[Clinical and bacteriological analysis of lymphoid tissue neoplasms patients with bacteria bloodstream infections]

Objective: To investigate the clinical status of lymphoid tissue neoplasms patients with bacteria bloodstream infections, bacteriology and drug susceptibility results, and provide the basis for rational clinical anti-infection option. Methods: A retrospectively analysis of clinical data and bacterial susceptibility test results of patients with bacteria bloodstream infections from September 2010 to December 2014 was conducted. Results: A total of 134 cases including 107 patients with bloodstream infections were enrolled. 84 cases were male, 50 cases were female, the median age was 31 (12-71) years old. 112 cases were agranulocytosis, and 106 cases were severe agranulocytosis (ANC<0.1×10(9)/L) . 27 cases underwent hematopoietic stem cell transplantation, 100 cases received chemotherapy[33 cases with VD (I) CP±L (vincristine+daunorubicin/idarubicin + cyclophosphamide + prednison±asparaginasum) induction chemotherapy, 41 cases with intensive chemotherapy of Hyper-CVAD/MA or MA (mitoxantrone+cytarabine) , 26 cases with other chemotherapy regimens], and 7 cases were infected without chemotherapy. 10 patients discharged from hospital owing to treatment abandoning, 120 cases were cured through anti-infective therapy, 2 patients died of bacteria bloodstream infections, 1 patient died of sudden cardiac, and 1 patient died of GVHD after allogenic hematopoietic stem cell transplantation. A total of 144 strains were isolated, including 108 strains (75.0%) of Gram-negative bacteria and 36 strains (25.0%) of Gram-positive cocci. The susceptibility of Gram-negative bacteria to the carbapenems was 98.00%, and the adjustment treatment rate of carbapenems was 3.0%. The susceptibility of Gram-negative bacteria to the other antibiotics was 60.30%, and the adjustment treatment rate was 90.5%. The susceptibility of Grampositive cocci to the carbapenems was 49.3%, and to glycopeptides and linezolid was 100.0%. Comparing all patients'empirical use of antimicrobial agents with the drugs susceptibility results of blood cultures, 80.1% of the patients'initial drug selection was sensitive. Conclusion: The lymphoid neoplasms patients experienced bacteria bloodstream infections most often after receiving the chemotherapy regimens of treating acute lymphoblastic leukemia. The majority type of bacteria was Gram-negative bacteria. Drug susceptibility test showed that susceptibility of Gram-negative bacteria to the carbapenems was the highest, and the treatment adjustment rate was obviously lower. The susceptibility of Gram-positive cocci to glycopeptides and linezolid was high, and which could be applied to the patients with Gram-positive cocci sepsis on basis of susceptibility results in general.

[Technical guidelines for seasonal influenza vaccination in China (2018-2019)]

Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4), including split-virus influenza vaccine and subunit vaccine. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)" . The main updates in this version include: epidemiology, disease burden, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, IIV3 and IIV4 immune response, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The influenza vaccine TWG provided the recommendations for influenza vaccination for the 2018-2019 influenza season based on existing scientific evidence. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2017-2018 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels.

Nanocrystalline Sb-doped SnO2 films modified with cyclometalated ruthenium complexes for two-step electrochromism

Sb-Doped nanocrystalline SnO2 (SnO2:Sb) thin films functionalized with cyclometalated ruthenium complexes 1 or 2 on FTO conductive glasses have been prepared and characterized. These complexes contain a redox-active amine unit separated from the ruthenium ion by a phenyl or biphenyl linker, respectively, to modify the absorption wavelengths at different redox states. Near-infrared electrochromism of both films has been examined by oxidative spectroelectrochemical measurements and double-potential-step chronoamperometry. A contrast ratio (ΔT%) of 33% at 1070 nm and 63% at 696 nm has been achieved for the SnO2:Sb/1 film in two stepwise oxidation processes, respectively. The other film with complex 2 shows two-step electrochromism at 1310 and 806 nm with ΔT% of 36% and 76%, respectively. The response time of electrochromic switching is around a few seconds. Taking advantage of the good contrast ratio, the rapid response, and the long retention time of each oxidation state, these films have been successfully used to demonstrate surface-confined flip-flop memory functions with a high ON/OFF ratio.

Electrochromism in Electropolymerized Films of Pyrene-Triphenylamine Derivatives

Two star-shaped multi-triphenylamine derivatives 1 and 2 were prepared, where 2 has an additional phenyl unit between a pyrene core and surrounding triphenylamine units. The oxidative electropolymerization of 1 and 2 occurred smoothly to give thin films of polymers P1 and P2. The electrochemistry and spectroelectrochemistry of P1 and P2 were examined, showing two-step absorption spectral changes in the near-infrared region. The electrochromic properties, including contrast ratio, response time, and cyclic stability of P1 and P2 were investigated and compared. Thin film of P2 displays slightly better electrochromic performance than P1, with a contrast ratio of 45% at 1475 nm being achieved.

Substituent Effects on the Electrochemistry and Electronic Coupling of Terphenyl-Bridged Cyclometalated Ruthenium-Amine Conjugated Complexes

Six terphenyl-bridged cyclometalated ruthenium-amine conjugated complexes 4(PF6)-9(PF6) were synthesized and studied. Three different substituents, methoxy, methyl, and chloro, were used to vary the electronic nature of the amine unit, and two terminal ligands 2,2':6',2″-terpyridine (tpy) and trimethyl-4,4',4″-tricarboxylate-2,2':6',2″-terpyridine (Me3tctpy) were used to tune the electronic nature of the ruthenium component. All complexes, except 7(PF6) with the methoxy substituent and Me3tctpy ligand, display two well-separated redox waves in the potential range of +0.5 to +1.1 V versus Ag/AgCl. The regular electrochemical changes of these complexes help to establish the oxidation order of ruthenium and amine and hence of the direction of the electron transfer in odd-electron state. The degree of electronic coupling was estimated by analyzing the donor-to-acceptor charge transfer band in the near-infrared region obtained by oxidative spectroelectrochemical measurements. Electron paramagnetic resonance analyses and density functional theory calculations were performed on the one-electron oxidized forms to obtain information on the spin distribution of these complexes.

[Current situation and challenges on the implementation of prevention and control programs regarding the seasonal influenza, in China]

In China, the control and prevention programs on any disease has always been based on comprehensive strategies. Take influenza as an example, related contents would include: strengthening the surveillance, recommendation and promotion of vaccination, rational use of antiviral drugs, conducting outbreak investigation and control, and publicizing individual protective measures, etc. In terms of the response to challenges, specific proposals would include: adjustment of case reports, optimization of surveillance systems, reinforcement of vaccination recommendation by health care workers, improvement of access to vaccination, development of rapid diagnostic reagents, and rational use of antiviral drugs, etc.

[Oncological safety and prognosis factors analysis of immediate breast reconstruction after nipple-areola-complex sparing mastectomy]

Objective: To explore the oncological safety of immediate breast reconstruction after nipple-areola complex(NAC) sparing mastectomy(NSM+ IBR) in patients with early stage breast cancer, and to analyze the prognostic factors of NSM+ IBR. Methods: From January 2004 to December 2015, the clinical data of 118 cases of stage Ⅰ-ⅡA breast cancer who had undergone NSM+ IBR in Tianjin Tumor Hospital were collected, comparing with 75 cases of Ⅰ-ⅡA breast cancer patients who had undergone immediate breast reconstruction after modified radical mastectomy (MRM+ IBR) at the same period. In addition to the prognosis of these two groups, the prognostic factors were also retrospectively analyzed. Results: The median follow-up were 53 months in the NSM+ IBR group and 51 months in the MRM+ IBR group, respectively. In the NSM+ IBR group, local recurrence, distant metastasis, death and NAC necrosis occurred in 4, 6, 9 and 4 cases during 3 years after operation, respectively. The local recurrence rate (LRR) was 3.4%, 3-year disease-free survival (DFS) rate was 91.5%, and the overall survival (OS) rate was 92.4%. In the MRM+ IBR group, local recurrence, distant metastasis, and death occurred in 1, 4, and 3 cases during 3 years after operation, respectively. The LRR was 1.3%, 3-year DFS was 93.3%, whereas the OS rate was 96.0%. No statistical difference was noted between the two groups (all P>0.05). That HER-2 positive and molecular type correlated with the 3-year DFS (P<0.05) independently and molecular type correlated with OS (P<0.05) independently in the NSM+ IBR group. Conclusions: NSM does not impair patients' prognosis and could ensure oncological safety of patients with early stage breast cancer. IBR could improve female patients' figure and ensure the quality of life. HER-2 status and molecular type are the independent prognostic factors of the 3-year DFS. Molecular type is the independent prognosis factor of OS.

Risk factors for late-onset hypogonadism

The European Male Aging Study (EMAS) has recently defined strict diagnostic criteria for late-onset hypogonadism (LOH) including the levels of serum total testosterone (TT), free testosterone (FT) and three sexual symptoms. However, there is no report on risk factors for LOH using these criteria. In this study, we investigated risk factors for LOH based on these criteria. We recruited 277 men (aged 36-80 years) who completed both a health check-up and two questionnaires (a health and lifestyle questionnaire, and a sexual function questionnaire). Data on parameters, such as systolic blood pressure (SBP), glucose, triglyceride (TG) and high-density lipoprotein (HDL), were obtained from medical records of the hospital in Shantou. TT and sex hormone-binding globulin (SHBG) were measured by chemiluminescent immunoassay, and FT was calculated. TT, FT, age, waist circumference, SBP and glucose showed significant differences between LOH-positive and LOH-negative individuals. Univariate regression analyses showed that age, waist circumference, SBP, glucose and health status were risk factors for LOH. Pearson's correlation analysis revealed that TT was inversely correlated with waist circumference, glucose and SBP, and FT was inversely correlated with age, SBP and health status. In conclusion, age, waist circumference, SBP, glucose and health status were risk factors for LOH.

