR-Fenton technologies.

Properties of Iron Primary Cosmic Rays: Results from the Alpha Magnetic Spectrometer

We report the observation of new properties of primary iron (Fe) cosmic rays in the rigidity range 2.65 GV to 3.0 TV with 0.62×10^{6} iron nuclei collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. Above 80.5 GV the rigidity dependence of the cosmic ray Fe flux is identical to the rigidity dependence of the primary cosmic ray He, C, and O fluxes, with the Fe/O flux ratio being constant at 0.155±0.006. This shows that unexpectedly Fe and He, C, and O belong to the same class of primary cosmic rays which is different from the primary cosmic rays Ne, Mg, and Si class.

Heating events in the nascent solar system recorded by rare earth element isotopic fractionation in refractory inclusions

Equilibrium condensation of solar gas is often invoked to explain the abundance of refractory elements in planets and meteorites. This is partly motivated, by the observation that the depletions in both the least and most refractory rare earth elements (REEs) in meteoritic group II calcium-aluminum-rich inclusions (CAIs) can be reproduced by thermodynamic models of solar nebula condensation. We measured the isotopic compositions of Ce, Nd, Sm, Eu, Gd, Dy, Er, and Yb in eight CAIs to test this scenario. Contrary to expectation for equilibrium condensation, we find light isotope enrichment for the most refractory REEs and more subdued isotopic variations for the least refractory REEs. This suggests that group II CAIs formed by a two-stage process involving fast evaporation of preexisting materials, followed by near-equilibrium recondensation. The calculated time scales are consistent with heating in events akin to FU Orionis- or EX Lupi-type outbursts of eruptive pre-main-sequence stars.

Organics removal in high strength petrochemical wastewater with combined microbubble-catalytic ozonation process

Ozonation is a well-known and widely applied advanced oxidation process (AOP) for industrial wastewater treatment, while the ozonation efficiency might be limited by low mass transfer, poor solubility, and rapid decomposition rate of ozone molecules in the aqueous phase. The present study aims to investigate the feasibility of combined microbubble-catalytic ozonation process (M-O₃/Fe/GAC) for improving the ozonation efficiency during treatment of petrochemical wastewater (PCW). M-O₃/Fe/GAC process optimization was carried out with different pH conditions, ozone dosages and catalyst loadings. The optimum operating conditions were identified as 50 mg L^-1 ozone dosage, real PCW pH (7.0-7.5) and 4 g L^-1 catalyst loading. Among different ozonation processes, M-O₃/Fe/GAC process achieved the highest chemical oxidation demand (COD) removal efficiency of 88%, which is 18% and 43% higher than those achieved by the microbubble and macrobubble ozonation processes, respectively. Phenolic compounds presented in PCW could be reduced by 63% within 15 min in M-O₃/Fe/GAC treatment process. Long-term continuous flow studies suggested M-O₃/Fe/GAC process to be the most cost-effective technology for PCW treatment with an operating cost of S$0.18 kg^-1 COD and S$0.4 m^-3 with good catalyst stability. Liquid size exclusion chromatography with organic carbon detection (LC-OCD) data suggested humic substances to be the dominant organic species in PCW, M-O₃/Fe/GAC could achieve significant humic substances removal and biodegradability enhancement in PCW. Kinetics and mechanism studies revealed that organics removal in M-O₃/Fe/GAC was 1.8 times higher than that in microbubble ozonation process, and hydroxyl radical (^●OH) was the dominant oxidant specie for organics removal in M-O₃/Fe/GAC process.

Organics removal and in-situ granule activated carbon regeneration in FBR-Fenton/GAC process for reverse osmosis concentrate treatment

Fluidized bed reactor Fenton (FBR-Fenton) process was adopted for reverse osmosis concentrate (ROC) treatment with three types of carriers, including sand, zeolite and granular activated carbon (GAC). Adsorption studies demonstrated that GAC achieved the best adsorption performance (maximum COD removal of 78% in 15 h) among the three carriers, and the adsorption of ROC organic matters followed a two-stage adsorption model. Fenton oxidations were carried out in three fluidized beds after column saturation, and FBR-Fenton/GAC process achieved highest COD removal (72%) and most BOD₅/COD ratio enhancement (from 0.03 to 0.3) in ROC. Long-term operation data demonstrated good performance stability of GAC as the carrier. In addition, GAC fluidized bed obtained highest total iron removal rate via iron crystallization process. Continuous in-situ GAC regeneration with more than 90% recoveries of surface area, pore volume and adsorption capacity were observed along the ROC treatment with FBR-Fenton/GAC process. Mechanism studies revealed that better COD removal performance in FBR-Fenton/GAC process was attributed to the combining effects of homogenous Fenton reaction, GAC adsorption and GAC/H₂O₂ catalytic reaction.

[Application and clinical study of clonal heterogeneity analysis in acute myeloid leukemia]

目的

探讨急性髓系白血病（AML）的克隆异质性特征及其临床价值。

方法

采用高通量测序技术靶向检测2016年1月至2019年6月河南省肿瘤医院收治的465例AML患者的68种相关基因，将检出的基因突变位点根据变异等位基因频率（VAF）及同期流式细胞学结果进行克隆异质性分析，并分析其与预后的关系。

