[Value of APACHE.II score and DIC score in predicting the death of patients with heat stroke]

Objective: To investigate the predictive values of the acute physiology and chronic health evaluation II (APACHE.II) score and disseminated intravascular coagulation (DIC) score on death in patients with heat stroke. Methods: A total of 76 patients with heat stroke who were treated in Emergency Department of Harrison International Peace Hospital from June 2013 to September 2017 were studied. According to the outcome of patients, we distributed the patients to death group and survival group. APACHE.II score and DIC score were calculated according to the clinical data and the test results at admission. Evaluate the correlation between the two indicators associated with death. Results: There were 76 patients, with 23 deaths (30.3%) and 53 survivors (69.7%) . The APACHE-II score and DIC score were 26.26±6.48 and 4.00±1.38 in the death group.significantly higher than 20.74±4.17 and 2.28±1.21 in the survival group, and there were significant difference (P< 0.01) . The APACHE. II score was positively correlated with the DIC score, and the higher the score, the higher the mortality rate.Both indicators are significant for the Logitic regression analysis of death (P<0.01) .The sensitivity and specificity of the APACHE.II score were 65.2% and 81.1% in prediction of mortality, The sensitivity and specificity of DIC score were 65.2% and 84.9% in prediction of mortality. The specificity of the APACHE II score plus DIC score were higher than that of single APACHE. II score or DIC score in prediction of mortality (P<0.05) . Conclusion: The APACHE.II score and DIC score are significantly increased in the early stage of the patients with heat stroke, and the APACHE. II score combined with DIC score may improve the value in prediction of mortality with heat stroke.

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.

Compound heterozygosity for a frameshift mutation and an upstream deletion that reduces expression of SERPINH1 in siblings with a moderate form of osteogenesis imperfecta

SERPINH1 encodes the collagen chaperone HSP47 that binds to arginine-rich sequences in the type I procollagen trimers and provides the final steps in the folding and stabilization of the triple helical domain. Loss of both alleles in mice results in very early embryonic lethality. SERPINH1 mutations have been associated with one of the rarest forms of recessively inherited osteogenesis imperfecta (OI) with a moderate to severe phenotype. We identified a family with non-consanguineous unaffected parents who had two children with moderate short stature, low bone density, and fractures. Both children were compound heterozygotes for two mutations: a frameshift in the last exon that deleted the RER retention signal, and a 5,274 bp deletion 2.37 kb upstream from the transcription start site. The maternally-inherited frameshift allele was expressed at normal levels, but the protein was unstable. The mRNA encoded by the second allele represented about 50% of that from the frameshift-containing allele. The upstream deletion was inherited from the father, and the mRNA encoded by that allele in his cultured dermal fibroblasts was also expressed at a low level, which confirmed that this domain had a regulatory function for SERPINH1. Regulatory mutations are uncommon causes of human genetic disorders, and the ability to measure expression levels in appropriate cells is key to their identification.

[Applicational value of modified pancreaticojejunostomy and risk factors of pancreatic fistula following pancreaticoduodenectomy]

Objective: To compare the efficacy of modified pancreaticojejunostomy with traditional pancreaticojejunostomy following pancreaticoduodenectomy, and to investigate the risk factors of postoperative pancreatic fistula. Methods: Clinical data of 68 patients who underwent pancreaticoduodenectomy between October 2017 and October 2018 at the Second Department of Biliary Tract Surgery, Eastern Hepatobiliary Surgery Hospital was retrospectively collected and analyzed.According to the method of pancreaticojejunostomy, the patients were divided into two groups: modified pancreaticojejunostomy group (34 patients) and traditional pancreaticojejunostomy group (34 patients). There were 18 males and 16 females, aged (60.4±9.6) years of modified pancreaticojejunostomy groups; there were 17 males and 18 females, aged (58.9±10.9) years of traditional pancreaticojejunostomy group. The major postoperative complications such as pancreatic fistula were compared between the two groups, and the risk factors of postoperative pancreatic fistula were analyzed by univariate and multivariate analyses. Results: All of the 68 operations were successfully completed. The overall incidence of postoperative complications was 51.5% (35/68). The incidence of postoperative pancreatic fistula was 13.2% (9/68), of which all were cases of grade B.There were 16 patients (23.5%) occurred with abdominal infection, and 11 patients (16.2%) occurred with delayed gastric emptying, including 1 case of grade A, 1 case of grade B and 9 cases of grade C.And 9 patients (13.2%) occurred with postoperative bleeding was, including 2 cases of mild bleeding, 5 cases of moderate bleeding, and 2 cases of severe bleeding.Biliary leakage occurred in one patient (1.5%) and chylous leakage occurred in two patients (2.9%). The modified pancreaticojejunostomy could significantly reduce the incidence of postoperative bleeding compared with control group (χ(2)=4.610, P=0.032). And there were no significant differences for other postoperative complications between the two groups (all P>0.05). According to the results of univariate analysis: age, intraoperative bleeding and diameter of pancreatic tube were related factors affecting postoperative pancreatic fistula (P=0.025, 0.019, 0.017, respectively). The results of multivariate analysis showed that intraoperative bleeding>400 ml and diameter of pancreatic tube <3 mm were independent risk factors of pancreatic fistula following pancreaticoduodenectomy (P=0.025, 0.008, respectively). Conclusion: The modified pancreaticojejunostomy is feasible with advantages of reducing postoperative bleeding following pancreaticoduodenectomy.

