Changes in facial signs due to age and their respective weights on the perception of age, on a tired-look or a healthy glow among differently aged Chinese men

OBJECTIVE

To determine the respective weights of certain facial signs on the assessment of perceived age, tired-look and healthy glow on Chinese men of different ages.

MATERIAL AND METHODS

Photographs were taken of the faces of 420 Chinese men of different ages, under standardized conditions. These photographs allowed to focus and define 15 facial signs, which were then graded by 15 experts and dermatologists, using standardized scales provided by a reference Skin Aging Atlas. The facial signs were dispatched into 5 clusters, namely wrinkles/texture, ptosis/sagging, pigmentation disorders, vascular disorders and cheek skin pores. A naïve panel, composed of 80 Chinese women, of similar age range were asked, when viewing full-face photographs, to: (i) attribute on a 0-10 scale their perception of both the tired-look and healthy glow aspects and (ii) estimate the age of the subject.

RESULTS

With the exception of vascular disorders, the severity of all 4 clusters increased with age, although at different rates. The ptosis/sagging or pigmentation disorders showed a rather regular progression. Although perceived ages and real ages were found to be closely correlated, the vast majority of subjects were judged older by 2-10 years. The changes in facial signs (and their related clusters) were significantly correlated with perceived age, with the exceptions of skin spot density and cheek skin pores. Although the aspects of tired-look and healthy glow were logically found to be anti-correlated, tired-look was more statistically associated with perceived age for the five clusters. Signs of eye contour appear to be closely correlated with the perception of a tired-look.

CONCLUSION

Within facial clinical clusters, wrinkles/texture and ptosis/sagging are major factors in the assessment of perceived age in Chinese men. Tired-look appears to be strongly associated with perceived age.

[Effect of intestinal preparation on the efficacy and safety of fecal microbiota transplantation treatment]

Objective: To investigate the effect of intestinal preparation on the efficacy and complications of fecal microbiota transplantation (FMT). Methods: A retrospective cohort study was performed. Clinical and follow-up data of 1501 patients who received FMT in the department of Colorectal Disease Specialty, Intestinal Microecology Diagnosis and Treatment Center, the Tenth People's Hospital, Tongji University from February 2018 to June 2019 were collected retrospectively. According to the intestinal preparation before FMT treatment, patients were divided into non-intestinal preparation group (n=216), antibiotic pretreatment group (n=383), intestinal cleansing group (n=267), and antibiotic combined with intestinal cleansing group (n=635). The adverse reactions after FMT treatment and the effective rates at 4-week and 8-week after treatment among the groups were compared. Patients, who repeated FMT treatment in the 3rd month and the 6th month due to reduced efficacy or ineffectiveness were divided into two subgroups: without intestinal preparation group and with intestinal preparation group. The effective rates of the two subgroups were compared. Results: Of the 1501 cases, 588 were male and 913 were female with mean age of (43.3±13.7) years and body mass index of (20.2±2.1) kg/m(2). Transplantation course was (3.3±1.7) weeks. The underlying diseases mainly included constipation (n=564), Crohn's disease (n=157), ulcerative colitis (n=142), irritable bowel syndrome (n=158), recurrent C. difficile infection (CDI) (n=106), autism (n=84), radiation intestinal injury (n=133), radiation enteritis (n=133), and non-CDI chronic diarrhea (n=60); the remaining cases (n=155). Baseline data among the 4 groups were not significantly different (all P>0.05). The overall morbidity of complication was 31.1% (467/1501), including 41 cases of vomiting (2.7%), 91 of nausea (6.1%), 49 of diarrhea (3.3%), 41 of abdominal pain (2.7%), 79 of bloating (5.3%), 72 of throat pain (4.8%), 38 of dizziness (2.5%), 51 of fever (3.4%), 3 of pulmonary infection (0.2%) and 2 of intestinal infection (0.1%). The above symptoms disappeared after symptomatic treatment. There was no statistically significant difference in the incidence of adverse reactions among the 4 groups (P>0.05). After 4-week of FMT treatment, the overall effective rate was 63.5% (902/1420); the effective rate of non-intestinal preparation group, antibiotic pretreatment group, intestinal cleaning group, and antibiotic combined with intestinal cleansing groupwas 57.6% (114/198), 64.2% (231/360), 60.2% (154/265) and 66.5% (403/606), respectively, with no statistically significant difference (χ(2)=6.659, P=0.084). After 8-week of FMT treatment, the overall effective rate was 61.3% (729/1293); the effective rate of non-intestinal preparation group, antibiotic pretreatment group, intestinal cleaning group, and antibiotic combined with intestinal cleansing group was 54.0% (88/163), 62.2% (202/325), 57.4% (132/230) and 64.4% (370/575), respectively, with no statistically significant difference (χ(2)=13.620, P=0.003). The effective rates of antibiotic combined with intestinal cleansing group and antibiotic pretreatment group were obviously higher than that of non-intestinal preparation group (χ(2)=5.789, P=0.016; χ(2)=10.117, P=0.001). Subgroup analysis showed that in the third month, the effective rate at 4-week after treatment was 60.1% (184/306) in the without intestinal preparation group and 61.5% (115/187) in the with intestinal preparation group, whose difference was not significant (χ(2)=0.091, P=0.763); however, in the sixth month, the effective rate at 4-week after treatment was 51.4% (89/173) in the without intestinal preparation group and 61.2% (161/263) in the with intestinal preparationgroup, whose difference was significant (χ(2)=4.229, P=0.040). Conclusions: FMT treatment is safe and effective. The combination of antibiotics and intestinal cleaning can improve overall efficacy of FMT. For patients who need repeated FMT treatment, the combination of antibiotics and intestinal cleaning program within 3 months has no significant effect on the effective rate, but in the sixth month, combinedpreparation is necessary.

