[Epidemiological and spatial-temporal clustering characteristics of pertussis in Hebei Province from 2013 to 2022]

Objective: To analyze the spatial-temporal epidemiological characteristics of pertussis from 2013 to 2022 in Hebei Province and to provide a reference for improving prevention and control measures. Methods: Based on the data of pertussis reported in Hebei Province during 2013-2022 to analyze the popular characteristic, the ArcGIS 10.8 software was used to construct a ring map and to perform spatial autocorrelation analysis; the SaTScan 10.1 software was used for spatial-temporal scan statistics. Results: There were 6 715 cases of the cumulative report in Hebei Province from 2013 to 2022 without death. The annual report incidence was 0.90/100 000. The overall incidence rate showed an upward trend from 2013 to 2019, and during 2020-2021, it showed a sharp decline, but in 2022, it showed a sharp increase. Summer and autumn are the peak seasons of the epidemic. The incidence was highest in age group <1 year (48.67%), and the lowest age group in age group ≥15 years (0.45%) and mainly scattered children (78.03%); the incidence about men is higher than women. Spatial autocorrelation analysis showed that the onset of pertussis has spatial clustering, and high-high clusters were found in Langfang, Baoding, and Cangzhou, the top three countries with reported incidence. The area covered by a low-low cluster was consistent with the distribution of the corresponding low-incidence areas in this study. Space-time scan detects five statistically significant areas, and three zones were concentrated in 2022. Conclusions: The incidence of pertussis in Hebei had obvious season, population, and area-specific differences. There was obvious spatiotemporal and clustering, so the control of key areas should target the characteristics of time and space.

New caffeoyl derivatives with potent DPPH radical scavenging activity from Elephantopus tomentosus

Eight new caffeoyl derivatives, elephantomentosides A-H (1 - 8), together with ten known ones (9 - 18), were isolated from the whole plant of Elephantopos tomentosus L. Their structures were elucidated using detailed spectroscopic analysis. Structurally, compounds 1 - 8 are composed of β-D-glucopyranose, and almost all of the substituent positions are at the C-1' and C-4' of glucopyranose. The anti-inflammatory and antioxidant activities of all isolated compounds were evaluated in vitro. Compounds 9-10, 13-15, and 17-18 exhibited significant DPPH scavenging capacity with IC50 values in the range of 10.01-25.07 μM, in comparison with Vc (IC50, 17.98 μM).

[Efficacy and safety of allogeneic hematopoietic stem cell transplantation for the treatment of primary myelofibrosis]

Objective: To evaluate the efficacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of primary myelofibrosis (PMF) patients. Methods: A total of 14 cases of PMF who underwent allo-HSCT from December 2008 to December 2022 were analyzed retrospectively, including 8 males and 6 females with a median age [M(Q1, Q3)]of 36 (24, 42) years. Three-year overall survival (OS), disease free survival (DFS), cumulative incidence of relapse (CIR), transplantation-related mortality (TRM) were analyzed. Meanwhile, the complications were followed up by telephone and outpatient appointments for 49.6 (9.0,93.1) months. Results: All patients received myeloablative conditioning regimens (MAC). All patients had successful engraftment, and the median time of neutrophils and platelet engraftment were 13.5 (11.8, 18.0) days and 19.5 (13.5, 24.5) days, respectively. Ⅱ-Ⅳ acute graft versus host disease (GVHD) occurred in 3 cases, while chronic GVHD in 8 cases. The rate of 3-year OS,DFS,CIR and TRM were (92.9±6.9)%, (76.0±12.2)%, (38.6±2.7)% and (7.1±0.5)% respectively after a median follow-up time of 1 489.0 (270.3,2 794.8) days. Two patients died from treatment-related complications, one of which died 39 days after transplantation due to heart failure caused by severe anemia, the other patient died 6 years after relapse due to pulmonary infection. Conclusion: Allo-HSCT can be used as a safe and effective approach to treat PMF.

[Efficacy and feasibility of catheter-based adrenal ablation on Cushing's syndrome associated hypertension]

Objective: To explore the value of catheter-based adrenal ablation in treating Cushing's syndrome (CS)-associated hypertension. Methods: A clinical study was conducted in patients with CS, who received catheter-based adrenal ablation between March 2018 and July 2023 in Daping Hospital. Parameters monitored were blood pressure (outpatient and 24-hour ambulatory), body weight, clinical characteristics, serum cortisol and adrenocorticotropic hormone (ACTH) at 8 am, 24-hour urinary free cortisol (24 h UFC), fasting blood glucose and postoperative complications. Procedure effectiveness was defined as blood pressure returning to normal levels (systolic blood pressure<140 mmHg (1 mmHg=0.133 kPa) and diastolic blood pressure<90 mmHg), cortisol and 24 h UFC returning to normal and improvement of clinical characteristics. The parameters were monitored during follow up in the outpatient department at 1, 3, 6, and 12 months after catheter-based adrenal ablation. Results: A total of 12 patients (aged (40.0±13.2) years) were reviewed. There were 5 males, with 5 cases of adenoma and 7 with hyperplasia from imaging studies. Catheter-based adrenal ablation was successful in all without interruption or surgical conversion. No postoperative complication including bleeding, puncture site infection, adrenal artery rupture or adrenal bleeding was observed. The mean follow up was 28 months. Compared to baseline values, body weight declined to (59.48±11.65) kg from (64.81±10.75) kg (P=0.008), fasting blood glucose declined to (4.54±0.83) mmol from (5.53±0.99) mmol (P=0.044), outpatient systolic blood pressure declined to (128±21) mmHg from (140±19) mmHg (P=0.005), diastolic blood pressure declined to (78±10) mmHg from (86±11) mmHg (P=0.041), and the mean ambulatory daytime diastolic blood pressure declined to (79±12) mmHg from (89±8) mmHg (P=0.034). Catheter-based adrenal ablation in 8 patients was defined as effective with their 24 h UFC significantly reduced after the procedure (1 338.41±448.06) mmol/L from (633.66±315.94) mmol/L, P=0.011). The change of 24 h UFC between the effective treatment group and ineffective group was statistically significant (P=0.020). The postoperative systolic blood pressure in the treated adenoma group was significantly lower than those of hyperplasia group (112±13) mmHg vs. (139±20) mmHg, P=0.026). Conclusions: For patients with CS-associated hypertension who are unwilling or unable to undergo surgical treatment, catheter-based adrenal ablation could improve the blood pressure and cortisol level. Catheter-based adrenal ablation could be a safe, effective, and minimally invasive therapy. However, our results still need to be validated in further large-scale studies.

[Study on clearance of chlorfenapyr via blood purification (a case analysis)]

This paper analyzed the clinical data of a patient with acute oral emamectin·chlorfenapyr poisoning, and discussed the effect of blood purification therapy on chlorfenapyr poisoning. Chlorfenapyr was detected in the blood, urine, ultrafiltrate and plasma exchange fluid of the patient, and the concentrations of chlorfenapyr poison gradually decreased with time. Blood purification has a certain effect on chlorfenapyr, and early blood purification may be an effective measure to treat chlorfenapyr poisoning.

[The impact of human umbilical cord-derived mesenchymal stem cells on the pancreatic function of type 2 diabetic mice and their regulatory role on NLRP3 inflammasomes]

Objective: To investigate the effect and regulation of umbilical cord-derived mesenchymal stem cells (UC-MSCs) on islets function and NOD-like receptor family, pyrin domain containing 3 (NLRP3) and autophagy in type 2 diabetic mellitus (T2DM) mice. Methods: Experimental study. Twenty, 8-week-old, male C57BL/6J mice were selected and divided into a normal control group (n=5) and a high-fat feeding modeling group (n=15). The model of T2DM was established by high-fat feeding combined with intraperitoneal injection of low-dose streptozotocin. After successful modeling, those mice were divided into a diabetes group (n=7) and a UC-MSCs treatment group (n=7). The UC-MSCs treatment group was given UC-MSCs (1×106/0.2 ml phosphate buffer solution) by tail vein infusion once a week for a total of 4 weeks; the diabetes group was injected with the same amount of normal saline, and the normal control group was not treated. One week after the treatment, mice underwent intraperitoneal glucose tolerance tests and intraperitoneal insulin tolerance tests, and then the mice were sacrificed to obtain pancreatic tissue to detect the expressions of interleukin-1β (IL-1β) and pancreatic and duodenal homeobox 1 (PDX-1) by immunofluorescence. The bone marrow-derived macrophages were stimulated with lipopolysaccharide and adenosine triphosphate (experimental group) in vitro, then co-cultured with UC-MSCs for 24 h (treatment group). After the culture, enzyme-linked immunosorbent assay was used to detect the secretion level of IL-1β in the supernatant, and immunofluorescence staining was used to detect the expression of NLRP3 inflammasome, and related autophagy proteins. Statistical analysis was performed using unpaired one-way analysis of variance, repeated measure analysis of variance. Results: In vivo experiments showed that compared with the diabetes group, the UC-MSCs treatment group partially repaired islet structure, improved glucose tolerance and insulin sensitivity (all P<0.05), and the expression of PDX-1 increased and IL-1β decreased in islets under confocal microscopy. In vitro experiments showed that compared with the experimental group, the level of IL-1β secreted by macrophages in the treatment group was decreased [(85.9±74.6) pg/ml vs. (883.4±446.2) pg/ml, P=0.001], the expression of NLRP3 inflammasome and autophagy-related protein P62 was decreased, and the expressions of microtubule-associated protein 1 light chain 3β (LC3) and autophagy effector Beclin-1 were increased under confocal microscopy. Conclusions: UC-MSCs can reduce the level of pancreatic inflammation in T2DM mice, preserving pancreatic function. This might be associated with the ability of UC-MSCs to inhibit the activity of NLRP3 inflammasomes in macrophages and enhance autophagy levels.

