[Design of an improved percutaneous transhepatic cholangio drainage tube based on MRCP imaging data]

Objective: Quantified MRCP imaging data was used as a reference for design and preparation of a modified percutaneous transhepatic cholangio drainage (PTCD) tube. Methods: 3.0 T upper abdominal MR and MRCP imaging data of 2 300 patients treated from July 2015 to July 2020 at the Department of Radiology of the Affiliated Cancer Hospital of Zhengzhou University were screened and a total of 381 patients diagnosed with biliary duct structures were identified. Causative etiologies among these patients included pancreatic adenocarcinoma (pancreatic head), cholangiocarcinoma, ampullary carcinoma, as well as intrahepatic and/or extrahepatic bile duct dilation. An improved PTCD tube was designed based on MRCP quantification of left and right hepatic and common hepatic duct length. Results: In the setting of biliary obstruction caused by malignancy, the distance of the left hepatic duct from its origin to the point of left and right hepatic duct confluence was 15.9±3.8 mm, while the distance of the right hepatic duct from its origin to the point of left and right hepatic duct confluence was 12.4±3.2 mm; the length of the bile duct from its origin to the point of left and right hepatic duct confluence was 34.0±8.1 mm. The improved PTCD tube design incorporated an altered length of the drainage orifice. Conclusion: MRCP imaging of the biliary tract is effective for measuring biliary tract length in the setting of pathological dilation. Based on our biliary tract measurements, a modified PTCD tube was designed to more effectively meet drainage requirements and manage biliary obstruction caused by Bismuth-Corlette type Ⅱ and Ⅲ malignancies.

[Investigation on reproductive health status of women workers in different positions in oilfield enterprises]

Objective: The status and influencing factors of reproductive health (including menstrual period and gynecological diseases) of female workers in different positions of oilfield enterprises were analyzed. Methods: From January to December 2020, a total of 979 female workers in an oil field were selected as research objects by the judgment sampling method, and the "Female Reproductive Health Survey" was used as the investigation tool to investigate the demographic characteristics, menstrual status and gynecological diseases. The influential factors were analyzed by 2-test and logistic regression analysis. Results: The prevalence of abnormal menstruation was 26.1% (256/979), dysmenorrhea 53.1% (520/979), and gynecological diseases 54.34% (532/979). The prevalence of breast disease was 23.39% (229/979), uterine disease 11.03% (108/979), cervical disease 10.32% (101/979), and HPV infection 7.97% (78/979). Age, the nature of the job and whether occupational harmful factors were clear were the influencing factors of gynecological diseases (P=0.001, 0.000, 0.007). Age, job nature, working hours and work intensity were the influencing factors of abnormal menstruation (P=0.005, 0.000, 0.000, 0.010) . Conclusion: The reproductive health status of female workers in different positions of oil field enterprises is not optimistic, and the reproductive health status of female workers in professional and technical positions needs to be improved.

[Comprehensive clinical evaluation of bedaquiline in the treatment of multidrug-resistant tuberculosis]

Objective: To assess the clinical value of bedaquiline in five dimensions: effectiveness, safety, economics, appropriateness, and social benefits, to provide a reference for medical and health insurance-related decisions. Methods: A total of 792 patients with multidrug-resistant tuberculosis who were hospitalized at Wuhan Pulmonary Hospital, Ganzhou Fifth People's Hospital and Jiangxi Chest Hospital between January 2018 and December 2020 were included in the study. Based on a retrospective survey of case data, and each evaluation dimension of bedaquiline was statistically analyzed by causal analysis or chi-square test, using linezolid as the reference drug. Results: In terms of effectiveness, bedaquiline significantly increased treatment success by 23.9% (95%CI:4.8%-43.0%) and shortened treatment duration by 64 days(95%CI:18-109 days). In terms of safety, the incidence of adverse reactions to bedaquiline and the discontinuation rate of adverse reactions (5.11%,4.55%) were significantly lower than those for linezolid (22.49%,15.24%), with statistically significant differences (χ²=27.50,P<0.001;χ²=14.09,P<0.001). In terms of economics, patients treated with bedaquiline had a significantly higher anti-TB drug course cost of RMB 48 209.4 Yuan(95%CI: 28 336.0-68 082.8 Yuan). In terms of appropriateness, the proportion of bedaquiline in patients' initial treatment regimens was lower than that of linezolid (16.7% vs. 86.5%) in the 2020 observation sample, with a statistically significant difference (χ²=238.96,P<0.001). In terms of social benefits, the infection control rate was significantly increased by 27.8% (95%CI:8.2%-47.5%) in patients using bedaquiline. Conclusions: Bedaquiline performed well in terms of efficacy, safety, and social benefits. However, it was less economical and the actual use rate of bedaquiline in clinical practice was lower than that of its counterpart drug, linezolid. Price reductions might be needed to increase the clinical use and performance of bedaquiline in the future.

How did consumers’ self-protective behavior formed during the COVID-19 pandemic?

Introduction

This study explored the formation mechanism of consumers’ self-protective behavior during the COVID-19 pandemic, which is very important for policy settings to regulate consumer behavior. Based on the basic framework of the Protective Action Decision Model (PADM), this study analyzed the formation mechanism of consumers’ self-protective willingness from the perspective of risk information, and explained the deviation between consumers’ self-protective willingness and behavior from the perspective of protective behavior attributes.

Methods

Based on 1,265 consumer survey data during the COVID-19 pandemic, the empirical test was carried out.

Results and Discussion

The amount of risk information has a significant positive impact on the consumers’ self-protective willingness, where the credibility of risk information plays a positive moderating role between them. Risk perception plays a positive mediating role between the amount of risk information and the consumers’ self-protective willingness, and the positive mediating effect of risk perception is negatively moderated by the credibility of risk information. In the protective behavior attributes, hazard-related attributes play a positive moderating role between the consumers’ self-protective willingness and behavior, while resource-related attributes play the opposite role. Consumers pay more attention to hazard-related attributes than resource-related attributes, and they are willing to consume more resources to reduce risk.

Risk factors analysis and establishment of predictive nomogram of extranodal B-cell lymphoma of mucosal-associated lymphoid tissue

PURPOSE

The role of radiation therapy in mucosa-associated lymphoid tissue (MALT) lymphoma is poorly defined. The objective of this study was to explore the factors associated with the performance of radiotherapy and to assess its prognostic impact in patients with MALT lymphoma.

PATIENTS AND METHODS

Patients with MALT lymphoma diagnosed between 1992 and 2017 were identified in the US Surveillance, Epidemiology, and End Results database (SEER). Factors associated with the delivery of radiotherapy were assessed by chi-square test. Overall survival (OS) and lymphoma-specific survival (LSS) were compared between patients with and without radiotherapy, using Cox proportional hazard regression models, in patients with early stage as well as those with advanced stage.