Antimicrobial resistance of staphylococci and streptococci isolated from dogs

A study was conducted for the examination of bacterial species isolated in dogs from Animal Clinics of Nanjing Agricultural University, China. Forty nasal swabs were taken from dogs having respiratory signs. Staphylococcus pseudintermedius was the most frequently isolated pathogen (37.50 %) followed by Staphylococcus aureus (18.75%), Streptococcus pluranimalium (10.93%), Streptococcus canis (9.37%), Staphylococcus schleiferi (9.37%), Staphylococcus intermedius (6.25%), Staphylococcus cohnii (4.71%) and Staphylococcus hominis (3.12%). S. pseudintermedius and S. pluranimalium were subjected to commonly used antibiotics for determination of resistant drugs. Antimicrobial resistance in S. pseudintermedius was common in gentamicin (70.83%) and tetracycline (50%) while in S. pluranimalium was common in enrofloxacin (71.42%) and gentamicin (57.14%).

The prognostic value of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system in triple-negative breast cancer

The American Joint Committee on Cancer (AJCC) released its 8th edition of cancer staging implemented in early 2018. This study aims to compare anatomic staging (AS) with prognostic staging (PS) based on the updated AJCC 8th edition staging manual. A retrospective single-center analysis of 313 triple-negative breast invasive ductal carcinoma patients who received surgery at department of breast surgery in the Fourth Hospital of Hebei Medical University from 01/2010 -12/2012 was performed. All cases were restaged using the AJCC 8th edition AS and PS system. The 7-year disease-free survival (DFS) and the 7-year overall survival (OS) rates were 76.30% and 78.27%, respectively. Applying the PS system, 277 (88.5%) patients of the AS groups were upstaged to the PS groups, 31 cases with IIIC and 5 cases with IV unchanged (11.5%) and no cases downstaged. Both 7-year DFS and 7-year OS were significantly different in the different AS and PS groups (all, p<0.001). The PS system was found to provide better prognostic information in patients with AS group IIB. A total of 43 patients with AS group IIB were upstaged by PS system, in which 30 patients were +2 upstaged to PS IIIB, and 13 patients were +3 upstaged to PS IIIC. PS IIIB and IIIC from AS IIB had significant differences in 7-year DFS (χ2=5.628, p=0.014) and 7-year OS (χ2=6.037, p=0.018). Both AS and PS systems proposed in the 8th edition of the AJCC breast cancer staging manual had prognostic value in TNBC. Moreover, the PS system predicts clinical outcomes of TNBC patients more accurately than the traditional AS system.

Amplification of DNA damage-inducible transcript 3 (DDIT3) is associated with myxoid liposarcoma-like morphology and homologous lipoblastic differentiation in dedifferentiated liposarcoma

