Unlocking the potential of phenolated kraft lignin as a versatile feed additive

Lignin, a renewable natural antioxidant and bacteriostat, holds promise as a versatile, cost-effective feed additive. However, traditional industrial lignin faces limitations, including low reactivity, poor uniformity, and unstable properties, necessitating chemical modification. Complex modification methods pose economic and toxicity challenges, so this study adopted a relatively simple alkali-catalyzed phenolization approach, using phenol, catechol, and pyrogallol to modify kraft lignin, and characterized the resulting products using various techniques. Subsequently, their antioxidant, antibacterial, adsorption properties for heavy metal ions and mycotoxins, growth-promoting properties, and antiviral abilities were assessed. The phenolation process led to lignin depolymerization and a notable increase in phenolic hydroxyl content, particularly in pyrogallol-phenolated lignin (Py-L), rising from 3.08 to 4.68 mmol/g. These modified lignins exhibited enhanced antioxidant activity, with over 99 % inhibition against E. coli and S. aureus, and remarkable adsorption capacities for heavy metal ions and mycotoxins. Importantly, Py-L improved the growth performance of mice and reduced influenza mortality. Furthermore, density functional theory calculations elucidated the mechanism behind the enhanced antioxidant properties. This study presents a promising avenue for developing versatile feed additives to address challenges related to animal feed antioxidant supplementation, bacterial control, and growth promotion.

Genome constitution and evolution of Elymus atratus (Poaceae: Triticeae) inferred from cytogenetic and phylogenetic analysis

BACKGROUND

Elymus atratus (Nevski) Hand.-Mazz. is perennial hexaploid wheatgrass. It was assigned to the genus Elymus L. sensu stricto based on morphological characters. Its genome constitution has not been disentangled yet.

OBJECTIVE

To identify the genome constitution and origin of E. atratus.

METHODS

In this study, genomic in situ hybridization and fluorescence in situ hybridization, and phylogenetic analysis based on the Acc1, DMC1 and matK sequences were performed.

RESULTS

Genomic in situ hybridization and fluorescence in situ hybridization results reveal that E. atratus 2n = 6x = 42 is composed of 14 St genome chromosomes, 14 H genome chromosomes, and 14 Y genome chromosomes including two H-Y type translocation chromosomes, suggesting that the genome formula of E. atratus is StStYYHH. The phylogenetic analysis based on Acc1 and DMC1 sequences not only shows that the Y genome originated in a separate diploid, but also suggests that Pseudoroegneria (St), Hordeum (H), and a diploid species with Y genome were the potential donors of E. atratus. Data from chloroplast DNA showed that the maternal donor of E. atratus contains the St genome.

CONCLUSION

Elymus atratus is an allohexaploid species with StYH genome, which may have originated through the hybridization between an allotetraploid Roegneria (StY) species as the maternal donor and a diploid Hordeum (H) species as the paternal donor.

Expression and Significance of LINC02418 in Breast Cancer

Purpose

The complicated pathogenesis and poor prognosis of breast cancer have become a major difficulty in medical research. This study aims to explore new lncRNA as prognostic markers for breast cancer and explore their roles and molecular mechanisms to lay a foundation for the treatment of cancer patients.

Patients and Methods

The expression of LINC02418 and miR-766-5p in breast cancer tissues and cells was first identified using polymerase chain reaction, and Pearson was used to examine the correlation between the two. The cancer cells activities under different transfection conditions were detected using the Transwell assay and CCK8 assay. The correlation between LINC02418 and patient prognosis was analyzed using multifactor Cox regression and Kaplan-Meier.

Results

It was shown that LINC02418 expression was upregulated in breast cancer tissues and cells. There are significant differences in lymph node metastasis and TNM stage between high and low LINC02418 expression groups. The higher the expression of LINC02418, the higher the mortality rate of breast cancer patients. miR-766-5p expression was downregulated and negatively correlated with LINC02418. There are binding sites between LINC02418 and miR-766-5p; Transfection with miR-766-5p inhibitor boosted LINC02418 luciferase activity, but transfection with miR-766-5p mimic decreased it. Knockdown of LINC02418 promoted miR-766-5p expression and inhibited cancer progression, which was alleviated to some extent by transfection with miR-766-5p inhibitors.

Conclusion

LINC02418 has the potential to serve as a poor prognostic marker for breast cancer and plays a pro-oncogenic role by targeting miR-766-5p.

[Application of modified urethral separation method in artificial urethral sphincter implantation and its influence on intraoperative urethral pressure profilometry]

Objective: To explore the application of modified urethral separation method in artificial urethral sphincter (AUS) implantation in patients with stress urinary incontinence (SUI), and its influence on the results of urethral pressure profilometry. Methods: A prospective collection of clinical data was conducted on 25 patients with stress urinary incontinence who underwent modified urethral separation method in AUS implantation and underwent urethral pressure profilometry in Beijing Hospital, Beijing Jishuitan Hospital Affiliated to Capital Medical University and the Second Hospital Affiliated to Tianjin Medical University from March 2019 to June 2023. The improved urethral separation method was to borrow part of the white membrane tissue of the cavernous body while freeing the dorsal side of the cavernous body of the urethra. The circumference of the urethra, sleeve size, and urethral pressure were recorded, the patient's autonomous urinary control before and after surgery and the changes of the international consultation on incontinence questionnaire-short form (ICI-Q-SF) score, incontinence quality of life questionnaire (I-QoL) score, urinary frequency score, nocturia score were compared. Follow-up was conducted in the clinic or by telephone at 1, 3, 6, and 12 months after activation of the device, and once a year thereafter. Local skin status and urine control were assessed, residual urine volume was measured by ultrasound and subjective score scale was completed. Results: All patients were male, aged 27-85 (65.8±15.7) years old. The circumference of the cuff used in this study was 4.0 cm in 4 patients (16.0%), 4.5 cm in 16 patients (64.0%), 5.0 cm in 4 patients (16.0%), and 5.5 cm in 1 patient (4.0%). Among them, the urethral circumference matched the cuff size in 14 cases (56.0%), the urethral circumference was smaller than the cuff size in 4 cases (16.0%), and the urethral circumference was larger than the cuff size in 7 cases (28.0%). Preoperative urodynamic examination showed that the maximum urethral pressure (MUP) was (78.0±25.9) cmH2O, (1 cmH2O=0.098 kPa) and the maximum urethral closure pressure (MUCP) was (53.4±26.6) cmH2O. The MUP of AUS device in the inactivated state was (88.0±26.5) cmH2O, which was not significantly higher than that before operation (P>0.05). The MUCP was (68.2±24.5) cmH2O, which was significantly higher than that before operation (P<0.05). The MUP and MUCP of the AUS device in the activated state were (146.6±25.2) cmH2O and (123.0±28.3) cmH2O, which were significantly higher than those before surgery and in the inactivated state (both P<0.001). All patients in the group reached the social urinary control standards at the first month of device activation. During a follow-up period of 2-50 months, 22 patients (88.0%) used the initial AUS device and all met social urinary control standards. The AUS device was replaced in 1 case. One patient died of cerebrovascular accident. One patient removed the device due to complications. The number of pads [M (Q1, Q3)] used in 25 patients before and after operation was 4.5 (3.0, 6.5) and 1 (0, 1) respectively, with statistically significant differences (P<0.001). ICI-Q-SF score, I-QoL score, urinary frequency score and nocturia score of 25 patients were significantly improved after surgery (all P<0.05). The incidence of postoperative complications was 20.0% (5/25), including 2 cases of painless hematuria, 1 case of infection, 1 case of urethral erosion, and 1 case of dysuria. Except for one patient who experienced urethral erosion and had his sleeve removed, the remaining four patients regained social urination control with active support treatment, and no symptoms recurred until the last follow-up. Conclusion: The modified urethral separation method has no significant effect on urethral pressure in patients with SUI, and can increase the volume of peri-urethral tissue in the cuff, thereby reducing the risk of intraoperative urethral injury and the incidence of postoperative urethral erosion.

Drivers of diversification in Linum (Linaceae) by means of chromosome evolution: correlations with biogeography, breeding system and habit

BACKGROUND AND AIMS

Chromosome evolution leads to hybrid dysfunction and recombination patterns and has thus been proposed as a major driver of diversification in all branches of the tree of life, including flowering plants. In this study we used the genus Linum (flax species) to evaluate the effects of chromosomal evolution on diversification rates and on traits that are important for sexual reproduction. Linum is a useful study group because it has considerable reproductive polymorphism (heterostyly) and chromosomal variation (n = 6-36) and a complex pattern of biogeographical distribution.

METHODS

We tested several traditional hypotheses of chromosomal evolution. We analysed changes in chromosome number across the phylogenetic tree (ChromEvol model) in combination with diversification rates (ChromoSSE model), biogeographical distribution, heterostyly and habit (ChromePlus model).

KEY RESULTS

Chromosome number evolved across the Linum phylogeny from an estimated ancestral chromosome number of n = 9. While there were few apparent incidences of cladogenesis through chromosome evolution, we inferred up to five chromosomal speciation events. Chromosome evolution was not related to heterostyly but did show significant relationships with habit and geographical range. Polyploidy was negatively correlated with perennial habit, as expected from the relative commonness of perennial woodiness and absence of perennial clonality in the genus. The colonization of new areas was linked to genome rearrangements (polyploidy and dysploidy), which could be associated with speciation events during the colonization process.

CONCLUSIONS

Chromosome evolution is a key trait in some clades of the Linum phylogeny. Chromosome evolution directly impacts speciation and indirectly influences biogeographical processes and important plant traits.

