Factors affecting resolution of oculomotor nerve palsy following endovascular embolization of posterior communicating artery aneurysms

PURPOSE

To investigate the effect of endovascular embolization of posterior communicating artery (Pcom) aneurysms on concomitant oculomotor nerve palsy (OMNP) and factors affecting the effect of treatment.

MATERIALS AND METHODS

Patients with the Pcom aneurysms concomitant with OMNP were retrospectively enrolled for endovascular treatment of the aneurysms. All patients had the endovascular management. The clinical effect, degree of OMNP, size of the aneurysm, type of treatment, subarachnoid hemorrhage (SAH), and time from onset to treatment were analyzed on the resolution of OMNP.

RESULTS

Ninety-six patients with 99 Pcom aneurysms were enrolled and treated endovascularly, with the success rate of 100%. Immediately after endovascular treatment, 75 aneurysms (75.75%) got complete occlusion, and 24 (24.24%) nearly complete occlusion. Followed up for 3-18 (mean 8.52±0.56) months, complete resolution of the OMNP was achieved in 63 patients (65.63%), partial resolution in 21 (21.88%), and non-recovery in the other 12 (12.50%). The degree of OMNP at onset, SAH, and time from onset to treatment were significantly (P<0.05) correlated with the resolution of OMNP. Univariate analysis revealed that younger age of the patient, degree of OMNP at onset, presence of subarachnoid hemorrhage, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP. Multivariate analysis revealed that the younger age, degree of OMNP at onset, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP.

CONCLUSION

Endovascular embolization of Pcom aneurysms concomitant with OMNP can effectively improve the OMNP symptoms, especially for patients with moderate and a shorter history of OMNP. Younger age, degree of oculomotor nerve palsy at onset, and time from onset to treatment may significantly affect recovery of oculomotor nerve palsy.

[A retrospective study of postoperative adjuvant therapy following immunotherapy combined with targeted therapy and sequential curative surgical procedures for initially unresectable hepatocellular carcinoma]

Objective: To report the clinical efficacy of adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures in patients with initially unresectable hepatocellular carcinoma. Methods: This is a retrospective case series study. Data from 100 patients who underwent adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures with long-term survival were collected from December 2018 to December 2022 at the Faculty of Hepato-Pancreato-Biliary Surgery, First Medical Center, Chinese People's Liberation Army General Hospital. According to inclusion and exclusion criteria, 47 cases were included, among which patients who met the discontinuation criteria and maintained a drug-free tumor-free status. Thirty-nine male and eight female patients were included, with an age of (54.2±18.8)years(range:38 to 73 years) at initial diagnosis. At the time of initial diagnosis, 43 cases (91.5%) were classified as Barcelona Clinic Liver Cancer(BCLC) stage C. Survival curves were made using Kaplan Meier method. Results: Forty-seven patients underwent R0 resection, all achieved a drug-free tumor-free state through postoperative adjuvant therapy based on pathological examination results. Thirty-six patients(76.6%) maintained a drug-free tumor-free survival status for more than 6 months,28 patients(59.6%) for more than 12 months,and 8 patients(17.0%) for more than 24 months. The longest drug-free tumor-free survival in this cohort reached 48 months. The median follow-up time in this study was 32 months. After diagnosis, the overall survival rates at 1- and 3- years were 97.7%(95%CI:93.4% to 100%) and 90.7%(95%CI:82.5% to 99.8%). The postoperative recurrence-free survival rates at 1- and 3- years were 91.0%(95%CI:83.0% to 99.8%) and 71.3%(95%CI:58.7% to 86.5%). Conclusions: The adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical approach provides long-term survival benefits for patients with initially unresectable hepatocellular carcinoma. Standardized adjuvant therapy maybe sustain long-term tumor-free status,and achieve drug-free tumor-free survival.

Immunocapture of cell surface proteins embedded in HIV envelopes uncovers considerable virion genetic diversity associated with different source cell types

HIV particles in the blood largely originate from activated lymphocytes and can overshadow variants which may be expressed from other cell types. Investigations of virus persistence must be able to distinguish cells refractory to viral clearance that serve as reservoirs. To investigate additional cell types that may be associated with in vivo HIV expression we developed a virus particle immunomagnetic capture method targeting several markers of cellular origin that become embedded within virion envelopes during budding. We evaluated the ability of markers to better distinguish cell lineage source subpopulations by assessing combinations of different antibodies with cell-sorted in vitro culture and clinical specimens. Various deductive algorithms were designed to discriminate source cell lineages and subsets. From the particle capture algorithms, we identified distinct variants expressed within individuals that were associated with disparate cellular markers. Among the variants uncovered were minority-level viruses with drug resistance mutations undetected by sequencing and often were associated with markers indicative of myeloid lineage (CD3-/CD10-/CD16+ or /CD14+, and CD3-/CD16-/CD14-/CD11c+ or /HLA-DR+) cell sources. The diverse HIV genetic sequences expressed from different cell types within individuals, further supported by the appearance of distinct drug-resistant variants, highlights the complexity of HIV reservoirs in vivo which must be considered for HIV cure strategies. This approach could also be helpful in examining in vivo host cell origins and genetic diversity in infections involving other families of budding viruses.

HIV Immunocapture Reveals Particles Expressed in Semen under INSTI-based Therapy are Largely Myeloid Cell-Derived and Disparate from Circulating Provirus

As use of HIV integrase strand transfer inhibitors (INSTI) increases and formulations are being developed for maintenance therapies and chemoprophylaxis, assessing virus suppression under INSTI-based regimens in prevention-relevant biologic compartments, such as the male genital tract, is timely. We used cell-source marker virion immunocapture to examine amplification of particle RNA then assessed the phylogenetic relatedness of seminal and blood viral sequences from men with HIV who were prescribed INSTI-based regimens. Seminal plasma immunocaptures yielded amplifiable virion RNA from 13/24 (54%) men, and the sequences were primarily associated with markers indicative of macrophage and resident dendritic cell sources. Genetic distances were greatest (>2%) between seminal virions and circulating proviruses, pointing to ongoing low-level expression from tissue-resident cells. While the low levels in semen predict an improbable likelihood of transmission, viruses with large genetic distances are expressed under potent INSTI therapy and have implications for determining epidemiologic linkages if adherence is suboptimal.

[A case of heritable pulmonary arterial hypertension treated with long-term oral low-dose imatinib]

Heritable pulmonary arterial hypertension (HPAH) is a rare type of pulmonary arterial hypertension that often presents with progressive exertional dyspnea and for which there is no significant effective drug. A HPAH patient was admitted to our hospital more than three years ago, and the gene mutation was bone morphogenetic protein 2 (BMPR2). For the first 45 months, she was given oral imatinib 100 mg once daily, and her symptoms and hemodynamics improved significantly, with no apparent side effects. It is reported that, in combination with the characteristics of the case and related literatures, it provides clinicians with other feasible treatment options for HPAH.

[Synchronization isolation method for multiple types of cells from mouse liver]

Objective: To explore a simple and feasible method for the isolation and purification of hepatocytes, hepatic stellate cells (HSC), and lymphocytes from mice. Methods: The cell suspension was obtained from male C57bl/6 mice by hepatic perfusion through the portal vein digestion method and then isolated and purified by discontinuous Percoll gradient centrifugation. Trypan blue exclusion was used to determine cell viability. Glycogen staining, cytokeratin 18, and transmission electron microscopy were used to identify hepatic cells. Immunofluorescence was used to detect α-smooth muscle actin combined with desmin in HSCs. Flow cytometry was used to analyze lymphocyte subsets in the liver. Results: After isolation and purification, about 2.7×10(7) hepatocytes, 5.7×10(5) HSCS, and 4.6×106 hepatic mononuclear cells were obtained from the liver of mice with a body weight of about 22g. The cell survival rate in each group was > 95%. Hepatocytes were apparent in glycogen deposited purple-red granules and cytokeratin 18. Electron microscopy showed that there were abundant organelles in hepatocytes and tight junctions between cells. HSC had expressed α-smooth muscle actin and desmin. Flow cytometry showed hepatic mononuclear cells, including lymphocyte subsets such as CD4, CD8, NKs, and NKTs. Conclusion: The hepatic perfusion through the portal vein digestion method can isolate multiple primary cells from the liver of mice at once and has the features of simplicity and efficiency.

[Research progress of radiomics in the evaluation of microvascular invasion in hepatocellular carcinoma]

Microvascular invasion (MVI) is an independent predictor of early recurrence and poor prognosis following hepatocellular carcinoma (HCC) resection and transplantation. As a novel non-invasive diagnostic tool, radiomics can extract the quantitative imaging features of tumors and peritumoral tissues with high throughput, providing more information on tumor heterogeneity than conventional and functional imaging of visual analysis and having a good application prospect in predicting the presence of MVI in HCC patients, thereby improving the accuracy of HCC diagnosis and prognosis. The value of the multimodal radiomics method based on various imaging methods in evaluating the possibility of MVI in HCC patients is elucidated here in combination with the latest research progress.

