[Investigation and analysis of oral health resources allocation status in Yunnan Province]

Objective: To investigate and analyze the allocation status of oral health resources in Yunnan Province at the end of the 13th Five-Year Plan, providing a scientific basis for the rational resource allocation and formulation regional oral health plan for government health administrative departments. Methods: With the method of general survey, a cross-sectional study was conducted to investigate the allocation of material and human resources of all kinds of stomatological medical institutions registered in the health administrative departments in Yunnan before January 1, 2020. The general situation of oral health resources was analyzed by descriptive statistical analysis. Results: There were 2 712 stomatological medical institutions in Yunnan, 634 public and 2 078 non-public included. The largest number was in Kunming (1 167) and the least in Diqing (19). There were 9 018 dental chairs in total, among which 2 584 in public and 6 434 in non-public. Kunming had the largest number of chairs (3 612) and Nujiang had the least (57). There were 702 oral and maxillofacial surgical beds, all of which were distributed in public. There were 15 148 stomatological personnel, including 3 667 in public and 11 481 in non-public. The average ratio of stomatologist to population was 1∶6 615. Dehong (1∶6 620) was close to this average level, while Kunming (1∶2 283) and Yuxi (1∶4 936) were lower than the average and the other 13 states (cities) were higher. The population ratio of licensed stomatologist was only 1∶9 110. The average ratio of stomatologist to nurses was 1∶0.94. Honghe (1∶1.05), Kunming (1∶1.00), Yuxi (1∶1.18) and Qujing (1∶0.94) was better than or reached the average level, while the other 13 states (cities) were lower than this average. And this ratio in public comprehensive medical institutions was only 1∶0.38. Conclusions: The distribution of oral health resources in Yunnan was unbalanced between public and non-public institutions and among states (cities), mainly distributed in economically developed states (cities) and non-public institutions. For the oral health in Yunnan Province, the workforce was insufficient and the structure was unreasonable, and the proportion of nurses was seriously insufficient in public comprehensive medical institutions.

[Survival and prognosis analysis of patients with Hodgkin lymphoma treated with standard treatment paradigm]

Objective: To analyze the survival and prognosis of Hodgkin lymphoma (HL) patients receiving standard first-line therapy. Methods: Data of clinical characteristics and treatment outcomes of patients with HL diagnosed in Cancer Hospital Chinese Academy of Medical Sciences (CHCAMS) from January 1st, 2000 to December 31st, 2018 who received standard first-line treatment were retrospectively analyzed and compared with that of HL patients who received treatment in the Surveillance, Epidemiology and End Results (SEER) database in the United States during the same period. Factors associated with freedom from progression (FFP) of patients in CHCAMS were analyzed. Treatment and survival data of patients with relapsed/refractory HL (r/rHL) who had failed the standard first-line treatment during the corresponding period in CHCAMS were collected to analyze the outcomes of salvage therapy. Results: A total of 764 HL patients in CHCAMS were included in this study. The median age was 30 years (range, 14-83 years), with 424 males and 340 females. By February 26th, 2022, the patients were followed-up for a median time of 111 months(range, 0.3-262.0 months). Lymphoma-specific survival (LSS) rate and overall survival (OS) rate at 10 years for HL patients in CHCAMS was 91.7% (95%CI: 89.5%-93.9%) and 87.1% (95%CI: 84.5%-89.8%), respectively. LSS and OS rate at 10 years for HL patients from SEER database was 86.8% (95%CI: 86.3%-87.2%) and 79.0% (95%CI: 78.5%-79.5%), respectively. The unadjusted LSS and OS rate for patients in CHCAMS were higher than those for patients from SEER database (both P<0.001). No significant difference was observed in LSS and OS rate (both P>0.05) between the two groups after adjustment. European Organization for Research and Treatment of Cancer staging system (early-stage unfavorable: HR=2.35, 95%CI: 1.13-4.89, P=0.023; advanced stage: HR=5.44, 95%CI: 2.62-11.30, P<0.001) and serum β2 microglobulin (HR=1.67, 95%CI: 1.08-2.58, P=0.021) were influencing factors of FFP for patients in CHCAMS. The complete remission rate, median progression-free survival (PFS), 5-year PFS rate and 5-year OS rate for the 116 patients with r/rHL was 37.9% (95%CI: 29.6%-47.0%), 15.0 months (95%CI: 9.9-20.1 months), 29.9% (95%CI: 20.9%-38.9%) and 62.9% (95%CI: 54.1%-71.7%), respectively. Conclusions: The outcomes of HL patients receiving standard first-line treatment are excellent. However, the therapeutic effect of HL patients who incurrs disease progression or relapse after standard first-line treatment is not satisfying.