[Predictive value of left ventricular ejection fraction reserve assessed by SPECT G-MPI for major adverse cardiovascular event in patients with coronary artery disease]

Objective: To evaluate the prognostic value of left ventricular ejection fraction (LVEF) reserve assessed by gated SPECT myocardial perfusion imaging (SPECT G-MPI) for major adverse cardiovascular event (MACE) in patients with coronary artery disease. Methods: This is a retrospective cohort study. From January 2017 to December 2019, patients with coronary artery disease and confirmed myocardial ischemia by stress and rest SPECT G-MPI, and underwent coronary angiography within 3 months were enrolled. The sum stress score (SSS) and sum resting score (SRS) were analyzed by the standard 17-segment model, and the sum difference score (SDS, SDS=SSS-SRS) was calculated. The LVEF at stress and rest were analyzed by 4DM software. The LVEF reserve (ΔLVEF) was calculated (ΔLVEF=stress LVEF-rest LVEF). The primary endpoint was MACE, which was obtained by reviewing the medical record system or by telephone follow-up once every twelve months. Patients were divided into MACE-free and MACE groups. Spearman correlation analysis was used to analyze the correlation between ΔLVEF and all MPI parameters. Cox regression analysis was used to analyze the independent factors of MACE, and the optimal SDS cutoff value for predicting MACE was determined by receiver operating characteristic curve (ROC). Kaplan-Meier survival curves were plotted to compare the difference in the incidence of MACE between different SDS groups and different ΔLVEF groups. Results: A total of 164 patients with coronary artery disease [120 male; age (58.6±10.7) years] were included. The average follow-up time was (26.5±10.4) months, and a total of 30 MACE were recorded during follow-up. Multivariate Cox regression analysis showed that SDS (HR=1.069, 95%CI: 1.005-1.137, P=0.035) and ΔLVEF (HR=0.935, 95%CI: 0.878-0.995, P=0.034) were independent predictors of MACE. According to ROC curve analysis, the optimal cut-off to predict MACE was a SDS of 5.5 with an area under the curve of 0.63 (P=0.022). Survival analysis showed that the incidence of MACE was significantly higher in the SDS≥5.5 group than in the SDS<5.5 group (27.6% vs. 13.2%, P=0.019), but the incidence of MACE was significantly lower in the ΔLVEF≥0 group than in theΔLVEF<0 group (11.0% vs. 25.6%, P=0.022). Conclusions: LVEF reserve (ΔLVEF) assessed by SPECT G-MPI serves as an independent protective factor for MACE, while SDS is an independent risk predictor in patients with coronary artery disease. SPECT G-MPI is valuable for risk stratification by assessing myocardial ischemia and LVEF.

[Laboratory diagnosis of hepatitis type E]

Hepatitis type E virus (HEV) infection is a common cause of acute viral hepatitis in China, and its etiological diagnosis relies on laboratory detection. Therefore, this article introduces the HEV RNA, HEV antigen, anti-HEV IgM, and IgG detection methods and their diagnostic application value. In addition, it also discusses the current international diagnostic standard and HEV infection presentation.

Study on Synthesizing Isobornyl Acetate/Isoborneol from Camphene Using α-Hydroxyl Carboxylic Acid Composite Catalyst

This study examined the preparation of isobornyl acetate/isoborneol from camphene using an α-hydroxyl carboxylic acid (HCA) composite catalyst. Through the study of the influencing factors, it was found that HCA and boric acid exhibited significant synergistic catalysis. Under optimal conditions, when tartaric acid-boric acid was used as the catalyst, the conversion of camphene and the gas chromatography (GC) content and selectivity of isobornyl acetate were 92.9%, 88.5%, and 95.3%, respectively. With the increase in the ratio of water to acetic acid, the GC content and selectivity of isobornol in the product increased, but the conversion of camphene decreased. The yield of isobornol was increased by adding ethyl acetate or titanium sulfate/zirconium sulfate to form a ternary composite catalyst. When a ternary complex of titanium sulfate, tartaric acid, and boric acid was used as the catalyst, the GC content of isobornol in the product reached 55.6%. Under solvent-free conditions, mandelic acid-boric acid could catalyze the hydration reaction of camphene, the GC content of isoborneol in the product reached 26.1%, and the selectivity of isoborneol was 55.9%. The HCA-boric acid composite catalyst can use aqueous acetic acid as a raw material, which is also beneficial for the reuse of the catalyst.

Confirmation of Natural Hybridization between Kengyilia (StStYYPP) and Campeiostachys (StStYYHH) (Triticeae: Poaceae) Based on Morphological and Molecular Cytogenetic Analyses

Natural hybridization has been frequently observed in Triticeae; however, few studies have investigated the origin of natural intergeneric Triticeae hybrids. In the present study, we discovered three putative hybrid Triticeae plants in the Western Sichuan Plateau of China. Morphologically, the putative hybrids were intermediate between Kengyilia melanthera (2n = 6x = 42; StStYYPP) and Campeiostachys dahurica var. tangutorum (2n = 6x = 42; StStYYHH) with greater plant height and tiller number. Cytological analyses demonstrated that the hybrids were hexaploid with 42 chromosomes (2n = 6x = 42). At metaphase I, 12.10-12.58 bivalents and 13.81-14.18 univalents per cell were observed in the hybrid plants. Genomic in situ hybridization demonstrated that the hybrids had StStYYHP genomes. Phylogenetic analysis of Acc1 sequences indicated that the hybrids were closely related to K. melanthera and C. dahurica var. tangutorum. Our morphological, cytological, and molecular analyses indicate that these hexaploid natural hybrid plants may be hybrids of K. melanthera and C. dahurica var. tangutorum.

Effect of chromium stress on metal accumulation and cell wall fractions in Cosmos bipinnatus

As one of the major pollutants in the environment, chromium (Cr), a heavy metal, poses a serious threat to urban green spaces and human life and health. Cosmos bipinnatus is considered a potential accumulator of Cr, and the differences in cellular Cr distribution and compartmentalization may uncover the mechanisms involved in its tolerance to Cr. To elucidate the effects of Cr stress on C. bipinnatus and determine the mechanism of Cr tolerance in C. bipinnatus, we investigated the physiological indicators, subcellular distribution and chemical forms, cell wall fractions and their Cr contents, uronic acid content in the cell wall fractions, and Fourier transform infrared spectroscopy (FTIR) of the cell wall. The results showed that the antioxidant enzyme activities in C. bipinnatus under Cr stress and most of the Cr were fixed in the cell wall. Notably, changes in the content of pectin fractions in the cell wall affected the accumulation of Cr in the cell wall of C. bipinnatus and the stability of negatively charged groups. In addition, the carboxyl and hydroxyl groups played a role in fixing metal in various parts of the C. bipinnatus cell wall.

[Preclinical evaluation of a veno-venous bypass device for liver transplantation based on the principle of magnetic levitation drive]

Objective: To explore the performance of a self-made venous-venous bypass (VVB) device for liver transplantation based on the principle of magnetic levitation drive. Methods: Experimental study was conducted from August 2020 to January 2022. Eight Bama minipigs underwent VVB of hepatic portal vein-femoral vein-internal jugular vein after occlusion of hepatic portal vein and inferior vena cava. The animals were divided into two groups according to the VVB devices used during VVB. A self-made VVB device was used in group A(n=5),and an imported VVB device was used in group B(n=3). The hemodynamic changes of the two groups of animals were compared at 6 time points including before vascular occlusion, during vascular occlusion, 30 minutes, 60 minutes, 90 minutes after the start of VVB, and 30 minutes after vascular opening. In addition,the changes of blood compatibility indexes,intestinal injury indexes,kidney injury indexes and internal environment indexes of the two groups of animals at each time point were compared. The independent samples t test was used for the quantitative data between the two groups with non-repeated measures,and the repeated measures analysis of variance was used for the quantitative data between the two groups with repeated measures. Results: During the VVB of the two devices,the venous drainage was sufficient,and the main manifestations were that the color of the intestine of the Bama miniature pig was ruddy, the peristalsis was normal, and the urine output was normal. There were no significant differences in hemodynamics,blood injure indexes,intestinal injury indexes,kidney injury indexes,neutropil gelatinase-associated lipocalin,and internal environment indexes(all P>0.05).The indexes at 30 minutes after vascular opening in the group A and the group B were as follows:mean arterial pressure were (71.0±7.7)mmHg(1 mmHg=0.133 kPa) and (74.0±8.7)mmHg,central venous pressure were (7.0±1.4)cmH₂O(1 cmH₂O=0.098 kPa) and (7.7±0.6)cmH₂O,heart rate were (131±10) beats/minutes and (132±8)beats/minutes; red blood cell count were (6.43±0.89)×10¹²/L and (6.32±0.58)×10¹²/L,hemoglobin were (108.4±5.9)g/L and (110.0±3.5)g/L,free hemoglobin were (78.28±3.96)mg/L and (78.08±4.54)mg/L; intestinal fatty acid binding protein were (2.27±0.49)μg/L and (2.40±0.78)μg/L;creatinine were (68.30±9.77)μmol/L and (79.90±26.91)μmol/L,blood urea nitrogen were (3.94±1.39)mmol/L and (3.45±0.65)mmol/L;neutropil gelatinase-associated lipocalin were (4.02±0.53) μg/L and (3.86±0.23)μg/L;pH value were 7.27±0.04 and 7.23±0.03,lactic acid were (6.18±2.62)mmol/L and (4.30±0.50)mmol/L,concentrations of Na⁺ were (136.3±3.0)mmol/L and (137.6±1.6) mmol/L,concentrations of K⁺ were (3.89±0.42) mmol/L and (3.98±0.17)mmol/L,concentrations of Ca²⁺ were (1.40±0.03)mmol/L and(1.40±0.04)mmol/L;all indexes in the two group had no differences(all P>0.05). Conclusion: The self-made venous bypass device can be safely and effectively applied to VVB of Bama minipigs,and achieves the same performance as the imported venous bypass device.

Comparative physiological and root transcriptome analysis of two annual ryegrass cultivars under drought stress

Annual ryegrass is a widely cultivated forage grass with rapid growth and high productivity. However, drought is one of the abiotic stresses affecting ryegrass growth and quality. In this study, we compared the physiological and transcriptome responses of Chuansi No.1 (drought-tolerant, DT) and Double Barrel (drought-sensitive, DS) under drought stress simulated by PEG-6000 for 7 days. The results showed that Chuansi No. 1 had stronger physiological and biochemical parameters such as root properties, water content, osmotic adjustment ability and antioxidant ability. In addition, RNA-seq was used to elucidate the molecular mechanism of root drought resistance. We identified 8588 differentially expressed genes related to drought tolerance in root, which were mainly enriched in oxidation-reduction process, carbohydrate metabolic process, apoplast, arginine and proline metabolism, and phenylpropanoid biosynthesis pathways. The expression levels of DEGs were consistent with physiological changes of ryegrass under drought stress. We found that genes related to sucrose and starch synthesis, root development, osmotic adjustment, ABA signal regulation and specifically up-regulated transcription factors such as WRKY41, WRKY51, ERF7, ERF109, ERF110, NAC43, NAC68, bHLH162 and bHLH148 in Chuansi No. 1 may be the reason for its higher drought tolerance. This study revealed the underlying physiological and molecular mechanisms of root response to drought stress in ryegrass and provided some new candidate genes for breeding rye drought tolerant varieties.

