[Effectiveness of abdominal minimal incision sacrocolpopexy for advanced pelvic organ prolapse]

Objective: To evaluate the indications, surgical skills and clinic outcomes of abdominal minimal incision sacrocolpopexy (AMISC) for treatment of advanced pelvic organ prolapse (POP). Methods: The retrospective study analyzed 30 women with advanced POP who underwent AMISC between June 2016 and October 2019, including 9 cases of recurrent prolapse and 10 cases of vault prolapse. AMISC was especially applicable to: (1) patients with several medical complications who was unable to tolerate general anesthesia or laparoscopic surgery, but able to tolerate combined spinal-epidural anesthesia and open surgery; (2) other abdominal procedures were indicated to perform with AMISC simultaneously, such as myomectomy, subtotal hysterectomy etc, the specimens were easy to get out of the abdominal cavity and morcellation was avoided; (3) surgeons preferring open surgery to laparoscopic surgery or skilled in open surgery; (4) patients with prior pelvic operations, presenting severe abdominal and pelvic adhesions. Objective outcomes were assessed by pelvic organ prolapse quantification (POP-Q) system. Subjective outcome were assessed by pelvic floor distress inventory-short form 20 (PFDI-20), pelvic floor impact questionnaire-short form (PFIQ-7) and patient global impression of improvement (PGI-I). Results: All patients with 1-3 medical complications were successfully performed with AMISC without stopping procedure, enlarging the incision or changing to other procedure, the operation duration was (110±19) minutes. The mean time of follow-up was (33.5±12.4) months (range: 8-49 months). The postoperative points of Aa, Ba, C, Ap, Bp reduced significantly and point C improved from (2.33±2.50) cm to (-7.54±1.18) cm after AMISC (P<0.01). The objective cure rates were both 100% (30/30) in apex and posterior compartment, while 97% (29/30) in anterior compartment. Postoperative scores of PFDI-20 and PFIQ-7 were all significant decreased (all P<0.01). About PGI-I, 29 patients chose "significant improvement", subjective satisfaction was 97% (29/30). Anterior sacral plexus hemorrhage occurred in 2 cases (7%, 2/30). There was no intestinal obstruction or injury of bladder, bowel and ureter intra- and postoperation. Two cases (7%, 2/30) had mesh exposure. Conclusion: AMISC is a safety, convenient, minimal traumatic and durable procedure for apical prolapse with short learning curve in the most of cases.

[Clinicopathological features of Caroli disease/Caroli syndrome: an analysis of 21 cases]

Objective: To summarize and compare clinicopathological features of Caroli disease and Caroli syndrome. Methods: A total of 21 patients diagnosed with Caroli disease or Caroli syndrome in Beijing Friendship Hospital, Capital Medical University, from January 2015 to December 2018 were included. Through the clinical manifestations and comparative analysis of the differences between different clinical types, the liver pathological features of these patients were described. Results: Of all patients included, 8 were male and 13 were female, and the medium age was 13.5 year old. The initial symptom was fever in 6 cases (28.6%), gastrointestinal bleeding in 6 cases (28.6%) and hepatosplenomegaly in 9 cases (42.8%). Caroli disease accounted for 6 cases (28.6%) and Caroli syndrome 15 cases (71.4%). The total bilirubin [6.7 (4.7, 15.0) vs 16.0(10.9, 33.0)μmol/L] and direct bilirubin [1.3(0.9,6.4)vs 3.5(2.7, 16.2)μmol/L] were significantly lower in Caroli disease group in comparison to those in Caroli syndrome group(both P<0.05). The hemoglobin [117.0 (106.0, 126.2) vs 85.0 (74.0, 103.0) g/L] and platelet count [286.0 (149.8, 467.5)×10(9)/L vs 76.1(55.0,123.0)×10(9)/L] in Caroli disease group were significantly higher than those in Caroli syndrome group (both P<0.05). There were 10 patients (47.6%) who underwent liver transplantation. Child-Pugh-Turcotte Score (liver function reserve) were significantly higher than that in the non-liver transplantation group[8.0(8.0, 10.2)vs 5.0 (5.0, 6.0), P<0.05]. Conclusions: Early symptoms of Caroli disease/Caroli syndrome are atypical and prone to misdiagnosis and misdiagnosis. The diagnosis is usually based on pathology and may be supplemented by laboratory examination and imaging analysis.

Short communication: Influence of intramuscular injection of vitamin B12 in early-lactation dairy cows on Mozzarella cheese quality and vitamin B12 stability