[Association between the clinical efficacy of fecal microbiota transplantation in recipients and the choice of donor]

Objective: To examine the association between the clinical efficacy of fecal microbiota transplantation (FMT) in recipients and the choice of donor, and to observe the characteristics of intestinal flora and metabolites among different donors. Methods: A retrospective case-control study was conducted. Donor whose feces was administrated for more than 30 recipients was enrolled. Data of 20 FMT donors and corresponding recipients at Intestinal Microecology Diagnosis and Treatment Center of the Tenth People's Hospital from October 2018 to December 2019 were collected retrospectively. During follow-up, the efficacy of each recipient 8-week after FMT treatment was recorded and analyzed. Based on the efficacy of each donor, the donors were divided into three groups: high efficacy group (effective rate >60%, 10 donors), moderate efficacy group (effective rate 30%-60%, 6 donors) and low efficacy group (effective rate <30%, 4 donors). The structure of the bacterial flora and the content of fecal short-chain fatty acids in each group of donors were detected and compared among groups. Association of the efficacy of each donor group with the morbidity of complications, and association of efficacy of recipients with donors were analyzed. The evaluation indicators of FMT efficacy included objective clinical effectiveness and/or subjective effectiveness. Objective effectiveness indicated clinical cure plus clinical improvement, and subjective effectiveness indicated marked effectiveness plus medium effectiveness through questionnaire during follow-up. Results: A total of 1387 recipients were treated by 20 donors, including 749 cases of chronic constipation, 141 cases of chronic diarrhea, 107 cases of inflammatory bowel disease (IBD), 121 cases of irritable bowel syndrome (IBS), 83 cases of autism, and 186 cases of other diseases, such as radiation bowel injury, intestinal pseudo-obstruction, paralytic intestinal obstruction, functional bloating and allergic diseases. There were 829 cases, 403 cases, and 155 cases in high efficacy group, moderate efficacy group and low efficacy group respectively. Baseline data among 3 groups were not significantly different (all P> 0.05). In comparison of bacterial abundance (operational taxonomic unit, OTU) among different effective donor groups, the high efficacy group was the highest (330.68±57.28), the moderate efficacy group was the second (237.79±41.89), and the low efficacy group was the lowest (160.60±49.61), whose difference was statistically significant (F=16.910, P<0.001). In comparison of bacterial diversity (Shannon index), the high efficacy group and the moderate efficacy group were higher (2.96±0.36 and 2.67±0.54, respectively), and the low efficacy group was lower (2.09±0.55), whose difference was statistically significant (F=5.255, P=0.017). In comparison of butyric acid content among three groups, the high efficacy group had the highest [(59.20±9.00) μmol/g], followed by middle efficacy group [(46.92±9.48) μmol/g], and the low efficacy group had the lowest [(37.23±5.03) μmol/g], whose difference was statistically significant (F=10.383, P=0.001). The differences of acetic acid and propionic acid among three groups