[Transoral endoscopic resection of benign tumors in parapharyngeal space via medial pterygomandibular raphe approach]

Objective: To explore the surgical methods and effects of transoral endoscopic resection of benign tumors in parapharyngeal space via medial pterygomandibular raphe approach. Methods: The clinical data of 23 patients who underwent resection of benign tumors in parapharyngeal space by endoscopic medial pterygomandibular raphe approach from January 2016 to July 2020 in the Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University were analyzed retrospectively. There were 14 males and 9 females with a median age of 43 years. The tumors were located in the anterior space of the styloid process in 13 cases and in the posterior space in 10 cases. The smallest tumor volume was 7.3 ml and the largest was 80.2 ml. The preoperative imaging features, the characteristics and risks of this approach in the operation were analyzed, and the feasible mode of operation was explored. Results: All patients completed the operation successfully. The intraoperative blood loss was 20 to 50 ml, with an average of 28.3 ml. The operation time was 40 to 110 min, with an average of 75.4 min. The incision length was 2 to 4 cm, with an average of 3.0 cm. The postoperative pain score was 2 to 4, with an average of 3.2. The postoperative hospital stay was 4 to 9 d, with an average of 6.7 d. Postoperative pathological diagnosis included pleomorphic adenoma (n=12), neurilemmoma (n=10) and basal cell adenoma (n=1). The patients were followed up for 6 to 60 months. There was no postoperative complication such as infection or serious bleeding, and there was no tumor recurrence after operation. Conclusion: Endoscopic resection of benign tumor in parapharyngeal space via medial pterygomandibular raphe approach is a safe, effective, and minimally invasive surgical method for the treatment of tumors in parapharyngeal space.

[Clinical application and mechanism of botulinum toxin type A in scar treatment]

Pathological scars cause both local physical discomforts and mental disorders for patients. With the development of research, botulinum toxin type A (BTX-A) has been gradually used in the clinical treatment of scars. This article summarizes three potential mechanisms of BTX-A, including early tension reduction, inhibition of connective tissue hyperplasia, and alleviation of skin inflammation, as well as the clinical application of BTX-A in treating different types of scars. However, at present there is no uniform standard for the time, method, and proportioning of BTX-A injection for scar treatment, and there is also a lack of long-term follow-up results. Further researches are needed in future to clarify the mechanism of BTX-A in inhibiting scars, establish a uniform protocol of BTX-A injection, and provide a more effective treatment plan for scars.

[Historical changes of a missionary hospital - Shanghai General Hospital (1864-1953)]

The Christian missionaries preached through medicine by combining religious preaching with secularisation and social adaptiveness of medicine in the 19th century. They attempted to avoid the negative influence of culture differences between the West and China. Desjacques Marin, one of the missionaries in China, was entrusted by Benoit Edan, a French consul in Shanghai to establish a hospital in 1864, named the "General Hospital". This hospital was moved to the north bank of Suzhou Creek in 1877 and renamed as the Gongji Hospital. The hospital was designated by the Japanese Army in 1940 as a hospital for sick foreign prisoners in the war. It was taken over as an enemy property by the government of the Republic of China in 1945 and became a public hospital opened formally to Chinese patients. It was renamed as "Shanghai First People's Hospital" in 1953. Review of the historical changes of the missionary hospital is of significance for the study on Chinese medical history and medical communication between China and the West.

A positive feedback loop between Periostin and TGFβ1 induces and maintains the stemness of hepatocellular carcinoma cells via AP-2α activation

Background

Liver cancer stem cells (LCSCs) play key roles in the metastasis, recurrence, and chemotherapeutic resistance of hepatocellular carcinoma (HCC). Our previous research showed that the POSTN gene is closely related to the malignant progression and poor prognosis of HCC. This study aimed to elucidate the role of POSTN in generating LCSCs and maintaining their stemness as well as the underlying mechanisms.

