[Analysis of the application effect and safety of transnasal humidified rapid insufflation ventilatory exchange technique in hysteroscopic diagnostic and therapeutic surgery]

Objective: To investigate the effect and safety of transnasal humidified rapid insufflation ventilatory exchange (THRIVE) technique in hysteroscopic diagnostic and therapeutic surgery. Methods: This study was a randomized controlled trial. A total of 100 female patients undergoing hysteroscopy surgery at Beijing Tongren Hospital from September to December 2023 were selected and randomly divided into two groups by the random number table method: the THRIVE group and the mask oxygen group, with 50 patients in each group. Patients in both groups were given total intravenous anesthesia with propofol combined with remifentanil and preserved spontaneous respiration. The THRIVE group was given oxygen by the THRIVE device with an oxygen flow rate of 50 L/min, while the mask oxygen group was given oxygen by the mask with an oxygen flow rate of 5 L/min; the oxygen concentration of both groups was set at 100%. The general condition of the patients, vital signs during the operation, the amount of anesthesia drugs used and the operation time were recorded. The primary observation index was the incidence of hypoxic events in the two groups; the secondary observation indexes were the incidence and time of intraoperative apnea as well as the corresponding oxygenation interventions and the incidence of non-hypoxic adverse events. Results: The age of the THRIVE group was (42±14) years, and the age of the mask oxygen group was (43±15) years. The duration of surgery in the THRIVE group was (15.9±3.4) min, which was statistically lower than that of the mask oxygen group (16.3±4.5) min (P=0.041), and there were no differences observed in the duration of awakening time and anesthesia time (both P>0.05). There was no significant difference in the dosage of propofol, remifentanil, and intraoperative vasoactive drugs between the two groups (all P>0.05). The SpO2 of the patients in the THRIVE group at the end of the operation was (99.7±1.1) %, which was higher than that of the mask-oxygen group (99.1±1.1) % (P<0.05). There was no difference in SpO2 of the two groups at the other time points (all P>0.05). There were no differences in HR and MAP of two group patients at each time point (all P>0.05). The incidence of hypoxic events in the THRIVE group was 12.0% (6/50), which was lower than that of 28.0% (14/50) in the mask oxygen group (P=0.045). The difference in the incidence and duration of apnea between the two groups was not statistically significant (all P>0.05). There were no cases of temporary need for laryngeal mask or tracheal intubation during surgery in both groups. There was no statistically significant difference in the incidence of intraoperative body movement, dizziness, nausea and vomiting between the two groups (all P>0.05), and no cardiac, cerebral, renal or other important organ insufficiency occurred in the two weeks after surgery. Conclusion: THRIVE technology can provide effective oxygenation for patients undergoing hysteroscopic diagnosis and treatment, maintain patients' circulatory stability, and improve the safety and efficiency of surgery.

Object detection: A novel AI technology for the diagnosis of hepatocyte ballooning

Metabolic dysfunction-associated fatty liver disease (MAFLD) has reached epidemic proportions worldwide and is the most frequent cause of chronic liver disease in developed countries. Within the spectrum of liver disease in MAFLD, steatohepatitis is a progressive form of liver disease and hepatocyte ballooning (HB) is a cardinal pathological feature of steatohepatitis. The accurate and reproducible diagnosis of HB is therefore critical for the early detection and treatment of steatohepatitis. Currently, a diagnosis of HB relies on pathological examination by expert pathologists, which may be a time-consuming and subjective process. Hence, there has been interest in developing automated methods for diagnosing HB. This narrative review briefly discusses the development of artificial intelligence (AI) technology for diagnosing fatty liver disease pathology over the last 30 years and provides an overview of the current research status of AI algorithms for the identification of HB, including published articles on traditional machine learning algorithms and deep learning algorithms. This narrative review also provides a summary of object detection algorithms, including the principles, historical developments, and applications in the medical image analysis. The potential benefits of object detection algorithms for HB diagnosis (specifically those combined with a transformer architecture) are discussed, along with the future directions of object detection algorithms in HB diagnosis and the potential applications of generative AI on transformer architecture in this field. In conclusion, object detection algorithms have huge potential for the identification of HB and could make the diagnosis of MAFLD more accurate and efficient in the near future.

Tartaric acid coupled with gibberellin improves remediation efficiency and ensures safe production of crops: A new strategy for phytoremediation

Phytoremediation is the direct use of living green plants and it is an effective, inexpensive, non-invasive, and environmentally friendly technique used to transfer or stabilize all the toxic metals and environmental pollutants in polluted soil or ground water. To study the effect of tartaric acid, gibberellin, and tartaric acid coupled with gibberellin on rape-kenaf or rape-sweet sorghum rotation, a field experiment was carried out on a farmland combined polluted with Cd and Pb in eastern Hunan Province, China. The results showed that these two rotation systems coupled with superposition measure has potential to enhance yield and biomass of rape (Brassica napus L.), kenaf (Hibiscus cannabinus) and sweet sorghum (Sorghum dochna (F.) Snowden), as well as to increase Cd and Pb uptake of the three crops, thus accelerating phytoextraction. The Cd and Pb annual removal by rape-kenaf rotation in one year under different treatments were 269-438 and 112-149 g·hm-2, respectively. And the Cd and Pb annual removal by rape-sweet sorghum rotation in one year under different treatments were 68.0-111 and 43.8-92.3 g·hm-2, respectively. Under the two rotation systems, these integrated management measures can remove Cd and Pb up to 438 g·hm-2·year-1 and 149 g·hm-2·year-1, respectively. The Cd and Pb content in rape seeds or sweet sorghum stems and leaves were lower than the food or forage standard, indicating that we can use this rotation system for both remediation and safety production. Furthermore, the two rotation systems also generated considerable economic value. These results showed that the combination of phytoremediation and agricultural production is a feasible technical mode in the field of Cd and Pb co-contamination, and also provides useful information for further study of the interaction mechanism between rotation crops and enhancement measures. In subsequent experiments we can set concentration gradients for tartaric acid and gibberellin, and we can also select other crops for rotation, with a view to finding the optimal auxiliary measure and crop rotation modern.

[Metabolic study of iron deposition based on magnetic resonance in patients with nonalcoholic fatty liver disease]

Objective: To explore the relationship between liver iron deposition and steatosis in patients with non-alcoholic fatty liver disease (NAFLD) through MRI. Methods: 163 cases of liver biopsy underwent MRI examination. R2* was used to measure liver iron content. Dixon-based proton density fat fraction (PDFF) was used to measure liver fat content. One-way ANOVA, r-correlation, ROC curve, and others were used to assess the relationship between clinical case data, serological indices, and imaging results in accordance with the pathological results of the liver biopsy. Results: R2* gradually increased as the pathological steatosis grade rose. The R2* that corresponded to no steatosis (< 5%), mild steatosis (14.95%±8.55%), moderate steatosis (46.30%±9.32%), and severe steatosis (73.86%±6.35%) were 27.56±4.40, 31.06±5.95, 38.06±4.80, and 48.10±5.55 (P < 0.001), respectively. There was a positive correlation between R2* and liver steatosis content (r= 0.769, P < 0.05). The area under the ROC curve and cut-off value were 0.88 and 31.77, respectively, and there was no distinct relationship with liver inflammation or fibrosis. Conclusion: R2* can quantitatively and non-invasively evaluate liver iron deposition in patients with NAFLD. A distinct relationship exists between liver steatosis and iron deposition, and iron deposition tends to increase as the steatosis aggravates.

Biliary sepsis complication with congenital hepatic fibrosis: an unexpected outcome

BACKGROUND

CHF (Congenital hepatic fibrosis) is a rare hereditary disease characterized by periportal fibrosis and ductal plate malformation. Little is known about the clinical presentations and outcome in CHF patients with an extraordinary complication with biliary sepsis. Our case described a 23-year-old female diagnosed as CHF combined with biliary sepsis. Her blood culture was positive for KP (Klebsiella pneumoniae), and with a high level of CA19-9 (> 1200.00 U/ml, ref: <37.00 U/ml). Meanwhile, her imaging examinations showed intrahepatic bile duct dilatation, portal hypertension, splenomegaly, and renal cysts. Liver pathology revealed periportal fibrosis and irregularly shaped proliferating bile ducts. Whole-exome sequencing identified two heterozygous missense variants c.3860T > G (p. V1287G) and c.9059T > C (p. L3020P) in PKHD1 gene. After biliary sepsis relieved, her liver function test was normal, and imaging examination results showed no significant difference with the results harvested during her biliary sepsis occurred.

CONCLUSION

The diagnosis of CHF complicated with biliary sepsis in the patient was made. Severely biliary sepsis due to KP infection may not inevitably aggravate congential liver abnormality in young patients. Our case provides a good reference for timely treatment of CHF patients with biliary sepsis.

Mucin 1 promotes salivary gland cancer cell proliferation and metastasis by regulating the epidermal growth factor receptor signaling pathway

Background/purpose

Salivary gland cancer (SGC) is the common malignant tumor of the head and neck region with poor prognosis. Mucin 1 (MUC1) has been reported to be associated with the development of cancer. However, whether MUC1 contributed to the progression of SGC remains to be explored.

Materials and methods

Immunohistochemical analysis was used to explore the expression levels of MUC1 in SGC tissues. Cell proliferation, colony formation, wound healing, transwell, and xenograft assays were performed to examine the effects of MUC1 on SGC in vitro and in vivo.

Results

We found that the expression level of MUC1 was significantly upregulated in SGC tissues, and the expression level of MUC1 was significantly correlated with lymph node metastasis and TNM stage of SGC. Further exploration demonstrated that MUC1 knockdown drastically inhibited, while its overexpression promoted, cell growth, colony formation, migration, and invasion abilities of SGC cells in vitro. MUC1 knockdown significantly inhibited tumor growth in vivo, and vice versa. More importantly, we found that MUC1 promotes malignant phenotypes of SGC cells by regulating the epidermal growth factor receptor (EGFR) signaling pathway.

Conclusion

Our results revealed that MUC1 promotes the development of SGC by mediating the EGFR signaling pathway, which highlights the potential therapeutic target of MUC1/ EGFR in SGC.