The current study explored the effect of intramuscular injection of vitamin B₁₂ (VB₁₂) in early-lactation dairy cows on subsequent low-moisture part-skim Mozzarella cheese quality and VB₁₂ levels during cheese processing and storage. Twenty-four peripartum dairy cows were blocked based on parity and milk yield and randomly assigned into 2 treatments: basal diet (CON) and basal diet with an intramuscular injection of 10 mg of VB₁₂ per cow per week (VB₁₂). Raw milk was collected to determine VB₁₂ content and then used to make low-moisture part-skim Mozzarella cheese 8 wk after injection. The VB₁₂ content of raw milk and cheese was determined using ultra-performance liquid chromatography coupled with tandem mass spectrometry. We found that VB₁₂ content was significantly increased in milk (15.43 vs. 3.30 ng/mL) and fresh cheese (3.72 ng/g vs. undetectable) from the VB₁₂ group compared with the CON group. However, approximately 70% of VB₁₂ was lost in the whey during cheese making, and no VB₁₂ was detectable in either cheese treatment after 8 wk of storage. Furthermore, no significant differences were observed in fat and protein contents in the cheese between the 2 groups. For cheese color, the b* value increased and the a* value decreased slightly in fresh VB₁₂ cheese. Functional properties of stretchability, flowability, and meltability of VB₁₂ cheese were initially comparable to that of CON cheese, but higher flowability and meltability was observed in VB₁₂ cheese after 8 wk of storage. In summary, intramuscular injection of VB₁₂ in early-lactation dairy cows increases the content of VB₁₂ in milk and fresh cheese with no adverse effect on cheese quality, but substantial VB₁₂ is lost during cheesemaking and declines rapidly during storage.

[Analysis of EGFR mutation and clinical features of lung cancer in Yunnan]

Objective: To analyze the EGFR mutation profile of lung cancer patients in Yunnan, and to provide evidence for clinical personalized treatment. Methods: Demographic and clinical data of 2 967 lung cancer patients undergoing EGFR identification were collected and analyzed from January 2014 to August 2019 in Yunnan Cancer Hospital. Results: The proportion of EGFR mutation in 2 967 patients with lung cancer was 46.2%. Univariate analysis showed that the proportion of EGFR mutation in women was higher than that in men (P<0.001) and displayed a downward trend with age (P=0.03). The mutation rate of ethnic minorities was higher than Han (P=0.012). Mutation rate in patients without smoking history was higher than those with smoking history (P<0.001), and patients without drinking history was higher than patients with drinking history (P<0.001). Mutation rate in patients without family history of lung cancer was higher than those with family history (P=0.008). The mutation rate of adenocarcinoma was higher than other pathological types (P<0.001). The mutation rate was different among stages, and it was higher in early patients than that in advanced patients (P<0.001). The mutation rate of tissue specimens was higher than those of cytology and peripheral blood samples (P<0.001). The mutation rate of Xuanwei area was lower than that in non-Xuanwei area (P<0.001). Multivariate analysis showed that gender (P<0.001), age (P=0.036), smoking history (P<0.001), pathological type (P<0.001), specimen type (P<0.001), and whether or not Xuanwei area (P<0.001) were the independent factors of EGFR mutation.The EGFR mutation was more common in female, non-smokers, adenocarcinoma, non-Xuanwei area, tissue specimen and young lung cancer patients.The mutation types of EGFR in 1 370 cases mainly included 19-Del and L858R. The predominant mutation of EGFR in Xuanwei area was L858R, while in non-Xuanwei area was 19-Del.The mutation rates of G719X, G719X+ L861Q, G719X+ S768I, and S768I in Xuanwei were higher while the mutation rates of 19-Del, L858R, and 20-ins were lower than non-Xuanwei area (P<0.05). The 19-Del mutation rate of ethnic minorities is higher than that of Han (P<0.001). The combined mutation rate of G719X, L861Q in Han was higher than that of ethnic minorities (P=0.005). Conclusions: The EGFR mutation rate in lung cancer patients in Yunnan is similar to Asian and Chinese, and higher in female, non-smokers, adenocarcinomas, young and non-Xuanwei area patients. The most common types of EGFR mutation in Yunnan are 19-Del and L858R. The predominant mutation of EGFR in Xuanwei area is L858R, while in non-Xuanwei area is 19-Del. The mutation rates of G719X, G719X+ L861Q, G719X+ S768I and S768I are higher in Xuanwei patients than those in non-Xuanwei patients. The combined mutation rate of G719X and L861Q in Han nationality is higher than that of ethnic minorities.

Short communication: The antilipogenic effect of trans-10,cis-12 conjugated linoleic acid in bovine mammary epithelial cells is associated with proteasome activity and ATP production

Proteasomes play a widespread role in the control of protein abundance via degrading ubiquitinated proteins. Activity of proteasomes is regulated by constitutive ATPases that respond to intracellular concentrations of ATP. Although recent data suggest a role of proteasomes in fatty acid metabolism, whether lipogenic activity in mammary cells is responsive to ATP concentrations and proteasome activity is unknown. To investigate whether proteasomes play a role in milk fat depression induced by trans-10,cis-12 conjugated linoleic acid (t10,c12 CLA), a bovine mammary epithelial cell line was treated with t10,c12 CLA for 24 h before analysis of lipogenic protein abundance. Western blot analysis of inactive sterol response element-binding protein-1 (pSREBP1) and active (nSREBP1) fragments indicated a decrease in abundance induced by exogenous t10,c12 CLA. At 150 nM t10,c12 CLA, abundance of both pSREBP1 and nSREBP1 was lowest, and decreased from basal levels by 16 and 64%, respectively. Exogenous t10,c12 CLA had no effect on abundance of peroxisome proliferator-activated receptor-gamma (PPARγ), but at 150 and 300 nM it decreased abundance of SREBF chaperone (SCAP). Inhibition of proteasome activity via incubation with MG-132 (a proteasome inhibitor) alone had no effect on pSREBP1, nSREBP1, PPARγ, or SCAP abundance. However, when cells were pre-incubated with MG-132, treatment with t10,c12 CLA reduced pSREBP1 (∼27%) and nSREBP1 (∼41%) abundance without affecting PPARγ or SCAP. Compared with the control, exogenous t10,c12 CLA increased ATP concentrations, and MG-132 alone had no effect. However, ATP concentration decreased markedly in cells incubated with both MG-132 and t10,c12 CLA. Combined with the alteration of SCAP and nSREBP1, the increase of ATP concentrations with t10,c12 CLA suggested that this fatty acid influenced the function of the SREBP1-SCAP complex through altering proteasome activity. Collectively, the current data highlight a role of proteasomes and intracellular ATP concentrations in the antilipogenic effect induced by t10,c12 CLA that leads to milk fat depression.