结果

338例（81.4%）初诊患者检出基因突变，其中携带DNMT3A、NRAS和RUNX1突变患者出现2个及以上克隆比例显著增加（DNMT3A：χ²=15.231, P<0.001；NRAS：χ²=19.866, P<0.001；RUNX1：χ²=23.647, P<0.001）。不同年龄组间克隆数差异有统计学意义（χ²=17.505, P=0.022），其中>60岁患者携带2个和≥3个克隆的比例增加。初诊患者与复发或继发AML患者间克隆分布差异具有统计学意义（χ²=11.302, P=0.010），且患者多克隆的比例随预后危险度增加而逐渐增加（χ²=17.505, P=0.022）。而主克隆分析中，RUNX1突变标志的主克隆比例较高（χ²=4.527, P=0.033）。克隆异质性与疗效相关分析显示，携带3个及以上克隆患者的总生存（OS）期和无进展生存（PFS）期均远低于其他患者（OS：χ²=13.533，P=0.004；PFS：χ²=9.817，P=0.020），而在中危组患者中，克隆数目多的患者其PFS期显著缩短（χ²=10.883，P=0.012）。Cox回归多因素分析显示，携带3个及以上克隆为影响预后的独立危险因素，其OS期和PFS期显著短于无克隆患者（OS：HR=3.296，95%CI 1.568~6.932，P=0.002；PFS：HR=3.241，95%CI 1.411~7.440，P=0.006）。

结论

克隆异质性可反映肿瘤的生物学特性，提示其耐药性、难治性及侵袭性，可进一步用来评估疗效和AML中危组患者的预后。

[Clonal heterogeneity and its prognostic significance in acute lymphoblastic leukemia]

Objective: To explore the characteristics and clinical significance of clonal heterogeneity in patients with acute lymphoblastic leukemia(ALL). Methods: From January 2016 to June 2019, 170 newly diagnosed ALL patients were enrolled in the Department of Hematology, Henan Cancer Hospital, including 93 males and 77 females, with a median age of 17 (2-80) years. Fifty-two ALL-related genes were detected by high-throughput sequencing technique. The clonal heterogeneity of mutations was analyzed according to the variant allele frequency (VAF) and the results of flow cytometry. The prognostic value of mutations was also evaluated. Results: Gene mutations were detected in 121 (71.2%, 121/170) patients, of which 2 or more clones were detected in 18 (52.9%, 18/34) T-cell acute lymphoblastic leukemia patients, while only 23 (16.9%, 23/136) B-cell acute lymphoblastic leukemia patients were positive of multiple mutations (P<0.01).Gene mutation-related clonal heterogeneity analysis showed that 2 or more clones were frequent in patients with NOTCH1 mutations (13/19 patients) (P<0.01). Event free survival (EFS) in patients with 3 or more clones was significantly lower than other patients (χ(2)=10.330, P=0.016). Child ALL patients had similar result, that multiple clones predicted lower overall survival (OS) and EFS (OS: χ(2)=7.974, P=0.047; EFS: χ(2)=10.860, P=0.013). Conclusion: Clonal heterogeneity in ALL patients is closely related to the different origin of lymphocyte lineages and the age of onset, which may reveal the nature of the disease and predict the clinical outcome.

[Preventive medicine curriculum system in training program of clinical medicine in the era of Healthy China]

Objective: To understand the provision of preventive medicine curriculum system in the training programs of clinical medicine in the era of Healthy China. Methods: A total of 36 training programs of clinical medicine were selected from different areas of China for a statistical analysis on their basic information, involvement of concept of preventive medicine in program objectives, and provision of preventive medicine curriculum system. Results: Of all the 36 training programs of clinical medicine, 22(61%) have no mentions of prevention medicine in their program objectives; only one university's training program states preventive medicine together with basic medicine and clinical medicine as one of the three main disciplines. The total class hours for the core courses of preventive medicine (hygiene, medical statistics, epidemiology, evidence-based medicine, and social medicine) range from 80 to 252, with an average of (156.7±43.2) hours. The average percentage of class hours for preventive medicine courses among the total class hours is 4.3%±1.1% (range: 2.5%-7.5%), and obvious differences exist among universities. Conclusions: In current training programs of clinical medicine, the proportion of prevention medicine curriculum is insufficient, the percentage of hours for preventive medicine course is very low, and the differences among various universities are obvious. It is urgently needed to strengthen preventive medicine curriculum in training programs for clinical medical students in new era. It is suggested to further promote the concept of putting prevention first, improve the curriculum system of clinical medicine, intensify the integrated development preventive medicine and clinical medicine and pay attention to clinical research ability enhancement for the further improvement of training program of clinical medicine.

Properties of Neon, Magnesium, and Silicon Primary Cosmic Rays Results from the Alpha Magnetic Spectrometer

We report the observation of new properties of primary cosmic rays, neon (Ne), magnesium (Mg), and silicon (Si), measured in the rigidity range 2.15 GV to 3.0 TV with 1.8×10^{6}  Ne, 2.2×10^{6}  Mg, and 1.6×10^{6}  Si nuclei collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. The Ne and Mg spectra have identical rigidity dependence above 3.65 GV. The three spectra have identical rigidity dependence above 86.5 GV, deviate from a single power law above 200 GV, and harden in an identical way. Unexpectedly, above 86.5 GV the rigidity dependence of primary cosmic rays Ne, Mg, and Si spectra is different from the rigidity dependence of primary cosmic rays He, C, and O. This shows that the Ne, Mg, and Si and He, C, and O are two different classes of primary cosmic rays.

[Clinical analysis of gene mutation characteristics and mutation burden in myelodysplastic syndrome]

