Cesarean section and risks of overweight and obesity in school-aged children: a population-based study

BACKGROUND

Obesity puts a great health burden in the world. Previous studies suggest that caesarean section (CS) may increase the risk of obesity in children, but it is still uncertain whether this association is causal or due to residual confounding by medical indication.

AIM

To assess the association between CS, CS without medical indications in particular and the risk of overweight and obesity in school-aged children.

DESIGN

Cross-sectional survey.

METHODS

The 2014 Shanghai Child Health, Education and Lifestyle Evaluation was a large population-based survey with cluster random probability sampling in 26 primary schools in Shanghai, China, in 2014. The mode of delivery was reported by parents. The height, weight and waist circumference of the children were measured. Logistic regression models with SURVEYLOGISTIC procedure were used to estimate the risk of childhood obesity. Pupils delivered vaginally were served as the reference group.

RESULTS

A total of 17 571 pupils completed this survey, and 13 724 of them who were singleton, born term and between 5 and 13 years old were included in our analysis. CS was associated with increased risks of overweight and obesity (BMI: adjusted OR = 1.28 [95%CI 1.13-1.45] and 1.44 [1.26-1.66], respectively; weight for height ratio [WHtR] >0.46: 1.33 [1.20-1.48]). Similar results were found in CS without medical indication (BMI: overweight = 1.24 [1.05-1.47], obesity = 1.43 [1.19-1.72]; WHtR > 0.46: 1.30 [1.13-1.50]).

CONCLUSIONS

CS overall and CS without medical indications were associated with increased risks of overweight and obesity in primary school children.

Erratum: Observation of D^{0} Meson Nuclear Modifications in Au+Au Collisions at sqrt[s_{NN}]=200 GeV [Phys. Rev. Lett. 113, 142301 (2014)]

This corrects the article DOI: 10.1103/PhysRevLett.113.142301.

Comprehensive analysis of the mitochondrial DNA diversity in Chinese cattle

Complete mitochondrial DNA D-loop sequences of 1105 individuals were used to assess the diversity of maternal lineages of cattle populations in China. In total, 250 taurine and 88 zebu haplotypes were identified. Five main haplogroups-T1a, T2, T3, T4 and T5-were identified in Bos taurus, whereas Bos indicus harbored two haplogroups-I1 and I2. Our results suggest that the distribution of T1a in Asia was concentrated mainly in the northeast region (northeast China, Korea and Japan); haplogroups T2, T3 and T4 were predominant in Chinese cattle; and T5 was sporadically detected in Mongolian and Pingwu cattle. In contrast to the widespread presence of I1, I2 was distributed only in southwestern China (Yunnan-Guizhou Plateau and the Tibet Autonomous Region) and Xinjiang Uygur Autonomous Region. This is the first time that all five taurine haplogroups and two zebu haplogroups have been found in Mongolian cattle. In addition, eight individuals in Tibetan cattle carried the Bos grunniens mtDNA type. The high mtDNA diversity (H = 0.904 ± 0.008) and the weak genetic structure among the 57 Chinese cattle breeds/populations are consistent with their complex historical background, migration route and ecological environment.

Genetic diversity of Chinese cattle revealed by Y-SNP and Y-STR markers

With its vast territory and complex natural environment, China boasts rich cattle genetic resources. To gain the further insight into the genetic diversity and paternal origins of Chinese cattle, we analyzed the polymorphism of Y-SNPs (UTY19 and ZFY10) and Y-STRs (INRA189 and BM861) in 34 Chinese cattle breeds/populations, including 606 males representative of 24 cattle breeds/populations collected in this study as well as previously published data for 302 bulls. Combined genotypic data identified 14 Y-chromosome haplotypes that represented three haplogroups. Y2-104-158 and Y2-102-158 were the most common taurine haplotypes detected mainly in northern and central China, whereas the indicine haplotype Y3-88-156 predominates in southern China. Haplotypes Y2-108-158, Y2-110-158, Y2-112-158 and Y3-92-156 were private to Chinese cattle. The population structure revealed by multidimensional scaling analysis differentiated Tibetan cattle from the other three groups of cattle. Analysis of molecular variance showed that the majority of the genetic variation was explained by the genetic differences among groups. Overall, our study indicates that Chinese cattle retain high paternal diversity (H = 0.607 ± 0.016) and probably much of the original lineages that derived from the domestication center in the Near East without strong admixture from commercial cattle carrying Y1 haplotypes.

