[Survey on present status of noise exposure of workers in metal processing industry]

Objective: To investigate the distribution of noise exposure between non-steady state noise and steady-state noise for metal processing workers, which will provide scientific basis for the prevention and treatment of noise hazards in metal processing industry. Methods: The cross-section method was used to investigate the noise exposure of 737 workers from three metal processing industries in Zhejiang Province from October to December 2017. The general demographic information and occupational history were collected by questionnaire. The noise was recorded by individual noise meters, and the noise exposure intensity (equivalent continuous A-weighted noise exposure level normalized to an 8 h-working-day, L(Aeq, 8 h)) and kurtosis were calculated. Results: Workers exposed to noise in the metal processing industry were mainly 18-40 years old (527 workers, 71.51%) , men (570 workers, 77.34%) , and junior high school education background (416 workers, 56.45%) . There were 572 workers (77.61%) with noise exposure intensity (L(Aeq, 8 h)) greater than 85 dB (A) , 558 workers (75.71%) exposed to non-steady state noise (kurtosis ≥4) , and 634 workers (86.02%) with exposure duration less than 8 years. Among the 30 work types investigated, the work types with noise intensity reaching 100% were the stamping, welding and others from a children's car manufacturing factory in Ningbo, operating, chamfering, tapping, and thread rolling from an automobile parts manufacturing factory in Ningbo; The work types with a rate of 100% exposed to non-steady state noise were the grinding from a children's car manufacturing factory in Ningbo, assembling, assembly operating and others from an automobile brake manufacturing factory in Wenzhou, and polishing from an automobile parts manufacturing factory in Ningbo. Conclusion: Metal processing workers have a high rate of over-standard exposed to high noise intensity and a high proportion exposed to non-steady state noise. It is necessary to take sound insulation and noise reduction engineering control, and strengthen personal protection and occupational health management measures to prevent and control the noise hazards.

[Impact of enhanced recovery after surgery strategy on early postoperative quality of recovery in patients undergoing laparoscopic surgery for gynecologic malignancy]

Objective: To investigate the impact of perioperative anesthesia management with enhanced recovery after surgery (ERAS) strategy on postoperative recovery in patients undergoing laparoscopic surgery for gynecologic malignancy. Methods: Ninety patients undergoing laparoscopic surgery for gynecologic malignancies from April 2018 to April 2019,aged 18-65 years,with American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, were recruited and randomly divided into two groups (n=45) using a random number table:ERAS group (group E) and control group (group C). Patients in group E received general anesthesia combined with transverses abdominis plane block and a series of interventions to optimize anesthetic and perioperative management, while patients in group C were treated with routine anesthesia management. Quality of Recovery-40 questionnaire (QoR-40) was administered to assess the early postoperative quality of recovery on 1 day before surgery, and at 24 and 48h after surgery. C-reactive protein (CRP) before and after the operation were evaluated. The incidence of nausea, vomiting and shivering, the time of first exhaust, ambulation, resumption of normal diet, postoperative hospital stay and complications were recorded. Results: The scores of QoR-40 [M(Q₁, Q₃)] in Group E were 175(171, 179) and 185(183, 189) at 24 h and 48 h after operation, which were higher than those in group C [162(160, 167) and 180(179, 183)] (both P<0.01). The levels of CRP in both group E and group C increased at 24 h and 72 h after operation. Moreover, the extent of increasing level of CRP in group C was much higher than that in group E [(39.8±18.0) mg/L vs (13.4±6.3) mg/L, (16.6±8.6) mg/L vs (6.7±2.5) mg/L] at 24 h and 48 h after operation (both P<0.01). Compared with group C, the numerical rating scale (NRS) for nausea decreased significantly in group E [0(0, 2) vs 3 (0, 5), P<0.01]. Meanwhile, the incidence of vomiting and shivering in group E was lower than that in group C [8.9% (4/45) vs 26.7% (12/45); 11.1% (5/45) vs 31.1% (14/45); both P<0.05]. The time of first exhaust, ambulation and resumption of normal diet in group E was (14±6) h, 6(6, 13) h and 1(1, 2) d, respectively, which was markedly shorter than that in group C [(25±10) h, 21(19, 27) h and 3(2, 3) d] (all P<0.01). Overall, the postoperative length of hospital stay reduced significantly for patients who followed the ERAS protocol [7(5, 11) d vs 10(7, 14) d, P<0.01]. The incidence of postoperative complications was 17.8% (8/45) and 37.8% (17/45) in group E and group C, respectively, with a significant difference (P<0.05). Conclusion: Implementation of ERAS anesthesia management in gynecologic oncology patients undergoing minimally invasive surgery alleviates perioperative discomfort, decreases surgical stress response, and improves the early postoperative quality of recovery.

[Diagnostic value of diffusion-weighted imaging and conventional magnetic resonance imaging in testicular tumor]

Apparent diffusion coefficient(ADC) of magnetic resonance imaging≤0.90×10^-3 mm²/s and T2-hypointensity, intratuminal septa, and peritumoral infiltration could achieve best diagnostic efficiency. ADC values and cyst or necrosis were independent predictors for the differential diagnosis of nonseminomatous germ cell tumor versus seminoma and nonseminomatous germ cell tumor versus lymphoma. ADC value and intratuminal septa were independent predictors for the differential of seminoma versus lymphoma.

Effect of Babao Dan on angiogenesis of gastric cancer in vitro by regulating VEGFA/VEGFR2 signaling pathway

Background

To further elucidate the anti-angiogenesis effect of Babao Dan (BBD) in vitro, gastric cancer (GC) cells and human umbilical vein endothelial cells (HUVECs) were used to evaluate the regulation role of BBD by vascular endothelial growth factor A (VEGFA)/vascular endothelial growth factor receptor 2 (VEGFR2) signaling pathway.

Methods

After induced by VEGFA, GC cells (AGS, MGC80-3 and BGC823) were treated by different concentrations of BBD and then were detected cell viability, migration and VEGFA level. And the anti-angiogenesis effect of BBD was evaluated with HUVECs. To furtherly mimic the tumor microenvironment of angiogenesis, VEGFA as an inducer (10 ng/mL) was used to trigger a cascade of angiogenesis of HUVECs in vitro.

Results

The viability and migration of GC cells with VEGFA-induced or non-induced and VEGFA levels in GC cells were significantly inhibited by BBD with concentration-dependent manner (P<0.01). BBD significantly inhibited the HUVECs viability with concentration-dependent manner (P<0.01), which was consistent with the inhibitory action on augmentation of cell viability induced by VEGFA (P<0.01). BBD exhibited the similar inhibitory trend on cyto behavioral variability such as wound repairing (P<0.05), migration (P<0.01) and tube formation (P<0.01) and activation effect on cell apoptosis rate (P<0.01) with VEGFA-induced or non-induced. Moreover, BBD notably regulated the levels of VEGFA, VEGFR2, matrix metalloprotein 2 (MMP2) and matrix metalloprotein 9 (MMP9) of HUVECs on present or absent of VEGFA with dose-dependent manner.

Conclusions

BBD inhibited GC growth against VEGFA-induced angiogenesis of HUVECs by VEGFA/VEGFR2 signaling pathway in vitro.

[Detection of neuron-specific enolase in patients with subacute 1, 2-dichloroethane poisoning]

Objective: To investigate the changes of neuron-specific enolase (NSE) in serum and cerebrospinal fluid of patients with subacute 1, 2-dichloroethane (DCE) poisoning. Methods: Ten patients with subacute 1, 2-DCE poisoning hospitalized in Guangzhou 12th Municipal People's Hospital from December 2014 to March 2019 were taken as the subacute 1, 2-DCE poisoning group, 34 typical acute toxic encephalopathy patients hospitalized at the same time as typical acute toxic encephalopathy group, 40 healthy physical examinees as normal control group. The levels of serum NSE in patients of subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy group during onset and improvement were detected by chemiluminescence method, and the results were analyzed statistically. The level of NSE in cerebrospinal fluid of subacute 1, 2-DCE poisoning group was detected and analyzed its correlation with the level of NSE in serum. Using receiver operator characteristic (ROC) curve to analyze the diagnostic efficacy of NSE in subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy (area under curve, AUC) . Results: There was no significant difference between the serum NSE level of the patients with subacute 1, 2-DCE poisoning in the onset group and the normal control group and the improvement group (P>0.05) . The serum NSE level of subacute 1, 2-DCE poisoning in the improvement group was lower than those in the normal control group (P<0.01) . The serum NSE level of the subacute 1, 2-DCE poisoning in the onset group was lower than those in the typical acute toxic encephalopathy in the onset group (P<0.01) . There was no linear correlation between cerebrospinal fluid NSE and serum NSE in patients with subacute 1, 2-DCE poisoning (r=-0.183, P=0.52) . ROC curve showed that the AUC of serum NSE in diagnosing subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy were 0.661 and 0.726, respectively. Conclusion: There is no significant change in serum NSE in patients with subacute 1, 2-DCE poisoning.