[The effect of axillary lymph node status on the prognosis of patients with local-regional recurrence after breast-conserving surgery]

Objective: To investigate the effect of axillary lymph node status in evaluating the prognosis of patients with local recurrence after breast-conserving surgery. Methods: The clinical data of 72 patients with local-regional recurrence who had undergone breast-conserving therapy in Tianjin Cancer Hospital from February 2001 to December 2009 were collected and retrospectively analyzed. These patients were divided into axillary lymph node positive group (23 cases) and negative group (49 cases), according to their axillary lymph node status. Results: Among 72 patients, 21 cases were local recurrence, 35 cases were regional recurrence, and 16 cases were local-regional recurrence. In the axillary lymph node positive group, 7 cases were local recurrence, 10 cases were regional recurrence, 6 cases were local-regional recurrence. In the axillary lymph node negative group, 14 cases were local recurrence, 25 cases were regional recurrence, 10 cases were local-regional recurrence. There was no significant difference between these two groups (P=0.807). Moreover, no significant differences of the age, recurrent site, estrogen receptor (ER) and/or progesterone receptor (PR) status, human epidermal growth factor receptor 2 (HER-2) status, disease-free period, local and systemic therapeutic effect, non-distant metastasis survival between these two groups were observed (P>0.05). However, the overall survival of axillary lymph node positive group after recurrence was significantly lower than that of negative group (P=0.014). Cox multivariate analysis showed that recurrent site is an independent prognostic factor of disease-free survival of patients with regional recurrence after breast-conserving surgery (OR=2.050, P=0.002). The axillary lymph node status and recurrent site were independent prognostic factors of overall survival of these patients (OR=3.469, P=0.003; OR=3.676, P<0.001). Conclusions: Axillary lymph node status is an independent factor of overall survival of patients with regional recurrence after breast-conserving surgery, but it is marginally related with their non-distant metastasis survival.

[The long-term effect analysis of the tongue base traction/ hyoid suspension with Repose system in multiplanar surgery]

Objective:To explore the long-term effect of Repose bone screw system in the treatment of severe obstructive sleep apnea syndrome in patients with severe obstructive sleep apnea. Method:The follow-up group was divided into the short-term (<12 months, control group, 30 cases) and the long-term (more than 12 months, observation, 46 cases). And compared the operation effect of the two groups. Furthermore, the parameters and related factors of surgical efficacy of patients with different follow-up time and different surgical methods were further analyzed.Result:①There was no statistical difference in the preoperative parameters of the two groups, and the overall efficiency of the postoperative long-term observation group was 78.3%, compared with 90.0% in the short-term control group, and the inefficiencies increased from 10.0% to 21.7%. ②In the observation group, the mean of the AHI increased gradually with the follow-up time, and the blood oxygen gradually decreased. The effectiveness of the surgical treatment gradually decreased, the total efficiency of the tongue base traction group decreased from 100% to 60%, and the hyoid suspension group decreased from 94.4% to 77.8%. ③And 15 patients with a second review X-head shadow measurements,we found there are statistically significant (P<0.05) in vallecula epiglottica-lateral pharyngealwall,pharyngeal airway space. Conclusion:Repose screw system of tongue base traction/ hyoid suspension technique is positive in the treatment of severe OSAHS lingual pharyngeal plane obstruction, but short-term surgical results are not stable.

[Temporal-spatial analysis of bacillary dysentery in the Three Gorges Area of China, 2005-2016]

Objective: To analyze the spatial and temporal distributions of bacillary dysentery in Chongqing, Yichang and Enshi (the Three Gorges Area) from 2005 to 2016, and provide evidence for the disease prevention and control. Methods: The incidence data of bacillary dysentery in the Three Gorges Area during this period were collected from National Notifiable Infectious Disease Reporting System. The spatial-temporal scan statistic was conducted with software SaTScan 9.4 and bacillary dysentery clusters were visualized with software ArcGIS 10.3. Results: A total of 126 196 cases were reported in the Three Gorges Area during 2005-2016, with an average incidence rate of 29.67/100 000. The overall incidence was in a downward trend, with an average annual decline rate of 4.74%. Cases occurred all the year round but with an obvious seasonal increase between May and October. Among the reported cases, 44.71% (56 421/126 196) were children under 5-year-old, the cases in children outside child care settings accounted for 41.93% (52 918/126 196) of the total. The incidence rates in districts of Yuzhong, Dadukou, Jiangbei, Shapingba, Jiulongpo, Nanan, Yubei, Chengkou of Chongqing and districts of Xiling and Wujiagang of Yichang city of Hubei province were high, ranging from 60.20/100 000 to 114.81/100 000. Spatial-temporal scan statistic for the spatial and temporal distributions of bacillary dysentery during this period revealed that the temporal distribution was during May-October, and there were 12 class Ⅰ clusters, 35 class Ⅱ clusters, and 9 clusters without statistical significance in counties with high incidence. All the class Ⅰ clusters were in urban area of Chongqing (Yuzhong, Dadukou, Jiangbei, Shapingba, Jiulongpo, Nanan, Beibei, Yubei, Banan) and surrounding counties, and the class Ⅱ clusters transformed from concentrated distribution to scattered distribution. Conclusions: Temporal and spatial cluster of bacillary dysentery incidence existed in the three gorges area during 2005-2016. It is necessary to strengthen the bacillary dysentery prevention and control in urban areas of Chongqing and Yichang.

Dynamics of methanogenesis, ruminal fermentation, and alfalfa degradation during adaptation to monensin supplementation in goats

This study aimed to examine the temporal (hourly within a day and daily over the long term) effects of monensin on CH₄ emissions, ruminal fermentation, and in situ alfalfa degradation in dairy goats during dietary monensin supplementation by controlling the confounding effects of feed intake and ambient temperature. Six ruminally cannulated dairy goats were used, and they were housed in environmental chambers and fed a restricted amount of ration throughout the experiment. The experiment included a baseline period of 20 d followed by a treatment period of 55 d with 32 mg of monensin/d. During the whole experiment, CH₄ production was measured every 5 d, whereas fermentation characteristics and in situ alfalfa degradation were analyzed every 10 d. The CH₄-depressing effect of monensin was time dependent on the duration of treatment, highly effective at d 5 but thereafter decreased gradually until d 55 even though CH₄-suppressing effect still remained significant. The decreasing effects of monensin on ruminal acetate proportion and acetate to propionate ratio also faded over days of treatment, and the acetate proportion returned up to the pre-supplementation level on d 50. Monensin supplementation elevated ruminal propionate proportion and decreased the effective ruminal degradability of alfalfa NDF, but both measurements tended to recover over time. The postprandial increase rate of hourly CH₄ emissions was reduced, whereas that of propionate proportion was enhanced by monensin supplementation. However, the postprandial responses to monensin in CH₄ emission rates, ruminal VFA profiles, and in situ degradation kinetics declined with both hours after feeding and days of treatment. Our results suggest that the CH₄-suppressing effect of monensin supplementation in goats was attributed to reductions in both ruminal feed degradation and acetate to propionate ratio, but those reductions faded with time, hours after feeding, and days of treatment.

[Investigation of human brucellosis diagnosis and report quality in medical institutions in key areas of Shanxi province]

Objective: To evaluate the accuracy of human brucellosis diagnosis and reporting in medical institutions in Shanxi province, and understand the performance of clinical doctors to diagnose human brucellosis according to diagnostic criteria. Methods: Field investigation was conducted in 6 medical institutions in the key areas of human brucellosis in Shanxi province. The diagnosis data of the reported brucellosis cases in 2015 were collected and reviewed retrospectively for the evaluation of the diagnosis accuracy with systematic sampling method. The database was established with Excel 2010 and the descriptive analysis and statistical test were conducted with software R 3.3.2. Results: The diagnosis consistent rate of the 377 brucellosis cases reviewed was 70.8% (267/377), the diagnosis consistent rates in medical institutions at city-level and country-level were 77.0% (127/165) and 66.0% (140/212) respectively, the differences had significance (χ(2)=5.4, P=0.02). Among the reviewed cases, the diagnosis consistent rate of laboratory diagnosis and clinical diagnosis were 87.1% (256/294) and 13.3% (11/83) respectively, and the differences had significance (χ(2)=170.7, P<0.001). Among the 21 investigated clinical doctors, the numbers of the doctors who correctly diagnosed the suspected cases, probable cases and lab-confirmed cases were only 3, 0 and 8 respectively. All of the clinical doctors knew that it is necessary to report the brucellosis cases within 24 hours after diagnosis. Conclusion: The accuracy of human brucellosis diagnosis in key areas of human brucellosis in Shanxi was low, and the performance of the clinical doctors to diagnose human brucellosis according to diagnostic and case classification criteria was unsatisfied.