Objective: To investigate the relationship between gene mutation characteristics, mutation burden and general condition, disease subtype and karyotype of patients with myelodysplastic syndrome (MDS), and its clinical value. Methods: High-throughput sequencing was used to detect 65 blood tumor-related genes in 191 MDS patients and 9 secondary acute myelocytic leukemia patitents(SAML), and to analyze the characteristics of abnormal genes, mutation burden, as well as the relationship with disease subtypes, chromosome karyotypes and age. Results: Mutations were found in 148 patients (77.5%), including 47 abnormal genes and 186 mutation sites. And gene mutations were found in 9 SAML patients, the number of mutations was significantly higher than that in MDS patients (χ(2)=11.911, P=0.018). Among the abnormal genes, the mutation frequency of U2AF1 (37.3%) and ASXL1 (41.6%) were higher, and there were significant differences in mutation burden among different abnormal genes (F=91.946, P<0.001). There were differences in the number of gene mutations among different subtypes of MDS, and the number of EB-2 gene mutations was the highest (2.2±1.5). In SLD, MLD, EB-1 and EB-2, the proportion of carrying ≥ 3 mutations increased gradually (χ(2)=52.471, P=0.037). TP53 mutation was associated with abnormal karyotype (r(φ)=0.177, P=0.019), especially with complex karyotype (r(φ)=0.440, P<0.001), while NPM1 mutation is associated with normal karyotype (r(φ)=0.173, P=0.024). The number of mutations carried by patients under 30 years old was the least, and the number of mutations increased with the increase of age. The number of mutations was the most in patients aged 60 to 79 years old (P=0.017), and the mutation frequency of epigenetic related genes increased with the increase of age (P=0.041). Conclusions: The mutation characteristics and mutation load of MDS-related genes are closely related to clinical factors such as disease subtype, chromosome karyotype and patient age.

[The mediation mechanism of coronary artery lesions in both male and female patients with Kawasaki disease]

Objective: To explore the mediation mechanism of coronary artery lesion among both male and female Kawasaki disease (KD) children. Methods: Children with KD that hospitalized in the Wenzhou Medical University affiliated Yuying Children's Hospital from January 2009 to December 2014, were included in this study. Differences on demographical characteristics, clinical manifestations, laboratory indicators, regimen and time of treatment, results from pre/post echocardiography and treatment between male and female patients, were compared. The independent effect of gender on the risk of coronary artery lesions (CAL) was evaluated, and the mediating effect of BMI, visiting time and KD type on the association between gender and CAL were also studied. Results: The average BMI level of male patients was higher than that of female patients. The difference was statistically significant (P<0.001). The prevalence of overweight among male patients (20.9%) was higher than female (14.1%). The difference was statistically significant (P=0.011). Data from the multivariate logistic regression analysis confirmed that the incidence of CAL in male patients was higher than that in female patients (aOR=1.50, 95%CI: 1.06-2.12) but the CAL was mainly different before on the immunoglobulin therapy. Results from the mediation analysis showed that BMI was an important mediator in the association between gender and CAL, with the indirect effect as 1.05 (95%CI: 1.01- 1.10) and the proportion mediated as 13.0%. Conclusions: Male patients presented higher incidence of CAL but was mainly reflected in the difference of CAL before the treatment. BMI was probably an important mediator related to the association between gender and CAL.

[The genetic characteristics of BCR-ABL-negative myeloproliferative neoplasms]

Objective: To explore the relationship between driver gene mutation (JAK2, MPL and CALR) and disease type in BCR-ABL negative myeloproliferative neoplasms (MPNs) including primary myeloid fibrosis (PMF), essential thrombocytosis (ET) and polycythemia vera (PV). Methods: A total of 32 MPN related genes were detected by high-throughput sequencing in 156 MPN patients. The relationships between disease type and patients' general performance, the characteristics of driver gene mutations, concomitant gene mutations were analyzed. Results: In the population with JAK2 V617F positive mutation, the proportion of patients over 60 years old in PMF was higher than that with ET or PV. By high-throughput sequencing, 22 concomitant gene mutations were detected in 46 patients with JAK2, MPL or CALR mutations, including 4 (8.3%) in PV, 20 (29.4%) in ET, and 22 (55.0%) in PMF. DNMT3A mutation was detected only in patients with PV, while splicing factor related genes including SF3B1, SRSF2 and U2AF1 were only accompanied by PMF. According to the variation allele frequency (VAF) value of JAK2 V617F mutation, the VAF value associated with PV was the highest (68.15%), followed by PMF (37.7%) and ET (23%). However, there were significant differences in the incidence of JAK2 V617F homozygous among 3 different diseases. In patients with JAK2 mutation, the proportion of other gene mutations in PV and ET was significantly lower than that in PMF. Conclusions: Under the condition of common driver gene mutations (JAK2, MPL and CALR), patients' age, VAF value and homozygous state, concomitant gene mutations are closely related to different disease type. These correlations help to improve clinical understanding of disease characteristics and risk assessment.

Determination of Flumorph Residues in Vegetables, Soil, and Natural Water by Solid-Phase Extraction Cleanup and High-Performance Liquid Chromatography with UV Detection

A method for high-performance liquid chromatographic (HPLC) determination of flumorph residues in cucumber, tomato, soil, and natural water was developed and validated. Primary secondary amine or octadecylsilyl (C18) solid-phase extraction cartridges were used for sample preparation. Reversed-phase HPLC with UV detection was used for separation and quantification of the pesticide. The combined cleanup and chromatographic method steps were sensitive and reliable for simultaneous determination of residues of the 2 isomers of flumorph in the studied samples. This method is characterized by recovery &gt;97.9, coefficient of variation &lt;6.2, and limit of quantification of 0.01 mg/kg, in agreement with directives for method validation in residue analysis. Flumorph residues in the samples were further confirmed by HPLC/mass spectrometry. The proposed method is fast, easy to perform, and could be used for monitoring of pesticide residues.

Determination of Forchlorfenuron Residues in Watermelon by Solid-Phase Extraction and High-Performance Liquid Chromatography

A method using solid-phase extraction for cleanup, followed by high-performance liquid chromatography with ultraviolet detection (HPLC/UV), was developed for the determination of forchlorfenuron residues in watermelon. The pesticide is extracted from the sample with acidic acetonitrile, and the extract is loaded onto a primary-secondary amine (PSA) column. The pesticide is eluted with acetone and determined by HPLC/UV. The PSA column was found to provide effective cleanup, removing the greatest number of sample matrix interferences. The acetonitrile extraction followed by the PSA cleanup provided recoveries of &gt;95%, coefficients of variation (precision) of &lt;10%, and sensitivity of 0.005 mg/kg, in agreement with the directives for method validation in residue analysis. The proposed method was successfully used to determine forchlorfenuron residue levels and dissipation rates in watermelon grown in an experimental greenhouse in Beijing, People's Republic of China.