Hepatocytic ballooning in non-alcoholic steatohepatitis: Dilemmas and future directions

Hepatocytic ballooning is a key histological feature in the diagnosis of non-alcoholic steatohepatitis (NASH) and is an essential component of the two most widely used histological scoring systems for diagnosing and staging non-alcoholic fatty liver disease (NAFLD) [namely, the NAFLD activity score (NAS), and the steatosis, activity and fibrosis (SAF) scoring system]. As a result of the increasing incidence of NASH globally, the diagnostic challenges of hepatocytic ballooning are unprecedented. Despite the clear pathological concept of hepatocytic ballooning, there are still challenges in assessing hepatocytic ballooning in 'real life' situations. Hepatocytic ballooning can be confused with cellular oedema and microvesicular steatosis. Significant inter-observer variability does exist in assessing the presence and severity of hepatocytic ballooning. In this review article, we describe the underlying mechanisms associated with hepatocytic ballooning. Specifically, we discuss the increased endoplasmic reticulum stress and the unfolded protein response, as well as the rearrangement of the intermediate filament cytoskeleton, the appearance of Mallory-Denk bodies and activation of the sonic Hedgehog pathway. We also discuss the use of artificial intelligence in the detection and interpretation of hepatocytic ballooning, which may provide new possibilities for future diagnosis and treatment.

Evolution of the CBL and CIPK gene families in Medicago: genome-wide characterization, pervasive duplication, and expression pattern under salt and drought stress

BACKGROUND

Calcineurin B-like proteins (CBLs) are ubiquitous Ca²⁺ sensors that mediate plant responses to various stress and developmental processes by interacting with CBL-interacting protein kinases (CIPKs). CBLs and CIPKs play essential roles in acclimatization of crop plants. However, evolution of these two gene families in the genus Medicago is poorly understood.

RESULTS

A total of 68 CBL and 135 CIPK genes have been identified in five genomes from Medicago. Among these genomes, the gene number of CBLs and CIPKs shows no significant difference at the haploid genome level. Phylogenetic and comprehensive characteristic analyses reveal that CBLs and CIPKs are classified into four clades respectively, which is validated by distribution of conserved motifs. The synteny analysis indicates that the whole genome duplication events (WGDs) have contributed to the expansion of both families. Expression analysis demonstrates that two MsCBLs and three MsCIPKs are specifically expressed in roots, mature leaves, developing flowers and nitrogen fixing nodules of Medicago sativa spp. sativa, the widely grown tetraploid species. In particular, the expression of these five genes was highly up-regulated in roots when exposed to salt and drought stress, indicating crucial roles in stress responses.

CONCLUSIONS

Our study leads to a comprehensive understanding of evolution of CBL and CIPK gene families in Medicago, but also provides a rich resource to further address the functions of CBL-CIPK complexes in cultivated species and their closely related wild relatives.

[Survival analysis of long-term HIV/AIDS cases aged 15 years and over under antiretroviral treatment in Henan Province from 2002 to 2020]

Objective: To analyze the survival and influencing factors of HIV infections and AIDS cases (HIV/AIDS) aged 15 years and over who had received antiretroviral treatment (ART) for more than 10 years in Henan Province. Methods: In this retrospective cohort study, data of HIV infections and AIDS cases in Henan province were collected from the AIDS Prevention and Control System between January 1, 2002 and December 31, 2020. This study included 20 256 participants alive after 10-year ART with complete baseline and follow-up information, such as demographic characteristics, CD4⁺T lymphocyte count and viral load. Cox proportional risk regression model was used to analyze influencing factors of HIV/AIDS survival. Results: A total of 20 256 participants were followed up for 82 738.2 person-years, with an average follow-up of 4.1 person-years, of which most cases were blood transmission (85.5%) and married (71.2%). The male to female ratio was 1∶1.06 and the age at 10 years of ART was (51.2±8.7) years old. About 88.5% of HIV/AIDS patients received ART in village/township treatment institutions. Overall, there were 2 030 deaths during this period, among which 1 897 were due to AIDS-related diseases (93.5%) and the case fatality rate was 9.4% (1 897/20 256). Cox proportional risk regression model showed that participants aged 40-54, 55-69, and ≥70 years had a higher risk of death compared to those aged 25-39, with adjusted HRs (95%CI) of 1.57 (1.19-2.08), 3.78 (2.86-4.99), and 6.17 (4.33-8.79), respectively. Participants with the initial CD4⁺T lymphocyte count about 200-349/μl and<200/μl had a higher risk of death compared to those with initial CD4⁺T lymphocyte count ≥350/μl, with adjusted HRs (95%CI) of 1.81 (1.61-2.04) and 3.64 (3.20-4.15), respectively. Participants with the initial viral load outcome ≥1 000 copies/ml had a higher risk of death compared to those with the initial viral load outcome<1 000 copies/ml, with adjusted HRs (95%CI) of 1.73 (1.52-1.97). Participants receiving the second-line ART had a lower risk of death compared to those receiving the first-line ART, with adjusted HRs (95%CI) of 0.12 (0.11-0.14). Conclusion: From 2002 to 2020, the survival rate of HIV/AIDS treated with ART for more than 10 years is high in Henan Province. Age, CD4⁺T lymphocyte count and viral load are influencing factors of HIV/AIDS survival.

[The core techniques of airway and circulation management in eye and ear-nose-throat anesthesia]

With the continuous update of anesthesia techniques, equipment and research field, the techniques and concepts of anesthesia in eye and ear-nose-throat (ENT) surgery are constantly optimized and developed. Eye and ENT anesthesia has its unique technical characteristics and problems. By reviewing related literature extensively and combining with our experience, this article analyzed and discussed the challenges of ENT anesthesia, such as difficult airway, airway hyperactivity, controlled hypotension and so on, as well as summarizing and evaluating the advantages and disadvantages of the techniques applied in ENT anesthesia.

Enrichment and speciation of chromium during basalt weathering: Insights from variably weathered profiles in the Leizhou Peninsula, South China

Basalt-derived soils are widespread worldwide. Such soils contain high levels of heavy metals like chromium (Cr), which is a serious environmental concern. However, little is known regarding the enrichment and speciation of Cr during the basalt weathering process. Therefore, two basalt-derived soil profiles (Nitisol and Ferralsol) in the Leizhou Peninsula, south tropical China, were investigated to explore the redistribution and transformation of Cr during basalt weathering. All profiles could be divided into three layers: rocks, saprolites, and soils. The Nitisol and Ferralsol profiles exhibited strong (kaolinization) and extreme (laterization) degrees of weathering, respectively. Results showed that Cr concentrations in the saprolites (234 to 315 mg·kg^-1) were higher than those in basalt rocks (139 to 159 mg·kg^-1), indicating that Cr was enriched with the continuous loss of Si and other mobile macro-elements. While high levels of Cr were also enriched in the soils (178 to 430 mg·kg^-1) accompanied with Fe. However, in the upper soils of the Ferralsol profile, the acidity and organic matter could promote the leaching of Cr. Geochemical fractions and EPMA mapping showed that chromite and olivine were the main Cr-bearing minerals in basalt, but Fe-oxides (e.g., goethite and hematite) contained the highest portion of Cr in weathered saprolites and soils. The availability of Cr in the soil was extremely low due to the high stability of Cr bound to Fe-oxides. However, the decreasing contents of Cr bound to Fe-oxides in the upper soils of the Ferralsol profile indicated that Cr could also be released during Fe leaching. In conclusion, the weathering of basalt can lead to the enrichment of Cr in Fe-(hydro)oxides, which are the main controlling minerals for Cr mobility in basalt-derived soils. Further research is needed to evaluate the effect of Fe-(hydro)oxide formation and dissolution on the release of soil Cr.

Hepatopulmonary metastases from papillary thyroid microcarcinoma: A case report

BACKGROUND

Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy. Papillary thyroid microcarcinoma (PTMC) accounts for the majority of PTC cases. However, concurrent pulmonary and hepatic metastases of PTMC are rarely seen. Here, we present a patient with coexisting liver and lung metastases from PTMC.

CASE SUMMARY

We describe a 26-year-old woman with PTMC with multiple concurrent metastases. After 3 d of unexplained fever, she was admitted to our hospital. Her thyroid functional tests were abnormal. Her positron emission tomography (PET)/magnetic resonance imaging (MRI) examination showed increased fluorodeoxyglucose (FDG) metabolism and space-occupying lesions in the left lobe of the thyroid. Additionally, PET/MRI images revealed multiple nodules in the lung and liver with increased FDG metabolism. Chest computer tomography (CT) showed multiple pulmonary metastases. Abdominal ultrasound and liver MRI showed multiple space-occupying lesions in the liver. The patient underwent total thyroidectomy and central lymph node dissection. Postoperative pathological analysis showed a papillary microcarcinoma multiplex in the left lobe of the thyroid. A diagnosis of hepatopulmonary metastases from papillary thyroid microcarcinoma was made. The patient was given iodine-131 treatment one year after the surgery. She recovered well after the operation, and the incision healed well. After discharge, she was treated with oral levothyroxine sodium tablets, and symptomatic and supportive treatments were also given to promote radioactive excretion and prevent bone marrow suppression by iodine-131 treatment.

CONCLUSION

Since patients with thyroid cancer concurrent with hepatopulmonary metastases have rarely been reported, our case will highlight the clinical and pathological profiles of these patients.

A Case of Sporadic Pseudohypoparathyroidism Type 1B Presented with Hypokalemia

Luo et al. 1 reported two cases of autosomal dominant pseudohypoparathyroidism type 1B (AD-PHP1B) and reviewed literature about the genetic and epigenetic characteristics of AD-PHP1B. Pseudohypoparathyroidism (PHP) is a cluster of heterogeneous diseases characterized by hypocalcemia and hyperphosphatemia due to resistance to parathyroid hormone (PTH). PHP1B almost results from methylation abnormalities of the maternal differentially methylated regions (DMRs) and can be divided into sporadic PHP1B and AD-PHP1B 1. As mentioned in this article 1, AD-PHP1B is caused by heterozygous maternal deletions within GNAS or STX16, which are associated with loss of methylation at the A/B DMR alone or at all maternally methylated GNAS exons. While sporadic PHP1B remains unclear at the molecular level, except for approximately 10% of the patients caused by paternal uniparental isodisomy or heterodisomy involving chromosome 20q (patUPD20q) 2. Here, we would like to present a rare case of sporadic PHP1B occurring in association with hypokalemia.