RESULTS

Of the 10,344 patients identified with a diagnosis of MALT lymphoma, 33.6% had received radiotherapy; this rate was 38.9% for stage I/II patients and 12.0% for stage III/IV patients, respectively. Older patients and those who already received primary surgery or chemotherapy had a significantly lower rate of receiving radiotherapy, regardless of lymphoma stage. After univariate and multivariate analysis, radiotherapy was associated with improved OS and LSS in patients with stage I/II (HR=0.71 [0.65-0.78]) and (HR=0.66 [0.59-0.74]), respectively, but not in patients with stage III/IV (HR=1.01 [0.80-1.26]) and (HR=0.93 [0.67-1.29]). The nomogram built from the significant prognostic factors associated with overall survival of stage I/II patients had a good concordance (C-index=0.749±0.002).

CONCLUSION

This cohort study shows that radiotherapy is significantly associated with a better prognosis in patients with early but not advanced MALT lymphoma. Prospective studies are needed to confirm the prognostic impact of radiotherapy in patients with MALT lymphoma.

Survey on public awareness, attitudes and self-protective behavior adoption in different periods of COVID-19

Introduction

The outbreak and spread of the pandemics have been an issue of critical concern globally, posing a significant threat to the health sector globally. This study aimed to examine the basic knowledge and attitudes toward the recommended protective measures at different times, respond to the COVID-19 pandemic, and provide recommendations for developing targeted strategies and measures for preventing and controlling public health emergencies.

Methods

The study used self-filled questionnaires to examine the public's knowledge, attitudes, and practices on COVID-19 at two different period, from 20 to 31 March 2020 (the beginning period) and 22-27 April 2022 (the regular epidemic prevention and control period). Descriptive and quantitative analyses were used for statistical analysis.

Results and discussion

The survey collected 2375 valid questionnaires. A comparison of the two periods reveals that as the epidemic continued over a long period, the level of knowledge, attitudes toward preventive measures, risk perceptions, and adoption behavior of the respondents at the beginning of the epidemic were significantly higher than during the regular epidemic prevention and control period. With the upsurge in the spread of the epidemic, the public needs a multi-channel, targeted, and all-round guidance and information on prevention and control of the COVID-19, and internalizes knowledge into individual's behavior of actively responding to diseases.When the epidemic lasts for a long time, the relevant agencies should strengthen their monitoring role to promote public compliance with the recommended measures.

Risk aversion, marketing outlets, and biological control practice adoption: insight from pear farmers in China

Biological control (BC) is an important component of green control techniques, and its adoption in the production of fresh produce holds economic and ecological importance as an alternative to chemical pesticides, yet its current adoption rate is not high. To clarify the issue, this study analyzes the factors that influence growers' adoption of BC practices in China's orchard systems. We focus on how marketing outlets and risk attitudes affect farmers' adoption of BC practices. A field survey of 327 pear growers was conducted in three main pear-producing areas of Hebei, Shandong, and Hubei provinces of China between October and December 2020. Results show that farmers' risk aversion has a significant and negative impact on their adoption of BC practices. The market environment is another dramatic factor affecting farmers' adoption. Both green certification and cooperative marketing have a significant role in promoting farmers' adoption of BC practices. Our findings highlight the importance of risk reduction and market environment to BC adoption. Furthermore, it can provide critical information for policymakers in formulating strategies to promote the application and extension of BC practices among farmers in developing countries, such as China.

LACK OF EMBRYONIC HOMOZYGOUS OR ADULT HETEROZYGOUS LYMPHATIC PHENOTYPES FOR A Sos1 MUTATION AND LACK OF LYMPHATIC EMBRYONIC PHENOTYPES FOR A HOMOZYGOUS Cx47 MUTATION IN MICE

We have studied the lymphatic phenotypes of 2 mutations, known to cause abnormalities of lymphatics in humans, in mice. The Cx47 R260C mutation (variably penetrant in humans heterozygous for it and causing limb lymphedema) had an adult mouse phenotype of hyperplasia and increased lymph nodes only in homozygous condition but we did not find any anatomical phenotype in day 16.5 homozygous embryos. Mice harboring the Sos1 mutation E846K (causing Noonan's 4 in man which occasionally shows lymphatic dysplasia) had no adult heterozygous phenotype in lymphatic vessel appearance and drainage (homozygotes are early embryonic lethals) while day 16.5 heterozygous embryos also had no detectable anatomical phenotype.

Ecological efficiency of hog scale production under environmental regulation in China: based on an optimal super efficiency SBM-Malmquist-Tobit model

China's hog production is facing the dual pressures of the market and environment. A systematic analysis of the ecological efficiency (eco-efficiency) of hog cultivation is of great significance for the development of sustainability and distribution optimization in the industry. This paper investigates the eco-efficiency of hog production and the determinants of eco-efficiency in China using panel data (2004-2018). An optimal super efficiency slacks-based measure (SBM)-Malmquist-Tobit model is adopted for hog production analysis, and the empirical results show a great variation in eco-efficiency across provinces, ranging from 0.557 to 1.19 with a mean value of 0.937 in 2018. The predominant production area of hogs is found being transferred from north to south, with small- and medium-scale predominant production areas shifted from East China to Southwest China, and large-scale predominant production areas shifted from North China to South Central China. Another finding is that eco-efficiency increased by the improvement of technical efficiency. In addition, the Tobit regression results show that rural economic development, the government's investment in environmental control, the market advantage index, and transportation conditions had positive effects on the eco-efficiency; meanwhile, the forbidden policy for livestock cultivation in certain areas, the structure of the hog breeding industry, the density of slaughtered fattened hogs, and the prices of hogs had negative effects on the eco-efficiency.

How do microalgae in response to biological pollution treat in cultivation? A case study investigating microalgal defense against ciliate predator Euplotes vannus

Microalgae have significant amounts of proteins, lipids, carotenoids, vitamins, minerals, and unique pigments. However, with the gradual expansion of microalgae cultivation, hostile biological pollution seriously restricted the large-scale microalgae cultivation and limited the exploitation of its biological resources. Moreover, protozoan poses the greatest threat to microalgae cultivation. Here, the relationship between six marine economic microalgae populations and their ciliate predator Euplotes vannus was examined. And four concentrations were designed for each type of microalgae to carry out the experiment. It was revealed that four species of microalgae inhibit the ciliate population growth at high density. Furthermore, the experiment which was the influence of microalgae at three different growth stages on the growth of the ciliates for these four kinds of high-density inhibitory microalgae was designed. The microalgae inhibitory effects were already exhibited at the end of the exponential growth phase, and it was significantly inhibited during the stationary growth phase. As the microalgae concentration increased, the inhibitory effect became more pronounced. This study provides fundamental data for screening protozoan-inhibiting microalgae and shows potential to be used in algae cultivation.