were not statistically significant (all P>0.05). A total of 418 cases developed complications (30.1%). Morbidity of complication in low efficacy group, moderate efficacy group and high efficacy group was 40.6% (63/155), 30.0% (121/403) and 28.2% (243/829) respectively, and the difference was statistically significant (χ(2)=9.568, P=0.008). The incidence of diarrhea in low efficacy group, moderate efficacy group and high efficacy group was 7.1% (11/155), 4.0% (16/403) and 2.8% (23/829) respectively, and the difference was statistically significant (χ(2)=7.239, P=0.027). Comparing the incidences of other types of complications, no statistically significant differences were found (all P>0.05). Follow up began 8 weeks after the FMT treatment. The total follow-up rate was 83.6% (1160/1387). The overall effective rate 58.3% (676/1160). Effective rates of various diseases were as follows: chronic constipation 54.3% (328/604), chronic diarrhea 88.5% (115/130), IBD 56.1% (55/98), IBS 55.1% (59/107), autism 61.6% (45/73), and other diseases 50.0% (74/148). Comparing the effective rate of three groups of donors for different diseases, there was no statistically significant difference in chronic diarrhea (P>0.05); there was a positive correlation trend in IBD, IBS and autism, but the differences were not statistically significant (all P>0.05). For chronic constipation and other diseases, high efficacy group had the highest effective rate [65.0% (243/374) and 63.2% (55/87)], followed by moderate efficacy group [49.4% (86/174) and 38.1% (16/42)], and low efficacy group had the lowest [16.1% (9/56) and 15.8% (3/19)], whose differences were significant (all P<0.05). Conclusions: Different donors have different efficacy in different diseases. Chronic constipation, radiation bowel injury, etc. need to choose donors with high efficacy. IBD, IBS and autism may also be related to the effectiveness of donors, while chronic diarrhea is not associated to the donor. The efficiency of the donor is negatively correlated to the morbidity of complications. The abundance and diversity of intestinal flora and the content of butyric acid may affect the efficacy of the donor.

[Pay attention to the diagnosis and treatment of intestinal infectious diarrhea after colorectal surgery]

Colorectal surgery patients have severe intestinal flora disorders and antibiotic resistant bacteria due to the disease itself and preoperative treatment, as well as the influence of dietary structure and environmental factors. Perioperative anesthesia and operative stress can cause gastrointestinal motility disorders. In addition, the widespread use of prophylactic broad-spectrum antibiotics and antiacids aggravate intestinal flora disorders and induces severe postoperative infectious diarrhea, such as pseudomembranous enteritis and fatal enteritis. The clinical manifectation are severe infectious diarrhea with high fever and abdominal distension after surgery. The disease progresses rapidly. When the diagnosis and treatment are delayed, the patient can quickly develop shock and other serious complications such as anastomotic leakage, even die of multiple organ failure. Therefore, early diagnosis and treatment are crucial.

Effect of potential HONO sources on peroxyacetyl nitrate (PAN) formation in eastern China in winter

