[Current status of hearing loss and related influencing factors in workers with noise exposure in refining and chemical industry]

Objective: To investigate the current status of hearing loss and related influencing factors in workers with noise exposure in refining and chemical industry. Methods: From August 2015 to March 2016, the investigation method of collecting the data of past occupational health examinations and measuring noise in working environment was used to enroll 8 672 male workers. Results: Of all workers, 11.6% were diagnosed with hearing loss. There were significant differences in the distribution of hearing impairment among workers exposed to noise at different ages, device types and types of work (χ(2)=17.80, 77.80 and 30.53, all P<0.05) . The level of noise exposure≥85 dB (A) (OR=5.79, 95%CI 3.70-8.81) , working years with noise exposure (OR=1.57, 95%CI 1.05-2.43) , and 25 years (OR=3.29, 95%CI 2.08-5.71) were risk factors for hearing loss in workers with noise exposure in refining and chemical industry. Conclusion: The level of noise exposure and working years with noise exposure are main influencing factors for hearing loss in workers with noise exposure in refining and chemical industry.

[Application of vascular replacement technique with allogenic blood vessel in radical resection for pancreatic carcinoma: a report of 33 cases]

Objective: To analyze the application of vascular replacement technique with allogenic blood vessel in radical resection for pancreatic carcinoma. Methods: The clinical data of 33 patients with vascular invasion of pancreatic carcinoma who underwent radical resection from April 2013 to April 2017 in Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital were retrospectively analyzed. There were 14 males and 19 females with age of (62.5±10.6)years(ranging from 35 to 78 years). Vascular replacement technique with allogenic blood vessel was used on all patients who underwent radical resection for pancreatic carcinoma. The operation procedure was made according to the specific location of the carcinoma, and the allogenic blood vessel was selected according to the type of vascular invasion. The matching vessel was selected for replacement to the patient who was invaded only one vessel. And the "Y" type of iliac vein was selected for replacement to the patient who was invaded the confluence of portal vein, splenic vein and superior mesenteric vein. After the operation, the patients were followed up by telephone and outpatient review. Results: All of 33 patients were successfully completed the operations. There were 28 patients underwent pancreaticoduodenectomy with vascular replacement, and 5 patients underwent total pancreatectomy with vascular replacement. All the patients were confirmed pancreatic carcinoma and R0 resection according to the postoperative pathology. There were 16 patients with the carcinoma invasion the confluence of portal vein, splenic vein and superior mesenteric vein, 12 patients with the carcinoma invasion the superior mesenteric vein, and 5 patients with the carcinoma invasion the portal vein. There was no perioperative death in this group and no complications related to allogenic blood vessel. The incidence of postoperative complications was 18.2% (6/33), and the incidence of pancreatic fistula was 6.1% (2/33), all of which were biochemical fistula. There were 32 patients were followed up, and the follow-up rate was 96.9%. The median survival time was 14.6 months. The half-year, 1-year and 2-year survival rates were 75.6%, 37.6% and 27.4%. Conclusion: The application of vascular replacement technique with allogenic blood vessel for pancreatic carcinoma has a great significance for improving the R0 resection rate and the prognosis of patients.

Precision Measurement of the e^{+}e^{-}→Λ_{c}^{+}Λ[over ¯]_{c}^{-} Cross Section Near Threshold

The cross section of the e^{+}e^{-}→Λ_{c}^{+}Λ[over ¯]_{c}^{-} process is measured with unprecedented precision using data collected with the BESIII detector at sqrt[s]=4574.5, 4580.0, 4590.0 and 4599.5 MeV. The nonzero cross section near the Λ_{c}^{+}Λ[over ¯]_{c}^{-} production threshold is cleared. At center-of-mass energies sqrt[s]=4574.5 and 4599.5 MeV, the higher statistics data enable us to measure the Λ_{c} polar angle distributions. From these, the Λ_{c} electric over magnetic form-factor ratios (|G_{E}/G_{M}|) are measured for the first time. They are found to be 1.14±0.14±0.07 and 1.23±0.05±0.03, respectively, where the first uncertainties are statistical and the second are systematic.

[Effects of sural nerve nutrition vess els-supported flap for reconstruction of distal lower leg and ankle soft tissue defects]

Objective: To observe the effects of sural nerve nutrition vessels-supported flap for reconstruction of distal lower leg and ankle soft tissue defects. Methods: From June 2014 to June 2017, 37 patients with calf distal and ankle soft tissue defect were repaired with sural nerve nutrition vessels-supported flap, of them 12 cases with calf distal soft tissue defect wounds and 25 cases with ankle soft tissue defect wounds.The scope of flaps was 9 cm×4 cm to 18 cm×9 cm, anti-infection, anti-freezing and dressing treatments were carried out after operation.The results of two-point discrimination among reexamination were recorded. Results: All the flaps survived without ulcer and effusion, only 1 flap for reconstruction of medial malleolus swelled and deactivated at the beginning while it recovered with proper dressings.During the follow-up periods, all the flaps kept favorable feelings, aspects and functions, and the two-point discrimination was 5 to 15 mm [averaged (11.2±1.7) mm]. Conclusion: Sural nerve nutrition vessels-supported flap brings significant effects with excellent safety and reliability in repairing calf and ankle soft tissue defects.

[Prognostic significance of neoplastic central nervous system tumor classification for patients with low grade glioma]

Objective: To explore the prognostic impact of 2016 World Health Organization (WHO) classification of central nervous system (CNS) tumors on patients with low grade gliomas (LGG). Methods: A total of 482 patients diagnosed with LGG in Beijing Tiantan Hospital affiliated to Capital Medical University from January 2009 to May 2016 were pathologically reclassified and retrospectively reviewed. In the survival analysis, Kaplan-Meier Plot was used to univariate analysis and Cox proportional hazards model was used to multivariate analysis. Results: According to the 2016 WHO CNS criterion, a total of 232 LGG were reclassified as O 1p/19q-deleted and IDH-mutant, 134 as A IDH-mutant and 116 as A IDH-wildtype. Univariate analysis showed that 2016 WHO CNS divided LGG into three subgroups with distinct survival (P<0.001). Multivariate analysis showed that both 2007 WHO CNS and 2016 WHO CNS were independent prognostic factors, but the Hazard ratio (HR) of 2016 WHO CNS was significantly higher than that of 2007 WHO CNS (P<0.01). Conclusions: 2016 WHO CNS classification criteria can divide LGG into three subgroups with significantly distinct survival, which has further improved the clinical prognostic value of it and fully reflected its advantages in predicting prognosis.

[Cross-sectional survey of autism spectrum disorders in children aged 0-6 years in Hainan province]

Objective: To understand the prevalence of autism spectrum disorders (ASD) in children aged 0-6 years old and influencing factors in Hainan province. Methods: A total of 37 862 children aged 0-6 years were selected from 18 counties in Hainan province for a screening by using questionnaire of"warning signs in child development", then field diagnosis was made, and general descriptive statistic analysis was conducted. The prevalence of ASD and related factors were analyzed with χ(2) test and unconditional logistic regression model. Results: Among 37 862 children aged 0-6 years, 235 were diagnosed with ASD, the prevalence of ASD was 0.62% (0.99% in boys, 0.17% in girls), the differences was significant (χ(2)=101.91, P=0.000). The prevalence of ASD increased with age (χ(2)=288.62, P=0.000). The prevalence of ASD was significantly higher in urban area than in other areas (χ(2)=114.77, P=0.000). Factors such as full term pregnancy or not, neonatal asphyxia, father's characteristics, father's habit of chewing areca or smoking, mother's general mood, and mother's induced abortion history were the influencing factors for ASD. Conclusion: The prevalence of ASD in children aged 0-6 years was high in Hainan and was influenced by genetic factors, pregnancy and delivery process, parents unhealthy habit before and during pregnancy and other factors.

Determination of the Spin and Parity of the Z_{c}(3900)

The spin and parity of the Z_{c}(3900)^{±} state are determined to be J^{P}=1^{+} with a statistical significance larger than 7σ over other quantum numbers in a partial wave analysis of the process e^{+}e^{-}→π^{+}π^{-}J/ψ. We use a data sample of 1.92  fb^{-1} accumulated at sqrt[s]=4.23 and 4.26 GeV with the BESIII experiment. When parametrizing the Z_{c}(3900)^{±} with a Flatté-like formula, we determine its pole mass M_{pole}=(3881.2±4.2_{stat}±52.7_{syst})  MeV/c^{2} and pole width Γ_{pole}=(51.8±4.6_{stat}±36.0_{syst})  MeV. We also measure cross sections for the process e^{+}e^{-}→Z_{c}(3900)^{+}π^{-}+c.c.→J/ψπ^{+}π^{-} and determine an upper limit at the 90% confidence level for the process e^{+}e^{-}→Z_{c}(4020)^{+}π^{-}+c.c.→J/ψπ^{+}π^{-}.