[Effect of different tourniquet releasing strategy on blood loss in total knee arthroplasty]

Objective: To explore the influences on peri-operative blood loss and postoperative blood transfusion in primary total knee arthroplasty when using different methods to release the pneumatic tourniquet. Methods: From January 2015 to December 2016, 484 patients with osteoarthritis were enrolled, undergoing primary unilateral total knee arthroplasty in the Orthopedics Department of Peking University Third Hospital. Retrospective data was used, and all the patients had been operated on by three independent working groups. Group A was the strategic tourniquet release group. After the completion of all osteotomy and soft tissue balance, the tourniquet was released for five minutes for coagulation of bleeding tissue and was then inflated again before component cementation untill the end of the operation. In Group B, full-time tourniquet usage was applied to patients, and was just released post wound closure and pressure dressing. In Group C, the tourniquet was inflated from the beginning of incision to the end of cementation. It was then released after the prosthesis was cemented. A series of data in these three groups were observed and recorded, including output of drain, decrease of hemoglobin level in the first and third day after operation, the total measured blood loss, the hidden blood loss, the number of transfused patients, and the rates of allogenic blood transfusion. Results: The decrease of hemoglobin level in the first day after operation, the output of drain and the total level of measured blood loss were slightly higher in Group A. The decrease of hemoglobin level in the third day after operation and the hidden blood loss was slightly higher in Group B. Group C had the lowest total measured blood loss and hidden blood loss among the three groups. However, no significant differences of outcomes were observed among these groups. A total of 29 patients received blood transfusion(Group A 10/165, 6.1%; Group B 11/177, 6.2%; Group C 8/142, 5.6%). There was no significant differences among the three groups in output of drain(P=0.496), decrease of hemoglobin level(P=0.242), total measured blood loss(P=0.390), hidden blood loss(P=0.204), or postoperative blood transfusion rate(P=0.976). Conclusions: Under the routine application of the multimodal blood-loss prevention approach, including tranexamic acid, drain under atmospheric pressure, compression and cryotherapy after operation, the different choices of tourniquet releasing strategies have no significant effect on peri-operative blood loss or postoperative blood transfusion rate in total knee arthroplasty.

[Epidemiological characteristics of diarrheagenic Escherichia coli among diarrhea outpatients in China, 2012-2015]

Objective: To understand the epidemiological characteristics of diarrheagenic Escherichia (E.) coli (DEC) among diarrhea outpatients in China. Methods: Diarrhea surveillance program was conducted in outpatient and emergency departments from 170 hospitals that under the sentinel programs in 27 provinces, from 2012-2015. Clinical and epidemiological data regarding diarrhea patients were collected, with fecal specimens sampled and tested for DEC in 92 network-connected laboratories. Results: Among all the 46 721 diarrhea cases, 7.7% of them appeared DEC positive in those with geographic heterogeneity. In 2 982 cases (6.4%) with available data on PCR subtypes of DEC, enteroaggregative E. coli (EAEC, 1 205 cases, 40.4%) appeared the most commonly seen pathogens, followed by enteropathogenic E. coli (EPEC, 815 cases, 27.3%), and enterotoxigenic E.coli (ETEC, 653 cases, 21.9%). The highest positive rate of DEC was observed in outpatients of 25-34 years old (10.1%), living in the warm temperate zones (11.1%), and with mucous-like stool (9.4%). The positive rate of DEC showed a strong seasonal pattern, with peaks in summer, for all the subtypes. Conclusions: DEC seemed easy to be detected among diarrhea outpatients in China, with EAEC, EPEC and ETEC the most commonly identified subtypes. Epidemiological characteristics regarding the heterogeneities of DEC appeared different, in regions, age groups and seasons. Long-term surveillance programs should be strengthened to better understand the epidemiology of DEC, in China.

[Management of T3 supraglottic carcinoma: a retrospective study]

Objective: To discuss the strategy of therapeutic management of T3 supraglottic carcinoma. Methods: A retrospective analysis of 459 patients with T3 supraglottic carcinoma treated in our hospital was performed. We evaluated the results of different managements, including surgery alone, preoperative radiotherapy, postoperative radiotherapy and radiotherapy alone. The extent of the lesion was also put into analysis. Statistical analysis of the overall survival (OS), cause-specific survival (CSS), local control (LC), regional control(RC), function-conservation (FC) were performed with the statistical package from SPSS. Results: In all patients, the rates of 5-year OS, CSS, LC, RC and FC were 64.2%, 71.2%, 87.8%, 78.8% and 64.5% respectively. The OS, LC and FC of the patients treated by surgery alone, preoperative radiotherapy and postoperative radiotherapy had no significant difference, and were remarkably better than that of patients treated by radiotherapy alone (P<0.001). In 412 patients treated by surgery, 300 patients received function-conservation laryngectomy. 209 patients (50.7%, 209/412) survived and maintained well-function of larynx for 5 years, which was significantly better than those in the radiotherapy alone group (27.7%, 13/47). The patients with the lesion invading the pre-epiglottic space but limited in supraglottic area had better OS (70.2%), LC (93.5%) and FC (85.1%). The rate of 5-year neck lymphatic metastasis was 56.2%(258/459), and the 5-year OS of patients with N0, N1, N2 and N3 stage were 76.0%, 66.2%, 50.5% and 13.0% respectively. Conclusions: Surgical treatment was the best therapeutic approach for T3 supraglottic laryngeal carcinoma. Most patients with T3 lesions are suitable for function-conservation laryngectomy. Surgical procedure was determined by tumor invaded location and extension. The combined therapy of surgery and radiotherapy had no significant advantage.

[Long-term follow-up of multiple myeloma after autologous hematopoietic stem cell transplantation: a single center results]

目的

评价诱导治疗联合自体周血造血干细胞移植（ASCT）治疗、移植后巩固维持治疗的整体方案治疗多发性骨髓瘤（MM）患者的有效性和长期随访结果。

方法

回顾性分析2005年1月1日至2016年2月1日接受整体方案治疗的144例MM患者资料，总结其长期随访结果，分析移植前疗效、移植后缓解深度，以及早期移植、晚期移植、不同预后分期系统等因素对患者生存的影响。

结果

144例患者中获得部分缓解（PR）以上治疗反应率为89.4%[完全缓解（CR）率64.1%]。中位随访47（6~121）个月，患者中位总体生存（OS）和无进展生存（PFS）时间分别为120.9和56.9个月；早期和晚期移植组患者的中位OS分别为120.9和50.1个月，中位PFS时间分别为60.2和16.7个月（P值均<0.001）。127例可进行修订的国际分期系统（R-ISS）分期患者中，Ⅰ期（43例）、Ⅱ期（64例）、Ⅲ期（20例）患者的中位OS时间分别为120.9、88.4、35.6个月，组间差异有统计学意义（P=0.000）。对早期和晚期移植组患者进行亚组生存分析，R-ISS Ⅲ期患者中位OS时间差异有统计学意义（35.6个月对15.8个月，P=0.031）；两组患者各期中位PFS时间差异均有统计学意义（Ⅰ期：72.1个月对18.9个月；Ⅱ期：53.4个月对16.7个月；Ⅲ期：28.5对5.9个月，P值分别为0.000、0.012、0.001）。多因素分析结果显示R-ISS Ⅲ期是影响患者OS的危险因素（HR=8.486，95%CI 2.549~28.255，P=0.003），移植后未获得CR是影响患者PFS的危险因素（HR=2.412，95%CI 1.364~4.266，P=0.002）。

结论

以新药为基础的化疗联合ASCT的整体治疗方案对适合移植的MM患者是有效的，可进一步提高缓解率和缓解深度，延长患者的PFS和OS时间。早期较晚期移植可明显延长患者的OS和PFS时间。R-ISS分期和移植前疗效是影响患者生存的预后因素。

[Outcomes of lenalidomide-based treatment for 57 patients of relapsed or refractory multiple myeloma]

目的

探讨来那度胺（商品名瑞复美）为基础的化疗方案在复发或难治性多发性骨髓瘤（MM）患者中的疗效及安全性。

方法

回顾性分析2013年6月至2016年2月收治的57例应用来那度胺为基础的方案治疗的复发或难治性MM患者资料。

结果

①国际分期系统（ISS）Ⅲ期患者比例为60.4%，修改的国际分期系统（R-ISS）Ⅲ期患者比例为37.9%，53.3%的患者存在高危遗传学异常。②患者应用来那度胺中位疗程为6（1~32）个。治疗的总体缓解率（ORR）为58.9%（33/56），其中完全缓解率为8.9%，非常好的部分缓解率为19.8%，部分缓解（PR）率为30.4%。此外有10.7%（6/56）的患者达到微小缓解，临床获益率69.6%。前期接受一线以上治疗、既往沙利度胺耐药及R-ISS Ⅲ期患者ORR较低。③中位随访27个月，患者中位无进展生存（PFS）时间8个月，中位达PR时间2个月，中位缓解持续时间（DOR）8个月，中位总体生存（OS）时间19个月。单因素分析中，染色体核型异常、R-ISS分期Ⅲ期、疗效未达PR及以上是影响患者PFS和OS的不良因素。多因素分析显示，染色体核型异常、R-ISS分期Ⅲ期具有独立预后意义。④安全性分析显示，最常见的3/4级非血液学不良反应为感染（17.5%）、皮疹（1.8%）、血栓（1.8%）。最常见的3/4级血液学不良反应为中性粒细胞减少（7.0%）和血小板减少（3.5%）。共有3例（5.3%）患者因不良反应停药。共观察到第二肿瘤2例（3.5%）。