As an important secondary photochemical pollutant, peroxyacetyl nitrate (PAN) has been studied over decades, yet its simulations usually underestimate the corresponding observations, especially in polluted areas. Recent observations in north China found unusually high concentrations of PAN during wintertime heavy haze events, but the current model still cannot reproduce the observations, and researchers speculated that nitrous acid (HONO) played a key role in PAN formation. For the first time we systematically assessed the impact of potential HONO sources on PAN formation mechanisms in eastern China using the Weather Research and Forecasting/Chemistry (WRF-Chem) model in February of 2017. The results showed that the potential HONO sources significantly improved the PAN simulations, remarkably accelerated the RO_x (sum of hydroxyl, hydroperoxyl, and organic peroxy radicals) cycles, and resulted in 80%-150% enhancements of PAN near the ground in the coastal areas of eastern China and 10%-50% enhancements in the areas around 35-40°N within 3 km during a heavy haze period. The direct precursors of PAN were aldehyde and methylglyoxal, and the primary precursors of PAN were alkenes with C > 3, xylenes, propene and toluene. The above results suggest that the potential HONO sources should be considered in regional and global chemical transport models when conducting PAN studies.

Morphometric characteristics of feminine eyebrows: variations with ethnicities and age

OBJECTIVE

To explore some morphological features of the eyebrows of women of different ethnicities and ages.

MATERIALS AND METHODS

Standard digital photographs of 3600 women of six ethnicities, aged 18-84 years, previously used to describe the morphology of the human eyes, allowed us to focus on their eyebrows, as supplementary and opportunistic study. Photographs of both eyebrows were analysed partly by manual markings and automatically by dedicated algorithms. Six parameters of the eyebrows were recorded: length, waviness/curvature, oblique aspect, size (vertical height), total surface and hair coverage (density).

RESULTS

Most criteria present ethnic specificities. These are: length (longer eyebrows of Indian, shorter among African women); waviness where the straighter eyebrows were found among Chinese and Japanese women. In general, the longer the eyebrows, the higher their waviness and vice versa. Thickness (or height) of the eyebrows presents a wide ethnic variability as well as hair coverage, where African women present the lower hair density, inversely to Indian women. The same holds true with regard to the total surface of eyebrows, of a large variability (by about four times). Some criteria appear more individually dependent than ethnic-specific, such as the oblique positioning, at the exception of Indian women with less oblique eyebrows. In all subjects, the criteria of both eyebrows (Left vs. Right) were found to be highly correlated (r > 0.7, P < 0.001).

CONCLUSION

The present investigation brings new findings on a scarcely studied facial element, the morphologic features of which are, for most, ethnic-dependent. As applied consequences, the results of the present work pave the road to better adapt adorning procedures of the eyebrows vis-à-vis ethnic and age specificities.

Assessing the impact of an aerial chronic urban pollution (UP) on some facial signs of differently-aged Chinese men

OBJECTIVE

To assess the impact of an aerial chronic urban pollution (UP) on the severities of some facial signs of Chinese men living in two close but differently polluted Chinese cities.

MATERIALS AND METHODS

Standardized digital photographs were taken on 201 subjects from two cohorts of Chinese men (100 inhabitants of Baoding/very polluted and 101 inhabitants of Dalian/less polluted) differently aged (20-60 years) allowing a focus on 17 different facial signs. The latter were graded by 15 experts, using a clinical referential skin atlas. A questionnaire was filled by all subjects collecting their habits and uses with regard sun-exposures and skincare products. A naïve panel of 80 Chinese women, of comparable ages, attributed a perceived age to each subject under blind conditions.

RESULTS

These confirm previous data obtained on Chinese women, with a similar protocol, i.e. that some facial signs show an increased severity in the more polluted city. However, changes in facial signs, with age, are of a different pattern according to gender. In Chinese men, most signs show early onsets with however low age-related changes, inversely to those observed in women, at the exception of vascular disorders. Habits of sun-exposures and uses of skincare product were found totally similar in both cohorts, reinforcing the specific role of UP in the progressive changes of facial signs. Similar to the results previously obtained on Chinese women, men living in a more polluted city were judged older than those living in a less polluted aerial environment.

CONCLUSION

The present work confirms that a more severe UP increases the severities of some facial signs in Chinese men.