[Predicting value on short-term outcome of various established risk prediction models in extracorporeal membrane oxygenation treated cardiogenic shock patients due to ST-segment elevation myocardial infarction]

Objective: To investigate the predicting value of different risk prediction models for short-term death in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock and treated with extracorporeal membrane oxygenation (ECMO). Methods: This study was a retrospective case-control study. Forty patients with STEMI complicated by cardiogenic shock who hospitalized in the First Affiliated Hospital of Zhengzhou University from April 2017 to August 2021 and treated with percutaneous coronary intervention (PCI) and ECMO, were enrolled in this study. Patients were divided into survival group and death group according to their clinical outcomes at 30 days after ECMO implantation, and clinical data of the two groups were collected and analyzed. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to compare the predictive value of ACEF, AMI-ECMO, Encourage and SAVE risk scores for mortality at 30 days after ECMO implantation. According to the evaluation results of DCA, the optimal risk score was selected. Kaplan-Meier curve estimating the 30-day survival after ECMO implantation was plotted by grouping risk scores with reference to previous literatures. Results: A total of 40 patients with STEMI combined with cardiogenic shock were included, age was (57.4±16.7) years, 31 (77.5%) patients were male, there were 21 (52.5%) patients in the death group and 19 (47.5%) in the survival group. Compared with the survival group, patients in the death group had higher lactic acid values, higher proportion of anterior descending artery or left main artery lesions, and a higher proportion of acute renal failure and continuous renal replacement therapy during hospitalization (all P<0.05). Compared with survival group, ACEF, AMI-ECMO and Encourage scores were higher in death group, SAVE score was lower in death group (all P<0.05). The ROC curve analysis showed that the area under the curve (AUC) of ACEF, AMI-ECMO, Encourage and SAVE scores in predicting mortality were 0.707, 0.816, 0.757, and 0.677 respectively (P>0.05). ACEF score demonstrated the highest sensitivity (90.5%) and Encourage score exhibited the highest specificity (89.5%). DCA indicated that the AMI-ECMO and Encourage scores had the best performance in predicting the 30-day mortality after ECMO therapy. Kaplan-Meier survival curve analysis showed that the 30-day mortality after ECMO implantation increased with the increase of AMI-ECMO and Encourage scores (log-rank P≤0.001). Conclusions: The 4 scoring systems are all suitable for predicting 30-day mortality after VA-ECMO therapy in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock. Among them, AMI-ECMO and Encourage scores have better predicting performance.

[Efficacy and safety of combination therapy with chemotherapy, programmed death-1 inhibitor and anlotinib in the treatment of advanced dedifferentiated liposarcoma]

Objective: To investigate the efficacy and safety of the combination therapy with chemotherapy, programmed death-1 (PD-1) inhibitor and anlotinib in the treatment of advanced dedifferentiated liposarcoma (DDLPS). Methods: The clinical data of patients with dedifferentiated liposarcoma who received chemotherapy combined with PD-1 inhibitor and anlotinib in the Department of Medical Oncology, Zhongshan Hospital Affiliated to Fudan University from January 1, 2020 to November 30, 2021 were retrospectively analyzed. A total of 24 patients were included in this study, including 12 males and 12 females, with a median age of onset of 56 years (range, 31-69 years). Efficacy and safety in those patients were assessed. Results: All patients had unresectable or metastatic dedifferentiated liposarcoma with G2 (moderate differentiation) or G3 (differential differentiation) in a concise three-grade grading scheme of tumor pathology. Twelve patients received the regimen as the first-line treatment, while the other 7 taken the regimen as second-line treatment and 5 as third-line or above. The median follow-up time for overall survival (OS) was 7.7 months. The overall response rate (ORR) was 20.8% (5/24) and disease control rate (DCR) was 83.3% (20/24) with 5 partial response (PR), 15 stable disease (SD) and 4 progressive disease (PD). Overall, the median progression-free survival (PFS) was 4.9 months (95%CI: 3.4-16.2 months). The ORR of anthracycline-based, eribulin-based or gemcitabine-based regimens was 1/12, 2/6 and 2/6, respectively; and the median PFS was 7.7, 7.3 and 4.4 months, respectively. Waterfall plots showed notable tumor shrinkage of any degree in eribulin and gemcitabine-based regimens(3/6 and 2/6, respectively), while there were more patients presented with SD in anthracycline-based group(9/12). Common adverse reactions included myelosuppression, fatigue, anorexia, rash, pruritus, palpitate, hypothyroidism and hypertension. Conclusions: The combination regimen with chemotherapy, PD-1 inhibitor and anlotinib in the treatment of advanced DDLPS is effective and well tolerable. There are more responders in eribulin or gemcitabine-based regimens.

Chondrocyte apoptosis in temporomandibular joint osteoarthritis promotes bone resorption by enhancing chemotaxis of osteoclast precursors

OBJECTIVE

This study aimed to explore the effect and mechanism of chondrocyte apoptosis on the chemotaxis of osteoclast precursors (OCPs) during bone destruction.

DESIGN

The relationship between cartilage and bone destruction was verified with a rat temporomandibular joint osteoarthritis (TMJOA) model. The pan-caspase inhibitor Z-VAD-FMK (ZVAD) was applied to confirm the chemotactic effect of chondrocyte apoptosis on OCPs. Synthesis and release of the key chemokine CX3CL1 in apoptotic and non-apoptotic chondrocytes was assessed with IHC, IF, WB, and ELISA. The function of CX3CL1-CX3CR1 axis in the chemotaxis of OCPs was examined by CX3XR1 inhibitor AZD8797 (AZD) and si-CX3CL1. The regulatory effect of p38 MAPK on CX3CL1 release was verified by p38 inhibitor PH-797804.

RESULTS

A temporal and spatial association between cartilage degradation and bone resorption was found in the TMJOA model. The caspase-dependent chondrocyte apoptosis promoted chemotaxis of OCPs, which can be restrained by ZVAD. CX3CL1 was significantly upregulated when chondrocytes underwent apoptosis, and it played a critical role in the recruitment of OCPs, blockage of CX3CL1-CX3CR1 axis resulted in less bone resorption in TMJOA. P38 MAPK was activated in apoptotic chondrocytes, and had a regulatory effect on the synthesis and release of CX3CL1. After inhibition of p38 by PH-797804, the chemotactic effect of apoptotic chondrocytes on OCPs was limited.

CONCLUSIONS

This study indicates that apoptosis of chondrocytes in TMJOA enhances chemotaxis of OCPs toward osteoclast precursors through upregulation of the p38-CX3CL1 axis, thereby promoting the activation of local osteoclasts.

Evolutionary patterns of plastome resolve multiple origins of the Ns-containing polyploid species in Triticeae

Tracing evolutionary history proves challenging for polyploid groups that have evolved rapidly, especially if an ancestor of a polyploid is extinct. The Ns-containing polyploids are recognized as the NsXm and StHNsXm genomic constitutions in Triticeae. The Ns originated from Psathyrostachys, while the Xm represented a genome of unknown origin. Here, we use genetic information in plastome to trace the complex lineage history of the Ns-containing polyploid species by sampling 26 polyploids and 90 diploid taxa representing 23 basic genomes in Triticeae. Phylogenetic reconstruction, cluster plot of genetic distance matrix, and migration event demonstrated that (1) the Ns plastome originated from different Psathyrostachys species, and the Xm plastome may originate from an ancestral lineage of Henrardia, Agropyron, and Eremopyrum; (2) the Ns, Xm, and St genome donors separately served as the maternal parents during the speciation of the Ns-containing polyploid species, resulting in a maternal haplotype polymorphism; (3) North AmericanLeymusspecies might originate from colonization during late Miocene via the Bering land bridge and were the paternal donor of the StHNsXm genome Pascopyrum species. Our results shed new light on our understanding of the rich diversity and ecological adaptation of the Ns-containing polyploid species.

[Pancreas multidisciplinary team optimizes the diagnosis and treatment of pancreas-related diseases and improves the prognosis of pancreatic cancer patients]

Objectives: To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer. Methods: The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ2 test. Results: Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months,P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%,P<0.05;32.9% vs. 21.9%,P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%,P>0.05). Conclusions: The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients' compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

[Early effect of extracorporeal membrane oxygenation and factors related to early outcome in adult patients with fulminant myocarditis]

Objective: To evaluate the efficacy within the first 24 h post extracorporeal membrane pulmonary oxygenation (ECMO) and the impact of early efficacy on the prognosis of adult patients with fulminant myocarditis (FM). Methods: This retrospective case analysis study included hospitalized patients (age≥18 years) who were diagnosed with fulminant myocarditis from November 2016 to May 2021 in the First Affiliated Hospital of Zhengzhou University. Patients were divided into survival or non-survival groups according to treatment outcomes. The age, sex, treatments, drug use, ECMO use, clinical and laboratory data (before and 24 h after the use of ECMO) were analyzed. The change rate of clinical and laboratory data after 24 h use of ECMO was calculated to find differences between two groups. Multivariate logistic regression was used to analyze the related factors with in-hospital death and complication between the two groups. Results: A total of 38 FM patients treated with ECMO were included. There were 23 cases (60.5%) in the survival group, aged (39.6±13.7) years, and 17 (73.9%) cases were female. The total ECMO time was (134.4±71.3)h. There were 15 cases (39.5%) in non-survival group, aged (40.0±15.8) years, and there were 12(80.0%) female, the ECMO time was (120.1±72.4) h in this group. The proportion of tracheal intubation and continuous renal replacement therapy in the survivor group and dosage of norepinephrine within 24 h after ECMO implantation were significantly less than in non-survival group (all P<0.05). There was no significant difference in all efficacy related biochemical indexes between two groups before ECMO use. The levels of lactic acid, procalcitonin, creatinine, alanine aminotransferase, aspartate aminotransferase, creatine kinase-MB, cardiac troponin I and N-terminal B-type natriuretic peptide prosoma were significantly less in survival group than in non-survival group at 24 h after the use of ECMO (all P<0.05). Results of multivariate logistic regression analysis showed that the higher 24 h change rate of creatinine (OR=0.587, 95%CI 0.349-0.986, P=0.044) and creatine kinase-MB (OR=0.177, 95%CI 0.037-0.841, P=0.029) were positively correlated with reduced risk of in-hospital mortality. The central hemorrhage and acute kidney injury in survival group were less than in non-survivor group (P<0.05). Conclusions: After 24 h early use of ECMO in FM patients, the improvement of various efficacy related biochemical test indexes in the survival group was better than that in the non-survival group. Faster reduction of creatine kinase-MB and creatinine values within 24 h ECMO use is positively correlated with reduced risk of in-hospital mortality in adult patients with FM.