结论

来那度胺为基础的化疗方案在复发或难治性MM患者中有效率高、耐受性良好。预后因素分析显示，在这一患者群体中染色体核型异常、R-ISS分期Ⅲ期是独立预后不良因素。

Genetic diversity of mtDNA D-loop sequences in four native Chinese chicken breeds

1. To explore the genetic diversity of Chinese indigenous chicken breeds, a 585 bp fragment of the mitochondrial DNA (mtDNA) region was sequenced in 102 birds from the Xichuan black-bone chicken, Yunyang black-bone chicken and Lushi chicken. In addition, 30 mtDNA D-loop sequences of Silkie fowls were downloaded from NCBI. The mtDNA D-loop sequence polymorphism and maternal origin of 4 chicken breeds were analysed in this study. 2. The results showed that a total of 33 mutation sites and 28 haplotypes were detected in the 4 chicken breeds. The haplotype diversity and nucleotide diversity of these 4 native breeds were 0.916 ± 0.014 and 0.012 ± 0.002, respectively. Three clusters were formed in 4 Chinese native chickens and 12 reference breeds. Both the Xichuan black-bone chicken and Yunyang black-bone chicken were grouped into one cluster. Four haplogroups (A, B, C and E) emerged in the median-joining network in these breeds. 3. It was concluded that these 4 Chinese chicken breeds had high genetic diversity. The phylogenetic tree and median network profiles showed that Chinese native chickens and its neighbouring countries had at least two maternal origins, one from Yunnan, China and another from Southeast Asia or its surrounding area.

[Effect of Liangge powder on expression of inflammatory mediators and hepatic and renal function in rats with sepsis]

Objective: To investigate the effect of Liangge powder on the expression of inflammatory mediators and hepatic and renal function in rats with sepsis via a preliminary analysis. Methods: A total of 195 Wistar rats were randomly divided into sham-operation group (15 rats) , model group (90 rats) , and treatment group (90 rats) using a random number table, and according to the time point after modeling, the model group and the treatment group were further divided into 24, 48, and 72 hour subgroups, with 30 rats in each subgroup. Cecal ligation and puncture (CLP) was performed to establish a rat model of sepsis, and solid-phase sandwich enzyme-linked immunosorbent assay was used to measure the expression of interleukin-10 (IL-10) , interleukin-1 (IL-1) , interleukin-4 (IL-4) , and lipopolysaccharide (LPS) at 24, 48, and 72 hours after CLP. An automatic biochemical analyzer was used to measure the levels of alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , blood urea nitrogen (BUN) , and creatinine (Cr) . Results: Compared with the sham-operation group, the model group had significant increases in the serum levels of IL-1, IL-4, IL-10, LPS, BUN, Cr, AST, and ALT at 24, 48, and 72 hours after CLP (P<0.05) . Compared with the model group, the treatment group had a significant reduction in the serum level of IL-1 at 24, 48, and 72 hours after CLP, a significant increase in the serum level of IL-4 at 24 and 48 hours after CLP, and a significant increase in the serum level of IL-10 and a significant reduction in the serum level of LPS at 24 and 72 hours after CLP (P<0.05) . Compared with the model group, the treatment group had a significant reduction in ALT at 24 hours after CLP, significant reductions in BUN and Cr at 48 hours after CLP, and a significant reduction in AST at 72 hours after CLP (P<0.05) . Conclusion: In the early stage of sepsis, imbalance between pro-inflammation and anti-inflammation and immunosuppression may cause hepatic and renal impairment in rats with sepsis. The traditional Chinese medicine Liangge powder can regulate inflammatory response, restore the balance between pro-inflammation and anti-inflammation, and improve hepatic and renal function in rats with sepsis.

[Analysis on the causes of unscheduled suspensions of knee and hip arthroplasty]

OBJECTIVE

To analyze and summarize the causes of unscheduled suspension of knee and hip arthroplasty and to provide the method for optimizing the patient's preoperative management and improving the efficiency of medical resources as well as the patient's satisfaction.

METHODS

The data for this report was retrospectively collected from September 2013 to August 2014 in our hospital, from cases of knee and hip arthroplasty that were suspended before the scheduled operation time. Acquisition data from the collected cases including the patients' gender, age and the surgical procedure. At the same time, the suspension reasons were recorded and analyzed. All the decisions of suspension was made by the surgeons and the anesthesiologists according to the abnormal result of preoperative examinations, after communicating with the patients and their families and obtaining their understandings.

RESULTS

In the collecting period, our department scheduled 1 146 cases of knee and hip arthroplasty, among which 1 003 were completed, 143 suspended (12.5% suspension rate). Among the causes of suspension, the top four common causes were cardiovascular disease (44/143, 31%), other infections (20/143, 14%), bacteriuria (18/143, 13%) and inappropriate surgical indication (16/143, 11%). Other causes include surgeon's reason, Blood system abnormalities, high inflammatory index, deep vein thrombosis, other diseases uncontrolled, abnormal liver function and poor diabetes mellitus control, etc. For the rate of suspension, there was no significant difference between the patients with different genders (male: 15.0%, and female: 11.7%, P=0.149), or age (≤50 years: 13.0%; 51-65 years: 11.6%; 66-80 years 13.3%; >80 years 11.1%; P=0.864). However compared with knee arthroplasty, hip arthroplasty had a higher suspension rate (knee arthroplasry 11.1%, hip arthroplasry 16.1%, P=0.021).

CONCLUSION

It is important to educate and manage the patients before their knee and hip arthroplasty. Through clear diagnosis, detailed medical history analysis careful physical examination, and targeted outpatient examinations and tests for which priority was focused on cardiovascular or other system diseases we could minimize the occurrence of operative suspension post hospitalization, therefore improving the efficiency of the use of medical resources.

[Epidemiological analysis of the deaths of malaria in China, 2005-2014]

OBJECTIVE

To explore the epidemiological features of deaths of malaria from 2005 to 2014, so as to provide the evidence for subsequently more effective strategic planning of malaria elimination in China.

METHODS

The data of individual malaria cases (including probable and confirmed cases, population data, geographic distribution, diagnosis and reporting information) were obtained from the National Notifiable Infectious Disease Reporting Information System from 2005 to 2014 and the epidemiological investigation information (including the clinical systems and the imported and indigenous cases) was extracted from Parasite Disease Prevention and Control Information System from 2011 to 2014. All of the data didn't include Hongkong, Macao, Taiwan and foreign cases. The population characteristics, clinical systems, geographic distribution, diagnosis and reporting and sources of infections of deaths were analyzed.

RESULTS

From 2005 to 2014, a total of 228 deaths of malaria were reported, with 203 (89.0%) of P. falciparum malaria, 13 (5.7%) of P. vivax malaria, 1 (0.5%) of P. malariae malaria and 11(4.8%) other cases. The fatality rate of malaria increased since 2010. Among the deaths, 48 (81.4% ) had serious complications, which included cerebral lesion, coma, severe renal and hepatic injuries and hemolysis and so on. In 2005-2010, the geographical distribution of malaria deaths was mainly in Yunnan (78 deaths, 56.1%), Sichuan (13 deaths, 9.4%), Henan (7 deaths, 5.0%), Shandong (6 deaths, 4.3%) and Zhejiang (5 deaths, 3.6%) province. However, since the initiation of malaria elimination program in 2010, the areas with malaria deaths have changed, which mainly distributed in Henan (10 deaths, 11.2%), Sichuan (9 deaths, 10.1%), Shandong (8 deaths, 9.0%), Jiangsu (7 deaths, 7.9%) and Hunan province (7 deaths, 7.9%). Besides there were nine deaths (10.0%) reported in non-endemic areas of malaria (Beijing, Inner Mongolia, Jilin, and Ningxia) in 2011-2014. The median time from illness onset to diagnosis for deaths was 5.5 (P25-P75: 3.0-8.5) d, which was longer than 3.0 (2.0-6.0)d for survivors. Moreover, for deaths, the median P50 (P25-P75)(6.0, 4.0-9.0 d) from illness onset to diagnosis in 2011-2014 was longer than that in 2005-2010 (5.0, 3.0-9.0 d). Among imported deaths, 77 deaths (90.6%) originated from Africa and 8 deaths (9.4%) from Southeast Asia.

CONCLUSION

Although the reported deaths of malaria were stable in 2005-2014, the geographical distribution of malaria deaths changed significantly and the time from illness onset to the diagnosis was longer since 2010. Special attention should be paid to the diagnosis and treatment of imported cases to reduce the fatality at the malaria elimination stage.

[The progression of parenteral and enteral nutrition based on new guidelines]

As people are getting a better understanding of organism's metabolism and the concept of disease treatment is being continuously updated, parenteral and enteral nutrition become an inter discipline subject that serves for the clinic and involves a number of disciplines. Just in the past five years, related guidelines at home and abroad have been published as much as more than 40. In order to better serve the clinical decision making, this text attempts to give a carding and interpretation from the three aspects of nutrition screening and assessment, the implementing of nutritional intervention and the progress of special nutrition support. It is observed that the standard clinical nutrition diagnosis and treatment process has been formed consensus. But in the practical application, there are still many details need to confirm and further study.