[Epidemiology and etiology of bacillary dysentery in Xinjiang Uigur Autonomous Region, 2004-2014]

Objective: To understand the epidemiological and etiological characteristics of bacillary dysentery in Xinjiang Uigur Autonomous Region (Xinjiang) during 2004-2014, and provide evidence for the prevention and control of bacillary dysentery. Methods: Descriptive epidemiological analysis was conducted by using the incidence data of bacillary dysentery in Xinjiang during 2004-2014 and the serotyping and the antibiotic susceptibility test of the pathogens isolated were performed. Results: A total of 123 238 cases of bacillary dysentery were reported in Xinjiang from 2004 to 2014. The average annual incidence of bacillary dysentery ranged from 25.91 per 100 000 to 76.04 per 100 000 and the average annual mortality ranged from 0.00 to 46.90 per 100 000. The incidence of bacillary dysentery was higher in eastern Xinjiang than other areas. The incidence peak was during July-September. The incidence of bacillary dysentery in males was higher than that in females. The incidence was highest in infants and young children under five years old. Most cases were children outside child care settings, farmers and students. Shigella flexneri was the predominant pathogen and F2a was the most frequently detected subtype. The isolated strains were highly resistant to streptomycin, penicillin, doxycycline and tetracycline. The resistant rates to penicillin, tetracycline, doxycycline and streptomycin increased with year. Up to 71.43% of the strains were resistant to more than five antibiotics. Conclusion: The incidence of bacillary dysentery was in decrease in Xinjiang from 2004 to 2014, but in some area, the incidence of bacterial dysentery was higher than national average level. It is necessary to strengthen the surveillance and conduct targeted prevention and control in areas and population at high risk and in season with high incidence. The serious drug resistance and multi drug resistance of the pathogens have posed challenge to the prevention and treatment of bacillary dysentery in Xinjiang.

[An analysis of 181 cases with blood stream infection caused by Streptococcus agalactiae in children from 2011 to 2015: a multi-center retrospective study]

OBJECTIVE

To analyze the clinical characteristics of blood stream infection caused by Streptococcus agalactiae in children and the drug-resistance of the isolates.

METHOD

All cases with Streptococcus agalactiae growth in blood or cerebrospinal fluid cultures from January 1, 2011 to December 31, 2015 were enrolled by checking the laboratory information system (LIS) from 7 Class 3 Grade A hospitals (4 in Zhejiang, 2 in Shanghai and 1 in Chongqing). Clinical data were collected for analysis. χ(2) test, t test and non parametric test were used in the study.

RESULT

One hundred and eighty-one pediatric cases of blood stream infection caused by Streptococcus agalactiae were included in current study. Eighty-six cases (47.5%) were male, and with age range from one day to 9 years (media 13 days). Thirty cases (16.6%) were premature infants and 127 cases (70.2%) were born via vaginal delivery. Seventy-one cases (39.2%) had early onset (<7 d) infections, and 106 cases (58.6%) had late onset (7-89 d) infections. Seventy-eight cases (43.1%) were complicated with purulent meningitis. Incidences of vaginal delivery(81.7%(58/71) vs. 62.3%(66/106)), shortness of breath moaning (43.7%(31/71) vs. 15.1%(16/106)) and preterm premature rupture of membranes (25.4%(18/71) vs. 3.8%(4/106)) were higher in the early onset infection group compared with the late onset group(P all<0.05). However, the number of cases who had fever(25.4%(18/71)vs.85.8%(91/106)) and complicated with purulent meningitis (29.6%(21/71) vs. 53.8%(57/106)) in early onset infections group was less than that in the late onset group(P both<0.05). The blood cultures of most patients (87.8%) were performed before the use of antibiotics. Drug-resistant tests showed that the sensitive rates to penicillin G, ceftriaxone and cefotaxime were 98.9%, 99.0% and 99.0% respectively. All strains were sensitive to vancomucine. The rates of resistance to clindamycin and erythromycin were 68.0% and 34.0%, respectively. Only 39 cases (22.0%) were treated with single antibiotics of either penicillins or cephalosporins, 80 cases (45.2%) were treated with antibiotics containing β lactamase inhibitor, 61 cases (34.5%) were treated with either meropenem or cefoperazone-sulbactam. One hundred and fifty-four cases were cured, while 19 died (including 13 complicated with purulent meningitis) and 8 lost to follow up after giving up of treatment.

CONCLUSION

The incidence and mortality of blood stream infection caused by Streptococcus agalactiae complicated with purulent meningitis are high in children. Penicillin is the first choice in treatment. Antibiotics should be selected accorrding to the drug-resistance test.

Cupping therapy versus acupuncture for pain-related conditions: a systematic review of randomized controlled trials and trial sequential analysis

Background

Both cupping therapy and acupuncture have been used in China for a long time, and their target indications are pain-related conditions. There is no systematic review comparing the effectiveness of these two therapies.

Objectives

To compare the beneficial effectiveness and safety between cupping therapy and acupuncture for pain-related conditions to provide evidence for clinical practice.

Methods

Protocol of this review was registered in PROSPERO (CRD42016050986). We conducted literature search from six electronic databases until 31st March 2017. We included randomized trials comparing cupping therapy with acupuncture on pain-related conditions. Methodological quality of the included studies was evaluated by risk of bias tool. Mean difference, risk ratio, risk difference and their 95% confidence interval were used to report the estimate effect of the pooled results through meta-analysis or the results from each individual study. Trial sequential analysis (TSA) was applied to adjust random errors and calculate the sample size.

Results

Twenty-three randomized trials with 2845 participants were included covering 12 pain-related conditions. All included studies were of poor methodological quality. Three meta-analyses were conducted, which showed similar clinical beneficial effects of cupping therapy and acupuncture for the rate of symptom improvement in cervical spondylosis (RR 1.13, 95% CI 1.01 to 1.26; n = 646), lateral femoral cutaneous neuritis (RR 1.10, 95% CI 1.00 to 1.22; n = 102) and scapulohumeral periarthritis (RR 1.31, 95% CI 1.15 to 1.51; n = 208). Results from other outcomes (such as visual analogue and numerical rating scale) in each study also showed no statistical significant difference between these two therapies for all included pain-related conditions. The results of TSA for cervical spondylosis demonstrated that the current available data have not reached a powerful conclusion. No serious adverse events related to cupping therapy or acupuncture was found in included studies.

Conclusion

Cupping therapy and acupuncture are potentially safe, and they have similar effectiveness in relieving pain. However, further rigorous studies investigating relevant pain-related conditions are warranted to establish comparative effectiveness analysis between these two therapies. Cost-effectiveness studies should be considered in the future studies to establish evidence for decision-making in clinical practice.

[Solitary fibrous tumor/hemangiopericytoma of central nervous system: a clinicopathologic analysis of 71 cases]

Objective: As solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) share the same molecular genetics features, the 2016 WHO classification of central nervous system (CNS) tumors had created the combined term SFT/HPC and assigns three grades. This study aims to investigate the clinicopathologic characteristics, diagnosis, differential diagnosis and prognosis of CNS SFT/HPC. Methods: Seventy-one cases of CNS SFT and HPC were retrospectively reclassified and studied. Histopathological, immunohistochemical and imaging features were analyzed. The follow-up data were analyzed. Results: There were 37 male and 34 female patients. The median age was 48 years (range, 3-77 years). Twelve cases (17%) were WHO grade Ⅰ, 26 (37%) were WHO grade Ⅱ and 33 (46%) were WHO grade Ⅲ. Microscopically the tumor could show traditional SFT phenotype, HPC phenotype or mixed phenotype. Immunochemically, 97%(69/71) were positive for STAT6, with 96%(66/69)showing diffuse strong staining. Approximately 90% were diffusely positive for bcl-2, CD99 and vimentin. The expression rate of CD34 decreased with increasing tumor grade, and the mean expression rate was 78%. SSTR2a was variably expressed in 10% (7/71) of cases including one case showing strong cytoplasmic staining. A few cases expressed EMA, CD57 and S-100 focally. The Ki-67 index ranged from 1% to 50%. Thirty four patients were followed up for 8-130 months; 12 patients(35%)had recurrences, and two (6%) had liver metastases. Conclusions: CNS SFT/HPC is relatively uncommon. There was significant morphological overlap or transition between different grades. STAT6 is a specific marker for the diagnosis of this tumor. Surgical resection is the preferred treatment. WHO grade Ⅱ and Ⅲ SFT/HPC show rates of local recurrence and systemic metastasis, with liver being the most common site of extracranial metastasis.