[Long non-coding RNA RAB11B-AS1 prevents osteosarcoma proliferation via its sense gene RAB11B]

Objective: To detect the expression of lncRNA RAB11B-AS1 in osteosarcoma and investigate its role in osteosarcoma cells proliferation and the responsible mechanisms. Methods: Osteosarcoma and corresponding adjacent normal tissues were collected from 24 patients subjected to operations from October 2015 to October 2017 in the Third Affiliated Hospital of Southern Medical University.RAB11B-AS1 expression was detected in osteosarcoma specimens by quantitative real-time polymerase chain reaction (qRT-PCR). Lentiviral vectors that stably over-expressing RAB11B-AS1 were constructed and transfected into U2OS osteosarcoma cell line.The effect of RAB11B-AS1 on osteosarcoma cell proliferation and apoptosis was investigated by cell counting kit (CCK-8) assay and flow cytometry.U2OS osteosarcoma xenograft model of nude mice was established to observe the effect of RAB11B-AS1 on xenograft growth in mice, and the role of RAB11B-AS1 in proliferation and apoptosis of osteosarcoma cells was investigated by immunohistochemistry and TUNEL staining of osteosarcoma slices.The relationship between RAB11B-AS1 and RAB11B was explored using luciferase reporter assay.The data were compared with t test between the two groups. Results: Expression of RAB11B-AS1 was significantly down-regulated in osteosarcoma (0.010±0.015) versus their paired non-neoplastic tissues (0.022±0.030) (t=2.117, P=0.045). Up-regulation of RAB11B-AS1 resulted in decreased proliferative rate of U2OS cells (F=15.659, P<0.001). The ratios of cells in G0-G1 phase, S phase, G2-M phase were 62.6%±6.3%, 21.4%±2.2%, 16.3%±1.6% respectively in RAB11B-AS1 up-regulated group versus 59.4%±5.9%, 25.9%±2.6%, 15.5%±1.1% respectively in control group, and cell ratio in G0-G1 and S phase were increased significantly by RAB11B-AS1 up-regulation (t=17.124, 17.321, both P<0.05). Apoptosis rate was significantly elevated in RAB11B-AS1 over-expressed cells (12.7%±1.3%) when compared with that in control (10.3%±1.0%)(t=17.321, P=0.003). Mice transplanted with osteosarcoma cells that overexpressed RAB11B-AS1 exhibited lower growth rate of tumor (F=8.798, P=0.009). Mechanistically, RAB11B-AS1 expression correlated negatively with RAB11B expression (r=-0.356, P=0.044). Conclusions: lncRNA RAB11B-AS1 expression is down-regulated significantly in osteosarcoma tissues.RAB11B-AS1 may suppress the progression of osteosarcoma via down-regulating RAB11B.