[Monitoring and research on pathogen spectrum in patients with acute diarrhea from sentinel hospital of Zhejiang Province during 2009 to 2014]

Objective: To explore pathogen spectrum constitution of acute diarrhea in outpatient and emergency of Zhejiang Province, and provide basis for treatment, prevention and control of the disease. Methods: During January 2009 to December 2014, we selected seven sentinel hospitals in different regions of Zhejiang, monitored and researched on pathogen spectrum in patients with acute diarrhea from outpatient and emergency. We recorded patients' personal basic information, the main symptoms and signs, and collected stool samples (5 g). Eight kinds of bacteria (Vibrio cholerae, Shigella spp., Salmonella spp., Diarrheagenic E. coli, Vibrio parahaemolyticus, Aeromonas hydrophila, Yersinia enterocolitica and Plesiomonas shigelloides) and five kinds of viruses (Rotavirus, Norovirus, Sappovirus, Astrovirus and Adenovirus) were detected. Chi-square test and Fisher's exact probability method were used to compare different characteristics of patients with single bacterial infection, single virus infection and multiple infection (bacteria-bacteria, bacteria-viruses, virus-virus). Results: During 2009 to 2014, 9 364 fecal samples from acute diarrhea patients were collected and tested, among which 3 500 cases were tested positive, with total positive rate of 37.38%. Positive rates of bacteria and viruses were 13.14% (1 230 cases) and 20.75% (1 943 cases), respectively. Mixed infection positive rate of multiple pathogens was 3.49% (327 cases). Positive rate of Vibrio parahaemolyticus (5.96% , 558 cases) was the highest among bacterial pathogens, followed by pathogenic Escherichia coli (3.86%, 361 cases). Viruses were mainly Norovirus (10.73%, 1 005 cases) and rotavirus (8.35%, 782 cases). A big difference existed in diarrheogenic pathogen spectrum between patients less than 15 years old and patients equal or older than 15 years old. Pathogens for patients less than 15 years old were mainly virus, with the positive rate of 32.69% (1 014 cases). However, the positive rate of bacteria was 16.86% (1 056 cases) in patients equal or older than 15 years old. Single bacterial infection was highest in age group of 25-34 years old (18.62%, 302 cases) , single virus infection was highest in age group of 1-4 years old (41.12%, 435 cases) , and mixed infections of multiple pathogens were mainly existed in age group of 1-4 years old (7.37%, 78 cases) . Pathogen positive rate were increasing year by year. Pathogen positive rate of patients with acute diarrhea has obvious seasonality, with single bacterial infection being highest during July to September and single virus infection being highest during December to March. Pathogen spectrum of outpatient and emergency patients with acute diarrhea in Zhejiang Province changed a little from 2009 to 2014, mainly rotavirus (22.34% (782/3 500)), norovirus (28.71% (1 005/3 500)), vibrio parahaemolyticus (15.92% (558/3 500)) and Escherichia coli (10.31% (361/3 500)). However, pathogen spectrums in different years owned different features. Conclusion: Common pathogens in outpatient and emergency patients with acute diarrhea in Zhejiang Province were tested with significant seasonal epidemic law. The composition of pathogenic spectrum was variant in different age group. Constitutes of major pathogen spectrum in different years differed a little.

Promoter analysis and tissue expression of the chicken ASB15 gene

1. This study was conducted to explore the promoter region of the chicken ASB15 gene by detecting the activities of the dual luciferase reporter gene and to assess expression profiles of the ASB15 gene in 10 different tissues from Gushi chickens. 2. Five dual luciferase reporter gene vectors were constructed and transfected into DF1 cells. The activities of recombined plasmids were measured and the core promoter was confirmed by bioinformatic analysis. Total RNA was extracted and the relative expression of the ASB15 gene was examined. 3. Data analysis indicated that the promoter was located from -955 to -212 bp. Results showed that the chicken ASB15 gene was expressed in heart, breast muscle and leg muscle. 4. This study has confirmed the promoter region and the expression profile of the chicken ASB15 gene, which provides a foundation for further exploring its transcriptional regulation and function.

[Value of endobronchial ultrasound-guided transbronchial needle aspiration of enlarged mediastinal lymph nodes and analysis of false negative results]

Objective: To explore the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results of EBUS-TBNA. Methods: A retrospective analysis of the clinical and imaging data of 389 patients who underwent EBUS-TBNA for sampling enlarged hilar and mediastinal lymph nodes from October 2009 to October 2015 in Shandong Tumor Hospital, to evaluate its significance in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results. Results: Among the 389 collected cases, positive biopsy results were obtained in 362 cases, and false negative results in 27 cases. The sensitivity, specificity, positive predictive value and negative predictive value were 92.9%, 100%, 100% and 25.0%, respectively. There was a positive correlation between the size of lymph node and biopsy positive rate (P=0.021). The subcarinal lymph nodes had the highest positive rate (97.7%), followed by the paratracheal lymph nodes (91.2%), with a statistically significant difference (P=0.006). The positive rates obtained by cytology (88.7%) and pathology (92.5%, ) showed no significant difference (P=0.065). The positive rate of EBUS-TBNA was not correlated with pathological types (P=0.932). Needle types (21G, 22G) had no significant effect on diagnosis accuracy (P=0.142). Conclusions: EBUS-TBNA is a practical technology for diagnosis of enlarged mediastinal lymph nodes, with unique characteristics such as minimally invasiveness, local anesthesia, good safety and repeatability. Along with the accumulation of surgical experience, improvement of operative skills, more close cooperation between surgeons, cytologists and pathologists, false negative results will be reduced and positive rate of EBUS-TBNA examination will be further improved.

Polymorphisms of Flanking Region of the ASB15 Gene and Their Associations with Performance Traits in Chicken

Research on the identity of genes and their relationship with traits of economic importance in chickens could assist in the selection of poultry. In this study, an F₂ resource population of Gushi chickens crossed with Anka broilers was used to detect single-nucleotide polymorphisms (SNPs) in the flanking region of the ASB15 gene by DNA sequencing and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). One SNP of -1271 C>T in 5' flanking region of the chicken ASB15 gene and two SNPs of the 10618 A>G and 10716 G>A in 3' flanking region were identified. Furthermore, the 10618 A>G and 10716 G>A in 3' flanking region were in complete linkage. Association analysis results showed that -1271 C>T was not associated with performance traits, while the 10618 A>G and 10716 G>A were significantly associated with BW2, 4, 6, 8, 10, 12, SL12, CD8, CW4, 8, 12, BSL4, 8, 12, and SEW, EW, WW, BMW, LW, CW, SFT. Our results suggest that the ASB15 gene profoundly affects chicken performance traits.

[Gastric pull-up reconstruction after pharyngoesphagectomy for advanced hypopharyngeal or cervical esophageal squamous cell carcinoma]

Objective: To analyze the clinical results of gastric pull-up reconstruction following total pharyngoesophagectomy. Methods: A total of 90 patients with hypopharyngeal or cervical esophageal cancinoma who underwent gatric pull-up reconstruction after pharyngoesophagectomy between June 2006 and June 2015 were reviewed retrospectively. Clinical data were analyzed. Rates of survival, recurrence and complicates were calculated with SPSS software. Results: Of 90 patients, 8 patients had hypopharyngeal cancinoma invading cervical esophagus, 51 patients had cervical esophageal carcinoma, and 31 patients had hypophageal and esophageal multiple parimary carcinomas. Forty patients were treated with surgery alone, 29 patients with planned surgery, and 21 patients with salvage surgery. After follow up of 6-104 months with a median of 22 months, 54 patients died and the total 3-year survival rate was 36.3%. Seventeen patients developed local recurrences and 10 patients cervical or mediastinal lymph node metastasis (LNM). The 3-year survival rates of patients with and without recurrence or LNM were respectively 5.9%, and 45.7% (χ²=11.564, P=0.001). Twenty-three patients developed distant metastasis. The 3-year survival rate of patients with and without distant metastasis were respectively 22.9% and 41.8% (χ²=4.534, P=0.033). Multivariate analysis showed local recurrence and distant metastasis as predictors for poor survival. The rates of perioperative mortality and anastomotic fistula were 3.3% (3/90) and 13.3%(12/90), respectively. Conclusions: Gastric pull-up reconstruction is a relatively safe and effective method for esophageal reconstruction after removal of hypopharyngeal or cervical esophageal carcinoma. Some patients could achieve good survival with low mortality and acceptable morbidity after multidisciplinary treatments.

[Using (1)H-nuclear magnetic resonance metabolomics and gene ontology to establish pathological staging model for esophageal cancer patients]

OBJECTIVES

By combining the metabolomics and computational biology, to explore the relationship between metabolic phenotype and pathological stage in esophageal cancer patients, to find the mechanism of metabolic network disturbance and develop a new method for fast preoperative clinical staging.

METHODS

A prospective cohort study (from April 2013 to January 2016) was conducted. The preoperative patients from Sichuan Provincial People's Hospital, who were diagnosed with esophageal cancer from May 2013 to April 2014 were included, and their serum samples were collected to detect (1)H-nuclear magnetic resonance (NMR) metabolomics for the purpose of drawing the metabolic fingerprinting in different stages of patients with esophageal cancer. The data were processed with these methods-principal components analysis: partial least squares regression and support vector machine, for the exploration of the enzyme-gene network regulatory mechanism in abnormal esophageal cancer metabolic network regulation and to build the quantitative prediction model of esophageal cancer staging in the end. All data were processed on high-performance computing platforms Matalab. The comparison of data had used Wilcoxon test, variance analysis, χ(2) test and Fisher exact test.