[A prospective multi-center trial of non-interventional and observational study of lenalidomide in Chinese patients with multiple myeloma]

Objective: To evaluate the efficacy and safety of lenalidomide in a real-world clinical practice in Chinese patients with multiple myeloma (MM). Methods: It was a prospective, multi-center, observational study. A total of 165 consecutive patients with MM treated with lenalidomide-based regimens were enrolled in 12 hospitals from June 2013 to November 2015. Relevant information was recorded, such as baseline clinical data, cytogenetic abnormalities, treatment regimens, and duration of treatment, safety, and survival. Results: (1)There were 126 relapsed and refractory MM (RRMM) patients, 25 newly diagnosed patients and 19 maintenance patients. The evaluable RRMM patients accounted for 120 cases, among which 74 cases(61.7%) reached the partial response (PR) or above, and a very good partial response (VGPR) in 16 patients (13.3%), a complete response (CR) in 14 cases (11.7%), a strictly complete response (sCR) in 4 cases (3.3%). Thus, a VGPR or above in 34 patients accounted for 28.3%. (2)The median follow-up was 13 months, the median time to progression 12 months. The median survival after receiving lenalidomide was 19 months, and the median overall survival (OS) was 62 months. (3) The univariate analysis in 120 RRMM patients suggested that prognostic factors for significant improvement in PFS included normal karyotype, international staging system (ISS) Ⅰ-Ⅱ, t(4; 14) negative (detected by fluorescence in situ hybridization), non-bortezomib resistance and response to previous regimens. As to OS, non-bortezomib resistance, response to previous regimens and non-primary refractoriness were positive factors. Multivariate analysis showed that the response to previous regimens (PR or better) was an independent good prognostic factor for progress-free survival(PFS), non-bortezomib resistance and non-primary refractoriness for OS. (4) Grade 3 or 4 adverse events that occurred in more than 10% of all enrolled patients were neutropenia (12.7%), leukocytosis(11.5%) and thrombocytopenia (12.7%). Owing to intolerance of toxic side effects, 7 cases withdrew lenalidomide. Conclusions: No matter what combination, regimens containing lenalidomide are effective to RRMM patients with overall response rate 61.7%, a time to progression 12 months and an overall survival 62 months.The toxicity is quite tolerable and manageable. In addition, the response to previous treatment (reached PR or above) is the independent good prognostic factor for PFS, non-bortezomib resistance and non-primary refractoriness for OS. Clinical trail registration: Clinicaltrials.gov, NCT01947309.

Spatial and temporal evolution of climatic factors and its impacts on potential evapotranspiration in Loess Plateau of Northern Shaanxi, China

Agriculture is very sensitive to climate change, and correct forecasting of climate change is a great help to accurate allocation of irrigation water. The use of irrigation water is influenced by crop water demand and precipitation. Potential evapotranspiration (ET₀) is a measure of the ability of the atmosphere to remove water from the surface through the processes of evaporation and transpiration, assuming no control on water supply. It plays an important role in assessing crop water requirements, regional dry-wet conditions, and other factors of water resource management. This study analyzed the spatial and temporal evolution processes and characteristics of major meteorological parameters at 10 stations in the Loess Plateau of northern Shaanxi (LPNS). By using the Mann-Kendall trend test with trend-free pre-whitening and the ArcGIS platform, the potential evapotranspiration of each station was quantified by using the Penman-Monteith equation, and the effects of climatic factors on potential evapotranspiration were assessed by analyzing the contribution rate and sensitivity of the climatic factors. The results showed that the climate in LPNS has become warmer and drier. In terms of the sensitivity of ET₀ to the variation of each climatic factor in LPNS, relative humidity (0.65) had the highest sensitivity, followed by daily maximum temperature, wind speed, sunshine hours, and daily minimum temperature (-0.05). In terms of the contribution rate of each factor to ET₀, daily maximum temperature (5.16%) had the highest value, followed by daily minimum temperature, sunshine hours, relative humidity, and wind speed (1.14%). This study provides a reference for the management of agricultural water resources and for countermeasures to climate change. According to the climate change and the characteristics of the study area, farmers in the region should increase irrigation to guarantee crop water demand.

Simultaneous measurement of thermal conductivity and heat capacity by flash thermal imaging methods

Thermal properties are important for material applications involved with temperature. Although many measurement methods are available, they may not be convenient to use or have not been demonstrated suitable for testing of a wide range of materials. To address this issue, we developed a new method for the nondestructive measurement of the thermal effusivity of bulk materials with uniform property. This method is based on the pulsed thermal imaging-multilayer analysis (PTI-MLA) method that has been commonly used for testing of coating materials. Because the test sample for PTI-MLA has to be in a two-layer configuration, we have found a commonly used commercial tape to construct such test samples with the tape as the first-layer material and the bulk material as the substrate. This method was evaluated for testing of six selected solid materials with a wide range of thermal properties covering most engineering materials. To determine both thermal conductivity and heat capacity, we also measured the thermal diffusivity of these six materials by the well-established flash method using the same experimental instruments with a different system setup. This paper provides a description of these methods, presents detailed experimental tests and data analyses, and discusses measurement results and their comparison with literature values.

[Cerebrospinal fluid adenosine deaminase and its dynamic changes in tuberculous meningitis]

Objective: To explore the diagnostic value of cerebrospinal fluid (CSF) adenosine deaminase (ADA) level in tuberculous meningitis. Methods: We retrospectively analyzed 139 patients (73 males, 66 females) who visited Beijing Chest Hospital for suspected TBM from January 2010 to June 2015. Of them, 99 patients were diagnosed to have TBM, with 45 males and 54 females, and a mean age of (33±15) years. Forty patients were diagnosed as having Non-TBM, with 28 males and 12 females, and a mean age of (35±18) years. All patients underwent lumbar puncture, and CSF ADA, routine, biochemical and bacteriological tests were performed. Thirty-five TBM patients reviewed CSF ADA test after treatment for 4 weeks, 8 weeks and 6 months. Results: The level of CSF ADA in TBM group was higher than that in the non-TBM group, the difference being statistically significant (5.6 U/L vs 2.3 U/L, P=0.000). When the cut-off value of the CSF ADA was 3.8 U/L , the sensitivity and specificity for diagnosis of TBM were 60.6% (95%CI 50.3%-70.1%) and 87.5% (95%CI 72.4%-95.3%), respectively, and the area under the ROC curve was 0.734.The CSF ADA level was (6.7±4.2) U/L in the 35 cases of TBM before treatment. After 4 weeks, 8 weeks and 6 months of anti-tuberculosis treatment, the CSF ADA levels were (4.5±3.3) U/L, (3.7±2.7) U/L and (2.0±1.5) U/L, respectively; all significantly decreased as compared to that before treatment (P<0.001). There was no significant change in the ADA level between 8 weeks and 4 weeks (P=0.128). After 6 months of treatment, the level of CSF ADA was significantly lower than those after 4 and 8 weeks' treatment (P<0.001). Conclusions: CSF ADA in TBM patients was significantly higher than in non-TBM patients. The sensitivity of CSF ADA level in the diagnosis of TBM was poor, but the specificity was better. CSF ADA was significantly reduced and showed dynamic changes with effective anti-tuberculosis treatment and maybe helpful in evaluating the effect of treatment.

[Isolation of cariogenic Streptococcus mutans and the inhibitory effect of egg yolk antibody on caries]

Objective: To isolate the cariogenic Streptococcus mutans (Sm) strains and study the therapeutical effect of egg yolk antibody (IgY) of the Sm on dental caries development. Methods: Sm strains were isolated from the children's dental plaque samples. Morphological, biochemical and molecular biological methods were applied to identify the serotype, acid producing and adhesion abilities of isolated Sm strains. After inactivation one of the Sm strains was used as antigen to immune laying hens to collect and extract the specific anti-Sm IgY. The rats were infected with Sm (serotype e). After 16 weeks of infection, all the rats were found developing dental caries. The rats were then randomly divided into two groups. The rats in experimental group were supplied with diet containing anti-Sm IgY while the rats in control group with normal IgY. All rats were sacrificed after another 8 weeks' observation. The degree of caries for each rat was assessed using Keyes' method. Results: We isolated 7 Sm strains from the children's dental plaque samples in the present study. The numbers of serotype c, e, f, k were 3, 2, 0 and 2, respectively. All strains showed similar morphological and biochemical characters as standard UA159 Sm strain, and possessed strong capabilities of acid production and adherence. Interestingly, even the same serotypec strains, such as No.3 and No.7 strains, demonstrated significant difference on acid producing and adherence capabilities. After 16 weeks infection with serotype e strain, the rats' mandibular teeth were apparently decayed, and treatment with specific anti-Sm IgY obviously attenuated the development of caries in the experiment group rats (16.4±2.0) compared with that in the control group rats (30.2±9.3) (P<0.05) determined by Keyes' method. Conclusions: Seven cariogenic Sm strains of different serotypes were isolated, which possesses similar morphology and biochemical characters. Although belonging to the same serotype strains they always show significant difference in acid-producing and adherencec apabilities. Further experiment provides evidences that the serotype e strain could obviously induce caries independently, and employment of specific anti-Sm IgY as passive immunotherapy additive might effectively inhibit the further development of dental caries.