[Pharmacokinetics and pharmacodynamics of antibiotics in septic children treated with extracorporeal membrane oxygenation]

Objective: To investigate the characteristics of pharmacokinetic (PK) and pharmacodynamic (PD) parameters of antibacterial agents in children with sepsis treated by extracorporeal membrane oxygenation (ECMO). Methods: In this prospective cohort study, 20 children with sepsis (confirmed or suspected) who were treated with ECMO and antimicrobial in the Department of Critical Medicine of Hunan Children's Hospital from March 2021 to December 2022 were enrolled as the ECMO group. Through therapeutic drug monitoring (TDM), the PK-PD parameters of antibacterial agents were analyzed. Twenty five children with sepsis in the same department who were treated with vancomycin but no ECMO at the same time were enrolled as the control group. The individual PK parameters of vancomycin were calculated by Bayesian feedback method. The PK parameters in the two groups were compared, and the correlation between trough concentration and area under the curve (AUC) was analyzed. Wilcoxon rank sum test was used for inter group comparison. Results: Twenty patients in the ECMO group, included 6 males and 14 females, with an onset age of 47 (9, 76) months. In the ECMO group, 12 children (60%) were treated with vancomycin, and the trough concentration was less than 10 mg/L in 7 cases, 10-20 mg/L in 3 cases, and >20 mg/L in 2 cases; AUC/minimum inhibitory concentration (MIC) (MIC=1 mg/L)<400 was in 1 case, 400-600 in 3 cases, and >600 in 8 cases. Among the 11 children (55%) who were treated with β-lactam antibiotics, there were 10 cases with drug concentration at 50% dosing interval (C_T50)>4 MIC and 9 cases with trough concentration>MIC, both C_T50 and trough concentration of cefoperazone reached the target. Among the 25 cases of control group, 16 were males and 9 females, with an onset age of 12 (8, 32) months. There was a positive correlation between vancomycin trough concentration and AUC (r²=0.36, P<0.001). The half-life of vancomycin and the 24-hour AUC (AUC_{0-24 h}) in the ECMO group were higher than those in the control group (5.3 (3.6, 6.8) vs. 1.9 (1.5, 2.9) h, and 685 (505, 1 227) vs. 261 (210, 355) mg·h/L, Z=2.99, 3.50, respectively; both P<0.05), and the elimination rate constant and clearance rate was lower than those in the control group (0.1 (0.1, 0.2) vs. 0.4 (0.2, 0.5), 0.7 (0.5, 1.3) vs. 2.0 (1.1, 2.8) L/h, Z=2.99, 2.11, respectively; both P<0.05). Conclusion: The PK-PD parameters in septic children treated by ECMO varied with a longer half-life, higher AUC_{0-24 h}, lower elimination rate constant and clearance rate.

[Influencing factors of mild cognitive impairment among the Chinese elderly: a meta-analysis]

Objective: To conduct a meta-analysis on the influencing factors of mild cognitive impairment (MCI) in the Chinese elderly. Methods: The literature related to the influencing factors of MCI in Chinese elderly population was retrieved through CNKI, Wanfang, VIP, PubMed, Embase and Web of Science databases up to March 13, 2022. Stata17.0 software was used to calculate the combined risk ratio (RR) with the 95% confidence interval (CI), test the heterogeneity, and assess the publication bias. Results: A total of 2 450 articles were retrieved, and 49 articles met the inclusion criteria, including 5 cohort studies and 44 case-control studies. Meta-analysis results showed that male (RR=0.778, 95%CI: 0.696-0.870, I²=73.1), education>6years (RR=0.428, 95%CI: 0.374-0.490, I²=86.9) and regular exercise (RR=0.496, 95%CI: 0.421-0.585, I²=81.5) were protective factors for MCI, while age≥70 years (RR=2.431, 95%CI: 2.086-2.833, I²=79.3), family history of dementia (RR=3.228, 95%CI: 2.140-4.867, I²=0.0), smoking (RR=1.214, 95%CI: 1.098-1.342, I²=78.8), alcohol consumption (RR=1.165, 95%CI: 1.047-1.297, I²=68.2), solitary living (RR=2.816, 95%CI: 2.123-3.736, I²=42.0), insomnia (RR=1.402, 95%CI: 1.093-1.799, I²=41.3), overweight/obesity (RR=1.431, 95%CI: 1.207-1.696, I²=75.9), hypertension (RR=1.731, 95%CI: 1.589-1.886, I²=67.1), hyperlipidemia (RR=1.722, 95%CI: 1.541-1.924, I²=63.9), diabetes mellitus (RR=1.495, 95%CI: 1.341-1.666, I²=71.6), cardiovascular diseases (RR=1.671, 95%CI: 1.446-1.932, I²=74.6) and cerebrovascular diseases (RR=2.309, 95%CI: 2.040-2.613, I²=76.3) were risk factors of MCI. Conclusion: The present study indicates that male, junior high school education or above and regular exercise are protective factors of MCI, while age≥70 years, family history of dementia, smoking, alcohol consumption, living alone, insomnia, overweight/obesity, hypertension, hyperlipidemia, diabetes, cardiovascular diseases and cerebrovascular diseases are risk factors of MCI.

Energy transfer across magnetopause under dawn-dusk IMFs

A parametric study on the energy transfer of the solar wind across the magnetopause entering the magnetosphere is conducted using a global magnetohydrodynamic numerical simulation. The characteristics of the mechanical and electromagnetic energy distribution under the dawn-dusk interplanetary magnetic fields (IMFs) are investigated by analyzing magnetic reconnection and viscous effect, and compared with the radial and north-south IMFs. It is shown that (1) the interactions at the magnetopause and the transfer of energy across this boundary move in relation to the IMF orientation. (2) For the duskward IMF, the mechanical energy flow clearly enters the equatorial and low-latitude regions on the dayside, and the electromagnetic energy flow has a small inflow on the equatorial and low latitudes of the dayside. A significant energy inflow appears on the dawn side in the northern hemisphere and the dusk side in the southern hemisphere near the polar cusp. (3) The energy distribution characteristics across the magnetopause under dawn-dusk IMFs are mirror symmetric about the [Formula: see text] plane. (4) For a magnetic field of 5 nT, the electromagnetic energy input under the dawn-dusk IMFs is twice as large as the mechanical energy and the electromagnetic energy under the radial IMF, which is five times as large as the electromagnetic energy during the pure northward IMF, but only half as large as the electromagnetic energy under the pure southward IMF. The mechanical energy input under dawn-dusk IMFs has the same magnitude as that under radial and north-south IMFs. The magnitude of the energy transfer rate for the dawn IMF and dusk IMF (about 3.5%) is between 1.71% for the northward IMF and 4.95% for the southward IMF, but higher than 2.22% for the radial IMF. The Akasofu-type energy-coupling formula, [Formula: see text], underestimates the energy input from the solar wind under [Formula: see text] dominated IMF.

[A case of pulmonary aspergillus infection in underground coal mine workers]

The underground environment is dark and humid, and it is easy to breed pathogenic microorganisms. A lump in the right lung of a coal mine underground transport worker was found druing occupational health examination. CT examination showed that the lump was located in the posterior segment of the upper lobe of the right lung, with point strip calcification, liquefaction necrosis, and proximal bronchial stenosis and occlusion. MRI examination FS-T(2)WI and DWI showed "target sign", annular low signal around the central high signal, and low mixed signal around the periphery, and annular high signal in the isosignal lesions on T(1)WI. Then the pulmonary aspergillus infection was confirmed by pathology.

[Survival efficacy of MDS/AML patients with TP53 abnormal received allogeneic hematopoietic stem cell transplantation]

Objective: TP53-abnormal MDS/acute myeloid leukemia (AML) patients' allogeneic hematopoietic stem cell transplantation (allo-HSCT) treatment's effectiveness and influencing factors should be studied. Methods: 42 patients with TP53 gene status change MDS/AML who underwent allo-HSCT from 2014.8.1 to 2021.7.31 at the Hematology Hospital of the Chinese Academy of Medical Sciences were the subject of a retrospective analysis. The 42 patients were divided into three groups: the TP53 deletion group (group A) , TP53 mono-alle mutation group (group B) , and TP53 multi-hit group (group C) . The differences in clinical features and prognostic factors after transplantation were analyzed. Results: There were 42 MDS/AML patients, including 21 patients with MDS, and 21 patients with AML. The median follow-up period was 34.0 (7.5-75.0) months and the median patient age at the time of transplantation was 41.5 (18-63) years old. The total OS was 66.3% (95% CI 53.4%-82.4%) in 3 years after transplantation, and EFS was 61.0% (95% CI 47.7%-78.0%) in 3 years. For 3 years after receiving hematopoietic stem cell transplantation, there were no statistically significant differences in 3-year OS and EFS in groups A, B, and C (P≥0.05) . The 3 years OS was 82.5% (95% CI 63.1%-100.0%) in group A, 60.6% (95% CI 43.5%-84.4%) in group B, and 57.1% (95% CI 30.1%-100.0%) in group C. Univariate analysis revealed that the number of co-mutant genes, pre-HSCT treatment, and disease type did not affect prognosis, while age, karyotype, co-mutation, positive blast cell before transplantation, and positive blast cell after transplantation were common prognostic factors for OS and EFS (P<0.1) . MRD levels before transplantation were found to be independent risk factors for OS (P=0.037, HR=33.40, 95% CI 1.24-901.17) in a multivariate analysis. Conclusion: Patients with MDS/AML who have TP53 mutations can benefit from allo-HSCT, but patients with complex karyotypes have a worse prognosis. Meanwhile, the final flow cytometry (FCM) monitoring blast cell test before HSCT has a certain guiding significance for prognostic assessment.