Lack of embryonic homozygous or adult heterozygous lymphatic phenotypes for a Sos1 mutation and lack of lymphatic embryonic phenotypes for a homozygous Cx47 mutation in mice

We have studied the lymphatic phenotypes of 2 mutations, known to cause abnormalities of lymphatics in humans, in mice. The Cx47 R260C mutation (variably penetrant in humans heterozygous for it and causing limb lymphedema) had an adult mouse phenotype of hyperplasia and increased lymph nodes only in homozygous condition but we did not find any anatomical phenotype in day 16.5 homozygous embryos. Mice harboring the Sos1 mutation E846K (causing Noonan's in man which occasionally shows lymphatic dysplasia) had no adult heterozygous phenotype in lymphatic vessel appearance and drainage (homozygotes are early embryonic lethals) while day 16.5 heterozygous embryos also had no detectable anatomical phenotype.

Potential to resist biological contamination in marine microalgae culture: Effect of extracellular substances of Nannochloropsis oceanica on population growth of Euplotes vannus and other protozoa

The commercially important marine microalgae Nannochloropsis oceanica is easily ingested by protozoan predators during large-scale cultivation. However, investigations into the effect of microalgae on the growth of protozoa are scant. A feeding experiment was conducted with Euplotes vannus grazing on different concentrations of N. oceanica. The ciliate population was significantly lower in the high concentration of algae than that in the low or medium algal concentration treatments. The density of ciliates cultured in algae filtrate media was significantly lower than that in lysate media and the blank control. Furthermore, the algal cell filtrate was added to three other protozoan populations, and they all gradually lost their ability to move and their body shape changed. This study investigated the interactions between N. oceanica and protozoan predators and provides insight on using microalgal extracellular substances to control biological contamination in the future.

Three-dimensional vectorcardiographic characteristics of breast cancer patients treated with chemotherapy

Funding Acknowledgements

Type of funding sources: None.

Background

 Patients receiving chemotherapy for breast cancer (BC) may develop cardiac electrophysiological abnormalities. The aim of this study is to examined possible alterations in cardiac electrophysiological parameters detected by three-dimensional vectorcardiograms (3D-VCGs) in BC patients who received chemotherapy.

Methods

This was a prospective single-center cohort study conducted. Patients with BC referred for chemotherapy from May 1, 2019, to October 1, 2019 were invited to participate in the study. 3D-VCG and echocardiography were recorded at rest four times (baseline, after the first cycle, after third cycles and at the end of the regimen, respectively). 

Results

 A total of 63 patients were included. Compared with baseline, decreases in 3-dimensional maximum T vector magnitude (TVM) (0.29 ± 0.10 vs. 0.25 ± 0.10mV; p &lt; 0.05) and 3-dimensional T/QRS ratio (0.26 ± 0.11 vs. 0.21 ± 0.11; p &lt; 0.05) were observed by the end of chemotherapy regimen, while echocardiographic parameters showed no significant variation before and after chemotherapy (all P &gt; 0.05). Maximum TVM showed a significant positive correlation with left ventricular ejection fraction (LVEF) (all p &lt; 0.05). Furthermore, the cut-off value with 0.23 of 3-dimensional T/QRS ratio (the area under the curve [AUC] 0.725) for differentiating LVEF reduction ≥10% following initiation of chemotherapy. The AUC of the front plane T/QRS ratio and horizontal plane T/QRS ratio for the detection of an LVEF reduction ≥10% was 0.725 and 0.763, respectively.

Conclusions

 3D-VCGs can be used to detect electrophysiological abnormalities in BC patients receiving chemotherapy. Subclinical cardiac dysfunction can be revealed by 3D-VCGs before alterations in traditional echocardiographic parameters.

Protective effects of zingerone on high cholesterol diet-induced atherosclerosis through lipid regulatory signaling pathway

AIM

A high cholesterol diet (HCD) is known to cause metabolic dysregulation, oxidative stress, cardiovascular diseases and atherogenesis. Zingerone is a pharmacologically active component of dry ginger. Zingerone has been shown to have a wide range of pharmacological properties, including scavenging free radicals, high antioxidant activity, suppressing lipid peroxidation and anti-inflammatory. This study aimed to investigate the effects of Zingerone on HCD-induced atherosclerosis in rats.

METHODS

Animals were divided into four categories (n = 6). Group I: normal control, Group II: zingerone control (20 mg/kg b.wt.), group III: HCD-induced atherosclerosis, Group IV: HCD + zingerone, respectively, for 8 weeks.

RESULTS

The HCD-fed rats resulted in a significant increase in an atherosclerotic lesion, lipid peroxidation, lipid profile, high-density lipoprotein concentration, cardiac markers, body weight, reduced antioxidant status, and displayed atherosclerosis. These findings were conventional by up-regulated expression of lipid regulatory genes like sterol-regulatory-element-binding protein-c (SREBP-c), fatty acid synthase (FAS), acetyl-CoA carboxylase (ACC), acetyl-CoA synthetase (ACS), liver X receptor-alpha (LXR-α), and down-regulated expression of acetyl-CoA oxidase (ACO), peroxisome proliferator-activated receptor-alpha (PPAR-α) and carnitine palmitoyl transferase-1 (CPT-1) in HCD-fed rats. These significant changes were observed in the zingerone-treated rats for the last 4 weeks.

CONCLUSION

These findings suggest that zingerone reduced atherosclerosis by modulated the atherosclerotic lesion, lipid profile, antioxidant status and lipid regulatory gene expression in HCD-fed rats.

Does microplastic ingestion dramatically decrease the biomass of protozoa grazers? A case study on the marine ciliate Uronema marinum

Microplastic debris has become a significant global environmental issue. Yet, the effects on ingestion of microplastics by protozoan grazers-an important link in the microbial loop-are scant. Feeding experiments were conducted with the free-living marine ciliate Uronema marinum grazing on cultured bacteria Pseudoaltermonas sp., exposing them to different concentrations or sizes of polystyrene beads for 96 h. The number of beads decreased during exposure experiments. Under the microplastic influence, the ciliate cells were observed to decrease in abundance, body size, and biomass. It was noted that the ciliate biomass in the highest microplastic density treatment was significantly lower than that in the control (98.1% lower) and that microplastics can be ingested by ciliate protozoa which performed an important role in the transportation of energy across the microbial loop. Moreover, carbon biomass of ciliates exposed to microplastics of different particle diameters decreased significantly compared to the control. However, this effect does not seem to vary depending on microplastic sizes. This study is a first step in providing experimental insight into the feeding relationship between microplastics and marine protozoan grazers. Further research based on components of the microbial loop is needed to explore the impacts of microplastics in marine food webs.