Methods

Human HCC tissues and matched adjacent normal tissues were obtained from 110 patients. Immunohistochemistry, western blotting (WB), and RT-PCR were performed to detect the expression of POSTN and stemness factors. The roles of transforming growth factor (TGF)-β1 and AP-2α in the POSTN-induced stemness transformation of HCC cells were explored in vitro and in vivo using LCSCs obtained by CD133⁺ cell sorting.

Results

The high expression of POSTN was correlated with the expression of various stemness factors, particularly CD133, in our HCC patient cohort and in TCGA and ICGC datasets. Knockdown of POSTN expression decreased the abilities of HCC cell lines to form tumours in xenograft mouse models. Knockdown of POSTN expression also suppressed cell viability and clone formation, invasion, and sphere formation abilities in vitro. Knockdown of AP-2α attenuated the generation of CD133⁺ LCSCs and their malignant behaviours, indicating that AP-2α was a critical factor that mediated the POSTN-induced stemness transformation and maintenance of HCC cells. The role of AP-2α was verified by using a specific αvβ3 antagonist, cilengitide, in vitro and in vivo. Activation of POSTN could release TGFβ1 from the extracellular matrix and initiated POSTN/TGFβ1 positive feedback signalling. Furthermore, we found that the combined use of cilengitide and lenvatinib suppressed the growth of HCC cells with high POSTN expression more effectively than the use of lenvatinib alone in the patient-derived xenograft (PDX) mouse model.

Conclusions

The POSTN/TGFβ1 positive feedback pathway regulates the expression of stemness factors and the malignant progression of HCC cells by regulating the transcriptional activation of AP-2α. This pathway may serve as a new target for targeted gene therapy in HCC.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13046-021-02011-8.

No pulsed radio emission during a bursting phase of a Galactic magnetar

Fast radio bursts (FRBs) are millisecond-duration radio transients of unknown physical origin observed at extragalactic distances^1-3. It has long been speculated that magnetars are the engine powering repeating bursts from FRB sources^4-13, but no convincing evidence has been collected so far¹⁴. Recently, the Galactic magnetar SRG 1935+2154 entered an active phase by emitting intense soft γ-ray bursts¹⁵. One FRB-like event with two peaks (FRB 200428) and a luminosity slightly lower than the faintest extragalactic FRBs was detected from the source, in association with a soft γ-ray/hard-X-ray flare^18-21. Here we report an eight-hour targeted radio observational campaign comprising four sessions and assisted by multi-wavelength (optical and hard-X-ray) data. During the third session, 29 soft-γ-ray repeater (SGR) bursts were detected in γ-ray energies. Throughout the observing period, we detected no single dispersed pulsed emission coincident with the arrivals of SGR bursts, but unfortunately we were not observing when the FRB was detected. The non-detection places a fluence upper limit that is eight orders of magnitude lower than the fluence of FRB 200428. Our results suggest that FRB-SGR burst associations are rare. FRBs may be highly relativistic and geometrically beamed, or FRB-like events associated with SGR bursts may have narrow spectra and characteristic frequencies outside the observed band. It is also possible that the physical conditions required to achieve coherent radiation in SGR bursts are difficult to satisfy, and that only under extreme conditions could an FRB be associated with an SGR burst.

[Application of endoscopic resection of benign tumor in infratemporal fossa]