[A 5-year follow-up study of pneumoconiosis patients with positive autoantibody]

Objective: To explore the progress of small shadow and the change of lung function in pneumoconiosis with positive autoantibody, so as to provide basis for clinical treatment of pneumoconiosis. Methods: A total of 756 patients were admitted to the pneumoconiosis department of the Guangzhou Occupational Disease Prevention Hospital from January 1, 2013 to June 1, 2019. The patients with combined infection were excluded. According to whether the autoantibody was positive, they were divided into positive group and negative group, 25 cases in each group. Follow-up observation of X-ray chest radiographs, chest CT, forced expiratory volume in one second (FEV(1)) and forced expired flow at 50% of FVC (MEF(50)) of pneumoconiosis patients for 5 years, to analyze the influence of positive autoantibody on the morphology of X-ray chest film, the pneumoconiosis promotion in 5 years and lung function. Results: There were 22 males and 3 females in the autoantibody positive group, aged 53.14±10.51 years. In the autoantibody negative group, there were 23 males and 2 females, aged 53.88±8.10 years. During the 5-year observation period, there was no significant difference of small shadow shape, pneumoconiosis stage, and the pneumoconiosis promotion in 5 years between the autoantibody positive group and the autoantibody negative group (P>0.05). However, the increment of small shadow area in the autoantibody positive group was higher than that in the autoantibody negative group (P<0.05). FEV(1) and MEF(50) of the autoantibody positive group were significantly lower than those of the autoantibody negative group in the fourth and third years, respectively (P<0.05). Positive autoantibody was negatively correlated with FEV(1) and MEF(50) (P<0.05). Conclusion: The positive autoantibody can't promote the progress of X-ray, but show more small shadows on chest CT; the positive autoantibody may aggravate the decline of lung function.

Search for an Invisibly Decaying Z^{'} Boson at Belle II in e^{+}e^{-}→μ^{+}μ^{-}(e^{±}μ^{∓}) Plus Missing Energy Final States

Theories beyond the standard model often predict the existence of an additional neutral boson, the Z^{'}. Using data collected by the Belle II experiment during 2018 at the SuperKEKB collider, we perform the first searches for the invisible decay of a Z^{'} in the process e^{+}e^{-}→μ^{+}μ^{-}Z^{'} and of a lepton-flavor-violating Z^{'} in e^{+}e^{-}→e^{±}μ^{∓}Z^{'}. We do not find any excess of events and set 90% credibility level upper limits on the cross sections of these processes. We translate the former, in the framework of an L_{μ}-L_{τ} theory, into upper limits on the Z^{'} coupling constant at the level of 5×10^{-2}-1 for M_{Z^{'}}≤6  GeV/c^{2}.

Prevention of systemic inflammation and neuroprotective effects of Qingda granules against angiotensin II-mediated hypertension

Qingxuan Jiangya Decoction (QXJYD), prescribed by academician Ke-ji Chen, has long been used as a Traditional Chinese Medicine formula in blood pressure control and has achieved good clinical outcomes in hypertensive patients. Qingda granules (QDGs), which is a formula simplified from QXJYD, might serve as a novel anti-hypertensive pharmaceutical. However, the functional mechanism of QDGs remains unclear. This study aimed to evaluate the effect of QDGs against the elevation of blood pressure, systemic inflammation and brain injury in Ang II-mediated hypertensive mice. Ang II-mediated hypertensive mice were treated with 28.63mg QDG of per mouse every day. The blood pressure of all mice was measured on days 0, 1, 3, 5, 7, 14 and 28 by using the tail-cuff plethysmograph method. Following 28 days of treatment, the mice were sacrificed and their whole blood and brain tissues were used for analysis. The results showed that QDGs significantly decreased elevated systolic and diastolic blood pressure in Ang II-mediated hypertensive mice while body weight did not change, which demonstrated anti-hypertensive activities of QDGs without obvious toxicity. QDGs significantly attenuated the level of serum cytokines (IL-6, TNF-a) and chemokines (MCP-1, MIP-1a, RANTES) in the Ang II-mediated hypertensive mice. Moreover, pathological staining showed that QDGs significantly ameliorated cerebral histopathology changes, reduced the loss of neurons and activations of astrocytes. Additionally, QDGs inhibited neuronal apoptosis by down-regulation of Bax expression and up-regulation of Bcl-2 expression. These results suggested that QDGs exhibited excellent anti-hypertensive properties by preventing systemic inflammation and providing neuroprotective effects against Ang II-mediated hypertension.

[Analysis of 18 cases of toxic encephalopathy caused by occupational acute 1, 2-dichloroethane poisoning]

Retrospective analysis of 18 cases of occupational acute 1, 2-dichloroethane (1, 2-DCE) poisoning. The results showed that all patients have the main manifestations such as dizziness, headache, unresponsiveness and other symptoms of nervous system damage; Brain CT showed varying degrees of diffuse white matter lesions. Brain MRI showed extensive involvement of white matter in both cerebral hemispheres. Affected white matter area presented low intensity on T1WI, hyperintensity on T2WI and T2-Flair; Lumbar puncture examination of cerebrospinal fluid (CSF) pressure (262.5±48.39) mm H(2)O; After treatment, the required time for CSF pressure to restore was (161.56±75.27) days (50-280) days. Summary, Occupational acute 1, 2-DCE poisoning caused by toxic encephalopathy can be manifested as persistent abnormalities in CSF pressure, and the CSF pressure drops slowly during treatment; Early head CT and lumbar puncture examination will be helpful for early detection of intracranial pressure in toxic encephalopathy caused by acute 1, 2-DCE poisoning. Dynamic monitoring of CSF provides guidance for acute 1, 2-DCE poisoning with a long time of treatment and various types of dehydrating agents.

[Correlation of capillary plexus with visual acuity in idiopathic macular epiretinal membrane eyes using optical coherence tomography angiography]

Objective: To observe changes in foveal avascular zone(FAZ) and capillary plexus in idiopathic macular epiretinal membrane (IMEM) in optical coherence tomography angiography (OCTA) and analyze their correlation with the visual acuity. Methods: Cross-sectional study. 42 patients (15 Males and 27 females, age 64.8) from the Eye Hospital of Wenzhou Medical University were included with 51 eyes diagnosed as IMEM (IMEM group), and 23 normal eyes (9 Males and 14 females, control group). All patients received the examination of fissure lamp combined with fundus pre-set lens, best corrected visual acuity (BCVA), OCT angiography (OCTA) and fundus photo. OCTA was performed on 3 mm× 3 mm sections centred on the fovea. The software automatically measured the superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density(VD) and retinal thickness(RT) and FAZ area. The IMEM eyes were compared with the normal eyes and correlation between the parameters of OCTA and BCVA was analyzed in IMEM. Independent-sample t test and MannWhitney test were used for comparison between groups, and Spearman test was used for correlation analysis. Results: LogMAR BCVA in the IMEM group was 0.40(0.15, 0.70), in the control group was 0.10(0.05, 0.22). FAZ area of IMEM group was (0.09±0.05) mm(2), while that of control group was (0.34±0.13)mm(2).Compared with the control group, in IMEM group, the BCVA was worse (Z=-4.443, P<0.001), FAZ area was smaller (t=-9.198, P<0.001), RT was increased (P<0.001), The foveal DCP and SCP vessel density was increased (t=4.280, 9.079, P<0.01), The parafoveal DCP vessel density was decreased (P<0.05), The parafoveal SCP vessel density was decreased in superior, inferior and nasal side (t=-2.759, Z=-3.998, Z=-2.108; P<0.05). The BCVA was negatively correlated with FAZ area (r=-0.337, P=0.017), positively correlated with center macular thickness (r=0.324, P=0.020). The BCVA was no correlated with foveal VD and parafoveal DCP vessel density (P>0.05), but correlated with SCP vessel density(P<0.05). Conclusions: In the IMEM eyes the BCVA was worse, FAZ area was smaller, foveal vessel density was increased and the parafoveal vessel density was decreased compared with the normal eyes. The smaller the FAZ area, the smaller foveal SCP vessel density, the poorer BCVA. There was no correlation between BCVA and DCP vessel density. Changes in VD in IMEM eyes may lead to changes in vision. (Chin J Ophthalmol, 2019, 55:757-762).