Asian Pacific association for the study of liver (APASL) guidelines: hepatitis B virus in pregnancy

Hepatitis B virus (HBV) infection still remains a major public health issue in the Asia-Pacific region. Most of the burden of HBV-related disease results from infections acquired in infancy through perinatal or early childhood exposure to HBV in Asia-Pacific. Hepatitis B during pregnancy presents unique management issues for both the mother and fetus. These APASL guidelines provide a comprehensive review and recommendations based on available evidence in the literature, for the management of females with HBV infection through every stage of pregnancy and postpartum. These also address the concerns, management challenges, and required follow-up of children born to hepatitis B-positive mothers.

Biosystematics studies on Elymus breviaristatus and Elymus sinosubmuticus (Poaceae: Triticeae)

BACKGROUND

Elymus breviaristatus and Elymus sinosubmuticus are perennial herbs, not only morphologically similar but also sympatric distribution. The genome composition of E. sinosubmuticus has not been reported, and the relationship between E. sinosubmuticus and E. breviaristatus is still controversial. We performed artificial hybridization, genomic in situ hybridization, and phylogenetic analyses to clarify whether the two taxa were the same species.

RESULTS

The high frequency bivalent (with an average of 20.62 bivalents per cell) at metaphase I of pollen mother cells of the artificial hybrids of E. breviaristatus (StYH) × E. sinosubmuticus was observed. It illustrated that E. sinosubmuticus was closely related to E. breviaristatus. Based on genomic in situ hybridization results, we confirmed that E. sinosubmuticus was an allohexaploid, and the genomic constitution was StYH. Phylogenetic analysis results also supported that this species contained St, Y, and H genomes. In their F₁ hybrids, pollen activity was 53.90%, and the seed setting rate was 22.46%. Those indicated that the relationship between E. sinosubmuticus and E. breviaristatus is intersubspecific rather than interspecific, and it is reasonable to treated E. sinosubmuticus as the subspecies of E. breviaristatus.

CONCLUSIONS

In all, the genomic constitutions of E. sinosubmuticus and E. breviaristatus were StYH, and they are species in the genus Campeiostachys. Because E. breviaristatus was treated as Campeistachys breviaristata, Elymus sinosubmuticus should be renamed Campeiostachys breviaristata (Keng) Y. H. Zhou, H. Q. Zhang et C. R. Yang subsp. sinosubmuticus (S. L. Chen) Y. H. Zhou, H. Q. Zhang et L. Tan.

[Initial exploration of transfusion-free liver transplantation]

Objective: To evaluate the effect of transfusion-free techniques on the prognosis of liver transplant patients. Methods: The recipients of adult liver transplantation at Tianjin First Central Hospital from August to December 2019 were included in the clinical observation. Liver transplantation without allogeneic blood transfusion was performed through anesthesia management techniques such as acute hemodilution or phlebotomy without volume replacement,maintaining decreased baseline central venous pressure and cell saver. According to the actual results,the patients were divided into two groups: transfusion-free group(n=21) and allogeneic transfusion group(n=28). There were 13 males and 8 females aged of (56.3±11.6) years in the transfusion-free group;and there were 16 males and 12 females aged (54.3±14.2)years in the allogeneic transfusion group. The transplant recipients who had not adopted transfusion management strategy from January to July 2019 were included as control group(27 males and 13 females,aged of (58.9±14.1)years). The clinical data of patients in perioperative period were collected to compare whether there were differences in the recovery of liver function and early complications among the three groups, one-way ANOVA test, rank-sum test, and χ² test were used for data analysis. Results: The amount of intraoperative blood loss in both the transfusion-free group and the transfusion group was less than that in the control group((454.2±271.3)ml vs.(673.6±333.4)ml vs.(890.3±346.7)ml;q=-6.342,-5.286,both P<0.05).The duration of stay in ICU of the transfusion-free group was less than that of the transfusion group and control group((36.4±9.1)hours vs.(44.3±14.9)hours vs.(58.2±21.1)hours;q=-4.432,-3.824,both P<0.05).The mean ALT level at 7 days after operation was significantly lower in the transfusion-free group than in the control group((56.8±32.1)U/L vs.(89.6±45.6)U/L;q=-3.358,P<0.05). Conclusions: The improvement of multi-disciplinary transfusion management technology aimed at transfusion-free liver transplantation can effectively reduce intraoperative hemorrhage and help to avoid surgical transfusion. Transfusion-free liver transplantation is beneficial to the early postoperative recovery,and its long-term clinical significance is worthy of further clinical research.

[The effects of posterior chamber intraocular lens implantation on accommodative function in high myopia]

Objective: To investigate the effects of implantable Collamer lens (ICL) with a central hole on the accommodative function of patients with high myopia at different ages after implantation. Methods: A retrospective cohort study was conducted on 75 patients (150 eyes, 23 men and 52 women) with high myopia who underwent ICL implantation in Department of Ophthalmology of First Affiliated Hospital of Army Medical University from January 2017 to December 2018. The age was (28.99±7.26) years (range, 18-48 years). Forty patients (80 eyes) aged 18-34 years were included in the younger group and 35 patients (70 eyes) aged 35-48 years were included in the elderly group. To compare the changes and differences of accommodative function between the two groups, the uncorrected visual acuity, best corrected visual acuity, spherical equivalent error, amplitude of accommodation (AMP), negative relative accommodation (NRA), positive relative accommodation, single and both eyes' accommodation of facility (AF), fused cross cylinder, near and far distance horizontal phoria, accommodative convergence/accommodation and visual satisfaction questionnaire before surgery and at 1, 3, 6 and 12 months after surgery were analyzed. ANOVA for repeated design, LSD, unpaired sample t-test, Paired t-test, Chi-square test and Fisher's exact test were used for data analyses. Results: At each time point before and after operation, there were significant differences between the two groups in the AMP (F=16.511, P<0.05). The AMP of the younger group increased from (8.88±2.27) D at baseline to (9.51±1.34) D at 12 months, while it was decreased in the elderly group from (7.67±2.36) D at baseline to (6.56±2.63) D at 12 months. The trend of changes was significantly different (F=15.044,P<0.05). The AMP of the elderly group was significantly lower than that of the younger group at all time points (F=47.678, P<0.05). The NRA of the younger group was better than that of the elderly group (F=13.459, P<0.05), but the NRA had no significant changes in both groups postoperatively (F=1.788, P=0.141). We could not find any significant changes of positive relative accommodation between two groups (F=1.447, P=0.233). The monocular and binocular AF of two groups was increased significantly after surgery (F=34.296, 21.839, P<0.05). The AF of the younger group was better than that of the elderly group (F=80.327, 43.08, P<0.05). The fused cross cylinder was improved from baseline (0.12±0.32) D to (0.38±0.49) D at 12 months (F=4.752, P<0.05), while the difference was not found in the younger group (F=2.110, P=0.151). We could not find any significant changes of accommodative convergence/accommodation between two groups (F=0.389, P=0.505) or in each group (F=1.049, P=0.309) preoperatively and at 1, 3, 6 and 12 months after surgery. Conclusions: ICL implantation is effective in the treatment of high myopia. The visual acuity, AMP, monocular and binocular AF may increase obviously. Big improvements in the accommodative function and high satisfaction of vision can be achieved, especially in younger patients. (Chin J Ophthalmol, 2021, 57: 113-121).

[Agreement of EV-A71 neutralization assay: serial 4-fold versus 2-fold dilution comparison]

Objective: To evaluate consistency between 2-fold serial and 4-fold serial diluted neutralization tests against Enterovirus A71 (EV-A71) in estimating titer, Geometric mean titer (GMT), seroprevalence, and seroincidence. Methods: Based on a prospective cohort of 1-9 years old children, mothers and infants established in Anhua County, Hunan Province, during 2013-2018, from which 92 participants with a total of 386 blood specimens were sampled and tested with a 2-fold serial dilution and a 4-fold serial dilution neutralization tests against EV-A71 at the same time. Agreement was estimated using the Bland-Altman method. Stratified analysis was conducted to estimate effect dilution approach on GMT, seroprevalence and seroincidence. Results: The mean difference (0.04, 95%CI:-0.02-0.10) between the two dilution approaches was not significant. However, the limits of agreement (LOA) (-1.12-1.21), with the 95% confidence interval of upper LOA (1.10-1.31) and of lower LOA (-1.22--1.02), significantly exceeded the Clinic accept interval (-1, 1) indicating insufficient agreement between the two approaches in practice. While the dilution approaches did not affect estimates of GMT of the total population and the positive population, and seroincidence with seroconversion only, the differences were 2, 6 and 2%, respectively (P>0.05). Estimates of seroincidence with at least 4-fold increase and seroconversion/4-fold increase were significantly higher using a 4-fold dilution neutralization test compared to the 2-fold dilution neutralization test with 8% (95%CI: 1%-12%) and 9% (95%CI: 1%-17%), respectively. Conclusion: The 2-dilution and 4-dilution neutralization tests yielded comparable results when estimating the population's GMT; however, the difference between the two is not negligible when assessing the seroincidence.

Variation in Plastome Sizes Accompanied by Evolutionary History in Monogenomic Triticeae (Poaceae: Triticeae)

To investigate the pattern of chloroplast genome variation in Triticeae, we comprehensively analyzed the indels in protein-coding genes and intergenic sequence, gene loss/pseudonization, intron variation, expansion/contraction in inverted repeat regions, and the relationship between sequence characteristics and chloroplast genome size in 34 monogenomic Triticeae plants. Ancestral genome reconstruction suggests that major length variations occurred in four-stem branches of monogenomic Triticeae followed by independent changes in each genus. It was shown that the chloroplast genome sizes of monogenomic Triticeae were highly variable. The chloroplast genome of Pseudoroegneria, Dasypyrum, Lophopyrum, Thinopyrum, Eremopyrum, Agropyron, Australopyrum, and Henradia in Triticeae had evolved toward size reduction largely because of pseudogenes elimination events and length deletion fragments in intergenic. The Aegilops/Triticum complex, Taeniatherum, Secale, Crithopsis, Herteranthelium, and Hordeum in Triticeae had a larger chloroplast genome size. The large size variation in major lineages and their subclades are most likely consequences of adaptive processes since these variations were significantly correlated with divergence time and historical climatic changes. We also found that several intergenic regions, such as petN-trnC and psbE-petL containing unique genetic information, which can be used as important tools to identify the maternal relationship among Triticeae species. Our results contribute to the novel knowledge of plastid genome evolution in Triticeae.