Eudesmane-type sesquiterpenes from the rhizomes of Atractylodes macrocephala and their bioactivities

Fifteen undescribed eudesmane-type sesquiterpenes, named atramacronoids D-R, along with fourteen known analogues were isolated from the rhizomes of Atractylodes macrocephala. The structures of atramacronoids D-R were elucidated based on extensive spectroscopic data analysis, Snatzke's rule, electronic circular dichroism (ECD) calculations, and X-ray crystallographic analysis. Notably, of the undescribed isolates, atramacronoids D and E are the first example of eudesmanolactam-phenol and eudesmanolactam-ethyl hybrids obtained from plants, respectively. A pair of enantiomers, (+)- and (-)-atramacronoids F, were successfully resolved by chiral-phase HPLC. Atramacronoid D exhibited weak cytotoxicity against SGC-7901 cells. Atramacronoid E significantly promoted the proliferation of LPS-induced IEC-6 cells.

[Inhibition of receptor-interacting protein 3 improves experimental autoimmune hepatitis]

Objective: To evaluate the potential of receptor-interacting protein 3 (RIP3) as a therapeutic target for autoimmune hepatitis (AIH). Methods: Immunofluorescence assay was used to observe the activated expression levels of RIP3 and its downstream signal mixed lineage protein kinase domain-like protein (MLKL) in the liver tissues of patients with AIH and hepatic cyst. Concanavalin A (ConA) was injected into the tail vein to induce acute immune-mediated hepatitis in mice. Intervention was performed by intraperitoneal injection of RIP3 inhibitor GSK872 or solvent carrier. Peripheral blood and liver tissues were collected. Serum transaminases level, qPCR and flow cytometry were analyzed. The intergroup comparison was performed with an independent sample t-test. Results: The expression level of p-RIP3 (the activated forms of RIP3) and phosphorylated p-MLKL (MLKL after phosphorylation) downstream signal were significantly higher in the liver tissue of AIH patients than those of controls. Compared with the control group, the expression levels of RIP3 and MLKL mRNA were significantly increased in the liver tissue of AIH patients (relative expression levels 3.28±0.29 vs. 0.98±0.09, 4.55±0.51 vs. 1.06±0.11), and the differences were statistically significant (t=6.71 and 6.77, respectively, and P<0.01). The expression levels of RIP3 and MLKL mRNA were significantly higher in the mice liver tissue of ConA-induced immune hepatitis than those in the control group (relative expression levels 2.35±0.09 vs. 0.89±0.11,2.77±0.22 vs. 0.73±0.16,t=10.4,6.33, P<0.01). RIP3 inhibitor GSK872 had significantly attenuated ConA-induced immune liver injury and inhibited the expression of tumor necrosis factor-α, interleukin-6, interleukin-1β and NLRP3 in liver. Compared with the control group, the proportions of CD45⁺F4/80⁺ macrophages, CD4⁺ IL-17⁺ Th17 cells, CD4⁺ CD25⁺ regulatory T (Treg) cells and CD11b⁺ Gr-1⁺ myeloid derived suppressor cells (MDSCs) were significantly increased in the liver of ConA + Vehicle group. Compared with ConA + Vehicle group, the proportion of CD45⁺F4/80⁺ macrophages and CD4⁺ IL-17⁺ Th17 cells were significantly decreased, while the proportion of CD4⁺ CD25⁺Treg cells and CD11b⁺ Gr-1⁺ MDSCs with immunomodulatory functions were significantly increased in mice liver of ConA+GSK872 group. Conclusion: AIH patients and ConA-induced immune hepatitis mice have activated RIP3 signal in liver tissues. Inhibition of RIP3 reduces the expression and proportion of proinflammatory factors and cells, and promotes the accumulation of CD4⁺ CD25⁺ Treg cells and CD11b⁺ Gr-1⁺ MDSCs with immunomodulatory functions in the liver of mice with immune hepatitis, thereby alleviating liver inflammation and injury. Therefore, the inhibition of RIP3 is expected to be a new approach for the treatment of AIH.

1H-NMR-guided isolation of enantiomeric coumarin-monoterpenes with anti-inflammatory activity from Gerbera piloselloides

¹H-NMR guided fractionation led to the isolation of twenty-two coumarin monoterpenes from the whole plant of Gerbera piloselloides, among which fourteen were undescribed. All coumarin monoterpenes were initially found to be racemates without optical activity. Subsequently, eleven pairs of optically pure enantiomers were successfully separated by chiral phase HPLC. Their structures and absolute configurations were unambiguously determined based on their spectroscopic data, calculated/experimental electronic circular dichroism (ECD) data, and X-ray diffraction analysis. Bioassays in LPS-treated RAW 264.7 cells revealed that the four compounds possessed moderate anti-inflammatory activity. In addition, the correlations between the cotton effect (CE) from δ-lactone at approximately 210-220 nm in CD spectra and γ-C or the ring fused at γ-C of the skeleton were reported for the first time.

[Distribution, Risk, and Influencing Factors of Microplastics in Surface Water of Huangshui River Basin]

In order to explore the distribution of microplastics in the freshwater environment of Qinghai-Tibet Plateau, 63 surface water samples were collected in Huangshui River basin of Qinghai province during the wet season, and the distribution characteristics and main influencing factors of microplastics in the surface water were analyzed by means of metallographic microscope, Fourier infrared spectroscopy, field investigation, and image data analysis. The potential ecological risks of microplastics were evaluated using risk index (H) and pollution load index (PLI) models. The abundance of microplastics in surface water ranged from 665-8780 n·m^-3, with the highest average abundance of 5414 n·m^-3 in Huangyuan County. The abundance of microplastics increased from upstream to downstream. The main colors of microplastics were transparent (67%) and black (17%), and the particle size was less than 50 μm (70%). Polyethylene (66%) and polypropylene (12%) were the main polymer types. The abundance of microplastics was positively correlated with cultivated land area, precipitation, and ultraviolet intensity, but the opposite results were observed in dissolved oxygen, redox potential, and wind speed. Additionally, the potential ecological risk of surface water in the Huangshui River basin was relatively low.

[Efficacy and safety of combination therapy with chemotherapy, programmed death-1 inhibitor and anlotinib in the treatment of advanced dedifferentiated liposarcoma]

Objective: To investigate the efficacy and safety of the combination therapy with chemotherapy, programmed death-1 (PD-1) inhibitor and anlotinib in the treatment of advanced dedifferentiated liposarcoma (DDLPS). Methods: The clinical data of patients with dedifferentiated liposarcoma who received chemotherapy combined with PD-1 inhibitor and anlotinib in the Department of Medical Oncology, Zhongshan Hospital Affiliated to Fudan University from January 1, 2020 to November 30, 2021 were retrospectively analyzed. A total of 24 patients were included in this study, including 12 males and 12 females, with a median age of onset of 56 years (range, 31-69 years). Efficacy and safety in those patients were assessed. Results: All patients had unresectable or metastatic dedifferentiated liposarcoma with G2 (moderate differentiation) or G3 (differential differentiation) in a concise three-grade grading scheme of tumor pathology. Twelve patients received the regimen as the first-line treatment, while the other 7 taken the regimen as second-line treatment and 5 as third-line or above. The median follow-up time for overall survival (OS) was 7.7 months. The overall response rate (ORR) was 20.8% (5/24) and disease control rate (DCR) was 83.3% (20/24) with 5 partial response (PR), 15 stable disease (SD) and 4 progressive disease (PD). Overall, the median progression-free survival (PFS) was 4.9 months (95%CI: 3.4-16.2 months). The ORR of anthracycline-based, eribulin-based or gemcitabine-based regimens was 1/12, 2/6 and 2/6, respectively; and the median PFS was 7.7, 7.3 and 4.4 months, respectively. Waterfall plots showed notable tumor shrinkage of any degree in eribulin and gemcitabine-based regimens(3/6 and 2/6, respectively), while there were more patients presented with SD in anthracycline-based group(9/12). Common adverse reactions included myelosuppression, fatigue, anorexia, rash, pruritus, palpitate, hypothyroidism and hypertension. Conclusions: The combination regimen with chemotherapy, PD-1 inhibitor and anlotinib in the treatment of advanced DDLPS is effective and well tolerable. There are more responders in eribulin or gemcitabine-based regimens.