Dedifferentiated liposarcoma is defined as progression of atypical lipomatous tumor/well-differentiated liposarcoma to a higher grade usually non-lipogenic sarcoma, with amplification of 12q13-15. This region contains several genes involved in liposarcoma pathogenesis, including MDM2, CDK4, and DDIT3. While the former two are thought of as the main drivers in dedifferentiated liposarcoma, DDIT3 is typically rearranged in myxoid liposarcoma. Overexpression of DDIT3, along with MDM2 and CDK4, may contribute to the pathogenesis of dedifferentiated liposarcoma by interfering with adipocytic differentiation. Dedifferentiated liposarcoma with DDIT3 amplification has not been well characterized. In this study we evaluate the presence of DDIT3 amplification in 48 cases of dedifferentiated liposarcoma by cytogenomic microarray analysis and its correlation with demographic, clinical, and morphologic characteristics. Data from The Cancer Genome Atlas were also evaluated to determine a relationship between DDIT3 amplification and prognostic outcomes. Of the 48 cases, 16 (33%) had amplification of DDIT3; these patients were on average 11 years younger than patients without DDIT3 amplification (P < 0.05). Myxoid liposarcoma-like morphologic features were identified in 12/16 (75%) cases with DDIT3 amplification and in 7/32 (22%) cases without amplification (P < 0.05). Homologous lipoblastic differentiation was seen in 6/16 (38%) cases with DDIT3 amplification and 2/32 (6%) cases without it (P < 0.05). There was no significant correlation between DDIT3 amplification and tumor location, disease-specific or recurrence-free survival, and distant metastasis. DDIT3 amplification appears to interfere with the adipogenic molecular program and plays a role in inducing or maintaining a lipogenic phenotype in dedifferentiated liposarcoma. From a diagnostic standpoint, it is important to consider DDIT3-amplified dedifferentiated liposarcoma in the differential diagnosis of myxoid liposarcoma, particularly in small biopsies. Further studies evaluating the significance of DDIT3 amplification in the pathogenesis of dedifferentiated liposarcoma, as well as a potential predictor of tumor behavior in well-differentiated liposarcoma, are needed.

[Effects of calcium supplementation during the pregnancy and early infancy stage on the body mass index and gut microbiota in the infants]

Objective: To investigate the effects of calcium supplementation during the pregnancy and early infancy stage on body mass index (BMI) and gut microbiota in the infants. Methods: A total of 1 752 healthy pregnant women and their infants (breast feeding) in two maternal and child health care hospitals of Beijing were chosen as the subjects in this study from May to October 2016. Questionnaires were used to obtain the general information and supplementation of calcium and vitamin D in mothers and their infants. The body length and weight of infants at birth and 6 months were recorded to calculate the BMI. The random number table method was used to randomly select 40 infants from each group for gut microbiota analysis (If less than 40 infants were all included in this study, 23 infants in the pregnancy and early infancy would be all treated with calcium supplements. There were 6 infants who was not added calcium during the pregnancy but added in the early infancy). Then it was compared that the effects of calcium supplementation during the pregnancy and early infancy on the BMI and gut microbiota composition of infants were determined at birth and 6 months. Results: Compared to the group with no calcium supplementation during the pregnancy ((12.76±1.23), (17.68±0.76)kg/m(2)), the BMI of infants at birth and 6 months in the group with calcium supplementation during the pregnancy ((13.51±0.47), (17.91±0.23)kg/m(2)) were significantly higher(P<0.05). In the group with maternal calcium supplementation, the BMI at 6 months ((18.63±0.52)kg/m(2)), BMI increment ((5.71±0.54)kg/m(2)) and the content of lactobacillus (21.04%±3.68%) in the only calcium supplementation subgroup in the early infancy were higher than those in only vitamin D supplementation subgroup ((17.69±0.89) kg/m(2), (4.17±1.01) kg/m(2) and 12.28%±3.86%) (P<0.05). In the group without maternal calcium supplementation, the content of lactobacillus (20.15%±4.87%) in the only calcium supplementation subgroup were also higher than those in only vitamin D supplementation subgroup (14.64%±3.71%) (P<0.05). Conclusion: Appropriate calcium supplementation during the pregnancy is good for the growth and development of the fetus. Calcium supplementation in the early infancy could increase the BMI of infants, and promote the growth of intestinal lactobacillus.

[Transmission cluster and network of HIV-1 CRF01_AE strain in China, 1996-2014]