Characterization of MyD88 in Japanese eel, Anguilla japonica

Myeloid differentiation factor 88 (MyD88) is a key adaptor protein required for the signaling of all Toll-like receptors except TLR3, which results to the interaction of activated TLR complexes via C-terminal TIR domain and the binding of downstream kinase via N-terminal death domain. In this study, the MyD88 gene from the Japanese eel (Anguilla japonica) was identified. The open reading frame of AjMyD88 was 918 bp in length, encoding a protein composed of conserved N-terminal death domain and C-terminal TIR domain, respectively. Multiple alignment revealed highly conserved sites across all examined vertebrate lineages in death and TIR domains. Site-directed mutagenesis and luciferase analysis revealed that the W78A, L91A and L95A mutations in death domain had modest impairment of their ability in activating NF-κB promoter. The expression level of AjMyD88 was investigated by real-time PCR in response to poly I:C stimulation and Edwardsiella tarda infection. Significantly increased MyD88 expression was observed at early phase in all tested tissues/organs in response to E. tarda infection and slight increase was detected in intestine and gill at 16 hpi and in head kidney, spleen and liver at 24 hpi after poly I:C stimulation. Immunofluorescence staining revealed that AjMyD88 is present as condensed forms in the cytoplasm. Taken together, sequence characterization, gene expression and cellular distribution data obtained in this study suggest that AjMyD88, similar to its mammalian ortholog, plays an important role in eel immune response against bacteria.

Low-p_{T} e^{+}e^{-} Pair Production in Au+Au Collisions at sqrt[s_{NN}]=200 GeV and U+U Collisions at sqrt[s_{NN}]=193 GeV at STAR

We report first measurements of e^{+}e^{-} pair production in the mass region 0.4<M_{ee}<2.6  GeV/c^{2} at low transverse momentum (p_{T}<0.15  GeV/c) in noncentral Au+Au collisions at sqrt[s_{NN}]=200  GeV and U+U collisions at sqrt[s_{NN}]=193  GeV. Significant enhancement factors, expressed as ratios of data over known hadronic contributions, are observed in the 40%-80% centrality of these collisions. The excess yields peak distinctly at low p_{T} with a width (sqrt[⟨p_{T}^{2}⟩]) between 40 and 60  MeV/c. The absolute cross section of the excess depends weakly on centrality, while those from a theoretical model calculation incorporating an in-medium broadened ρ spectral function and radiation from a quark gluon plasma or hadronic cocktail contributions increase dramatically with an increasing number of participant nucleons. Model calculations of photon-photon interactions generated by the initial projectile and target nuclei describe the observed excess yields but fail to reproduce the p_{T}^{2} distributions.

[A study of the curative effect of endoscopic-assisted posterior nasal neurotomy on patients with moderate severe persistent allergic rhinitis]

Objective:To investigate the feasibility and effect of endoscopic-assisted posterior nasal neurotomy on patients with moderate-severe persistent allergic rhinitis (AR).Method:Endoscopic-assisted posterior nasal neurotomy were operated on 32 moderate-severe persistent AR patients who were insensitive to drugs and desensitization treatment,and curative effect were evaluated by scoring according to the diagnosis and curative effect evaluation standard of AR.Result:Follow-up evaluations were perfected after one year. Among them 17 cases were markedly effective,15 cases were effective,and the rate of total effective was 100%,without complications such as nose bleeds,dry eye,etc.Conclusion:The advantages of endoscopic-assisted posterior nasal neurotomy on moderate-severe persistent allergic rhinitis patients include the localization of posterior nasal nerve is clear,easy to operate,the short-term effect is remarkable,and less complications,therefore it's worth using on the AR patients who are failing in drugs and specific immune treatment.

Beam Energy Dependence of Jet-Quenching Effects in Au+Au Collisions at sqrt[s_{NN}]=7.7, 11.5, 14.5, 19.6, 27, 39, and 62.4 GeV

We report measurements of the nuclear modification factor R_{CP} for charged hadrons as well as identified π^{+(-)}, K^{+(-)}, and p(p[over ¯]) for Au+Au collision energies of sqrt[s_{NN}]=7.7, 11.5, 14.5, 19.6, 27, 39, and 62.4 GeV. We observe a clear high-p_{T} net suppression in central collisions at 62.4 GeV for charged hadrons which evolves smoothly to a large net enhancement at lower energies. This trend is driven by the evolution of the pion spectra but is also very similar for the kaon spectra. While the magnitude of the proton R_{CP} at high p_{T} does depend on the collision energy, neither the proton nor the antiproton R_{CP} at high p_{T} exhibit net suppression at any energy. A study of how the binary collision-scaled high-p_{T} yield evolves with centrality reveals a nonmonotonic shape that is consistent with the idea that jet quenching is increasing faster than the combined phenomena that lead to enhancement.