Objective: To explore the application of endoscopy and clinical effect of endoscopic resection of benign tumor in infratemporal fossa. Methods: The clinical data of 11 patients with benign tumors in infratemporal fossa admitted to the Department of Otorhinolaryngology Head and Neck Surgery and Skull Base Surgery of the Affiliated Hospital of Qingdao University from January 2016 to September 2018 were retrospectively analyzed. There were 6 males and 5 females, with the age ranging from 11 to 63 years old. The main clinical manifestations were pharyngeal foreign body sensation, submaxillary pain, maxillofacial numbness and tongue numbness. Imaging examination showed that the tumor was round and had a clear boundary with the surrounding tissue. All the patients underwent endoscopic surgery. Appropriate surgical approach was selected according to the location of the tumor and its relationship with the internal carotid artery. The endoscopic surgical approaches included trans-oropharyngeal approach in 7 cases, trans-lateral pterygomandibular raphe approach in 1 case and trans-medial pterygomandibular raphe approach in 3 cases. The pathological results, prognosis, complications and relapse of patients were summarized through descriptive statistics. Results: The tumors were completely resected under endoscope in all patients, and there was no significant complication occurred after surgery. The average pain VAS score was 3.1 after surgery and average hospital stay was 5.9 d. The postoperative pathological diagnoses consisted of 6 cases of pleomorphic adenoma, 4 cases of neurilemmoma and 1 case of basal cell adenoma. All patients were followed up regularly from 6 to 39 months without recurrence of tumor. Conclusion: Endoscopic resection of benign tumors in infratemporal fossa has the advantages of minimal damage, rapid recovery, few complications, and definite curative effect, which can be used as an important alternative for surgical treatment of benign tumors.

Expression and characterization of anticoagulant activity of salivary protein alALP from Asian tiger mosquito Aedes albopictus

Several bioactive molecules isolated from the saliva of blood-sucking arthropods, such as mosquitoes, have been shown to exhibit potential anticoagulant function. We have previously identified a 30kDa allergen named Aegyptin-like protein (alALP), which is highly homologous to Aegyptin, from the salivary glands of female Aedes albopictus (Asian tiger mosquito). In this study, we identified the conserved functional domain of alALP by using bioinformatic tools, and expressed the His-tagged alALP recombinant protein in sf9 insect cells by generation and transfection of a baculoviral expression plasmid carrying the fulllength cDNA of alALP. We purified this recombinant protein and examined its function on the inhibition of blood coagulation. The results showed that the purified His-alALP prolonged the Activated Partial Thromboplastin Time (APTT), Prothrombin Time (PT) and Thrombin Time (TT) in vitro as well as the Bleeding Time (BT) in vivo, which suggest that alALP could be a novel anticoagulant.

[Clinical analysis of transnasal endoscopic repair of cerebrospinal fluid rhinorrhea]

Objective:To summarize the common clinical types of cerebrospinal fluid（CSF） rhinorrhea and key points of transnasal endoscopic repair of CSF rhinorrhea. To evaluate clinical effects. Method:In 29 patients with cerebrospinal fluid rhinorrhea, 9 patients with traumatic CSF rhinorrhea, 10 patients with spontaneous CSF rhinorrhea, 7 patients with CSF rhinorrhea after tumour excision, and 3 patients with iatrogenic CSF rhinorrhea. All the 29 patients were treated with transnasal endoscopic repair of CSF rhinorrhea. Result:There were 25 patients were successfully repaired at one time. Three patients developed intracranial infection and 2 patient developed pneumocephalus after surgery, all of them were cured with conservative treatment. All the patients who were followed-up for more than half a year had no recurrence. Conclusion:Transnasal endoscopic repair of CSF rhinorrhea is safe and effective, the success rate of operation is high, it is not easy to recur, and the complications are few. It can be used as the first choice for repairing of CSF rhinorrhea and effective prevention measures. Accurate location of leak, appropriate repair, effective reconstruction of the skull base, continuous drainage of the lumbar cistern when necessary and active prevention of intracranial infection are critical to the success of operation.

[Diagnostic performance of pathology, culture and ROSE of lung biopsy for suspected pulmonary infectious diseases]