Genome-Wide Survey and Expression Analysis of the KT/HAK/KUP Family in Brassica napus and Its Potential Roles in the Response to K+ Deficiency

The KT/HAK/KUP (HAK) family is the largest potassium (K⁺) transporter family in plants, which plays key roles in K⁺ uptake and homeostasis, stress resistance, and root and embryo development. However, the HAK family has not yet been characterized in Brassica napus. In this study, 40 putative B. napus HAK genes (BnaHAKs) are identified and divided into four groups (Groups I–III and V) on the basis of phylogenetic analysis. Gene structure analysis revealed 10 conserved intron insertion sites across different groups. Collinearity analysis demonstrated that both allopolyploidization and small-scale duplication events contributed to the large expansion of BnaHAKs. Transcription factor (TF)-binding network construction, cis-element analysis, and microRNA prediction revealed that the expression of BnaHAKs is regulated by multiple factors. Analysis of RNA-sequencing data further revealed extensive expression profiles of the BnaHAKs in groups II, III, and V, with limited expression in group I. Compared with group I, most of the BnaHAKs in groups II, III, and V were more upregulated by hormone induction based on RNA-sequencing data. Reverse transcription-quantitative polymerase reaction analysis revealed that the expression of eight BnaHAKs of groups I and V was markedly upregulated under K⁺-deficiency treatment. Collectively, our results provide valuable information and key candidate genes for further functional studies of BnaHAKs.

Serine Metabolism Controls Dental Pulp Stem Cell Aging by Regulating the DNA Methylation of p16

To investigate the characteristics and molecular events of dental pulp stem cells (DPSCs) for tissue regeneration with aging, we isolated and analyzed the stem cells from human exfoliated deciduous teeth (SHED) and permanent teeth of young (Y-DPSCs) and old (A-DPSCs) adults. Results showed that the stemness and osteogenic differentiation capacity of DPSCs decreased with aging. The RNA sequencing results showed that glycine, serine, and threonine metabolism was one of the most enriched gene clusters among SHED, Y-DPSCs, and A-DPSCs, according to analysis based on the Kyoto Encyclopedia of Genes and Genomes. The expression of serine metabolism-related enzymes phosphoserine aminotransferase 1 (PSAT1) and phosphoglycerate (PHGDH) decreased in A-DPSCs and provided less methyl donor S-adenosylmethionine (SAM) for DNA methylation, leading to the hypomethylation of the senescence marker p16 (CDNK2A). Furthermore, the proliferation and differentiation capacity of Y-DPSCs and SHED decreased after PHGDH siRNA treatment, which reduced the level of SAM. Convincingly, the ratios of PSAT1-, PHGDH-, or proliferating cell nuclear antigen-positive cells in the dental pulp of old permanent teeth were less than those in the dental pulp of deciduous teeth and young permanent teeth. In summary, the stemness and differentiation capacity of DPSCs decreased with aging. The decreased serine metabolism in A-DPSCs upregulated the expression of p16 via attenuating its DNA methylation, resulting in DPSC aging. Our finding indicated that serine metabolism and 1 carbon unit participated in stem cell aging, which provided new direction for stem cell aging study and intervention.

The knockdown of SNHG3 inhibits the progression of laryngeal squamous cell carcinoma by miR-340-5p/YAP1 axis and Wnt/β-catenin pathway

Laryngeal squamous cell carcinoma (LSCC) is a common malignancy of the head and neck. Long noncoding RNAs (lncRNAs) play essential roles in the development and treatment of LSCC. However, the role and regulatory mechanism of lncRNA small nucleolar RNA host gene 3 (SNHG3) in LSCC progression remain largely unknown. Twenty-five paired LSCC tissues and normal samples were collected. The expression levels of SNHG3, Yes-associated protein 1 (YAP1), and microRNA-340-5p (miR-340-5p) were measured via quantitative real-time polymerase chain reaction or western blot. Cell viability, apoptosis, and glycolysis were investigated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide, flow cytometry, and specific assay kit, respectively. The association between SNHG3 and miR-340-5p or miR-340-5p and YAP1 was assessed by dual-luciferase reporter assay. The expression of a protein involved in the Wnt/β-catenin pathway was detected by western blot. The xenograft model was established to assess the anti-cancer role of SNHG3 inhibition in vivo. We found that the levels of SNHG3 and YAP1 were increased but the miR-340-5p expression was decreased in LSCC tissues and cells. The knockdown of SNHG3 or YAP1 inhibited cell viability and glycolysis but induced apoptosis in LSCC cells. Overexpression of YAP1 reversed the effect of SNHG3 knockdown on LSCC progression. SNHG3 could regulate YAP1 expression by competitively binding with miR-340-5p. Overexpression of miR-340-5p suppressed cell viability and glycolysis but promoted apoptosis in LSCC cells. Knockdown of SNHG3 repressed Wnt/β-catenin pathway by regulating miR-340-5p and YAP1. The silencing of SNHG3 reduced LSCC xenograft tumor growth. In conclusion, knockdown of SNHG3 inhibited LSCC progression via inactivating Wnt/β-catenin pathway by regulating the miR-340-5p/YAP1 axis.

[Consideration of surgeons participating in 2019 coronavirus disease emergency medical rescue]

As a newly epidemic, 2019 coronavirus disease (COVID-19) with a concentrated outbreak poses a great challenge to medical treatment. The severe and critical patients are complex complicatied with the psychological problems, and the medical staff are overworked and under tremendous psychological pressure. The surgeon participated in emergency medical rescue could provide professional treatment for the patients combined with surgical diseases, as well as specialized training for the non-surgeon crew, to reduce surgical-related mortality. With the advantages of good team consciousness, strong aseptic concept and good psychological quality, the surgeons can quickly adapt to and carry out rescue work under the premise of good self-protection. Surgeons need to develop critical care management concepts and focus on the critical care support equipment. Some suggestions are put forward for the standardized training of resident surgeons to cultivate compound talents. It is hoped that this article can lead to the thinking of how to participate in the emergency medical rescue of infectious diseases among surgeons and provide some enlightenment for future surgical education.

Evolutionary patterns of plastome uncover diploid-polyploid maternal relationships in Triticeae

To investigate the diploid-polyploid relationships and the role of maternal progenitors in establishment of polyploid richness in Triticeae, 35 polyploids representing almost all genomic constitutions together with 48 diploid taxa representing 20 basic genomes in the tribe were analyzed. Phylogenomic reconstruction, genetic distance matrix, and nucleotide diversity patterns of plastome sequences indicated that (1) The maternal donor of the annual polyploid species with the U- and D-genome are related to extant Ae. umbellulata and Ae. tauschii, respectively. The maternal donor to the annual polyploid species with the S-, G-, and B-genome originated from the species of Sitopsis section of the genus Aegilops. The annual species with the Xe-containing polyploids were donated by Eremopyrum as the female parent; (2) Pseudoroegneria and Psathyrostachys were the maternal donor of perennial species with the St- and Ns-containing polyploids, respectively; (3) The Lophopyrum, Thinopyrum and Dasypyrum genomes contributed cytoplasm genome to Pseudoroegneria species as a result of incomplete lineage sorting and/or chloroplast captures, and these lineages were genetically transmitted to the St-containing polyploid species via polyploidization; (4) There is a reticulate relationship among the St-containing polyploid species. It can be suggested that genetic heterogeneity might associate with the richness of the polyploids in Triticeae.

[Comments on 2019 Chinese practice guideline for the prevention and treatment of hepatitis B virus mother-to-child transmission]

Recently, the Society of Infectious Diseases of Chinese Medical Association and Chinese GRADE Center jointly released the "2019 Chinese practice guideline for the prevention and treatment of hepatitis B virus mother-to-child transmission" . We concerned several issues in the Guideline, including the improper citation of some references, no recommendations for some key strategies for the prevention of hepatitis B virus mother-to-child transmission, insufficient or even lack of evidence for some recommendations and others. Based on the principle of academic contention, we present in this article our comments on the Guideline to discuss these issues with the Guideline's authors and readers.

[Comparison of the visual quality at 1 year following femtosecond laser-assisted LASIK, wavefront-guided femtosecond LASIK and small incision lenticule extraction for myopia and astigmatism]