Feasibility and advantages of endoscope-assisted parotidectomy: a systematic review and meta-analysis

The object of this paper was to explore the feasibility and advantages of endoscope-assisted parotid tumour resection. Three databases (PubMed, Web of Science, and Cochrane) were used to search for all related randomised controlled trials or controlled trials (up to November 2019). The key parameters for assessment included 'Endoscope', 'Endoscopes', 'Cancer of Parotid', and 'Parotid Cancer'. To evaluate the feasibility and advantages of endoscope-assisted resection of parotid tumours, the data for each parameter were pooled, based on patients who received endoscope-assisted surgery and those who received conventional surgery. This meta-analysis included seven studies, involving 170 patients in the endoscopy group and 270 patients in the control group. The analysis using the pooled data showed that there were no significant differences in the operating times between the two groups; however, the endoscopy group had significantly shorter incisions and less intraoperative bleeding. In addition, the patients who received endoscope-assisted surgery had lower incidences of temporary facial paralysis and Frey's syndrome after surgery. Patients in the endoscopy group had greater postoperative satisfaction. Endoscope-assisted parotid tumour resection results in only a small, concealed incision wound and fewer postoperative complications. Therefore, it is promising for the surgical treatment of parotid tumours.

[Difficulties and countermeasures for the perioperative management of megasplenectomy in patients with advanced schistosomiasis]

The etiology, pathology, clinical features and prognosis of megalosplenic advanced schistosomiasis have their specific features, and therefore, the perioperative management of this disorder has special countermeasures. The review analyzes the difficult problems in the perioperative management of megalosplenic advanced schistosomiasis, including ultra - low platelet counts, extensive and severe adhesive splenomegaly, massive hemorrhage during surgery and portal vein thrombosis, and proposes countermeasures to tackle these problems, with aims to guide the clinical treatment and cure of schistosomiasis, thereby improving the prognosis, reducing complications and improving the quality of life.

[Effect of rational emotive therapy on negative emotion in advanced schistosomiasis patients with repeated hospitalization]

OBJECTIVE

To examine the effect of rational emotive therapy on negative emotions among advanced schistosomiasis patients with repeated hospitalizations.

METHODS

A total of 97 advanced schistosomiasis patients with anxiety and depressive emotions that were hospitalized in Xiangyue Hospital of Hunan Institute of Schistosomiasis Control for three times or more were enrolled, and given rational emotive therapy for 4 weeks in addition to routine nursing care. The scores for anxiety, depression and quality of life were estimated in patients before and after the rational emotive therapy using the Self-Rating Anxiety Scale (SRS), the Self-Rating Depression Scale (SDS) and WHOQOL-BREF Form.

RESULTS

The SAS and SDS scores were significantly lower 4 weeks following rational emotive therapy than before the intervention (SAS score, 45.40 ± 7.77 vs. 59.25 ± 9.29, t = 14.021, P < 0.01; 51.48 ± 8.01 vs. 63.93 ± 9.59, t = 12.991, P < 0.01). The percentages of patients with moderate and severe anxiety and depression were significantly lower 4 weeks following rational emotive therapy than before the intervention (P < 0.01), and the scores for each item in the quality of life were all significantly greater 4 weeks following rational emotive therapy than before the intervention (P < 0.01).

CONCLUSIONS

Rational emotive therapy may improve the negative emotions and the quality of life of advanced schistosomiasis patients with repeated hospitalizations.

Short communication: Effects of dietary N-carbamoylglutamate supplementation on the milk amino acid profile and mozzarella cheese quality in mid-lactating dairy cows

N-Carbamoylglutamate (NCG) is an enhancer of Arg, which is a functional AA and could prevent cardiovascular disease and improve immunity. The present study was conducted to investigate the effects of supplementing NCG in diets of lactating cattle on the NCG concentration and AA composition of raw milk and on mozzarella cheese quality. Thirty multiparous cows with a mean body weight of 669 kg (standard deviation = 71) and days in milk of 176 (standard deviation = 55) were blocked based on parity and milk production and randomly assigned to 1 of 2 treatments: basal diet (CON) and basal diet supplemented with 40 g of NCG per day per cow (NCG). After 8 wk of treatment, raw milk samples were collected from the 2 groups for AA analysis and mozzarella cheese-making. Furthermore, the NCG concentration and distribution in milk and mozzarella cheese were detected. The AA concentration in milk was greater and the NCG concentration in raw milk was approximately 6 times greater in the NCG group than in the CON group. No NCG was detected in cheese from the CON group, and very little NCG (<1.0 μg/kg) of cheese was detected in the NCG group. Most of the dietary NCG was transferred into whey, stretch water, and brine during cheese production. No significant difference was found between the 2 groups on cheese texture and color except that hardness was lower in the NCG group. Overall, the results indicated that dietary supplementation of NCG could improve the NCG and AA concentrations in raw milk without affecting the quality of cheeses such as mozzarella.