[Studying the correlation between ferritin and non-alcoholic fatty liver disease]

Objective: To analyze the correlation between serum ferritin and steatosis in non-alcoholic fatty liver disease. Methods: Data of 167 cases who underwent liver biopsy in the Affiliated Hospital of Hangzhou Normal University were collected. Hydrogen proton magnetic resonance spectroscopy were performed within one week. The pathological results of liver biopsy were used as the gold standard to analyze the case data, serological indicators, magnetic resonance spectroscopy-proton density fat fraction. Results: Pathological monitoring result showed that the serum ferritin in patients without steatosis, and with mild, moderate and severe steatosis were (206.20 ± 189.83), (286.65 ± 200.80), (326.55 ± 214.71), (391.50 ± 184.93) ng/ml, respectively, P < 0.005. Serum ferritin was correlated to body mass index, PDFF, alanine aminotransferase, gamma glutamyltransferase, low-density lipoprotein, high-density lipoprotein. The area under ​​the receiver operating characteristic curve with ferritin for the diagnosis of non-alcoholic fatty liver disease was 0.716, and the optimal diagnostic threshold was 214.56 ng/ml. The sensitivity and specificity were 80.1%, and 68.8%, respectively. There was no statistically significant difference between the intralobular inflammation, fibrosis, and ferritin. Prussian blue iron staining had no apparent deposition of iron particles. Conclusion: Ferritin has significant positive correlation with the results of pathological and magnetic resonance imaging for liver steatosis. Therefore, it can be used as a non-invasive diagnostic method for liver steatosis evaluation.

[Analysis on mortality in HIV/AIDS cases aged 15 years and older under antiretroviral treatment in Henan province, 2002-2019]

Objective: To analyze the mortality in HIV/AIDS cases aged ≥15 years under antiretroviral treatment (ART) in Henan province from 2002 to 2019, and provide evidence for reducing the mortality rate of HIV/AIDS and AIDS prevention and treatment. Methods: Data of HIV/AIDS cases aged ≥15 years who received ART in Henan from 2002 to 2019 were obtained from "Infectious Disease Surveillance System - Basic Information on AIDS Prevention and Control". In this retrospective study, Cox proportional risk model was used to analyze the influencing factors for HIV/AIDS related deaths. Software SPSS 23.0 was used for statistical analysis. Results: From 2002 to 2019, a total of 72 986 HIV/AIDS cases aged ≥15 years received ART, in whom, 16 634 died during this period. Most of the death cases were aged ≥40 years old (68.5%,11 393/16 634), males (62.6%,10 419/16 634), infected through blood-borne transmission (71.7%,11 927/16 634), and farmers or migrant workers (91.7%,15 249/16 634). Most of the deaths were due to AIDS related diseases (73.7%, 12 261/16 634), and the case fatality rate was 16.8% (12 261/72 986). A total of 34.6% (4 237/12 261) of HIV/AIDS cases died of AIDS-related diseases in the first year of ART, and the cumulative survival rates at 10 and 18 years of ART were 78.3% and 71.8%, respectively. The proportion of the HIV/AIDS cases with baseline CD4⁺T lymphocyte (CD4) counts <200 cells/μl at age 15 years when ART started was 45.5% (30 432/66 898). Cox proportional risk regression model showed that, compared with the cases with baseline CD4 counts ≥350 cells/μl, the risk of death was 1.78 times higher than in the cases with CD4 counts <200 cells/μl (95%CI: 1.64-1.94) and 1.24 times higher in the cases with CD4 counts ≥200 cells/μl (95%CI: 1.13-1.36), respectively. The risk of death in symptomatic cases at baseline survey was 1.25 times higher than that in asymptomatic cases (95%CI: 1.16-1.35). The cases with a latest viral load ≥1 000 copies/ml had 7.09 times higher risk of death than those with a last viral load<1 000 copies/ml (95%CI: 6.65-7.54). Conclusions: The majority of HIV/AIDS deaths occurred in the cases aged ≥15 years receiving ART in Henan province during 2002-2019, who were infected through blood-borne transmission and farmers/migrant workers, and AIDS-related diseases were the main causes of the deaths. With the gradual implementation of ART policy, the high survival rate in HIV/AIDS cases can be maintained for a long time in Henan. To reduce the case fatality rate and improve the quality of life of HIV/AIDS patients, CD4 counts test should be further strengthened and eligible HIV/AIDS patients should be covered by standard ART in a timely manner.

P–392 Clinical outcomes of endometrium receptivity analysis(ERA) testing in patients with repeated IVF failures

Study question

Is ERA testing different between RIF patients with control group?

Summary answer

In RIF patients, there were more chances of non-receptive endometrium. ERA testing may be helpful for the patients with repeated IVF failure. What is known already: The endometrium receptivity analysis testing might have the ability to detect the implantation window. In repeat implantation failure patients, detecting of precisely implantation window may have some benefits.

Study design, size, duration

This was a single-center retrospective observational study. Two hundred and forty-nine patients who underwent ERA testing following frozen-thawed embryo transfer in our center were including in this study between January 2019 and May 2020.

Participants/materials, setting, methods

181 patients having unexplained repeated IVF failure (RIF group, at least tow implantation failure) and 68 patients having no experience with embryo transfer (Control group) who underwent ERA testing were including in this study. Both of Patients having a receptive (R) ERA and having a non-receptive (NR) ERA underwent a personalized embryo transfer (pET) on ERA. ERA results and clinical outcomes compared between RIF group and control group were analyzed by Chi-square test.

Main results and the role of chance

The proportion of R/NR results were 33:35 for the RIF group and 118:63 for the Control group, demonstrating the displacement of the window of implantation in patients with RIF. Our results revealed an endometrial factor in 51% RIF patients, which was significantly greater than the Control group 34.8% (P = 0.02). Among the patients with NR ERA result, there are not significantly difference in clinical pregnancy rate in the RIF group compared with control group (57.1%. vs. 61.9%). The clinical pregnancy rate of the patients with receptive ERA result also is comparable in both group (70.3% vs. 66.7%).

Limitations, reasons for caution

This is a retrospective, single center study with limited case number. There were may some bias with ERA testing errors.

Wider implications of the findings: In RIF patients, there were more chances of non-receptive endometrium. ERA testing may be helpful for the patients with repeated IVF failure. Larger randomized studies are required to validate these results.

Trial registration number

18MMHISO70e

Nano-Fe3O4-modified biochar promotes the formation of iron plaque and cadmium immobilization in rice root

Rice as a paddy field crops, iron-containing materials application could induce its iron plaque formation, thereby affecting cadmium (Cd) transportation in the rhizosphere and its uptake in root. In this study, a hydroponic experiment was conducted to investigate the effects of three exogenous iron materials, namely nano-Fe₃O₄-modified biochar (BC-Fe), chelated iron (EDTA-Fe), and ferrous sulfate (FeSO₄), on the iron plaque formation on the surface of rice root, and to investigate the effects of formed iron plaque on the absorption, migration, and transportation of Cd and Fe in rice plant. The results showed that yellow-brown and brown iron plaque was formed on surface cells of the Fe-treated rice root, and some black particles were embedded in the iron plaque formed by BC-Fe. The proportion of crystallized iron plaque (31.8%-35.9%) formed by BC-Fe was much higher than that formed by EDTA-Fe and FeSO₄. The Cd concentrations in the crystallized iron plaque formed by BC-Fe were 7.64-13.0 mg·kg^-1, and increased with the increasing of Fe concentrations in the plaque. The Cd translocation factor from root to stem (TF_r-s) and the Cd translocation factor from stem to leaf (TF_s-l) with BC-Fe treatment decreased by 84.7% and 80.0%, respectively. The results demonstrated that application BC-Fe promoted the formation of iron plaque and enhanced the sequestration of Cd and Fe in roots, thus reduced the transportation and accumulation of Cd in aerial rice tissues.

Single-cell RNA sequencing identifies molecular targets associated with poor in vitro maturation performance of oocytes collected from ovarian stimulation

STUDY QUESTION

What is the transcriptome signature associated with poor performance of rescue IVM (rIVM) oocytes and how can we rejuvenate them?

SUMMARY ANSWER

The GATA-1/CREB1/WNT signalling axis was repressed in rIVM oocytes, particularly those of poor quality; restoration of this axis may produce more usable rIVM oocytes.

WHAT IS KNOWN ALREADY

rIVM aims to produce mature oocytes (MII) for IVF through IVM of immature oocytes collected from stimulated ovaries. It is not popular due to limited success rate in infertility treatment. Genetic aberrations, cellular stress and the absence of cumulus cell support in oocytes could account for the failure of rIVM.

STUDY DESIGN, SIZE, DURATION

We applied single-cell RNA sequencing (scRNA-seq) to capture the transcriptomes of human in vivo oocytes (IVO) (n = 10) from 7 donors and rIVM oocytes (n = 10) from 10 donors. The effects of maternal age and ovarian responses on rIVM oocyte transcriptomes were also studied. In parallel, we studied the effect of gallic acid on the maturation rate of mouse oocytes cultured in IVM medium with (n = 84) and without (n = 85) gallic acid.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Human oocytes were collected from donors aged 28-41 years with a body mass index of <30. RNA extraction, cDNA generation, library construction and sequencing were performed in one preparation. scRNA-seq data were then processed and analysed. Selected genes in the rIVM versus IVO comparison were validated by quantitative real-time PCR. For the gallic acid study, we collected immature oocytes from 5-month-old mice and studied the effect of 10-μM gallic acid on their maturation rate.

MAIN RESULTS AND THE ROLE OF CHANCE

The transcriptome profiles of rIVM/IVO oocytes showed distinctive differences. A total of 1559 differentially expressed genes (DEGs, genes with at least 2-fold change and adjusted P < 0.05) were found to be enriched in metabolic processes, biosynthesis and oxidative phosphorylation. Among these DEGs, we identified a repression of WNT/β-catenin signalling in rIVM when compared with IVO oocytes. We found that oestradiol levels exhibited a significant age-independent correlation with the IVO mature oocyte ratio (MII ratio) for each donor. rIVM oocytes from women with a high MII ratio were found to have over-represented cellular processes such as anti-apoptosis. To further identify targets that contribute to the poor clinical outcomes of rIVM, we compared oocytes collected from young donors with a high MII ratio with oocytes from donors of advanced maternal age and lower MII ratio, and revealed that CREB1 is an important regulator. Thus, our study identified that GATA-1/CREB1/WNT signalling was repressed in both rIVM oocytes versus IVO oocytes and in rIVM oocytes of lower versus higher quality. Consequently we investigated gallic acid, as a potential antioxidant substrate in human rIVM medium, and found that it increased the mouse oocyte maturation rate by 31.1%.