Potential role of circulating exosome miRNAs in left ventricular remodeling of patients with ST-segment elevation myocardial infarction

Background

Left ventricular remodeling (LVR) in patients with ST-segment elevation myocardial infarction (STEMI) may lead to poor prognosis in which circulating exosome miRNAs play a critical role. The aim of the present study is to identify specific exosome miRNAs for LVR in patients with STEMI.

Method

Plasma exosome miRNAs were assessed in 20 patients (90% male, mean age of 66.95±1.65 years) 3–6 months after STEMI and 24 healthy individuals (83% male, mean age of 33.2±0.93 years) by using qPCR. Of the 20 patients, 8 had post-STEMI LVR according to echocardiographic evaluation, and the others did not. Clinical biochemical data including total cholesterol, HDL-C, LDL-C, LDH and NT-pro-BNP were collected from the patients with STEMI at same time as exosome miRNAs assessment. Specific exosome miRNAs for LVR were identified by using qPCR. Correlations between the dysregulated exosome miRNAs and the clinical biochemical parameters in patients with STEMI were analyzed using spearman correlation test.

Results

Five exosome miRNAs including hsa-miR-181a-3p (p&lt;0.05, fold change = 0.59), let-7d-3p (p=0.01, fold change = 0.51), hsa-miR-224-5p (p&lt;0.01, fold change = 0.11), hsa-miR-23a-3p (p&lt;0.01, fold change = 1.42) and miR-874-3p (p&lt;0.01, fold change = 0.48) were dysregulated in the post-STEMI patients comparing with the healthy individuals. Among them, the exosome miR-181a-3p (p=0.01, fold change = 0.09) and let-7d-3p (p=0.01, fold change = 0.16) were significantly lower expressed in patients with LVR compared to those without (Figure 1). There was no significant difference in expression of the other three miRNAs between patients with and without LVR. Exosome hsa-miR-874-3p positively associated with LDH (p&lt;0.01, r=0.50) in all the patients with STEMI. In vitro cell culture confirmed that the miR-874-3p mimics upregulated expression of apoptosis related gene BMF (p&lt;0.05, fold change = 1.7) in cardiomyocyte. Exosome hsa-miR-23a-3p and hsa-miR-224-5p positively correlated with both HDL-C (p&lt;0.01, r=0.61; p=0.02, r=0.50) and LDL-C (p=0.02, r=0.50; p&lt;0.05, r=0.52) in all patients with STEMI. No correlation between the dysregulated exosome miRNAs and cholesterol or NT-ProBNP was observed (Figure 2).

Conclusions

Circulating exosome miR-181a-3p and let-7d-3p might play a potential role in LVR in patients 3–6 months after STEMI. Exosome hsa-miR-874-3p might be associated with cardiomyocyte injury. Hsa-miR-23a-3p and hsa-miR-224-5p demonstrated an activity in regulation of lipid metabolism and biosynthesis in patients with STEMI.

Funding Acknowledgement

Type of funding sources: Public hospital(s). Main funding source(s): This work was supported by grants from the 3×3 Clinical Scientist Fund of Sun Yat-sen Memorial Hospital

[Mechanical analysis of the impact of the morphology of the iris and ciliary body on the central vault after posterior chamber phakic intraocular lens implantation]

Objective: To investigate the impact of the iris and ciliary body morphology on the central vault after phakic posterior chamber intraocular lens (pIOL) implantation. Methods: This research was based on the retrospective analysis of 123 patients (123 eyes) who underwent pIOL implantation in the Department of Ophthalmology, Affiliated Hospital of Qingdao University between June 2018 and June 2020. The anterior segment structure was observed with an ultrasound biomicroscope before surgery, and all morphological parameters of the iris and ciliary body were measured manually using the ImageJ software, including iris span (IS), iris convexity (IC), iris-ciliary body contact distance (ICCD) and iris-lens contact distance (ILCD). The ICCD was divided into Q1, Q2 and Q3 groups according to the equidistant distance of 0.36 mm. The lens thickness was measured with the IOLMaster. The horizontal corneal diameter and anterior chamber depth were measured using the Pentacam. The central vaults were measured by optical coherence tomography at 1 week, 3 months and 1 year after surgery. The relationships between vault values and preoperative parameters of the anterior segment were evaluated using the Pearson correlation analysis, Spearman correlation analysis, and multiple linear regression. The repeated measures ANOVA was applied to identify changes of vault values over time. Results: The mean values of the vaults at 1 week, 3 months and 1 year after surgery were (723±265) μm, (642±255) μm and (613±280) μm, respectively. The difference among them was statistically significant (F=50.143, P<0.001). The vaults continued to decline within 1 year after pIOL implantation, and the total decline was (122±86) μm. The vaults declined by (69±98) μm from postoperative 1 week to 3 months and by (52±54) μm from postoperative 3 months to 1 year. The regression formula showed that the pIOL size and ILCD were positively related with the vault, while the LT, IS and IC were negatively related with the vault at 1 week postoperatively (adjusted R²=0.404, P<0.001). The pIOL size and ILCD were positively related with the vault, while the IS and IC were negatively related with the vault at 3 months postoperatively (adjusted R²=0.342, P<0.001). The pIOL size was positively related with the vault, while the IS and IC were negatively related with the vault at 1 year postoperatively (adjusted R²=0.661, P<0.001). The vault values were higher in group Q3 compared to group Q1 at every timepoint, and the vault value was higher in group Q2 compared to Q1 at 1 year postoperatively. Conclusions: In the early postoperative period, eyes with a larger pIOL, shorter iris span, longer contact distance between the iris and ciliary body, and longer contact distance between the iris and lens were associated with a higher rate of excessive vaults. Meanwhile, eyes with a thicker lens and larger iris reverse convexity were more likely to obtain insufficient vaults. Within one year after surgery, the pIOL size, IS, IC and ICCD continued to impact on the vault. The ICCD, ILCD and IC can reflect the posterior chamber volume and change the haptic location and force, thus affecting the vault.

[Study on the effect of AIDS preventive cascade services provided by social organizations for men who have sex with men in China]

Objective: To analyze the effect and main gaps of each stage in the AIDS prevention cascade for men who have sex with men (MSM) provided in intervention projects supported by the China AIDS Fund for non-governmental organizations (CAFNGO) and provide suggestions to improve the quality of cascade services and project management. Methods: Data were collected through the CAFNGO management information system and field interviews to analyze the differences in the number of MSM receiving HIV testing and confirming tests, the newly reported patients, and the number of antiviral treatment (ART) referrals of newly established reported patients among different social organization service areas. A service chain chart was also drawn. Results: Between 2016 and 2020, 1 508 MSM intervention projects were funded by CAFNGO, including 1 183 234 MSM being mobilized to receive HIV testing. However, only 68.8% (1 183 234/1 719 139) of the testing capacity of social organizations was covered by these projects. As a result, 55 783 HIV-positive MSM were detected in preliminary screening, and only 86.6% (48 327/55 783) received confirming tests. The proportion of newly reported infections was 3.8% (45 347/1 183 234). The ratio of antiviral treatment (ART) referrals for newly reported patients between 2017 and 2020 was 89.8% (32 719/36 444). 75.8%(1 143/1 508) of total MSM intervention projects were implemented by community-based organizations (Non-registered civil affairs departments). In comparison, organizations registered in civil affairs departments took up 24.2% (365/1 508) of the total MSM intervention projects. No significant difference was noticed in the proportion of newly reported infected (3.8% and 3.8%) and the ratio of ART referrals (89.7% and 89.9%) between community-based organizations and registered organizations' projects. But these two proportions are significantly different between these two types of organizations in some areas in China. Conclusions: The AIDS prevention cascade established in CAFNGO has effectively promoted the early detection and treatment of infected MSM. However, CAFNGO needs more financial support to extend testing coverage for MSM. Meanwhile, confirmation testing for positives in preliminary screening and ART referrals needs to be improved for newly reported patients. In addition, various capacity building needs to be provided for different social organizations.

The Effect of Kangaroo Mother Care After Duodenal Obstruction in Neonates

Objective

The present study aimed to explore the effectiveness of clinical application of kangaroo mother care (KMC) in neonates after surgery for duodenal obstruction in achieving total enteral nutrition (TEN) and shortening the length of hospital stay.