[Analysis of the effectiveness of coracoid osteotomy and concentric coaxial reconstruction of the glenoid cavity in the treatment of recurrent anterior dislocation of the shoulder joint]

Objective: To investigate the clinical efficacy of the modified Latarjet procedure in the treatment of recurrent anterior subluxation of the shoulder by "coaxial co-arc" reconstruction of the glenoid cavity. Methods: The clinical data of 103 cases (106 shoulders) of recurrent anterior dislocation of the shoulder admitted to the First Affiliated Hospital of the Army Military Medical University from January 2005 to December 2020 were retrospectively studied. Out of these cases, 84 were males and 19 were females; 31 with left-sided injuries while 75 with right-sided injuries, with a mean age of (29.4±11.5) years (16-61 years). The preoperative anterior fear test was positive, and a modified Latarjet procedure was used to reconstruct the shoulder glenoid defect through a "coaxial co-arc". The Rowe score, simple shoulder test (SST) score, and Visual analogue scale (VAS) score of pain were used to assess the shoulder's function. Parameters such as the postoperative shoulder recurrent dislocation rate, shoulder body external rotation angle, and subscapularis muscle strength changes were recorded postoperatively. Moreover, radiographs and CT scans were used to check for the incidence of osteoarthritis (Samson-Prieto score). Results: After a mean follow-up of 9.0 years (1 to 16 years), bony healing occurred 3 to 6 months postoperatively. The Rowe score improved from 40.4±6.5 preoperatively to 93.2±2.5 (P<0.001), the SST score improved from 5.2±1.3 preoperatively to 10.1±1.5 (P<0.001), and the VAS pain score decreased from 3.5±1.9 preoperatively to 1.1±1.2 (P<0.001) at the final follow-up. The angle of lateral external rotation of the shoulder joint was 58.8°±15.6° preoperatively and 57.6°±14.5° postoperatively with no statistically significant difference (P>0.05). There was no statistically significant difference in the measurement of subscapularis muscle strength between the healthy side and the affected side (P>0.05). In 89.6% of patients after surgery, coaxial co-arc reconstruction of the shoulder glenoid was obtained, and the shoulder glenoid defect and postoperative inclusion angle were significantly improved compared with those before surgery (P<0.001). Postoperatively, new-onset osteoarthritis developed in 7 cases (7/98), arthritis progressed in 2 cases (2/8), incisional healing was poor in 2 cases (2/98), and revision surgery was performed in 2 cases (2/98) due to bone mass detachment. Conclusion: Coracoid osteotomy and concentric coaxial reconstruction of the glenoid cavity elicits adequate good clinical efficacy for cases of recurrent anterior shoulder dislocation, with low recurrence rates, low revision rates and low incidence of osteoarthritis.

Quality markers of Baizhu dispensing granules based on multi-component qualitative and quantitative analysis combined with network pharmacology and chemometric analysis

ETHNOPHARMACOLOGICAL RELEVANCE

The dispensing granules of traditional Chinese medicines (TCMs) is an innovative form of medicinal material for TCMs decoction, which is gradually recognized in the clinic due to being suitable for production on a large scale and convenient to take for patients. However, the quality control of TCMs dispensing granules is being challenged, because they contain too many unrevealed hydrophilic components.

AIM OF THE STUDY

Here, the dispensing granules produced from the rhizome of Atractylodes macrocephala (Baizhu dispensing granules), were explored as a case to explore the quality markers correlated to the clinical efficacy of TCMs dispensing granules by a comprehensive strategy of integrating chemical profiling, network pharmacology, and chemometric analysis.

MATERIALS AND METHODS

First, the chemical profiling of Baizhu dispensing granules was characterized by using ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS). Subsequently, the potential active components responsible for the efficacy of Baizhu dispensing granules were screened via network pharmacology, and the ultra-performance liquid chromatography coupled with photodiode array detector (UPLC-PDA) method was developed for quantitative analysis of the potential active components in 26 batches of Baizhu dispensing granules. Finally, the quality markers of Baizhu dispensing granules were deciphered based on content variations of potential active components and chemometric analysis.

RESULTS

A total of 69 components were identified from Baizhu dispensing granules. Network pharmacology analysis further revealed that eight of them including five caffeoylquinic acids (31, 32, 36, 42, 44) and three sesquiterpenoids (63, 67, 76) were intimately connected to the core targets of dyspepsia, enteritis, gastritis and immunity. The contents of eight components differed greatly among 26 batches of Baizhu dispensing granules. Chlorogenic acid (31), cryptochlorogenic acid (32) and atractylenolide III (63) have higher concentrations and make great contributions to distinguish different batches of the Baizhu dispensing granules based on principal component analysis (PCA) and orthogonal partial least squares-discriminate analysis (OPLS-DA), and could be used as the quality markers of Baizhu dispensing granules.

CONCLUSIONS

Our study defined the quality markers of Baizhu dispensing granules, which will benefit further investigation on the quality evaluation of TCMs dispensing granules containing Baizhu. The strategy used in this study will be helpful for discovering the quality markers of other TCMs dispensing granules.

[Analysis and management of delayed cerebrospinal fluid rhinorrhea after invasive pituitary adenoma surgery]

Objective: To investigate the related factors and treatments of delayed cerebrospinal fluid rhinorrhea (CFR) after invasive pituitary adenoma (IPA) surgery. Methods: One hundred and forty-two patients with IPA treated in Tianjin Huanhu Hospital from January 2014 to January 2019 were analyzed retrospectively, including 62 males and 80 females, aging from 38 to 67 years. The clinical data of patients before and after operation were collected. All patients with postoperative CFR underwent endoscopic CFR repair. During the operation, residual or recurrent pituitary adenomas were resected, the dura around the leak was enlarged and the necrotic tissue was removed. For those who still had fluid leakage after repair, the necrotic tissue was cleaned up, the leakage was filled and reinforced under endoscopy. Endoscopic rhinorrhea repair was performed if necessary. The cerebrospinal fluid leak was repaired with multi-layer materials. The related risk factors of delayed CFR after operation were analyzed. SPSS 19.0 software was used for statistical analysis. Results: Among the 142 patients in this group, 64 cases underwent total tumor resection and 78 cases underwent non-total tumor resection. They were followed up for 6 to 72 months. Thirty-one cases had delayed CFR, with an incidence of 21.83%, and occurred between 1 and 5 years postoperatively, with an average of 2.4 years. All 31 patients with delayed CFR underwent endoscopic CFR repair. The nasal endoscopy was rechecked at 2 weeks, 1 month, 3 months and 6 months after operation. Twenty-eight patients were repaired successfully after 1 operation, while 2 patients after 2 operations and 1 patient after 3 operations. These patients were followed up for 6 to 60 months, and no CFR occurred again. Univariate analysis showed that the degree of tumor resection, recurrence, size, texture, postoperative radiotherapy and operator experience were the risk factors of delayed CFR (all P<0.05). Multivariate analysis showed that the degree of tumor resection and recurrence were the highest independent risk factors for postoperative CFR, and tumor size, texture, postoperative radiotherapy and operator experience were the independent risk factors in this study. Conclusions: Delayed CFR after IPA is related to the degree of tumor resection, recurrence, size, texture, postoperative radiotherapy and the operator experience. It is necessary to completely remove the tumor under endoscope, to expand resection of the dura and necrotic tissue around the leak, to repair the defect with multi-layer materials, to follow-up closely and to repair timely after operation.

One pair of new enantiomeric trinorsesquiterpenes from the aerial parts of Justicia gendarussa

A pair of new enantiomeric trinorsesquiterpenes, (+)-genpenterpene A (1a) and (-)-genpenterpene A (1b), together with seven known compounds (2-8), were isolated from the aerial parts of Justicia gendarussa Burm.f.. All of these known compounds were isolated from this plant for the first time. Racemic genpenterpene A was separated by chiral HPLC column. Their chemical structures were elucidated based on extensive spectroscopic analysis, single crystal X-ray diffraction, and ECD calculations. (+)-genpenterpene A (1a) exhibited potent inhibitory effect against nitric oxide production in lipopolysaccharide-activated RAW 264.7 mouse macrophage cells with an IC₅₀ value of 9.54 ± 1.02 μM.

Effects of topical application of different molecular weight marine fish skin collagen oligopeptides on UVB-induced photoaging rat skin

OBJECTIVE

The objective of this work was to develop a peptide production process of the exact molecular weight propitious to topical application for cosmetics and to investigate the effects of enzymolysis-derived peptide on UVB-induced photoaging rat skin.

METHODS

The chum salmon fish skins were hydrolyzed by alkaline protease and neutral protease and spray-dried at different conditions, and three kinds of molecular weight peptide (MFSOP) were obtained. A total of 66 ICR rats (female, 20 ± 1 g) were randomly divided into eleven groups, including the normal, model, and experimental groups. The three kinds of MFSOP were dissolved at different dosages (5‰, 2.5%, and 5%) and then applied on the ICR hairless back skins prior to exposing UVB irradiation of 3000mJ/cm² to them 4 h later. After 8 weeks, the rats were killed and the hair-shaved skins were tested for skin moisture, hyaluronic acid, hydroxyproline, antioxidant activity, and RNA expression.

RESULTS

Three kinds of MFSOP were obtained, with the average molecular weights of 495.16, 1194.00, and 2032.46 Dalton, respectively. The MFSOPs, especially the MFSOP of average molecular weight of 1194.00 Dalton, played an important role in the recovery of the UVB-injured skin tissue in lock in moisture, in antioxidant activity and in promotion in collagen and elastin protein to some extent.

CONCLUSION

MFSOPs, especially MFSOP of average molecular weight of 1194.00 Dalton, derived from enzymolysis are potential materials to apply in cosmetics for the UVB9-induced anti-photoaging activity (lock in moisture, antioxidant activity, and promotion in collagen and elastin protein).

[Clinicopathological characteristics and prognosis of young patients with upper tract urethelial carcinoma]

Objective: To investigate the clinicopathological characteristics and prognosis of the young patients with upper tract urothelial carcinoma (UTUC). Methods: The clinical data of 839 UTUC patients receiving radical nephroureterectomy at Peking University Third Hospital, Beijing, China from September 1999 to September 2019 were retrospectively analyzed. The patients were divided into the young (<55 years old, 107 cases) and elderly groups (≥55 years old, 732 cases). After the variables were balanced using propensity score matching, the patients were paired at a 1∶1 ratio. The clinicopathological characteristics and survival rates were compared between the two groups. Results: Compared with the elderly group, the young group had more males (P=0.047), a higher rate of smoking history (P=0.042), a higher rate of renal transplantation history (P<0.01), and fewer symptoms of hematuria (P=0.048). The 1-, 3-, and 5-year cancer specific survival (CSS) rates after surgery were 77.9%, 62.2%, 60.2% and 85.7%, 70.3%, 65.0% in the young and the elderly groups, respectively. The CSS and disease free survival (DFS) of young patients were shorter than those of elderly patients, but the difference was not significant either by subgroup analysis or propensity matching analysis (P>0.05). Young female patients had shorter CSS (P=0.034) and DFS (P=0.046) than elderly females. Perineural invasion (CSS, P=0.002; DFS, P<0.01) and extensive necrosis (CSS, P=0.041; DFS, P=0.001) were the independent risk factors of survival in young patients. Conclusions: Young UTUC patients are different from elderly ones in the frequencies of gender, smoking history, renal transplantation history, and first symptoms. Young female patients have a worse prognosis than elderly female ones. Perineural invasion and extensive necrosis could help clinicians to evaluate the prognosis of young UTUC patients.