Population Structure and Genetic Diversity of Fungi Causing Rice Seedling Blight in Northeast China Based on Microsatellite Markers

Rice seedling blight, which is caused by diverse pathogenic microorganisms, occurs worldwide and is the most important seedling disease affecting rice production in Northeast China. To further characterize the population structure and genetic diversity of the fungi responsible for rice seedling blight in Northeast China, 225 fungal strains were isolated from diseased rice seedlings collected from various rice-producing areas. The isolated strains included Fusarium oxysporum (48.0%), F. verticillioides (11.6%), F. tricinctum (8.0%), F. redolens (6.7%), F. equiseti (6.2%), F. solani (6.2%), Rhizoctonia solani (6.7%), Alternaria alternata (4.0%), and Curvularia coatesiae (2.7%). F. oxysporum was the dominant fungal species causing rice seedling blight, with most isolates exhibiting moderate pathogenicity. Moreover, to our knowledge, this is the first study to identify A. alternata and C. coatesiae as causal agents of rice seedling blight in Northeast China. None of the F. oxysporum isolates were sensitive to 10 μg/ml of carbendazim, implying that carbendazim is ineffective for controlling rice seedling blight in Northeast China. The F. oxysporum isolates were divided into nine groups based on a simple sequence repeat analysis involving 14 primer pairs. In addition, an analysis of molecular variance revealed a significant correlation between the F. oxysporum population and geographical location, which had a significant effect on the differentiation of the dominant isolate population. The results of this study provide insights into the genetic diversity of F. oxysporum strains causing rice seedling blight and may be useful for selecting isolates to screen for disease-resistant rice varieties, evaluating fungicide efficacy, and developing effective disease management strategies.

Lactobacillus rhamnosus GG components, SLP, gDNA and CpG, exert protective effects on mouse macrophages upon lipopolysaccharide challenge

The aim of this study was to determine whether Lactobacillus rhamnosus GG (LGG) components (surface layer protein, SLP; genomic DNA, gDNA; unmethylated cytosine-phosphate-guanine-containing oligodeoxynucleotide, CpG-ODN), alone or in combination, could affect immunomodulation, and evaluate the signalling mechanism in mouse macrophage RAW264.7 cells challenged with lipopolysaccharide (LPS). LGG components were used to treat cells before LPS stimulation. Cytokine and Toll-like receptor (TLR) expression were assessed using real-time quantitative PCR (RT-qPCR). Mitogen-activated protein kinase (MAPK), extracellular regulated protein kinase (ERK) and nuclear factor-kappa B (NF-κB) signalling pathways were evaluated using immunoblots and immunofluorescence. SLP or SLP + gDNA pre-treatment significantly reduced the LPS-induced mRNA expression of tumour necrosis factor alpha (TNF-α). Pre-treatment with LGG single components (SLP, gDNA or CpG) or their combinations (SLP + gDNA or SLP + CpG) significantly decreased the LPS-induced interleukin-6 (IL-6) mRNA level (P < 0·05). Pre-treatment with SLP or gDNA, alone or in combination, significantly suppressed LPS-induced TLR2 and TLR4 mRNA levels (P < 0·05). SLP pre-treatment also significantly decreased the LPS-induced expression of TLR9 (P < 0·05). Pre-treatment with LGG single components or combinations significantly suppressed the LPS-induced phosphorylation levels of ERK (P > 0·05). In conclusion, pre-incubation with LGG components, singly or in combination, generally inhibited the activation of TLR, MAPK and NF-κB signalling pathways in LPS-stimulated cells, leading to attenuated inflammatory cytokine TNF-α and IL-6 production. These results indicate that nonviable probiotic LGG components exert an anti-inflammation effect on epithelial cells. SIGNIFICANCE AND IMPACT OF THE STUDY: Lactobacillus rhamnosus GG (LGG) is widely used as probiotics. However, its main components are not well known for affecting immunomodulation. This study investigated the effects of pre-treatments with different components such as surface layer protein, genomic DNA and unmethylated cytosine-phosphate-guanine-containing oligodeoxynucleotides, alone or in combination on immunomodulation, and evaluated the signalling mechanism in mouse macrophage RAW264.7 cells challenged with lipopolysaccharide. Pre-incubation with components alone or in combination generally inhibited the activation of Toll-like receptor, mitogen-activated protein kinases, extracellular regulated protein kinases and nuclear factor-kappa B signalling pathways in lipopolysaccharide-stimulated cells, which generally leads to attenuated inflammatory cytokine interleukin-6 and tumour necrosis factor alpha production. These results indicate that nonviable probiotic LGG components exert an anti-inflammation effect on epithelial cells.