[The influence of additive clonal chromosome abnormalities in Ph negative cells on the efficacy of chronic myeloid leukemia]

Objective: To investigate the influence of additional clonal chromosome abnormalities in Ph negative cells (CCA/Ph(-)) on the efficacy of chronic myeloid leukemia (CML) after tyrosine kinase inhibitors (TKI) treatment. Methods: The clinical data of 28 CML patients with CCA/Ph(-) treated in Henan Cancer Hospital from July 2014 to December 2017 were analyzed retrospectively. The univariate analysis was carried out by Kaplan-Meier method. Multivariate analysis was done by Cox proportional risk model. Results: A total of 28 CCA/Ph(-)patients were recruited including 17 males and 11 females with median age of 42.5 years old. The most common CCA/Ph(-)were trisomy 8 (60.7%), monosomy 7 (14.3%). 64.3% CCA/Ph(-)were transient and 35.7% recurrent (more than 2 times). Cytopenia in two or three lineages of peripheral blood was seen in 42.9% patients. As to the efficacy, 89.3% patients achieved major cytogenetic response (MCyR), 25% with major molecular response (MMR). The median follow-up time was 26.5 months. Treatment failure (TF) of TKI occurred in 32.1% patients with median duration of response 8 (1-41) months. Univariate analysis showed that TF rate was significantly correlated with the frequency of CCA/Ph(-)and cytopenia (all P<0.05). The MMR rate was also significantly correlated with cytopenia (P<0.05). Cytopenia of two lineages or pancytopenia was an independent risk factor related to MMR rate (RR=3.868, 95%CI 1.216-12.298, P=0.022) . Conclusions: Cytopenia in CCA/Ph(-)appears to be an independent risk factor of MMR in CML patients with TKI treatment. The recurrent CCA/Ph(-)may link to higher treatment failure rate. Drug withdrawal or alternative strategy should be considered according to response and the ABL kinase mutations.

Effect of cooled perches on the efficacy of an induced molt in White Leghorn laying hens previously exposed to heat stress

This study examined the effect of water-chilled perches on hen production and physiological responses to induced molt during elevated temperatures. A total of 288White Leghorns at 82 wk of age were housed in 36 cages of 6 banks. Each bank was assigned to 1 of 3 treatments: cooled perches, air perches, and no perches. The hens were subjected to 2 heat episodes during their first laying cycle at week 21 to 35 and week 73 to 80, respectively. The hens were subjected to a 28 D nonfasted molting regimen starting at 85 wk of age. Cyclic heat of 32°C (6:00 am to 6:00 pm) was applied daily during the molting period. After molt, hens were returned to a layer diet and housed under thermoneutral condition. Two birds per cage were monitored for BW change during molt. Egg production was recorded daily. Feed utilization was measured during molt at 86 and 88 wk of age. Egg weight and eggshell traits were examined at 84 wk (pre-molt) and post-molt at 92, 96, and 104 wk of age. Rectal temperature and blood samples were collected from 2 birds per cage at the end of molt. Blood samples were used for determining heterophil/lymphocyte ratio, corticosterone, and thyroid hormones. Plumage condition was examined at 22 wk post-molt. Compared to control and air perch hens, cooled perch hens had higher feed usage and greater BW loss, lower heterophil/lymphocyte ratios (P < 0.05) with no difference in thyroid hormones and corticosterone at the end of molt. Cooled perch hens also had higher egg production beginning at 98 wk of age (Ptreatment*age < 0.0001) than control hens and sometimes the air-perch hens. Cooled perch hens had higher rectal temperature than control but not air perch hens at end of molt. Moreover, cooled perch hens had better breast feather scores than air perch hens but worse vent plumage (P ≤ 0.05) than both control and air perch hens. These results indicate that the provision of cooled perches assists hens with better adaptation to stressors, such as induced molt plus heat exposure, resulting in improved post-molt egg production.

[A comparative study of intrahepatic cholangiocarcinoma and hepatocellular carcinoma with reference to clinical features and prognosis]

Objective: To comparatively study intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) with reference to clinical features and prognosis in Chinese Han population. Methods: 699 cases of HCC and 170 cases of ICC confirmed by surgical pathological files from 2009 to 2010 were included and followed-up. The differences in demographic characteristics, hepatitis B virus infection, clinical characteristics, biochemical indexes, tumor markers and prognosis of HCC and ICC were analyzed retrospectively by means of paired t-test, analysis of variance, chi-square test and Pearson's correlation coefficient. Results: Among 869 cases of primary liver cancer, HCC and ICC accounted for 80.43% and 19.57%. The old aged (P < 0.001) male incidence of HCC was higher than that of ICC (P < 0.001). The infection rates of hepatitis B virus were 89.84% and 35.88% in HCC and ICC, respectively, and the infection rates of hepatitis B, serum HBsAg postive rate and DNA account in HCC were higher than ICC (P < 0.001). The incidence of liver cirrhosis and hepatic schistosomiasis in HCC was also significantly different from that in ICC (both P < 0.01). Pearson's correlation analysis showed that there was a significant negative correlation between HCC or ICC tumor type and hepatic schistosomiasis (r = -0.018, P < 0.001), and there was a significant positive correlation between HCC and hepatic cirrhosis (r = 0.179, P < 0.001, and r = 0.528, P < 0.001, respectively). However, the proportion of cirrhosis and schistosomiasis in hepatitis B positive ICC cases was not significantly different from that in HCC cases (P > 0.05). Among the biochemical indicators, there were significant differences between HCC and ICC in the abnormal rate of ALT(P < 0.01), AST(P < 0.05), ALP (P < 0.01), GGT (P < 0.01) and TBIL (P < 0.01) while there was no significant difference between ALB and pre-ALB (P > 0.05) in HCC and ICC groups. The content and abnormal rate of alpha-fetoprotein were higher in HCC (P < 0.01), while the content and abnormal rate of carcinoembryonic antigen and carbohydrate antigen 19-9 were higher in ICC (P < 0.01). The 10-year survival rate and median survival time (46.92% and 80.3 months) of HCC were higher than those of ICC (12.57% and 12.4 months) (P < 0.01). Conclusion: In the study population, compared with ICC cases, the old aged male HCC cases are more common and has higher infection rate of hepatitis B virus and cirrhosis, but liver schistosomiasis is less common. The inflammatory damage, secretion and metabolic function of HCC were different from that of ICC cases, while the synthetic reserve function was similar to that of ICC and the prognosis of HCC cases was significantly better. The incidence of cirrhosis and schistosomiasis in ICC cases with positive hepatitis B virus infection was not significantly different from that of HCC cases.