Objective: To explore the diagnostic performance of CT guided percutaneous lung biopsy (PTLB) with pathology, culture and rapid on-site evaluation (ROSE) in patients with pulmonary infectious diseases. Methods: From January 2016 to June 2018, a retrospective study was implemented in the Department of Pulmonary and Critical Care Medicine of the First Affiliated Hospital of Wenzhou Medical University. Patients who received PTLB, suspected with lung infection were included. The basic information, clinical symptoms, imaging findings, diagnostic methods, complications, and changes in treatment of cases were collected. The diagnostic sensitivity of histopathology, microbial culture, and ROSE were evaluated at the same time. Results: A total of 529 cases were enrolled, including 354 males and 175 females, (59±14) years old in average. Tuberculosis was identified in 197 cases, non-tuberculosis mycobacteria (NTM) pulmonary disease in 8, cryptococcosis in 95, pulmonary aspergillosis in 27, filamentous fungal pneumonia in 3, talaromyces marneffei pulmonary infection in 3 and pulmonary candidiasis in 1, bacterial pneumonia in 39, and pathogen were unknown in 156 cases. A total of 417 cases were submitted for histopathology and microbial culture at the same time, the diagnostic value of pathology and microbial culture were 35.0% (146/417) and 45.6% (190/417), respectively. Combined pathology with microbial culture, the diagnostic value increased to 62.8% (262/417). The diagnostic accuracy of ROSE was 51.8% (71/137). The most common complication of PTLB was pneumothorax 26.1% (138/529). 56.1% (297/529) of the patients received targeted treatment after the diagnosis was confirmed, and 43.9% (232/529) maintained the original treatment. Conclusion: The pathology, microbial culture, and ROSE of PTLB have relative high diagnostic value for pulmonary infectious diseases.

[Analysis of clinical features of respiratory epithelial adenomatoid hamartoma in the nasal cavity]

Objective: To analyze the clinical features of respiratory epithelial adenomatoid hamartoma (REAH) in the nasal cavity. Methods: Clinical datas of 23 patients, who were hospitalized in Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, from February 2016 to February 2018 with histopathologically proved REAH in the nasal cavity were reviewed. There were 18 males and 5 females, with the age range from 16 to 71 years old. The most common area, main symptoms, surgical methods and follow-up results were analyzed. Results: The most common area was olfactory cleft (21 cases), and the mainly symptom was nasal congestion (18 cases). All the patients received transnasal endoscopic surgery and had no recurrence during following-up from three months to one year. Conclusions: The most common area of REAH in the nasal cavity is the olfactory cleft. Histopathological result is needed to make a definite diagnosis. Complete surgical resection is the main treatment.

Nanostructures in high-performance (GeTe)(x)(AgSbTe(2))(100-x) thermoelectric materials

The thermoelectric properties of (GeTe)(x)(AgSbTe(2))(100-x) compounds (x = 75, 80, 85 and 90; TAGS-x) have been studied as a function of temperature from 300 to 720 K. At 720 K the dimensionless figure of merit ZT reaches the state-of-the-art value of 1.53 for TAGS-75 and 1.50 for TAGS-80 and TAGS-85 samples, respectively. But the ZT value of the TAGS-90 sample is only 0.50 at 720 K due to the high carrier concentration. Utilizing high-resolution transmission electron microscope and selected area electron diffraction techniques, we identify a considerable number of nanoscale domains with typical size ∼10 nm in the samples that show high ZT values. It is suggested that the presence of nanoscale domains, like the situation in PbTe-AgSbTe(2) compounds, should make a slight contribution to the low lattice thermal conductivity of TAGS compounds due to the enhanced mid-frequency phonon scattering.

Apoptosis induced by 5-flucytosine in human pancreatic cancer cells genetically modified to express cytosine deaminase

AIM

To elucidate the pattern of 5-flucytosine (5-FC)-induced apoptosis and its role in gene therapy of human pancreatic cancer.

METHODS

The human pancreatic cancer SW1990 cells (CEA-producing) were infected with recombinant adenoviruses (Adex1CEA-prCD or Adex1CEA-prZ). Expression of CD gene protein was examined by western blot. Apoptosis induced by 5-FC in human pancreatic cancer SW1990 cells genetically modified to express cytosine deaminase was observed by means of electron microscopy, DNA electrophoresis, and flow cytometry analysis techniques.

RESULTS

The SW1990 cells infected with Adex1CEA-prCD were treated with 5-FC at 100 mumol.L-1 for 48 h, and cell apoptosis was observed. Typical apoptosis morphological feature appeared and DNA ladder could be demonstrated on DNA electrophoresis. Apoptosis peak was also showed by flow cytometry. Apoptotic cells accounted for 34.6% of the cell population. Cells in G1, S, and G2/M phase of cell cycle were 64%, 11%, and 7%, respectively.

CONCLUSION

The apoptosis induced by 5-FC may be a primary mechanism in CD gene therapy of pancreatic cancer.