[High-intensity focused ultrasound in the treatment of glaucoma]

In recent years, with the improvement of high-intensity focused ultrasound technology, ultrasound cycloplasty has once again gained clinical recognition, becoming one of the non-invasive procedures for glaucoma treatment. Although high-level evidence is still lacking so far, the existing literature has shown that ultrasound cycloplasty can effectively and safely decreases the intraocular pressure in glaucoma by reducing the formation of aqueous humor and increasing the drainage of aqueous humor through the uveoscleral pathway. This article focuses on the efficacy and safety of ultrasound cycloplasty in the treatment of glaucoma, reviews the existing literature, and summarizes the information on the development of equipment, treatment mechanisms, surgical procedures, effectiveness of intraocular pressure reduction, and post-operative complications, with the purpose to provide reference for clinical research and application. (Chin J Ophthalmol, 2020, 56: 66-70).

Association between Skeletal Muscle Strength and Dysphagia among Chinese Community-Dwelling Elderly Adults

OBJECTIVES

Swallowing disorder is a health burden for the elderly in China. This study aimed to investigate the prevalence of dysphagia and to test the association between skeletal muscle strength and swallowing problems among community-dwelling older adults.

DESIGN

A cross-sectional study.

SETTING

Community-dwelling Chinese elderly in China.

PARTICIPANTS

3361 adults aged 65 years or above were involved, among which 1740 (51.8%) were female, with average age of 72.64 (Standard deviation, SD=6.10) years old.

MEASUREMENTS

Handgrip strength (HGS) was used to evaluate skeletal muscle strength. Dysphagia assessment was performed using the Eating Assessment Tool-10 (EAT-10) and the 30mL water swallow test (WST). Binary logistic regression was used to evaluate the relationship between skeletal muscle strength and dysphagia, and covariates as age, gender, material status, etc. were adjusted.

RESULTS

The prevalence of dysphagia were 5.5% and 12.9%, screened by EAT-10 and 30mL WST respectively. Participants with dysphagia showed lower HGS (21.73 ± 9.20 vs. 25.66 ± 11.32, p<0.001, by EAT-10; 20.26 ± 9.88 vs. 26.22 ± 11.28, p<0.001, by WST). The adjusted model suggested that muscle strength is a protective factor for swallowing disorders (adjusted OR=0.974, 95%CI: 0.950-0.999, by EAT-10; adjusted OR=0.952, 95%CI: 0.933-0.972, by WST). Subgroup analyses of WST found the effects were significant among participants aged in 70-74 years group and ≥75 years group, rather than those aged under 70.

CONCLUSION

Dysphagia was significantly associated with skeletal muscle strength among the community-dwelling elderly population. Effective interventions should be taken to manage the decline of muscle strength for the older adults, especially early prevention before 70 years old.

[Gastroenteropancreatic neuroendocrine tumor microenvironment and related therapy]

Neuroendocrine tumor(NET) is a kind of highly heterogeneous and ubiquitous tumor, frequently localized in the gastrointestinal tract and pancreas. Surgery combined with regional ablation, endocrine therapy,chemotherapy and targeted therapy presents a favorable prognosis when treated with G1 or G2 gastroenteropancreatic neuroendocrine tumor(GEP-NET). However, there are only limited therapeutic strategies for metastatic unresectable tumors and poorly differentiated NEC,which are closely related to the special tumor microenvironment of neuroendocrine tumors.Targeting tumor microenvironment therapy is an important method in current systematic therapy, but till now the knowledge of neuroendocrine tumor microenvironment and its related treatment are limited. This article will specifically introduce the characteristics of tumor microenvironment in GEP-NET from the following aspects: the formation of enrichment vascular supply in TME,the role of tumor stroma,immune cells and cancer associacted fibroblast, and immune checkpoint and future trend of immunotherapy.

Multiplicity conversion based on intramolecular triplet-to-singlet energy transfer

The ability to convert between molecular spin states is of utmost importance in materials chemistry. Förster-type energy transfer is based on dipole-dipole interactions and can therefore theoretically be used to convert between molecular spin states. Here, a molecular dyad that is capable of transferring energy from an excited triplet state to an excited singlet state is presented. The rate of conversion between these states was shown to be 36 times faster than the rate of emission from the isolated triplet state. This dyad provides the first solid proof that Förster-type triplet-to-singlet energy transfer is possible, revealing a method to increase the rate of light extraction from excited triplet states.