[Effects of Meek skin grafting on patients with extensive deep burn at different age groups]

Objective: To investigate the effect of Meek skin grafting on patients with extensive deep burn at different age groups. Methods: Eighty-four patients with extensive deep burns conforming to the study criteria were hospitalized in our unit from April 2011 to April 2015. Patients were divided into children group (C, with age less than 12 years old), young and middle-aged group (YM, with age more than 18 years and less than 50 years old), and old age group (O, with age more than 55 years old) according to age, with 28 patients in each group. All patients received Meek skin grafting treatment. The use of autologous skin area, operation time, wound healing time, and hospitalization time were recorded. The survival rate of skin graft on post operation day 7, complete wound healing rate in post treatment week 2, and the mortality were calculated. Data were processed with one-way analysis of variance, t test, and χ(2) test. Results: The use of autologous skin area of patients in group C was (5.1±1.0)% total body surface area (TBSA), significantly less than (8.3±1.0)%TBSA and (8.3±1.4)%TBSA in groups YM and O, respectively (with t values 32.900 and 52.624, respectively, P values below 0.05). The operation time, wound healing time, and hospitalization time of patients in group C were (1.368±0.562) h, (9.6±0.6) and (32±11) d, significantly shorter than those in group YM [(3.235±0.011) h, (16.9±2.6) and (48±12) d, respectively] and group O [(3.692±0.481) h, (17.3±2.6) and (46±13) d, respectively, with t values from 4.350 to 21.160, P values below 0.05]. The survival rate of skin graft of patients on post operation day 7 in group C was (92±15)%, significantly higher than (81±10)% and (72±12)% in groups YM and O, respectively (with t values 5.509 and 3.229, respectively, P values below 0.05). The above indexes in groups YM and O were similar (with t values from 0.576 to 22.958, P values above 0.05). Complete wound healing rate in post treatment week 2 and the mortality of patients in group C were similar to those in groups YM and O (with χ(2) values 0.365 and 0.122, respectively, P values above 0.05). Conclusions: Meek skin grafting can be used in the treatment of patients with extensive deep burns at different age groups, compared with the young and middle-aged and old patients, the effect in children was better.

Observation of Λ_{c}^{+}→nK_{S}^{0}π^{+}

We report the first direct measurement of decays of the Λ_{c}^{+} baryon involving the neutron. The analysis is performed using 567  pb^{-1} of e^{+}e^{-} collision data collected at sqrt[s]=4.599  GeV with the BESIII detector at the BEPCII collider. We observe the decay Λ_{c}^{+}→nK_{S}^{0}π^{+} and measure the absolute branching fraction to be B(Λ_{c}^{+}→nK_{S}^{0}π^{+})=[1.82±0.23(stat)±0.11(syst)]%. A comparison to B[Λ_{c}^{+}→p(K[over ¯]π)^{0}] provides an important test of isospin symmetry and final state interactions.

Precise Measurement of the e^{+}e^{-}→π^{+}π^{-}J/ψ Cross Section at Center-of-Mass Energies from 3.77 to 4.60 GeV

The cross section for the process e^{+}e^{-}→π^{+}π^{-}J/ψ is measured precisely at center-of-mass energies from 3.77 to 4.60 GeV using 9  fb^{-1} of data collected with the BESIII detector operating at the BEPCII storage ring. Two resonant structures are observed in a fit to the cross section. The first resonance has a mass of (4222.0±3.1±1.4)  MeV/c^{2} and a width of (44.1±4.3±2.0)  MeV, while the second one has a mass of (4320.0±10.4±7.0)  MeV/c^{2} and a width of (101.4_{-19.7}^{+25.3}±10.2)  MeV, where the first errors are statistical and second ones are systematic. The first resonance agrees with the Y(4260) resonance reported by previous experiments. The precision of its resonant parameters is improved significantly. The second resonance is observed in e^{+}e^{-}→π^{+}π^{-}J/ψ for the first time. The statistical significance of this resonance is estimated to be larger than 7.6σ. The mass and width of the second resonance agree with the Y(4360) resonance reported by the BABAR and Belle experiments within errors. Finally, the Y(4008) resonance previously observed by the Belle experiment is not confirmed in the description of the BESIII data.

Evidence of Two Resonant Structures in e^{+}e^{-}→π^{+}π^{-}h_{c}

The cross sections of e^{+}e^{-}→π^{+}π^{-}h_{c} at center-of-mass energies from 3.896 to 4.600 GeV are measured using data samples collected with the BESIII detector operating at the Beijing Electron Positron Collider. The cross sections are found to be of the same order of magnitude as those of e^{+}e^{-}→π^{+}π^{-}J/ψ and e^{+}e^{-}→π^{+}π^{-}ψ(2S), but the line shape is inconsistent with the Y states observed in the latter two modes. Two structures are observed in the e^{+}e^{-}→π^{+}π^{-}h_{c} cross sections around 4.22 and 4.39  GeV/c^{2}, which we call Y(4220) and Y(4390), respectively. A fit with a coherent sum of two Breit-Wigner functions results in a mass of (4218.4_{-4.5}^{+5.5}±0.9)  MeV/c^{2} and a width of (66.0_{-8.3}^{+12.3}±0.4)  MeV for the Y(4220), and a mass of (4391.5_{-6.8}^{+6.3}±1.0)  MeV/c^{2} and a width of (139.5_{-20.6}^{+16.2}±0.6)  MeV for the Y(4390), where the first uncertainties are statistical and the second ones systematic. The statistical significance of Y(4220) and Y(4390) is 10σ over one structure assumption.

Influence of Treg cells and HBV genotype on sustained response and drug resistance in the treatment with nucleoside drugs

We aimed to investigate the influence of regulatory T cells including CD4+CD25+, CD8+CD28- and hepatitis B virus (HBV) genotype on sustained virological response and tolerance of nucleoside drugs. One hundred and thirty-seven patients were enrolled. Lamivudine was administered to 84 patients. Entecavir was administered to the other 53 patients. Before treatment, biochemical tests, HBV DNA load, HBV serum level, HBV genotype, PB CD3+, CD4+, CD8+, CD4+CD25+/CD3+, and CD8+CD28-/CD3+ frequencies were measured. Based on HBV DNA loads after 4 weeks of therapy, patients were divided into response group and suboptimal response group. The lamivudine group received treatment continuously, and then patients were categorized into non-resistance group and resistance group. Compared with the suboptimal response and resistance groups for lamivudine, CD4+CD25+/CD3+ levels were higher in the response and non-resistance groups (t=4.372, P=0.046; t=7.262, P=0.017). In the non-resistance group, CD8+CD28-/CD3+ frequency was lower than in the resistance group (t=5.527, P=0.037). Virus load and hepatitis B E antigen (HBeAg)-positive rate were significantly lower than in the response and resistance group (t=2.164, P=0.038; X2=4.239, P=0.040; t=2.015, P=0.044; X2=16.2, P=0.000). Incidence of drug resistance was high in patients with virogene type C. For the virological response to entecavir, CD8+CD28-/CD3+ level was significantly lower than that of the suboptimal response group (t=6.283, P=0.036). Response and suboptimal response groups were compared in CD3+, CD4+, CD8+, CD4+CD25+/CD3+ and virus genotype, and differences were not statistically significant (P>0.05). Baseline regulatory T cells including CD4+CD25+/CD3+ and CD8+CD28-/CD3+ frequencies have a relationship with the incidence of rapid virological response and the resistance to nucleoside drugs. Patients with HBV genotype C receiving lamivudine more often underwent drug resistance. Antiviral efficacy and the resistance to lamivudine were closely correlated with baseline factors; the same cannot be found for entecavir.

[Association between cured meat consumption and risk of colorectal cancer in people with different dietary habits and lifestyles]

OBJECTIVE

To explore the association between the intakes of cured meat and the risk of colorectal cancer, and analyze the role of the interaction between cured meat intake and dietary habit or lifestyle for the risk of colorectal cancer.

METHODS

A well-designed questionnaire were used to collect retrospective information about demography, lifestyle and dietary habit from 400 patients diagnosed with colorectal cancer and 400 controls matched by age and gender. Logistic regression analysis was conducted to examine the possible association between the intake of cured meat and the risk of colorectal cancer. Generalized multifactor dimensionality reduction(GMDR)was used to analyze the interaction between cured meat intake and other dietary habits or lifestyle factors.