Contributions of lower extremity joints to energy dissipation during landings

PURPOSE

The purpose of the study was to investigate changes in lower extremity joint energy absorption for different landing heights and landing techniques.

METHODS

Nine healthy, active male subjects volunteered to perform step-off landings from three different heights (0.32 m, 2.5 m(-s); 0.62 m, 3.5 m(-s); and 1.03 m, 4.5 m(-s)) using three different landing techniques (soft, SFL; normal, NML; and stiff landing, STL). Each subject initially performed five NML trials at 0.62 m to serve as a baseline condition and subsequently executed five trials in each of the nine test conditions (3 heights x 3 techniques).

RESULTS

The results demonstrated general increases in peak ground reaction forces, peak joint moments, and powers with increases in landing height and stiffness. The mean eccentric work was 0.52, 0.74, and 0.87 J x kg(-1) by the ankle muscles, and 0.94, 1.31, and 2.15 J x kg(-1) by the hip extensors, at 0.32, 0.62, and 1.03 m, respectively. The average eccentric work performed by the knee extensors was 1.21, 1.63, and 2.26 J x kg(-1) for the same three heights.

CONCLUSIONS

The knee joint extensors were consistent contributors to energy dissipation. The ankle plantarflexors contributed more in the STL landings, whereas the hip extensors were greater contributors during the SFL landings. Also a shift from ankle to hip strategy was observed as landing height increased.

Phase Lag and Coherence Function of X-Ray Emission from Black Hole Candidate XTE J1550-564

We report the results from measuring the phase lag and coherence function of X-ray emission from black hole candidate XTE J1550-564. These temporal X-ray properties have been recognized to be increasingly important in providing important diagnostics of the dynamics of accretion flows around black holes. For XTE J1550-564, we found significant hard lag-the X-ray variability in high-energy bands lags behind that in low-energy bands-associated both with broadband variability and quasi-periodic oscillation (QPO). However, the situation is more complicated for the QPO: while hard lag was measured for the first harmonic of the signal, the fundamental component showed significant soft lag. Such behavior is remarkably similar to what was observed of microquasar GRS 1915+105. The phase lag evolved during the initial rising phase of the 1998 outburst. The magnitude of both the soft and hard lags of the QPO increases with X-ray flux, while the Fourier spectrum of the broadband lag varies significantly in shape. The coherence function is relatively high and roughly constant at low frequencies and begins to drop almost right after the first harmonic of the QPO. It is near unity at the beginning and decreases rapidly during the rising phase. Also observed is that the more widely separated the two energy bands are, the less the coherence function between the two. It is interesting that the coherence function increases significantly at the frequencies of the QPO and its harmonics. We discuss the implications of the results on the models proposed for black hole candidates.

Three-layered atmospheric structure in accretion disks around stellar-mass black holes

Modeling of the x-ray spectra of the Galactic superluminal jet sources GRS 1915+105 and GRO J1655-40 reveals a three-layered atmospheric structure in the inner region of their accretion disks. Above the cold and optically thick disk with a temperature of 0.2 to 0.5 kiloelectron volts, there is a warm layer with a temperature of 1.0 to 1.5 kiloelectron volts and an optical depth around 10. Sometimes there is also a much hotter, optically thin corona above the warm layer, with a temperature of 100 kiloelectron volts or higher and an optical depth around unity. The structural similarity between the accretion disks and the solar atmosphere suggests that similar physical processes may be operating in these different systems.

Sputum induction to improve the diagnostic yield in patients with suspected pulmonary tuberculosis

OBJECTIVE

To evaluate the utility of sputum induction in the large-scale tuberculosis control program.

METHODS

Prospective study on sputum induction for improving the diagnostic yield of pulmonary tuberculosis, and estimation of the direct costs for sputum induction.

RESULTS

Of 1,648 tuberculosis suspects with poor or absent sputum production, induced sputum was smear-positive in 558 patients (353 previously smear-negative, 97 inadequate sputum and 108 unproductive). The direct cost per induced sputum was US $0.37.

CONCLUSION

Sputum induction is an effective, low-cost, and simple technique for improving the smear-positive case detection rate in a tuberculosis control program.