RESULTS

Twenty patients with different stages of esophageal cancer were included; and their serum metabolic fingerprinting could differentiate different tumor stages. There were no difference among the five teams in the age (F=1.086, P>0.05), the body mass index (F=1.035, P>0.05), the distance from the incisors to tumor (F=1.078, P>0.05). Among the patients with different TNM stages, there was a significant difference in plasma metabolome. Compared to ⅡB, ⅢA, Ⅳstage patients, increased levels of butanone, ethanol amine, homocysteine, hydroxy acids and estriol, together with decreased levels of glycoprotein, creatine, choline, isobutyricacid, alanine, leucine, valine, were observed inⅠB, ⅡA stage patients. Four metabolic markers (ethanol amine, hydroxy-propionic acid, homocysteine and estriol) were eventually selected. gene ontology analysis showed that 54 enzymes and genes regulated the 4 key metabolic markers. The quantitative prediction model of esophageal cancer staging based on esophageal cancer NMR spectrum were established. Cross-validation results showed that the predicted effect was good (root mean square error=5.3, R(2)=0.47, P=0.036).

CONCLUSIONS

The systems biology approaches based on metabolomics and enzyme-gene regulatory network analysis can be used to quantify the metabolic network disturbance of patients with advanced esophageal cancer, and to predict preoperative clinical staging of esophageal cancer patients by plasma NMR metabolomics.

[Isolation and biological characteristics on Yersinia pestis phage YP060]

OBJECTIVE

To isolate and identify the characteristics of Yersinia pestis phage YP060 from mice nests in Yunnan plague focus.

METHODS

Phage YP060 was isolated from Yunnan plague focus by double-layer agar plate method with attenuated vaccine Yersinia pestis strain EV76 as the host bacterium. Phage particle was observed under the electron microscope while biological properties of phage YP060 including lytic capacity, host spectrum, optimal multiplicity of infection (MOI), one-step growth curve, sensitivity to temperature, pH, ultraviolet ray and chloroform etc. were identified.

RESULTS

The particles of phage YP060 presented tadpoles-like features, with optimal multiplicity of infection as 0.1. Latent period and burst period appeared as 50 min and 80 min, respectively. The phage endured the temperature between 30-50 ℃, and it contained a stronger lysis activities in a range of pH 5 to 10. Phage YP060 was sensitive to ultraviolet rays but insensitive to chloroform while presented special lysic ability to Yersinia pestis.

CONCLUSION

Yersinia pestis phage YP060 was isolated for the first time from mice nests in plague natural focus in China. Our findings related to narrow host spectrum and stronger lysis activities.

[Effects of forsythia suspense on the liver gene expression levels of rats with sepsis model]

OBJECTIVE

To study the effects of forsythia extract on the liver gene expression levels of rats with sepsis model.

METHODS

The 90 Wistar rats were randomly divided into three groups: sham operation group (n=30) , sepsis model group (n=30) and forsythia group (n=30). The survival rates at 48 h and 72 h were observed for all groups. The sepsis model and forsythia group rats were prepared by "CLP" method. 72 h later the rats were sacrificed by removed the vertebra. Under sterile conditions,cut the size of about 10 mm×10 mm×3 mm rat liver tissue and placed in liquid nitrogen for use. The same with the sham operation group. The gene expression levels of livers in all groups were detected by the Applications Rat Genome 230 2.0 microarray,and the relative strength of both the fluorescence signal ratio>2 or <-2 screening significantly different genes, by the US National Center for Biotechnology Information (NCBI) database query gene function and classify.

RESULTS

Forsythia group 48 h, 72 h rat mortality rates were 30% and 50%, the sepsis model group 48 h, 72 h rat mortality rates were 46.7% and 70%, two groups 48 h, 72 h mortality rates were compared, the differences were statistically significant (P<0.05). 72 hours after CLP, the genes with up-regulation in sepsis model group/sham operation group and with down-regulation in Forsythia group/sepsis model group were 14. The genes with down-regulation in sepsis model group/sham operation group and with up-regulation in Forsythia group/sepsis model group were 11. The genes involves immune-related genes 8, metabolism genes 5, material transport two related genes, cell adhesion two related genes, cell proliferation, differentiation and apoptosis related genes 4, transcriptional regulation genes 2and other related gene.

CONCLUSION

Forsythia can reduce the 48, 72 h mortality of rats with sepsis and can regulate abnormal sepsis liver genes which associated with tissue immunity, inflammation, metabolism occur regression expression.

Toll-like receptor-4-dependence of the lipopolysaccharide-mediated inhibition of osteoblast differentiation

Bone fractures or bones subjected to open conduction and internal fixation are easily infected by bacteria; bacterial lipopolysaccharide (LPS) has been recognized as an important pathogenic factor affecting bone fracture healing. Therefore, the effect of LPS on bone metabolism is relevant for bone healing. In this study, we investigated the effect of LPS on the expression of Toll-like receptor (TLR)-4 (an LPS receptor) by using real-time quantitative PCR and western blotting. We also examined the regulatory role of LPS in osteoblast differentiation by measuring the ALP activity, matrix mineralization, and ALP, OCN, and Runx2 mRNA (essential factors affecting osteoblast differentiation) expression in LPS-treated mouse osteoblast MC3T3-E1 cells. We also evaluated the effect of TLR-4 on LPS-mediated inhibition of osteoblast differentiation using RNA interference. LPS promotes TLR-4 mRNA and protein expression in MC3T3-E1 cells (P < 0.05, P < 0.01 or P < 0.001), and inhibits osteoblast differentiation by downregulating matrix mineralization and ALP activity (P < 0.05, P < 0.01 or P < 0.001), and suppressing the expression ALP, OCN, and Runx2 mRNA in MC3T3-E1 cells (P < 0.05 or P < 0.01). Conversely, RNAi-mediated TLR-4 knockdown abrogates the LPS-mediated inhibition of osteoblast differentiation (P < 0.05 or P < 0.01). In summary, LPS was shown to inhibit osteoblast differentiation by suppressing the expression of ALP, OCN, and Runx2 in a TLR-4-dependent manner. The results of this study may provide insights into the signal pathway of LPS-induced bone loss or delayed bone fracture healing.

[Clinical analysis of lymphocytic thyroiditis coexistent with papillary thyroid carcinoma]

OBJECTIVE

To analyse the clinical features and treatment strategies of papillary thyroid carcinoma(PTC) coexistent with lymphocytic thyroiditis (LT).

METHODS

A total of 292 patients including 25 males and 267 females with LT and thyroid nodules treated in the department of head and neck surgery between Sep 2011 and Sep 2014 was analysed retrospectively and divided into two groups according to pathological results, of them 262 patients, with a median age of 47 years old, were LT with PTC and 30 patients, with a median age of 54 years old, were LT with benign nodules. Among 262 patients having LT with PTC, 259 were diagnosed as having malignant or suspicious malignant nodules and 3 having benign nodules with ultrasound before surgery, 98 cases were considered multifocal malignant nodules by preoperative ultrasound, and 112 cases were positive in cervical lymph nodes, including bilateral positive in 37 cases. Of 30 patients having LT with benign nodules, 14 were diagnosed malignant or suspicious malignant nodules and 16 benign nodules.

RESULTS

The mean age in 262 patients with PTC was less significantly than that in 30 patients with benign nodules (P<0.05). Ultrasound showed a high proportion of calcification and microcalcification in patients with PTC (34%) compared to patients with benign nodules(13%)(P<0.05). There were not significant differences in the mean levels of serum thyroid stimulating hormone(TSH) (2.80 vs 2.99 mU/L, P=0.233), thyroglobulin(TG) (27.14 vs 18.60 μg/L, P=0.747), and anti-thyroglobulin antibodies(ATG)(417.3 vs 378.7 U/ml, P=0.834) between patients with PTC and those with benign nodules. In patients with PTC, multifocal tumor accounted for 42%. The central and lateral lymph node metastasis rates were respectively 50% and 24%, and the occult metastasis rate of lateral neck lymph node was 16%. Univariate analysis showed that age less than 45 years old, multifocal tumor, tumor diameter more than or equal to 2cm and extrathyroidal extension were associated with central lymph node metastasis (P<0.05), but not with lateral neck metastasis. Multivariate analysis showed a closed correlation only between the lymph node metastases in central and lateral neck levels (P<0.05).

CONCLUSIONS

Calcification and microcalcification have the same importance in the ultrasonic diagnosis for PTC in patients with LT. Total thyroidectomy and prophylactic central lymph node should be a choice for LT with PTC. Lymph node metastasis in level Ⅵ indicates the possibility of lateral cervical lymph node metastasis in the patients having LT with PTC.

[Epidemic features and impact factors on hospitalization of Plasmodium vivax in China 2011-2014]

OBJECTIVE

To investigate the epidemiological characteristics and impact factors on hospitalization of Plasmodium vivax (P.vivax) since initiation of national malaria elimination program, so as to facilitate the adjustment of technical guideline in response to the epidemic changing of malaria in China.

METHODS

The data of individual P. vivax case (probable and confirmed) and population during 2011-2014 were collated from China National Notifiable Infectious Disease Reporting Information System, and the data of epidemiological investigation for individual P. vivax case (imported and indigenous) during 2011-2014 were collected from China Parasite Disease Prevention and Control Information System. All of the data didn't include China's Hongkong, Macao, Taiwan and foreign cases. The risk factors on hospitalization were explored by multiple factors variable binary classification unconditioned logistic regression model.