Scale-Dependent Waylaying Effect of Pollinators and Pollination of Mass-Flowering Plants

Pollinators foraging for food resources can be waylaid by mass-flowering plants located in their foraging pathway in landscapes. The waylaying effect of pollinators is often studied at a single spatial scale; to date, little is known about the best spatial extent at which waylaying effect of pollinators can be measured. In this study, we selected a landscape with mass-flowering tufted vetches to determine the spatial scale of waylaying effect of honey bees as well as the consequence of waylaying effect on vetch pollination service. The spatial scale of waylaying effect was determined by the strongest association between honey bee density and distance, selected from a gradient of nested circular buffers centering on apiaries in three different locations. Linear models were used to predict the influence of flower visitor densities on pollination service. For our landscape, honey bee densities were best associated with distances at spatial scales of 500 m, 1150 m, and 1400 m respectively for the three locations of apiaries. Honey bee was the only pollinator whose density displayed a positive relationship with pollination service. At the scales of effect, honey bee density and pollination service declined along the distance. Our findings suggest that the waylaying effect of pollinators needs to be examined at a specific spatial scale and farmers who use honey bees to pollinate their mass-flowering crops need to consider the spatial scale of waylaying effect of pollinators in order to maximize pollination service within agricultural ecosystems.

[Lung transplantation in patients with paraquat poisoning: a case report and literature review]

Objective: To analyze 8 cases of paraquat lung transplantation in the world, and to explore the timing of lung transplantation and the factors affecting prognosis. Methods: An analysis of the clinical data of a paraquat poisoning lung transplant patient completed by The 12th People's Hospital of Guangzhou Medical University and The First People's Hospital affiliated to Guangzhou Medical University in August 2017 and literature review. Results: A 26 years old female patient was admitted to the hospital ingested 20% paraquat solution 20ml. On the 58th day of poisoning, she underwent double lung transplantation under general anesthesia. The operation was successful. Excised lungs show extensive lung fibrosis in both lungs, which was consistent with paraquat poisoning. Used tacrolimus and corticosteroids and mycophenolate antirejection, the patient discharged 46 days after surgery. 7 articles were retrieved through the search tool, and a total of 8 articles included this case were reported. Five patients who underwent lung transplantation within 1 month after poisoning all died, And 3 patients conducted lung transplantation for more than 1 month after poisoning survived; Pathogenic bacteria were isolated from the sputum in 3 of the 8 cases, all containing Pseudomonas, 2 of which died, and our case survived. Conclusion: Appropriate transplantation time window is very important for the prognosis of paraquat poisoning after lung transplantation. Active treatment of the sputum pathogens, improving the donor receptor matching, and exhausting the various means to remove the paraquat from the storage pool which may improve success rate of lung transplantation.

A11 Evaluation of phylogenetic inference methods to determine direction of HIV transmission

It has been postulated that the direction of HIV transmission between two individuals can be determined by phylogenetic analysis of HIV sequences. This approach may be problematic, since HIV sequences from newly infected individuals are often more similar to index sequences from samples collected years before transmission, compared to those from samples collected at the time of transmission. We evaluated the accuracy of phylogenetic methods for determining the direction of HIV transmission by analyzing next-generation sequencing (NGS) data from index–partner pairs enrolled in the HIV Prevention Trials Network (HPTN) 052 trial. HIV-infected index and HIV-uninfected partner participants were enrolled as serodiscordant couples; samples were analyzed from couples with index-to-partner HIV transmission that was confirmed by genetic linkage studies. NGS for HIV gp41 (HXB2 coordinates: 7691–8374) was performed using plasma samples from thirty-nine index–partner pairs (seventy-eight samples collected within 3 months of partner seroconversion). Maximum likelihood trees were generated using the entire dataset using FastTree v.2. Topological patterns of HIV from each index–partner pair were analyzed. The analysis included 9,368 consensus sequences and 521,145 total sequence reads for the seventy-eight samples analyzed. In 10 per cent (four out of thirty-nine) of couples, the phylogeny was inconsistent with the known direction of transmission. In 26 per cent (ten out of thirty-nine) of couples, the phylogeny results could not discern directionality. In 64 per cent (twenty-five out of thirty-nine) of couples, the results correctly indicated index-to-partner transmission; in two of these twenty-five cases, only one index sequence was closest to the most recent common ancestor. Phylogenetic analysis of NGS data obtained from samples collected within 3 months of transmission correctly determined the direction of transmission in 64 per cent of the cases analyzed. In 36 per cent of the cases, the phylogenetic topology did not support the known direction of infection, and in one-third of these cases the observed topology was opposite to the known direction of transmission. This demonstrates that phylogenetic topology alone may not be sufficient to accurately determine the direction of HIV transmission.

Ursolic acid suppresses the invasive potential of colorectal cancer cells by regulating the TGF-β1/ZEB1/miR-200c signaling pathway

Ursolic acid (UA) is a biologically active compound, commonly used in traditional Chinese medicine (TCM). It has been reported to exhibit strong anticancer properties against a variety of cancers. Our previous studies showed that UA promoted apoptosis in colorectal cancer (CRC) cells and inhibited cellular proliferation and angiogenesis. However, the effect and underlying molecular mechanism of UA in CRC progression remain unclear. In the present study, the role of UA in suppressing the migration and invasion of human colon cancer HCT116 and HCT-8 cells was investigated, using Transwell assays. In addition, to evaluate whether the anticancer properties of UA were mediated by the regulation of a double-negative feedback loop consisting of the transforming growth factor-β1 (TGF-β1)/zinc finger E-box-binding homeobox (ZEB1) pathway and microRNA (miR)-200a/b/c, reverse transcription-quantitative PCR and western blot analysis were performed. The results indicated that UA treatment significantly suppressed cellular growth, migration and invasion in HCT116 and HCT-8 cells in a dose-dependent manner. Furthermore, following UA treatment, several crucial mediators of the TGF-β1 signaling pathway, including TGF-β1, phosphorylated (p)-Smad2/3, p-focal adhesion kinase and ZEB1, were significantly downregulated in the HCT116 and HCT-8 cell lines compared with the control group. Furthermore, the ratio of N-cadherin/E-cadherin, two proteins directly downstream of the TGF-β1 signaling pathway, was found to be downregulated in UA treated CRC cells. Finally, UA significantly upregulated miR200a/b/c, with miR-200c exhibiting the highest increase in expression levels following UA treatment. Collectively, the present study suggested that inhibition of CRC cell invasion by UA occurred via regulation of the TGF-β1/ZEB1/miR-200c signaling network, which may be one of the mechanisms by which UA appears to be an effective therapeutic agent against colon cancer.

[Relationship between the level of estrogen, calcium and phosphorus concentration in serum with benign paroxysmal positional vertigo]

Objective:To investigate relationship between the level of estrogen, calcium and phosphorus concentration in serum with benign paroxysmal positional vertigo(BPPV). Method:A total of 84 patients with idiopathic BPPV were enrolled in the experimental group, including 32 non-menopausal women, 24 menopausal women, and 28 males; 83 healthy people without vertigo and vestibular disease were selected as the control group consisted with 32 non-menopausal women, 24 menopausal women and 27 males. The levels of estradiol, serum calcium and serum inorganic phosphorus were measured in all participants. The difference of estrogen level, serum calcium and serum inorganic phosphorus concentration between the experimental group and the control group was analyzed by t test. Result:The total number, age distribution and gender composition of the experimental group and the control group were basically paired, and the age difference was not statistically significant (P=0.71). The overall estrogen level in the experimental group was lower than that in the control group (P<0.01). Among them, the female group's estrogen level, menopausal female estrogen level and male estrogen level in the experimental group were lower than the control group (P<0.01); there was no significant difference in serum calcium and serum inorganic phosphorus concentration between the experimental group and the control group (P=0.55, 0.11, respectively). Conclusion:The decrease of estrogen level may be a risk factor for idiopathic BPPV. The relationship between serum calcium and serum inorganic phosphorus concentration and BPPV needs further study.

[Risk factors of retinopathy of prematurity in extremely low birth weight infants by strictly controlling oxygen inhalation after birth]