[Short-term effects of air pollution on lung function of school-age children in Hangzhou]

A total of 1 685 school-age children selected from Hangzhou received lung function testing to evaluate the short-term effects of air pollution on their lung function. The results showed that in every 10 μg/m(3) increase of average concentration of PM(2.5) and PM(10) on the day of the test and the day before the test,peak expiratory flow (PEF) decreased 0.039 (95%CI: 0.012-0.067) L/s and 0.031 (95% CI:0.011-0.051) L/s,respectively. When the average concentration of SO(2) increased 10 μg/m(3) on the day of test and the day prior to the test, PEF and 75% of the forced vital capacity that has not been exhaled (MEF(75)) decreased 0.437 (95%CI: 0.217-0.658) L/s and 0.396 (95%CI: 0.180-0.613) L/s. After being adjusted for NO(2),with every 10 μg/m(3) increase of average concentration of PM(2.5) and PM(10) on the day of the test and the day before the test,PEF and MEF(75) decreased 0.056 (95%CI: 0.028-0.085), 0.053(95%CI: 0.027-0.081) and 0.047 (95%CI: 0.026-0.068) L/s,0.044 (95%CI: 0.023-0.065) L/s on the day before the test, respectively. The results indicate that air pollution have short-term and lag effects on lung function of school-age children in Hangzhou.

[Preliminary efficacy of penetrating canaloplasty in primary angle-closure glaucoma]

Objective: To evaluate the preliminary efficacy and safety of penetrating canaloplasty for treating primary angle-closure glaucoma (PACG). Methods: It is a prospective interventional case series study. Twenty-two patients (24 eyes) with PACG were treated with penetrating canaloplasty (video attached) at the Eye Hospital of Wenzhou Medical University from June 2015 to August 2018. This modified canaloplasty was performed by making a window at the corneal-scleral bed. Aqueous was redirected to the opening of Schlemm's canal after the canaloplasty with intension sutures. Postoperative follow-up was made at 1 day, 7 days, 1 month, 3 months, and 6 months. Surgical success was defined as intraocular pressure (IOP) ≤ 21 mmHg (1 mmHg=0.133 kPa) with glaucoma medication (quantified success) and without any glaucoma medication (complete success). Main outcome measures included IOP, number of medication, surgical success rate, complications, and filtering bleb status. One-way repeated measure ANOVA and rank sum test were used in statistical analysis. Results: Due to the failure of circumferential catheterization of the canal, 4 eyes converted to trabeculectomy. A total of 19 PACG patients (20 eyes) achieved the successful 360-degree catheterization of the canal, including 11 males and 8 females. The mean age was (54±7) years old (range: 41-65 years old), and the mean angle-closure range was (326.3±46.6) degrees. The mean preoperative IOP was (38.0±11.9) mmHg with the median medication number of 3 (range: 2-5). The mean postoperative IOP was (14.5±11.1), (16.1±6.0), (17.7±5.5), (15.7±5.0), and (15.4±3.7) mmHg at 1 day, 7 days, 1 month, 3 months, and 6 months, respectively. There was significant difference in IOP between postoperative and preoperative (all P<0.01). The median medication number (range) was 0 (0-3), 0 (0-2), 0(0-3), 0(0-2), and 0 (0-2) at the 5 time points, respectively. There was significant difference in medication number between postoperative and preoperative (all P<0.01). The quantified success rate was 95%(19/20), and the complete success rate was 90%(18/20) at 6 months. Postoperative complications were observed in 7 eyes (35%) of 20 PACG eyes, including 3 eyes (15%) with hyphema, 2 eyes (10%) with shallow anterior chamber, 1 eye (5%) with Descemet membrane detachment, and 1 eye (5%) with filtration obstruction at the trabeculum ostium. According to the results of slit lamp and ultrasound biomicroscopy examinations, 70% of the eyes (14/20) had no filtering bleb. Eight eyes (40%) with IOP spike were observed. Conclusion: Preliminary study shows penetrating canaloplasty is safe and effective in the treatment of PACG, but needs a longer follow-up. (Chin J Ophthalmol, 2019, 55: 448-453).