Barbaram, a bicyclic neolactam from the root and stem of Lycium barbarum

Barbaram (1), a neolactam together with other five known compunds (2-6) was isolated from the EtOAc-soluble fraction of an EtOH extract of the root and stem of Lycium barbarum by using silica gel, Sephadex LH-20 column chromatography and semi-preparative RP-C₁₈ HPLC. Based on HR-TOF-MS, NMR spectral data, quantum chemistry ECD calculations and referencing to the data reported earlier, the structures of these compounds (1-6) were determined, specially including the absolute configuration of the neolactam (1). Compounds 2 and 4 showed significant anti-inflammatory activity in LPS-induced RAW 264.7 macrophages with the IC₅₀ values of 8.98 ± 0.57 μM, 6.68 ± 0.77 μM.

[Analysis of pregnancy outcomes of D6 single blastocyst transplantation in fresh and frozen-thawed cycles]

Objective: To compare the main clinical outcomes of Day 6 (D6) single blastocyst transplantation in fresh and frozen-thawed cycles. Methods: The data of fresh blastocyst transplantation patients and frozen-thawed blastocyst transplantation patients from January 2013 to December 2017 were retrospectively analysed. Fresh blastocyst transplantation and frozen-thawed blastocyst transplantation were matched in a ratio of 1∶3 by using propensity score matching, the matching factors included age, body mass index, thickness of endometrium and blastocyst grade. Totally 180 cases were included in the fresh cycle group and 540 cases in the frozen-thawed cycle group. Results: There was no significant difference in basal FSH between the two groups [(6.9±2.5) versus (6.4±3.8) U/L, P=0.334]. The positive rate of hCG in D6 blastocyst fresh cycle transplantation group [32.8%(59/180) versus 48.1%(260/540)], clinical pregnancy rate [28.9%(52/180) versus 43.5%(235/540)] and live birth rate [21.1%(38/180) versus 32.2%(174/540)] were lower than those of frozen-thawed cycle group (all P<0.05). The miscarriage rate was higher [26.9%(14/52) versus 24.7%(58/235)], but there was no statistical difference (P>0.05). Conclusions: The clinical pregnancy outcome of D6 single blastocyst frozen-thawed cycle transplantation is better than that of fresh cycle. In order to obtain better clinical outcomes, frozen-thawed cycle transplantation of blastocysts formed on the 6th day is recommended.

[Therapeutic effect of tonsillectomy on IgA nephropathy after kidney transplantation]

Objective: To observe the clinical effect of tonsillectomy on IgA nephropathy (IgAN) after renal transplantation. Methods: From March 2011 to July 2018, 201 kidney transplantation recipients who were diagnosed of IgAN by transplant renal biopsy in the Department of Organ Transplantation of the First Affiliated Hospital of Sun Yat-sen University were retrospectively reviewed, of which 18 patients underwent tonsillectomy after renal biopsy. The clinical data of the 18 patients were collected, patient and kidney survival time and function of the transplanted kidney were analyzed. Results: Of the 18 recipients, 13 were male and 5 were female, with an average age of (36.0±10.9) years. All 18 patients survived during follow-up. Two patients returned to dialysis treatment 10 months and 14 months after tonsillectomy, respectively. The creatinine was 94 (78, 133) μmol/L, 95 (74, 139) μmol/L, 106 (87, 158) μmol/L and 95(81, 147) μmol/L before tonsillectomy, 3 months, 1 year and 2 years after tonsillectomy, respectively (P=0.206). Urinary protein quantification was 0.31 (0.16, 1.38) g/24 h, 0.34 (0.10, 1.42) g/24 h, 0.33 (0.11, 0.56) g/24 h and 0.25 (0.10, 0.50) g/24 h at the same time points, respectively (P=0.104). The two patients who returned to dialysis were diagnosed of IgAN by transplant renal biopsy because of elevated creatinine, proteinuria and hematuria, 9 years and 4 years after kidney transplant respectively. Renal biopsy suggested that glomerular and segmental sclerosis were 7/24, 5/24 and 1/6, 2/6, respectively. Additionally, interstitial fibrosis and tubular atrophy (IF/TA) were both occupied 30% in the biopsies, and tonsillectomy was performed 461 days and 1 077 days after diagnosis of IgAN, respectively. Conclusions: Tonsillectomy can maintain the stability of renal function and prevent the aggravation of proteinuria in IgAN patients after renal transplantation. However, if pathology suggests obvious glomerulosclerosis or IF/TA, tonsillectomy may not be effective.

New phenylpropanoids from the fruits of Xanthium sibiricum and their anti-inflammatory activity

Seven new phenylpropanoids, including two pairs of enantiomers of 8-O-4'-type neolignans, named (±)-xanthiifructins A-B (1a/1b-2a/2b), a pair of simple phenylpropanoid derivatives (±)-xanthiifructins C (3a/3b), and a racemic phenylpropanoid derivative xanthiifructin D (4), together with four known analogues (5-8) were isolated from the fruits of Xanthium sibiricum. Racemic xanthiifructins A-C were separated on chiral HPLC columns. Their structures were elucidated by comprehensive spectroscopic data analysis and comparison with the literatures. The anti-inflammatory and cytotoxic activities were evaluated for all isolates. Among them, (-)-xanthiifructin C (3b) exhibited potent inhibitory effect against nitric oxide production in lipopolysaccharide-activated RAW 264.7 mouse macrophage cells with an IC₅₀ value of 9.94 ± 0.57 μM. All compounds obviously were inactive for three human tumor cell lines (MCF-7, HepG2, and A549) with IC₅₀ values much more than 10 μM.

[Chemical constituents from Xanthii Fructus]

This study was carried out to investigate the chemical constituents from Xanthii Fructus(the fruits of Xanthium sibiricum). The compounds were separated and purified by silica gel column chromatography, Sephadex LH-20 and ODS chromatography and semi-preparative HPLC. Base on HR-ESI-MS, NMR and other spectral data, their structures were identified. The anti-inflammatory activity of the isolated compounds was evaluated by lipopolysaccharide(LPS)-induced macrophage RAW264.7 as a screening model. A total of twenty-one compounds were isolated from the EtOAc fraction of 95% ethanol extract and identified as uracil(1), thymine(2), uridine(3), indole-3-carbaldehyde(4), indole-3-carboxylic acid(5), 2'-O-methyluridine(6), guanosine(7), 2,4(1H,3H)-quinazolinedione(8), 3-hydroxy-3-(2-hydroxyethyl)indolin-2-one(9), nicotinamide(10), N-acetyl-L-phenylalaninol(11), heliolactam(12), terresoxazine(13), caudatin(14), qingyangshengenin(15), caudatin-3-O-β-D-oleandropyranosyl-(1→4)-β-D-cymaropyranosyl-(1→4)-β-D-cymaropyranoside(16), caudatin-3-O-β-D-cymaropyranosyl-(1→4)-β-D-oleandropyranosyl-(1→4)-β-D-cymaropyranosyl-(1→4)-β-D-cymaropyranoside(17), caudatin-3-O-α-L-cymaropyranosyl-(1→4)-β-D-cymaropyranosyl-(1→4)-β-D-cymaropyranosyl-(1→4)-α-L-cymaropyranosyl-(1→4)-β-D-oleandropyranosyl-(1→4)-β-D-cymaropyranoside(18), qinyangshengenin-3-O-β-D-oleandropyranosyl-(1→4)-β-D-oleandropyranosyl-(1→4)-β-D-cymaropyranoside(19), qinyangshengenin-3-O-β-D-oleandropyranosyl-(1→4)-β-D-cymaropyranosyl-(1→4)-β-D-digitoxopyranoside(20), rostratamine-3-O-β-D-oleandropyranosyl-(1→4)-β-D-cymaropyranosyl-(1→4)-β-D-cymaropyranoside(21). Compounds 5-21 are obtained from genus Xanthium for the first time. Compounds 12 and 13 indirectly exhibited anti-inflammatory activity by suppressing LPS-induced NO production in RAW264.7 cells with IC_(50) values of(15.45±0.56) and(20.14±0.78) μmol·L~(-1), respectively.