Objective: To understand the transmission patterns and risk factors of HIV-1 strain CRF01_AE subtypes in China, and to provide guidance for the implementation of precise intervention. Methods: A total of 2 094 CRF01_AE pol sequences were collected in 19 provinces in China between 1996 and 2014. Phylogenetic tree was constructed by PhyML 3.0 software to select the transmission clusters. Transmission network was constructed by Cytoscape 3.6.0, which was further used for exploring of the major risk factors. Results: Of the 2 094 sequences, 12.18% (255/2 094) were in clusters. A total of 82 transmission clusters were identified. The numbers of clusters and contained sequences in intra-provincial transmission (61, 173) were significantly more than those in inter-provincial transmission (21, 82). The ratio of transmission clustering in MSM increased over time from 2.41% (2/83) during 1996-2008 to 23.61% (72/305) during 2013-2014, showing a significant upward trend (χ(2)=27.800, df=1, P=0.000). The proportion of MSM with inter-provincial transmission clusters were higher than those with intra-provincial transmission clusters, which increased from 0.67% (2/297) during 1996-2008 to 6.36%(30/472) during 2013-2014, showing a significant upward trend (χ(2)=20.276, df=1, P=0.000). The transmission rate in homosexuals of the inter-transmission clusters (86.59%, 71/82) was higher than that of intra-provincial transmission clusters (56.65%, 98/173), and the difference was statistically significant (χ(2)=22.792, P=0.000). The proportion of inter-provincial transmission clusters with more than 2 transmission routes (33.33%, 7/21) was higher than that of intra-provincial clusters (13.11%, 8/61), and the difference was statistically significant (χ(2)=4.273, P=0.039). Results from the transmission network analysis indicated that the proportion of high risk population (degree≥4) with inter-provincial transmission clusters (51.22%, 42/82) was significantly higher than that with intra-provincial transmission clusters (26.59%, 46/173), and the difference was statistically significant (χ(2)=14.932, P=0.000). Inter-provincial clusters were mainly detected in and and MSM. Conclusions: Complex transmission networks were found for HIV-1 CRF01_AE strains in the mainland of China. Inter-provincial transmission clusters increased rapidly, MSM played an important role in the wide spread of the strain. More researches in transmission networks are needed to guide the precision intervention.

[Application of multiplex PCR assay to study early multiple herpesviruses infection during HSCT]

Objective: To investigate herpesvirus infection in early stage of hematopoietic stem cell transplantation (HSCT) by multiplex polymerase chain reaction (PCR), and to explore the association between multiple herpesviruses infection and clinical characteristics in HSCT patients and its impact on post-transplant complications and prognosis. Methods: A total of 734 peripheral blood samples were collected from 90 patients undergoing HSCT in the Department of Hematology, the First Affiliated Hospital of Soochow University between February 2017 and August 2017. The peripheral blood specimens were obtained before and within 90 days after transplantation at different time points. Lab-Aid824 Nucleic Acid Extraction Mini Reagent was used to extract DNA and multiplex PCR assay was used to simultaneously detect 8 kinds of human herpesviruses from genomic DNA. The incidence of various herpesvirus infections, its correlation with clinical features and effects on post-transplant complications and prognosis were analyzed. Results: The median follow-up time was 192 (range: 35-308) days. Among the 90 patients before transplantation, the incidence of herpes virus infection was 35.6% (32/90), including 12.2% (11/90) with one herpes virus infection and 23.3% (21/90) with multiple viruses infection. The incidence of herpes virus infection after transplantation was 77.8% (70/90), including 20.0% (18/90) with one herpes virus infection and 57.8% (52/90) with multiple herpes virus infection. Among the 52 patients with multiple herpes viruses infection, 30 (57.7%) patients were infected by 2 kinds of viruses, 18 (34.6%) patients by 3 kinds of viruses and 4 (7.7%) patients by 4 kinds of viruses. There was a correlation between HHV-6 and HHV-7 herpesvirus infection (OR=13.880, Q=0.026). EBV infection was related to HHV-7 infection (OR=0.093, Q=0.044). The age of patients was correlated with the incidence of HHV-1 infection before transplantation. There were 24 patients in our study experienced clinical symptoms associated with viral infection. The main manifestations were hemorrhagic cystitis (HC), interstitial pneumonia, enteritis, viral encephalitis and fever of unknown origin. EBV infection was related to HLA incompatibility and the inconsistent of the ABO blood group and grade Ⅱ-Ⅳ aGVHD after transplantation. HLA incompatibility and the unrelated donor and grade Ⅱ-Ⅳ aGVHD were related to multiple viruses infection. Conclusion: Multiple herpesviruses were common in patients undergoing HSCT, which were closely related to HLA mismatch, unrelated donor and grade Ⅱ-Ⅳ aGVHD.

[Endoscopic transnasal approach for surgical treatment of skull base clival area chordomas (Report of 2 cases)]

The case 1 performanced submandibular trauma because of the faint Suddenly. There were no obvious abnormality in physical examination. CT result showed that the tumour located in the lower clivus, and the atlas was infringed. MRI imaging showed the tumour located in the both sides of the internal carotid artery, infringed clivus and atlas front, forwarded into the nasal cavity and oral cavity. The case 2 performanced the left nose stuffy and increased gradually, nasopharyngeal mirror showed the left nasal cavity filled with new life. CT showed the lesions located in the cranial fossa under the sella turcica and sphenoid bone, down into the sphenoid sinus and the nasopharyngeal cavity. MRI imaging showed the lesions located in the front of clivus. According to the CT and MRI imaging features before surgery, the two cases adopted endoscopic transsphenoidal approach, and the postoperative pathology were chordoma in the central line of the skull base.