Cytochrome P450 1A1 (CYP1A1) Catalyzes Lipid Peroxidation of Oleic Acid-Induced HepG2 Cells

Nonalcoholic fatty liver disease (NAFLD) is a chronic hepatic disease associated with excessive accumulation of lipids in hepatocytes. As the disease progresses, oxidative stress plays a pivotal role in the development of hepatic lipid peroxidation. Cytochrome P450 1A1 (CYP1A1), a subtype of the cytochrome P450 family, has been shown to be a vital modulator in production of reactive oxygen species. However, the exact role of CYP1A1 in NAFLD is still unclear. The aim of this study was to investigate the effects of CYP1A1 on lipid peroxidation in oleic acid (OA)-treated human hepatoma cells (HepG2). We found that the expression of CYP1A1 is elevated in OA-stimulated HepG2 cells. The results of siRNA transfection analysis indicated that CYP1A1-siRNA inhibited the lipid peroxidation in OA-treated HepG2 cells. Additionally, compared with siRNA-transfected and benzo[a]pyrene (BaP)-OA-induced HepG2 cells, overexpression of CYP1A1 by BaP further accelerated the lipid peroxidation in OA-treated HepG2 cells. These observations reveal a regulatory role of CYP1A1 in liver lipid peroxidation and imply CYP1A1 as a potential therapeutic target.

[Results of sentinel surveillance on men who have sex with men in Jilin province between 2010 and 2015]

Objective: To explore the HIV epidemic and related factors among MSM in Jilin province. Methods: During the implementation of sentinel surveillance program from 2010 to 2015, continuous cross-sectional studies were conducted to monitor the awareness of AIDS, sexual behavior, HIV and syphilis positive rates, with the sample size no less than 400 in each surveillance site. Results: From 2010 to 2015, a total of 7 823 MSM were involved in this study. The overall HIV prevalence among MSM was 5.4% (42/7 823), with an increasing trend during 2010 and 2015 (Trend test χ(2)=110.023, P<0.001). The rates of awareness on AIDS were higher than 90.0%. The proportion of consistent condom use was 27.0% (2 112/7 823) in the last 6 months, and significant differences were found in these years (χ(2)=234.038, P<0.001). Results from multivariate logistic regression analysis showed that the HIV infection related risk factors among MSM in Jilin province would include: residency from other provinces (aOR=1.797, 95%CI: 1.185-2.726), recruitment through internet (aOR=1.717, 95%CI: 1.332-2.215), diagnosed of having sexually transmitted diseases in the previous year (aOR=1.893, 95%CI: 1.356-2.643) and positive testing on syphilis (aOR=4.309, 95%CI: 3.097-5.995). And consistent condom uses in the last 6 months (aOR=0.387, 95%CI: 0.143-0.557), tested HIV in the last year (aOR=0.632, 95%CI: 0.375-0.891) were preventive factors. Conclusions: HIV prevalence was increasing among MSM in Jilin province, but both the proportion of consistent condom use and the former HIV testing rate were at a low level. Aggressive measurement including consistent condom use and periodical HIV testing among MSM was warranted.