RESULTS

During study period of four years, a total of 5 656 Plasmodium vivax cases were detected. Among them, 69.9% (3 951 cases) were imported cases and 30.1% (1 705 cases) were autochthonous cases. The male cases accounted for 82.7% of all cases. Among the autochthonous cases, 535 cases (31.4%) occurred in the cross-bordering areas, and 577 cases (33.8%) were reported in the junction of difference provinces. The amount of autochthonous cases decreased from 1 363 cases in 2011 to 53 cases in 2014, and the county affected by autochthonous cases was shrunk from 185 counties to 10 counties. The proportion of autochthonous cases introduced by domestic migrants increased constantly, which reached 41.5% in 2014. The imported cases were detected from 614 counties of 30 provinces, who were originated from 57 overseas countries of 4 continents, with Southeast Asia being the leading origins (2 772 cases, 70.2%). There were 1 494 cases hospitalized for treatment, with the male (OR=1.41, 95%CI: 1.16-1.71), 14 years old and younger (OR=2.26, 95%CI: 1.44-3.56), and oversea imported cases (OR=2.73, 95%CI: 2.30-3.25) were the high risk group for hospitalization.

CONCLUSION

The scale and scope of P. vivax occurrence decreased dramatically since initiation of malaria elimination grogram in 2010. However, the risk of P. vivax introduction by the overseas imported cases and domestic migrants should be highlighted.

[Comparison of demographical characteristics of malaria cases from malaria control to elimination in China]

OBJECTIVE

To further identify the high-risk population at malaria elimination phase, and to provide the scientific evident for targeted prevention and control measures, we compared the demographical feature and its change trend for malaria cases between malaria control stage and elimination stage in China.

METHODS

The data of individual case (probable and confirmed) and population during 2007-2014 were collected from China National Notifiable Infectious Disease Reporting Information System, and the data of epidemiological investigation for malaria case (imported and indigenous) during 2011-2014 were collected from China Parasite Disease Prevention and Control Information System. All of the data didn't include China's Hongkong, Macao, Taiwan and foreign cases. We described the demographic features of malaria cases, e.g. sex, age, occupation and mobility, to compare the differences of cases between malaria control stage (2007-2010) and the elimination phase (2011-2014).

RESULTS

From 2007 to 2014, a total of 108 076 malaria cases were reported nationwide, which 13 355 cases were reported at the elimination stage. The proportion of male cases considerably increased from 65.1% (6 1625 cases) at the control stage to 91.4% (12 209 cases) at the elimination phase, with the cases aged 15-64 years among male cases dramatically rose from 74.3% (45 793 cases) to 97.2% (11 870 cases). In terms of occupation, the proportion of children and students decreased from 17.8% (16 891 cases) to 2.7% (356 cases), while the percentage of migrant workers, workers and other professional cases increased from 8.5% (8 031 cases), 3.5% (3 319 cases) and 3.6% (3 435 cases) to 13.1% (1 757 cases), 11.5% (1 534 cases) and 11.4% (1 517 cases), respectively. During the elimination stage,P. faliparium cases have higher proportion of male (96.4%, 7 179 cases) and adult aged 15-64 year (99.4%, 7 399 cases) than that of P. vivax cases , 83.9% (4 344 cases) and 90.3% (4 679 cases), respectively. Moreover, the proportion of imported cases rose from 63.6% (2 599 cases) in 2011 to 97.7% (2 854 cases) in 2014, and the proportion of the migrants in indigenous cases also showed an increasing trend from 13.5% (201 cases) in 2011 to 28.4% (19 cases) in 2014.

CONCLUSION

Compared with the control stage, great changes of demographical characteristics of malaria cases occurred at the elimination stage. Male adults aged 15-64 year-old, imported cases and domestic migrants were the high-risk population for targeted control and prevention at the malaria elimination stage.

[Epidemiologic characteristics of Plasmodium ovale in China in 2011-2014]

OBJECTIVE

To investigate the epidemiological characteristics of Plasmodium ovale in 2011-2014 for malaria control policy making during the phase of malaria elimination in China.

METHODS

The data of individual Plasmodium ovale case (probable and confirmed) and population during 20011-2014 were collated from China National Notifiable Infectious Disease Reporting Information System, and the data of epidemiological investigation for individual Plasmodium ovale case (imported and indigenous) during 2011-2014 were collected from China Parasite Disease Prevention and Control Information System. All of the data didn't include China's Hongkong, Macao, Taiwan and foreign cases. The epidemiological characteristics, diagnosis and reporting were compared and analyzed.

RESULTS

During study period of 2011-2014, a total of 373 Plasmodium ovale imported cases were reported, with male being 98.4% and median age being 40 years old. Jiangsu (100 cases), Guangxi (76 cases), Henan (55 cases), Anhui (28 cases) and Shandong(18 cases) reported Plasmodium ovale imported cases ranked the top 5 place in the list. Totally 182 counties from 21 provinces were reported Plasmodium ovale imported cases. 94.6% of ovale malaria imported cases (353/373) got infected from African countries and comprehensive hospitals, CDCs and hospital of infectious disease reported 40.0%, 37.8%, and 16.6% of Plasmodium ovale imported cases, respectively. 4 days of median time lag of Plasmodium ovale imported cases from date of onset to diagnosis was longer than 3 days.

CONCLUSION

From 2011 to 2014, the rising number of Plasmodium ovale imported cases reported from wilder scope of China. Diagnosis time lag of Plasmodium ovale was longer than that of other Plasmodium. Diagnosis and prompt treatment of Plasmodium ovale imported cases and relapse case should be highlighted.

[Epidemiologic characteristics of noroviruses isolated in outpatients with acute gastroenteritis in Hangzhou area, from 2014 to 2015]

OBJECTIVE

To explore the epidemiologic characteristics of noroviruses isolated in patients with acute gastroenteritis in Hangzhou between March 2014 and April 2015.

METHODS

Stool specimens and clinical data were collected from 1 109 patients with acute gastroenteritis. Specimens were detected for noroviruses with GⅠand GⅡsubtypes by one-step double real-time RT-PCR. Some of the positive specimens were then randomly selected and amplified by multiplex RT-PCR. Those positive PCR products were sequenced and analyzed phylogenetically for testing the partial capsids of noroviruses.

RESULTS

Of the 1 109 stool specimens, positive rate of noroviruses was 26.87% (298/1 109). GⅡgenotype was the major viruses with the proportion as 25.52% (283/1 109), while 1.35% (15/1 109) belonged to GⅠgenotypes. There was no significant difference in the noroviruses detection rate of the different genders (P>0.05). However, in different age groups, GⅡgenotypes were predominant types of noroviruses, and the positive rates of GⅡgenotypes were 16.94% (<5 years-old), 19.45% (5-18 years-old) and 32.26% (≥18 years-old), respectively. In different seasons, noroviruses could be detected all year round, with positive rate as 29.67%-37.08% in the highly epidemic seasons (between December and March of the following year). The distribution trends were seen certain difference between noroviruses-GⅡand GⅠtypes. Additionally, results from the sequence analysis demonstrated that GⅡ-4 genotype was the prevalent strain of GⅡ genotypes, clustered into GⅡ-4/Sydney (46.43%, 13/28) and GⅡ-4/2006b (25.0%, 7/28), while GⅠstrains clustered into GⅠ-1.

CONCLUSION

Noroviruses appeared one of the major pathogens, leading to acute gastroenteritis. G Ⅱgenotypes of noroviruses, especially the G Ⅱ-4/Sydney variant strains and GⅡ-4/2006b variant strains, were considered to be the prevalent strains prevailed in Hangzhou areas from 2014 to 2015.

Association between left ventricular end-diastolic pressure and coronary artery disease as well as its extent and severity

Patients with myocardial ischemia exhibit increased left ventricular end-diastolic pressure (LVEDP). The study was to evaluate the relationship between LVEDP measured by left cardiac catheterization and coronary artery disease (CAD) as well as its extent and severity evaluated by coronary angiography (CAG). 912 patients who underwent CAG and left cardiac catheterization were enrolled. There were 313 patients without CAD and 599 with CAD according to CAG. The extent and severity of coronary artery was evaluated by number of vessels and Gensini score. Analyze the correlation of LVEDP and CAD as well as its extent and severity. LVEDP was significantly higher in CAD patients than non-CAD (9.58±5.78 mmHg vs 10.9±5.46 mmHg, P<0.001), and was correlated independently with the presence of CAD (OR = 0.11, per 5 mmHg increase, 95% CI 1.02-1.29, P = 0.02). LVEDP was increased with an increase of number of vessels. By linear regression analysis, LVEDP was significantly associated with Gensini score (standardized β = 0.034, P = 0.001). In non-CAD group, LVEDP was only correlated with age (r = 0.123, P = 0.030). In conclusion, our findings suggest that elevated LVEDP was significantly associated with CAD as well as its extent and severity. LVEDP was only correlated with age in non-CAD patients. LVEDP measurement provides incremental clinical value for CAD and non-CAD patients.