How do microplastics affect the marine microbial loop? Predation of microplastics by microzooplankton

Protozoans play an integral role in the microbial loop, an important process of material and energy transfer in marine ecosystems. The number of microplastics in the marine environment has greatly increased, but the potential impacts of small nanoplastics and microplastics on marine organisms remain unclear. Here, we conducted a series of feeding experiments with various concentrations of microplastic beads (ca. 1 μm) to characterize the response of the planktonic ciliated protozoan Strombidium sulcatum to microplastics and a set of additional exposure experiments with four different particle diameters of microplastics to explore whether the feeding response exhibited size selectivity. As the microplastic concentration increased, the number, body size, and biomass of ciliates decreased sharply during the exposure period. Predator biomass in all microplastic treatments was markedly reduced relative to the microplastic-free control. For example, at 72 h of exposure, the biomass in the highest microplastic concentration treatment was observed to decrease by 96.59% relative to the control. There was no obvious difference in the biomass of ciliates exposed to various diameters of microplastics; however, compared with the free bead control, the biomass still significantly decreased. These findings suggest that microplastics in the ocean negatively affect the growth of protozoan microzooplankton that might have accidentally ingested these tiny particles during the feeding process. Generally, this study provides basic and novel data for understanding the effect of microplastics on the microbial loop in marine ecosystems.

How Do Spillover Effects Influence the Food Safety Strategies of Companies? New Orientation of Regulations for Food Safety

The food safety strategies of companies are a key point in the reduction of food safety risks. In order to encourage the evolution of food safety strategies of companies from food fraud to safety investment, this study builds an evolutionary game model, taking large and small companies as participants, to reveal the dynamic process of spillover effects influencing the choice of food safety strategies of companies. The study shows that (1) the food safety strategies of companies change from safety investment to food fraud, along with the increasing opportunity costs of safety investment. (2) The costs structure of small companies mainly determines whether the industry reaches the equilibrium of safety investment, while the costs structure of large companies mainly determines whether the industry reaches the equilibrium of food fraud. (3) Both competition effects and contagion effects encourage companies to choose safety investment. The more obvious spillover effects of incidents on food safety are, the more likely it is that companies will choose safety investments. (4) Increasing the costs to companies for incidents on food safety and reducing the opportunity cost of safety investment motivates companies to choose safety investment. Consequently, a new orientation of regulations for food safety is formed: the government should allocate different regulatory resources to counteract food fraud behaviors or technologies with a different benefit, should increase the technical costs and costs incurred from committing acts of food fraud, and should expand spillover effects of incidents on food safety.

Downregulation of lncRNA MEG3 attenuates high glucose-induced cardiomyocytes injury by inhibiting mitochondria-mediated apoptosis pathway

OBJECTIVE

The aim of the present work was to investigate the effects and mechanisms of long non-coding RNA (lncRNA) maternally expressed gene 3 (MEG3) in cardiomyocytes injury and apoptosis induced by high glucose (HG) in vitro.

MATERIALS AND METHODS

HG-induced rats' cardiomyocytes with si-MEG3 transfection were constructed. Cell viability and lactate dehydrogenase (LDH) level were examined using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) and LDH assay kits, respectively. Cardiomyocytes apoptosis was detected by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labeling (TUNEL) staining. The expressions of Bcl-2, Bax, cleaved caspase-9 and cleaved caspase-3 proteins were determined by Western blot. The expression of lncRNA MEG3 was measured by Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR).

RESULTS

Our results indicated that the expression of MEG3 was significantly upregulated in HG-treated cardiomyocytes. The downregulation of MEG3 could attenuate cardiomyocytes injury and apoptosis by decreasing the Bax/Bcl-2 ratio, cleaved caspase-9 and cleaved caspase-3 expression.

CONCLUSIONS

The downregulation of MEG3 could attenuate cardiomyocytes injury and apoptosis induced by HG. The molecular mechanism was associated with the inhibition of the mitochondria-mediated apoptosis pathway.

[Blood loss in total knee arthroplasty using computer-assisted navigation or 3D-printed patient-specific instruments]

Objective: To compare the perioperative blood loss in patients undergoing a total knee arthroplasty (TKA) across three different techniques: computer-assisted navigation surgery (CAS), patient specific instrumentation (PSI) and conventional instrumentation (CI). Methods: Ninety consecutive patients with severe knee osteoarthritis who underwent unilateral primary TKA in Peking University Third Hospital Orthopedics Department from January 2018 to December 2018 were enrolled in this prospective study. The patients were randomly divided into three groups (30 case in each group): CAS-TKA group, PSI-TKA group and CI-TKA group. The study measured intraoperative blood loss, total blood loss, hidden blood loss, decreases of hemoglobin and hematocrit, and the post-TKA blood transfusions in the three groups. One-way ANOVA was used to detect the differences among the cohorts, and LSD was used for the post-hoc test. Results: The overall intraoperative blood loss of all patients was 6 ml (5~8 ml). The mean total blood loss and hidden blood loss in CAS-TKA group, PSI-TKA group and CI-TKA group was (1 147.0±301.8) and (1 140.1±301.9)ml, (1 044.3±454.1) and (1 038.5±454.0)ml, (1 154.0±483.6) and (1 145.3±482.7)ml, respectively; there was no significant differences among the three groups (F=0.639, 0.616, both P>0.05). There were no patients who received allogeneic blood transfusion. There were no significant differences in decrease of hemoglobin and hematocrit among the three groups neither (both P>0.05). Conclusions: Compared with conventional TKA, CAS and PSI does not increase the total blood loss of TKA. However, they both demonstrate a potential benefit in reducing blood loss of TKA.

0913 Ambulatory Blood Pressure Monitoring In Children With Obstructive Sleep Apnea Syndrome

Introduction

This study was performed to investigate the differences in blood pressure among different groups of snoring children and among different sleep stages.In recent years, the incidence of OSAS in children has increased year by year. Blood pressure research of OSAS children can better understand the occurrence of OSAS related complications. Early detection and intervention of blood pressure changes in children with OSAS can effectively reduce the incidence of cardiovascular disease in adulthood and lower the disease burden.