Beam-Energy Dependence of Directed Flow of Λ, Λ[over ¯], K^{±}, K_{s}^{0}, and ϕ in Au+Au Collisions

Rapidity-odd directed-flow measurements at midrapidity are presented for Λ, Λ[over ¯], K^{±}, K_{s}^{0}, and ϕ at sqrt[s_{NN}]=7.7, 11.5, 14.5, 19.6, 27, 39, 62.4, and 200 GeV in Au+Au collisions recorded by the Solenoidal Tracker detector at the Relativistic Heavy Ion Collider. These measurements greatly expand the scope of data available to constrain models with differing prescriptions for the equation of state of quantum chromodynamics. Results show good sensitivity for testing a picture where flow is assumed to be imposed before hadron formation and the observed particles are assumed to form via coalescence of constituent quarks. The pattern of departure from a coalescence-inspired sum rule can be a valuable new tool for probing the collision dynamics.

[Relationship between C-C chemokine receptor type 2 and P38 mitogen-activated protein kinase signaling pathway in the spinal cord of rats with bone cancer pain]

Objective: To investigate the relationship between C-C chemokine receptor type 2(CCR2) and P38 mitogen-activated protein kinase (P38MAPK) signaling pathway in the spinal cord of rats and further clarify the mechanism of bone cancer pain (BCP). Methods: A total of 92 healthy female SD rats, of which 60 were subjected to behavioral tests using a ciliary mechanical stimulation needle. SD rats were randomly divided into six groups: sham operation group (group S), bone cancer pain group (group B), sham operation + DMSO solvent group (group SD), bone cancer pain + DMSO solvent group (group BD), sham operation + RS102895 CCR2 inhibitor group (group SR), bone cancer pain + RS102895 CCR2 inhibitor group (group BR), and Von Frey was used in the behavioral test. Another 32 SD rats were randomly divided into the following 8 groups (n=4): sham operation group (group S), bone cancer pain 5 d group (group B5), bone cancer pain 9 d group (group B9), bone cancer pain 14 d group (group B14), bone cancer pain + DMSO solvent group (group BD), bone cancer pain + RS102895 CCR2 inhibitor 0.5 h group (group BR0.5 h), bone cancer pain + RS102895 CCR2 inhibitor 4 h group (group BR4 h), bone cancer pain + RS102895 CCR2 inhibitor 12 h group (group BR12 h). Western blot was used to detect the expression of P38, p-P38 and CCR2 in spinal cord of rats. Results: At day 5, 7, 9, 14, 21 post-injection, mechanical withdrawal thresholds of group S were(30.9±1.5), (31.9±1.2), (32.0±1.1), (31.6±1.5), (32.2±1.4)g respectively, the mechanical withdrawal thresholds of group B were( 26.4±0.7), (24.4±0.8), (21.4±0.8), (13.5±0.4), (9.9±0.2)g respectively, the mechanical withdrawal thresholds in group B decreased obviously versus group S, and the differences were statistically significant(t=-13.177, -16.660, -23.778, -35.574, -48.401, all P<0.01). At day 9 post-injection, the mechanical withdrawal thresholds in SD, BD, SR and BR groups were (32.4±1.7), (19.4±1.1), (32.1±1.3), (26.3±1.0) g respectively, the difference was statistically significant (F=224.681, P<0.01), and the mechanical withdrawal thresholds in group BD decreased obviously versus group SD, while the mechanical withdrawal thresholds in group BR increased obviously versus group BD. The expression levels of p-P38 in spinal cord of group S, group B5, group B9 and group B14 were(0.08±0.03), (0.20±0.05), (0.40±0.17), (0.65±0.14)respectively, the expression levels of CCR2 were(0.08±0.04), (0.18±0.05), (0.30±0.09), (0.58±0.07)respectively, the difference was statistically significant(F=19.123, 40.746, all P<0.01), and the expression of p-P38 and CCR2 in group B9 were showed a significant up-regulation versus group S. The expression levels of p-P38 in spinal cord of group BD, group BR0.5 h, group BR4 h and group BR12 h were (0.57±0.06), (0.17±0.11), (0.03±0.01), (0.25±0.11)respectively, and the difference was statistically significant(F=29.582, P<0.01). The expression of p-P38 in group BR0.5 h, BR4 h, BR12 h showed a significant down-regulation versus group BD. Conclusion: CCR2 in the spinal cord may be involved in the development of bone cancer pain by activating P38MAPK signaling pathway in rats.