[A five-year analysis of effect on transvaginal high uterosacral ligament suspension with or without native-tissue repair for middle compartment defect]

Objective: To assess the five-year effect of the transvaginal high uterosacral ligament suspension (HUS) with or without additional concomitant native-tissue anterior and (or) posterior repair in women suffering from middle compartment defect. Methods: A retrospective review of records identified 79 women who underwent transvaginal HUS with or without additional concomitant native-tissue anterior and (or) posterior repair from January 2007 to January 2018 in Fourth Medical Center, General Hospital of People's Liberation Army. The middle compartment defects were predominant in these patients with point C no less than point Ba or Bp if accompanied with anterior or posterior vaginal wall prolapse. Follow-up visits were performed 2,6 and 12 months after surgery and then annually. Anatomic results of pelvic organ prolapse (POP) was established by pelvic examination using pelvic organ prolapse quantitation system (POP-Q) staging. Funtional results were obtained by patient global impression of improvement (PGI-I) scale in POP, pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7). Surgical success required the fulfillment of all 3 criteria: (1) anterior or posterior vaginal wall prolapsed leading edge of 0 cm or less and apex of 1/2 total vaginal length or less; (2) the absence of POP symptoms as reported on the PFDI-20 question No.3 ( "Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?" ); and (3) no prolapse reoperations or pessary use during the study period. Results: Of 79 women, 51(65%, 51/79) women completed the five-year follow-up during the study period. The median follow-up time was 5.2 years (2.8-8.3 years). The overall surgery success rate was 86% (44/51) according to above all 3 criteria. Prolapse recurrence rates were isolated anterior 8% (4/51), isolated apical 0, isolated posterior 2% (1/51) and multiple compartments 4% (2/51). Seven women (14%,7/51) developed anterior or posterior prolapse beyond the hymen with the leading edge≤1 cm. No apical prolapsed occurred. None of recurrent women underwent retreatment,including either surgery or pessary usage at last follow-up. The subjective satisfaction rate was 90% (46/51). There was a 1% (1/79) rate of intraoperative ureteral kinking and 3% (2/79) rate of postoperative morbidity. Conclusions: The transvaginal HUS for middle compartment defect offers good long-term anatomical results with excellent vault suspension. With additional concomitant native-tissue anterior and (or) posterior repair, it will be a reconstructive surgery for the majority of moderate-to-severe POP. It is minimal traumatic and worthy of being popularized for clinical application.

Comparison of efficacy of fluticasone propionate versus clarithromycin for postoperative treatment of different phenotypic chronic rhinosinusitis: a randomized controlled trial

BACKGROUND

Chronic rhinosinusitis (CRS) can be divided to CRS without nasal polyps (CRSsNP) and eosinophilic and non-eosinophilic CRS with nasal polyps (CRSwNP). There is little evidence on the efficacy of glucocorticoids and macrolides in different phenotypic patients. The aim of this study was to compare the benefit of glucocorticoids and macrolides following endoscopic sinus surgery (ESS) in different phenotypic CRS.

METHODS

This study was a prospective single-blind comparative effectiveness trial. A total of 187 Chinese patients with CRS were stratified to CRSsNP and eosinophilic and non-eosinophilic CRSwNP group and then randomized to receive fluticasone propionate nasal spray at 200 microgram or clarithromycin tablet at 250 mg once daily for 3 months after ESS. Oral prednisone was given as a rescue therapy after the stop of study medication. Patients were assessed before ESS and 1, 3, 6 and 12 months after dosing. Symptom severity was scored by patients using visual analog scale method and endoscopic findings were scored by the senior physician blinded to treatment according to European Position Paper on Rhinosinusitis and Nasal polyps 2012.

RESULTS

The total and individual symptom scores, and total and individual endoscopic domain scores were reduced significantly after ESS in both medication groups, whereas no significant difference was observed for two medications at most follow-up visits in each subtype of CRS. No difference in the frequency of subjects with rescue therapy or refractory CRS was found between two medication groups either.

CONCLUSIONS

We could not show significant difference of effect between fluticasone propionate and clarithromycin in the post-operative treatment for CRSsNP and eosinophilic and non-eosinophilic CRSwNP patients.

[Teleost Type 2 Interleukin-1 Receptor (IL-1R2) from the Spotted Halibut (Verasper variegatus): 3D Structure and a Role in Immune Response]

The type 2 interleukin-1 receptor (IL-1R2) is one of natural IL-1β singling inhibitors in mammals. We cloned and sequenced the IL-1R2 gene in V. variegatus (VvIL-1R2). The phylogenetic analysis showed that the molecular structure VvIL-1R2 is similar to that of its orthologues in other vertebrates. The expression levels of VvIL-1R2 are relatively high in the peripheral blood leukocytes (PBLs), gill, and spleen. In addition, peculiar expression patterns for his molecule were detected at various developmental stages, implying that in flatfishes the IL-1R2 may have be important for embryonic development and metamorphosis. In PBLs, the treatment with pathogen-associated molecular patterns (PAMPs) induced a significant and rapid up-regulation of VvIL-1R2, pointing at its involvement in the immune responses against bacterial and viral pathogens.