Methods

Habitually snoring children (snoring frequency of ≥3 nights per week) aged 3to 11 years were recruited from Beijing Children’s Hospital, Capital Medical University from 1 January 2017 to 30 June 2018. All children underwent polysomnography, and their blood pressure was monitored and calculated by the pulse transit time. The children were divided into those with primary snoring (PS), mild obstructive sleep apnea syndrome (OSAS), and moderate to severe OSAS according to their obstructive apnea-hypopnea index (OAHI).

Results

In total, 140 children were recruited. Ninety-seven had PS, 24 had mild OSAS, and 19 had moderate to severe OSAS. There were no differences in age, sex, or body mass index z-score among the groups. Statistically significant differences were found in the OAHI, oxygen desaturation index 3%, respiratory arousal index, and lowest oxygen saturation among the three groups. Children with moderate to severe OSAS had higher systolic and diastolic blood pressure than those with mild OSAS and PS (P &lt; 0.001). In all children, systolic and diastolic blood pressure was higher in the rapid eye movement (REM) sleep stage than in the non-REM sleep stage (P &lt; 0.05).

Conclusion

Children with moderate to severe OSAS had higher blood pressure than those with PS and mild OSAS. Blood pressure in the REM sleep stage was higher than that in other sleep stages in all groups of children.

Support

The Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority (XTYB201807);Capital Health Research and Development of Special Funding (2018-1-2091);National Key Research and Development Plan (2017YFC0112502)

Molecular genetic analysis in 21 Chinese families with congenital insensitivity to pain with or without anhidrosis

BACKGROUND AND PURPOSE

Hereditary sensory and autonomic neuropathies (HSANs) are a group of clinically and genetically heterogeneous neurological disorders characterized by sensory dysfunctions. Here, 21 affected Chinese families are reported, including 19 with congenital insensitivity to pain with anhidrosis (CIPA; namely HSAN IV) and two with congenital insensitivity to pain (CIP; namely HSAN IID) caused by biallelic variations in NTRK1 and SCN9A, respectively, aiming to identify causative variants in these families and compare how different variants in NTRK1 affect the function of tropomyosin receptor kinase A (TrkA).

METHODS

Recombinant plasmids harboring the wild-type and six mutant alleles (p.Gln216*, p.Glu584Lys, p.Leu595Arg, p.Pro684Leu, p.Val709Leu and p.Arg765Cys) of NTRK1 cDNA were constructed and transfected into HEK293 cells.

RESULTS

The results suggested that the five missense variants only presented a subtle influence on the expression level and glycosylation of TrkA but compromised the receptor phosphorylation. Our findings also suggested that a synonymous variant c.219C>T in NTRK1 may cause aberrant splicing, indicating a potential novel pathogenic mechanism of CIPA. Furthermore, gross deletion of SCN9A was first associated with CIP.

CONCLUSIONS

This study identified multiple forms of variants responsible for CIPA/CIP in the Chinese population and might provide new insights into the pathogenesis of CIPA.

Rethinking Food Production: Nexus of Mobile Phones and Production Cost Minimization

Information and communication technologies are a ready tool for all strata of society and are indeed redefining the way almost everything is done. Mobile phone technology, in particular, plays a vital role in expediting improvement in the efficiency of the household resource through access to information on various available technologies. Can mobile phones improve the cost efficiency of agricultural production? Comprehension of such effect is critical, especially in the context of the Sustainable Development Goals. We addressed this topic using cross-sectional data from smallholder maize producers in Zambia. The Stochastic Frontier Analysis was applied to estimate cost efficiency. The results indicate that mobile phone use improves the cost efficiency of maize production significantly and as such, adopters have made a rational decision to adopt mobile phone use for information access. Precisely, we found a 10.2% efficiency gap in favor of users. Nevertheless, if non-users were to adopt mobile phones for agricultural information access, maize production per hectare would increase by 21.38%. Eventually, food production would be increased in an environmentally friendly manner and the price of maize would be set at a competitive price within the region because agricultural inputs would be allocated cost efficiently. Therefore, in an attempt to minimize production cost in food production, this study strongly endorses the use of mobile phones for agricultural information access.

[An investigation of occupational exposure to welding fume, manganese, and manganese compounds in a large container manufacturing enterprise]

Objective: To investigate the current status of the occupational hazards of welding fume, manganese, and manganese compounds in the welding environment of a large container manufacturing enterprise, as well as the status of occupational health examination of workers, and to provide a basis for improving the welding environment of this enterprise. Methods: In August 2016, July 2017, and August 2018, convenience sampling was used to perform an on-site occupational hygiene survey of the welding workshop for three consecutive years, and welding fume, manganese and, manganese compounds (counted as manganese dioxide) were measured for their workplace exposure concentrations and exposure levels in workers. A comprehensive analysis was performed for the results of occupational health examination. Results: Welding fume, manganese, and manganese compounds in the welding environment gradually increased from 2016 to 2018 (χ(2)(trend)=5.14 and 5.54, P<0.05). The maximum over-standard rate of concentration-short term exposure limit was 43.3% (13/30) for welding fume and 40.0% (12/30) for manganese and its compounds, and the maximum over-standard rate of time-weighted average concentration was 26.7% (8/30) for welding fume and 23.3% (7/30) for manganese and its compounds. Abnormalities were observed in the occupational health examination of welding workers in 2016-2018, among which respiratory system abnormalities (cough, expectoration, and wheezing), nervous system abnormalities (dizziness, fatigue, sleep disorders, amnesia, hyperhidrosis, and palpitations), and electrocardiogram abnormalities (bundle conduction block) had an incidence rate of above 10.0%, and the incidence rate of abnormalities on posterior-anterior X-ray high-kV chest radiograph was close to 8.9% (30/336) . Conclusion: There is severe exposure to welding fume, manganese, and manganese compounds among workers in this enterprise, which cause great hazards to the health of workers. It is necessary to strengthen occupational health management, take measures to improve the welding environment, and enhance occupational disease prevention.