[Interrupted time series analysis for influence on HIV related fatality of implementation of 'Four Free Services One Care' policy in China]

Objective: To analyze influence on HIV related fatality of implementation of 'Four Free Services One Care' policy in China during 1993-2012, and evaluate effectiveness for the policy of HIV/AIDS prevention and treatment. Methods: The data during 1993-2003 (before the implementation of the policy) and during 2005-2012 (after the implementation of the policy) were collected from the national HIV/AIDS Comprehensive Response Information Management System for the analysis on HIV related fatality in Chinese, especially in rural residents. Interrupted time series analysis was used to analyze the trends of HIV related fatality during 1993 and 2012. Results: During the twenty years from 1993 to 2012, the HIV related fatality in China decreased, and the HIV related fatality in rural areas was higher than the overall HIV related fatality. Compared with the period before the implementation of the policy, the overall HIV related fatality decreased by 1.5% (P=0.156) and the HIV related fatality in rural residents decreased by 2.6% in 2004 when the policy was implemented (P=0.094). As for the change of slope, the overall slope rate after the policy implementation was -0.466 (P=0.005), indicating a decrease trend of HIV related fatality. The slope rate after the policy implementation in rural residents was-0.592 (P=0.005), indicating a decrease trend of HIV related fatality. At the same time, the slope rate after the policy implementation in rural residents infected through blood transmission route was-0.766 (P<0.001), indicating a decrease trend of HIV related fatality. Conclusions: The implementation of the 'Four Free Services One Care' policy in China has made remarkable progress in free HIV antiviral therapy.

Bioactive sulfur-containing compounds from Xanthium sibiricum, including a revision of the structure of xanthiazinone

Seven previously undescribed sulfur-containing compounds, (+)- and (-)-xanthiazinone A, (+)- and (-)-xanthiazinone B, (+)- and (-)-xanthiazinone C and xanthiazinone D, and four known thiazinedione derivatives, together with three thiophene derivatives were isolated from the fruits of Xanthium sibiricum. Racemic xanthiazinones A-C were separated by chiral HPLC columns. Their chemical structures were elucidated based on extensive spectroscopic analyses, ECD calculations, and single crystal X-ray diffractions. The X-ray crystallographic analyses for xanthiazinones A-C represent the first example described for the structure elucidation of the thiazinedione with the five-membered lactone ring attached via an oxygen atom. Accordingly, the previously proposed structure for xanthiazinone was revised. The anti-inflammatory and cytotoxic activities were evaluated for all the isolated compounds. (+)-xanthiazinone B and 2-hydroxy-xanthiazone exhibited potent inhibitory effects against nitric oxide production in lipopolysaccharide-activated RAW 264.7 mouse macrophage cells with IC₅₀ values of 8.75 and 10.90 μM, respectively. All compounds obviously were inactive for three human tumor cell lines (HepG2, MCF-7, and A549) with IC₅₀ values more than 10 μM.

[Association of dietary patterns and diabetes risk level among adult residents in Datong city of Shanxi Province]

Objective: To explore the association of dietary pattern and type 2 diabetes mellitus (T2DM) risk. Methods: In 2013, 3 747 participants from 87 coalmine branches of a large coal mine group in Datong City, Shanxi Province were selected by using a two-stage cluster stratified sampling method. Data on demographic characteristics, smoking, drinking, and family history of diabetes were collected by using a self-made questionnaire, and the International Physical Activity Questionnaire was used to assess the level of physical activity. Physical, glucose and lipid metabolism indicators were measured and subjects were divided into high-risk groups and low-risk groups of T2DM according to the T2DM risk score. Dietary data were collected by using Semi-quantitative Food Frequency Questionnaire, and dietary patterns were derived by using the exploratory factor analysis and cluster analysis. The unconditional logistic regression model was used to assess the association of dietary patterns and T2DM risk. Results: The age of the subjects was(41.48±8.62) years old, and 2 843 of them were males (84.31%). A total of 1 819 subjects were in the high-risk group and 1 553 in the low-risk group. Four dietary patterns, healthy diet, high-salt diet, meats diet, and carbohydrate-rich diet, were identified in this study. The unconditional logistic regression analysis showed that compared with the healthy diet pattern, after the adjustment of demographic characteristics, smoking, and drinking, the OR (95%CI) of T2DM risk in high-salt diet, carbohydrate-rich diet and meats diet patterns was 1.54 (1.26-1.88), 1.80 (1.43-2.28) and 1.20 (0.99-1.46), respectively. Conclusion: High-salt diet and carbohydrate-rich diet were positively associated with T2DM risk, whereas there was no association of meats diet and T2DM risk.

[HIV infection rate in people aged 50 years and older in China: a Meta-analysis]

Objective: The prevalence of HIV/AIDS in people aged ≥50 years is increasing in China, resulting in another focus for AIDS prevention and control. A Meta-analysis was conducted to evaluate the HIV infection, its area and time distributions in people aged ≥50 years in China to provide evidence for the prevention and control of HIV/AIDS. Methods: Information on HIV infection rate in people aged ≥50 years in China were collected from Wanfang digital database, China National Knowledge Infrastructure (CNKI), PubMed and Embase. The R Studio1.1.456 software was used to calculate the pooled infection rate, and assessed the publication bias. Results: A total of 30 studies which covered 13 provinces were selected. From 2010 to 2018, the pooled HIV infection rate in people aged ≥50 years was 1.68% (95%CI:1.00%-2.79%). The HIV infection rate (2.60%) was higher in eastern China than in central and western China (0.16%, 2.13%). Conclusion: The overall HIV infection rate in people aged ≥50 years is generally high in China. It is important to control the HIV infection in this population to facilitate the AIDS prevention and control in China.

Lyciiterpenoids A-D, four new rearranged eudesmane sesquiterpenoids from Lycii Cortex

Four new rearranged eudesmane sesquiterpenoids, Lyciiterpenoids A-D (1-4), together with four known compounds (5-8) were isolated from the aqueous extract of Lycii Cortex. Their structures were elucidated by spectroscopic analysis, and the absolute configurations of compounds 1-4 were determined by the quantum chemical ECD calculations. The absolute configuration of 1 was further confirmed by X-ray crystallographic data analysis. All the isolated compounds were evaluated for their cytotoxicity against three human cancer cell lines (MCF-7, HepG2, and A549). However, no significant activities were detected even with a concentration up to 100 μM.

[Malfunction of autophagy in tibial growth plate chondrocytes causes increased apoptosis rate in chronic renal insufficiency rats]

Objective: To observe the effect of autophagy of tibial growth plate chondrocyte on apoptosis in chronic renal insufficiency (CRI) rats. Methods: Male 4-week-old SD rats were randomly divided into two groups: (1) Sham group: only the left ureter was exposed (n=10); (2) CRI group: the left ureter was ligated to cause CRI (n=10). The urine from all the rats was collected 6 weeks after the operation and the total protein content was measured. Then all the rats were sacrificed and the concentrations of creatinine and urea nitrogen in intracardiac blood were detected. The proximal tibia were fixed and decalcified to prepare histological sections, and the number of chondrocytes of column cells in the proliferative area of tibia growth plate was observed by saffron O staining. The expression rate of protein Light Chain-3, an autophagy marker of chondrocytes, was detected by immunofluorescence. The apoptosis rate of chondrocytes was detected by the method of TUNEL assay. The level of glycogenin-1, a glycogen formation marker of chondrocyte was detected by immunohistochemistry in chondrocytes. Results: The 24 h urine total protein was higher in CRI group [(163.5±11.3) mg vs (38.6±9.8) mg, t=25.620, P<0.001]. The levels of blood creatinine [(67.3±16.2) μmol/L vs (28.4±11.5) μmol/L, t=5.974, P<0.001] and urea nitrogen [(16.4±6.4) mmol/L vs (4.8±2.0) mmol/L, t=5.198, P<0.001] were higher in CRI group. The number of chondrocytes of column cells in the proliferating area of tibia growth plate was lower in CRI group (4.2±2.1 vs 9.1±3.8, t=3.109, P=0.006). The expression rate of LC-3 protein in chondrocytes of CRI group was lower [(27.2±12.6)% vs (51.4±18.2)%, t=3.457, P=0.003]. The level of glycogenin-1 of chondrocytes in CRI group increased significantly (6.1±2.5 vs 3.5±1.8, t=2.669, P=0.016). The apoptosis rate of chondrocytes in CRI group also increased [(17.2±4.8)% vs (5.1±3.4)%, t=6.505, P<0.001]. Conclusion: Malfunction of autophagy in tibial growth plate chondrocytes causes increased apoptosis rate in CRI rats, which might be caused by the failure of glycogen degradation in chondrocytes.

[The Role of Soluble HLA-G in the Vertical Transmission of Toxoplasma gondii]

Soluble human leukocyte antigen G (sHLA-G) plays a key role in pregnancy through interaction with decidual natural killer (dNK) cell inhibitory receptors at the maternal-fetal interface. To demonstrate the possible role of sHLA-G during the pregnancy with Toxoplasma gondii infection, we compared the concentration of a murine functional homolog of sHLA-G, Qa-2, in T. gondii infected and non-infected pregnant C57BL/6 mice, and that of sHLA-G in BeWo culture supernatant. In addition, the levels of KIR2DL4 expressed on human dNK cells and NKG2A in pregnant mice were evaluated. We showed that T. gondii infection result in significant increase in the level of Qa-2 and NKG2A in pregnant mice. sHLA-G and KIR2DL4 in human samples were also significantly upregulated under the condition of T. gondii infection. The further treatment with sHLA-G antibody could reduce the expression level of KIR2DL4 which was upregulated by T. gondii infection. In summary, sHLA-G could upregulate the expression level of KIR2DL4 which lead to excessive immunological tolerance, and further contributed to T. gondii immunity escaping and affecting fetus via vertical transmission which may lead to adverse outcomes.