Objective: To observe the incidence and severity of retinopathy of prematurity (ROP) in extremely low birth weight (ELBW) infants by strictly controlling the risk factors of ROP, such as oxygen inhalation after birth, to explore the related factors of ROP in ELBW infants. Methods: This was a cross-sectional study. 166 ELBW infants underwent neonatal screening were enrolled in this study, whose birth weight was less than 1 000 g. There were 79 males and 87 females infants, whose average gestational age was (27.99±1.73)weeks, and average birth weight was (904.45±80.23)g. According to the final screening results, the ELBW infants were grouped as follows: (1)ROP group and non-ROP group; (2)severe ROP group and mild or no ROP group. Risk factors included gestational age, birth weight, test-tube infants, fetuses number, complications during pregnancy, delivery mode and Apgar scores in 1 to 10 minutes, weight and weight gain proportion at 1-6 weeks after birth, postnatal feeding mode, history of oxygen inhalation, anemia and blood transfusion, and other systemic diseases were recorded. And their correlation with severe ROP was analyzed by SPSS 20.0 statistical software. Results: Ninty-four (56.63%) ELBW infants developed ROP, 16 (9.64%) were severe ROP and 14(8.43%) received treatment. Average birth weight between ROP group (911.95±72.80)g and non-ROP group (894.67±88.58)g had no difference(t=1.379, P=0.170). Average gestational age between ROP group (27.49±1.53) weeks and non-ROP group (28.64±1.76) weeks had significant difference(t=-4.491,P<0.001).And pregnancy-induced hypertension during pregnancy (χ(2)=4.479, P=0.034), Apgar score in 5 minutes (t=-2.760, P=0.006) and 10 minutes (t=-2.099, P=0.043), pneumonia (χ(2)=6.233, P=0.013), neonatal pneumonia (χ(2)=18.026, P<0.001) had significant difference between ROP group and non-ROP group. There was no effect on weight (F=0.009,P=0.753) or weight gain proportion (F=2.394,P=0.124) at 1-6 weeks after birth in ELBW infants with or without ROP. Average birth weight between severe ROP group(875.63±74.85)g and mild or no ROP group(907.53±80.41)g had no difference(t=-1.518, P=0.131).Average gestational age between severe ROP group(26.88±1.31)weeks and mild or no ROP group (28.11±1.73)weeks had significant difference(t=-2.766,P=0.006).And only fundus hemorrhage (χ(2)=4.507,P=0.034) had significant difference between severe ROP group and mild or no ROP group. There was no effect on weight (F=2.683,P=0.103) or weight gain proportion (F=0.431,P=0.513) at 1-6 weeks after birth in ELBW infants with or without ROP. Logistic regression analysis revealed that only gestational age was correlated to the incidence (β=-0.437,P<0.001) and severity (β=-0.616,P=0.007) of ROP significantly. Conclusion: By strictly controlling the risk factors of ROP, such as oxygen inhalation after birth, the severe rate of ROP in ELBW infants is low. However, gestational age is still the inevitable independent high risk factor for the incidence of ROP in ELBW infants. (Chin J Ophthalmol, 2019, 55:280-288).

[A study on the status and problem countermeasures of key occupational disease monitoring in Shandong, China, from 2015 to 2017]

Objective: To analyze the completion status, monitoring results, and existing problems of key occupational disease monitoring in Shandong, China, from 2015 to 2017, and to provide reference materials for improving monitoring quality and carrying out occupational disease prevention and control. Methods: The monitoring situation including project coverage, data collection, monitoring results, and monitoring quality of key occupational diseases in Shandong from 2015 to 2017 were described and comparatively analyzed. Results: In the past three years, the uncoverage rate of monitored counties (38.69% in 2015, 10.95% in 2016, and 5.11% in 2017) , the non-work rate of occupational health examination institutions (41.67% in 2015, 18.02% in 2016, and 8.72% in 2017) , and the non-work rate of occupational disease diagnosis institutions (42.31% in 2015, 38.46% in 2016, and 38.46% in 2017) in Shandong decreased year by year. The number of institutions with key occupational hazard factors reported to the safety supervision and management department increased year by year (it was 24140 in 2017, with an increase of 40.50% compared with 2016 and an increase of 114.62% compared with 2015) ; the key occupational hazard factors in enterprises were mainly noise (72.76%) , followed by benzene, silica dust, and coal dust. The number of workers exposed to key occupational hazard factors reported to the safety supervision and management department increased year by year; in 2017, it was 729245, with an increase of 39.78% compared with 2016 and an increase of 84.81% compared with 2015. The ratio of people exposed to key occupational hazard factors identified by the medical examination to the total people in the safety supervision system in a year decreased year by year (40.87% in 2015, 23.86% in 2016, and 17.95% in 2017) . Conclusion: In Shandong, the supervision of enterprises with key occupational hazard factors and the responsibility of enterprise protection should be strengthened. The occupational health examination rate of workers should be improved. It is suggested that we should carry out the special investigations and occupational health risk assessment for key enterprises and key populations.

[Seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China]

Objective: To understand the seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China. Methods: This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout 7 geographic areas in the mainland of China (northeast, north, central, east, south, northwest and southwest). The numbers of asthmatic patients and total inpatients of the respiratory department of each hospital were recorded. The monthly ratio of asthmatic patients to the total inpatients in every area was calculated and compared. Results: During the study period, 6 480 patients were admitted for asthma exacerbation, accounting for 3.14% of all the 206 135 patients admitted to the respiratory departments in the 29 hospitals. The ratio of asthmatic patients to total inpatients in the northeast area (5.61%) was highest, and the ratio in east area was lowest (1.97%). Statistical analysis showed that the difference among different areas was significant (P<0.000 1). In most areas, both the number and proportion of hospitalized asthmatic patients peaked in spring (February-April) and autumn (September-October). In the northeast area, east area and south area, the peaks in spring were more obvious, while in the north area and southwest area, the peaks in autumn were more obvious. In the northwest area the peaks occurred in winter (December-January) and summer (June-August), respectively. The differences in hospitalization due to asthma among different months were significant in the northeast, north, and southwest areas (P<0.005). Conclusion: The number of patients hospitalized for asthma exacerbation fluctuated with season in different areas in China. In most areas, more asthmatic patients were admitted to hospitals in spring and autumn.

[Seasonal characteristics of patients hospitalized for asthma exacerbation in China]

Objective: To study the seasonal characteristics of patients hospitalized for asthma exacerbation in China. Methods: This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout mainland China during 2013-2014. The number of patients hospitalized for asthma exacerbation in each hospital was calculated, as well as the ratio of asthmatic patients to all the hospitalized patients. The analysis by month was conducted. The number and ratio of asthmatic patients in the northern and southern cities were calculated respectively. Results: During the study period, there were 6 480 patients hospitalized for asthma exacerbation, accounting for 3.14% (6 480/206 135) of all the hospitalized patients of the respiratory department in 29 hospitals. The analysis by month showed that the ratio of patients hospitalized for asthma exacerbation was highest in March (3.49%), then declined from April to June, then rose again from July, reaching a second peak at September (3.28%), and then declined again from October to December. The ratio of asthmatic patients in every month was higher in northern cities than in southern cities. Conclusions: The ratio of patients hospitalized for asthma exacerbation in China fluctuates with the changes of seasons, and March and September are the two peak months. Northern cities have a higher ratio of asthmatic patients than southern cities.

[Warning symptoms of asthma attack and asthma self-management: a national asthma control survey from China]

Objective: To investigate warning symptoms of asthma attack and evaluate asthma self-management status of asthma patients in urban China. Methods: A multi-center, cross-sectional, questionnaire-based survey was carried out from 30 general hospitals dispersed in 30 provinces of mainland China (except for Tibet) during Oct 2015 to May 2016. Information of frequency and warning symptoms of asthma attack, the time from warning symptoms to asthma attack, the impact of asthma attack and asthma self-management were collected from asthma patients of outpatient department. Results: Altogether 3 875 asthmatic outpatients were recruited. 78.1% (3 026/3 875) of the patients reported restriction of exercise and daily activities during asthma exacerbation. 82.5% (3 160/3 829) of the patients had warning symptoms before asthma attack, the most common warning symptoms were cough, chest tightness and shortness of breath. The median time from warning symptoms to asthma attack was 2 h, the mean time was 90 h. Only 4.4% (167/3 829) of the patients had definite confidence to control asthma when symptoms deteriorated. 76.7% (2 937/3 828) of the patients used medications to control asthma when asthma symptoms deteriorated. Medication choice: inhaled corticosteroid (ICS) + formoterol 45.8% (1 776/3 875), short-acting beta-agonist (SABA) 23.9% (927/3 875). Conclusions: Most asthma patients have warning symptoms before asthma attack, the most common symptoms are cough, chest tightness and shortness of breath. The proportion of patients conducting effective asthma self-management remains low.

[The level of asthma control in China from a national asthma control survey]

Objective: To assess the overall asthma control level in urban China. Methods: A multi-center, cross-sectional, questionnaire-based survey was carried out in 30 provinces in China (except Tibet). Asthmatic outpatients who met the inclusion criteria were recruited consecutively from 30 sub-centers from October 2015 to May 2016. Data of demographic characteristics, asthma control, asthma management, asthma exacerbations and self-management, and disease perception were collected by face-to-face interviews. Results: Totally 3 875 asthmatic outpatients were recruited. Asthma control level was assessed according to GINA 2015. The prevalence of asthma control was 28.5%(1 099/3 854). Among 10 cities, which were also involved in the asthma control survey in 2008, the level of asthma control improved from 28.7% in 2008 to 39.2%(533/1 361) in 2016. The rate of hospitalizations due to asthma exacerbations was 26.4%(1 017/3 858) and the rate of emergency visits was 22.4%(864/3 858). Among adult patients, 18.4%(568/3 092) of them had been absent from work while 63.6%(63/99) adolescent patients had been absent from school because of asthma attacks in the previous year. Conclusion: Although the level of asthma control in China is still far from ideal at present, the status has been improved in some cities. Poorly controlled asthma resulted in increase of hospitalizations, emergency department visits and work/school absences.