Effect of hydroxyselenomethionine on lactation performance, blood profiles, and transfer efficiency in early-lactating dairy cows

The current study investigated the effects of hydroxyselenomethionine (HMBSe), a novel organic selenium (Se) additive, on lactation performance, blood profiles, antioxidative status, and transfer efficiency of Se in early-lactation dairy cows. Sixty multiparous early-lactating dairy cows with similar days in milk (57 d; standard deviation = 9.9) and milk yield (36.5 kg/d; standard deviation = 1.42) were fed a basal diet containing 0.04 mg of Se/kg (dry matter basis). These cows were assigned to 1 of 4 groups following a randomized complete block design as follows: control (basal diet) or HMBSe addition (0.1, 0.3, or 0.5 mg of Se/kg of dry matter). The experiment lasted for 13 wk, with the first week as adaptation. The results showed that milk yields (raw, protein, and lactose) and feed efficiency were improved in a quadratic manner following increased dietary HMBSe addition, whereas energy-corrected milk, 4% fat-corrected milk, and total solid yields tended to be enhanced quadratically. In terms of whole-blood variables, red blood cell and white blood cell levels were increased quadratically, whereas hemoglobin concentration increased linearly with increased HMBSe addition. Plasma nonesterified fatty acid concentrations tended to increase linearly along with HMBSe addition. Plasma superoxide dismutase activity increased quadratically with increased HMBSe addition. The total antioxidant capacity in plasma tended to improve quadratically when cows were fed more HMBSe. Moreover, plasma malondialdehyde concentrations of dairy cows tended to decrease in a quadratic manner when dietary HMBSe increased. The Se concentrations in milk, plasma, and milk/plasma ratio increased linearly following increased HMBSe addition. In conclusion, HMBSe improved lactation performance, health status, and milk Se concentrations in early-lactating dairy cows.

[Effectiveness of vaginal high uterosacral ligament suspension for treatment of recurrent pelvic organ prolapse]

Objective: To evaluate the indications and clinic outcomes of vaginal high uterosacral ligament suspension (HUS) for treatment of recurrent advanced pelvic organ prolapse (POP). Methods: This retrospective study analyzed 42 women with recurrent advanced POP who were referred to Fourth Medical Center of PLA General Hospital and underwent transvaginal HUS between November 2005 and January 2018. Primary surgeries included 30 vaginal colporrhaphy, 5 Manchester operation, 5 transvaginal mesh repair,2 sacrospinous ligament fixation.The median time for recurrence from primary pelvic floor repair surgery was 9 months, including 14 cases (33%, 14/42) ≤3 months (median time was 2 months) and 25 cases (67%, 28/42) longer than 3 months (median time was 18 months).The rate of recurrent prolapse in stage Ⅲ or Ⅳ was 79% (33 cases), 45% (19 cases) and 17%(7 cases) in anterior, apical and posterior compartment respectively. Results: Transvaginal high bilateral uterosacral ligaments were identified and used for successful vaginal vault suspension after vaginal hysterectomy and residual cervical resection in all 42 consecutive patients. The cases of transvaginal mesh used in anterior wall and posterior wall were 25 (60%, 25/42) and 3 (7%, 3/42) respectively. There was no major intra- and postoperative complications,such as ureter and other pelvic organ injury. The median time of follow-up was 5.3 years after transvaginal HUS. The points of pelvic organ prolapse quantification system reduced significantly and point C improved from +0.3 cm to -8.2 cm after reoperation (P<0.01). The objective cure rate were 100% (42/42) both in apex and posterior compartment,while 93% (39/42) in anterior compartment. None had reoperation or pessary usage for recurrence of prolapse. Conclusion: Transvaginal HUS with vaginal wall repair could be as a safety, cost-effective, minimal traumatic and durable procedure for recurrent POP in the most of cases.

Assessment of rumen bacteria in dairy cows with varied milk protein yield

The present study was conducted to assess rumen bacteria in lactating cows with different milk protein yield, aiming to understand the role of rumen bacteria in this trait. Cows with high milk protein yield (high milk yield and high milk protein content, HH; n = 20) and low milk protein yield (low milk yield and low milk protein content, LL; n = 20) were selected from 374 mid-lactation Holstein dairy cows fed a high-grain diet. Measurement of the rumen fermentation products showed that the concentrations of ruminal total volatile fatty acids, propionate, butyrate, and valerate and the proportion of isobutyrate were higher in the HH cows than in the LL cows. Amplicon sequencing analysis of the rumen bacterial community revealed that the richness (Chao 1 index) of rumen microbiota was higher in the LL cows than in the HH cows. Among the 10 predominant bacterial phyla (relative abundance being >0.10%, present in >60% of animals within each group), the relative abundance of Proteobacteria was 1.36-fold higher in the HH cows than in the LL cows. At the genus level, the relative abundance of Succinivibrio was significantly higher and that of Clostridium tended to be higher in the LL cows than in the HH cows. Sharpea was 2.28-fold enriched in the HH cows compared with the LL cows. Different relationships between the relative abundances of rumen microbial taxa and volatile fatty acid concentrations were observed in the HH and the LL animals, respectively. Succinivibrio and Prevotella were positively correlated with acetate, propionate, and valerate in the LL cows, whereas Sharpea was positively correlated with propionate and valerate concentrations in the HH cows. Collectively, our results revealed that rumen bacterial richness and the relative abundances of several bacterial taxa significantly differed between dairy cows with high and low milk protein yields, suggesting the potential roles of rumen microbiota contributing to milk protein yield in dairy cows.