Lyciyunin, a new dimer of feruloyltyramine and five bioactive tyramines from the root of Lycium yunnanense Kuang

Lyciyunin, a new dimer of feruloyltyramine (1), together with five known tyramines (2-6), was isolated from the water-soluble fraction of an EtOH extract of the root of L. yunnanense. Based on HR-TOF-MS, NMR spectral data and quantum chemistry ECD calculations, the structure of this new compound was determined, including its absolute configuration. Compounds (1-6) were tested for their antioxidant activity using in vitro DPPH radical scavenging assay, and 1-6 showed the moderate antioxidant activities with IC₅₀ values of 12.44 ± 0.39, 21.29 ± 0.75, 24.44 ± 1.63, 21.15 ± 0.66, 21.15 ± 0.66 and 45.15 ± 0.56 μM, respectively. Compounds (5-6) showed anti-inflammatory activity in LPS-induced RAW 264.7 macrophages with the IC₅₀ values of 43.95 ± 6.11 and 33.50 ± 2.04 μM, respectively.

[Study on safety of adjuvant radiotherapy concurrent with weekly chemotherapy for stage ⅡB-ⅣA esophageal carcinoma after radical resection]

Objective: To evaluate the tolerability and short-term efficacy of chemo-radiotherapy in 125 patients with stage ⅡB-ⅣA esophageal carcinoma after radical resection. Methods: We retrospectively evaluated the rate of completion, toxicity and survival of patients undergoing adjuvant concurrent chemo-radiotherapy after radical resection of esophageal carcinoma from January 2004 to December 2014 in our institution. The survival rate was determined by the Kaplan-Meier method and analyzed using the log-rank test. Multivariate prognostic analysis was performed using the Cox proportional hazard model. Results: 122 patients received more than 50 Gy dose (97.6%). A total of 52 patients received more than 5 weeks chemo-radiotherapy (41.6%), while 73 patients underwent only 1-4 weeks (58.4%). The median following up was 48.4 months. 8 patients lost follow up (6.4%). The 1-year and 3-year overall survival rate were 91.6% and 57.0%, respectively, with a median survival time of 64.4 months. The 1-year and 3-year disease free survival rate were 73.2% and 54.3%, respectively, with a median disease free survival time of 59.1 months. The most common acute complications associated with chemo-radiotherapy were myelosuppression, radiation esophagitis and radiation dermatitis, the majority of which were Grade 1-2. Of the 125 patients, there were 59 cases of recurrence, including 23 cases with local regional recurrence, 26 cases with hematogenous metastasis, and 8 cases with mixed recurrence. Univariate analysis showed that the numbers of concurrent chemotherapy was associated with the overall survival (P=0.006). But receiving more than 5 weeks was not the prognostic factor compared to 1 to 4 weeks chemotherapy (P=0.231). Multivariate analysis showed that only the numbers of concurrent chemotherapy was an independent prognostic factor (P=0.010). Conclusions: Postoperative radiotherapy concurrent with weekly chemotherapy could improve the overall survival and decrease the recurrence for stage ⅡB-ⅣA esophageal carcinoma after radical resection. However, the completion rate of chemotherapy was low, so it was necessary to explore reasonable regimens to improve the completion rate and carry out prospective randomized controlled trial.

[Research progress of magnetic resonance imaging in hepatocellular carcinoma]

Hepatocellular carcinoma (HCC) is the most common malignant tumors of liver. Rational treatment in early stage of HCC can significantly increase the survival rate of patients. Detection of early-stage liver lesions through diffusion-weighted imaging, diffusion kurtosis imaging, incoherent motion within voxels, magnetic resonance spectroscopy imaging, dynamic contrast-enhanced imaging, or other functional imaging can accurately evaluate grade of malignancy and guide towards the curative effect of different treatment schemes. Volumetric interpolated breath-hold examination (VIBE) with three techniques, namely, CAIPIRINHA, Dixon, and TWIST, i.e., CDT-VIBE sequence can provide multiple sets of arterial phase images in a short time, and detect small foci transient enhancement that cannot be detected by other examinations, and the differences in initial enhancement phase of apparent lesions are of great significance for suggesting hemodynamic characteristics. In addition, magnetic resonance imaging predicts microvascular invasion of HCC, i.e., indirectly predicts HCC lesions recurrence rate, and overall survival time after liver transplantation. This article reviews the current research progress of magnetic resonance imaging technology in HCC.

[Altered regional brain activity of functional connectivity in patients with obstructive sleep apnea]

Objective: To investigate the changes of default mode network in subjects with obstructive sleep apnea (OSA) using functional connectivity (FC). Methods: Clinical data were collected from thirty-three subjects with OSA who went to the Zhongda Hospital, Southeast University, and twenty-nine normal controls were recruited from community from Jan 2016 to Jan 2018. The OSA group was divided into two subgroups according to apnea-hypopnea index (AHI) and the lowest oxygen saturation at night: 15 patients in the mild group and 18 in the moderate to severe group. Both of the two group subjects underwent functional magnetic resonance imaging scans, and their default network was extracted based on independent component analysis to compare the differences in FC. Results: Body Mass Index (BMI), AHI, oxygen desaturation index (ODI), mini-mental state examination (MMSE) and Epworth Sleepiness Scale (ESS) in the OSA group were significantly higher than those in the control group [(27.1±4.3) vs (22.2±2.7) kg/m(2), (29.5±22.1) vs (2.4±1.6) events/h, 19.5 (4.6, 39.1) vs 0.6 (0.2, 1.6) events/h, (27.5±1.5) vs (29.4±0.8) score, (8.6±3.3) vs (3.5±1.6) score] (all P<0.001). The OSA group showed an increase in left limbic lobe, left cingulate, left parietal lobe, left inferior parietal lobule; a decrease in bilateral temporal lobe, bilateral limbic lobe and parahippocampa gyrus, left frontal lobe in FC value, compared with the normal control group (all P<0.001). The moderated-severe group showed a significant increase in the left occipital lobe, bilateral cuneus, right parietal lobe; a decrease in the bilateral parietal lobe, inferior parietal lobule in FC value compared with the mild group (all P<0.01). Conclusions: The FC of default mode network in OSA group is disrupted, with parts of brain regions suffering injury,while parts of brain regions experiencing compensatory reaction. Additionally, the compensatory period translates to the decompensation period with disease progression in OSA group.

The stability of Cu clusters and their adsorption for CH4 and CH3 by first principle calculations

Two-dimensional (2D) and three-dimensional (3D) Cu _n clusters (n indicates the atom number) and their adsorption behaviors for both methane (CH₄) and methyl (CH₃) are studied in this work using the density functional theory method, where n ranges from 6 to 20. In these small clusters, it is found that the CH₄ molecule is always adsorbed on the top site with the adsorption energy between -0.05 eV and -0.21 eV. Considering methane dehydrogenation, stronger adsorption for CH₄ is required, so 2D clusters with n = 7, 14, 15, and 16 and 3D clusters with n = 6, 10, 12, and 17 are found to have relatively stronger adsorption. However, for the adsorption of CH₃, there is an obvious even-odd oscillation change in the size of 3D clusters, while it is not clear in 2D clusters since one cannot find an even-odd change as n > 14. The weaker adsorption for CH₃ occurs on 3D clusters when n is even except 6 and also on 2D clusters when n = 6, 7, 10, and 12 with higher carbon poisoning resistance. Based on these calculated results, some Cu clusters which show good potential ability for methane dehydrogenation are provided, especially when n = 10 and 12 for 3D structures, and n = 7 for the 2D ones.

[Timeless promotes the proliferation of hepatocellular carcinoma cell by reprogramming of glucose metabolism]

Objective: To explore the function and molecular mechanism of Timeless in promoting hepatocellular carcinoma (HCC) growth. Methods: The expression of Timeless in HCC and paracancer tissues were analyzed by using the public data of HCC. Timeless was overexpressed in MHCC97L cells and silenced in MHCC97H cells, respectively, and the expression of Timeless and its downstream molecules were detected by real-time PCR and western blot. The effects of Timeless on cell glycolysis, oxidative phosphorylation and proliferation were detected by the glucose uptake experiment, lactic acid detection experiment, the extracellular fluid pH detection experiment, cell oxygen consumption test and cell viability assay, respectively. Results: The level of Timeless in HCC tissue was significantly higher than that of paracancer tissue (P<0.05). The relative cellular glucose uptake levels in the groups of Timeless knockdown, including siTimeless-1 and siTimeless-2 group were 0.510±0.119 and 0.508±0.099, respectively, significantly different from that of control group (P<0.05); The relative cellular uptake level of Timeless overexpressed group was 1.953±0.324, significantly different from that of vector transfected group (P<0.05). The relative levels of lactic acid production in the siTimeless-1 and siTimeless-2 group were 0.579±0.096 and 0.550±0.120, respectively, significantly different from that of control group (P<0.05); The relative production level of lactic acid in the Timeless overexpressed group was 1.463±0.179, significantly different that of vector transfected group (P<0.05). The extracellular pH values of siTimeless-1 and siTimeless-2 group were 7.390±0.035 and 7.370±0.060, respectively, significantly different from that of control group (P<0.05); the extracellular pH value of Timeless overexpressed group was 7.130±0.031, significantly different than vector transfected group (P<0.05). Oxygen consumption rate of siTimeless-1 and siTimeless-2 group were 3.686±0.389 and 3.955±0.431, respectively, significantly higher than 1.690±0.297 of control group (P<0.05); Oxygen consumption rate of Timeless overexpressed group was 1.302±0.336, significantly lower than 3.185±0.262 of vector transfected group (P<0.05) Timeless inhibited the expression of p53. The cell glucose uptake, lactic acid production, the pH of extracellular culture medium and cell oxygen consumption of control group were not significantly different from that of Timeless and p53 co-silenced group [(si-Timeless+sip53) group] (P>0.05); the glucose uptake, the production of lactic acid, the pH of the extracellular culture medium and the oxygen consumption of Timeless co-transfected with p53 (Timeless+p53) group were not significantly different from those of vector transfected group (P>0.05). Timeless promoted the proliferation of HCC cells through inhibiting the expression of p53. Conclusion: Timeless promotes reprogramming of glucose metabolism and proliferation of HCC cells by inhibiting the p53-dependent signaling pathway.