Metabolic Biomarkers of Aging and Aging-related Diseases in Chinese Middle-Aged and Elderly Men

BACKGROUND

Aging is an acknowledged risk factor for most chronic diseases and functional impairments. The practicability of potential biomarkers of aging remains unsure. Moreover, biomarkers related to certain geriatric diseases, such as carotid atherosclerosis and multiple co-morbidities are less understood. The purpose of this study was to investigate the definite relationship between metabolic biomarkers and aging-related diseases.

METHODS

Eighty-five male adults aged fifty years or older from the general population were enrolled. Plasma metabolic biomarkers, including fourteen amino acids and thirty-six acylcarnitines, were measured by liquid chromatography mass spectrometry. Bivariate correlation analysis was employed to estimate the correlations between variables and age, and also to evaluate the relationship between metabolic biomarkers and aging-related diseases. Receiver operating characteristic (ROC) curve was conducted to judge the diagnostic efficiency of potential metabolic biomarkers for co-morbidities.

RESULTS

Certain metabolic biomarkers were strongly positively correlated with age, such as tetradecenoylcarnitine (C14:1), microalbumin-urine creatinine ratio (UACR), dodecenoylcarnitine (C12:1) and citrulline (p < 0.001). Carotid atherosclerosis and co-morbidities were positively correlated with aging (p < 0.001). After adjustment for age, hydroxytetradecanoylcarnitine (C14OH) remained positively correlated with carotid plague area. Besides, citrulline had diagnostic power for co-morbidities.

CONCLUSIONS

Citrulline may be a promising metabolic biomarker in the middle-aged and elderly men. Larger-scale and long-term studies are needed to confirm our findings.

High performance composites of spinel LiMn2O4/3DG for lithium ion batteries

A highly crystalline nanosized spinel LiMn₂O₄/3DG composite cathode material for high rate lithium ion batteries was successfully prepared by mixing spinel LiMn₂O₄ particles with reduced graphene oxide (3DG). Spinel LiMn₂O₄ and reduced three-dimensional graphene oxide were synthesized using a hydrothermal method and freeze-drying technology, respectively. The structure, morphology and electrochemical performance of the synthesized materials were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS) and galvanostatic charge–discharge techniques. The results showed that the LiMn₂O₄/3DG composites exhibited excellent rate capability and stable cycling performance. The discharge capacity was 131 mA h g⁻¹ and the capacity remains at 89.3% after 100 cycles at a 0.5 C rate, while the discharge capacity was 90 mA h g⁻¹ at 10 C. Compared with spinel LiMn₂O₄ materials, the LiMn₂O₄/3DG composites showed obvious improvement in electrochemical performance.

3DG/LiMn₂O₄ composites exhibit a high specific capacity and excellent rate performance.

Effect of implant placement depth on the peri-implant bone defect configurations in ligature-induced peri-implantitis: An experimental study in dogs

Background

The subcrestal placement of implant platform has been considered a key factor in the preservation of crestal bone, but the influence of implant placement depth on bone remodeling combined with peri-implantitis is not fully understood. The aim of this study was to assess the effect of the crestal or subcrestal placement of implants on peri-implant bone defects of ligature-induced peri-implantitis in dogs.

Material and Methods

Eight weeks after tooth extraction in six beagle dogs, two different types of implants (A: OsseoSpeed™, Astra, Mölndal, Sweden; B: Integra-CP™, Bicon, Boston, USA) were placed at either crestal or subcrestal (-1.5 mm) positions on one side of the mandible. Ligature-induced peri-implantitis was initiated four weeks after the installation of the healing abutment connections. After 12 weeks, tissue biopsies were processed for histological analyses.