Objective: To investigate mesopic contrast sensitivity (CS) and high-order aberrations after femtosecond laser-assisted LASIK (FS-LASIK), wavefront-guided femtosecond LASIK (WF-LASIK) and small incision lenticule extraction (SMILE) for myopia and astigmatism. Methods: In this case-control study, 212 eyes of 108 patients with myopia and astigmatism from September 2014 to September 2016 were treated by refractive surgery. There were 34 males (66 eyes) and 74 females (146 = eyes), aged 27 (24, 32) years. They were divided into 3 groups, with 37 patients (71 eyes), 35 patients (69 eyes) and 36 patients (72 eyes) treated by FS-LASIK, WF-LASIK and SMILE, respectively. Refraction diopters, corneal tomography, wavefront aberrations and contrast sensitivity were evaluated before and at 12 months after surgery. The results of different groups were compared by rank sum test. Results: At 12 = months of follow-up, 69 eyes (97.18%) treated by FS-LASIK, 67 eyes (97.10%) by WF-LASIK and 69 eyes (95.83%) by SMILE had the uncorrected distance visual acuity of 20/20 or better. Fifty-nine eyes (83.10%) treated by FS-LASIK, 60 eyes (86.96%) by WF-LASIK and 61 eyes (84.72%) by SMILE had better postoperative uncorrected distance visual acuity than preoperative corrected distance visual acuity. Surface regularity index of the WF-LASIK group decreased from 0.11 (0.07, 0.28) to 0.07 (0.06, 0.20) (Z=-2.662, P=0.008), which was less than that of the FS-LASIK and SMILE groups (Z=-3.236, -3.118, P=0.001, 0.000). Surface asymmetry index of the WF-LASIK group increased from 0.34 (0.25, 0.43) to 0.38 (0.30, 0.52) (Z=-2.140, P=0.032), which was less than that of the FS-LASIK and SMILE groups (Z=-2.910, -3.779, P=0.004, 0.000). The root mean square of high-order of the FS-LASIK group increased from 0.32 (0.27, 0.41) to 0.53 (0.40, 0.65) (Z=-6.228, P=0.000), which was more than that of the WF-LASIK and SMILE groups (Z=-3.595, -4.806, P=0.000, 0.000). Coma of the WF-LASIK group increased from 0.16 (0.11, 0.24) to 0.26 (0.15, 0.37) (Z=-3.816, P=0.000), which was less than that of the FS-LASIK group (Z=-3.528, P=0.000). Spherical aberration of the FS-LASIK and WF-LASIK groups increased from 0.10 (0.05, 0.21) and 0.08 (0.04, 0.12) to 0.24 (0.13, 0.34) and 0.15 (0.09, 0.26), respectively (Z=-5.141, -4.864, P=0.000, 0.000), which were more than that of the SMILE group (Z=-2.549, -4.682, P=0.011, 0.000). CS of the WF-LASIK group at 12 cycles per degree (c/d) increased from 1.34 (1.18, 1.48) to 1.48 (1.34, 1.63) (Z=-2.985, P=0.003), which was more than that of the FS-LASIK and SMILE groups (Z=-3.194, -2.977, P=0.001, 0.003). CS with glare of the WF-LASIK group at 12.0 c/d increased from 1.26 (1.18, 1.34) to 1.34 (1.34, 1.63) (Z=-3.608, P=0.000), which was more than that of the FS-LASIK and SMILE groups (Z=-4.033, -2.913, P=0.000, 0.004). Conclusions: FS-LASIK, WF-LASIK and SMILE achieved ideal visual outcomes at 12 months postoperatively. WF-LASIK treated eyes showed the best corneal symmetry, the least increase of high-order aberrations and the best visual quality among three kinds of surgeries. (Chin J Ophthalmol, 2020, 56: 118-125).

DPSCs Attenuate Experimental Progressive TMJ Arthritis by Inhibiting the STAT1 Pathway

Severe inflammation, progressive cartilage, and bone destruction are typical pathologic changes in temporomandibular joint (TMJ) arthritis and lead to great difficulty for treatment. However, current therapy is inefficient to improve degenerative changes in progressive TMJ arthritis. This study investigated the therapeutic effects of human dental pulp stem cells (DPSCs) on severe inflammatory TMJ diseases. Progressive TMJ arthritis in rats was induced by intra-articular injection of complete Freund's adjuvant and monosodium iodoacetate. DPSCs were injected into the articular cavity to treat rat TMJ arthritis, with normal saline injection as control. Measurement of head withdrawal threshold, micro-computed tomography scanning, and histologic staining were applied to evaluate the severity of TMJ arthritis. Results showed that local injection of DPSCs in rats with TMJ arthritis relieved hyperalgesia and synovial inflammation, attenuated cartilage matrix degradation, and induced bone regeneration. Inflammatory factors TNF-α and IFN-γ were elevated in progressive TMJ arthritis and partially decreased by local injection of DPSCs. MMP3 and MMP13 were elevated in the arthritis + normal saline group and decreased in the arthritis + DPSCs group, which indicated amelioration of matrix degradation. The isolated primary synoviocytes were cocultured with DPSCs after inflammatory factors stimulated to explore the possible biological mechanisms. The expression of MMP3 and MMP13 in synoviocytes was elevated after TNF-α and IFN-γ stimulation and partially reversed by DPSC treatment in the in vitro study. The signal transducer and activator of transcription 1 (STAT1) was activated by inflammatory stimulation and suppressed by DPSC coculture. The upregulation of MMP3 and MMP13 triggered by inflammation was blocked by STAT1-specific inhibitor, suggesting that STAT1 regulated the expression of MMP3 and MMP13. In conclusion, this study demonstrated the possible therapeutic effects of local injection of DPSCs on progressive TMJ arthritis by inhibiting the expression of MMP3 and MMP13 through the STAT1 pathway.

Controllable scattering of a single photon inside a one-dimensional coupled resonator waveguide with second-order nonlinearity

We note that most of the studies of the single photon scattering inside a one-dimensional coupled resonator waveguide are based on the waveguide coupling with the atom systems. In this paper, we will study the single photon scattering enabled by another system, i.e., the second-order nonlinearity, which can act as a single photon switch to control the single photon transmission and reflection inside the one-dimensional coupled resonator waveguide. The transmission rate is calculated to analyze the single-photon scattering properties. In addition, a more complicated second-order nonlinear form, i.e., three-wave mixing, is discussed to control single photon transmission inside the one-dimensional coupled resonator waveguide.

[Occupational hazards and risk assessment of benzene-related enterprises in yangzhou city from 2014 to 2018]

Objective: To investigate the benzene concentration in the workplace of benzene-related enterprises in Yangzhou City from 2014 to 2018, and the abnormal blood routine of workers exposed to benzene, and to assess their occupational hazards. Methods: The environmental monitoring data of benzene-related enterprises and the health examination data of benzene exposed workers were collected in March 2019. The inhalation risk assessment model of the National Environmental Protection Agency (EPA) was used to assess the carcinogenic and non-carcinogenic risks of benzene workers. Results: The qualified rate of benzene detection in the workplace was 100% from 2014 to 2018, the highest concentration was 1.42 mg/m(3) in five years. The abnormal rates of blood routine detection in benzene exposed workers in five years was 7.10% (213/2 998) 、5.17% (218/4 214) 、5.61% (196/3 493) 、7.65% (288/3 767) 、7.83% (280/3 574) and 7.83%. respectively. The results of risk assessment showed that the minimum carcinogenic risk value was 7.56×10(-6) and the maximum carcinogenic risk value was 31.33×10(-6) in 2014-2018. The hazard quotient values were than 1. Conclusion: Benzene monitoring concentration in benzene-related enterprises in Yangzhou City from 2014 to 2018 was low, which meets the occupational exposure limit in China. However, the abnormal rate of blood routine in five years is still high, and there are both carcinogenic and non-carcinogenic risks. We should pay more attention to the health risk of workers exposed to low concentrat in benzene.

Properties of Rigid Polyurethane Foam Modified by Tung Oil-Based Polyol and Flame-Retardant Particles

Although tung oil is renewable, with an abundant production and low price in China, and it is used to synthesize different polyols for rigid polyurethane foam (RPUF), it remains a challenge to improve the properties of RPUF by redesigning the formula. Therefore, we propose four novel compounds to strengthen the properties of RPUF, such as the catalyst-free synthesis of tung oil-based polyol (PTOK), aluminum phosphate micro-capsule (AM), silica micro-capsule (SiM), and grafted epoxidized monoglyceride of tung oil on the surface of SiO2 (SiE), which were designed and introduced into the RPUF. Because of the PTOK with a catalytic function, the foaming process of some RPUF samples was catalyst-free. The results show that the incorporation of AM, SiM, and SiE, respectively, endow RPUF with a better thermal stability at a high temperature, and the T5%, Tmax1, and Tmax2 of RPUF appeared to be reduced, however, the Tmax3 and residue rate at 800 °C were improved, which may have a positive effect on the extension of the rescue time in case of fire, and the limiting oxygen index (LOI) value was increased to 22.6%. The formula, containing 25% PTOK made the RPUF environment-friendly. The results were obtained by comparing the pore size and mechanical properties of the RPUF-the AM had a better dispersion in the foam, and the foam obtained a better mechanical, thermal, and flame retardancy.

[Diagnostic value and patient compliance of a pancreas-oriented multidisciplinary clinic: a retrospective analysis from a Chinese pancreatic disease center]

Objective: To evaluate the role of multidisciplinary team (MDT) clinic in the diagnosis of pancreatic diseases and patient compliance with MDT advice in the current medical system. Methods: The study included 512 patients that had visited the pancreas-oriented MDT clinic of Zhongshan Hospital between May 2015 and May 2019.The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. Compliance was determined according to whether a patient received corresponding therapies or undergoing further checks or follow-ups. Results: Among the 512 patients that had visited the MDT clinic, 121 patients were referred due to undetermined diagnosis. Classified according to the final diagnosis, the rate of undetermined diagnosis in different disease categories from high to low in order was inflammatory diseases of the pancreas (75.0%, 24/32), other lesions of the pancreas (56.1%,23/41), pancreatic cystic lesions (19.1%,17/89), pancreatic carcinomas (18.3%,48/262) and pancreatic neuroendocrine neoplasms (pNEN)(10.2%,9/88). The MDT clinic made diagnosis to 68 patients directly with an accuracy of 89.7%. The rate of compliance in the entire cohort was 63.4%. The rate of compliance of patients from June 2017 to May 2019 (68.4%) was higher than that of patients from May 2015 to May 2017(59.6%). The compliance rate of patients in different disease categories from high to low in order was inflammatory diseases of the pancreas(84.4%, 27/32), pancreatic carcinomas (67.9%, 178/262), pNEN(60.2%,53/88), other lesions of the pancreas (56.1%,23/41), and pancreatic cystic lesions(49.4%, 44/89). The compliance rate of patients with different MDT advice from high to low in order was best supportive care(78.6%,22/28), antitumor approaches beyond surgery(71.6%,159/222), further tests(62.6%, 77/123), surgery(53.7%, 65/121) and follow-up(49.2%, 31/63). In patients suggested for surgery, the compliance rate of patients with carcinomas(67.4%, 33/49) was higher than patients with other kinds of neoplasms. Conclusions: MDT clinic could facilitate the diagnosis of pancreatic diseases conveniently and inexpensively. The overall compliance rate of MDT clinic patients is rather low, and patients with carcinomas have a relative high rate of compliance with the suggestion of surgery.