Methods

A prospective study of 60 cases of surgery for duodenal obstruction in pediatric patients in the neonatal intensive care unit of Kunming Children's Hospital between January 2018 and December 2019 was conducted. The study subjects included 15 cases with intestinal malrotation, 18 cases with circular pancreas, 10 cases with a duodenal septum, and 17 cases with duodenal atresia or duodenal stenosis. According to the single and double numbers of the operation date, the subjects were randomly divided into the control group and observation group, with 30 cases in each group. The conventional care of enhanced recovery after surgery (ERAS) was carried out in the control group, and KMC based on ERAS conventional care was implemented in the observation group. The difference in the duration to achieve TEN and the length of hospital stay between the two groups of patients after care was compared and analyzed.

Results

The average duration to achieve TEN for neonates with duodenal obstruction in the control group was 14.23 ± 3.17 days, while that in the observation group was 12.27 ± 1.15 days. The average length of hospital stay in the control group was 17.22 ± 4.71 days, while that in the observation group was 13.34 ± 2.70 days. There was a significant difference in the duration to achieve TEN and the average length of hospital stay between the two groups (P < 0.05). The duration to achieve TEN and the length of hospital stay in pediatric patients were significantly shorter in the observation group than in the control group.

Conclusion

Kangaroo mother care has important clinical significance and application value in shortening the duration to achieve TEN and the length of hospital stay in neonates after surgery for duodenal obstruction.

Factors affecting resolution of oculomotor nerve palsy following endovascular embolization of posterior communicating artery aneurysms

PURPOSE

To investigate the effect of endovascular embolization of posterior communicating artery (Pcom) aneurysms on concomitant oculomotor nerve palsy (OMNP) and factors affecting the effect of treatment.

MATERIALS AND METHODS

Patients with the Pcom aneurysms concomitant with OMNP were retrospectively enrolled for endovascular treatment of the aneurysms. All patients had the endovascular management. The clinical effect, degree of OMNP, size of the aneurysm, type of treatment, subarachnoid hemorrhage (SAH), and time from onset to treatment were analyzed on the resolution of OMNP.

RESULTS

Ninety-six patients with 99 Pcom aneurysms were enrolled and treated endovascularly, with the success rate of 100%. Immediately after endovascular treatment, 75 aneurysms (75.75%) got complete occlusion, and 24 (24.24%) nearly complete occlusion. Followed up for 3-18 (mean 8.52±0.56) months, complete resolution of the OMNP was achieved in 63 patients (65.63%), partial resolution in 21 (21.88%), and non-recovery in the other 12 (12.50%). The degree of OMNP at onset, SAH, and time from onset to treatment were significantly (P<0.05) correlated with the resolution of OMNP. Univariate analysis revealed that younger age of the patient, degree of OMNP at onset, presence of subarachnoid hemorrhage, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP. Multivariate analysis revealed that the younger age, degree of OMNP at onset, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP.

CONCLUSION

Endovascular embolization of Pcom aneurysms concomitant with OMNP can effectively improve the OMNP symptoms, especially for patients with moderate and a shorter history of OMNP. Younger age, degree of oculomotor nerve palsy at onset, and time from onset to treatment may significantly affect recovery of oculomotor nerve palsy.

[Treatment efficiency evaluation of left cardiac sympathetic denervation for patients with inherited arrhythmia by exercise-stress test]

Objective: To evaluate the efficiency of left cardiac sympathetic denervation (LCSD) in inherited arrhythmia patients with adrenergic activity-induced malignant ventricular arrhythmia, and observe exercise-stress test features before and after LCSD. Methods: This retrospective observational study included catecholaminergic polymorphic ventricular tachycardia(CPVT) and long QT syndromes(LQTS) patients who underwent video-assisted LCSD at Beijing Tsinghua Changgung Hospital and Peking University People's Hospital from September 2006 to May 2020. The indications for LCSD surgery were intolerant or refractory to beta-blocker medication. Clinical and exercise-stress tests data of included patients were collected before and 1 month after LCSD. Heart rate, exercise tolerance, atrial and ventricular arrhythmia, QTc interval and predictors for sudden cardiac death were analyzed. Patents were regularly followed up at 1, 3, 6, and 12 months after LCSD and then once every year thereafter. Cardiac events and medication adjustment records were collected. Results: Five patients (2 CPVT, 1 LQT1, and 2 LQT2)were included in the study. All patients experienced syncope as first symptom at the median age of 12(10, 16)years, and underwent LCSD at the median age of 21(16, 26)years, Baseline heart rate was similar before and after LCSD ((65.6±6.5) beats/min vs. (68.0±11.1) beats/min, P=0.57); while maximum workload tended to be lower after LCSD ((12.1±2.8) metabolic equivalents (METS) before surgery vs. (10.5±2.4) METS after surgery, P=0.07). Incidence of atrial and ventricular arrhythmia were significantly reduced post LCSD, and the ventricular arrhythmia score was decreased after LCSD in CPVT patients (4 points before LCSD vs. 3 points after LCSD in case 1;5 points before LCSD vs. 3 points after LCSD in case 2). QTc interval was shortened significantly in three LQTs patients (QTc interval at baseline heart rate: (546.6±72.3) ms before surgery vs. (493±61.1) ms after LCSD, P=0.047; QTc interval at maximal exercise heart rate: (516.3±73.7) ms before surgery vs. (486.7±64.2)ms after LCSD, P=0.035). Additionally, sudden cardiac death risk indicator ΔHRR1 (heart rate decreasing value within the first 1 min during recovery phase) decreased from (51.5±21.1) beats/min before surgery to (32.0±13.9) beats/min after surgery (P=0.035). During a median follow-up of 1(1, 4) year, all five patients were on low dosage of propranolol (37.0±21.7) mg/d. Cardiac events free survival was achieved in four out of 5 patients (80%) after sympathectomy, while 1 case suffered from sudden cardiac death after emotional stress. Conclusion: LCSD surgery can be safely and effectively performed in most hereditary arrhythmia patients with adrenergic activity-induced life-threatening cardiac events. Exercise stress test results show that LCSD could reduce malignant arrhythmias and improve sudden cardiac death risk indicators without decreasing heart rate.

[Effect of axillary lymph node status on prognosis of different types of invasive breast cancer]

Objective: To investigate the effect of axillary lymph node status on the prognosis of different types of invasive breast cancer. Methods: Patients with invasive breast cancer of different molecular subtypes diagnosed in the breast cancer prevention and treatment center of Beijing Cancer Hospital from January 2000 to July 2011 were collected as a historical cohort, and the influence of lymph node status on the prognosis of different types of breast cancer was analyzed. Results: A total of 4 269 female breast cancer patients with molecular subtypes [aged (50.8±11.2) years] information and 3 824 female breast cancer patients with complete axillary lymph node status information [aged (50.5±10.9) years] were included in the study, including 3 135 cases with both molecular subtypes and lymph node status information. The 10-year event free survival (EFS) rates of hormone receptor (HR)⁺/human epidermal growth factor receptor-2(HER2)^-, HR^-/HER2^-and HER2⁺were 82.2%, 79.0% and 76.8%, respectively; the 10-year overall survival (OS) rates were 88.1%, 83.1% and 84.4%, respectively, and the differences of 3 molecular subtypes in EFS and OS were statistically significant (both P<0.001). The 10-year EFS rate of lymph node positive and negative patients was 68.8% and 88.2%, respectively; the 10-year OS rate was 76.7% and 92.5%, respectively, and the differences of lymph node status in EFS and OS were statistically significant (both P<0.001). In lymph node negative subgroup, 3 subtypes showed similar EFS and OS rate (both P>0.05); In lymph node positive subgroup, 3 subtypes showed significantly different EFS and OS (both P<0.05). No modification effect was detected of lymph node status on the correlation of molecular subtypes and EFS, DDFS and OS(all P_interactive>0.1). Conclusions: Different molecular subtypes of breast cancer have different prognosis. Compared with molecular subtype, lymph node status may be a more important prognostic factor.

[Study on the demand of social organizations working for female sex workers regarding project management and capacity building of HIV prevention and treatment]

Objective: To understand the capacity building needs on social organizations providing HIV prevention and treatment services for female sex workers (FSW). Methods: Questionnaires and interview were conducted with the heads of social organizations participating in China AIDS Fund for Non-Governmental Organizations (CAFNGO) project 2017-2018. Data from the CAFNGO's information system were compiled and analyzed using Excel 2016 and SPSS 25.0 software. The distribution of social organizations, availability of funds, and social organizations' needs for capacity building were analyzed. Results: Nationwide, 184 social organizations were involved in project '2017-2018 CAFNGO's FSW field work'. Out of which, 156 answers were valid. Social organizations that participated in the implementation of fund projects were mainly concentrated in the western region, accounting for 44.0% (81/184), with Sichuan, Guangxi, and Yunnan being the majority. However, the eastern part received the most financial support. Social organizations expressed the highest demand for project data collection and analysis, accounting for 68.6% (107/156). Items on risk analysis, response, and quality control project ranked the second, accounting for 64.1% (100/156). Results showed that statistically significant differences were seen on capacity building needs among social organization leaders with different levels of training on management of planning and finance of the project (χ²=5.78,P=0.016;χ²=8.99,P=0.003). Conclusions: Currently, the number of social organizations and the related fund provision concerning HIV prevention and control among FSWs were not consistent in China. Thus, it is necessary to encourage, guide, and support the development of social organizations and satisfy social organizations' needs on capacity-building and planning.