LARGE SCALE DATA

Raw data from this study can be accessed through GSE158539.

LIMITATIONS, REASONS FOR CAUTION

In the rIVM oocytes of the high- and low-quality comparison, the number of samples was limited after data filtering with stringent selection criteria. For the oocyte stage identification, we were unable to predict the presence of oocyte spindle, so polar body extrusion was the only indicator.

WIDER IMPLICATIONS OF THE FINDINGS

This study showed that GATA-1/CREB1/WNT signalling was repressed in rIVM oocytes compared with IVO oocytes and was further downregulated in low-quality rIVM oocytes, providing us the foundation of subsequent follow-up research on human oocytes and raising safety concerns about the clinical use of rescued oocytes.

STUDY FUNDING/COMPETING INTEREST(S)

This work was supported by the Collaborative Research Fund, Research Grants Council, C4054-16G, and Research Committee Funding (Research Sustainability of Major RGC Funding Schemes), The Chinese University of Hong Kong. The authors have no conflicts of interest to declare.

[Urinary retinol binding protein and β2-microglobulin were associated with urinary albumin to creatinine ratio and renal function in hospitalized diabetic patients]

Objective: To explore the associations of urinary retinol binding protein (RBP) and β₂-microglobulin (β₂-MG) with urinary albumin to creatinine ratio (UACR) and renal function in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods: A total of 1 030 Chinese patients with T2DM were included in this study. The subjects were divided into the UACR normal group (<30 mg/g), microalbuminuria group (30-300 mg/g) and macroalbuminuria group (>300 mg/g). Patients with normal UACR were further divided into two groups according to the estimated glomerular filtration rate (eGFR): the eGFR low group (<90 ml·min^-1·1.73m^-2) and the normal eGFR group (≥90 ml·min^-1·1.73m^-2). Urine RBP and β₂-MG levels among the groups were compared. Multiple linear regression analyses were applied to evaluate risk factors of urine RBP and β₂-MG. Results: In all patients (n=1 030), urine RBP and β₂-MG increased gradually with the increase of UACR across the three groups, the proportions of abnormal urine RBP (>0.7 mg/L) and β₂-MG (>370 μg/L) in these groups were 3.8%, 8.5%, 39.0% (P<0.001), and 12.9%, 26.7%, 46.8% (P<0.001), respectively. In the UACR normal group (n=788), 12.2% of the patients were with eGFR<90 ml·min^-1·1.73m^-2. The proportion of abnormal β₂-MG (>370 μg/L) was higher in the eGFR low group than that in the eGFR normal group (29.2% vs. 10.7%, P<0.001). Multivariate linear stepwise regression analyses were performed using natural logarithm of urine RBP or β₂-MG as dependent variable, and showed that urine RBP was independently associated with UACR (β=0.0005, P<0.001), serum creatinine (β=0.006, P<0.001) and glycosylated hemoglobin A1c (β=0.050, P=0.001), and β₂-MG was independently correlated with UACR (β=0.000 4, P<0.001), serum creatinine (β=0.011, P<0.001), systolic blood pressure (β=0.005, P=0.031) and fasting blood-glucose (β=0.027, P=0.046). Conclusions: Urine RBP and β₂-MG are positively associated with high UACR and impaired renal function in T2DM patients, and these changes could occur before UACR and eGFR turned out to be abnormal. It is recommended that urine RBP and β₂-MG be detected as early as possible to identify diabetic kidney disease in patients with normal UACR and eGFR.

MicroRNA-139-5p upregulation is associated with diabetic endothelial cell dysfunction by targeting c-jun

Dysfunction of endothelial cells (ECs) and their progenitor cells is an important feature of diabetic vascular disease. MicroRNA (miR)-139-5p is involved in inhibiting the metastasis and progression of diverse malignancies. However, the role of miR-139-5p in ECs still remains unclarified. Here we demonstrated that miR-139-5p expression was elevated in endothelial colony-forming cells (ECFCs) isolated from patients with diabetes, ECs derived from the aorta of diabetic rodents, and human umbilical vein endothelial cells (HUVECs) cultured in high glucose media. MiR-139-5p mimics inhibited tube formation, migration, proliferation, and down-regulated expression of c-jun, vascular endothelial growth factor (VEGF), and platelet-derived growth factor (PDGF)-B, in ECFCs and HUVECs, respectively; moreover, miR-139-5p inhibitors reversed the tendency. Further, gain- and-loss function experiments and ChIP assay indicated that miR-139-5p regulate functions of ECFCs by targeting c-jun-VEGF/PDGF-B pathway. In vivo experiments (Matrigel plug assay and hindlimb ischemia model) showed that miR-139-5p downregulation further promoted ECFC-mediated angiogenesis and blood perfusion. In conclusion, diabetes-mediated high miR-139-5p expression inhibits the c-jun-VEGF/PDGF-B pathway, thus decreasing ECFCs migration, tube formation and proliferation, which subsequently reduces ECs survival. Therefore, miR-139-5p might be an important therapeutic target in the treatment of diabetic vasculopathy in the future.

Identification of Novel Variants in MEN1: A Study Conducted with Four Multiple Endocrine Neoplasia Type 1 Patients

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant inherited endocrine tumor syndrome caused by inactivating variants of the MEN1 gene. The aim of this study is to explore the clinical and genetic characteristics of four MEN1 patients. We isolated genomic deoxyribonucleic acid from lymphocytes, parathyroid, and thymic tumoral tissue specimens from the MEN1 patients. All exons of the MEN1 and CDNK1B genes and adjacent exon-intron sequences were amplified by polymerase chain reaction and subsequently sequenced. Further, the splice alterations were studied by sequencing the amplified RT-PCR products for MEN1 cDNA. We identified four heterozygous MEN1 germline variants: c.564delC, c.1268G>A, IVS5+5delG, and c.1546_1547insC. Both c.564delC and IVS5+5delG were novel variants. The impact of the MEN1 splice variant, IVS5+5delG, was evaluated using bioinformatics and in vitro analyses. The analyses indicated that this variant resulted in skipping of the neighboring exon and was disease-causing. Two novel somatic variants, c.249_252delGTCT and c.313_314insC, were found. Additionally, loss of heterozygosity (LOH) for the MEN1 locus (IVS5+5delG and c.564delC) was found in tumor tissue samples from the MEN1 patients, consistent with Knudson's two-hit mechanism. We identified four MEN1 germline variants and two novel somatic variants. Early recognition of the phenotype coupled with variant screening of the MEN1 gene is the key to diagnosing and treating MEN1 effectively at an early stage.

Prevalence and prognosis of 5022 cases of gastric cancer in Ningxia

BACKGROUND

Ningxia is located in the northwest of China, which is a high incidence area of gastric cancer (GC), and GC is the top cause of malignancy related death in this area. However, epidemiological data on the prevalence and prognosis of GC in Ningxia are very limited.

AIM

To retrospectively analyze the clinicopathologic features of 5022 patients with GC in Ningxia to understand the epidemiological characteristics and identify prognostic risk factors in patients with GC.

METHODS

A total of 5022 hospitalized GC patients from January 2009 to December 2017 were involved. Clinicopathologic data and survival status were collected. Overall survival (OS) was calculated from the time of initial diagnosis to either the date of death due to GC or the last follow-up date. OS was generated by the Kaplan-Meier method, and the differences between subgroups were compared using the log-rank test. Multivariate analysis was performed with the Cox proportional hazards model. Relative risk was estimated by calculating hazard ratios and 95%CI. The prevalence of GC in this area was then analyzed, and the main risk factors affecting its prognosis were identified.

RESULTS

Among the 5022 cases of GC in Ningxia, 3888 (77.4%) were male and 1134 (22.6%) were female, with a male-to-female ratio of 3.43:1. The patients ranged in age from 15-93 years, with a median age of 61 (15) years. Totally, 1734 patients died of GC, with a mortality rate of 34.5%. The mortality rate of patients with GC increased with age. Multivariate survival analysis showed that age, Tumor-Node-Metastasis (TNM) stage, tumor location, tumor size, and tumor differentiation were independent risk factors for the prognosis of GC patients in Ningxia, and surgery and postoperative radiochemotherapy were protective factors.

CONCLUSION

The majority of GC patients in Ningxia are elderly men. The overall mortality rate of GC patients in Ningxia is high and the prognosis is poor. Age, TNM stage, and tumor location are independent risk factors for prognosis of GC patients in this region, and surgery and postoperative chemoradiotherapy are protective factors.

[Key Stage of As Accumulation in Rice Under As Stress at Different Growth Stages]

The absorption and accumulation of As at different stages of rice growth are significantly different. To study the key growth stages of As accumulation in brown rice and to determine the contribution of As accumulation at different growth stages to As contribution in brown rice, a rice hydroponics experiment was carried out by adding external As during the different rice growth stages: tillering stage (30 d), jointing stage (16 d), booting stage (13 d), filling stage (17 d), dough stage (15 d), maturity stage (13 d), and full growth period (104 d). The results showed that: ① As stress at different growth stages had a significant effect on the biomass of rice plants. In comparison with the control CK, the treatments of As stress with five single-stages decreased the rice biomass, except during the tillering stage. Among these treatments, although the As stress at booting stage had the lowest rice biomass, the biomass of all the rice plants were higher than that for As stress in the full growth period. ② The content of As in brown rice for all the treatments of As stress at six single-stages, ranging from 0.08-0.24 mg ·kg^-1, was higher than that of CK. Among these six treatments, the As stress at booting stage had the highest As content in brown rice, accounting for 64.9% of the As content in the full growth period. ③ The accumulation of As in brown rice for all the treatments of As stress at six single-stages was higher than that of CK, and ranged from 1.4-1.5 μg ·plant^-1. Among these six treatments, the As stress at booting stage had the highest As accumulation, followed by filling stage. The accumulation of As in brown rice treated with As stress was highest in the full growth period with a value of 5.7 μg ·plant^-1. ④ The relative contribution of As stress at the booting stage was the highest for the As accumulation in brown rice and reached to 40.3%, followed by filling stage with 26.0%. Therefore, the rice growth stages of the booting stage and filling stage were the key stages of As accumulation in brown rice.