[A multi-center retrospective study of clinical characteristics and hospitalization costs of patients hospitalized for asthma exacerbation in China during 2013-2014]

Objective: To study the characteristics of patients hospitalized for asthma exacerbation in 29 teaching hospitals in China and to evaluate the hospitalization costs of these patients. Methods: This was a retrospective study and involved patients hospitalized for asthma exacerbation in 29 hospitals throughout China during 2013-2014. Information about the demographic features, conditions before the admission, the outcome, the complications, and the costs was collected using the pre-designed case report form. The influencing factors of the hospitalization costs were analyzed. Results: 3 240 asthmatic patients (1 369 males and 1 871 females) were included and data were analyzed. There were 41.5% (1 346/3 240) patients who had a history of previous hospitalization or emergency department visits during the last year. Only 28.0% (907/3 240) patients had used asthma-controlling medications regularly before the admission. Seventy-three(2.3%) patients were admitted to ICU and used mechanical ventilation. Mortality among these patients hospitalized for asthma exacerbation was 0.25% (8/3 240). The median hospitalization costs was 9 045(6 431, 13 035) RMB. The costs of medications, examinations and treatment accounted for 52.1%, 27.6%, and 9.6% respectively. The costs of asthma medications accounted for only 22.7% of the total medication costs, while the costs of antibiotics accounted for 44.0%. The patients who were admitted to ICU, used mechanical ventilation, complicated with pneumonia, or had a history of hospitalization or emergency department visits during the last year due to asthma exacerbations tended to cost more. Conclusion: In this study, we demonstrated that only a minority of the patients had used asthma controllers regularly before the admissions with exacerbations. The in-hospital mortality of asthma patients in this study was much lower than that reported in other countries. The average cost of hospitalization was much higher than the yearly cost of maintenance therapy. Medication was the predominant component of the total hospitalization costs, and the costs of antibiotics made up the major part of the total medication costs.

[Association between hyponatremia and hemodynamic and prognosis in patients with intermediate-risk acute pulmonary embolism]

Objective: To investigate the association between hyponatremia and hemodynamic and prognosis in patients with intermediate-risk acute pulmonary embolism. Methods: We retrospectively recruited 110 intermediate-risk acute pulmonary embolism patients (right ventricular dysfunction was confirmed by echocardiography and CT scan with or without the elevated levels of cardiac injury biomarkers) in the first and the second affiliated hospital of Harbin medical university from January 1,2011 to December 31, 2014. The patients were aged (58.4±14.9) years old.There were 49 males and 61 females.Patients were divided into 2 groups as non-hyponatremia group (plasma sodium>135 mmol/L, 93 cases) and hyponatremia group (plasma sodium≤135 mmol/L, 17 cases). Baseline clinical and hemodynamic parameters were obtained from these patients. All enrolled patients were followed up after discharge. Results: Heart rate ((106.7±21.9) beats per minute vs. (93.4±19.4) beats per minute, P=0.043),N-terminal pro B type natriuretic peptide (NT-proBNP, (5 561±1 593) ng/L vs. (1 738±589) ng/L, P=0.005), mean pulmonary arterial pressure((42.6±12.6)mmHg(1 mmHg=0.133 kPa) vs. (33.9±13.3)mmHg, P=0.046), mean right atria pressure ((20.6±8.1)mmHg vs. (10.2±5.4)mmHg, P=0.014), systolic right atria pressure ((27.3±9.0)mmHg vs. (15.6±6.1)mmHg,P=0.013) and diastolic right atria pressure(6.5(4.3,15.5)mmHg vs. 5.0(2.0,8.0)mmHg,P=0.016) were significantly higher in hyponatremia group than in non-hyponatremia group,and systolic blood pressure was significantly lower in hyponatremia group than in non-hyponatremia group ((113.5±21.9)mmHg vs.(129.5±28.9)mmHg, P=0.048). Pearson correlation analysis showed that hyponatremia was negatively correlated with heart rate (r=-0.262, P=0.043), NT-proBNP (r=-0.227, P=0.048), mean pulmonary arterial hypertension (r=-0.259, P=0.046), mean right ventricular pressure (r=-0.296, P=0.047), mean right atria pressure (r=-0.550, P=0.001), systolic right atria pressure (r=-0.552, P=0.001), and diastolic right atria pressure (r=-0.542, P=0.001). Kaplan-Meier survival analysis showed that the 1-year, 2-year and 3-year cumulative survival rates were 76.5%,70.6%,and 64.7% in the hyponatremia group, and 90.3%,86.0%,and 83.9% in the non-hyponatremia group(log-rank test, P=0.036).Multivariate Cox regression analysis showed that hyponatremia was an independent risk factor of death of intermediate-risk pulmonary embolism patient(HR=4.126, 95%CI 1.982-11.343, P=0.036). Conclusion: Hyponatremia is associated with adverse hemodynamic and reduced survival in patients with intermediate-risk pulmonary embolism.

Fusion protein tTF-EG3287 induces occlusion of tumor vessels and impairs tumor growth in human colon caner

The problems including narrow indications, low drug loading, and difficulty in intervention severely affect the clinical efficacy of anti-tumor embolization. Here, we designed a novel tTF-EG3287 protein consisting of the truncated tissue factor (tTF) fused with the bicyclic polypeptide which was encoded by exons 7 and 8 for accurate localization in the tumor vascular endothelial cells (EG3287). This study aims to explore its anti-cancer effect. Gene sequencing was used to verify the fusion gene and SDS-PAGE gel to confirm the optimal induction time and concentration of tTF-EG3287. Nickel affinity chromatography column was used to purify the fusion protein. Confocal microscopy was used to assess the target activity of tTF-EG3287 on colon cancer cells in vitro. Thrombelastography assay was used to identify the pro-coagulant activity of tTF-EG3287. In in vivo experiments, the specific localization of tTF-EG3287 in tumor tissues and the effect of tTF-EG3287 on tumor thrombosis were further detected by in vivo imaging and HE staining, respectively. The tTF-EG3287 fusion protein was efficiently purified by nickel-affinity chromatography column. Moreover, tTF-EG3287 fusion protein showed strong coagulation a ctivity and specific binding ability to the cell surface of colon cancer. In vivo, tTF-EG3287 stably and persistently accumulated in tumor tissues, and specifically induced mixed thrombus formation in tumor vessels, and then impaired tumor growth (tumor inhibition rate=79.2%, p<0.01). Our data prove that the fusion protein tTF-EG3287 could be used as a novel and promising anti-cancer strategy and has great potential value for clinical applications.

[A retrospective study of the treatment of patients hospitalized for asthma exacerbation in China]

Objective: To study the treatment of patients hospitalized for asthma exacerbation in China. Methods: This was a retrospective study and involved patients hospitalized for asthma exacerbation in 29 hospitals throughout China during Jan 2013 to Dec 2014. Information of the demographic features, the severity of the exacerbation, the medicine prescribed during the hospitalization and the use of mechanical ventilation were collected and analyzed. Results: During the study period, there were 3 240 patients hospitalized for asthma exacerbation, and 1 369(42.3%) of them were males 1 871(57.7%)were females. Patients of mild, moderate, severe, and life-threatening exacerbation counted for 41.7%, 37.8%, 19.2% and 1.0%, respectively of the total patients. Of all the patients, 72.6% used bronchodilators by nebulizer, 70.8% used inhaled corticosteroids by nebulizer, 60.5% used intravenous corticosteroids, 17.3% used oral corticosteroids, and 80.5% used antibiotics. The percentages of patients using systemic corticosteroids and antibiotics were higher in patients with more severe exacerbation. In patients with mild exacerbation, there were 74.9% and 52.2% who used antibiotics and systemic corticosteroids, respectively. A total of 73 patients (2.3%) used mechanical ventilation, and 62 of them used noninvasive ventilation, 16 used invasive ventilation, and 5 used both. Conclusions: Nebulizer therapy has been accepted as the main administration route of medicine in the treatment of asthma exacerbation. A large amount of patients used antibiotics and systemic corticosteroids during hospitalization, indicating there may be some overuse of these medicines.