[Corneal nerve repair and optical density in patients with high myopia after three kinds of corneal refractive surgery]

Objective: To investigate the repair of subepithelial nerve fibers in different areas of the cornea and the difference of corneal transparency 12 months after small incision lenticule extraction (SMILE), femtosecond laser in situ keratomileusis (FS-LASIK) and excimer laser in situ keratomileusis (LASEK) in high myopia. Methods: A cohort study. From June 2018 to October 2019, 30 patients with high myopia (60 eyes) were selected for corneal refractive surgery in the Department of Ophthalmology, Affiliated Hospital of Qingdao University, including 16 females (32 eyes) and 14 males (28 eyes). According to the mode of operation, the patients were divided into the SMILE group (n=10), FS-LASIK group (n=11) and LASEK group (n=9). The repair of subepithelial nerves in different areas of the cornea was observed by laser confocal microscopy 12 months after operation,and the morphological parameters were analyzed by ACCMetrics software. The parameters included corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal nerve fiber length (CNFL), corneal nerve fiber total branch density (CTBD) and corneal nerve fiber width. The Pentacam anterior segment analyzer was used to measure the optical density of the cornea in different diameters. The nerve fiber parameters and corneal optical density were compared by random block analysis of variance, and multiple comparisons were performed between groups by the Turkey test. Results: Twelve months after operation, there was no significant difference in the CNFD among the three groups(all P>0.05). The CNBD around the upper corneal incision in the SMILE group, FS-LASIK group and LASEK group was (7.81±7.93), (9.61±7.18) and (21.25±15.55) branches/mm², respectively. The CTBD was (22.00±16.02), (24.44±11.42) and (54.37±22.13) branches/mm², respectively. The values in the LASEK group significantly differed from the other two groups (HSD=2.823, -3.010, 3.053, -3.048, P<0.01). The CNFL was (9.19±3.25), (12.88±3.52) and (15.75±2.36) mm/mm², respectively. The value in the SMILE group was significantly different (HSD=-3.151, -4.418; P<0.0l). The corneal optical density after SMILE was 13.16±0.72 in the 0-6 mm diameter area(HSD=-4.164, -4.489; P<0.01), 16.12±3.18 in the 6-12 mm diameter area(HSD=-3.918, -3.493;P<0.01) and 14.06±1.36 in the total diameter (HSD=-6.031, -5.519;P<0.01), which differed significantly from the other two groups. Conclusions: Twelve months after SMILE for high myopia, the nerve repair around the superior corneal incision is slightly worse than that after FS-LASIK and LASEK, but the nerve repair in other areas has some advantages, and the corneal transparency is better. (Chin J Ophthalmol, 2021, 57:268-276).

[Long-term recurrence rate and survival in different aged patients with breast cancer undergoing breast conserving therapy]

Objective: To examine the difference of long-term recurrence rate and survivals between the young patients and the old patients undergoing breast conserving therapy (BCT). Methods: Women with primary invasive breast cancer receiving BCT between December 1999 and December 2014 were selected retrospectively from the database of Breast Cancer Center, Peking University Cancer Hospital & Institute. The median age of all patients was 47 years (range: 21 to 91 years). The cases were categorized according to age at diagnosis into two subgroups: the ≤40 years group and the>40 years group. A total of 2 778 patients were included: 677 patients in the ≤40 years group and 2 101 patients in the >40 years group. Clinicopathological characteristics between two groups were compared. The recurrence rate and survival were calculated using the Kaplan-Meier method. The differences of outcomes were compared in different aged groups using the Log-rank test. Factors affecting local recurrence, distant disease-free survival (DDFS), disease-free survival (DFS), and breast cancer-specific survival (BCSS) were assessed by multivariable Cox proportional hazard models. Results: Proportions of T1 (301/677 vs. 1 160/2 101, χ²=37.660, P<0.01), involved lymph node (314/677 vs. 713/2 101, χ²=34.966, P<0.01) hormone receptor-negative (490/677 vs. 1 581/2 101, χ²=6.981, P=0.030) and neoadjuvant chemotherapy (413/677 vs. 1 010/2 101, χ²=34.272,P<0.01)in the ≤40 years group were higher than that in the>40 years group. Median follow-up duration was 102 months. No significant difference in 10-year local recurrence was found between the two groups (2.5% vs. 1.6%, P=0.147). Ten-year DDFS rate in the ≤40 years group and in the>40 years group was 90.6% and 95.3%, respectively (P<0.01). Ten-year DFS rate in the ≤40 years group and in the>40 years group was 86.5% and 91.1%, respectively (P=0.001). Ten-year BCSS rate in the ≤40 years group and in the >40 years group was 91.0% and 93.7%, respectively (P=0.105). Age was not the prognosis factor of local recurrence. Lymph node status (positive vs. negative: HR=2.73, 95%CI: 1.94 to 3.84, P<0.01), age (≤40 years vs.>40 years: HR=1.73, 95%CI: 1.24 to 2.42, P=0.001) and T stage (>2 cm vs. ≤2 cm: HR=1.61, 95%CI: 1.14 to 2.28, P=0.001) were the prognosis factors of DDFS, and also for DFS. Hormone receptor status (positive vs. negative: HR=0.54, 95%CI: 0.39 to 0.74, P<0.01), lymph node status (positive vs. negative: HR=2.94, 95%CI: 2.12 to 4.07, P<0.01) and T stage (>2 cm vs. ≤2 cm: HR=1.45, 95%CI: 1.05 to 2.01, P=0.025) were the prognosis factors of BCSS. Conclusions: The risk of local recurrence was similar between ≤40 years patient and >40 years patients receiving breast conserving therapy. Worse survivals in the ≤40 years group were found comparing to those in the >40 years group.

Acceptability and practicability of self-management for patients with Parkinson's disease based on smartphone applications in China

BACKGROUND

China has had about 1.2 billion mobile-phone users, and this number continues to grow. However, mobile-health services (mHealth) are currently in the initial stage, and have not yet prevailed in China. Additionally, the prevalence of Parkinson's disease (PD) in China is 1700/100,000 (≥65 years). Indeed, these PD patients would benefit from mHealth to manage their disease. Therefore, we designed a study to determine attitudes toward smartphone applications (apps) for chronic condition self-management, and to discover the practicality of these apps among PD patients in China.

METHODS

We selected 204 participants with PD between 52 and 87 years old and surveyed their attitudes concerning the use of smartphone apps for chronic condition management via questionnaires.

RESULTS

Among the participants, 65.19% had smartphones. Among these smartphone users, 82.84% expressed a preference for using apps for PD management. This group tended to be younger and more frequent web users with higher education and better medication compliance, and they tended to have a longer PD course and worse conditions (P < 0.001, P = 0.001, P < 0.001, P = 0.041, P < 0.001, P = 0.013). Additionally, the willingness to apply apps for PD self-management was positively related to education (P < 0.001) and negatively related to age and PD course (P = 0.017, P < 0.001).

CONCLUSION

In China, patients with PD have a generally positive attitude towards self-management through smartphone apps. Consequently, improving the coverage of smartphones with practical and handy apps is a promising strategy for PD self-management.

Hollow Plasma Acceleration Driven by a Relativistic Reflected Hollow Laser

In order to address the present difficulty in experimentally generating the relativistic Laguerre-Gaussian laser, primarily due to damage caused to optical modulators, a high-reflectivity phase mirror is applied in the femtosecond petawatt laser system to generate a relativistic hollow laser at the highest intensity of 6.3×10^{19}  W/cm^{2} for the first time. A simple optical model is used to verify that the vortex laser may be generated in this new scheme; using such a relativistic vortex laser, the hollow plasma drill and acceleration are achieved experimentally and proven by particle-in-cell simulations. With the development of the petawatt laser, this scheme opens up possibilities for the convenient production of the relativistic hollow laser at high repetition and possible hollow plasma acceleration, which is important for a wide range of applications such as the generation of radiation sources with orbital angular momentum, fast ignition for inertial confinement fusion, and jet research in the astrophysical environment.