[Expression changes of miRNA-29b-3p and miRNA-34c-3p in lung tissue of rats exposed to silica and A549 cells]

Objective: To investigate the role of microRNA-29b-3p (miRNA-29b-3p) and miRNA-34c-3p in the process of pulmonary fibrosis, we detected the expression levels of miRNA-29b-3p and miRNA-34c-3p in the lung tissue of rats exposed to silica and A549 cells. Methods: SPF male Wistar rats were randomly divided into 1, 7, 14, 21, 28 d control group and silica (SiO(2)) dusting group, with 6 rats in each group. One-time non-exposure method was used to infuse 1ml SiO(2) suspension. The rat SiO(2) dusting group was established in the liquid, and the control rats were intratracheally injected with 1 ml of sterile physiological saline in the same manner. The lung tissues of each group were collected at the corresponding time points after dusting. Three of the rats were taken out for pathological observation, and the other three were used to screen differentially expressed miRNAs in lung tissue by miRNA microarray technology. A549 cells were cultured at the in vitro cell level and divided into control group, SiO(2) stimulation group and TGF-β(1) stimulation group, and cells were collected at 12, 24 and 48 h after treatment. The expression levels of miRNA-29b-3p and miRNA-34c-3p in rat lung tissue and A549 cells were verified by real-time PCR (qRT-PCR), target gene prediction of miRNA-29b-3p and miRNA-34c-3p and perform GO enrichment analysis and KEGG pathway analysis. Results: The weight growth rate of the control group was significantly higher than that of the SiO(2) dusting group. Compared with the control group, the lung mass and lung coefficient of the SiO(2) dusting group were significantly increased (P<0.05). The inflammatory response of the lungs in the control group was significantly reduced at 21 and 28 days, and the inflammatory cells infiltrated in the lung tissue of the SiO2 group. The rats in the control group had a small amount of collagen at 21 and 28 days. A large amount of collagen fiber deposition began to appear in the lung tissue of rats exposed to SiO(2) for 21 days. Compared with the control group, the expression levels of miRNA-29b-3p and miRNA-34c-3p in the SiO(2) dusting group were significantly down-regulated, and there was significant difference compared with the control group (P<0.05). The expression levels of miRNA-29b-3p and miRNA-34c-3p in A549 cells treated with SiO(2) and human recombinant TGF-β1 were significantly lower than those in the control group at 24 h and 48 h, and the difference was statistically significant (P<0.05). Conclusion: Down-regulation of miRNA-29b-3p and miR-34c-3p in rat lung tissue A549 cells may be associated with the development of early silicosis and is expected to be an indicator of early silicosis diagnosis and prognosis.

Mitochondrial DNA mutation m.3243A>G is associated with altered mitochondrial function in peripheral blood mononuclear cells, with heteroplasmy levels and with clinical phenotypes

AIMS

To investigate the associations among heteroplasmy levels (i.e. the proportions of mutant and wild-type mitochondrial DNA in the same cell), mitochondrial function and clinical severity of the m.3243A>G mutation.

METHODS

A total of 17 participants carrying the m.3243A>G mutation and 17 sex- and age-matched healthy controls were included in this study. Heteroplasmy levels of the m.3243A>G mutation in leukocytes, saliva and urine sediment were determined by pyrosequencing. The clinical evaluation included endocrinological, audiological and ophthalmological examinations. Mitochondrial function was determined in peripheral blood mononuclear cells isolated from participants.

RESULTS

Heteroplasmy levels in urine sediment were higher than those in leukocytes and saliva. Reduced levels of adenosine triphosphate and mitochondrial membrane potential, and increased reactive oxygen species production were observed in mutant peripheral blood mononuclear cells (all P < 0.05). Linear regression analysis indicated that higher heteroplasmy levels in peripheral blood leukocytes were associated with increased levels of glycated albumin and HbA_1c , and decreased total hip bone mineral density T-score after adjustment for age and sex (all P < 0.05). Furthermore, mitochondrial membrane potential was independently associated with bone mineral density T-score at the femoral neck (P < 0.05).

CONCLUSIONS

Heteroplasmy levels in peripheral blood leukocytes and mitochondrial membrane potential in peripheral blood mononuclear cells were closely associated with clinical manifestations and were valuable for evaluation of the clinical severity of the m.3243A>G mutation.

A comprehensive analysis of candidate gene signatures in oral squamous cell carcinoma

This study aimed to unravel the molecular mechanism of oral squamous cell carcinoma (OSCC). With microarray dataset GSE30784, differentially expressed genes (DEGs) were identified between OSCC and control samples. The DEGs overlapped with genes obtained from online database MalaCards were determined as OSCCDEG, followed by Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. A total of 5177 up-regulated and 6081 down-regulated DEGs were identified between OSCC and control. Out of the DEGs, 451 genes were overlapped with the 704 genes gained from MalaCards and regarded as "OSCCDEG". Up-regulated OSCCDEG were associated with cell cycle pathway, while down-regulated OSCCDEG were linked to ErbB pathway. ANGPT1, ANGPT2 and 3 hub proteins (EGFR, HSP90AA1, RB1) in the PPI network were associated with the survival rates of several tumors. The largest network module with the hub protein EGFR was associated with positive regulation of cell communication. The second largest module with the hub node FN1 was related to angiogenesis. For the third network module in connection with DNA metabolism, the hub protein was PCNA. ErbB and cell cycle pathways were crucial for OSCC. EGFR, FN1, PCNA, ANGPT1 and ANGPT2 might be potential biomarkers for OSCC. These findings help provide guidelines for treating OSCC.

[Study on occupational exposure limits of tributyl phosphate in the workplace air]

Objective: To put forward the suggestion of the occupational contact limit of tributyl phosphate in the air of the workplace. Methods: Data of production and usage, workers' basic information, occupational history, and physical examinations were collected, and the environmental and individual levels of exposure were monitored using fixed-point and individual sampling. The results of the questionnaire and health examination were statistically analyzed using exact probability method of Fisher in the workers exposed to tributyl phosphate and the control group. Results: The results showed that tributyl phosphate was widely distributed in the workplace of production and using enterprises, and the concentration of tributyl phosphate in packaging area was highest at 2.47 mg/m(3), and in feeder nose was highest at 2.13 mg/m(3). The discomfort symptoms were classified and results showed that tributyl phosphate exposure group of 136 people, all symptoms of 128 people, accounting for 94.44% of the total, the remaining 5.56% of the staff report had psychiatric symptoms or lethargy and irritability skin itching, the control group had no symptoms. There is or not discomfort symptoms in the tributyl phosphate exposure group and the control group was compared with the exact probability of Fisher, and the difference was statistically significant (P<0.05) . The results of healthy physical examination of workers exposed to tributyl phosphate and control group were statistically analyzed by the exact probability method of Fisher. The results showed that there was no significant difference in the results of routine internal medical examination, nervous system examination, skin examination, five senses examination, blood routine, urine routine, lung ventilation, and X ray chest fluoroscopy between the tributyl phosphate exposure group and the control group (P<0.05) . Conclusion: The workplace permissible time-weighted tributyl phosphate and short-term exposure limit concentrations in China were set at 2.5 mg/m(3) and 5 mg/m(3), respectively.