RESULTS

Data from conditional logistic regression analysis showed that compared with the people who had <8 times per year of cured meat intake, those had 8-23 times of cured meat intakes(OR=3.480, 95%CI: 2.022-5.991, P<0.001), 24-47 times of cured meat intakes(OR=4.526, 95%CI: 2.553-8.025, P<0.001), ≥48 times of cured meat intakes(OR=5.472, 95% CI: 3.105-9.642, P<0.001)had increased risk of colorectal cancer. There was a multiplied interaction between cured meat intake and pepper intake(OR=0.379, 95% CI: 0.190-0.758, P=0.009). The synergistic effect existed between cured meat intake and pickled vegetable intake; and the antagonism existed between cured meat intake and tea-drinking habit. GMDR analysis showed that interaction among red meat intake, pickled vegetable and cured meat intake on the risk of colorectal cancer might exist(P=0.001).

CONCLUSIONS

With the increase of frequency of cured meat intake, the risk of colorectal cancer increased gradually. The synergistic effect might existed between pickled vegetable intake and cured meat intake. Tea-drinking, pepper intake and cured meat intake might be antagonism in the pathogenesis of colorectal cancer. Red meat intake, pickled vegetable intake and cured meat intake might have combined effect to increase the risk of colorectal cancer.

[The role of Tim-3 mRNA in acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation]

目的

探讨T细胞免疫球蛋白黏蛋白结构域分子3(Tim-3）mRNA表达在异基因造血干细胞移植（allo-HSCT）后急性移植物抗宿主病（aGVHD）中的作用。

方法

回顾性分析100例allo-HSCT患者，根据患者aGVHD状态[0（未发生）~Ⅰ度aGVHD组、Ⅱ~Ⅳ度aGVHD治疗前组、Ⅱ~Ⅳ度aGVHD治疗好转组]及移植后不同阶段（+14~＋30 d、+31~＋60 d、+61~＋100 d）比较各组外周血单个核细胞Tim-3 mRNA及血浆IFN-γ、IL-2水平。

结果

0~Ⅰ度aGVHD患者＋31~＋60 d Tim-3 mRNA相对定量（7.24±2.79）明显高于＋14~＋30 d(4.60±1.66）及＋61~＋100 d(3.86±1.36）（P值均<0.05）；+14~＋30 d、+31~＋60 d、+61~＋100 d Ⅱ~Ⅳ度aGVHD治疗前组的Tim-3 mRNA水平分别为9.54±3.05、10.14± 3.28、12.82±4.20，+14~+30 d、+61~＋100 d，均高于0~Ⅰ度aGVHD组及治疗好转组；+31~＋60 d Ⅱ~Ⅳ度aGVHD治疗前组明显高于治疗好转组（2.49±0.89），与0~Ⅰ度aGVHD组（7.24±2.79）相比差异无统计学意义；Ⅱ~Ⅳ度aGVHD组中Tim-3 mRNA水平在不同aGVHD程度、不同脏器之间比较差异均无统计学意义（P>0.05）。Ⅱ~Ⅳ度aGVHD治疗前组血浆IFN-γ、IL-2水平明显高于其他各组，治疗好转组血浆IFN-γ、IL-2水平与0~Ⅰ度aGVHD组比较差异无统计学意义。

结论

Tim-3在aGVHD的发生过程中发挥着重要作用。

Amplitude Analysis of the Decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0}

Based on a sample of 1.31×10^{9}  J/ψ events collected with the BESIII detector, an amplitude analysis of the isospin-violating decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0} is performed. A significant P-wave contribution from η^{'}→ρ^{±}π^{∓} is observed for the first time in η^{'}→π^{+}π^{-}π^{0}. The branching fraction is determined to be B(η^{'}→ρ^{±}π^{∓})=(7.44±0.60±1.26±1.84)×10^{-4}, where the first uncertainty is statistical, the second systematic, and the third model dependent. In addition to the nonresonant S-wave component, there is a significant σ meson component. The branching fractions of the combined S-wave components are determined to be B(η^{'}→π^{+}π^{-}π^{0})_{S}=(37.63±0.77±2.22±4.48)×10^{-4} and B(η^{'}→π^{0}π^{0}π^{0})=(35.22±0.82±2.54)×10^{-4}, respectively. The latter one is consistent with previous BESIII measurements.

[PTPS gene analysis and prenatal diagnosis in patients with 6-pyruvoyl-tetra hydropterin synthase deficiency]

Objective: To analyze the variations of PTPS gene in patients with suspected 6-pyruvoyl-tetra hydropterin synthase deficiency (PTPSD) and to make prenatal diagnosis in high-risk families. Methods: Chemiluminescence was used for phenylalanine detection in blood or dried blood spots.Patients with phenylalanine concentration over 120 μmol/L were detected by urine pterin analysis, and the activity of dihydropteridine reductase (DHPR) was detected. tetrahydrobiopterin loading tests were performed in suspected patients with abnormal urinary pterin profiles. PTPS gene variation analysis was performed by direct Sanger sequencing based on PCR amplification. Prenatal diagnosis in 7 high-risk families was performed by chorionic villus sampling when the genotype was identified. Results: In 656 patients with hyperphenylalanine, 22 cases were diagnosed as PTPSD clinically. 16 variations were detected in the 22 PTPSD cases. The 5 variations, p.Lys77Arg, p.Ile84Phe, c.315-2A>G, c.244-2A>T, c.187-1G>T, were identified as novel variations. Two fetuses carried the same mutation with the proband and therefore were thought to be PTPSD fetuses. Three fetuses carried only one mutant allele and thus were thought to be PTPSD carriers. The other 2 fetuses carried no mutations and were presumed normal. Conclusions: PTPS gene variation analysis is necessary to confirm the diagnosis. Prenatal diagnosis could help avoiding the defect birth in PTPSD families.

[Mutation screening of 433 families with Duchenne/Becker muscular dystrophy]

OBJECTIVE

Mutation analysis of unrelated families with Duchenne/Becker muscular dystrophy (DMD/BMD) was performed to investigate the characteristic of DMD gene mutation, especially the distribution pattern of point mutation of DMD gene in Chinese population.

METHODS

A total of 433 unrelated DMD/BMD families were collected at the Center of Prenatal Diagnosis of the First Affiliated Hospital of Zhengzhou University from March 2010 to December 2014. The deletions or duplications in 79 exons of DMD gene were screened using multiplex ligation-dependent probe amplification (MLPA). Any single-exon deletion detected by MLPA was further validated by PCR amplification. In the 117 unrelated Chinese families in which large-scale deletions and duplications had been excluded by MLPA, the point mutation in 79 exons of DMD gene were tested in the propositus using next-generation sequencing (NGS), and further verified the point mutation using Sanger sequencing.

RESULTS

In the 433 unrelated DMD/BMD families, 316 families with DMD deletions/duplications were identified by MLPA. Out of 57 single-exon deletions detected by MLPA, 3 were found as point mutations by PCR and Sanger sequencing, including 2 nonsense mutation (c.1729G>T [p.Glu577X], c. 3346A>T [p.Lys1116X]) and 1 frame-shift mutation (c.8605_8606delGT [p.Val2869ThrfsX25]). Direct sequencing with Ion PGM and Sanger sequencing in 117 families with negative results in MLPA detected 92 different point mutations in 96 families, including 46 novel mutations, 42 previously reported ones, and 4 possible polymorphisms (rs189143447, rs202008454, rs200213555, rs187617705). The 46 novel mutations consisted of 16 nonsense mutations (c.100A>T [p.Lys34X], c. 1201C>T [p.Gln401X], c. 1707C>A [p.Cys569X], c. 1831G>T [p.Glu611X], c. 1912C>T [p.Gln638X], c. 2213C>G [p.Ser738X], c. 3673_3673delA [p.Ile1225X], c. 3774C>A [p.Cys1258X], c. 4858G>T [p.Glu1620X], c. 5764A>T [p.Lys1922X], c. 6035T>G [p.Leu2012X], c. 6408G>A [p.Trp2136X], c. 7717C>T [p.Gln2573X], c. 7864G>T [p.Glu2622X], c. 8184_8185insT [p.Lys2729X], c. 8215C>T [p.Gln2739X]), 5 missense mutations (c.139G>A [p.Gly47Arg], c. 238G>C [p.Ala80Pro], c. 335G>T [p.Trp112Leu], c. 804A>C [p.Leu268Phe], c. 1149G>T [p.Glu383Asp]), 6 splice-site mutations (c.2293-3C>A, c. 2380+ 1G>T, c. 3277-1G>C, c.4519-7A>G, c. 5740-15G>T, c. 7661-1G>C), 16 small deletions (c.688_688delA [p.Met230CysfsX14], c.1760_1791del32 [p.Thr587IlefsX37], c. 2271_2271delA [p.Asp774ThrfsX22], c. 2281_2285delGAAAA [p.Glu761SerfsX10], c. 2527_2527delG [p.Glu843SerfsX3], c. 3405_3405delC [p.Asn1135LysfsX18], c. 4450_4450delC [p.His1484ThrfsX14], c. 4770_4770delA [p.Thr1590ThrfsX5], c. 4937_4937delA [p.Glu1646GlyfsX11], c. 5253_5256delATTA [p.Lys1751LysfsX2], c. 5654_5654delA [p.Gln1885ArgfsX6], c. 7441_7441delG [p.Glu2481AsnfsX13], c. 7860_7860delC [p.Ile2620IlefsX18], c. 8668-8668delG /c.8668+ 1-8668+ 1delG, c. 9009_9009delC [p.Thr3003ThrfsX18], c. 9021_9021delT [p.Ile3007IlefsX14]), and 3 small insertions (c.305_306insG [p.Gly102GlyfsX4], c. 3116_3117insA [p.His1039GlufsX11], c. 9197_9198insATCTC [p.Ser3066SerfsX25]). And 87.4% (83/95) of the pathologic point mutations disrupted the translational reading frame (46 nonsense mutations, 24 frame-shift mutations, and 13 splice-site mutations).