Diffuse-type tenosynovial giant cell tumor of the temporomandibular joint with skull base invasion: a report of 22 cases with literature review

OBJECTIVES

The aim of this study was to retrospectively analyze the clinical characteristics, surgical treatment, and prognosis of patients with diffuse-type tenosynovial giant cell tumor (D-TGCT) involving the temporomandibular joint (TMJ) and the skull base.

STUDY DESIGN

A retrospective study was performed in patients with D-TGCT involving the TMJ and the skull base at our institute from April 2009 to August 2018. Data on clinical characteristics, surgical treatment, and prognosis were collected and analyzed. A literature search on D-TGCT involving the TMJ was conducted and the data analyzed.

RESULTS

The study included 22 patients (14 males and 8 females), with an average age of 44 years. The main symptoms were headache and hearing limitation, accompanied by a swelling in the TMJ area. Magnetic resonance imaging (MRI) showed low signals on T1- and T2-weighted images. All lesions were completely removed. Temporal bone flap, titanium mesh, and temporal muscle flap were used for reconstruction. The recurrence rate was 4.5%. In the literature, 115 cases were reported. Surgery alone was performed in 88 cases; postoperative radiotherapy was performed in 19 cases; the tumor recurrence rates were 9.1% and 15.8% for the 2 procedures, respectively. All patients were alive at the end of the follow-up period.

CONCLUSIONS

D-TGCT involving the TMJ and the skull base is a locally aggressive but benign lesion necessitating complete resection and has a good prognosis.

The minimally invasive spinal surgery in the treatment of posterior edge separation

BACKGROUND

Posterior edge separation of the vertebral body is an uncommon but non-rare orthopedic disease, the traditional treatment is posterior open surgery. Recently, a lot of attempts in minimally invasive treatment of lumbar posterior edge fracture have been made. We set to discover the value of minimally invasive surgery in the treatment of posterior edge separation, we designed this retrospective study.

METHODS

Eighteen patients (10 males and 8 females) with posterior edge separation were included between September 2015 and May 2019. The mean age of the patients were 49.9 years. Patients that we included were divided into two groups: people in team A were treated with percutaneous endoscopic lumbar discectomy (PELD), while the other group (team B) were carried the minimally invasive spinal surgery-transforaminal lumbar interbody fusion (MISS-TLIF). The intraoperative/postoperative complications and index were recorded respectively. Visual analogue scale (VAS) and Oswestry disability index (ODI) were applied as evaluation parameters to evaluate the effect of the procedure.

RESULTS

The mean operation time and notch length in PELD group were 71 min and 6.8 mm, while these date in the other group were 105 min and 31.2 mm. In PELD group, the blood loss during the operation were 5 mL and the time lying in bed after the surgery 24 h, the data in corresponding group were 101 mL and 96 h. People included in our trial (excluding 1 defaulters) had a mean follow-up of 9 months (range, 3-12 months). The VAS and ODI score before and after the surgery had insignificant difference between the two groups (P>0.05). Compared with the data before the operation, the VAS and ODI score had significantly improved after the surgery in two groups (P<0.05).

CONCLUSIONS

The MISS-TLIF and PELD were all effective methods in the treatment of posterior edge separation.

Effects of nano-Fe3O4-modified biochar on iron plaque formation and Cd accumulation in rice (Oryza sativa L.)

Nano-Fe₃O₄-modified biochar (BC-Fe) was prepared by the coprecipitation of nano-Fe₃O₄ on a rice husk biochar surface. The effects of BC-Fe on cadmium (Cd) bioavailability in soil and on Cd accumulation and translocation in rice (Oryza sativa L. cv. 'H You 518') were investigated in a pot experiment with 7 application rates (0.05-1.6%, w/w). BC-Fe increased the biomass of the rice plants except for the roots and affected the concentration and accumulation of Cd and Fe in the plants. The Cd concentrations of brown rice were significantly decreased by 48.9%, 35.6%, and 46.5% by the 0.05%, 0.2%, and 0.4% BC-Fe treatments, respectively. Soil cation exchange capacity (CEC) increased by 9.4%-164.1% in response to the application of BC-Fe (0.05-1.6%), while the soil Cd availability decreased by 6.81%-25.0%. However, 0.8-1.6% BC-Fe treatments promoted Cd transport to leaves, which could increase the risk of Cd accumulation in brown rice. Furthermore, BC-Fe application promoted the formation of iron plaque and enhanced the root interception of Cd. The formation of iron plaque reduced the toxicity of Cd to rice roots, but this barrier effect was limited and had an interval threshold (DCB-Fe: 22.5-27.3 g·kg^-1) under BC-Fe treatments.

Effect of three Napier grass varieties on phytoextraction of Cd- and Zn-contaminated cultivated soil under mowing and their safe utilization

The use of Napier grass to remediate heavy metal-contaminated soil is a new phytoremediation technique. The objective of this study was to evaluate the ability of Napier grass (Pennisetum purpureum Schumach.) to remediate Cd- and Zn-contaminated cultivated soil under nonmowing and mowing and the possibility of safe utilization of the stem and leaf after detoxification by liquid extraction. Three Napier grass varieties, P. purpureum cv. Mott (PM), P. purpureum cv. Red (PR), and P. purpureum cv. Guiminyin (PG), were planted in a field with 3.74 mg kg^-1 Cd and 321.26 mg kg^-1 Zn for 180 days. The maximum amounts of Cd and Zn removed by PG were 197.5 and 5023.9 g ha^-1, respectively, almost equaling those of hyperaccumulators. Compared with nonmowing, mowing did not decrease the Cd and Zn contents in various tissues but increased the biomasses of PM, PR, and PG by 86.6%, 18.9%, and 26.1%, respectively. Compared with nonmowing, the amounts of Cd removed by PM, PR, and PG under mowing increased by 110.5%, 40.0%, and 107.9%, respectively, and that of Zn increased by 63.0%, 53.1%, and 71.6%. The dominant Cd and Zn chemical fractions in Napier grass were the pectate- and protein-integrated fractions. After liquid extraction, although the nutrient element (Ca, K, Mg, and Mn) contents in the stem and leaf were reduced significantly, the Cd and Zn contents decreased below the limit of the Chinese Hygienic Standard for Feeds, and the crude protein content was largely retained. Such detoxified stems and leaves can be safely used as feeds or as raw materials for energy production.

[Recommendations for public health protection against flood disaster]

Flood disaster is one of the most serious natural disasters in the world, and it could pose an inestimable impact on the affected people. Based on existing laws, regulations, and emergency manuals in China, extensive literature review, epidemiological and related protection evidence, and expert consultation, this study analyzed different health risk factors of flood disaster and proposed a multi-stage, multi-population, and multi-phase comprehensive protection measures for the public in the perspective of pre-event prevention, in-event intervention and post-event rescue strategy, which could provide a scientific basis for improving the level of public health protection against the flood disaster and corresponding health outcomes.

[Vertical Distribution Profiles and Release Potential of Mainstream Column Sediments in the Three Gorges Reservoir After Impoundment to 175 m]

To investigate the vertical distribution characteristics of phosphorus in the main stream sediments of the Three Gorges Reservoir (TGR), column sediment samples were collected from 5 sites in October 2010, and sediment particle size, organic matter contents, and mineral compositions were analyzed. Investigation of the contribution rate of phosphorus released from column sediments in the TGR was also conducted. The results show that the sediment pH is between 7.3-7.8. The mainstream column sediment is mainly constituted by silt and clay, which account for 49.4%-78.6% and 20.6%-50.6% of total sediments, while sand represents less than 4.4%. Median grain size of each sampling site presented a phased increase or decrease trend. The organic matter content was between 12.94 g·kg^-1 and 53.43 g·kg^-1, and it tended to slightly increase from upstream to downstream. The C/N ratio in the sediment was between 4.00 and 11.64, and organic matter content was mainly affected by terrigenous input. Total phosphorus (TP) content was between 861.86 mg·kg^-1 and 1024.54 mg·kg^-1, and it exhibited negligible change in vertical distribution. There is no obvious enrichment phenomenon of phosphorus for column sediment. The major component of sediment TP is calcium bound phosphorus (Ca-P, 47.83%-73.90%), and there are various trends for phosphorus distribution in different sampling sites. Exchangeable phosphorus (Ex-P), aluminum-bound phosphorus (Al-P), and iron-bound phosphorus (Fe-P) in the 0-4 cm surface sediment of each sampling sites was relatively high. For most sampling sites, no obvious change of phosphorus fractions in 16-20 cm of sediment was detected. Bioavailable phosphorus (the sum of Ex-P, Al-P, and Fe-P) accounted for 2.78%-7.05% of TP, indicating that bioavailability of phosphorus in the column sediments is low. The contents of bioavailable phosphorus and organic matter were significantly and positively correlated (P<0.05, N=50). The distribution and transformation of organic matter will affect the migration and transformation of sediment phosphorus in the TGR.

[A qualitative study on high risk behaviors and related factors of reported HIV/AIDS cases aged 60 years and above in some areas of Henan province]

Objective: To understand the major high risk behaviors and related factors among reported HIV/AIDS cases aged ≥60 years in some areas of Henan province. Methods: In Dengzhou, Xunxian county of Hebi and Xiangcheng county of Xuchang, where the reported number and proportion of HIV/AIDS cases aged ≥60 years were high, a face to face interview was conducted among the cases aged ≥60 years during July-August in 2016. The information about the high risk behaviors before HIV infection confirmation were collected by using a semi-structured questionnaire. Results: A total of 33 HIV/AIDS cases aged ≥60 years were interviewed, including 28 males and 5 females. Their average age was 67.4 years. The infection route was sexual contact. The main findings revealed that the main factor for HIV infection in elder males was commercial heterosexual behavior with local female sex workers. The condom use rate was low. The poor awareness of the knowledge about AIDS prevention could explain why the elderly could not recognize the risk of HIV infection. There were also homosexual and bisexual behaviors in elder male HIV/AIDS patients. Late detection of HIV transmission among couples was the main cause of HIV infection in elder women. Conclusions: The major epidemiological related factors for HIV infection in the elderly in some areas of Henan were unsafe sex behavior and the poor awareness of knowledge about AIDS prevention. A targeted strategy should be taken to control the spread of HIV in the elderly.