[Evaluation of asthma disease perception from China national asthma control survey]

Objective: In order to evaluate disease perception of asthma patients in urban China and provide evidence for further specific patient education. Methods: A multi-center, cross-sectional, questionnaire-based survey was carried out in 30 general hospitals dispersed in 30 provinces of mainland China (except for Tibet) during Oct 2015 to May 2016. Information of disease perception [Question 1: the disease nature of asthma; Question 2: medication choice of first-line in chronic asthma; Question 3: the occasion of using short-acting aerosols of receptor agonists; Question 4: perception of asthma treatment goal; Question 5: reason for not using peak flow meter (PFM)] were collected from asthma patients of outpatient department. These results were compared with the same type of survey results from 2007-2008. Results: Altogether 3 875 asthmatic outpatients were recruited. 69.0% (2 660/3 857) of the patients had right perception on the disease nature of asthma, 60.2% (2 321/3 857) of the patients considered inhaled corticosteroids (ICS)/inhaled corticosteroids plus long-acting beta2-agonists (ICS+ LABA) as daily-used first-line medication for chronic asthma. 85.7% (3 277/3 823) of the patients had right perception on the condition of using short-acting beta2-agonists (SABA). 75.4% (2 761/3 661) of the patients had right perception on asthma treatment goal. Only 10.1% (388/3 837) of the patients used PFM. Of the reasons for not using PFM, 65.2% (2 518/3 860) of the patients chose doctors never introduced. Among the 10 cities, which were also involved in the asthma control survey in 2007-2008, 71.1% (968/1 361) of the patients had right perception on the disease nature of asthma, 61.6% (839/1 362) of the patients considered ICS/ICS+ LABA as daily-used first-line medication for chronic asthma. 88.7% (1 207/1 361) of the patients had right perception on the condition of using SABA. 74.5% (1 013/1 360) of the patients had right perception on asthma treatment goal. 17.9% (244/1 360) of the patients used PFM. Of the reasons for not using PFM, 76.2% (931/1 221) of the patients chose doctors never introduced. Compared to the survey conducted in 2007-2008, the perception on disease nature and medication choice as daily-used first-line medication for chronic asthma significantly improved, the perception on occasion of using SABA and asthma treatment goal was comparable, while the rate of PFM usage showed no significant improvement. In reasons of not using PFM, doctors never introduced ranked the first. Conclusions: Compared to the similar survey conducted in 2007-2008, the overall status of disease perception of asthma patients has been improved in urban China, while the rate of PFM usage showed no significant improvement. Asthma education on asthma and asthma self-management should be further pushed forward.

[A retrospective study of the mortality and death-related risk factors of patients hospitalized for asthma exacerbation in Chinese urban areas]

Objective: To study the mortality and death-related risk factors of patients hospitalized for asthma exacerbation in Chinese urban areas. Methods: A retrospective study was carried out in 29 hospitals of 29 provinces throughout mainland China. Patients hospitalized for asthma exacerbation during 2013-2014 in each hospital were included. For each patient, information about demography, admission time, comorbidities, severity of diseases, intense care unit (ICU) admission, use of mechanical ventilation and the outcome was obtained. The mortality of patients hospitalized for asthma exacerbation was calculated, and the basic information and causes of death of the patients who died were summarized. The death-related risk factors and numbers of comorbidities were compared between the patients who survived and those who died during hospitalization. Results: A total of 3 240 patients (median age 57.0) were included and among them 8 patients (median age 68.5) died. The mortality of patients hospitalized for asthma exacerbation was 0.25%. All the patients who died were admitted during the winter and spring. One patient died of acute myocardial infarction, one of cardiac shock, one of tension pneumothorax, one of sudden death, one of respiratory failure and three of unknown causes. The average number of comorbidities of patients who died was 1.10, larger than that of patients who survived (0.83) (P>0.05). More patients had diabetes, coronary artery diseases and hypertension as comorbidities in the patients who died (2/8) than those who survived[7.6% (246/3 232), 7.6% (246/3 232), 22.6% (731/3 232), respectively](all P>0.05). Conclusions: The in-hospital mortality of patients hospitalized for asthma exacerbation of China in this study is low. The patients who died are much older, and with more comorbidities, and a higher percentage of comorbidities such as diabetes, coronary artery diseases, and hypertension.

[Occupational health risk assessment of coal dust in coal industry chain]

Objective: To grasp the present situation of occupational hazards of coal dust in our country, understand our country coal dust workers' occupational health risks, provide information based on evidence and analysis for the government and organize to effectively deal with the current status of high coal workers pneumoconiosis incidence in China, and protect coal dust workers' occupational health. Methods: The research object is the " mining-transportation-use" of coal industrial chain, referring to 33 units. Use field investigation to obtain the coal dust exposure, dust prevention measures and the occupational health data of study object. Use quantitative evaluation method of International council on mining and metals occupational health risk assessment model (ICMM method) and occupational hazard risk index method (index method) , with coal workers pneumoconiosis as health outcomes, to evaluate the coal dust occupational health risks of coal industrial chain. Results: The free silica content of partial coal dust in China is more than 10%, and even to 19.5%. coal dust concentration in workplaces, such as excavating system of dust coal mining (total dust: 22.1~46.5 mg/m(3), respiratory dust: 8.4~17.7 mg/m(3)) , dumper (total dust: 25.2 mg/m(3), respiratory dust: 6.9 mg/m(3)) , transfer tower (total dust: 35.4 mg/m(3)) of coal transportation and belt coal plough device of coal use (total dust: 36.3 mg/m(3), respiratory dust: 14.0 mg/m(3)) , are much higher than those in other workplaces, and coal dust concentration of workers in these places (2.6~9.3 mg/m(3)) are much higher than those in other places, which are statistically significant. ICMM method evaluation results show that the risk value of excavating system is between 504~1 089, and the risk value of comprehensive mining system is between 347~2 040, which are far statistically significant higher than that of other systems. Index method evaluation results (excavating system risk value between 3.1~9.7, fully mechanized system risk value between 3.7~9.3) , are basically identical with ICMM method (correlation coefficient r=0.857, P<0.01) . The new cases of coal worker pneumoconiosis are distributed in three post of coal mining, excavating and coal mine mixing. Conclusion: Coal-dust hazards are widely distributed in the coal "mining, transportation, and use" industrial chain, which of the underground coal mine is as serious as intolerable, meanwhile the risk of other industrial chain is basically can tolerable. The high coal dust concentration and the high risk of coal dust occupational hazard are concentrated in the excavating system and the comprehensive mining system. It is recommended to start the study on risk assessment and risk response of coal dust health hazard at the national level, and the occupational exposure limit of coal dust should be established according to the content of free silica.

[Relationship between the weight of hospitalized patients with pulmonary tuberculosis and the oral dose of isoniazid]

Objective: To study the relationship between the weight change trend of initial treatment patients with pulmonary tuberculosis and the dose change trend of isoniazid, and therefore to analyze the appropriate dose of isoniazid. Methods: Data of initial treatment inpatients with pulmonary tuberculosis from May 1955 to December 2012 were retrospectively analyzed. Elderly patients with pulmonary tuberculosis, patients with drug-resistant tuberculosis, extrapulmonary tuberculosis and those with complications were excluded from the study. The time period was separated as 20th century 1950s to 1960s, 1970s, 1980s, 1990s, 21th century 2000s and 2010s. Samples were selected in each year and month between 1950s to 1960s and 1970s. After 1980s, samples of 1 year were taken from each 5 years. The sex, age and weight for every patient were collected, as well as the dose of isoniazid of every inpatient on a day in therapeutic regimen. Meanwhile, the weight change trend of the patients in different ages and the dose change trend of isoniazid were compared. The total number of cases was 1 398, with 924 males and 474 females, averaging (36.7±14.4) years old. Results: The weight of the patients increased when it was compared between that in 1950s to 1960s, 1970s or 1980s and that in 2000s, with a increasing weight of 3 kg, 3.5 kg and 3 kg respectively. The difference showed statistical significance (P<0.003). The difference was also significant when the weight in 70s was compared with that in 2010s (P=0.002). The therapeutic dose of isoniazid remained invariable regardless of the weight change. At 1990s, 2000s and 2010s, the dose of isoniazid per kilogram of body weight would reduce to 0.005 4 g, 0.005 2 g and 0.0054 g relative to patients' weight increase, and the difference was statistically significant (P<0.001). Conclusions: The weight of pulmonary tuberculosis inpatients increased in recent 60 years. The weight has a close relation with the dose of isoniazid. A fixed dose of isoniazid (0.3 g/d) regardless of the weight change could result in low blood drug concentration . To avoid tolerance of isoniazid and increase the cure rates of pulmonary tuberculosis, the dosage of isoniazid should be increased based on the weight increase of patients.