Short communication: Relationship of blood DNA methylation rate and milk performance in dairy cows

The objective of this study was to investigate the global methylation rate in blood DNA and its relationship with lactation performance. A total of 196 mid-lactation dairy cows were fed the same diet under the same management. Milk yield was recorded and blood samples were collected from the jugular vein before morning feeding. The blood global DNA methylation rates were quantified using a methylation quantification kit. Overall, the average blood global DNA methylation rate of all cows was 12.4%. When DNA methylation rates were compared between cows with high (n = 40; 37.0 to 42.0 kg/d) and low (n = 33; 24.0 to 30.0 kg/d) milk yield, DNA methylation rates in the lower-yield cows (14.1 ± 0.7%) were significantly higher than those in the higher-yield animals (11.6 ± 0.7%). Our results indicated an association of milk and protein yields with global DNA methylation rates in lactating dairy cows. However, further research is needed to determine whether this association reflects the true influence of epigenetic mechanisms on yield or whether other factors, such as different proportions of blood cell types in high- and low-yielding cows, affect apparent global DNA methylation levels.

Effect of N-acetyl-l-methionine supplementation on lactation performance and plasma variables in mid-lactating dairy cows

The objective of current study was to investigate the effect of N-acetyl-l-methionine (NALM) supplementation on lactation performance and plasma variables in mid-lactating dairy cows. Forty-eight multiparous cows were blocked into 12 groups based on parity, days in milk, and milk production and were randomly assigned to 1 of the 4 treatments: 0, 15, 30, or 60 g/d of NALM per cow to supplement the basal diet. The experiment was conducted over a 13-wk period, with the first week as adaptation. The yields of milk, fat-corrected milk, and milk lactose were increased quadratically, and energy-corrected milk yield tended to increase with increased NALM supplementation in a quadratic manner. The dry matter intake, milk protein yield, milk fat yield, contents of milk composition (protein, fat, lactose, total solids, and milk urea nitrogen), feed efficiency, and body weight change were not affected by NALM supplementation. In addition, plasma methionine concentration was increased quadratically, and proline, total nonessential AA, and total AA concentrations were significantly higher in the 30 g/d group compared with that of the control group. However, other AA and total essential AA concentrations were not affected with supplementation of NALM. Adding NALM increased concentrations of total protein and globulin in plasma, but decreased plasma urea nitrogen concentration in a quadratic manner. Meanwhile, plasma malonaldehyde concentration decreased linearly as doses of NALM addition increased. Our results suggested that the supplementation of NALM improved milk yield and protein synthesis in the liver, and lowered lipid peroxidation in mid-lactating dairy cows.

[The value of lean nystagmus and sitting to supine positioning nystagmus in the diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo]

Objective: To explore the value of 1ean nystagmus and sitting to supine positioning nystagmus in the diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo. Method: One hundred cases of patients with definitive diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo were tested by 1ean nystagmus and sitting to supine positioning nystagmus and supine roll test. The affected side was recorded according to the nystagmus direction. After diagnosis, they were treated with canalith repositioning procedure. The canalith repositioning procedure was made according to the supine roll test result when 1ean nystagmus and sitting to supine positioning nystagmuscannot be induced. Furthermore，the canalith repositioning procedure was made according to the1ean nystagmus and sitting to supine positioning nystagmuswhenthe supine roll test cannot diagnose. The patients with canalolithiasis were randomly divided into two groups when both 1ean nystagmus and sitting to supine positioning nystagmusand the supine roll test can be induced. One group was treated with canalith repositioning procedure based on results of supine roll test and the other group was treated based on the results of1ean nystagmus and sitting to supine positioning nystagmus. The detection rate and diagnostic coincidence rate of 1ean nystagmus and sitting to supine positioning nystagmus were calculated and the shortterm outcome were evaluated one day after treatment. Result: The detection rate of 1ean nystagmus and sitting to supine positioning nystagmus was 83% and the coincidence rate with the roll test was 90.1%，respectively. There was no significant statistical difference between the treatment effect according to lean nystagmus and sitting to supine positioning nystagmus and supine roll test. Conclusion: Lean nystagmus and sitting to supine positioning nystagmus cannot be used alone in the diagnosis ofhorizontal semicircular canal benign paroxysmal positional vertigo. They need to be combined with supine roll test. However, when the supine roll test is difficult to demonstrate the affected side, it can be used as an auxiliary diagnostic method. When the results of 1ean nystagmus and sitting to supine positioning nystagmusand the supine roll test are inconsistent, repeat the test and conduct a comprehensive assessment to avoid missed diagnosis and misdiagnosis..

Different endosperm structures in wheat and corn affected in vitro rumen fermentation and nitrogen utilization of rice straw-based diet

Starchy grain is usually supplemented to diets containing low-quality forage to provide sufficient energy for ruminant animals. Ruminal degradation of grain starch mainly depends on the hydrolysis of the endosperm, which may be variable among grain sources. This study was conducted to investigate the influence of endosperm structure of wheat and corn on in vitro rumen fermentation and nitrogen (N) utilization of rice straw. The 3×4 factorial design included three ratios of concentrate to forage (35:65, 50:50 and 65:35) and four ratios of wheat to corn starch (20:80, 40:60, 60:40 and 80:20). The endosperm structure was detected by scanning electronic microscopy and a confocal laser scanning microscopic. An in vitro gas test was performed to evaluate the rumen fermentation characteristics and N utilization. Starch granules were embedded in the starch-protein matrix in corn, but more granules were separated from the matrix in the wheat endosperm. With the increasing ratio of wheat, rate and extent of gas production, total volatile fatty acids, and ammonia N increased linearly (P<0.01), but microbial protein concentration decreased (quadratic, P<0.01), with the maximum value at a ratio of 40% wheat. The efficiency of N utilization decreased linearly (P<0.01). Rumen fermentation and N utilization were significantly affected by the concentrate-to-forage ratio (P<0.01). Significant interactions between the concentrate-to-forage ratio and the wheat-to-corn ratio were detected in total volatile fatty acids and the efficiency of N utilization (P<0.01). In summary, the starch-protein matrix and starch granules in the wheat and corn endosperm mixture play an important role in the regulation of rumen fermentation and N utilization under low-quality forage.