[Sivelestat alleviates nonalcoholic steatohepatitis in mice through inhibiting activation of Kupffer cells]

Objective: To investigate the role of neutrophil elastase inhibitor, sivelestat, in preventing and treating nonalcoholic steatohepatitis (NASH) and its underling mechanisms. Methods: A total of forty 4-week-old male C57BL/6J ApoE-/-mice were equally divided into the following four groups: standard chow (SC)+isotonic saline; SC+sivelestat; high-fat, high-cholesterol (HFHC) diet+isotonic saline; and HFHC+sivelestat. These mice were treated with above methods for 12 weeks. Blood and liver tissue samples were collected to measure biochemical parameters, hepatic steatosis and non-alcoholic fatty liver disease (NAFLD) activity score (inflammation) were evaluated by oil red O staining and HE staining, respectively. The mRNA and protein expression levels of hepatic inflammatory cytokines, CD68, and F4/80 were determined by quantitative RT-PCR and immunohistochemistry, respectively. Comparison of means between the four groups was made by one-way analysis of variance, and comparison between any two groups was made by the LSD or SNK method (for data with homogeneity of variance) or the Tamhane or Dunnett method (for data with heterogeneity of variance). Results: Mice fed with an HFHC diet for 12 weeks developed typical pathological features of NASH compared with those fed with SC. Compared with mice fed with HFHC diet without sivelestat, those treated with HFHC and sivelestat exhibited the following features: (1) significantly reduced fast blood glucose, blood cholesterol, and hepatic biochemical parameters, as well as increased insulin sensitivity; (2) significantly reduced NAFLD activity score (5.71±1.11 vs 3.16±1.16, P < 0.05); (3) reduced monocyte chemoattractant protein-1 and tumor necrosis factor -α; (4) significantly reduced mRNA levels of CD68 and F4/80; and (5) reduced expression of CD68 in the liver. Conclusion: Sivelestat alleviates the hepatic steatosis and inflammation of NASH in mice by inhibiting the activation of Kupffer cells.

Genome-wide screening identifies oncofetal lncRNA Ptn-dt promoting the proliferation of hepatocellular carcinoma cells by regulating the Ptn receptor

Oncofetal genes are genes that express abundantly in both fetal and tumor tissues yet downregulated or undetected in adult tissues, and can be used as tumor markers for cancer diagnosis and treatment. Meanwhile, long noncoding RNAs (lncRNAs) are known to play crucial roles in the pathogenesis of hepatocellular carcinoma (HCC), including tumor growth, proliferation, metastasis, invasion, and recurrence. We performed a genome-wide screening using microarrays to detect the lncRNA expression profiles in fetal livers, adult livers, and liver cancer tissues from mice to identify oncofetal lncRNAs in HCC. From the microarray data analysis, we identified lncRNA Ptn-dt as a possible oncofetal gene. Both in vitro and in vivo experiments results confirmed that overexpression of Ptn-dt significantly promoted the proliferation of mouse HCC cells. RNA pulldown assay showed that Ptn-dt could interact with the HuR protein. Interestingly, miR-96 binds with HuR to maintain its stability as well. Overexpression of lncRNA Ptn-dt led to the downregulation of miR-96, which might be due to the interaction between Ptn-dt and HuR. Meanwhile, previous studies have reported that Ptn can promote tumor growth and vascular abnormalization via anaplastic lymphoma kinase (Alk) signaling. In our study, we found that overexpression of Ptn-dt could promote the expression of Alk through repressing miR-96 via interacting with HuR, thus enhancing the biologic function of Ptn. In summary, a new oncofetal lncRNA Ptn-dt is identified, and it can promote the proliferation of HCC cells by regulating the HuR/miR-96/Alk pathway and Ptn-Alk axis.

A sample model established by S-index predicting overall survival after curative resection of primary hepatocellular carcinoma

Purpose

Prognostic prediction after curative resection of primary hepatocellular carcinoma (PHCC) remains an arduous task. The S-index calculated from γ-glutamyl transpeptidase, albumin, and platelets is reported to predict the severity of liver fibrosis. We constructed a nomogram for predicting the survival probability of PHCC based on a new indicator, the S-index, combined with other routine clinical parameters.

Patients and methods

We selected 490 patients with PHCC postradical surgery at the First Affiliated Hospital of Wenzhou Medical University between January 2007 and January 2014. The subjects were randomly allocated into the training cohort and the validation cohort in the ratio 7:3 by the digital method. Important variables screened by univariate analysis were included in multivariate analysis to obtain independent risk factors for predicting the prognosis of PHCC. The construction of the nomogram was based on Cox proportional hazard regression models. The concordance index (C-index) was used in the nomogram for evaluating the model performance for prognosis. We drew time-dependent receiver operating characteristic curves to compare our model with other staging systems.

Results

The nomogram based on six independent risk factors after multivariate analyses had good predictive power after radical surgery of PHCC. In the training and validation groups, the C-index of the nomogram was highly consistent for evaluating survival from PHCC. Compared with the traditional scoring system, the areas under time-dependent receiver operating characteristic curves were 0.7382, 0.7293, and 0.7520 for 1-, 3-, and 5-year overall survival, respectively. In summary, the nomogram showed excellent results in terms of prognosis of PHCC.

Conclusion

Based on the S-index and the other clinical indicators, we developed a precise nomogram that predicts the survival probability of patients with PHCC after radical surgery. This tool can provide effective information for surgeons and patients.

Cadmium stable isotope variation in a mountain area impacted by acid mine drainage

The pollution of natural waters and sediments with metals derived from acid mine drainage (AMD) is a global environmental problem. However, the processes governing the transportation and transformation of AMD metals such as Cd in mountainous areas are poorly understood. In this study, the Cd isotopic composition and Cd concentration of river water and sediments (16 sampling sites) from an AMD-affected river in southern China were determined. Cd concentration in river water declined from its source at a tailings dam (304 μg L^-1) to a point 14 km downstream (0.32 μg L^-1). Sediment Cd concentration ranged from 0.18 to 39.9 μg g^-1, suggesting that anthropogenic Cd is derived primarily from the tailing dam and easily enters the solid phase of the river. Isotopic data showed that the dissolved Cd in rivers was characterized by δ^114/110Cd values ranging from 0.21‰ to 1.03‰, with a mean of 0.48‰. The greatest Cd isotope difference was observed between the water and sediments in the LW dam (Δ^114/110Cd_{river-sediment} = 1.61‰, site 1), likely due to a rapid weathering dissolution of the ore tailings. In the river's upper reach (sites 2-3), isotope difference between river and sediment (Δ^114/110Cd_{river-sediment}) ranged from 1.0‰ to 0.91‰. This suggests that a host of secondary processes might have impacted Cd isotope fractionation, including adsorption, ternary complexation and/or (co)precipitation of Cd on secondary oxides and hydroxides. In the middle and lower reaches, an abruptly elevated δ^114/110Cd value near farmland (site 10) suggests the existence of a second Cd source. Based on the chemical properties of water samples we can attribute this heavy isotope signature to agricultural fertilizer and drainage from agricultural fields. Our results suggest that Cd isotope is a tracer for identifying and tracking Cd sources and attenuation mechanisms (adsorption/(co)precipitation) in a complex mountain watershed.

[Association between total cholesterol and risk of lung cancer incidence in men: a prospective cohort study]

Objective: To assess the association and intensity of baseline TC level with the incidence of lung cancer in men in China. Methods: Since May 2006, all the male workers, including the employees and the retirees in Kailuan Group were recruited in the Kailuan male dynamic cohort study. Information about demographics, medical history, anthropometry and TC level were collected at the baseline interview, as well as the information of newly-diagnosed lung cancer cases during the follow-up period. According to guidelines for blood lipids in Chinese adults and the distribution in the population, TC level was classified into five groups as followed: <160, 160-, 180-, 200- and ≥240 mg/dl, with the second quintile group (160- mg/dl) serving as the referent category. Cox proportional hazards regression model and restricted cubic spline (RCS) model were used to evaluate the association and the nonlinear association between baseline TC level and the risk of lung cancer in the men. Results: By December 31, 2014, for the 109 884 men, a follow up of 763 819.25 person-years was made with a median follow-up period of 7.88 years. During the follow up, 808 lung cancer cases were identified. After adjustment for age, education level, income level, smoking status, alcohol consumption level, history of dust exposure, FPG level and BMI, HR (95%CI) of lung cancer for men with lower TC level (<160 mg/dl) and higher TC level (≥240 mg/dl) were 1.34 (1.04- 1.72) and 1.45 (1.09-1.92), respectively, compared with men with normal TC level (160- mg/dl). The results didn't change significantly after exclusion of newly diagnosed cancer cases within 2 years of follow up and subjects with the history of hyperlipidemia. Conclusion: Our results showed that TC might be associated with higher risk of lung cancer. Men with lower TC level or higher TC level had higher risk for lung cancer. Keep moderate TC level might be one of the effective precaution for the prevention of lung cancer.

Treatment of cryotherapy and orthotopic transplantation following chondromyxoid fibroma of zygomatic bone: A case report

INTRODUCTION

Chondromyxoid fibrotherma (CMF) is a rare benign cartilage tumor that occurs more frequently in young males at the age of 20 to 30. It occurs more frequently on long bones, but rarely involves craniofacial bones.

CASE PRESENTATION

This study mainly introduced a 30-year-old male with CMF of zygomatic bone. Single tumor excochleation was conducted initially. However, CMF reoccurred, and then the following steps were adopted: firstly, the tumor was extensively excised; secondly, in vitro tumor excochleation was conducted; thirdly, the excised tumor bone was placed in liquid nitrogen for 3 cycles of cryoablation; finally, the orthotopic transplantation was performed to reconstruct the zygomatic appearance, with satisfactory follow-up efficacy obtained.