Results

Supra-alveolar bone loss combined with a shallow infrabony defect was observed in crestal level implants while deep and wide infrabony defects were present in subcrestal level groups. Subcrestal groups showed significantly greater ridge loss, depths and widths of infrabony defects when compared to crestal groups (P<0.001).

Conclusions

Within the limitations of the animal study, it can be stated that the implants at subcrestal position displayed greater infra-osseous defect than implants at crestal position under an experimental ligature-induced peri-implantitis.

Key words:Subcrestal, peri-implantitis, histology.

Long-term safety of adalimumab in clinical trials in adult patients with Crohn's disease or ulcerative colitis

BACKGROUND

Adalimumab is used to treat moderate to severe Crohn's disease (CD) and ulcerative colitis (UC) when conventional therapies fail.

AIM

To update long-term adalimumab safety from CD and UC trials; the previous report was CD only, 3160 patients/3402 patient-years (PYs).

METHODS

Treatment-emergent adverse events (AEs; first dose to 70 days after last dose/December 31, 2015) in adults in phase 2/3 and 3/3b trials and open-label extensions were coded using Medical Dictionary for Regulatory Activities (MedDRA-v18.1). Rates were assessed as events/100 (E/100 PYs).

RESULTS

The database (16 trials; CD, N = 3606; UC, N = 1739) represented 4145 and 3397 PYs of exposure, respectively. For CD, incidences of any AEs with adalimumab were 60.8%-65.1%, depending on dose, and 71.5% with placebo; for UC, the incidences were 53.5%-54.8% and 56.1%, respectively. Rates of any AEs (CD, 605 E/100 PYs; UC, 361 E/100 PYs), serious AEs (CD, 36.1 E/100 PYs; UC, 18.9 E/100 PYs), and malignancies (CD, 1.2 E/100 PYs; UC, 1.0 E/100 PYs) were similar between current and prior analyses. Apparent rate of opportunistic infections was lowered to 0.3 and 0.2 E/100 PYs for CD and UC, respectively, by recent MedDRA changes excluding oral candidiasis and tuberculosis. Standardised incidence ratios for malignancies were similar to the general population (CD, 1.45 [95% CI, 0.90-2.22]; UC, 1.36 [95% CI, 0.84-2.07]). Demyelinating disorders were uncommon (CD, 0.1 E/100 PYs; UC, <0.1 E/100 PYs).

CONCLUSIONS

Patients with moderately to severely active Crohn's disease or ulcerative colitis continued to experience acceptable safety with adalimumab, without new safety signals.

[Dose-response relationship of ropivacaine for epidural block in early herpes zoster guided by CT]

Objective: To determine the dose-response relationship of ropivacaine for epidural block in early herpes zoster by CT guided. Methods: From January 2015 to February 2017, according to the principle of completely random digital table, 80 patients with early herpes zoster who were prepared for epidural block were divided into 4 groups(each group 20 patients): in group A the concentration of ropivacaine was 0.08%, in group B was 0.10%, in group C was 0.12% and in group D was 0.14%.Under CT guidance, epidural puncture was performed in the relevant section, mixing liquid 5.0 ml (with 10% iodohydrin)were injected into epidural gap.CT scan showed that the mixing liquid covered the relevant spinal nerve segmental.The numeric rating scale(NRS) values before treatment and at 30 minutes, the incidence of adverse reactions were recorded, and the treatment were evaluated. The response to ropivacaine for epidural block in early herpes zoster was defined as positive when the NRS values was less than or equal to one.The ED(50), ED(95) and 95% confidence interval (CI) of ropivacaine for epidural block in early herpes zoster guided by CT were calculated by probit analysis. Results: The NRS values before treatment were 5.00(4.00, 6.00), 5.00(4.25, 6.00), 5.50(5.00, 6.00) and 5.00(4.00, 6.00), the difference was no significant(Z=2.576, P=0.462). The NRS values at 30 minutes decreased and the effective rate of the treatment increased(χ(2)=8.371, P=0.004), following ropivacaine dose gradient increasing, they were 1.50(1.00, 2.00), 1.00(1.00, 2.00), 0.50(0.00, 1.00) and 0.00(0.00, 1.00), the difference was statistically significant (Z=17.421, P=0.001). There was one case in group C and four cases in group D were hypoesthesia, others were no significant adverse reactions occurred. The ED(50) and ED(95) (95%CI) of ropivacaine for epidural block in early herpes zoster guided by CT were 0.078%(0.015%-0.095%)and 0.157%(0.133%-0.271%), respectively. Conclusion: Ropivacaine for epidural block in early herpes zoster guided by CT is effective for neuropathic pain, with no significant adverse reactions.