Prospective evaluation of the cardiac safety of HER2-targeted therapies in patients with HER2-positive breast cancer and compromised heart function: the SAFE-HEaRt study

Purpose

HER2-targeted therapies have substantially improved the outcome of patients with breast cancer, however, they can be associated with cardiac toxicity. Guidelines recommend holding HER2-targeted therapies until resolution of cardiac dysfunction. SAFE-HEaRt is the first trial that prospectively tests whether these therapies can be safely administered without interruptions in patients with cardiac dysfunction.

Methods

Patients with stage I–IV HER2-positive breast cancer candidates for trastuzumab, pertuzumab or ado-trastuzumab emtansine (TDM-1), with left ventricular ejection fraction (LVEF) 40–49% and no symptoms of heart failure (HF) were enrolled. All patients underwent cardiology visits, serial echocardiograms and received beta blockers and ACE inhibitors unless contraindicated. The primary endpoint was completion of the planned HER2-targeted therapies without developing either a cardiac event (CE) defined as HF, myocardial infarction, arrhythmia or cardiac death or significant asymptomatic worsening of LVEF. The study was considered successful if planned oncology therapy completion rate was at least 30%.

Results

Of 31 enrolled patients, 30 were evaluable. Fifteen patients were treated with trastuzumab, 14 with trastuzumab and pertuzumab, and 2 with TDM-1. Mean LVEF was 45% at baseline and 46% at the end of treatment. Twenty-seven patients (90%) completed the planned HER2-targeted therapies. Two patients experienced a CE and 1 had an asymptomatic worsening of LVEF to ≤ 35%.

Conclusion

This study provides safety data of HER2-targeted therapies in patients with breast cancer and reduced LVEF while receiving cardioprotective medications and close cardiac monitoring. Our results demonstrate the importance of collaboration between cardiology and oncology providers to allow for delivery of optimal oncologic care to this unique population.

Electronic supplementary material

The online version of this article (10.1007/s10549-019-05191-2) contains supplementary material, which is available to authorized users.

Lymphovascular invasion as a poor prognostic indicator in thoracic esophageal carcinoma: a systematic review and meta-analysis

The ability to further stratify patients with esophageal carcinoma (EC) in the same stage into high-risk patients by the presence of lymphovascular invasion (LVI) may permit refinement of multi-modality therapy. However, the role of LVI in the prognosis of EC is not definite. A meta-analysis was conducted to investigate the relationship between LVI and EC prognosis. We searched PubMed, Embase, Web of Science, and Cochrane Library databases for studies on the association between LVI and prognosis of EC. Only studies with patient survival data related to LVI were included. The effect size for this analysis was the hazard ratio (HR) with 95% confidence intervals (CI) for overall survival (OS) and recurrence-free survival (RFS). Thirty-five studies with 9876 patients were included according to the defined inclusion and exclusion criteria. LVI was a poor indicator for the OS (HR = 1.64, 95% CI: 1.44-1.87, P < 0.001) and RFS (HR = 1.79, 95% CI: 1.38-2.34, P < 0.001). However, the heterogeneity was medium in OS (I2 = 61.2%, P < 0.001) and extreme in RFS (I2 = 77.5%, P < 0.001). In subgroup analysis, heterogeneity was originated from the staining method and proportion of early disease (stage (I + II)). We concluded that LVI was a poor prognostic indicator in patients with EC, especially in those studies with the IHC staining method and a high proportion of early disease (stage (I + II)).

[Mid-term clinical outcome of total knee arthroplasty with domestic A3 posterior stabilized prosthesis]

Objective: To observe the mid-term clinical outcome of total knee arthroplasty (TKA) with domestic A3 posterior stabilized prosthesis. Methods: The clinical data of 342 patients (438 knees) who underwent primary TKA by the same surgeon from June 2012 to December 2013 in Peking University Third Hospital were retrospectively collected. The patients were divided into 2 groups according to the type of prosthesis: 107 patients (137 knees) with domestic A3 prosthesis, as domestic group; 235 patients (301 knees) with a kind of imported prosthesis, as the control group. In the end, 311 patients (390 knees) received complete follow-up.The postoperative knee maximum flexion angle, postoperative Hospital for Special Surgery Knee Score (HSS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), postoperative coronal mechanical axis alignment and hospitalization costs were compared between the groups.Paired t-test was used to compare the preoperative and postoperative data in the same group, and independent sample t-test was used to compare the data between the two groups at the same time points. Results: The average follow-up time of all the patients was (5.6±1.1) years, and it was averaged for 64.8 months in the domestic group and 68.2 months in the control group.There was no significant difference in the HSS score and WOMAC score, the knee maximum flexion angle, and coronal mechanical axis alignment at the 3 months postoperatively and at the end of follow-up between the two groups (t=-0.890, -1.610, 1.740, 0.620, all P>0.05). In 2012, the average hospital cost was (24 879±1 627) yuan/knee in the domestic group and it was (49 611±1 589) yuan/knee in the control group (t=-48.902, P<0.01). In 2013, it was (38 393±2 773) yuan/knee in the domestic group, and was (55 931±3 533) yuan/knee in the control group (t=-14.795, P<0.01). Conclusion: It indicates that the domestic A3 posterior stabilized prosthesis brings comparable mid-term results with the imported prothesis and it reduces medical costs remarkably.

[Clinical observation of postprandial hypotension in patients with hypertensive and coronary heart disease]

Objective: To explore the prevalence and clinical characteristics of postprandial hypotension(PPH) in patients with essential hypertension and coronary heart disease. Methods: A total of 197 patients with essential hypertension and coronary heart disease, who had been treated in the First Department of Cardiology of the Second Hospital of Hebei Medical University from December, 2013 to December, 2014 were included. The patients' blood pressure before breakfast, lunch and dinner and 30, 60, 90, 120 minutes after the meal were monitored. Subjects were classified into PPH group (n=37) and non-PPH group (NPPH, n=160) according to postprandial decrease in systolic blood pressure, to explore the clinical characteristics and related factors and the major adverse cardiac and cerebral vascular events of PPH. Results: Among 197 patients, 37 cases (18.8%) showed at least once postprandial decline in systolic blood pressure greater than and equal to 20 mmHg. The incidence of PPH after breakfast and dinner were higher than lunch (P<0.05). There was no significant difference in the incidence of PPH among different age groups, among patients accompanied with different diseases, and among patients with different dining position (all P>0.05). According to the baseline systolic blood pressure, patients can be divided into 4 groups(<120 mmHg, 120-129 mmHg, 130-139 mmHg, >140 mmHg), the higher the level of the baseline systolic blood pressure was, the higher the incidence of PPH was. And the incidence of major adverse cardiac and cerebral vascular events in patients during hospitalization were increased by PPH. Conclusions: The prevalence of PPH in the patients with essential hypertension and coronary heart disease is 18.8%. The incidence of PPH after breakfast and dinner is higher than lunch. The baseline systolic blood pressure is considered to be the risk factor of PPH. And PPH could lead to an increase of the incidence of major adverse cardiac and cerebral vascular events.