CONCLUSIONS

Inexpensive and efficient genetic/prenatal diagnosis of DMD/BMD may be plausible by MLPA analysis, NGS, and Sanger sequencing. Most of the mutations identified in this study led to a predictable premature stop codon or splicing defects, resulting in defective function of dystrophin.

[The clinical characteristics and surgical treatment strategy of acute gangrenous cholecystitis after biliary tract stenting]

Objective: To analysis of the possible cause and surgical diagnosis and treatment strategies of acute gangrenous cholecystitis (AGC) after biliary stent drainage. Methods: The clinical data of 273 patients who received biliary stent drainage in Beijing Chaoyang Hospital from January 2015 to March 2016 were analyzed retrospectively. Among them, 22 patients who underwent surgical treatment were divided into two groups: 9 cases of AGC group and 13 cases of non-AGC group. The risk factors of AGC and surgical approach were analyzed. Result: All 22 patients underwent laparoscopic surgery. In AGC group, 1 patient with toxic shock died of multiple organ viscera function failure caused by infection, and 1 patient with gallbladder triangle inflammatory adhesion suffered from biliary leakage. The postoperative pathology of 2 patients was acute gangrenous cholecystitis. Non-AGC group had no death, bile duct injury and bleeding, with postoperative pathology of chronic cholecystitis. Patients were followed up for 2 month to restore well, without biliary calculi residual. Operation time, intraoperative blood loss, hospitalization days and hospitalization expenses of AGC group were higher than those of non-AGC group. Conclusion: The advocated AGC after biliary stent drainage should actively surgery after early diagnosis and endoscopic therapy should not be repeated. Laparoscopic surgery is a safe and effective treatment for AGC after carotid stenting.

Measurement of Singly Cabibbo Suppressed Decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}

Using 567  pb^{-1} of data collected with the BESIII detector at a center-of-mass energy of sqrt[s]=4.599  GeV, near the Λ_{c}^{+}Λ[over ¯]_{c}^{-} threshold, we study the singly Cabibbo-suppressed decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}. By normalizing with respect to the Cabibbo-favored decay Λ_{c}^{+}→pK^{-}π^{+}, we obtain ratios of branching fractions: [B(Λ_{c}^{+}→pπ^{+}π^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(6.70±0.48±0.25)%, [B(Λ_{c}^{+}→pϕ)/B(Λ_{c}^{+}→pK^{-}π^{+})]=(1.81±0.33±0.13)%, and [B(Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(9.36±2.22±0.71)×10^{-3}, where the uncertainties are statistical and systematic, respectively. The absolute branching fractions are also presented. Among these measurements, the decay Λ_{c}^{+}→pπ^{+}π^{-} is observed for the first time, and the precision of the branching fraction for Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-} and Λ_{c}^{+}→pϕ is significantly improved.

[Progress in the study of central auditory processing disorders]

Summary With the development of artifical ossicular and cochlear implant，the treatment of refractory hearing loss acquire significant breakthrough，thus central auditory processing disorders are becoming the major cause of refractory hearing loss.In this paper，research progress of central auditory processing disorders in clinical and fundamental are reviewed.

[Effect of expanded lateral thoracic abdominal flap transferred with pedicle on repairing large area of hypertrophic scar after burn of the upper extremity]

Objective: To observe the effect of expanded lateral thoracic abdominal flap transferred with pedicle on repairing large area of hypertrophic scar after burn of the upper extremity. Methods: Twelve patients with large area of secondary hypertrophic scar 8 month to 3 years after healing of burn wound on the upper extremity were hospitalized in Zhengzhou First People's Hospital from October 2008 to October 2015, with scar area ranging from 11 cm×7 cm to 20 cm×10 cm. Five patients were with limited straightening and bending of elbow. The scars were reconstructed with ipsilateral expanded lateral thoracic abdominal flap or that combined with expanded upper extremity flap according to the area of scar. Lateral thoracic abdominal incision was located near the anterior axillary line, and upper extremity incision was located near scar edge. A capsule cavity was formed by blunt dissection in the superficial fascia layer. Expander with suitable capacity was implanted with the injection pot being built-in. Volume of water reaching 1 time to 3 times of the capacity of expander was injected for excessive expanding. The expanded lateral thoracic abdominal flap supplied by lateral thoracic cutaneous artery and expanded upper extremity flap were dissected after the completion of expanding. The expanded upper extremity flap was advanced locally to cover the surrounding secondary wound after resection of hypertrophic scar. The expanded lateral thoracic abdominal flap was transferred with pedicle to reconstruct scar, with pedicle being sutured in skin tube-like shape, and the flap donor site was sutured directly. Flap pedicle separation was carried out 3 weeks after surgery. Anti-scar treatment was carried out after healing of sutured area. Results: Totally 18 expanders were implanted, without complications such as infection, exposure of expander, and so on. The areas of expanded lateral thoracic abdominal flaps were from 11 cm×7 cm to 16 cm×11 cm. The combined application of expanded upper extremity flaps with area ranging from 8 cm×4 cm to 9 cm×6 cm was used in 6 patients. All the flaps survived with incision healed. The color, texture, and thickness of skin area repaired by flap were close to those of the normal skin of upper extremity after 6 months to 2 years' follow-up afer discharge. The limited straightening and bending of elbow in 5 patients were rectified. Obvious linear scar was observed in the sutured area of surgery in 3 patients, while light linear scar was observed in the sutured area of surgery in 9 patients. Conclusions: Expanded lateral thoracic abdominal flap has constant blood vessel and is easy to be dissected. It can achieve well reconstruction of appearance and function in repairing large area of hypertrophic scar after burn of the upper extremity.

[Association and interaction of heat shock proteins B1 gene and tumor-suppressor protein p53 gene with chromosome damage levels among coke oven workers]

Objective: To investigate the association and interaction of heat shock proteins B1(HSPB1)gene rs2868371 and tumor-suppressor protein p53(TP53)gene rs1042522 polymorphisms with chromosome damage levels among coke oven workers. Methods: We recruited 1 333 male workers from a state-run coke oven plant in Wuhan in September-October 2010. Among them, 949 who had worked in coke oven workplaces, including auxiliary facilities and bottom, side, and top ovens, were nominated as coke oven workers(i.e., exposed), and 384 administrative or medical staff whose workplaces were offices were used as controls. General characteristics and 5 ml of venous blood were collected from each participant. The plasma concentrations of benzo[a]pyrene-diolepoxide(BPDE)-albumin adducts and the lymphocytic micronucleus(MN)frequencies for each individual were detected by ELISA and cytokinesis-block micronucleus assay, respectively. Gene polymorphisms were genotyped using TaqMan assays via quantitative PCR(ABI Prism 7900HT), and the corresponding frequency ratios(FR)with 95% confidence intervals(CI)were computed for all assays. Results: In the exposed group, the MN frequencies were higher in HSPB1 rs2868371 GC, CC, and GC+ CC genotype carriers((3.88 ± 2.88)‰,(4.00 ± 2.66)‰, and(3.91 ± 2.83)‰, respectively)than in rs2868371 GG genotype carriers((3.52±2.67)‰; FR=1.10, 1.13, and 1.11; 95% CI: 1.02-1.19, 1.02-1.25, and 1.03-1.19, respectively), and the HSPB1 rs2868371C allele was associated with increased MN frequency(P_trend=0.006). Further, in the exposed group, the MN frequencies were lower in TP53 rs1042522 CG and CG+GG genotype carriers((3.63±2.61)‰ and(3.66±2.61)‰, respectively)than in TP53 rs1042522 CC genotype carriers(3.95±3.06)‰(FR=0.87 and 0.90; 95% CI: 0.83-0.96 and 0.84-0.97, respectively). The effect of gene-gene interaction between HSPB1, rs2868371, and TP53 rs1042522 on MN frequency was significant among coke oven workers(P=0.001). Further stratified analyses showed that the effects of the HSPB1 rs2868371C allele in increasing MN frequencies were robust in subjects aged >40 years(FR=1.07, 95% CI: 1.01-1.12), those working >20 years(FR=1.08, 95% CI: 1.02-1.14), those with BMI ≤24 kg/m²(FR=1.07, 95% CI: 1.01-1.13), drinkers(FR=1.09, 95% CI: 1.02-1.16), and workers with higher BPDE-albumin adduct levels(FR=1.07, 95% CI: 1.01-1.13)(P_trend=0.023, 0.013, 0.029, and 0.020, respectively). The decreasing effect of the TP53 rs1042522 G allele on MN frequencies was robust in subjects aged >40 years(FR=0.94, 95% CI: 0.89-0.99), those with BMI ≤24 kg/m²(FR=0.94, 95% CI: 0.88-0.99), and drinkers(FR=0.94, 95% CI: 0.88-1.00)(P_trend=0.031, 0.023, and 0.038, respectively). In addition, there were interactions between HSPB1 rs2868371 and age and between HSPB1 rs2868371 and working years in terms of MN frequency(P=0.030 and 0.013, respectively). Conclusion: In coke oven workers, the HSPB1 rs2868371 C and TP53 rs1042522 G alleles were associated with increased and decreased chromosome damage levels, respectively, and their interaction effect on chromosome damage levels was significant.