[A multi-center study for the association between the perception and control of disease among asthmatic patients in Chinese urban areas]

Objective: To investigate the current perception of disease among asthmatic patients in Chinese urban areas, and to address its association with asthma control. Methods: This was a nationwide, multi-center, cross-sectional study covering 30 third-level, grade A hospitals in 30 provinces, municipalities and autonomous regions (not including Tibet) across Chinese mainland. The survey was carried out from October 2015 to May 2016. Asthmatic outpatients were selected to receive face-to-face questionnaire survey on asthma control including Asthma Control Test (ACT) score, classification of asthma control level[according to the Global Initiative for Asthma (GINA) 2015 classification system, as assessed by the physician completing the survey], perception of asthma (including question 1: nature of asthma as a disease; question 2: selection of first-line therapeutic agents to be regularly used daily for asthma; question 3: appropriate timing of the use of short-acting aerosols of β(2) receptor agonists; and question 4: therapeutic goals for asthma). Results: A total of 3 875 asthmatic outpatients were included; among them, 69.0% (2 660/3 857) were aware that asthma is "an airway inflammatory disorder resulting from the combined effects of heredity and environment" ; 60.2% (2 321/3 857) considered "inhaled glucocorticoids or their compound preparations" to be the first-line therapeutic agents to be regularly used daily for patients with persistent chronic asthma; 85.7% (3 277/3 823) considered it appropriate to use short-acting aerosols of β(2) receptor agonists "as needed in the event of disease aggravation or acute exacerbation" ; and 75.4% (2 761/3 661) were aware that asthma "can be adequately or completely controlled in the long term" . The ACT score[20 (16, 23) vs 19 (16, 22) points; Z=-3.928, P<0.001]and asthma control rate (29.92% vs 25.31%; χ(2)=8.616, P=0.003) were significantly higher, and the rate of uncontrolled asthma (19.92% vs 23.48%; χ(2)=6.267, P=0.012) was significantly lower among the 2 660 (69.0%) patients correctly answering question 1 than among the 1 197 (31.0%) patients giving incorrect answer. The ACT score[21 (17, 23) vs 19 (15, 22) points; Z=-9.190, P<0.001] and asthma control rate (32.66% vs 22.20%; χ(2)=49.614, P<0.001) were significantly higher, and the rate of uncontrolled asthma (18.40% vs 25.00%; χ(2)=24.267, P<0.001) was significantly lower among the 2 321 (60.2%) patient correctly answering question 2 than among the 1 536 (39.8%) patients giving incorrect answer. Conclusions: Compared to previous surveys, there has been improved perception of disease among asthmatic patients in Chinese urban areas. Correct perception of disease is favorable for improving asthma control level.

[Establishment and evaluation of a new method for determining hemodynamics of pulmonary hypertension rats]

Objective: By evaluating the hemodynamic parameters such as cardiac output (CO), right ventricular pressure (RVP), pulmonary artery pressure (PAP) and total pulmonary resistance index (TPRI) in pulmonary hypertension rat model, we established a more comprehensive hemodynamic evaluation system, which objectively evaluated the severity of disease and exercise tolerance in rats with pulmonary hypertension. Methods: SD rats were randomly divided into a control group and a model group with 5 rats in each group. The model group was intraperitoneally injected with SU5416 (20 mg/kg) and placed in an oxygen chamber at a 10% oxygen concentration for 21 days and then placed in a normoxic environment for 14 days. After modeling, rats were anesthetized and mechanically ventilated. The operator cut the skin along the right paraxial line, detached and ligated the intercostal artery, and then cut off the 3 and 4 ribs, exposing the heart and freeing aortic root about 0.2 cm. The flowmeter probe was set in the dissected aortic segment, and real-time recording time, blood flow waveforms, cardiac output were calculated accordingly. Then the needle attached to the baroreceptor was inserted into the right ventricle and the system acquired the right ventricular time-pressure waveform. After the waveform stabilized for about 30 seconds, the end of the cannula was sent to the pulmonary artery trunk through the entrance of the pulmonary artery to record the time-pressure curve of the pulmonary artery. Results: RVSP, PASP, PADP and mPAP in the model group were significantly higher than those of the control group [ RVSP(23.4±5.4) mmHg, 1 mmHg=0.133 kPa vs (56.4±13.0) mmHg, PASP (22.8±4.4) mmHg vs (58.5±14.9) mmHg, PADP (9.7±1.9) mmHg vs (30.3±7.0) mmHg, mPAP (14.1±2.7) mmHg vs (41.9±8.0) mmHg, all P<0.05 ]. Compared with the control group, the cardiac index in the model group was significantly lower [ CI (0.54±0.08) ml·min(-1)·g(-1) vs (0.40±0.09) ml·min(-1)·g(-1,) P=0.02 ]. Furthermore, compared with the control group, pulmonary vascular resistance index was significantly increased in the model group[PVRI (0.27±0.03) mmHg·ml(-1)·min(-1)·kg(-1) vs (0.06±0.01) mmHg·ml(-1)·min(-1)·kg(-1,) P<0.05]. The pathological results also showed that the middle part of pulmonary arterioles in the model group had muscular hypertrophy and muscular pulmonary arterioles, and even plexiform lesions. Conclusion: In this study, we established a new method that simultaneously determined several hemodynamic parameters such as RVSP, PASP, PADP, CO, CI and PVRI, which provided a more comprehensive assessment of hemodynamic changes in pulmonary hypertension rat models.

Surface elemental microanalysis with submicron lateral resolution by the laser-ablation laser-induced fluorescence technique

In order to realize surface elemental microanalysis of solid samples with submicron lateral resolution, laser-ablation (LA) combined with high sensitive laser-induced fluorescence (LIF) detection was investigated. A 532 nm or 266 nm nanosecond laser pulse with low pulse energy was used to realize submicron laser-ablation on the surface of a copper alloy, and LIF technique was used to sensitively detect a minor lead element in the ablated samples. ~344 nm and ~267 nm lateral resolutions could be achieved experimentally under 532 nm and 266 nm laser ablations under the current experimental condition, respectively. This demonstrated the feasibility of using a LA-LIF technique for surface elemental microanalysis of solid samples with submicron spatial resolution. The potentials of continually improving the spatial resolution of this technique to nanoscale were discussed.

[The efficiency of 23 G vitrectomy combined with preoperative subtenon injection of triamcinolone acetonide for treatment of retinal detachment associated with choroidal detachment]

Objective: To evaluate the efficiency of 23 G vitrectomy combined with preoperative subtenon injecfion of triamcinolone acetonide for treatment of rhegmatogenous retinal detachment associated with choroidal detachment. Methods: A retrospective analysis. Forty-eight (16 males and 32 females, aged 57.3±13.9) consecutive patients (48 eyes) who were diagnosed with rhegmatogenous retinal detachment associated with choroidal detachment and received 23 G vitrectomy at the Eye Hospital of Wenzhou Medical University during January 2012 and January 2015 were enrolled. Twenty-three eyes were treated with subtenon injection TA 5 d before the planned 23 G vitrectomy (TA group). Twenty-five eyes were treated with dexamethasone 3 to 5 d before the planned vitrectomy (Dex group). Type-B ultrasonic, intraocular pressure, best corrected visual acuity examinations were conducted for all eyes on admission day, preoperatively and at 1 month, 3 month postoperatively, and during the last visit. The rate of reattachment, change of height of choroidal detachment, intraocular pressure, best corrected visual acuity, and the complication of the eyes between the two groups were compared. All patients were followed up at least half a year after the repair surgery. Results: The intraocular pressure of the TA group was higher than the Dex group[(8.58±3.83)mmHg vs. (6.70±2.49)mmHg (1 mmHg=0.133 kPa), (t=2.032)], and the height of choroidal detachment was lower in TA group [0.90(0.00, 3.84)mm vs. 4.03(1.05, 5.38)mm, Z=-2.569, P<0.05]. There is no statistic difference between the reattachment rate of the two groups [95.7%(22/23) vs. 76.0%(19/25), χ(2)=2.304, P=0.129], but it seems it was better in TA group. The best corrected visual acuity results of the last visit was better in TA group than Dex group [(0.91±0.54) vs. (1.25±0.62), t=-2.034, P=0.048]. The rate of hypertention was higher in TA group than Dex group at 1 month, 3 month postoperatively(χ(2)=2.304, 5.648, P<0.05), while there was no statistic difference of hypertention rate during last visit between the two groups (χ(2)=0.006, P=0.941). Conclusions: The treatment of 23 G vitrectomy combined with subtenon injection of triamcinolone acetonide can improve the intraocular pressure, reduce the height of choroidal detachment, and improve the best corrected visual acuity after the surgery, but it may cause heyertenion. (Chin J Ophthalmol, 2018, 54: 252-257).

No copper supplementation in a corn-soybean basal diet has no adverse effects on late-phase laying hens under normal and cyclic high temperatures

Over supplementation of copper (Cu) in animal diets may cause serious pollution in soil, water and harvested crops. To minimize the potential pollution, the effects of corn-soybean basal diet with or without supplementation of 8 mg Cu/kg on laying performance, plasma biochemical metabolic indices, and antioxidant status in laying hens were evaluated under normal and cyclic high temperatures. A total of 240 Hy-Line Brown laying hens were randomly allotted to 4 treatments with 6 replicates of 10 hens per replicate according to factorial design involved in 2 temperatures [normal temperature (NT) vs. cyclic high temperature (CHT)] and 2 dietary Cu addition amount [Cu0 (0 mg/kg) vs. Cu8 (8 mg/kg in the form of CuSO4·5H2O)]. The experimental period included 1-week adaptation, 2-week heat stress and 2-week convalescence. The temperatures of NT groups in the same period or any groups during other periods were kept at 26 ± 2°C except that of CHT groups were 26 ± 2°C∼33 ± 2°C cyclically during heat stress period. CHT groups increased (P < 0.05) the rectal temperature and plasma glucose content under heat stress, but decreased (P < 0.01) the egg yield at the second week of heat stress and the first week of convalescence, and the plasma triglyceride, uric acid, and triiodothyronine levels under heat stress. Cu8 groups increased (P < 0.05) egg weight at the first week of convalescence, and plasma thyroxin level during the whole convalescence. Interactions between temperature and Cu content existed (P < 0.05) in the laying rate at the first week of convalescence, and the plasma lactic dehydrogenase level under heat stress. Conclusively, the CHT impaired laying performance. The Cu content (10.3 mg/kg) in corn-soybean basal diet might be sufficient for meeting the maintenance and production requirements of late-phase laying hens, and no Cu supplementation had no adverse effects on egg production and antioxidant indices under cyclic high (26 ± 2°C∼33 ± 2°C) or normal (26 ± 2°C) temperatures.