[Observation on safety of sequential vaccination schedule of different strain inactivated poliovirus vaccines]

Objective: To evaluate the safety of population based sequential vaccination schedule of inactivated poliovirus vaccines prepared with different strains. Methods: This randomized, parallel-group controlled trial was conducted from March, 2017 to May, 2018, in Shanghai. Adverse reaction data of Sabin strain inactivated polio vaccine (sIPV), wild strains inactivated polio vaccines (wIPV) and bivalent types Ⅰ and Ⅲ oral poliomyelitis vaccine (bOPV) were systematically collected through active observation in 1 917 infants in Shanghai after the vaccination at 2, 3, 4 months old. The eligible infants aged 2 months were divided into 4 groups: ①sIPV+sIPV+bOPV group; ②sIPV+wIPV+bOPV group; ③wIPV+sIPV+bOPV group; ④wIPV+wIPV+bOPV group. Results: The incidence of adverse reaction 30 days later after 3 basic dose vaccinations was 16.79% (946/5 633). No serious adverse reaction was reported. Local and systemic reactions were mainly mild. Common local reactions were pain, erythema, cutaneous nodule, etc.; and common systemic reactions were abnormal crying, drowsiness, diarrhea and appetite lost, etc.. The incidence of local reactions 30 days later after 3 basic dose vaccinations was 1.65% (93/5 633), and the incidence rates of grade 1-3 reactions were1.26% (71/5 633), 0.21% (12/5 633) and 0.20% (11/5 633) respectively. The incidence rate of systemic reactions 30 days later after 3 basic vaccinations was 15.14% (853/5 633), and the incidence rates of grade 1-3 reactions were 11.33% (638/5 633), 3.18% (179/5 633) and 0.64% (36/5 633) respectively. There were no significant differences in the rate of grade 3 reaction among different groups (χ(2)=4.17, P=0.24). Conclusions: No severe adverse reactions related to sequential vaccination of different strain inactivated polio vaccines were observed, most of reactions were mild and all of them were cured. It is safe to use sIPV and wIPV simultaneously or alternately for childhood sequential vaccination.

[Prognosis of clonal chromosomal abnormalities in Philadelphia negative metaphases cells in chronic myeloid leukemia with tyrosine kinase inhibitor therapy]

Objective: To investigate the characteristics and prognosis of clonal chromosomal abnormalities appearing in Philadelphia negative metaphases (CCA/Ph(-)) cells in chronic myeloid leukemia (CML) with tyrosine kinase inhibitor (TKI) therapy. Methods: The clinical data of 30 cases with CCA/Ph(-) during TKI treatment in Henan Cancer Hospital from August 2007 to July 2017 were retrospectively analyzed. The univariate factor was analyzed by Kaplan-Meier method. Multiple-factor was analyzed by Cox proportional risk model. Results: Of the 30 cases, 19 (63.3%) were males. At the first detection of CCA/Ph(-) the median age was 44 (rang 14-68) years old and the median treatment of TKI was 13 (rang 2-94) months. The clones proportion of first detected CCA/Ph(-)≥ 50% was found in 18 (60.0%) cases. TKI treatment for 3 months with BCR-ABL(IS) less than 10% was seen in 14 (46.7%) patients. 63.3% (19/30) of CCA/Ph(-) was transient (only one time) and 36.7% (11/30) was repeated (≥2 times) . Trisomy 8 dominant accounted for 60.0% (18/30) , -7/7q- for 13.3% (4/30) , loss of chromosome Y 6.7%. With a median of follow-up 50 months, 76.7% (23/30) cases were in complete cytogenetic response (CCyR) ; 63.3% (19/30) in major molecular response (MMR) , 43.3% (13/30) in undetectable minimal residual disease (UMRD) . The median event-free survival rate of (EFS) were 44 months, and 2-year and 5-year EFS were (82.1±7.3) % and (52.4±12.8) %, respectively. The median overall survival (OS) were 50 months, and 2-year and 5-year OS rates were (92.6±5.0) % and (77.2±14.7) %, respectively. Univariate analysis shows that the 2-year EFS of who in males, more than 2 times CCA/Ph(-), BCR-ABL(IS)>10% at 3 months after TKI were significantly lower than women, transient CCA/Ph(-), and BCR-ABL(IS)≤10% (P<0.05) . The 2-year OS rate in whom the occurrence frequency of CCA/Ph(-) more than twice was significantly lower than those with transient CCA/Ph(-) (P<0.05) . Multivariate analysis showed that CCA/Ph(-) was an independent risk factor (RR=4.741, 95%CI 1.21-18.571, P=0.018) for EFS in CML patients. Conclusion: Trisomy 8, -7/7q-, and -Y were the most common CCA/Ph(-) during TKI treatment, with high clones proportion of ≥50%. CCA/Ph(-) mainly occurred transiently or was permanent occasionally. CCA/Ph(-) recurrence (≥2 times) was an independent risk factor for EFS and OS in CML with TKI.