[Surgical resection for gastric cancer patients with liver metastasis]

Objective: To explore the surgical results and clinicopathological features of gastric cancer patients with liver metastases. Methods: The clinicopathological data and post-operative survival of 37 patients who underwent resection of liver metastasis from gastric cancer at our department from Dec. 2007 to Dec. 2014 were analyzed. Results: The 1-, 3-, and 5-year overall survival rates after resection were 91.4%, 57.9%, and 22.0%, respectively, with a median survival of 37 months. Univariate analysis revealed that lymph node metastasis, multiple hepatic metastases and no preoperative chemotherapy are unfavorable prognostic factors for overall survival. Multivariate analysis identified that lymph node metastasis and number of liver metastasis are independent prognostic factors. Conclusions: Gastric cancer patients with a solitary liver metastasis may be good candidates for gastric D2 resection combined with liver R0 resection.

Ultraviolet lasing in Zn-rich ZnO microspheres fabricated by laser ablation

Zinc (Zn) surface plasmons (SPs) have been widely reported for their impressive performance in improving the optical properties of semiconductors. Zn is an effective metal with SPs response in the ultraviolet region, but the disadvantage of strong metal activity limits the application mentioned above. Here, in order to ensure the stability of metal Zn, ZnO/Zn microspheres were synthesized by an one-step laser ablation method to distribute Zn nanoparticles simultaneously on both inner and outer surfaces of ZnO microspheres. Lasing performance enhancement and a lower threshold were obtained in the composite which originates from the coupling between Zn SPs and the excitation light source. Accompanied by the lasing emission measurements, the coupling mechanism was explained through time-resolved photoluminescence spectroscopy (TRPL) for the samples by rapid annealing in situ. This work displays the results of lasing enhancement and the physical process of Zn SPs resonance in the ZnO/Zn microsphere.

[Treatment of central nervous system leukemia with CD19-chimeric antigen receptor T-cell immunotherapy: two cases report and literature review]

Objective: To explore the efficacy and safety of chimeric antigen receptor T (CAR-T) cells in the treatment of central nervous system leukemia (CNSL). Methods: Two leukemia patients with CNSL were treated with CD19-CAR-T cells. The process and results of the entire treatment is reported and related literature review is conducted. Results: The patients were diagnosed as acute myeloid leukemia (AML)-M(2) with B lymphoid antigen expression and B cell acute lymphoblastic leukemia(B-ALL) by morphology and immunophenotype assay. The immunophenotype was consistent with the abnormal manifestations of AML-M(2) and B-ALL. Their clinical manifestations and laboratory tests met the diagnostic criteria of CNSL. The diagnosis was clear and the two patients were treated with CD19-CAR-T cell immunotherapy. Central nervous system symptoms were relieved. The imaging abnormalities of patient one has disappeared but cytokines release syndrome (CRS) occurred during the treatment. Cerebrospinal fluid of patient two was negative and no obvious CRS reaction was found. Conclusions: CAR-T cell immunotherapy is likely to induce the remission of CNSL and improve the prognosis.

[Caries prevention effectiveness of aresin based sealant and a glass ionomer sealants: a report of 5-year-follow-up]

Objective: To evaluate and compare the caries prevention effectiveness of a resin-based sealant and a glass ionomer sealant on permanent first molars in 7- to 9-years-old school children. Methods: A randomized controlled, examiner-blinded, 5-year clinical trial was conducted in 19 primary schools in Dalian, Liaoning province. Totally 419 children (with 664 first molars) who had at least one sound permanent first molar with deep fissures or fissures with signs of non-cavitated lesions were recruited and stratified and allocated randomly into three parallel groups. A resin-based sealant was used in Group R (136 children with 219 first molars) and a glass ionomer sealant was used in Group G (130 children with 218 first molars). The third group (Group N, 153 children with 227 first molars) with none of the two sealants applied was served as blank control. Follow-up examinations were conducted at 0.5, 1, 2, and 5 years after sealing in order to assess the retention of the sealants and the incidence of caries occurrence. Chi-square test was adopted to compare the differences of caries incidence among the 3 groups. Generalized estimating equations (GEE) was used to analyze the effective factors of caries incidence. Results: During the 5-year follow-up period, 13.4% (23/172) of the teeth in Group R, 22.5% (40/178) of the teeth in Group G and 34.5% (57/165) of the teeth in Group N were diagnosed as having developed cavitated lesions. And the differences in the incidence of caries among the three groups was statistically significant (P<0.05). According to GEE, the resin-based sealant and the glass ionomer sealant were found to be the protection factors and the non-cavitated lesion before sealing was found to be the risk factor. The resin-based sealant was found to be the protection factor to the glass ionomer sealant when the blank control group was removed. Conclusions: Both resin-based sealant and glass ionomer sealant could effectively prevent the permanent first molars from the occurrence of carious lesions in 5 years. The resin-based sealant was superior to the glass ionomer sealant in caries prevention.