Assessment of correlation between pre-miRNA-1757 polymorphism and chicken performance traits

Single nucleotide polymorphism in microRNAs (miRNA) may influence their target gene selection and regulation efficiency, leading to animal phenotypic variation. The aim of this study was to evaluate the possible effect of single nucleotide polymorphisms in the miRNA-1757 gene precursor region (pre-mir-1757) on economic-related traits in chicken. Genotyping was performed using Sequenom MassArray® iPLEX GOLD System. Association analysis was performed using SPSS19.0. The data showed that the G/C polymorphism was significantly correlated with semi-evisceration weight, evisceration weight, carcass weight, body weight at 10 weeks of age, shank length at 4 weeks of age, pectoral angle at 8 weeks of age, and body slanting length and pelvis breadth at 12 weeks of age (P < 0.05), and led to the alteration of the RNA secondary structure of pre-mir-1757. Our results provide useful information for further annotation studies of miRNA function.

Clinical significance of stem cell marker CD133 expression in colorectal cancer

OBJECTIVE

CD133, a glycoprotein, is expressed in different types of human stem cells and tumor cells. Detection of altered CD133 expression in colorectal cancer tissues could be useful as a marker for the prediction of colorectal tumorigenesis, progression, and prognosis.

METHODS

A total of 19 fresh and 145 paraffin-embedded tissue specimens from colorectal cancer patients were obtained for detection of CD133 expression using flow cytometry and immunohistochemistry, respectively. The tumorigenic capacity of tumor cells from 19 patients was assessed in nude mice. Association of CD133 expression was then analyzed for clinical significance.

RESULTS

The percentage of CD133-positive (CD133⁺) tumor cell population ranged between 0.84% and16.75% (mean ratio =7.15%) of tumor cells in the 19 freshly isolated tissue samples. CD133 expression in tumor cells was associated with tumor lymph node metastasis (9.81% vs. 3.22%; p=0.013) and poor tumor differentiation (8.32% vs. 5.07%; p=0.043). In the 145 paraffin-embedded samples, CD133⁺ colorectal cancer was also associated with local recurrence of tumorigenesis (p=0.035) and distant metastasis (p=0.017), while patients with over 5% CD133+ tumor cells exhibited a decreased survival rate (p=0.001). Multivariate COX analysis showed that the depth of tumor invasion, histology, stagWaes, lymph node metastasis, and CD133 expression were all independent prognosis factors for colorectal cancer (p=0.032, 0.011, 0.001, 0.002, and 0.030, respectively). Furthermore, as few as 5,000 CD133⁺ colorectal cancer HCT116 cells were sufficient to form tumor xenografts, whereas 1x10⁵ CD133⁻ tumor cells failed to develop tumor xenografts in nude mice.

CONCLUSIONS

CD133 expression is a useful biomarker for prediction of colorectal cancer progression and survival of patients.

Single-point position and transition defects in continuous time quantum walks

We present a detailed analysis of continuous time quantum walks (CTQW) with both position and transition defects defined at a single point in the line. Analytical solutions of both traveling waves and bound states are obtained, which provide valuable insight into the dynamics of CTQW. The number of bound states is found to be critically dependent on the defect parameters, and the localized probability peaks can be readily obtained by projecting the state vector of CTQW on to these bound states. The interference between two bound states are also observed in the case of a transition defect. The spreading of CTQW probability over the line can be finely tuned by varying the position and transition defect parameters, offering the possibility of precision quantum control of the system.

Local strain and defects in silicon wafers due to nanoindentation revealed by full-field X-ray microdiffraction imaging

Quantitative characterization of local strain in silicon wafers is critical in view of issues such as wafer handling during manufacturing and strain engineering. In this work, full-field X-ray microdiffraction imaging using synchrotron radiation is employed to investigate the long-range distribution of strain fields in silicon wafers induced by indents under different conditions in order to simulate wafer fabrication damage. The technique provides a detailed quantitative mapping of strain and defect characterization at the micrometer spatial resolution and holds some advantages over conventional methods.

Effect of ulinastatin on HMGB1 expression in rats with acute lung injury induced by sepsis

The aim of this study was to investigate the influence of ulinastatin (UTI) on high mobility group box 1 (HMGB1), tumor necrosis factor (TNF)-α, and interleukin (IL)-6 expression in acute lung injury (ALI) rats with sepsis caused by cecal ligation and puncture (CLP) surgery, as well as to examine the underlying biological mechanism. Thirty rats were randomly and evenly divided into sham (control), CLP, and CLP + UTI groups. Thirty minutes after the surgery, the rats in the CLP + UTI group received UTI via the caudal vein, while normal saline was administered to rats in the other groups. Blood, lung tissues, and bronchoalveolar lavage fluid (BALF) were collected at different time points (6, 12, 24, and 48 h) after surgery for determination of related indicators. Compared with the CLP group, rats in the CLP + UTI group exhibited higher seven day survival rates, less lung injury, and decreased HMGB1 expression in the lung tissue, serum, and BALF. In addition, the levels of TNF-α and IL-6 at 24 h in the CLP + UTI group were markedly lower than those in the CLP group. These results suggest that by deregulation, UTI might decrease the lung injury and increase the survival time of ALI rats by downregulating HMGB1 expression as well as by inhibiting TNF-α and IL-6 levels in serum and BALF.

Physiological integration enhanced the tolerance of Cynodon dactylon to flooding

Many flooding-tolerant species are clonal plants; however, the effects of physiological integration on plant responses to flooding have received limited attention. We hypothesise that flooding can trigger changes in metabolism of carbohydrates and ROS (reactive oxygen species) in clonal plants, and that physiological integration can ameliorate the adverse effects of stress, subsequently restoring the growth of flooded ramets. In the present study, we conducted a factorial experiment combining flooding to apical ramets and stolon severing (preventing physiological integration) between apical and basal ramets of Cynodon dactylon, which is a stoloniferous perennial grass with considerable flooding tolerance. Flooding-induced responses including decreased root biomass, accumulation of soluble sugar and starch, as well as increased activity of superoxide dismutase (SOD) and ascorbate peroxidase (APX) in apical ramets. Physiological integration relieved growth inhibition, carbohydrate accumulation and induction of antioxidant enzyme activity in stressed ramets, as expected, without any observable cost in unstressed ramets. We speculate that relief of flooding stress in clonal plants may rely on oxidising power and electron acceptors transferred between ramets through physiological integration.

Effect of prolonged dual anti-platelet therapy on reducing myocardial infarction rate after percutaneous coronary intervention

This paper aimed to review the interferential effect of prolonged dual anti-platelet therapy after Percutaneous Coronary Intervention (PCI), and the influence on reducing the myocardial infarction rate. A computer search was carried out in the relevant libraries and databases, regarding all the short-term (≤ 6 months) and long-term (> 6 months) dual anti-platelet therapies, and the curative and observational studies on the effects and safety of interventional therapy. RevMan5.1 software was used to meta-analyze the standard research. A total of 8 papers were finally selected. In the randomized controlled research, meta-analysis showed that the myocardial infarction rate of a long-term dual antiplatelet treatment group was lower than the short-term treatment group [OR=0.74, 95% CI (0.56, 0.98), P < 0.0001]. The meta-analysis of observational research showed that the myocardial infarction rate of the long-term treatment group was lower than the short-term treatment group [OR=0.7, 95% CI (0.45, 1.08), P=0.11]; the incidence rate of late stent thrombosis in the long-term treatment group was lower than in the short-term treatment group [OR=0.40, 95% CI (0.15, 1.07), P=0.07]. It can be concluded that in the long-term group (>6 months) dual anti-platelet therapy after PCI can reduce the incidence rate of myocardial infarction or death. In addition, long-term treatment can reduce the occurrence tendency of late stent thrombosis. Furthermore, in the long-term treatment group, serious bleeding events did not increase.

[Activation of transcription factor NF-κB in a rat model of cardiac fibrosis induced by β-adrenoceptor stimulation]

OBJECTIVE

To establish a model of cardiac fibrosis induced by isoproterenol (ISO), the non-selective β adrenoceptor agonist, injected subcutaneously for 7 days in rats, and to observe changes of transcription factor NF-κB in the model.

METHODS

Male SD rats weighing 280-320 g were injected with ISO (0.25 mg/kg/d) subcutaneously for 7 days to induce cardiac fibrosis. The collagen volume fraction was determined by quantitative morphometry of picrosirius red stained left ventricular sections. Collagen types I/III and IL-6 mRNA expressions were analyzed by real time PCR. The pathological changes of the heart were investigated by Hematoxylin and Eosin staining. NF-κB was localized by immunohistochemistry (IHC) and phosphorylated NF-κB levels were assessed by Western blot analysis.

RESULTS

Compared with the controls, ISO significantly elevated the sirius red stained area and collagen volume fraction (12.01±1.644 vs. 0.95±0.067, P<0.001). Similarly, ISO increased the mRNA expressions of collagen Iand collagen III of the heart compared with the controls (10.51±0.47 vs. 0.98±0.02,P<0.001 for collagen I; 9.58±1.33 vs. 1.02±0.02, P<0.001 for collagen III). The number of nuclei was increased and nuclear accumulation was presented in myocardial tissue induced by ISO. The mRNA expression of IL-6 increased in ISO group (1.64±0.18 vs. 1.04±0.07, P<0.01). ISO induced NF-κB nuclear translocation, accompanied by an increase in phosphorylation of NF-κB (10.83±2.05 vs. 1.05±0.27, P<0.001).

CONCLUSION

We conclude that the model of cardiac fibrosis can be successfully induced by ISO injected subcutaneously for 7 days in rats and the activation of nuclear factor NF-κB increased by β-adrenoceptor stimulation.