Proton transport enabled by a field-induced metallic state in a semiconductor heterostructure

Tuning a semiconductor to function as a fast proton conductor is an emerging strategy in the rapidly developing field of proton ceramic fuel cells (PCFCs). The key challenge for PCFC researchers is to formulate the proton-conducting electrolyte with conductivity above 0.1 siemens per centimeter at low temperatures (300 to 600°C). Here we present a methodology to design an enhanced proton conductor by means of a Na _x CoO₂/CeO₂ semiconductor heterostructure, in which a field-induced metallic state at the interface accelerates proton transport. We developed a PCFC with an ionic conductivity of 0.30 siemens per centimeter and a power output of 1 watt per square centimeter at 520°C. Through our semiconductor heterostructure approach, our results provide insight into the proton transport mechanism, which may also improve ionic transport in other energy applications.

[Translational research on gastric cancer: Ruijin experience]

Translational medicine refers to translating basic research achievements into the clinical application for diagnosis and treatment. There are still many issues of gastric cancer to be solved in clinical diagnosis and treatment. We need to focus on clinical questions, by means of basic research and multidisciplinary intersection approach, to further improve the overall efficacy of gastric cancer. Based on Ruijin Hospital's translational research experiences, in this paper, the authors describe the future direction in the field of translational research, such as the etiology and pathogenesis of gastric cancer, tumor markers for early diagnosis, prediction of recurrence and metastasis, classification criteria, evaluation of chemotherapy, tumor heterogeneity, targeted therapy, immunotherapy and research platform establishment. In addition, here we share our perspective of the research on serum biomarkers, specific antibodies and improvement of drug delivery for gastric cancer.

Phylodynamic Analysis Complements Partner Services by Identifying Acute and Unreported HIV Transmission

Tailoring public health responses to growing HIV transmission clusters depends on accurately mapping the risk network through which it spreads and identifying acute infections that represent the leading edge of cluster growth. HIV transmission links, especially those involving persons with acute HIV infection (AHI), can be difficult to uncover, or confirm during partner services investigations. We integrated molecular, epidemiologic, serologic and behavioral data to infer and evaluate transmission linkages between participants of a prospective study of AHI conducted in North Carolina, New York City and San Francisco from 2011-2013. Among the 547 participants with newly diagnosed HIV with polymerase sequences, 465 sex partners were reported, of whom only 35 (7.5%) had HIV sequences. Among these 35 contacts, 23 (65.7%) links were genetically supported and 12 (34.3%) were not. Only five links were reported between participants with AHI but none were genetically supported. In contrast, phylodynamic inference identified 102 unreported transmission links, including 12 between persons with AHI. Importantly, all putative transmission links between persons with AHI were found among large clusters with more than five members. Taken together, the presence of putative links between acute participants who did not name each other as contacts that are found only among large clusters underscores the potential for unobserved or undiagnosed intermediaries. Phylodynamics identified many more links than partner services alone and, if routinely and rapidly integrated, can illuminate transmission patterns not readily captured by partner services investigations.

[Effect of sacubitril/valsartan on cardiac function in heart failure rabbits with preserved ejection fraction]

Objective: To investigate the effect of sacubitril/valsartan on cardiac function in heart failure rabbits with preserved ejection fraction. Methods: Forty-five healthy adult male New Zealand rabbits were divided into sham operation group (n=12) and model group (n=33) by random number table method. HFpEF model was constructed by abdominal aortic constriction in model group. In sham operation group, 1 rabbit died due to anesthesia accident, and 1 rabbit in model group died of acute left heart failure. At 8 weeks of modeling, 3 rabbits were excluded due to the failure to establish the successful model. At the 8th week of modeling, 2 rabbits in sham operation group were selected and sacrificed by random number table method, and 3 rabbits in model group were selected and sacrificed for myocardial histological examination. Then, 9 rabbits in sham operation group and 26 rabbits in model group entered the subsequent experiment. The model group was randomly divided into untreated group (n=8), valsartan intervention group (n=9), and sacubitril/valsartan intervention group (n=9), respectively, drugs were applied per gavage. The feeding and exercise activity of rabbits in each group were evaluated by simple cardiac function classification at baseline, 4 and 8 weeks post intervention. Echocardiography was used to detect interventricular septal thickness at diastole(IVSd), interventricular septal thickness at systolic(IVSs), left ventricular posterior wall of diastolic(LVPWd), left ventricular internal diameter at diastolic(LVIDd), left ventricular internal diameter at systolic(LVIDs), and calculate the left ventricular ejection fraction(LVEF), mitral valve's early diastolic flow velocity(E)/late mitral diastolic maximum flow rate ratio(A) and heart rate at baseline, 4 and 8 weeks post intervention. Serum N terminal B-type natriuretic peptide (NT-proBNP) and angiotensin (Ang)Ⅱ and soluble matrix lysin 2(sST2) content was determined by ELISA at baseline, 4 and 8 weeks post intervention. Eight weeks after intervention, the hearts of rabbits were taken and weighed, and heart mass index (HMI) and left ventricular mass index (LVMI) were calculated. Results: (1) Evaluation results of cardiac function: there were 2, 5, and 2 rabbits with cardiac function grade Ⅰ,Ⅱ and Ⅲ before the drug intervention, and 4, 4, and 1 rabbits with respective cardiac function grade after 8 weeks of intervention in valsartan group (P>0.05). There were 2, 4, and 3 rabbits with heart function gradeⅠ,Ⅱ and Ⅲ before the drug intervention, and 7, 2, and 0 rabbits with respective heart function grade after 8 weeks of intervention in sacubitril/valsartan group(P<0.05). (2) Echocardiographic results: at 8 weeks after drug intervention, IVSd and IVSs of rabbits in untreated group were significantly higher than those in sham operation group, and the ratio of E/A was significantly lower than that in sham operation group(all P<0.01). IVSs of the valsartan group was significantly higher than that of sham operation group, and the ratio of E/A was significantly lower than that of sham operation group(all P<0.01). The E/A ratio in the sacubitril/valsartan group was significantly lower than that in sham operation group(P<0.01). IVSd and IVSs in valsartan group were significantly lower than those in untreated group(all P<0.05), and IVSd in sacubitril/valsartan group was significantly lower than that in untreated group(P<0.01). The IVSd, IVSs, LVPWd, LVIDd, LVIDs, LVEF, E/A ratios were similar between sacubitril/valsartan group and valsartan group(all P>0.05). There was no significant difference in heart rate between the groups(P>0.05). (3) Serum NT-proBNP, Ang Ⅱ and sST2 levels: 4 weeks after drug intervention, untreated group, valsartan group, and sacubitril/valsartan group's serum NT-proBNP levels were significantly higher than that of sham operation group(all P<0.01); serum NT-proBNP was significantly lower in sacubitril/valsartan group than that in untreated group(P<0.01). Four weeks after intervention, serum AngⅡ levels were significantly higher in untreated group, valsartan group, sacubitril/valsartan group than in sham group(all P<0.01), but there was no statistically significant difference between the modeling groups(P>0.05). Four weeks after drug intervention, the serum sST2 contents in untreated group, valsartan group, and sacubitril/valsartan group were significantly higher than in sham operation group(all P<0.01), and which was significantly lower in valsartan group and sacubitril/valsartan group than in untreated group(all P<0.01), which were significantly lower in sacubitril/valsartan group than in valsartan group(P<0.01). Eight weeks after drug intervention, serum NT-proBNP levels were significantly higher in untreated group, valsartan group, and sacubitril/valsartan group than in sham operation group(all P<0.01), which were significantly lower in valsartan group and sacubitril/valsartan group than in untreated group(all P<0.01), which were significantly lower in valsartan group than in sacubitril/valsartan group(P<0.01). Eight weeks after drug intervention, Ang Ⅱ levels were significantly higher in valsartan group and sacubitril/valsartan group than in untreated group(all P<0.01), which tended to be higher in untreated group and valsartan group, tended to be lower in sacubitril/valsartan compared to value at 4 weeks(all P>0.05). Eight weeks after drug intervention, serum sST2 was significantly higher in untreated group and valsartan group than in sham operation group(all P<0.01), which tended to be higher in sacubitril/valsartan group compared to sham operation group(P>0.05), which were significantly lower in valsartan group and sacubitril/valsartan group than in untreated group(all P<0.01), which was significantly lower in sacubitril/valsartan group than in valsartan group(P<0.01). (4) Comparison of whole-heart mass, left ventricular mass, HMI and LVMI: 8 weeks after drug intervention, the whole-heart mass, left ventricular mass, HMI and LVMI were significantly higher in untreated group than in sham operation group(all P<0.01), and the above indexes were also significantly higher in valsartan group than in sham operation group(all P<0.05), tended to be lower in valsartan group compared to untreated group (all P>0.05). HMI and LVMI were lower in sacubitril/valsartan group than in untreated group(all P<0.05). All the above indexes tended to be lower in sacubitril/valsartan group than in valsartan group(all P>0.05). Conclusion: Sacubitril/valsartan is superior to valsartan alone on improving cardiac function in HFpEF rabbits.