[Genetic Polymorphisms of 27 Y-STR Loci in Dongxiang Population of Gansu Province]

OBJECTIVES

To investigate the genetic polymorphisms of 27 Y-STR in Dongxiang population of Gansu province, and to explore the population genetic relationship and the value of forensic application.

METHODS

The genotyping of 27 Y-STR loci in 526 unrelated male individuals in Dongxiang population of Gansu province were detected by STRtyper-27Y kit. The allele frequencies and haplotype diversity were also calculated. Combining with other genetics data of 14 loci in same populations, which have been published at home and abroad, the genetic distance and clustering relationship in Dongxiang population of Gansu province were calculated.

RESULTS

Totally 55 haplotypes were found in the DYS385a/b biallelic loci, 39 haplotypes in DYF387S1 loci, and 4-16 alleles in the rest 23 single copy STR loci. The GD value was from 0.453 9 （DYS391） to 0.957 5 （DYS385a/b）. Totally 471 haplotypes were observed in 27 Y-STR loci in 526 individuals, and the value of haplotypes diversity was 0.999 5. The genetic distance between Dongxiang and Tibetan populations of Gansu province was the closest （0.068 2）, while it was the longest between Dongxiang population in Gansu province and Han population in Henan province （0.084 7）. The result of dimensional analysis established upon the genetic distance was basically matched with that of the cluster analysis.

CONCLUSIONS

The 27 Y-STR loci show a high genetic polymorphism in Dongxiang population of Gansu province, which has significance for the Y-STR database establishment, population genetics study and forensic practice.

[Effect of docosahexenoic acid supplementation on infant's growth and body mass index during maternal pregnancy]

Objective: To investigate the effects of docosahexenoic acid (DHA) supplementation on infant's growth and BMI during pregnancy. Methods: A total of 1 516 healthy pregnant women delivered their babies in two maternal and child health care hospitals in Beijing and were chosen as the subjects in this cohort study from May to October 2015. Self-developed questionnaires were used to gather general information of the subjects, including age, height, weight, weight gain during pregnancy, delivery mode, DHA supplementation etc., before giving birth. Information on body length, weight, head circumference and BMI at birth and 6 months postnatal, of the infants were recorded. Breast milk was collected to test the fatty acid profiles by using the gas chromatography (GC) method at one to three months postnatally. Results: The overall rate of DHA supplementation was 47.76% among the pregnant women, in which introduction of DHA from the early and second stage of the pregnancy accounted for 49.31% and 39.64% respectively. When DHA supplementation began from the early pregnant stage, the DHA concentration showed an increase in the milk (P<0.05), whereas the supplementation began from the second and third stages did not affect the milk DHA concentration (P>0.05). Higher height and lower BMI were seen in the infants at birth and 6 months in the supplementation group when comparing to the non-supplementary group (P<0.05), with the greatest effects noticed in the earliest supplementation group. Specifically, the head circumference appeared larger from the early pregnant stage in the DHA supplementary group, than that in the non-supplement group (P=0.001). The increment of head circumference was larger than that in the other groups when the infants were 6-month old (P<0.01). Results from the partial regression analysis showed that during pregnancy, there were positive correlations between DHA supplementation and height (r=0.324, r=0.216), head circumference (r=0.221, r=0.302) as well as the increment of head circumference (r=0.276) at birth and 6 months (P<0.05). Whereas, a negative correlation was shown between DHA and the infants' BMI (r=-0.310, r=-0.371) (P<0.05) when supplementation was given during maternal pregnancy. Conclusions: When DHA supplementation program was carried out during maternal pregnancy, it could increase the height and head circumference and inhibit the rapid increase of BMI in the infants BMI. Our findings seemed helpful in promoting brain development and preventing the childhood obesity.