[Method for recording tension changes of small pulmonary artery and vein using the isolated vessel tension measurement system]

Objective: To establish a standardized method for isolated pulmonary artery and vein rings with different diameter, pressure and length, which could provide a more scientific method for in vitro study of pulmonary vessel diseases. Methods: Male SD rats were anesthetized, and the right ventricular systolic pressure were measured. Small pulmonary artery and vein rings with 200-400 μm in diameter and 2 mm in length were prepared by dissecting pulmonary arteries and veins. The pulmonary vessel rings were mounted in the organ bath by 2 stainless steel wires with diameter of 40 μm. Then the internal circumference of the vessel rings was increased gradually with 100 μm per step. At the same time the vascular tension was recorded by the Myograph System and Acknowledgement data acquisition system, and subsequently the passive length-tension exponential curve was made. The initial tension of the rings was set, equilibrated for another 30 min, and then stimulated with 60 mmol/L KCl 3 times, and the best contractile reactivity was achieved. The contractile reactivity of pulmonary artery rings and endothelial integrity were detected by exposure to 1 μmol/L phenylephrine(PE) and 10 μmol/L acetylcholine(Ach), while the contractile reactivity of pulmonary vein rings was detected by exposure to 1 μmol/L U46619 and 10 μmol/L papaverine. Results: The contraction and relaxation effects of the pulmonary artery rings reached 0.39 mg and 92% when they were stimulated by 1 μmol/L PE and 10 μmol/L Ach. The contraction and relaxation effects of pulmonary vein rings were up to 0.13 mg and 84% when they were exposed to 1 μmol/L U46619 and 10 μmol/L papaverine, respectively. Conclusion: Pulmonary artery and vein rings with appropriate basal tension and optimal vasodilator activity were prepared, and a standardized method of tension experiment for isolated pulmonary artery and vein rings established.

Characterization of the triple-component linoleic acid isomerase in Lactobacillus plantarum ZS2058 by genetic manipulation

AIM

To assess the mechanism for conjugated linoleic acid (CLA) production in Lactobacillus plantarum ZS2058.

METHODS AND RESULTS

CLA has attracted great interests for decades due to its health-associated benefits including anticancer, anti-atherogenic, anti-obesity and modulation of the immune system. A number of microbial CLA producers were widely reported including lactic acid bacteria. Lactobacillus plantarum ZS2058, an isolate from Chinese traditional fermented food, could convert LA to CLA with various intermediates. To characterize the genetic determinants for generating CLA, a cre-lox-based system was utilized to delete the genes encoding myosin cross-reactive antigen (MCRA), short-chain dehydrogenase/oxidoreductase (DH) and acetoacetate decarboxylase (DC) in Lact. plantarum ZS2058, respectively. Neither intermediate was detected in the corresponding gene deletion mutant. Meanwhile all those mutants could recover the ability to convert linoleic acid to CLA when the corresponding gene was completed.

CONCLUSIONS

The results indicated that CLA production was a multiple-step reaction catalysed by triple-component linoleate isomerase system encoded by mcra, dh and dc.

SIGNIFICANCE AND IMPACT OF THE STUDY

Multicomponent linoleic acid isomerase provided important results for illustration unique mechanism for CLA production in Lact. plantarum ZS2058. Lactobacilli with CLA production ability offer novel opportunities for functional food development.

Extract of Syzygium aromaticum suppress eEF1A protein expression and fungal growth

AIMS

Clove extract has therapeutic potential as an antifungal drug, yet the mechanism of action remains ambiguous. Current study aimed to address the molecular process of the antifungal activity exerted by clove extract.

METHODS AND RESULTS

The antifungal assay results showed that clove extract had some effects on all of the tested yeast. Propidium iodide staining assay showed cell membrane damage in Saccharomyces cerevisiae after treatment of clove extract for 30 h. Interestingly, SDS-polyacrylamide gel electrophoresis assays revealed that the protein expression of eukaryotic elongation factor 1 alpha (eEF1A) was suppressed significantly after treatment with clove extract (not pure eugenol). Transcriptional analyses revealed that the TEF1 and TEF2 genes (translation elongation factor EF-1 alpha) encoding eEF1A were not disturbed with the addition of clove extract; however, the expression of related genes EFB1 (translation elongation factor 1 subunit beta), ENO2 (phosphopyruvate hydratase ENO2), GSP1 (Ran GTPase GSP1), RPP0 (ribosomal protein P0), YEF3 (translation elongation factor EF-3), TEF4 (translation elongation factor EF1B gamma), and RPS2 (ribosomal 40S subunit protein S2) increased significantly.

CONCLUSIONS

These results suggest that clove extract plays a role in disrupting growth and affecting yeast metabolism. eEF1A was affected by clove extract at the protein level but not at the transcriptional level.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study is based on a detailed study of antifungal action exerted by clove extract, and proposed that down-regulation of eEF1A protein expression may contribute to its antifungal activity. These results may have clinical significance for future application of clove extract as a natural antifungal agent.

[Study on application of two risk assessment methods in coal dust occupational health risk assessment]

Objective: To evaluate the applicability of quantitative grading method (GBZ/T 229.1-2010) and occupational hazard risk index method in coal dust occupational health risk assessment. Methods: Taking 4 coal mines as the research object of risk assessment and making occupational health field testing and investigation. Based on two risk assessment methods, we analysed the health risk levels of 20 occupations which were exposed to coal dust in workplaces. Results: Coal dust working post had different risk levels in 4 coal mines, the post of higher risk level were mainly concentrated in the underground workplace of coal mine, especially the post of coal mining and tunneling system. The two risk assessment results showed that the risk levels of coal-mining machine drivers and tunneling machine drivers were the highest. The risk levels of coal dust working post used by two risk assessment methods had no significant difference (P>0.05) and were highly correlated (r=0.821, P<0.001) . Evaluation results of two risk assessment methods were supported by the field investigation and literatures. Conclusion: The two risk assessment methods can be used in coal dust occupational health risk assessment.

[Prognostic value of dynamic monitoring of RUNX1-RUNX1T1 transcript in pediatric acute myeloid leukemia]

Objective: To investigate the prognostic value of dynamic monitoring of RUNX1-RUNX1T1 transcript in pediatric patients with t (8;21) acute myeloid leukemia (AML) . Methods: The clinical features and RUNX1-RUNX1T1 transcript levels of 55 pediatric t (8;21) AML patients, newly diagnosed from Jan. 2010 to Apr. 2016, were analyzed retrospectively. The relationship between the minimal residual disease (MRD) and prognosis was analysed by dynamic monitoring of RUNX1-RUNX1T1 transcript levels using real-time quantitative PCR (RQ-PCR) technology. Results: The RUNX1-RUNX1T1 transcript levels in bone marrow cells at diagnosis was not related to relapse. After one course of induction therapy, patients with a more than 2 Log reduction of RUNX1-RUNX1T1 transcript levels (>2 Log) had lower 5 years cumulative incidence of relapse (CIR) [ (24.3±8.4) % vs (52.6±9.7) %, χ(2)=9.046, P=0.003], relapse-free survival (RFS) [ (71.6±12.7) % vs (48.1±13.2) %, χ(2)=5.814, P=0.016], and better overall survival (OS) [ (76.9±12.5) % vs (48.9±14.7) %, χ(2)=6.346, P=0.012], compared to patients with a less than 2 Log reduction (a<2 Log) . Multivariate Cox survival analysis suggested that a>2 Log reduction in RUNX1-RUNX1T1 transcript levels after a course of induction therapy was an independent prognostic factor for RFS (HR=0.263, 95%CI 0.081-0.851, P=0.026) and OS (HR=0.214, 95% CI 0.057-0.808, P=0.023) . During consolidation therapy and follow-up period, molecular relapse of 16 cases and hematologic relapse of 13 cases were identified by continuous dynamic monitoring of RUNX1-RUNX1T1 transcript levels, with a median interval of 4.0 (1.5-5.8) months from the molecular relapse to hematologic relapse. 2 cases of molecular relapse who received timely allogeneic hematopoietic stem cell transplantation did not experience hematologic relapse. Conclusion: Dynamic monitoring RUNX1-RUNX1T1 transcript levels by RQ-PCR technique can subdivide patients into relatively low and high risk group, early screen patients at high risk of relapse and provide a scientific basis for precision stratification and risk-adapted therapy for pediatric t (8;21) AML children.