[Relationship between bile acid metabolism and chronic non - cholestatic liver disease]

Bile acid is a general term for a large class of cholic acid in bile and exerts its unique physiological functions by binding the relevant receptors and bile acid transporters. Bile acids not only promote the absorption of nutrients in the human body, but also as an important signaling molecule in the regulation of inflammatory processes and liver regeneration. Several studies have found that bile acid metabolism is involved in the occurrence and development of chronic non-cholestatic liver diseases. In this article, the latest research results are mentioned, and the relationship between nuclear receptors, membrane receptors, and bile acid transporters and chronic non-cholestatic liver disease that play a key role in the bile acid metabolism were emphatically reviewed.

[Pulmonary cavities with Takayasu arteritis: report of 3 cases and literature review]

Objective: To analyze the clinical features of 3 cases of Takayasu arteritis(TA) with pulmonary cavities on chest computed tomography(CT). Methods: The clinical data of 3 TA patients with cavities on the chest CT who were admitted into Beijing Chaoyang Hospital were retrospectively analyzed. A literature search was performed with "Takayasu arteritis" and "pulmonary" as the key words in China Knowledge Resource Intergrated Database (CNKI) and Pubmed Database for publications from Jan 1, 2000 to Dec. 31,2017. The relevant literatures were reviewed. Results: Among the 3 patients, 2 were males and 1 was female, aging 49, 28 and 28 years, respectively. They presented with cough, fever and chest pain, and chest CT showed cavities, single or multiple, either with thick or thin wall, or wedge-shaped consolidation, residual stripes after being absorbed, and one case had pulmonary biopsy results which showed hemorrhagic infarction. They were all misdiagnosed before as pneumonia, pulmonary tuberculosis, pulmonary thromboembolism. After being treated by combination therapy of glucocorticoids and immunosuppressive agents, the disease improved significantly. A total of 777 cases with TA involving pulmonary arteries were reported, from which 13 cases with involvement of pulmonary parenchyma were described. Therefore total 16 cases including the 3 cases in this article were included for analysis. Twelve cases showed patchy or wedge-shaped ground-glass opacity and consolidation, and peripheral lung stripes remained after being absorbed. Two cases showed pleural effusion, and 4 cases showed cavities, 3 cases were misdiagnosed as pulmonary tuberculosis, 7 as pulmonary infection, and 5 as pulmonary thromboembolism. Conclusions: TA with pulmonary arteries involved is susceptible to be misdiagnosed and missed, and therefore, in patients with cough, hemoptysis, chest pain and cavities in pulmonary parenchyma, TA should be suspected. Early diagnosis and appropriate treatment can lead to a better prognosis.

[Expression and significance of c-fos in resistant cell line TU177/VCR of larynx squamous cell carcinoma]

Objective: To explore the effect of c-fos on multidrug resistance of laryngeal cancer TU177 cells. Method: Increasing drug concentration gradient is adopted to establish the stability of the laryngeal cancer drug resistance in cell line; RT-PCR and Western blot were used to detect difference of the c-fos between TU177 and TU177/VCR cells; plasmids with human c-fos knockdown or over expression were transfected into TU177/VCR and TU177 cells respectively, and the effects of different treatment on cell proliferation were investigated with MTT. Results: The drug resistance of TU177/VCR cells was 26.25-fold in vincristine (VCR), 7.33-fold in Paclitaxel (TAX), 2.41 in cisplatin (DDP), and 5.50 in 5-fluorouracil (5-FU), comparing with TU177( P<0.05). The TU177/VCR cells had significantly higher c-fos expression compared to TU177 cells( P<0.05). The results showed that the IC(50) values of 5-FU for the NC group and c-fos shRNA group were (306.2±6.3)μmol/L and (81.3±3.9)μmol/L, respectively, which was decreased by 73% in the c-fos shRNA group compared to that in the NC group (P<0.05). Similarly, the results showed that the IC(50) values for 5-FU were (55.3±9.4) μmol/L in NC group and (288.1±7.3)μmol/L in c-fos WT group, which was increased 5.21-fold in c-fos WT cells. Conclusion: C-fos plays important role in multidrug resistance of larynx cancer cell TU177/VCR, and might become a new molecular target for laryngeal cancer treatment.

Predicting Shear Transformation Events in Metallic Glasses

Shear transformation is the elementary process for plastic deformation of metallic glasses, the prediction of the occurrence of the shear transformation events is therefore of vital importance to understand the mechanical behavior of metallic glasses. In this Letter, from the view of the potential energy landscape, we find that the protocol-dependent behavior of shear transformation is governed by the stress gradient along its minimum energy path and we propose a framework as well as an atomistic approach to predict the triggering strains, locations, and structural transformations of the shear transformation events under different shear protocols in metallic glasses. Verification with a model Cu_{64}Zr_{36} metallic glass reveals that the prediction agrees well with athermal quasistatic shear simulations. The proposed framework is believed to provide an important tool for developing a quantitative understanding of the deformation processes that control mechanical behavior of metallic glasses.

[Assessment of the Availability of Soil Copper and Related Influencing Factors at a County Scale]

Understanding the spatial distribution of total copper, available copper, and the spatial non-stationary relationships between available copper and relevant environmental factors is important for the delineation of soil risk areas and the development of related control measures. This study was conducted in Zhangjiagang County of Jiangsu Province, China. The risk status for soil copper was assessed based on 357 soil samples in the study area. The effects of soil type and land-use type on the concentration of available soil copper were discussed first. Then, ordinary kriging was adopted to map the spatial distribution patterns of the total soil copper and available soil copper, and the spatial distribution map of the copper availability ratio (i.e., available copper/total copper) was also developed for the study area. The risk areas for soil copper were delineated based on the spatial distribution patterns of available soil copper and the copper availability ratio. Finally, a new spatial local regression technique, geographic weighted regression (GWR), was used to explore the local spatial regression relationships between available copper and its three main impact factors (i.e., total soil copper, soil pH, and SOM). Results showed that both soil type and land-use type had some effect on the concentration of available soil copper. The copper availability ratio had a strong spatial heterogeneity, with the higher values mainly in the northeast, southeast, and northwest of the study area and the lower values mainly in the middle and southwest of the study area. The range of the copper availability ratio is 13.56% to 29.15%. The results of the comparison of the traditional ordinary least squares regression (OLSR) and GWR showed that the GWR model had higher fitting accuracy than the OLSR model[i.e., a larger decision coefficient R², and smaller corrected Akaike information criteria (AICc) and the sum of squares of residuals] in modeling the relationships between available copper and its three main impact factors. The GWR analysis showed that the effect of soil factors on the concentration of soil available copper was non-stationary. The GWR could effectively reveal the spatial non-stationary influence of the related soil factors on the concentration of available soil copper, and the results could explain the reasons for the accumulation of available soil copper in local areas. Potential risk areas for available soil copper were delineated based on the copper availability ratio and the concentration of available soil copper in the study area. The results should be crucial data for developing specific control measures for soil copper at a regional scale.

[Analysis on funds application of community based organizations involved in HIV/AIDS response and government financial investment in China, 2014]