Plasma soluble cluster of differentiation 147 levels are increased in breast cancer patients and associated with lymph node metastasis and chemoresistance

INTRODUCTION

Cluster of differentiation 147 (CD147) contributes to breast cancer invasion, metastasis, and multidrug resistance. Recent studies have shown that peripheral soluble CD147 (sCD147) is increased in hepatocellular tumour and multiple myeloma patients and correlated with disease severity. The primary aim of our study was to assess the level, as well as the biological and clinical significance of sCD147 in breast cancer.

METHODS

We tested plasma sCD147 levels in 308 breast cancer patients by enzyme-linked immunosorbent assay between February 2014 and February 2017. A subset of 165 cases of benign breast diseases was included as a control group at the same period. We analysed the clinical significance of plasma sCD147 with relevance to clinicopathological factors of breast cancer patients.

RESULTS

Plasma sCD147 levels were significantly higher in patients with primary breast cancer than those with benign breast diseases (P=0.001), in patients with locally advanced breast cancer (T3-T4 tumour) than those in early breast cancer (T1-T2 tumour; P=0.001), in patients with lymph node metastasis than in those without (P<0.001), and in patients with high recurrence risk than those with medium recurrence risk (P<0.001). Plasma sCD147 levels were also significantly higher in the chemotherapy-resistant group than in the chemotherapy-sensitive group (P=0.040). Plasma sCD147 was an independent predictor for lymph node metastasis in breast cancer patients (P=0.001).

CONCLUSION

This is the first study to demonstrate that plasma sCD147 levels are elevated in breast cancer patients. Soluble CD147 is also associated with tumour size, lymph node metastasis, high recurrent risk, and chemoresistance. Our findings support that plasma sCD147 is an independent predictive factor for lymph node metastasis.

Obesity-associated cardiac pathogenesis in broiler breeder hens: Development of metabolic cardiomyopathy

Feed intake is typically restricted (R) in broiler hens to avoid obesity and improve egg production and livability. To determine whether improved heart health contributes to improved livability, fully adult 45-week-old R hens were allowed to consume feed to appetite (ad libitum; AL) up to 10 wk (70 d). Mortality, contractile functions, and morphology at 70 d, and measurements of cardiac hypertrophic remodeling at 7 d and 21 d were made and compared between R and AL hens. Outcomes for cardiac electrophysiology and mortality, reported separately, found increased mortality in AL hens in association with cardiac pathological hypertrophy and contractile dysfunction. The present study aimed to delineate metabolic cardiomyopathies underlying the etiology of obesity-associated cardiac pathology. Metabolic measurements were made in hens continued on R rations or assigned to AL feeding after 7 d and 21 days. AL feeding increased plasma insulin, glucose, and non-esterified fatty acid (NEFA) concentrations by 21 d (P < 0.05). Metabolic cardiomyopathy in AL-hens was confirmed by cardiac triacylglycerol (TG) and ceramide accumulation consistent with up-regulation of related enzyme gene expressions, and by increased indices of oxidation stress (P < 0.05). In contrast to R hens, cardiac pyruvate dehydrogenase (PDH) activity and glucose transporter (GLUT) gene expressions increased progressively while carnitine palmitoyltransferase-1 (CPT-1) transcript levels in AL hens declined from 7 d to 21 d (P < 0.05), reflecting a shift from an oxidative to a more glycolytic metabolism, a typical metabolic derangement associated with cardiac hypertrophic remodeling. Cardiac pathogenesis in AL hens was further indicated by increased leukocyte infiltrates, interleukin-1β (IL-1β) and IL-6 production, cellular apoptosis, interstitial fibrosis, and expression of the heart failure marker myosin heavy chain (MHC-β; cardiac muscle beta) (P < 0.05). Results support the conclusion that diabetic conditions, cardiac inflammation and lipotoxic metabolic derangements act as pathological cues to trigger pathogenic changes along cardiac hypertrophy in AL hens.

Obesity-associated cardiac pathogenesis in broiler breeder hens: Pathological adaption of cardiac hypertrophy