[Prevention and treatment of Horner syndrome in treatment of head and face hyperhidrosis by thoracic sympathetic nerve modulation]

Objective: By summarize the Prevention and Treatment of Horner Syndrome of CT-guided thoracic sympathetic nerve modulation in the treatment of head and face Hyperhidrosis, reduce the occurrence of the complications. Methods: A retrospective analysis was made on 116 patients of CT-guided thoracic sympathetic nerve modulation in the treatment of head and face Hyperhidrosis in The First Hospital of Jiaxing from January 2010 to December 2016. Analysis the reasons of Horner syndrome and external management to sum up the corresponding prevention and treatment measures. Results: Under the guidance of CT positioning, 116 patients were successfully punctured to the intended target (both sides of the R3 above the rib head), after injection of local anesthetic plus contrast agent, CT scan showed there are 39 sides of the liquid parallel to the outside of pleural (26 sides) or over (13 sides) R1 above the rib head. CT scan again after the injection of anhydrous alcohol, there are 43 sides of the liquid parallel to the outside of pleural (24 sides) or over (19 sides) R1above the rib head.After the operation, 22 sides appeared Horner syndrome, 19 of which immediately give physiological saline 5 ml into the ipsilateral Satellite ganglion.Within 2 hours Horner's syndrome completely disappeared, while 3 cases were not treated, Horner syndrome lasts for 3 months to 2 years. Conclusion: The incidence of Horner syndrome relatively high during the CT-guided thoracic sympathetic nerve modulation to treatment of head and face Hyperhidrosis. Injecting 5 ml physiological saline into the ipsilateral Satellite ganglion immediately can completely eliminate this common complications.

[Diagnostic value of narrow-band imaging in detection of recurrent nasopharyngeal carcinoma]

Objective: To evaluate the diagnostic value and feasibility of narrow-band imaging in detection of recurrent nasopharyngeal carcinoma (NPC). Methods: One thousand three hundred and sixty-four NPC patients who had completed NPC treatment were enrolled. All patients were followed-up with imaging, serological examination of EB virus and nasopharyngeal endoscopy(WL and NBI mode), in which (1) both white light (WL) and NBI modes were done; (2) positive endoscopic patients were given nasopharyngeal biopsy; (3) using histologic finding as criterion standard, the sensitivity, specificity, accuracy and Yonden's index of two modes were compared. Kappa index was used to evaluate the consistency between the two modes and pathological results respectively; (4) the positive rates of WL and NBI in patients with early recurrent (stage Ⅰ+ Ⅱ) were compared. Results: A total of 265 cases were suspected as having recurrent lesions by endoscopy in WL mode and 68 cases of them were pathologically diagnosed as having NPC; and 82 cases were suspected as having recurrent lesions by endoscopy in NBI mode and 74 cases of them were pathologically diagnosed as having NPC. The sensitivity, specificity, accuracy and Yonden's index of WL mode were 91.89%, 0, 25.09% and -0.0811, respectively, with a kappa of -0.045; the sensitivity, specificity, accuracy and Yonden's index of NBI mode were 100.00%, 95.94%, 97.05% and 0.9594, respectively. Conclusion: NBI has higher sensitivity, specificity, early diagnosis rate and Yonden's index than WL.