System susceptibility and bound-states in structured reservoirs

We propose a formulation to obtain the exact susceptibility for system arbitrary operators to the external fields by means of the whole-system Hamiltonian (system plus reservoir) diagonalization methods, where the dissipative effects directly reflect the nature of the structured non-Markovian reservoir. This treatment does not make the Born-Markovian approximation in structured non-Markovian reservoir. The relations between linear response function and bound-states for the system as well as structured reservoir are found, which shows the photon bound-states and continuous energy spectrum can be readout from the susceptibility, respectively. These results are then used to examine the validity of second-order Born-Markovian approximation, where we find interesting features (e.g., bound-states) are lost in the approximate treatments for open systems. We study the dependence of the response function on the type (spectrum density) of interaction between the system and structured reservoir. We also give the physical reasons behind the disappearance of the bound-states in the approximation method. Finally, these results are also extended to a more general quantum network involving an arbitrary number of coupled-bosonic system without rotating-wave approximation. The presented results might open a new door to understand the linear response and the energy spectrum for non-Markovian open systems with structured reservoirs.

[Clinical analysis of 555 outpatients with hand, foot and mouth diseases caused by different enteroviruses]

Objective: To study the clinical characteristics of outpatients with hand, foot and mouth disease (HFMD) caused by different serotypes of enteroviruses. Methods: This was a prospective study. From February 2017 to March 2018, 563 outpatients with HFMD were enrolled by systematic sampling in the Department of Infectious Diseases, Henan Children's Hospital. Throat swabs were collected to determine the serotypes via PCR. Demographic, clinical, and laboratory data were collected by standard questionnaire. All cases were followed up twice at 2 and 9 weeks after the initial outpatient visit through telephone interview. A total of 563 cases were enrolled and 555 (98.6%) cases were positive for human enteroviruses, including 338 (60.9%) males. Analyses were stratified by enterovirus serotypes, Chi square test or Fisher's exact test, Rank sum test was used for comparison among different groups. Results: The age of 555 cases was 24.2 (16.4, 41.3) months. Among them 44.0% (224 cases) were identified as coxsackievirus (CV)-A6, while 189 cases, 35 cases, 14 cases and 73 cases were identified as CV-A16, enterovirus (EV)-A71, CV-A10 and other serotypes, respectively. Fever (≥37.5 ℃) was present in 51.4% (285/555) of laboratory confirmed cases. The proportions of fever in cases of CV-A6 (68.9%(168/244)) and CV-A10 (12/14) were significantly higher than those in cases of CV-A16 (31.7%(60/189),χ(2)=57.344,14.313,both P=0.000), other serotypes (43.8%(32/73),χ(2)=15.101 and 8.242, P=0.000 and 0.004) and EV-A71 (37.1%(13/35), χ(2)=13.506 and 9.441, P=0.000 and 0.002) respectively. There was no significant difference between CV-A6 and CV-A10 in presentation of fever (χ(2)=1.785, P=0.182). There were 359 cases (64.7%) with eruptions in mouth, hands, feet and buttocks. Cases infected with EV-A71 had the highest proportions (74.3%(26/35)) of rash emerging simultaneously in mouth, hands, feet, and buttocks. The proportion in cases of CV-A16, CV-A6, CVA10 and other serotype were 73.5% (139/189), 61.9% (151/244), 7/14 and 49.3% (36/73), respectively. The proportion of rash on other parts of body, such as face, limbs or torso in cases infected with CV-A6 (16.8% (41/244)) was the higherest and the proportion in cases of CV-A16, EV-A71, CV-A10 or other serotypes were 8.5% (16/189) , 5.7% (2/35) , 1/14, 6.8% (5/73) , respectively. None of these cases developed serious complications. Desquamation occurred in 45.5% (179/393) cases 7.5 (5.0, 9.0) days after disease onset and 13.5% (53/393) cases showed onychomadesis 31.0 (18.0, 33.5) days after disease onset. The proportion of desquamation and onychomadesis associated with CV-A6 (64.2% (95/148) and 31.8% (47/148)) was significantly higher than CV-A16 (31.8% (49/154) and 1.3% (2/154), χ(2)=33.601 and 52.482, both P=0.000) and other serotypes (38.0%(19/50) and 6.0%(3/50),χ(2)=10.236 and 12.988, P=0.001 and 0.000). Desquamation appeared more in cases of CV-A6 than in cases of CV-A10 (2/11,χ(2)=9.386, P=0.002), with the proportion of onychomadesis higher in CV-A6 than in EV-A71 (3.3% (1/30),χ(2)=11.088, P=0.001). Conclusion: Clinical manifestation such as fever, rash emerging parts, desquamation and onychomadesis are different among outpatient HFMD cases infected with CV-A16, CV-A6, EV-A71, CV-A10 and other enteroviruses.

Nondisjunction and unequal spindle organization accompany the drive of Aegilops speltoides B chromosomes

B chromosomes (Bs) are supernumerary chromosomes, which are often preferentially inherited. When transmission rates of chromosomes are higher than 0.5, not obeying the Mendelian law of equal segregation, the resulting transmission advantage is collectively referred to as 'chromosome drive'. Here we analysed the drive mechanism of Aegilops speltoides Bs. The repeat AesTR-183 of A. speltoides Bs, which also can be detected on the Bs of Aegilops mutica and rye, was used to track Bs during pollen development. Nondisjunction of CENH3-positive, tubulin interacting B sister chromatids and an asymmetric spindle during first pollen grain mitosis are key for the accumulation process. A quantitative flow cytometric approach revealed that, independent of the number of Bs present in the mother plant, Bs accumulate in the generative nuclei to > 93%. Nine out of 11 tested (peri)centromeric repeats were shared by A and B chromosomes. Our findings provide new insights into the process of chromosome drive. Quantitative flow cytometry is a useful and reliable method to study the drive frequency of Bs. Nondisjunction and unequal spindle organization accompany during first pollen mitosis the drive of A. speltoides Bs. The prerequisites for the drive process seems to be common in Poaceae.

[Orthodonticorthognathic treatment stability in skeletal class III malocclusion patients]

OBJECTIVE

To investigate stability of skeletal hard tissues, dental hard tissues and soft tissues after orthodonticorthognathic treatment in a long term. This study reviewed longitudinal changes in orthodontic-orthognathic patients of skeletal class III malocculsion, using lateral cephalometric radiographs in 3-12 years after treatment in comparison to treatment finishing.

METHODS

Twenty-two patients with skeletal Class III malocclusion following orthodontic-orthognathic surgery in Peking University School and Hospital of Stomatology from January 1, 2000 to January 1, 2009 were observed. The lateral cephalometric radiographs of the following stages were collected: treatment finishing (T1), 3 to 12 years after treatment (T2). Statistical analyses of cephalometrics were evaluated. Paired student t test was performed by SPSS 17.0.

RESULTS

Data of all the 22 patients were studied in longitudinal timeline after treatment and 3-12 years after treatment. From T1 to T2, we evaluated 11-SN (angle between the upper incisors axis and SN plane), 11-NA angle (angle between the upper incisors axis and NA plane), 11-NA mm (perpendicular distance from upper incisors to NA plane), 11-41 (angle between the upper incisors axis and lower incisors axis), 41-NB angle (angle between lower incisors and NB plane), 41-NB (perpendicular distance from lower incisors to NB plane), 41-MP angle (angle between lower incisors and GoGn plane), and IMPA [angle between lower incisor and mandibular plane (tangent line to submandibular border)]. Most hard tissues of the teeth remained stable but upper anterior teeth angulations decreased, indicating by significantly reducing 11-SN (T1: 110.98°±6.77°; T2: 109.21°±5.80°; P=0.005); reducing 11-NA (T1: 28.31°±6.80°; T2: 26.49°±6.18°; P=0.002); increasing 11-41 (T1: 123.51°±8.14°; T2: 125.7°±10.01°; P=0.035). From T1 to T2, we also evaluated SNA (angle of sella-nasion-A-point), SNB (angle of sella-nasion-B-point), ANB (angle of A-point-nasion-B-point), GoGn-SN (angle between GoGn and SN plane), GoGn-FH (angle between GoGn and Frankfort plane), Y axis (angel between Sella-Gn and Frankfort plane), N-ANS (distance from nasion point to ANS point), ANS-Me (distance from ANS point to Menton point), N-Me (distance from nasion point to Menton point), ANS-Me/N-Me% (proportion of ANS-Me to N-Me), and FMA (angle between Frankfort and mandibular plane), Wits appraisal (horizontal distance between points A and B on functional occlusal plane). Skeletal hard tissues also remained relatively stable, only N-Me value changed significantly with a decreasing facial height (T1: 124.98°±11.98°; T2: 122.4°±11.05°; P=0.024). From T1 to T2, we finally evaluated FH-NsPg angle (angle between NsPg and Frankfort plane), H angle (angel between H line and NB), FH-A'UL angle (angle between A'UL and Frankfort plane), FH-B'LL angle (angle between B'LL and Frankfort plane), UL-LL (angle between UL and LL), UL-EP (distance between UL and E line), LL-EP (distance between LL and E line), Sn-H (perpendicular distance between Sn point and H line), Nls-H (distance of nose-lip-sulcus to H line), Li-H (lower lip to H line), Si-H (lower lip sulcus to H line), and NLA (nasolabial angle, angle of Cm-Sn-UL-point). Soft tissues changes were observed in decreasing UL-EP [T1: (-2.78±2.20) mm; (-3.29±2.44) mm; P=0.02] and H angle (T1: 8.27°±3.71°; 7.32°±3.83°; P=0.006). Other soft tissues remained relatively stable by retruding upper lip position and chin changes with no statistical significance.

CONCLUSION

Orthodontic-orthognathic treatment can improve esthetics and occlusal function in patients of skeletal class III malocclusion with a stable long-term outcome.