Synthesis and biological evaluation of novel 6-alkoxy-3-aryl-[1,2,4]triazolo[4,3-b][1,2,4,5] tetrazines

A series of 6-alkoxy-3-aryl-[1,2,4]triazolo[4,3- b][1,2,4,5] tetrazine derivatives is synthesized and evaluated for their antitumor activities. These compounds exhibit potent antiproliferative activities against A549, Bewo, and MCF-7 cells. Molecular docking is performed to study the inhibitor–c-Met kinase interactions, and the results show that 6-ethoxyl-3-phenylethyl-[1,2,4]triazolo[4,3- b][1,2,4,5] tetrazine is potently bound to c-Met kinase with two hydrogen bonds and one π–π interaction. Based on these preliminary results, it is thought that compound 6-ethoxyl-3-phenylethyl-[1,2,4]triazolo[4,3- b][1,2,4,5] tetrazine with potent inhibitory activity may be a potential anticancer agent.

Prognostic significance of preoperative radiotherapy in stage II and III rectal cancer patients: A Strobe-compliant study of SEER 18 registries database (1988-2011)

Preoperative radiation therapy has been regarded as the optional neoadjuvant treatment to decrease local recurrence of rectal cancer in addition to surgery. However, its benefit in survival remained obscure. This study was aimed to measure the efficacy of preoperative radiation therapy for survival in stage II and III rectal cancer patients. Retrospective cohort study used the database of Surveillance, Epidemiology and End Results program of the National Cancer Institute in the United States from 1988 to 2011. A total of 49439 patients diagnosed with primary rectal cancer who underwent surgery were included. Clinicopathological characteristics and rectal cancer-specific survival between surgery alone group and surgery plus preoperative radiation therapy group were compared. Rectal cancer patients in surgery plus preoperative radiation therapy group had significantly better survival than those in surgery alone group (72.70% vs. 66.61%, P < 0.001), as well as stratified by stages (stage II: 77.4% vs. 74.3%, P < 0.001; stage III: 68.3% vs. 58.6%, P < 0.001). However, this beneficial impact was only observed after 2000s (P < 0.001). Multivariate survival analysis revealed that preoperative radiation therapy was an independent predictor for better survival in stage III (hazard ratio, 0.795; 95% CI, 0.753-0.840; P < 0.001), but not in stage II (P = 0.70). Preoperative radiation therapy might bring a better survival in stage II and III rectal cancer patients, but only as an independent predictor for stage III patients. As time progressed, preoperative radiation therapy might yield more profit for stage II and III rectal cancer patients.

Activity maintenance of the excised branches and a case study of NO2 exchange between the atmosphere and P. nigra branches

The efficient maintenance of the activity of excised branches is the powerful guarantee to accurately determine gas exchange flux between the detached branches of tall trees and the atmosphere. In this study, the net photosynthetic rate (NPR) of the excised branches and branches in situ were measured simultaneously by using two photosynthetic instruments to characterize the activity of the excised branches of Phyllostachys nigra. The ratio of normalized NPR of excised branches to NPR in situ was used to assess the photosynthetic activity of detached branches. Based on photosynthetic activity, an optimal hydroponics protocol for maintaining activity of excised P. nigra branches was presented: 1/8 times the concentration of Gamborg B5 vitamin mixture with pH = 6. Under the best cultivation protocol, photosynthetic activity of excised P. nigra branches could be maintained more than 90% within 6 hr in the light intensity range of 200-2000 μmol/(m²·sec) and temperature range of 13.4-28.7°C. The nitrogen dioxide (NO₂) flux differences between in situ and in vitro branches and the atmosphere were compared using double dynamic chambers. Based on the maintenance method of excised branches, the NO₂ exchange flux between the excised P. nigra branches and the atmosphere (from -1.01 to -2.72 nmol/(m²·sec) was basically consistent with between the branches in situ and the atmosphere (from -1.12 to -3.16 nmol/(m² sec)) within 6 hr. Therefore, this study provided a feasible protocol for in vitro measurement of gas exchange between tall trees and the atmosphere for a period of time.