Supplementation of Bacillus subtilis-based probiotic reduces heat stress-related behaviors and inflammatory response in broiler chickens

Probiotics reduce stress-related inflammation and abnormal behaviors in humans and rodents via regulation of the microbiota-gut-brain axis. The objective of this study was to determine if probiotic, Bacillus subtilis, has similar functions in broiler chickens under heat stress (HS). Two hundred forty 1-d-old broiler chicks were assigned to 48 pens with 4 treatments: Thermoneutral (TN)-RD (regular diet), TN-PD (the regular diet mixed with 1 × 106 CFU/g feed probiotic), HS-RD and HS-PD. Probiotic (Sporulin) was fed from day 1; and HS at 32°C for 10 h daily was initiated at day 15. The data showed that final BW, average daily gain , and feed conversion efficiency were improved in PD groups as compared to RD groups regardless of the ambient temperature (P < 0.01). Heterophil to lymphocyte ratio was affected by treatment and its value was in the order of HS-RD > HS-PD > TN-RD > TN-PD birds (P < 0.01). Compared to TN birds, HS birds spent more time in wing spreading, panting, squatting close to the ground, drinking, sleeping, dozing, and sitting but spent less time in eating, standing, and walking (P < 0.05 or 0.01). In addition, HS birds had greater levels of hepatic IL-6, IL-10, heat shock protein (HSP)70, and HSP70 mRNA expression (P < 0.01) and greater levels of cecal IgA and IgY (P < 0.01) compared to TN birds. Within TN groups, TN-PD birds had greater concentrations of hepatic IL-10 (P < 0.05) and cecal IgA (P < 0.01) than TN-RD birds. Within HS groups, HS-PD birds spent less time in wing spreading, panting, squatting close to the ground, drinking, sleeping, dozing, and sitting but spent more time in eating, foraging, standing, and walking than HS-RD birds (P < 0.05 or 0.01). The HS-PD birds also had lower concentrations of hepatic IL-6 and HSP70 (P < 0.01), whereas greater levels of IL-10 (P < 0.05) and lower concentrations of cecal IgA and IgY (P < 0.01). These results indicate that broilers fed the probiotic, B. subtilis, are able to cope with HS more effectively by ameliorating heat-induced behavioral and inflammatory reactions through regulation of microbiota-modulated immunity.

Impact of UVA pre-radiation on UVC disinfection performance: Inactivation, repair and mechanism study

Ultraviolet (UV) light emission diode (LED), which is mercury free and theoretically more energy efficient, has now become an alternative to conventional UV lamps in water disinfection industry. In this research, the disinfection performance of a novel sequential process, UVA_365nm LED followed by UVC_265nm LED (UVA-UVC), was evaluated. The results revealed that the responses of different bacterial strains to UVA-UVC varied. Coupled with appropriate dosages of UVC, a 20 min UVA pre-radiation provided higher inactivations (log inactivation) of E. coli ATCC 11229, 15597 and 700891 by 1.2, 1.4 and 1.2 times, respectively than the sum of inactivations by UVA alone and UVC alone. On the contrary, the inactivation of E. coli ATCC 25922, the most UVC sensitive strain, decreased from 3 log to 1.8 log after UVA pre-radiation. A 30 min UVA pre-radiation did not affect the photo repair capacity of the four strains (n = 23, p > 0.1), but their dark repair ability was significantly inhibited (n = 14, p < 0.05). Mechanism study was conducted for two representative strains, E. coli ATCC 15597 and 25922 to understand the observed effect. The hypothesis that UVA pre-radiation promoted the yield of reactive oxygen species (ROS) was rejected. ELISA results indicated that 18% more cyclobutane pyrimidine dimers (CPD) were formed in E. coli ATCC 15597 with UVA pre-radiation (n = 3, p < 0.01), however, the CPD levels of E. coli ATCC 25922 was the same with or without UVA pre-radiation (n = 3, p > 0.01). Considering the results of both dark repair and CPD formation, it was concluded that the increased UV sensitivity of E. coli 15597 was originated from the increased CPD. For E. coli ATCC 25922, the enhanced UV resistance was attributed to the strain's adoption of a survival strategy, translesion DNA synthesis (TLS), when triggered by UVA pre-radiation. The study on UmuD protein, which is a key protein during TLS, confirmed this hypothesis.

[Effect of connecting airbag in different filling state at the front end of piezometric tube in noninvasive ventilation circuit on man-machine synchronization]

Objective: To investigate the effect of connecting airbag in different filling state at the front end of piezometric tube in the noninvasive ventilation circuit on pressure transmission and human-machine synchronization. Method: In test 1, the airbag was connected to a piezometric tube which was placed in a closed container, the filling state of the airbag was regulated, and the pressure inside the container was changed to observe the corresponding pressure change in the piezometric tube. In test 2, the airbag in different filling state was connected at the front end of piezometric tube in noninvasive ventilation circuit. Twelve subjects were connected to the ventilator such that dynamic changes in the pressure inside the mask (Pmask) and piezometric tube (Ptube) could be measured. Data with normal distribution was analyzed by t test, while data with abnormal distribution was analyzed by K-W test. Results: In test 1, the pressure inside the container changed between 0 and 50 cmH(2)O(1 cmH(2)O=0.098 kPa), when the big airbag was filled at 1/5, 2/5, 3/5, 4/5, the medium-sized airbag was filled at 3/5, 4/5, 5/5, and the small airbag was filled at 4/5, the pressure inside the piezometric tube changed synchronously with the pressure inside the container with no statistically significant difference(P>0.05). In a state of no filling in the small airbag and the medium-sized airbag, and filled at 1/5 in the small airbag, the pressure inside the piezometric tube no longer changed with the pressure in the container when the pressure reached a certain level .When the small airbag was filled at 1/5, 2/5, 3/5, 5/5, the medium-sized airbag at 1/5, 2/5, and the big airbag at 5/5, and all the airbags were in the state of no filling , the difference in the pressure between the piezometric tube and the container was statistically significant. In test 2, respiratory ventilation parameters were set on 10/4 cmH(2)O-30/14 cmH(2)O , and the connecting airbag at the front end of piezometric tube in noninvasive ventilation circuit. The platform pressure in the mask was slightly higher than that in the piezometer tube, and the baseline pressure in the mask was slightly lower than that of the piezometer tube. When the big airbag was filled at 1/5, 2/5, 3/5, 4/5 and medium-sized airbag at 2/5, 3/5, 4/5, the pressure difference between Pmask and Ptube was less than 0.5 cmH(2)O, which was acceptable clinically. When the big airbag was filled at 1/5, 2/5, 3/5 and the medium-sized airbag at 2/5, 3/5, there was no significant difference in trigger work before and after connecting the airbag at the front end of the piezometric tube(P>0.05). Conclusion: Connecting the airbag at the front end of the piezometric tube could avoid the forming of condensate in piezometric tube. The airbag showed good properties of pressure conductivity under ideal size and filling state.