Band enhanced ultra-broadband terahertz absorber based on a high-impedance surface and cavity resonance

This paper demonstrates a band enhanced ultra-broadband terahertz absorber (UBTA) based on a high-impedance surface and cavity resonance; the absorber consists of a high-impedance surface and a metallic plate spaced by a dielectric spacing layer. Simulations indicate that ultra-broadband absorption over 90% from 4.65 to 8.86 THz is realized by the high-impedance surface. It is noted that the absorption is further broadened by inserting air cylinders (ACs), thus showing that the absorption rate exceeds 90% from 5.35 to 13.08 THz. The simulations also demonstrate that the UBTA can achieve high absorption under wider incident angles. Moreover, surface current, electric field distribution, and power loss density are simulated to expound the physical mechanism.

[Clinical management of 110 cases of polypropylene mesh and sling exposure after reconstructive pelvic floor surgery]

Objective: To explore the clinical management and outcomes of polypropylene mesh and sling exposure after reconstructive pelvic surgery (RPS) . Methods: A total of 110 cases of mesh and sling exposure after RPS were analyzed, who admitted between Jan. 2002 and Oct. 2017 in First Affiliated Hospital of PLA General Hospital, in which 3 cases were referred from other hospitals. Mesh and sling exposures were identified in the outpatient clinic and categorized and managed according to International Continence Society and International Urogynecology Association (ICS-IUGA) classification about category, time and site (CTS) of mesh complication. Outpatient management included observation, topical estrogen use and mesh removal. Management in hospital included surgical removal of exposed mesh and repair of the resulting defects under the anesthesia. Seventy-four cases were managed in the outpatient setting, and 36 cases required inpatient management. Follow-up was consecutively performed from 1 month to 10 years. Objective outcome included the surgeon's assessment of the healing state of the vaginal mucosa. Subjective outcome was evaluated with patient global impression of improvement questionnaire (PGI-I) . Results: One hundred and ten patients with mesh exposure were classified according to the different RPS underwent. There were 95 cases from transvaginal mesh surgery, 5 cases from anti-stress urinary incontinence sling surgery, and 10 cases from sacrocolpopxy. The outpatient group healed at an average of (3.0±1.8) months. Of the 36 patients who required inpatient management, 21 cases healed completely at an average of 7 days after one surgery. The remaining 8 cases required either two or three times surgeries or conservative management. In the outpatient group, the PGI-I scale very much better was found in 65 cases (87.8%) and much better in 9 cases (12.2%) . In the inpatient surgery group, the scale was very much better in 30 cases (83.3%) , and much better in 6 cases (16.7%) . Conclusions: Among patients with mesh exposure after mesh-augmented RPS, 2/3 of patients with a CTS classification 1-3 could be managed in the office, and remaining 1/3 with CTS classification 4-6 need operation under anesthesia in hospital. If the mesh and sling exposure could be scientifically classified, according to the size, site and accompany symptoms, as well as pain, most of the mesh complications after explosure could be resolved. Using the pelvic floor repair and polypropylene mesh sling, the majority of the patients could get a better outcome, without affecting the effect of the original operation.

The particulate passage rate, nutrient composition and fermentation characteristics across gastrointestinal tracts in lactating dairy cows fed three different forage source diets

This study was conducted to investigate the particulate passage rate, nutrient characteristics and fermentation parameters across the gastrointestinal tract (GIT) in lactating dairy cows fed cereal straws in comparison with alfalfa hay. Eighteen multiparous Holstein cows were randomly assigned to one of three experimental diets consisting of 55% concentrate, 15% corn silage and 30% different forage sources as follows (% of dry matter [DM]): (i) 23% alfalfa hay and 7% Chinese wild rye hay (AH); (ii) 30% corn stover (CS); and (iii) 30% rice straw (RS). The Cr-mordanted corn silage-neutral detergent fibre was used to estimate the passage flow at week 14. After 14-week feeding, the animals were slaughtered to collect the gastrointestinal digesta. Dietary forage sources had little effect on the fractional passage rates in the rumen (range from 5.05 to 6.25%/hr) or hindgut (range from 4.49 to 5.24%/hr). Total volatile fatty acid (VFA) concentration in the caecum was highest, followed by the rumen, colon and rectum, and the lowest in the abomasum and duodenum, indicating that the large intestines, especially caecum, are the important positions for carbohydrate degradation. Greater proportion of propionate and butyrate and lower acetate were found in the AH compared to CS or RS in colon, but higher acetate in abomasum was found in the cows fed CS or RS compared to AH. In conclusion, cereal straw diets did not change the particulate passage rate in the rumen and hindgut which might be mainly due to the similar DM intake among these three diets. Different forage source diets significantly changed VFA proportion in the abomasum and colon, indicating the existence of different digestion or absorption rates in these tracts among the experimental diets.