Objective: To understand the government financial investments to community based organizations (CBO) involved in HIV/AIDS Control and Prevention of China and its influencing factors. Methods: Questionnaire of the situation of CBO involved in HIV/AIDS control and prevention were designed, and filled by the staff of Provincial Health Administrative Departments of 31 provinces (autonomous regions and municipalities). The research focused on the fields of CBO involved in HIV/AIDS response in 31 provinces (autonomous regions and municipalities), including intervention on HIV/AIDS high risk population (female sex worker (FSW), man who sex with man (MSM), drug user (DU) and case management and care for people living with HIV/AIDS (PLWH)). 29 valid questionnaires were collecting, with Shanxi Province and Inner Mongolia Autonomous Regions not filled. Questionnaire included financial supports from local governments, transfer payment from central government for CBO involved in HIV/AIDS response in 2014, and unit cost for CBO involved in HIV/AIDS control and prevention. Multivariate analysis was conducted on the project application and financial investment of community based organizations involved in HIV/AIDS control and prevention in 2014. Results: The total amount of CBO to apply for participation in AIDS prevention and control was 64 482 828 Yuan in 2014. The actual total amount of investment was 50 616 367 Yuan, The investment came from the central government funding, the provincial level government funding, the prefecture and county level government funding investment and other sources of funding. 22 of 28 provinces (autonomous regions and municipalities) received the funds from the central government finance, and median of investment funds 500 000 Yuan. 15 provinces (autonomous regions and municipalities) gained the funds from the provincial government finance, and median of investment funds 350 000 Yuan. 12 provinces (autonomous regions and municipalities) got the funds from the prefecture and county level government finance, and median of investment funds 408 750 Yuan. 12 provinces (autonomous regions and municipalities) acquired the funds from other sources, and median of investment funds 228 400 Yuan. The median (P(25), P(75)) unit costs of intervention for FSW from 16 provinces (autonomous regions and municipalities) was 70 (23, 280) Yuan per year; DU from 14 provinces (autonomous regions and municipalities) was 83 (44, 200 ) Yuan per year; MSM from 16 provinces (autonomous regions and municipalities) was 100 (35, 280) Yuan per year; the follow-up and care for PLWH from 17 provinces (autonomous regions and municipalities) was 200 (45, 500) Yuan per year. Multivariate linear regression analysis results showed that the amount of PLWH in 2014 influenced on the total number of application funds of CBO involved in HIV/AIDS response (b=178.11, 95% CI: 51.86-305.36) and the amount of PLWH (b=77.72, 95% CI: 16.28-139.16), and Gross Domestic Product (GDP) per capita of the province (b=36.20, 95% CI: 4.60-67.80) impacted financial investment to CBO involved in HIV/AIDS response, respectively. Conclusion: Funds application and financial investment of CBO involved in HIV/AIDS control and prevention were huge. Financial investment from government was main resources for CBO in 2014. The amount of financial investment funds from governments was influenced by the HIV/AIDS epidemic situation and the development level of local economic.

Collisionless Shock Acceleration of High-Flux Quasimonoenergetic Proton Beams Driven by Circularly Polarized Laser Pulses

We present experimental studies on ion acceleration using an 800-nm circularly polarized laser pulse with a peak intensity of 6.9×10^{19}  W/cm^{2} interacting with an overdense plasma that is produced by a laser prepulse ionizing an initially ultrathin plastic foil. The proton spectra exhibit spectral peaks at energies up to 9 MeV with energy spreads of 30% and fluxes as high as 3×10^{12}  protons/MeV/sr. Two-dimensional particle-in-cell simulations reveal that collisionless shocks are efficiently launched by circularly polarized lasers in exploded plasmas, resulting in the acceleration of quasimonoenergetic proton beams. Furthermore, this scheme predicts the generation of quasimonoenergetic proton beams with peak energies of approximately 150 MeV using current laser technology, representing a significant step toward applications such as proton therapy.

[Breast-conserving surgery with immediate partial breast reconstruction using pedicled thoracodorsal artery perforator flap: a clinical analysis of 33 patients]

Objective: To explore the application value of pedicled thoracodorsal artery perforator flap in immediate partial breast reconstruction for breast cancer. Methods: This study is a prospective case series studies. Totally 128 cases of primary breast cancer patients who prepared to receive the breast-conserving surgery combine with immediate partial breast reconstruction of pedicled thoracodorsalartery perforator flap were enrolled in Breast Cancer Prevention and Treatment Center of Peking University Cancer Hospital from June 2013 to March 2016. Finally, the operations had been completed successfully in 33 eligible cases. All patients were female with a median age of 40 years (ranging from 22 to 52 years). The perforator vessel location, the donor area design, the post-operative complications, the influence of radiation and chemotherapy had been evaluated. Results: The average diameter of thoracic dorsal artery perforators measured by Doppler ultrasound before the operation was (1.5±0.4) mm (ranging from 0.6 to 2.7 mm). The average size of flaps was 15 cm×6 cm. The average time of operations was (271±72) minutes (ranging from 120 to 245 minutes). Drainage tube removed on (4.7±2.1) days after operation (ranging from 3 to 12 days). All patients received follow-up, and there was no local recurrence and distant metastasis during a median follow-up of 17(12) months (M(Q(R))) (ranging from 5 to 38 months). All TDAP flaps were survival, the wound complication rates was 6% (2/33). Conclusions: The breast reconstruction of pedicled thoracodorsal artery perforator flap is a good choice of repairing local breast defect of breast conserving surgery.Its advantages are no-influence of latissimus dorsi function and little complications in donor area.

[Impact of adjuvant chemotherapy on the prognosis of hormone receptor negative breast cancer with residual lymph node disease after neoadjuvant chemotherapy]

Objective: To explore the influence of adjuvant chemotherapy on the prognosis of hormone receptor negative breast cancer with residual lymph node disease(RLND)after neoadjuvant chemotherapy. Methods: A total of 110 hormone receptor negative breast cancer patients treated with 4-8 cycles of neoadjuvant chemotherapy were respectively analysed between 2002 and 2012. Residual lymph node disease was comfirmed by subsequent radical mastectomy. Then all these patients were classified into two groups: patients treated with adjuvant chemotherapy(group A) and patients untreated with adjuvant chemotherapy(group B). Results: All patients were female, the median age was 54.5 years old(IQR: 47-59 years). The median follow-up time was 61 months(IQR: 51-88 months). There were 82 patients (74.5%) in group A, and 28 patients (25.5%) in group B. The five-year disease-free survival (DFS) rate was 76.2% in group A and 57.6% in group B. The distant disease-free survival (DDFS) rate was 78.9% in group A and 60.4% in group B. Overall survival (OS) rate was 81.0% in group A and 60.0% in group B. Multivariate analysis showed that there were significant differences for DDFS rate (group A vs group B, P=0.033; hazard ratio [HR], 5.256; 95% confidence interval [95%CI], 1.14-24.17) and OS rates (group A vs group B, P=0.011; HR, 7.478; 95%CI, 1.58-35.30) between two groups. Conclusion: The patients who have hormone receptor negative breast cancer with RLND after neoadjuvant chemotherapy, may benefit from postoperative adjuvant chemotherapy.

Effect of a high-concentrate diet on milk components and mammary health in Holstein dairy cows

In order to evaluate the milk yield, milk quality, and health of dairy cows fed a high-concentrate (HC) diet, eight lactating Holstein dairy cattle were randomly assigned to HC or low-concentrate (LC) diet groups and fed for 50 days, and the auto-control studying before and after treatment with the two diets was used. During the experiment, plasma and milk samples were collected and measured. With regard to milk component, HC feeding led to higher milk production (P < 0.05), but significantly lower milk protein percentage (P < 0.05), milk protein yield (P < 0.05), and milk fat percentage (P < 0.05) throughout the five periods than LC feeding. Milk somatic cell count and N-acetyl-D-glucosaminidase activity (P < 0.01) were higher than those observed under LC feeding. mRNA expression levels of interleukin-8 (IL-8), C-C motif chemokine ligand (CCL5), and lactalbumin alpha (α-LA) were investigated by qPCR and found to be significantly lower (P < 0.01) in cattle fed the HC diet. The amino acid content was analyzed by high performance liquid chromatography (HPLC), and the content of Asp (P < 0.01), Gln (P < 0.01), Ala (P < 0.05), Leu (P < 0.05), Lys (P < 0.05), and Ile (P < 0.01) was significantly lower in the HC group, whereas the content of Arg (P < 0.05) and Phe (P < 0.01) was significantly higher. These results suggest that the HC diet might have an important influence on mammary health. The amino acid content was lower, suggesting that depletion of amino acids, resulting in depleted milk protein, affects milk quality.

[Impact of the response of primary tumor to preoperative chemotherapy and anti-HER2 therapy on survival of HER2-positive breast cancer patients]

OBJECTIVE

To study the impact of anti-HER2 therapy and response of primary tumor on distant disease free survival (DDFS) of the patients with HER2-positive breast cancer.

METHODS

The clinical data of the patients with HER2-positive breast cancer treated with neoadjuvant systemic therapy were analyzed retrospectively.

RESULTS

Patients treated with preoperative anti-HER2 therapy and chemotherapy had a significant improved pathological complete response (pCR) rate (48.4%) compared with those treated with preoperative chemotherapy (17.2%) (P=0.000). The median follow-up period was 62(6-160) months. The 5-year DDFS in patients with anti-HER2 therapy and patients without anti-HER2 therapy was 93.5% and 83.3% respectively (P=0.006). The 5-year DDFS in patients achieving a pCR and patients not achieving a pCR was 94.7% and 82.6% respectively(P=0.001). Among patients achieving a pCR, anti-HER2 therapy did not improve DDFS significantly (P=0.960). Benefits of anti-HER2 therapy in DDFS among patients without a pCR achieved statistical significance (P=0.028).

CONCLUSIONS

Combination of neoadjuvant anti-HER2 therapy and chemotherapy resulted in a higher pCR rate in HER2-overexpressing primary breast cancer. Patients treated with neoadjuvant systemic therapy who achieved a pCR have excellent outcome regardless of whether they received anti-HER2 therapy.