Broiler hens consuming feed to appetite (ad libitum; AL) show increased mortality. Feed restriction (R) typically improves reproductive performance and livability of hens. Rapidly growing broilers can exhibit increased mortality due to cardiac insufficiency but it is unknown whether the increased mortality of non-R broiler hens is also due to cardiac compromise. To assess cardiac growth and physiology in fully mature birds, 45-week-old hens were either continued on R rations or assigned to AL feeding for 7 or 21 days. AL hens exhibited increased bodyweight, adiposity, absolute and relative heart weight, ventricular hypertrophy, and cardiac protein/DNA ratio by d 21 (P < 0.05). Increased heart weights due to hypertrophic growth was attributed to enhanced IGF-1-Akt-FoxO1 signaling and its downstream target, translation initiation factor 4E-BP1 in conjunction with down-regulation of ubiquitin ligase atrogin-1/MAFbx (P < 0.05). Reduced activation of cardiac AMPK and downstream activation of ACC-1 in parallel with increased cardiac nitric oxide levels, calcineurin activity, and MAPK activation in AL hens (P < 0.05) suggested that metabolic derangement develops along the cardiovascular remodeling. These indictors of cardiac maladaptive hypertrophic growth were further supported by uregulation of heart failure markers, BNP and MHC-β (P < 0.05). Hens allowed AL feeding for 70 d exhibited a higher incidence of mortality (40% vs. 10%) in association with ascites, pericardial effusion, and ventricle dilation. A higher incidence of irregular ECG patterns and rhythmicity consistent with persistently elevated systolic blood pressure and ventricle fibrosis were observed in AL hens (P < 0.05). These observations support the conclusion that AL feeding in broiler hens results in maladaptive cardiac hypertrophy that progresses to overt pathogenesis in contractility and thereby increases mortality. Feed restriction provides clear physiological benefit to heart function of adult broiler hens.

Metabonomic analysis of toxic action of long-term low-level exposure to acrylamide in rat serum

This study assessed the effects of long-term, low-dose acrylamide (AA) administration in rats using ultra-performance liquid chromatography–mass spectrometry. Forty male Wistar rats were randomly divided into the following four groups: control, low-dose AA (0.2 mg/kg BW), middle-dose AA (1 mg/kg BW), and high-dose AA (5 mg/kg BW). AA was administered to rats via drinking water ad libitum. After 16-week treatment, rat serum was collected for metabonomic analysis. Biochemical tests were further conducted to verify metabolic alterations. Eleven metabolites were identified with significant changes in intensities (increased or reduced) as a result of treatment. These metabolites included citric acid, pantothenic acid, isobutyryl-l-carnitine, eicosapentaenoic acid, docosahexaenoic acid, sphingosine 1-phosphate, LysoPC(20:4), LysoPC(22:6), LysoPE(20:3), undecanedioic acid, and dodecanedioic acid. Results indicate that chronic exposure to AA at no observed adverse effect level does not exert a toxic effect on rats at the body metabolism level. AA disturbed the metabolism of lipids and energy, affected the nervous system of rats, and induced oxidative stress and liver dysfunction.

[Value of sepsis single-disease manage system in predicting mortality in patients with sepsis]

Objective: To observe the effect of sepsis single-disease manage system on the improvement of sepsis treatment and the value in predicting mortality in patients with sepsis. Methods: A retrospective study was conducted. Patients with sepsis admitted to the Department of Surgical Intensive Care Unit of Sun Yat-Sen University First Affiliated Hospital from September 22, 2013 to May 5, 2015 were enrolled in this study. Sepsis single-disease manage system (Rui Xin clinical data manage system, China data, China) was used to monitor 25 clinical quality parameters, consisting of timeliness, normalization and outcome parameters. Based on whether these quality parameters could be completed or not, the clinical practice was evaluated by the system. The unachieved quality parameter was defined as suspicious parameters, and these suspicious parameters were used to predict mortality of patients with receiver operating characteristic curve (ROC). Results: A total of 1 220 patients with sepsis were enrolled, included 805 males and 415 females. The mean age was (59±17) years, and acute physiology and chronic health evaluation (APACHE Ⅱ) scores was 19±8. The area under ROC curve of total suspicious numbers for predicting 28-day mortality was 0.70; when the suspicious parameters number was more than 6, the sensitivity was 68.0% and the specificity was 61.0% for predicting 28-day mortality. In addition, the area under ROC curve of outcome suspicious number for predicting 28-day mortality was 0.89; when the suspicious outcome parameters numbers was more than 1, the sensitivity was 88.0% and the specificity was 78.0% for predicting 28-day mortality. Moreover, the area under ROC curve of total suspicious number for predicting 90-day mortality was 0.73; when the total suspicious parameters number was more than 7, the sensitivity was 60.0% and the specificity was 74.0% for predicting 90-day mortality. Finally, the area under ROC curve of outcome suspicious numbers for predicting 90-day mortality was 0.92; when suspicious outcome parameters numbers was more than 1, the sensitivity was 88.0% and the specificity was 81.0% for predicting 90-day mortality. Conclusion: The single center study suggests that this sepsis single-disease manage system could be used to monitor the completion of clinical practice for intensivist in managing sepsis, and the number of quality parameters failed to complete could be used to predict the mortality of the patients.