[The expression of Akt/mTOR in VSMC calcification induced by high phosphate and its regulation of Cbfα1]

Objective: To observe the expression of protein kinase B (Akt) / mammalian target of rapamycin (mTOR) induced by high phosphorus in rat vascular smooth muscle cells (VSMC) calcification model, and its modulation on the expression of core binding factor alpha 1 (Cbfα1). Methods: Rat VSMC cells were cultured in vitro, and then divided into two groups: normal phosphorus group (Pi 1.3 mmol/L) and high phosphorus group (Pi 2.6 mmol/L). At day 7, calcium deposition was detected by Alizarin stain. The mRNA levels of Cbfα1 and osteopontin (OPN) were determined by real-time PCR. The protein expressions of p-Akt (ser473), p-mTOR (S2448), Cbfα1 and OPN were quantified by Western blot. Then, VSMC cultured with high phosphorus were treated with Akt inhibitor (Wortmannin) and mTOR inhibitor (Rapamycin) with different concentrations. After 24 h, the mRNA levels of Cbfα1 and OPN were determined and after 48 h, the protein expressions of p-Akt, p-mTOR, Cbfα1 and OPN were quantified. Also, at day 7, calcium deposition was also visualized by Alizarin stain. Results: After 7 days, compared with normal phosphorus group, calcium deposition was more obvious in high phosphorus group. The mRNA expressions of Cbfα1 and OPN increased significantly and the protein expressions of p-Akt, p-mTOR, Cbfα1 and OPN up-regulated significantly in high phosphorus group (all P<0.05). After treated with Wortmannin or Rapamycin for 24 h, compared with high phosphorus group, the mRNA expressions of Cbfα1 and OPN decreased significantly in high phosphorus + Wortmannin (30, 50 and 100 nmol/L) groups (all P<0.05) and high phosphorus + Rapamycin (1, 10 and 100 ng/ml) groups (all P<0.05). After treated with Wortmannin or Rapamycin for 48 h, compared with high phosphorus group, the protein expressions of p-Akt, Cbfα1 and OPN down-regulated significantly in high phosphorus + Wortmannin (30, 50 and 100 nmol/L) groups (all P<0.05). It showed a dose-dependent down-regulation of p-mTOR, Cbfα1 and OPN in high phosphorus + Rapamycin (1, 10, 100 ng/ml) groups (all P<0.05). After 7 days, compared with high phosphorus group, calcium deposition decresased significantly in high phosphorus + Wortmannin and high phosphorus + Rapamycin groups. Conclusions: High phosphorus can induce VSMC calcification. Akt and mTOR are involved in VSMC calcification induced by high phosphorus through the activation of Cbfα1.

Optimization of dietary zinc for egg production and antioxidant capacity in Chinese egg-laying ducks fed a diet based on corn-wheat bran and soybean meal

The aim of this study was to evaluate the effect of zinc supplementation on productive performance and antioxidant status in laying ducks. Five-hundred-four laying ducks were divided into 7 treatments, each containing 6 replicates of 12 ducks. The ducks were caged individually and fed a corn-soybean meal and wheat bran basal diet (37 mg Zn/kg) or the basal diet supplemented with 15, 30, 45, 60, 75, or 90 mg Zn/kg (as zinc sulfate). During the early laying period of 10 d (daily egg production <80%), egg production, daily egg mass, and FCR increased quadratically with increasing dietary Zn levels (P < 0.05). The highest egg production and daily egg weight were obtained when 30 or 45 mg Zn/kg diet was supplemented, with lowest FCR. Similarly, the highest egg production and daily egg mass were observed in the group supplemented with 30 or 45 mg Zn/kg during the peak laying period of the subsequent 120 d (daily egg production >80%). Average egg weight and feed intake did not differ among the groups of graded Zn supplementation.The egg quality was not affected by dietary Zn, including the egg shape index, Haugh unit, yolk color score, egg composition, and shell thickness. The activities of plasma activities of total superoxide dismutase (T-SOD) and glutathione peroxidase (GSH-PX) increased in a quadratic manner (P < 0.001) with increasing supplemental Zn. Plasma concentration of Zn increased quadratically (P < 0.05) as dietary Zn increased. The hepatic activity of Cu/Zn-SOD and GSH-PX increased quadratically (P < 0.05) with increasing dietary Zn. Plasma Zn concentrations were positively correlated with activities of T-SOD (P < 0.05), and positively with plasma Cu. Plasma concentration of reduced glutathione was correlated with plasma Cu. In conclusion, supplementation of Zn at 30 or 45 mg/kg to a corn-wheat bran and soybean basal diet may improve the productive performance and enhance the antioxidant capacity.

[The value of high resolution diffusion weighted imaging in differentiating benign and malignant epithelial tumors of parotid gland]

Objective: To investigate the diagnostic value of RESOLVE DWI in the evaluation of benign and malignant epithelial tumors of parotid gland. Methods: A total of 106 patients in the First Affiliated Hospital of Zhengzhou University with epithelial tumors of parotid gland confirmed by pathology from July 2015 to October 2017 were retrospectively analyzed. All patients underwent preoperative routine MRI and RESOLVE DWI, the ADC average values were calculated, t test were used to compare the ADC values of benign and malignant epithelial tumors of parotid gland. Diagnostic performance of ADC value was compared using receiver operating characteristic (ROC)curves. Results: All lesions were solitary, including 69 benign epithelial tumors and 37 malignant epithelial tumors. The mean ADC values of pleomorphic adenoma and basal cell adenoma, adenolymphoma and malignant epithelial tumors were (1.47±0.16)×10(-3) mm(2)/s, (0.83±0.19)×10(-3) mm(2)/s and(1.14±0.14)×10(-3) mm(2)/s, the mean ADC value of adenolymphoma lower than the rest of the two groups, there were statistically significant differences among them (P<0.05). Using 0.94×10(-3) mm(2)/s≤ADC value≤1.28×10(-3)mm(2)/s as the critical value for diagnosing malignant epithelial tumors of parotid gland and comparing with pathological results, the result obtained had a sensitivity of 81.1%, specificity of 88.9%. ADC value had high correlations compared with pathological results, kappa value was 0.600. Conclusion: RESOLVE DWI can be applied in differential diagnosis between benign and malignant epithelial tumors of parotid gland.

Effects of tumor-associated macrophages on the proliferation and migration of esophageal cancer-associated lymphatic endothelial cells

The aim of this study was to explore whether M2 macrophages can be transformed into M1 macrophages, and to investigate the effect of different types of macrophages on the proliferation, migration and ring-forming ability of esophageal cancer-related lymphatic endothelial cell (LEC). Human monocytic leukemia cell line (THP-1 cell) was induced to differentiate to M1 macrophages (M1 group) and M2 macrophages (M2 group), and co-cultured with esophageal cancer-associated LEC. The individual esophageal cancer co-cultured with LEC was used as control. Different types of macrophages were observed by Cell counting kit-8 (CCK-8). Enzyme-linked immunosorbent assay (ELISA) was used to detect the VEGF-C concentration; the expression of VEGFR-3 protein and its mRNA was detected by Western blot and qRT-PCR, respectively. The positive rate of the M1 group induced by IFN-γ and LPS was significantly higher than that of M2 macrophages (48.57%5.98% vs 25.83%1.95%). The expression of VEGF-C in the supernatant of the M2 group was higher than that in the control group, but no significant differences regarding the expression of VEGF-C between M1 and control groups were found. In addition, the expression of VEGFR-3 on both mRNA and protein in esophageal cancer-related LEC of the M2 group was significantly higher than those in the control group; however, the M1 group had a significantly lower VEGFR-3 level on both mRNA and protein than the control group. Human M2 macrophages can be transformed into M1 macrophages, and can promote the proliferation, migration and ring-forming ability of esophageal cancer-associated LEC.

[Phrenic nerve stimulation protects against mechanical ventilation-induced diaphragmatic dysfunction through myogenic regulatory factors]

Objective: To explore the protective effect of electrical stimulation of phrenic nerve on diaphragmatic function during mechanical ventilation. Methods: Forty healthy adult SD rats were randomly divided into 5 groups: blank control group (BC), spontaneous breathing group (SB), electrical stimulation group (ES), mechanical ventilation group (MV), and electrical stimulation and mechanical ventilation group (MS). The rats in each group were treated for 18 h except for the BC group. After treatment, the diaphragm muscle tissue was obtained and the diaphragm contractility including peak-to-peak value(Vpp) and maximum rate of contraction(+ dT/dt max) were measured. Expression of MyoD and myogenin were detected. Results: Except for the ES and the MS groups, there was a significant difference for peak-to-peak value (Vpp) between each 2 groups (P<0.05). Expression levels of MyoD in treatment groups were also significantly different (P<0.05). Expressions of MS(Q-PCR 2(-ΔΔCt) value: 11.66±2.80) and MV(Q-PCR 2(-ΔΔCt) value: 40.89±24.71) in the treatment group were significantly different (P<0.05). The expression of myogenin in the MS and the MV groups were significantly different from those of the BC group(P<0.05), however there was no significant difference between the MS(Q-PCR 2(-ΔΔCt) value: 2.58±2.75) and the MV group(Q-PCR 2(-ΔΔCt) value: 1.63±0.71). Conclusions: Electrical stimulation of the phrenic nerve can change the expression level of MyoD and myogenin to offset mechanical ventilation induced diaphragmatic function damage, and therefore plays a protective effect on the diaphragm.