De novo assembly, functional annotation, and marker development of Asian pear (Pyrus pyrifolia) fruit transcriptome through massively parallel sequencing

This study investigated the Asian pear transcriptome using the RNA-Seq normalized fruit cDNA library to create a transcriptomic resource for unigene and marker discovery. Following the removal of lowquality reads, 127,085,054 trimmed reads were assembled de novo to yield 37,649 non-redundant unigenes with an average length of 599 bp. Alternative splicing events were detected in 4121 contigs. A total of 30,560 single nucleotide polymorphisms (SNPs) and 7443 simple sequence repeat (SSR) makers were obtained. Approximately 21,449 (56.9%) unigenes were categorized into three gene ontology groups; 3682 (9.8%) were classified into 25 cluster of orthologous groups; and 10,451 (27.8%) were assigned to six Kyoto Encyclopedia of Genes and Genomes pathways. Differentially expressed genes were investigated using the reads per kilobase of the exon model per million reads methodology. A total of 546 unigenes showed significant differences in expression levels at different fruit developmental stages. Gene ontology categories associated with various aspects, including carbohydrate metabolic processes, transmembrane transport, and signal transduction, were enriched with genes with divergent expressions. These Pyrus pyrifolia transcriptome data provide a rich resource for the discovery and identification of new genes. Furthermore, the numerous putative SSRs and SNPs detected in this study will be important resources for the future development of a linkage map or of marker-assisted breeding programs for the Asian pear.

Mapping quantitative trait loci for five forage quality traits in a sorghum-sudangrass hybrid

The identification of quantitative trait loci (QTLs) affecting forage quality traits enables an understanding of the genetic mechanism of these loci. The aim of the present study was to detect QTLs for the whole-plant protein content (WP), whole-plant fat content (WF), neutral detergent fiber (NDF), acid detergent fiber (ADF), and whole-plant ash content (WA) using a population of 184 F2 individuals from a cross between sorghum Tx623A and sudangrass Sa. Correlation analysis was performed between the five forage quality traits. WP was found to be positively correlated with WF, NDF, and ADF. Furthermore, NDF was positively correlated with ADF but negatively correlated with WA. A genetic map with 124 SSR markers was constructed for QTL mapping. A total of 12 QTLs associated with the five forage quality traits were detected. Of these QTLs, qNDF3, qNDF8, and qADF8 explained more than 10% of the phenotypic variation. Additionally, although all of the QTLs exhibited additive and dominant effects, they mainly exhibited dominant effects. Our results provide important information for marker-assisted selection breeding of sorghum-sudangrass hybrids.

Polymorphisms and DNA methylation level in the CpG site of the GHR1 gene associated with mRNA expression, growth traits and hormone level of half-smooth tongue sole (Cynoglossus semilaevis)

The objectives of the present study were to estimate the GHR1 gene mutations and methylation status of CpGs, and whether those mutations and methylation were involved in the regulation of GHR1 gene expression, hormone level and growth traits in half-smooth tongue sole (Cynoglossus semilaevis). Identification of single-nucleotide polymorphisms was performed on 43 male fish. Through polymerase chain reaction-single-strand conformation polymorphism and sequencing, two SNPs were found. SNP1 [c.G1357A (p.Val376Ile)] creating one CpG site located in exon 8 was named L1 locus, and SNP2 (c.G1479A) located in exon 9 was named L2 locus. Individuals were divided into three genotypes, AA, AG and GG according to L1 locus (GG genotype had one more CpG site because of the mutation), and into two genotypes, AA- and GG-based on L2 locus. The results showed that only L1 locus was significantly associated with body weight (P < 0.01), gonad weight (P ≤ 0.05), triiodothyronine (T3) level (P ≤ 0.05) and mRNA expression (P < 0.01). At L1 locus, newly created CpG site in GG genotype was highly methylated (93.3 %), while there was no difference of methylation level in the other two CpG sites among three genotypes. AA genotype and AG genotype having higher T3 level were significantly different (P ≤ 0.05) from GG genotype. There were significant differences among body weights of AA, AG and GG genotypes (P < 0.01). Gonad weights of AA genotype and AG genotype were significantly lower than GG genotype. The GHR1 mRNA expression of GG genotype was significantly lower than AA and AG genotypes (P < 0.01). These implied that mutations and methylation status of GHR1 gene might influence the hormone level, growth traits and gene expression in male half-smooth tongue sole and the L1 locus could be regarded as a potential candidate genetic and epigenetic marker in half-smooth tongue sole selection.

A fast neighbor joining method

With the rapid development of sequencing technologies, an increasing number of sequences are available for evolutionary tree reconstruction. Although neighbor joining is regarded as the most popular and fastest evolutionary tree reconstruction method [its time complexity is O(n(3)), where n is the number of sequences], it is not sufficiently fast to infer evolutionary trees containing more than a few hundred sequences. To increase the speed of neighbor joining, we herein propose FastNJ, a fast implementation of neighbor joining, which was motivated by RNJ and FastJoin, two improved versions of conventional neighbor joining. The main difference between FastNJ and conventional neighbor joining is that, in the former, many pairs of nodes selected by the rule used in RNJ are joined in each iteration. In theory, the time complexity of FastNJ can reach O(n(2)) in the best cases. Experimental results show that FastNJ yields a significant increase in speed compared to RNJ and conventional neighbor joining with a minimal loss of accuracy.

The formation and degradation of active species during methanol conversion over protonated zeotype catalysts

The methanol to hydrocarbon (MTH) process provides an efficient route for the conversion of carbon-based feedstocks into olefins, aromatics and gasoline. Still, there is room for improvements in product selectivity and catalytic stability. This task calls for a fundamental understanding of the formation, catalytic mechanism and degradation of active sites. The autocatalytic feature of the MTH process implies that hydrocarbons are active species on the one hand and deactivating species on the other hand. The steady-state performance of such species has been thoroughly studied and reviewed. However, the mechanism of formation of the initial hydrocarbon species (i.e.; the first C-C bond) and the evolution of active species into deactivating coke species have received less attention. Therefore, this review focuses on the significant progress recently achieved in these two stages by a combination of theoretical calculations, model studies, operando spectroscopy and catalytic tests.

QTL mapping of forage yield and forage yield component traits in Sorghum bicolor x S. sudanense

The sorghum-sudangrass hybrid (Sorghum bicolor x S. sudanense) is an important forage crop. However, little is known about the genetic mechanisms related to forage yield and the 4 forage yield component traits in this forage crop. In this study, a linkage map was constructed with 124 assigned SSR markers using an F2 mapping population derived from the crossing of sorghum Tx623A and sudangrass Sa. Nine quantitative trait loci (QTLs) were detected for forage yield and the 4 forage yield component traits using inclusive composite interval mapping. Five fresh weight QTLs were identified and contributed >50% of the total phenotypic variance. Of these QTLs, all showed additive and dominant effects, but most exhibited mainly dominant effects. These results will provide useful information for improvements in sorghum-sudangrass hybrid breeding.

[A clinical prediction model for N2 lymph node metastasis in clinical stage I non-small cell lung cancer]

OBJECTIVE

To estimate the probability of N2 lymph node metastasis and to assist physicians in making diagnosis and treatment decisions.

METHODS

We reviewed the medical records of 739 patients with computed tomography-defined stage I non-small cell lung cancer (NSCLC) that had an exact tumor-node-metastasis stage after surgery. A random subset of three fourths of the patients (n=554) were selected to develop the prediction model. Logistic regression analysis of the clinical characteristics was used to estimate the independent predictors of N2 lymph node metastasis. A prediction model was then built and externally validated by the remaining one fourth (n=185) patients which made up the validation data set. The model was also compared with 2 previously described models.

RESULTS

We identified 4 independent predictors of N2 disease: a younger age, larger tumor size, central tumor location, and adenocarcinoma or adenosquamous carcinoma pathology. The model showed good calibration (Hosmer-Lemeshow test: P=0.923) with an area under the receiver operating characteristic curve (AUC) of 0.748 (95% confidence interval, 0.710-0.784). When validated with all the patients of group B, the AUC of our model was 0.781 (95% CI: 0.715-0.839) and the VA model was 0.677 (95% CI: 0.604-0.744) (P =0.04). When validated with T1 patients of group B, the AUC of our model was 0.837 (95% CI: 0.760-0.897) and Fudan model was 0.766 (95% CI: 0.681-0.837) (P < 0.01).

CONCLUSION

Our prediction model estimated the pretest probability of N2 disease in computed tomography-defined stage I NSCLC and was more accurate than the existing models. Use of our model can be of assistance when making clinical decisions about invasive or expensive mediastinal staging procedures.