CONCLUSIONS

Orthotopic transplantation after tumorectomy and cryopreservation of tumor bone in liquid nitrogen could lead to excellent therapeutic efficacy and deserves to be widely applied in clinical practice in the treatment of a male patient with CMF of zygomatic bone, because it not only radically eliminates the tumor and kills tumor cells, but also provides bony skeleton for the growth of new bone, thus greatly promoting postoperative aesthetic degree and reducing the occurrence rates of complications.

[Assessment of Physico-chemical Properties and Phosphorus Fraction Distribution Characteristics in Sediments after Impounding of the Three Gorges Reservoir to 175 m]

In order to understand the characteristics of the distribution of sediment total phosphorus (TP) and phosphorus fractions in the mainstream sediments in the Three Gorges Reservoir (TGR) after impounding the water level to 175 m, 13 surface sediment samples were collected from the Wujiang to Maoping sections in October 2010. The physico-chemical properties, including organic matter content, particle grain size distribution, and major mineral analysis, as well as total phosphorus and its fractions in the sediment, were determined. Moreover, the relationships among phosphorus fractions, organic matter contents, and particle grain size were discussed, and the effect of the impoundment on sediment phosphorus accumulation and bioavailability was also evaluated. Results indicated that the sediment organic matter content of the TGR was between 7.79 g·kg^-1 and 55.63 g·kg^-1, and the main mineral components were chlorite, illite, and quartz. The sediments were dominated with clayey silt with a median diameter (d₅₀) ranging from 3.84 μm to 23.65 μm. The measured total phosphorus content of the sediments were between 557.06 g·kg^-1 and 837.92 g·kg^-1, and the total phosphorus enrichment index of each sampling site is greater than 1, demonstrating a potential risk for phosphorus pollution. The calcium bound phosphorus (Ca-P) and the reductant soluble phosphorus (Oc-P) were the dominant sediment phosphorus fractions, while the exchangeable phosphorus (Ex-P), the iron bound phosphorus (Fe-P), and aluminum bound phosphorus (Al-P) content were relatively low. Bioavailable P only accounts for 2%-8% of the total phosphorus content. When referring to previous studies, the sediment particle size tended to be smaller and the content of comparatively easy-to-weather minerals slightly increased with the increase of the impoundment water level. However, the increase in the impoundment water level did not result in a significant increase tendency in sediment TP content. In the future, a reduction in sediment input and a decline in sediment particle size may facilitate the accumulation of phosphorus in the sediments in the broad valley section of the TGR. Moreover, large scale dry-wet alternation in the water level fluctuation zone and resuspension of floating mud near the dam both potentially impact the bioavailability of phosphorus in the sediments.

[Relationship between inflammatory markers and the risk of colorectal cancer in Kailuan male cohort]

Objective: To investigate whether elevated levels of high sensitivity C-Reactive Protein (hsCRP) and neutrophil (NE) at baseline are associated with an increased risk of colorectal cancer in Kailuan male cohort. Methods: Since May 2006, males from Kailuan cohort were included in this study. Information on demographics, medical history, anthropometry, hsCRP and NE were collectedat baseline for all subjects. Multivariable Cox proportional hazards regression models were used to calculate hazard ratios (HR) of association between baseline hsCRP and NE and colorectal cancer risk. Results: By December 31, 2015, a total of 73 869 participants were enrolled in this study. During the follow-up, 336 incident colorectal cancer cases were identified. All participants were divided into three groups according to the level of hsCRP (<1 mg/L, 1-3 mg/L and >3 mg/L). The cumulative incidence of colorectal cancer were 456/10(5,) 510/10(5) and 746/10(5) in these 3 groups, respectively (χ(2)=10.79, P=0.005). Compared with participants with lower hsCRP levels (<1 mg/L), individuals with the highest hsCRP (>3 mg/L) levels had significant increased risks of colorectal cancer (HR=1.38, 95%CI: 1.05-1.81, P=0.020)after adjusting for age, gender, smoking, drinking, BMI, diabetes and income. Furthermore, subjects were divided into two groups according to the level of NE (≤ 4.08×10(9)/L and > 4.08×10(9)/L). Multivariable Cox proportional hazards regression models indicated that there is no statistical significance of association between NE and colorectal cancer. Conclusions: Elevated levels of hsCRP at baseline might increase the risk of colorectal cancer in males.

CTGF secreted by mesenchymal-like hepatocellular carcinoma cells plays a role in the polarization of macrophages in hepatocellular carcinoma progression

M2 macrophages play critical roles in the progression of hepatocellular carcinoma (HCC), and they are associated with poor outcomes. TGF-β-induced epithelial-mesenchymal transition (EMT) has been shown to be critically important to cancer cell dissemination in HCC. However, the relationship between stromal-like HCC cells and M2 macrophages formation is not clear. Here, we interrogated the molecular link between mesenchymal-like HCC cells and the formation of M2 macrophages. We demonstrated that mesenchymal-like HCC cells secrete connective tissue growth factor (CTGF) to polarized macrophages. Reciprocally, Chemokine ligand 18 (CCL18) from M2 macrophages promotes HCC progression. Furthermore, CTGF and CCL18 were increased significantly in HCC compared to adjacent normal liver tissues. In summary, our study discovered a positive feedback loop between CTGF and CCL18 in HCC metastasis. Targeting CTGF or CCL18 might provide beneficial effects for the clinical treatment of HCC.

Berberine ameliorates non-alcoholic steatohepatitis in ApoE-/- mice

The aim of the present study was to explore the protective effects of Berberine (BBR) against non-alcoholic steatohepatitis (NASH). Male 4-week-old C57BL/6J Apolipoprotein E-deficient (ApoE^-/-) mice were divided into the following three groups, which were given different diets: Normal chow diet (SC group); high-fat high-cholesterol diet (HFHC group); and HFHC diet supplemented with BBR (BBR group). Serum biochemical indicators of hepatic function and histological liver tissue changes were evaluated. The expression of neutrophil elastase (NE) and genes involved in the inflammatory response was measured. ApoE^-/- mice fed a HFHC diet for 12 weeks developed NASH, characterized by steatosis and liver inflammation. Body weight, and serum triglyceride and cholesterol levels were markedly reduced by BBR. BBR supplementation significantly lowered serum alanine aminotransferase and aspartate aminotransferase levels in mice with HFHC diet-induced NASH, and significantly downregulated hepatic expression and activity of NE, whereas α1-antitrypsin (α1-AT) expression was significantly recovered by BBR (all P<0.05 vs. the HFHC group). Furthermore, treatment with BBR induced a significant reduction in the expression of key genes, including phospoinositide 3-kinase, nuclear factor-κB and interleukin-8, in the C-X-C chemokine receptor type 4 (CXCR4) signaling pathway (all P<0.05 vs. the HFHC group). These results suggest that BBR alleviates NASH in ApoE^-/- mice fed a HFHC diet. Restoration of the balance of NE and α1-AT levels, which in turn facilitate the inhibition of the CXCR4 signaling pathways, may be involved in the hepatoprotective effect of BBR. These results indicate that BBR may be a candidate therapeutic agent for the treatment of NASH.

Association between MPO-463G > A polymorphism and cancer risk: evidence from 60 case-control studies

BACKGROUND

Though a number of studies have been conducted to explore the association between myeloperoxidase (MPO)-463G > A polymorphism and cancer risk, the results remain inconsistent. Therefore, we performed a meta-analysis to derive a more systematic estimation of this relationship.

METHOD

Relevant studies were searched by PubMed, EMBASE, CNKI, Google Scholar, Ovid, and Cochrane library prior to December 2015. The strength of the association between MPO-463G > A polymorphism and cancer risk was estimated by odds ratios (OR) with 95% confidence interval (95%CI). Cumulative analysis was used to evaluate the stability of results through time.

RESULTS

The current analysis consisted of 16,858 cases and 21,756 controls from 60 studies. Pooled results showed that MPO-463G > A polymorphism were associated with the overall decreased cancer susceptibility in all the genetic models included in this study (additive model: OR = 0.84, 95%CI = 0.76-0.94; allele genetic model: OR = 0.90, 95%CI = 0.840-0.954; recessive genetic model: OR = 0.89, 95%CI = 0.83-0.95). However, in the stratified analysis of cancer type, the significant results were only found in lung cancer (dominant model: OR = 0.93, 95%CI = 0.87-0.99) and digestive system cancer groups (dominant model: OR = 0.67 0.53-0.84; allele frequency model = 0.71, 95%CI = 0.57-0.87), but not in the blood system cancer or breast cancer group. When we further stratified the digestive system cancer group into digestive tract and digestive gland cancer groups, results showed a significant association between allele A of MPO-463G > A and digestive gland cancer in all the genetic models (allele frequency model: OR = 0.63, 95%CI = 0.40-0.99; additive model: OR = 0.41, 95%CI = 0.23-0.73; recessive model: OR = 0.51, 95%CI = 0.29-0.89; dominant model: OR = 0.58, 95%CI = 0.35-0.96), digestive tract cancers in allele frequency model (OR = 0.75, 95%CI = 0.59-0.95), and dominant model (OR = 0.72, 95%CI = 0.56-0.92). When stratified by ethnicity, results demonstrated that the genotype A might be a protect factor for both Caucasians and Asians. In group analysis according to source of controls, significant results were found in population from hospital in all the genetic models. In cumulative analysis, result of allele contrast showed a declining trend and increasingly narrower 95% overall, while the inclination toward non-significant association with lung cancer risk.

CONCLUSIONS

This meta-analysis suggested that MPO-463G > A polymorphism was associated with the overall reduced cancer susceptibility significantly. It might be a more reliable predictor of digestive system cancer instead of lung cancer, blood system cancer, and breast cancer. In cumulative analysis, the stable trend indicated that evidence was sufficient to show the association between MPO-463G > A polymorphism and cancer risk.

[Survival effect after antiretroviral treatment initiating at different times on AIDS patients in Henan province, 2002-2014]

OBJECTIVE

To study the survival effect of AIDS patients after the antiretroviral treatment that initiated at different times and to understand the factors associated with the survival time.