[Predictive value for esophageal varices using acoustic radiation force impulse elastography in post-hepatitis B cirrhosis patients]

Objective: A retrospective analysis of the predictive value of acoustic radiation force impulse (ARFI) elastography for esophageal varices in post-hepatitis B cirrhosis patients. Methods: 124 patients with post-hepatitis B cirrhosis who were admitted to Tianjin Second People's Hospital from August 2016 to August 2017 were selected. According to the shape of esophageal varices under gastroscopy and the risk of bleeding, patients were divided into 4 groups, none, mild, moderate and severe. In ARFI mode, the VTQ function was used to detect the VTQ values of the liver and spleen. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the diagnosis of esophageal varices by VTQ values of the liver and spleen. Analysis of variance was performed on the data between the groups, and χ (2) test was performed for categorical data. Results: The difference in liver VTQ values between groups were statistically significant (F = 12.623, P < 0.01). There was a statistically significant difference in VTQ values between spleens (F = 9.022, P < 0.01). The liver VTQ predicts that the AUC value of mild esophageal varices in patients with cirrhosis was 0.701 (0.575-0.827); moderate varices was 0.802 (0.701-0.902); severe varices was 0.885 (0.784-0.986). The best cutoff value was 2.235, the specificity was 97.37%, the negative predictive value was 88.10%, and the accuracy was 90.16%. The VTQ value of spleen predicts the AUC value of mild esophageal varices in patients with liver cirrhosis was 0.688 (0.539-0.798); moderate varices were 0.762 (0.651-0.873); severe varices were 0.800 (0.671-0.928). The best cutoff value was 2.885, the specificity was 84.21%, and the negative predictive value was 82.05%. Conclusion: The application of ARFI elastography in the determination of VTQ values of liver and spleen has certain predictive value for esophageal varices and it might be useful for primary screening of esophageal varices in post-hepatitis B cirrhosis patients.

Chemical composition, antimicrobial activity and antioxidant activity of Litsea cubeba essential oils in different months

In this study, the chemical composition, antimicrobial and antioxidant activities of Litsea cubeba essential oils extracted in different months were analysed. Results showed that the essential oil contents of fruits collected in June, July and August were 3.47%, 5.02% and 5.64%, respectively, and contained 13, 17 and 17 components, respectively. Neral and geranial were the main components and accounted for 54.76%. The essential oil extracted from fruits collected in July had the highest antimicrobial activity against Staphylococcus aureus, Escherichia coli, and Salmonella typhimurium, and it was the most effective based on the OH· scavenging activity test. The essential oil extracted from fruits collected in August was the most effective based on the test for DPPH· scavenging activity and ferric reducing antioxidant power. Considering the contents, chemical compositions and antimicrobial and antioxidant activities, the appropriate harvest time for L. cubeba essential oils is from July to August.

[Combination of periodontal, orthodontic and endodontic therapy in upper anterior teeth with hopeless prognosis and long-time follow-up: a case report]

It is complicated to decide the treatment plan of hopeless anterior teeth in esthetic zone due to severe periodontitis, periodontal-endodontic combined lesion or teeth trauma. The optional treatment plan for this kind of teeth includes retention after periodontal treatment, extraction and implant treatment, extraction and prosthodontic treatment and so on. To make an appropriate treatment plan, patients' periodontal conditions, periodontal biotype, local anatomy, esthetic demand, economic condition and social psychological status should be comprehensively considered. A combine of periodontal, endodontic and orthodontic therapy may achieve a good treatment effect in hopeless anterior teeth with severe periodontal destruction, tooth extrusion and occlusal trauma. In this case, a 20-year-old female who presented with symptoms of bleeding on brushing and upper incisors loosening for 1 month came to the Department of Periodontology, Peking University School and Hospital of Stomatology. The clinical examinations revealed that the patient's right upper incisor had signs of mobility (III°), intrusion of 1-2 mm, and probing depth (PD) of 9-10 mm. The periapical radiograph showed that the alveolar bone of right upper incisor absorbed horizontally to the apex. And the patients showed Angle II° malocclusion with II° overbite in anterior teeth and maxillary protrusion. A diagnosis of aggressive periodontitis and Angle II° malocclusion was made. The treatment of this patient lasts for 5 years which include periodontal initial therapy, orthodontic therapy, guided tissue regeneration (GTR) of right upper incisor and supportive periodontal therapy and the clinical result is fine. A hopeless upper incisor was successfully retained and the longtime clinical condition was stable. The strategy of retention of hopeless upper anterior teeth, the relationship of periodontal treatment and orthodontic treatment, and the indications of periodontal and orthodontic combined therapy were also discussed on the basis of this case. Generally, the positive factors in retention of hopeless teeth includes young age, absence of systemic conditions, strong motivation for maintaining the tooth, single root anatomy, integrated dentition, good response to cause-related therapy, intrabony alveolar bone defect, thick periodontal biotype, and regular supportive periodontal therapy. And in the progress of orthodontic therapy, regular supportive periodontal therapy and good plaque control is extremely important.

[Hospitalization burden of hand, foot and mouth disease in Anhua county of Hunan province, 2013-2016]

Objective: To estimate the serotype and age-specific hospitalization burden associated with hand, foot and mouth disease (HFMD) in Anhua county of Hunan province, between October 2013 and September 2016. Methods: We collected hospitalization records of HFMD patients from 6 virological surveillance hospitals, and reimbursement records through new rural cooperative medical system from 23 township health centers to estimate the age-specific hospitalization burden of HFMD in Anhua. Combined with the results of virological surveillance, the serotype-specific hospitalization burden of HFMD in Anhua, was estimated. Results: During the three years, it was estimated that 3 541 clinical diagnosed HFMD cases, including 3 146 laboratory-confirmed HFMD cases, were hospitalized in Anhua, but only one was diaguosed as being severe. The estimated average hospitalization rate was 723/100 000(95%CI: 699/100 000-747/100 000) for clinical diagnosed HFMD and 642/100 000 (95%CI: 620/100 000-665/100 000) for laboratory-confirmed HFMD between October 2013 and September 2016. The cases caused by Cox A16 (208/100 000) and Cox A6 (202/100 000) had higher hospitalization rates compared with the cases caused by EV71 (130/100 000), Cox A10 (38/100 000) and other enterovirus (64/100 000), and the difference was statistically significant (P<0.001). HFMD-associated hospitalization rates peaked in children aged 1 year (3 845/100 000), and then decreased with age. Compared with the hospitalized HFMD caused by EV71 and Cox A16, Cox A6-associated hospitalizations mainly occurred in younger age groups (P<0.001). Conclusion: Our study revealed a substantial hospitalization burden associated with mild HFMD caused by EV71, Cox A16, Cox A6 and Cox A10, especially in young children, in Anhua.

[The anti-cancer effect of ZR30 protein via targeting extracellular signal proteins of different cell subpopulations of glioma]

Objective: To investigate the roles and anti-cancer mechanism of artificially synthesized EGF-containing fibulin-like extracellular matrix protein (EFEMP1) derived tumor suppressor ZR30 protein in glioma (GBM). Methods: ZR30 protein were in vitro expressed using a wheat germ cell-free system. GBM cell lines (U251, U251NS, and U87) were cultured for 2-3 days in the presence or absence of ZR30 treatment. MMP-2 level was detected by gelatin zymography assay, moreover, the expression of EGFR, Notch-1 and p-Akt/Akt levels were determined by western blot. Additionally, MTT assay was used to measure ZR30's effect on the cell proliferation of U251 and U251NS cells. Furthermore, pre-mixed U251-GFP and U251NS-RFP cells (1∶9) were injected into the brain of nude mice, and then ZR30 or PBS was injected into the intra-tumor after 10 and 21 days, respectively. Then DNA was extracted from the right brain of nude mice in each group. Comparative quantitative polymerase chain reaction (CQ-PCR) was used to examine the copy numbers of human gene hSPAG16, mouse gene mSpag16, GFP and RFP. The survival status of each group of nude mice was also observed. Results: The levels of activated MMP-2 in U87 and U251 cells were lower after 10, 50 and 100 ng/ml ZR30 treatment for 2-3 days. Western blot analysis showed that ZR30 treatment reduced the expression of EGFR, Notch-1 and p-Akt/Akt in U251 cells, and inhibited Notch-1 and p-Akt/Akt expression in U251NS cells, and then decreased the response of U251 cells to EGF stimulation. Moreover, ZR30 inhibited the cell proliferation of U251 and U251NS two days after exposure. The in vivo orthotopic GBM xenografts were successfully constructed. CQ-PCR results indicated that the hSPAG16/mSpag16 ratios of mice in PBS group and ZR30 treatment groups at 180, 700, and 1 800 ng dosages were 3.67±2.82, 1.18±0.97, 1.75±1.55 and 1.38±1.17, respectively, and ZR30 treatment groups showed significantly lower ratios than the PBS group (P<0.05 for all). Correspondingly, the ratios of GFP/RFP in each group were 1.97±0.80, 1.97±0.85, 1.48±0.71 and 1.73±0.77, respectively, showing no statistical significance (P>0.05 for all). When treatment was performed 10 d after cell implantation, and the median survival time of mice in PBS group and ZR30 group was 40.5 days and 59.0 days, respectively. When treatment was performed 21 d after cell implantation, the median survival time of mice in PBS group and ZR30 group was extended to 57.0 days and 74.5 days, respectively. The median survival time of ZR30 treatment groups significantly prolonged (P<0.05 for all). Conclusions: ZR30 inhibits in vitro cell growth, invasion, angiogenesis and stemness maintenance in glioma via suppressing activated MMP-2, EGFR, p-Akt/Akt and Notch-1 proteins. In vivo, ZR30 markedly increased survival of mice harboring glioma xenografts, even for only one intra-tumoral injection at the time of early tumor formation. Overall, the in vivo and in vitro experiments supported the therapeutic potential of ZR30 for GBM.

[Study on antimicrobial susceptibility of Brucella in a city]

Objective: To investigate the antimicrobial susceptibility of Brucella and to provide a scientific basis for rational drug use and effective treatment of patients with brucellosis. Methods: A total of 41 Brucella strains were isolated from the blood of patients with brucellosis in 5 counties and 2 districts in Yuxi City, China from 2014 to 2016. The susceptibility to 23 antimicrobial drugs was tested using Kirby-Bauer (K-B) disk diffusion method and the sizes of antimicrobial rings were recorded. The susceptibility testing results were interpreted according to the Drug Susceptibility Testing Guideline (2009 version) . Results: The susceptibility rate of Brucella was 100.00% to ofloxacin, ciprofloxacin, levofloxacin, and amikacin and >90% to cefotaxime, cefepime, imipenem, doxycycline, cefoperazone, minocycline, tobramycin, rifampicin, cefoperazone/sulbactam, and chloramphenicol. The high resistance to aztreonam and ampicillin was observed (87.80% and 41.46%). Doxycycline-intermediate strains, rifampicin-intermediate strains, and rifampicin-resistant strains were identified. Conclusion: Doxycycline and rifampicin are commonly used in the treatment of brucellosis, but doxycycline/rifampicin-intermediate and-resistant strains have been identified. The susceptibility of Brucella to fluoroquinolones and cephalosporins was high, so the two drugs can be considered in the treatment of brucellosis.