[Preliminary evaluation on self-developed dentin porcelain color prediction system]

OBJECTIVE

To apply the self-developed dentin porcelain color prediction system in the fabrication of porcelain-fused-to-metal-crown(PFMC), and to evaluate its accuracy in color-matching.

METHODS

Twenty upper central incisors were recruited according to preset criteria, and three PFMC were made for each tooth using three shade-matching techniques. Group A: PFMC were made according to the result of visual color selection; Group B: an spectrophotometer-based color-matching technique was used; Group C: PFMC were fabricated with dentin porcelain powder calculated by the prediction system according to the L(*), a(*), b(*) value measured by a spectrophotometer. Color differences(ΔE) (measured by spectrophotometer) of three groups of crowns were calculated in the cervical, middle, and incisal regions. The results were analyzed using one-way ANOVA.

RESULTS

Mean color differences in body regions were: Group A: 3.53±1.80, Group B: 2.86±1.63, Group C: 3.77±1.40(P>0.05), and those in incisal regions were: Group A: 2.70 ± 1.13, Group B: 2.80 ± 0.90, Group C: 3.04 ± 1.03(P>0.05). In cervical region, Group C had greater color difference than Group B(2.78±1.14)(P<0.05). Group A(3.80±2.02) and Group B, Group A and Group C had similar color difference(P>0.05).

CONCLUSIONS

PFMC fabricated using self-developed dentin porcelain color prediction system had similar color matching compared with conventional and instrument-based methods.

Effect of compound Maqin decoction on TGF-β1/Smad proteins and IL-10 and IL-17 content in lung tissue of asthmatic rats

In this research, compound Maqin decoction (CMD) has been shown to positively affect in airway inflammation of asthma models. We evaluated the effects of CMD on the expression of transforming growth factor (TGF)-β1/Smad proteins, interleukin (IL)-17, and IL-10 in lung tissue of asthmatic rats. Asthma was induced in a rat model using ovalbumin. After a 4-week treatment with CMD, rats were killed to evaluate the expression of TGF-β1 and Smad proteins in lung tissue. IL-10 and IL-17 levels in lung tissue homogenates were determined by ELISA. The expression of TGF-β1 and Smad3 protein increased, whereas expression of Smad7 protein decreased upon high-dose or low-dose treatment with CMD or by intervention with dexamethasone, compared to the control. There was a significant difference between treatment with a high dose CMD and the control treatment, but no significant difference was found between high-dose CMD treatment and dexamethasone intervention. The expression of TGF-β1 and Smad7 protein increased, whereas the expression of Smad3 protein decreased in the model group compared to other groups. In the CMD high-dose group, low-dose group, and dexamethasone intervention group, the IL-17 concentrations in lung tissue homogenates were decreased, while IL-10 levels were increased. Again, there was a significant difference between CMD high-dose and control treatment, but not between CMD high-dose treatment and dexamethasone intervention. Thus, positive effects of CMD against asthmatic airway remodeling may be due to its regulatory effect on TGF-β1, Smad3, and Smad7 protein levels and on cytokines such as IL-10 and IL-17.

Observation of an Anomalous Line Shape of the η^{'}π^{+}π^{-} Mass Spectrum near the pp[over ¯] Mass Threshold in J/ψ→γη^{'}π^{+}π^{-}

Using 1.09×10^{9} J/ψ events collected by the BESIII experiment in 2012, we study the J/ψ→γη^{'}π^{+}π^{-} process and observe a significant abrupt change in the slope of the η^{'}π^{+}π^{-} invariant mass distribution at the proton-antiproton (pp[over ¯]) mass threshold. We use two models to characterize the η^{'}π^{+}π^{-} line shape around 1.85  GeV/c^{2}: one that explicitly incorporates the opening of a decay threshold in the mass spectrum (Flatté formula), and another that is the coherent sum of two resonant amplitudes. Both fits show almost equally good agreement with data, and suggest the existence of either a broad state around 1.85  GeV/c^{2} with strong couplings to the pp[over ¯] final states or a narrow state just below the pp[over ¯] mass threshold. Although we cannot distinguish between the fits, either one supports the existence of a pp[over ¯] moleculelike state or bound state with greater than 7σ significance.

Evaluation of bone matrix gelatin/fibrin glue and chitosan/gelatin composite scaffolds for cartilage tissue engineering

This study was designed to evaluate bone matrix gelatin (BMG)/fibrin glue and chitosan/gelatin composite scaffolds for cartilage tissue engineering. Chondrocytes were isolated from costal cartilage of Sprague-Dawley rats and seeded on BMG/fibrin glue or chitosan/gelatin composite scaffolds. After different in vitro culture durations, the scaffolds were subjected to hematoxylin and eosin, Masson's trichrome, and toluidine blue staining, anti-collagen II and anti-aggrecan immunohistochemistry, and scanning electronic microscopy (SEM) analysis. After 2 weeks of culture, chondrocytes were distributed evenly on the surfaces of both scaffolds. Cell numbers and the presence of extracellular matrix components were markedly increased after 8 weeks of culture, and to a greater extent on the chitosan/gelatin scaffold. The BMG/fibrin glue scaffold showed signs of degradation after 8 weeks. Immunofluorescence analysis confirmed higher levels of collagen II and aggrecan using the chitosan/gelatin scaffold. SEM revealed that the majority of cells on the surface of the BMG/fibrin glue scaffold demonstrated a round morphology, while those in the chitosan/gelatin group had a spindle-like shape, with pseudopodia. Chitosan/gelatin scaffolds appear to be superior to BMG/ fibrin glue constructs in supporting chondrocyte attachment, proliferation, and biosynthesis of cartilaginous matrix components.

[Association between β-arrestin2 genetic polymorphism and response to methadone maintenance treatment in heroin-dependent patients in Han population in Hunan province]

OBJECTIVE

To study the distributions of three single nucleotide polymorphisms (SNPs) in β-arrestin2 (ARRB2) which including rs3786047, rs1045280 and rs2036657 and to elucidate the relationship between these SNPs and response to methadone maintenance treatment (MMT) among heroin-dependent patients of Han ethnicity population in Hunan.

METHODS

Han MMT patients were recruited in four random-chosen MMT clinics from Hunan province. Demographics, history of drug-use and MMT were recorded. ARRB2 SNPs were genotyped to determine the association between SNPs and response to MMT.

RESULTS

Distributions of the three SNPs were in Hardy-Weinberg equilibrium in both groups (responders vs. non-responders). There was no statistical significance in the distribution frequency of genotype on rs3786047 (χ(2)=0.486 2, P=0.784), rs1045280 (χ(2)=1.591 9, P=0.451) and rs2036657 (χ(2)=1.061 5, P=0.588) in ARRB2 among the responders or the non-responders.

CONCLUSION

Associations between the ARRB2 genotypes, rs3786047, rs1045280 and rs2036657, and MMT response in Han MMT patients in Hunan province did not appear.

Observation of h_{c} Radiative Decay h_{c}→γη^{'} and Evidence for h_{c}→γη

A search for radiative decays of the P-wave spin singlet charmonium resonance h_{c} is performed based on 4.48×10^{8} ψ^{'} events collected with the BESIII detector operating at the BEPCII storage ring. Events of the reaction channels h_{c}→γη^{'} and γη are observed with a statistical significance of 8.4σ and 4.0σ, respectively, for the first time. The branching fractions of h_{c}→γη^{'} and h_{c}→γη are measured to be B(h_{c}→γη^{'})=(1.52±0.27±0.29)×10^{-3} and B(h_{c}→γη)=(4.7±1.5±1.4)×10^{-4}, respectively, where the first errors are statistical and the second are systematic uncertainties.