Effect of salinity on medium- and low-pressure UV disinfection of Vibrio cholerae

The problem of biological invasions attributed to ballast water release is an ongoing problem that threatens ecosystems and human health. Ultraviolet (UV) radiation has been increasingly used for ballast water treatment mainly due to the advantages of short contact time and minimized harmful disinfection by products. In this study, the impact of salinity on the inactivation of Vibrio cholerae (NCTC 7253) was examined, and comparison of inactivation level and disinfection kinetics after medium-pressure (MP) (1 kW) and low-pressure (LP) (10 W) UV irradiation was made. MP UV exposure resulted in higher inactivation efficacy against V. cholerae than LP UV exposure especially at lower UV doses (≤3 mJ cm^-2) and salinity had a negative impact on both MP and LP UV disinfection, especially at higher UV doses (≥3 mJ cm^-2 for MP and ≥4 mJ cm^-2 for LP). To understand the mechanisms of salinity effect on V. cholerae, the enzyme-linked immunosorbent assay (ELISA) was employed to determine the number of cyclobutane pyrimidine dimers (CPDs), one major type of DNA damage. No significant effects of salinity were found at the CPDs level except for 3% artificial seawater after LP UV exposure case. It is imperative that site-specific conditions of salinity be taken into account in the design of UV reactors to treat V. cholerae and other species.

Residue and intake risk assessment of prothioconazole and its metabolite prothioconazole-desthio in wheat field

In the environment, plants and animals in vivo, pesticides can be degraded or metabolized to form transformation products (TPs) or metabolites, which are even more toxic than parent pesticides. Hence, it was necessary to evaluate residue and risk of pesticides and their TPs (or metabolites). Here, a rapid, simple, and reliable method using QuEChERS and LC-MS/MS had been developed for simultaneous analysis of prothioconazole and its toxic metabolite, prothioconazole-desthio, in soil, wheat plant, straw, and grain. The average recoveries of prothioconazole and prothioconazole-desthio in four matrices ranged from 86 to 108% with relative standard deviations (RSDs) of 0.53-11.87% at three spiking levels. The method was successfully applied to investigate the dissipation and terminal residues of the two compounds in wheat field. It was shown that prothioconazole was rapidly degraded to prothioconazole-desthio, with half-lives below 5.82 days. Prothioconazole-desthio was slowly dissipated in soil and plant. The terminal residues of prothioconazole in wheat grain with a pre-harvest interval (PHI) of 21 or 28 days were below the maximum residue limits (MRLs) (0.1 mg/kg, Codex Alimentarius Commission (CAC)). We also evaluated the intake risk of prothioconazole-desthio residues in wheat grain in China. For long-term intake assessment, the hazard quotients (HQ) ranged from 1.30 to 5.95%. For short-term intake assessment, the acute hazard indexes (aHI) ranged from 1.94 to 18.2%. It indicated that the intake risk of prothioconazole-desthio in wheat consumption was acceptable. Thus, the prothioconazole application on wheat with the scientific practices would not pose public health risk.

[The influence of condensate in the piezometric tube on patient ventilator interaction during noninvasive positive pressure ventilation]

OBJECTIVE

To study the effects of condensate in the piezometric tube on patient ventilator interaction during noninvasive positive pressure ventilation.

METHODS

Eleven healthy adults volunteered to receive noninvasive positive pressure ventilation. Different capacity of physiological saline was injected gradually into the piezometric tube until the volunteers could not trigger the ventilator or the total volume of the water reached 1.5 ml. The dynamic changes of the pressure of mask(Pmask), piezometric tube near mask (Ppro), piezometric tube near breathing machine(Pdis), and the flow were observed.

RESULTS

With increasing volume of saline injected, the trigger time TItri(Pmask) increased from 0.09(0.07-0.11) to 0.31(0.22-0.39)s, the trigger pressure TPtri(Pmask) increased from 0.26(0.15-0.33) to 2.29(1.76-3.09)cmH2O, and the pressure-time product PTP (Pmask) increased from 0.02(0.01-0.03) to 0.55(0.41-0.68) cmH2O·s. Ineffective triggering rate increased from 0 up to 9 times/min, and spurious triggering rate increased from 0 up to 33 times/min. The plateau pressure of Pmask and Ppro exceeded the preset parameters, increased significantly as compared with 0 ml, from (9.74±0.34)to (15.79±3.10) cmH2O and from(9.80±0.31) to(15.44±3.47) cmH2O. The change of plateau pressure of Pdis was not significant [from (9.85±0.29)to (12.58±2.64)cmH2O]. The baseline pressure of Pmask, Ppro and Pdis changed from (3.67±0.36) to (8.40±3.22) cmH2O, from (3.71±0.32) to (8.13±3.55) cmH2O and from( 3.77±0.32) to (5.36±1.25) cmH2O, respectively. The pressure fluctuation of platform of Pmask increased significantly compare with 0 ml, from 0.60(0.48-0.71) to 7.94(7.11-8.63)cmH2O. The frequency of fluctuation of platform increased as many as 7 times during a single respiratory period. The time when the pressure of the Pdis began to change was delayed to Pmask and Ppro, 0.11(0.08-0.12)s compared with 0 ml.