Multiple instruments motion trajectory tracking in optical surgical navigation

Optical surgical navigation system has been a hot research topic because of its high accuracy. This paper focuses on identifying and tracking multiple surgical instruments to meet the requirements of applying multiple surgical instruments in clinical medicine. The methods of instrument identification based on the marker's geometrical arrangement and instrument tracking based on markers' motion vector were applied in the proposed algorithm. The experiments of multiple instruments' identification and tracking, the instruments' stability, the space distance and rotation of a pair of instruments at the same tracking time were performed to verify the proposed algorithm. The stereoscopic camera is applied to capture images, and two 850 nm filters are added in front of the binocular camera. The tracking experiment shows that ten instruments can be fully and accurately identified, and then all of them can be quickly and accurately tracked at the same time. A pair of instruments is simultaneously measured in the stability test, such as the typical surgical instrument (TSI) and the miniature surgical instrument (MSI). The ranges of standard deviations (SD) of the stability test for the TSI in the X-, Y-, and Z- axes are from 0.016 mm to 0.127 mm, from 0.011 mm to 0.090 mm, and from 0.124 mm to 0.901 mm, respectively. And the ranges of SDs for the MSI's stability test are from 0.011 mm to 0.133 mm in the X-axis, from 0.010 mm to 0.106 mm in the Y-axis, and from 0.093 mm to 0.932 mm in the Z-axis. The sub-millimeter SDs show that the proposed algorithm has a high stability. Moreover, the space distance test and the rotation test were performed for simultaneously tracking TSI and MSI. All experimental results indicate the proposed algorithm is able to meet the clinical accuracy requirements.

The levels, sources and reactivity of volatile organic compounds in a typical urban area of Northeast China

Air concentrations of volatile organic compounds (VOCs) were continually measured at a monitoring site in Shenyang from 20 August to 16 September 2017. The average concentrations of alkanes, alkenes, aromatics and carbonyls were 28.54, 6.30, 5.59 and 9.78 ppbv, respectively. Seven sources were identified by the Positive Matrix Factorization model based on the measurement data of VOCs and CO. Vehicle exhaust contributed the most (36.15%) to the total propene-equivalent concentration of the measured VOCs, followed by combustion emission (16.92%), vegetation emission and secondary formation (14.33%), solvent usage (10.59%), petrochemical industry emission (9.89%), petrol evaporation (6.28%), and liquefied petroleum gas (LPG) usage (5.84%). Vehicle exhaust, solvent usage and combustion emission were found to be the top three VOC sources for O₃ formation potential, accounting for 34.52%, 16.55% and 11.94%, respectively. The diurnal variation of the total VOCs from each source could be well explained by their emission characteristics, e.g., the two peaks of VOC concentrations from LPG usage were in line with the cooking times for breakfast and lunch. Wind rose plots of the VOCs from each source could reveal the possible distribution of the sources around the monitoring site. The O₃ pollution episodes during the measurement period were found to be coincident with the elevation of VOCs, which was mainly due to the air parcel from the southeast direction where petrochemical industry emission was found to be dominant, suggesting that the petrochemical industry emission from the southeast was probably a significant cause of O₃ pollution in Shenyang.

A puzzling pregnancy epulis with aggressive bone loss mimicking malignant neoplasm: A case report

Epulis is a benign tumor, rarely involves aggressive alveolar bone resorption. This study reported a rare case of rapid growth of pregnancy epulis with extensive alveolar bone destruction and the management of this case. A 24-year old pregnant woman at 35 weeks and 1 day of gestation presented a large asymptomatic nodular mass with severe teeth loosening at the anterior mandibular region for 4 weeks. Radiographic examination showed extensive alveolar bone resorption around the affected teeth to the apical area. After delivery, the patient received an extended resection under general anesthesia. The final histopathological analysis revealed the diagnosis of epulis. In conclusion, the rapid growth of epulis during pregnancy mimicking malignant neoplasm with aggressive alveolar bone destruction was rare and puzzling. In such cases, the histopathological and immunohistochemical examinations are the only effective method to reach the correct diagnosis and clinician should proceed with high precaution.