[Security analysis of implanting drug-eluting stents for unprotected left main coronary artery disease patients with chronic kidney disease]

OBJECTIVE

To study the clinical characteristics and prognosis of unprotected left main (ULM) coronary artery disease patients with chronic kidney disease after drug-eluting stents (DES) implantation.

METHODS

267 ULM coronary artery disease patients who has implanted DES were included in the study from January 2005 to March 2010. Patients were divided into two groups according to their estimated glomerular filtration rate (eGFR): eGFR <60 ml·min(-1)·1.73 m(-2) (77 patients), and eGFR≥ 60 ml·min(-1)·1.73 m(-2) (190 patients) . The clinical parameters and prognosis of ULM patients treated with DES in different eGFR groups were retrospectively compared.

RESULTS

In higher eGFR group, left ventricular ejection fraction (LVEF) and morbidity of coronary ostial lesions were higher than the other group. Cerebrovascular diseases (13.0% vs 5.3%), chronic total occlusion (CTO, 28.6% vs 12.1%), hypertension (70.1% vs 53.2%) were more common in lower eGFR patients(all P<0.05). Total mortality and cardiac mortality were higher in eGFR<60 ml·min(-1)·1.73 m(-2) group (P=0.016, 0.006, respectively). Low eGFR level was an independent risk factor after adjusting multiple factors.

CONCLUSION

For the ULM disease patients with reduction in kidney function (eGFR<60 ml·min(-1)·1.73 m(-2)), DES should be selected with a careful study considering its increasing risk of death. Chronic renal insufficiency is a risk factor and may predict poor prognosis for patients with ULM after DES implantation.

Effects of the balance between type 1 and type 2 T helper cells on ovarian cancer

The balance between type 1 and type 2 T helper cells (the Th1-Th2 balance) is closely correlated with cancer, but the correlation in ovarian cancer remains unconfirmed. We investigated the Th1-Th2 balance for the diagnosis, treatment, and prognostic evaluation of ovarian cancer. Fifty healthy subjects and 50 ovarian cancer patients were recruited. The levels of various cytokines were determined in sera and ovarian cancer tissues using a Th1-Th2 human cytokine array. The usefulness of TNFα, IFNγ, TNFα/IL-4, and IFNγ/IL-4 for ovarian cancer diagnosis was assessed based on receiver operating characteristic (ROC) curves. The relationship between the TNFα/IL-4 level and survival time was investigated based on a survival curve. In the ovarian cancer patients, the levels of Th1 factors (IL-2, IFNγ, TNFα, and IL-13) increased significantly in the sera, and IFNγ and TNFα increased significantly in the ovarian cancer tissues. The levels of Th2 factors (IL-5 and IL-6) increased in the sera, but the level of IL-6 decreased significantly in the ovarian cancer tissues. Serum TNFα/IL-4 and IFNγ/IL-4 levels increased significantly in the peripheral blood of the ovarian cancer patients. ROC curve analysis revealed that TNFα, IFNγ, TNFα/IL-4, and IFNγ/IL-4 levels are useful for ovarian cancer diagnosis, with area under the curve values of 0.831, 0.753, 0.846, and 0.803, respectively. The TNFα/IL-4 level in the ovarian cancer patients was positively correlated with survival time, and the Th1-Th2 balance shifted toward Th1 in the ovarian cancer patients. The TNFα/IL-4 ratio might be useful for the diagnosis and prognosis of ovarian cancer.

[Clinical characteristics and outcome of patients with dilated-hypertrophic cardiomyopathy]

OBJECTIVE

To define the clinical characteristics and outcome of patients with dilated-hypertrophic cardiomyopathy (D-HCM).

METHODS

Clinical data of HCM patients hospitalized from January 2002 to December 2015 in our hospital were retrospectively analyzed. Patients were divided into D-HCM and classic HCM patients. The D-HCM patients were followed up by phone.

RESULTS

A total of 616 consecutive HCM patients were evaluated. Twenty one patients (3.4%) were diagnosed with D-HCM (average age(58.8±10.4) years, 13 males). It took (14.2±7.1)years for classic HCM patients to develop D-HCM. Compared to classic HCM patients, D-HCM patients were younger at the time of first HCM diagnosis ((39.7±10.4) years old vs. (48.5±9.5) years old, P<0.001) and had higher ratio of sudden cardiac death family history (19.0%(4/21) vs. 2.5%(14/558), P=0.003), more patients of future D-HCM patients had ventricular tachycardia (38.1%(8/21) vs. 5.7%(32/558), P<0.001) and higher Troponin-I(66.7%(14/21) vs. 9.3%(52/558), P<0.001) before the left ventricular cavity enlargement. Moreover, MLVWH ((24.8±4.2) mm vs. (17.2±3.5) mm, P<0.001) was significantly thicker and LAD ((39.8±5.9) mm vs. (35.2±3.3) mm, P<0.001) was significantly larger in D-HCM patients than in classical HCM patients. During the(3.8±1.9) years follow up period, 12 out of 21 D-HCM patients died (57.1%), 5 cases(23.8%)died of severe heart failure and 7 cases(33.3%) died of sudden cardiac death. One patient received heart transplantation.

CONCLUSIONS

Few classical HCM patients progressed into D-HCM in this cohort. Patients diagnosed as HCM at young age, HCM patients with abnormal Troponin I and ventricular tachycardia are at higher risk of developing D-HCM. The prognosis of D-HCM is very poor, and heart failure and sudden cardiac death are the main causes of death.

Observation of the Singly Cabibbo-Suppressed Decay D^{+}→ωπ^{+} and Evidence for D^{0}→ωπ^{0}

Based on 2.93  fb^{-1} e^{+}e^{-} collision data taken at center-of-mass energy of 3.773 GeV by the BESIII detector, we report searches for the singly Cabibbo-suppressed decays D^{+}→ωπ^{+} and D^{0}→ωπ^{0}. A double tag technique is used to measure the absolute branching fractions B(D^{+}→ωπ^{+})=(2.79±0.57±0.16)×10^{-4} and B(D^{0}→ωπ^{0})=(1.17±0.34±0.07)×10^{-4}, with statistical significances of 5.5σ and 4.1σ, where the first and second uncertainties are statistical and systematic, respectively.

Measurements of Absolute Hadronic Branching Fractions of the Λ_{c}^{+} Baryon

We report the first measurement of absolute hadronic branching fractions of Λ_{c}^{+} baryon at the Λ_{c}^{+}Λ[over ¯]_{c}^{-} production threshold, in the 30 years since the Λ_{c}^{+} discovery. In total, 12 Cabibbo-favored Λ_{c}^{+} hadronic decay modes are analyzed with a double-tag technique, based on a sample of 567  pb^{-1} of e^{+}e^{-} collisions at sqrt[s]=4.599  GeV recorded with the BESIII detector. A global least-squares fitter is utilized to improve the measured precision. Among the measurements for twelve Λ_{c}^{+} decay modes, the branching fraction for Λ_{c}^{+}→pK^{-}π^{+} is determined to be (5.84±0.27±0.23)%, where the first uncertainty is statistical and the second is systematic. In addition, the measurements of the branching fractions of the other 11 Cabibbo-favored hadronic decay modes are significantly improved.

Transcriptional analysis of atrial and ventricular muscles from rats

Previous studies have used microarray technology to explore gene expression differences between the atrium and the ventricle. However, selection criteria for the differentially expressed genes (DEGs) based only on either the fold change or the P value in these studies. Here, we aim to further identify the DEGs by setting a P value threshold of <0.05 and a fold change of >2, which may yield more specific gene expression differences between the atrium and the ventricle. Gene expression profiling of the atrial appendages and the ventricular free walls in 13 normal male Sprague Dawley rats were obtained from the Gene Expression Omnibus data base (accession No.: GSE5266). DEGs between the atrial and the ventricular samples were screened using the microarray significance analysis. The underlying functions of DEGs were predicted by gene ontology and pathway enrichment analyses. In addition, we also constructed protein interactions networks, and analyzed the function modules of the interacting proteins by MCODE. A total of 757DEGs between the atria and the ventricles were found. The genes highly expressed in the ventricular myocytes were associated with muscle contraction (e.g., Myl1, Myl2, Myl3, and Myh7) and energy production (e.g., Acadm and Acsl6), while the genes preferentially expressed in the atrial myocytes were involved in the integration of neurohumoral signals (e.g., Cldn1). These conclusions were confirmed by pathway enrichment and function module analyses. Our present study provides an overview of the transcript level differences between the atrium and the ventricle, which may be useful for determination of potential biomarkers.