CONCLUSION

Condensate in the piezometric tube during noninvasive positive pressure ventilation could influence patient-ventilator synchrony. To improve patient ventilator interaction in noninvasive positive pressure ventilation, condensate in the piezometric tube should be avoided.

[Clinical outcomes of early repair for open orbital fracture]

OBJECTIVE

To investigate the clinical outcomes following early repair for orbital fracture and soft tissue simultaneously for open orbital fractures.

METHODS

Retrospective clinical study. This study comprised of 19 patients(20 eyes) with open orbital fracture who underwent surgery within 48 hours in the Second Hospital of Dalian Medical University between August 2011 and August 2014. The wounds were evaluated at the same time and the surgical debridement was done. The surgical exposure was achieved through direct approach and auxiliary cosmetic incisions. Titanium mesh and plate was used for orbital reconstruction. Local flaps or island flaps were used for soft tissue repair. With the post-operative CT scan, the condition of the soft tissue which was herniated, the orbital rim and orbital wall were observed. The measurement of the exophthalmos of both eyes was performed using Hertel exophthalmometer. Compared with the intact eye, the globe displacement (upward or downward) of the reconstructed eye was measured. The follow up duration was 12-24 months. The eye movement, diplopia, restriction of mouth opening, depression of midface, the condition of soft tissue and scar as well as post-operative complications were recorded. Comparison of the reconstructed eye's globe displacement before and after operation were analyzed with wilcoxon signed ranks test. Comparison of the exophthalmos of the reconstructed eye relative to the intact eye were analyzed with t-paired test.

RESULTS

In all 19 cases (20 eyes), fractures were anatomically reconstructed, and no cases of infection, titanium mesh and plate migration and rejection occured during the follow-up. Seven cases had eyeball hypoglobus with median 3.0 mm (min 2.0 mm, max 4.0 mm) pre-operatively. The Reconstructed eye globe were corrected in 6 cases and 1 case had residual hypoglobus of 1.0 mm ,median 0.0 mm (min 0.0 mm, max 1.0 mm). The amount of the eye globe displacement between pre-and post-operation was statistically significant(z=-2.40, P<0.05). Enophthalmos was corrected in 16 cases (the mean of posterior globe displacement in reconstructed orbit relative to intact orbit was less than or equal to 2.0mm), but in 2 patients the residual enophthalmos was 3.0 mm. The difference of the exophthalmos of both eyes was not obvious (t=-0.46,P>0.05). Among 20 eyes, 16 patients had restrictive eye movement. After 12 months follow-up, 13 eyes with restrictive eye movement were corrected while the other 3 showed improvement. Eight patients of restriction of mouth opening or midface depression were corrected and no infection complications were noted. There was no flap necrosis in 13 patients of soft tissue defect.

CONCLUSION

Surgical treatment of open orbital fractures with simultaneous repair of orbital fracture and soft tissue within 48 hours after trauma could correct enophthalmos, hypoglobus and eye movement function effectively and improve periorbital aesthetics. (Chin J Ophthalmol, 2016, 52: 273-277).

Effects of probiotics feeding on meat quality of chicken breast during postmortem storage

This study evaluated the effects of dietary probiotic supplement and postmortem storage on meat quality of chicken breast during retail display. A total of 35 birds were randomly obtained from 3 feeding groups (control without probiotic supplement, 250 ppm Sporulin, and 500 ppm PoultryStar). The probiotic supplement had no influence on feed conversion ratio and body weight gain, as well as body weight at 29 and 44 d (P > 0.05). After slaughter, each side of the breast muscles (M. Pectoralis major) was assigned to either one d or 5 d of postmortem storage. Probiotic supplement had no influence on the rate of pH decline of chicken breast muscles during the initial 6 h postmortem (P > 0.05). No interactions between probiotic supplement and postmortem storage on meat quality were found (P > 0.05). Postmortem storage decreased drip loss from 25.30 to 18.05% (P < 0.05). Probiotics-fed chicken groups, particularly PoultryStar treatment, had a higher myofibrillar fragmentation index than the control group (P < 0.05). However, shear force values were not affected by the probiotic treatments. Decreases in color and lipid stabilities of breast muscles were found during display (P < 0.05), but were not affected by the probiotic supplement (P > 0.05). Our result suggests that probiotic supplement had no adverse impacts on proteolysis and oxidative changes during 5 d postmortem display storage.

Genome-wide analysis of single nucleotide polymorphisms in patients with atrophic age-related macular degeneration in oldest old Han Chinese

The aim of this study was to identify disease-associated loci in oldest old Han Chinese with atrophic age-related macular degeneration (AMD). This genome-wide association study (GWAS) only included oldest old (≥95 years old) subjects in Rugao County, China. Thirty atrophic AMD patients and 47 age-matched non-AMD controls were enrolled. The study subjects underwent a complete ophthalmic examination. Genomic DNA was extracted from peripheral blood samples. Single nucleotide polymorphisms (SNPs) were scanned by Genome-Wide Human Mapping SNP 6.0 Arrays and GeneChip Scanner 3000 7G. The results were read and analyzed by the Affymetrix Genotyping Console software. We filtered out the SNPs with a no-call rate ≥10%, MAF P < 0.05, and HWE P < 0.001. The remaining 561,277 SNPs were included in the association analysis. We found that the following 2 SNPs had the highest association with atrophic AMD: rs7624556 (located on 3q24) and rs13119914 (located on 4q34.3). In conclusion, we identified two atrophic AMD-associated SNPs (rs7624556 and rs13119914) in an oldest old Han Chinese population. This finding may lead to new strategies for screening of atrophic AMD for Han Chinese.