METHODS

Information on AIDS patients who started receiving the antiretroviral therapy during 2002-2014 was collected from the Chinese HIV/AIDS Integrated Control System in Henan province. According to the level of baseline immunology, all the participants were divided into earlier treatment group [Baseline CD4(+)T lymphocyte cell counts (CD4) between 350/μl and 500/μl] or conventional treatment group (Baseline CD4 cell counts≤350/μl). Data was analyzed with both Survival and Review methods.

RESULTS

A total number of 37 169 cases were selected, including 32 129 cases in the conventional treatment group and 5 040 cases in the earlier treatment group. Mortalities in the conventional treatment group and earlier treatment group were 4.3/100 person year and 1.8/100 person year, respectively. Data on the 11-year cumulative survival rate of both the conventional treatment group and earlier treatment group were 67.9% and 82.3%, respectively. By means of multi-variable analysis, we found that factors as gender, age, marital status, route of infection, number of symptoms, missed taking drugs in the past 7 days, degree of education at baseline of conventional treatment group etc. were associated with survival time of patients after the initiation of antiretroviral treatment (ART) (P<0.05) while factors as gender, age, marital status, ever missed taking drugs in the past 7 days at baseline etc. in the earlier treatment group were associated with the survival time of patients after the ART initiation (P<0.05).

CONCLUSION

Strategy including earlier initiation of antiretroviral treatment on AIDS patients who had met the treatment criteria and programs related to the improvement on adherence to medication, could prolong the survival time of AIDS patients, in Henan province.

[HCV infection status and related risk factors in drug users under HIV sentinel surveillance in Henan province, 2011-2015]

OBJECTIVE

To understand the hepatitis C virus infection status and related risk factors in drug users in Henan province during 2011-2015 and provide scientific evidence for the development of HCV infection prevention and control measures.

METHODS

Cross-sectional questionnaire surveys were conducted among the drug users and blood samples were taken from them for HCV antibody detection during HIV sentinel surveillance period in Henan province from April to June during 2011-2015.

RESULTS

The HCV infection rate in drug users increased from 3.70% in 2011 to 6.54% in 2015 (trend χ(2)=25.93, P<0.01). Multivariate analysis indicated that HCV infection related risk factors included age older (OR=1.23, 95% CI: 1.13-1.35, P=0.00), place of domicile (OR=3.45, 95%CI: 2.59-4.60, P=0.00), traditional drug user or mixed drug user (OR=1.46, 95%CI: 1.10-1.93, P=0.01; OR=1.82, 95%CI: 1.18-2.81, P=0.01), injecting drug user (OR=2.88, 95%CI: 2.45-3.39, P=0.00), commercial sex behavior in recent one year (OR=1.44, 95%CI: 1.20-1.72, P=0.00) and drug user in compulsory drug rehabilitation or those receiving methadone maintenance treatment (OR=1.79, 95% CI: 1.28-2.50, P=0.00; OR=1.74, 95% CI: 1.17-2.58, P=0.01).

CONCLUSION

The HCV infection rate in drug users was higher in Henan and increased rapidly with years. In order to control HCV spread, it is necessary to strengthen the management of drug users and take effective intervention measures.

Epidemiological characteristics and survival analysis of three types of upper gastrointestinal cancer in hospitalized Chinese Hui and Han patients

AIM

To retrospectively analyze the epidemiological characteristics and survival of Chinese Hui and Han patients with three types of upper gastrointestinal cancer in Ningxia.

METHODS

A total of 5616 hospitalized Hui and Han patients with upper gastrointestinal cancer (esophageal cancer, cardia cancer or gastric cancer) treated at the General Hospital of Ningxia Medical University from January 1, 2003 to December 31, 2012 were included in this study. The date of diagnosis was set as a starting point for observation and the date of death due to upper gastrointestinal cancer was set as the end of the observation, with a calculated survival time as of January 26, 2016. All patients who underwent surgery for upper gastrointestinal cancer (3634 cases) were followed by telephone, and a final successful follow-up was achieved in 1454 patients. A database was created to analyze the clinical characteristics including patients' age, sex, ethnicity, hospitalization time, outcome variables, and survival time by descriptive statistical method. The 1-, 3-, and 5-year survival rates were calculated using the life-table method. The median survival time was calculated by Kaplan-Meier method. Survival rates were compared using the Log-rank test.

RESULTS

Of the 5616 hospitalized patients included, 4695 (83.5%) were Han Chinese, and 921 (16.5%) were Hui Chinese. The ratio of Han to Hui patients was 5.10:1. There were 4325 male patients (77.0%) and 1291 female patients (23.0%). The ratio of male to female patients was 3.35:1. There were 1563 (27.8%) cases of esophageal cancer, 1478 (26.3%) cases of cardia cancer, and 2575 (45.9%) cases of gastric cancer. Esophageal cancer and cardiac cancer were mainly seen in patients aged ≥ 60 years (67.7% and 63.9%, respectively). Gastric cancer was mainly seed in patients aged 40-60 years (45.9%) and ≥ 60 years (45.1%). Of 3634 patients who underwent surgery for upper gastrointestinal cancer, 794 had esophageal cancer, in which the median survival time of Hui and Han patients was 29 mo vs 38 mo, and the 1-, 3-, and 5-year survival rates of Hui and Han patients were 72.3% vs 74.7%, 46.8% vs 50.9%, and 23.4% vs 30.9%, respectively; 734 had cardia cancer, in which the median survival time of Hui and Han patients was 62 mo vs 33 mo, and the 1-, 3-, and 5-year survival rates of Hui and Han patients were 73.9% vs 76.3%, 58.7% vs 48.0%, and 54.3% vs 39.9%, respectively; 2106 had gastric cancer, in which the median survival time of Hui and Han patients was 98 mo vs 81 mo, and the 1-, 3-, and 5-year survival rates of Hui and Han patients were 77.3% vs 77.0%, 50.7% vs 48.1%, and 24.7% vs 22.7%, respectively. There was no significant difference in the 1, 3, 5-year survival rates between Hui and Han patients with esophageal cancer, cardia cancer or gastric cancer (P > 0.05).

CONCLUSION

The distribution of sex and age in patients with the three types of upper gastrointestinal cancer in Ningxia is similar to that in other regions of China. The number of patients with gastric cancer and cardia cancer had an increasing trend during the past years. The 5-year survival rate of patients with gastric cancer in the northern regions including Ningxia is lower than that of the southern population.

In Situ Release of VEGF Enhances Osteogenesis in 3D Porous Scaffolds Engineered with Osterix-Modified Adipose-Derived Stem Cells

Adipose-derived stem cells (ADSCs) can differentiate into various cell types and thus have great potential for regenerative medicine. Herein, rat ADSCs were isolated; transduced with lentiviruses expressing Osterix (Osx), a transcriptional factor essential for osteogenesis. Osx overexpression upregulated key osteogenesis-related genes, such as special AT-rich binding protein 2, alkaline phosphatase, osteocalcin, and osteopontin, at both mRNA and protein levels. In addition, mineral nodule formation and alkaline phosphatase activity were enhanced in Osx-overexpressing ADSCs. The expression of dickkopf-related protein 1, a potent Wnt signaling pathway inhibitor, was also increased, whereas that of β-catenin, an intracellular signal transducer in the Wnt pathway, was decreased. β-catenin expression was partially recovered by treatment with lithium chloride, a canonical Wnt pathway activator. The Osx-expressing ADSCs were then combined with 3D gelatin-coated porous poly(ɛ-caprolactone) scaffolds with a unique release prolife of entrapped recombinant human vascular endothelial growth factor (VEGF). The controlled release of VEGF promoted osteogenic differentiation capacity in vitro. When the scaffold-ADSC complexes were transplanted into rat calvarial critical-sized defects, more bone formed on the gelatin/VEGF-coated scaffolds than on other scaffold types. Taken together, the results indicate that, Osx-overexpression promotes ADSCs' osteogenesis both in vitro and in vivo, which could be enhanced by release of VEGF.

[Quality of life and its related factors among HIV/AIDS patients from HIV serodiscordant couples in Zhoukou of Henan province]

OBJECTIVE

To investigate the quality of life and its related factors among HIV/AIDS patients from HIV serodiscordant couples in Zhoukou city of Henan province.

METHODS

During January to May in 2015, by the convenience sample, World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL-BREF) (Chinese version) and a self-edited questionnaire were used to investigate 1 251 HIV/AIDS patients who were confirmed with HIV positive by local CDC, registered in"HIV serodiscordant family" and agreed to participate in a face-to-face interview with above 18 year-old based on the local CDC , township hospitals and village clinics of 9 counties and 1 district of Zhoukou city, excluding the HIV/AIDS patients who were in divorce, death by one side, unknowing about his HIV status, with mental illness and disturbance of consciousness, incorrectly understanding the content of the questionnaire, and reluctant to participate in this study. The scores of quality of life of physical, psychological, social relations, and environmental domain were calculated. The related factors of the scores of different domains were analyzed by Multiple Two Classification Unconditioned Logistic Regression.

RESULTS

The scores of investigation objects in the physical, psychological, social relations, and environmental domain were 12.00± 2.02, 12.07 ± 2.07, 11.87 ± 1.99, and 11.09 ± 1.84, respectively. The multiple Unconditioned Logistic Regression analysis indicated that age <40 years, on ART and no other sickness in last two weeks were beneficial factors associated with physical domain with OR (95%CI): 0.61 (0.35-1.06), 0.52 (0.30-0.90), and 1.66 (1.09-2.52), respectively. The possibility of no poverty and no other sickness in last two weeks increased to 0.15(0.09-0.26) and 1.57(1.06-2.33) times of those who was in poverty and with other sickness in last two weeks in physical domain. The possibility of participants who were below 40 years old and with children increased to 0.58 (0.34-0.98) and 0.37 (0.23-0.57) times of who were above 40 years old and without children in psychological domain. The factors of with AIDS related symptoms, no children and with other sickness in last two week were found to be significantly associated with environmental domain with OR (95%CI): 0.65 (0.48-0.88), 0.66 (0.51-0.85), and 0.65 (0.51-0.84), respectively .

CONCLUSION

The scores of every domain of quality of life in HIV serodiscordant couples of Zhoukou city were good. Age, whether having AIDS related symptoms, whether to accept ART , children, status of poverty, and whether suffering from other diseases in last two weeks were the main factors associated with the quality of life.