Utility of apparent diffusion coefficient as an imaging biomarker for assessing the proliferative potential of invasive ductal breast cancer

AIM

To determine the clinical utility of apparent diffusion coefficient (ADC) metrics for the non-invasive assessment of tumour proliferation indicated by Ki-67 labelling index (LI) in invasive ductal breast cancer.

MATERIALS AND METHODS

Eighty patients with 80 histopathologically proven invasive ductal breast cancers underwent diffusion-weighted imaging with b-values of 0 and 800 s/mm² at a 3-T system. ADC metrics including ADC_mean, ADC_median, ADC_min, ADC_max, and ΔADC (ADC_max-ADC_min) were recorded from the entire tumour volume on ADC maps, and correlated with the Ki-67 LI. Ki-67 staining of ≥14% was considered to indicate high proliferation and <14% was considered to indicate low proliferation.

RESULTS

ADC_min, ADC_max, and ΔADC showed significant correlations with the Ki-67 LI (for all tumours, r=-0.311, 0.436, and 0.551, respectively; for luminal/human epidermal growth factor receptor 2 (HER2)-negative group, r=-0.437, 0.512, and 0.639, respectively; all p<0.01), whereas ADC_mean and ADC_median showed no significant correlation (both p>0.05). Receiver operating characteristic (ROC) curve analysis for the differentiation of high- from low-proliferation groups showed that ΔADC yielded the highest area under the ROC curve for the whole tumour population (0.825; 95% confidence interval [CI]: 0.724, 0.901), as well as for the luminal/HER2-negative group (0.844; 95% CI: 0.692, 0.940).

CONCLUSION

ΔADC may serve as a promising imaging biomarker for the prediction of Ki-67 proliferation status in invasive ductal breast cancer.

Two novel Mg(II)-based and Zn(II)-based complexes: inhibiting growth of human liver cancer cells

Two new Mg(II)-based and Zn(II)-based coordination polymers, {[Mg3(BTB)(DMA)4](DMA)2}n (1, H3BTB=1,3,5-benzenetrisbenzoic acid, DMA=N,N-dimethylacetamide) and {(H2NMe2)2[Zn3(BTB)2(OH)(Im)](DMF)9(MeOH)7}n (2, Im=imidazole, DMF=N,N-dimethylformamide), have been successfully synthesized and structurally characterized under solvothermal conditions. 1 contains a linear [Mg3(COO)6] cluster that connected by the fully deprotonated BTB3- ligands to give a kgd-type 2D bilayer structure; 2 represents a microporous 3D pillar-layered system based on the binuclear Zn units and pillared Im ligands, which shows a (3,5)-connected hms topological net. In addition, in vitro anticancer activities of compounds 1 and 2 on 4 human liver cancer cells (HB611, HHCC, BEL-7405 and SMMC-7721) were determined.

Procainamide-induced autoimmunity: Relationship to T-helper 2-type T-cell activation

Drug-induced autoimmunity (DIA) refers to a group of adverse drug reactions, and they remain unpredictable largely due to the limited understanding of the mechanisms involved. There is evidence that procainamide can cause autoimmune reactions in humans but the mechanisms involved remain unclear. To examine the cellular and genetic factors involved in the procainamide-induced autoimmune response, we compared rats that are genetically T-helper (Th)2-predisposed (Brown Norway (BN)), Th1-predisposed (Lewis (LEW)) or not genetically predisposed (Sprague Dawley (SD)). We revealed significant differences in response to autoimmunity induced by procainamide among three strains rats, BN was the most sensitive one, SD exhibited less sensitive, while LEW resistance to procainamide. Much more pronounced of Th2-type responses and more complex differentially expressed genes involved in immune regulation and response in BN might contribute to its susceptibleness to DIA. Moreover, similar immune mechanisms were found between BN and SD, which suggesting that these changes would serve as the potential bridge biomarkers to predict DIA among species. This study may also benefit to further understand the toxicological mechanism of drug-induced autoimmune reactions.

[Assessment for pain control efficiency of ultrasound guided adductor canal block in total knee arthroplasty: a report of 28 continuous cases]

Objective: To assess the pain control efficiency of continuous adductor canal block in total knee arthroplasty. Methods: From October to December 2015, patients with severe knee osteoarthritis undergoing primary unilateral TKA were observed clinically.All of the patients received ultrasound-guided continuous adductor canal block after surgery.NPRS Pain score in rest and activity at 2, 6, 12, 24, 48 h after surgery were collected, preoperative and postoperative quadriceps strength at 24, 48 h were analyzed. Opioids consumption and anesthesia related adverse effects were also recorded. Results: All of the patients were enrolled. Rest pain control was fairly good(1.8±1.5), (2.4±1.5), (2.7±1.3), (2.7±1.7), (2.3±1.4) score, but the patients were not satisfied with activity pain control(3.1±2.1), (3.1±2.1), (4.2±2.2), (4.7±2.5), (6.2±2.4) score. There were statistically differences comparing the NPRS in rest pain with the score in activity, except for the results between each other at 6 hours (P=0.252>0.05)after surgery.The results showed no significant differences comparing quadriceps strengthpreoperatively with 24, 48 h postoperatively by repeated measurements variance analysis.Eight patients acquired additional use of dolantin once (100 mg/per time) within 24 h and among them three patients acquired once dolantin during 24 to 48 h. Eleven patients complained nausea postoperatively, one reported vomiting and one experienced xerostomia. Conclusion: Ultrasound-guided continuous adductor canal block can reduce resting pain after TKA, but has a limited effect in activity pain control.Quadriceps strength had been spared after ACB, which might performearly benefits in rehabilitation. ACB-related complications need further observation to be defined.

Expression of Treg/Th17 cells as well as related cytokines in patients with inflammatory bowel disease

OBJECTIVE

To investigate the expressions of peripheral regulatory T cells (Treg) and T helper cells (Th17) as well as related cytokines in peripheral blood of patients with inflammatory bowel disease (IBD).

METHODS

One hundred four cases of IBD patients admitted in our hospital were selected for this study. One hundred cases of people receiving healthy physical examination were included in the control group in the corresponding period. The levels of CD4⁺CD25⁺Treg and Th17 subsets were analyzed in peripheral blood of two groups using flow cytometry. The expressions of IL-10, TGF-β1, IL-17 and IL-23 mRNA and protein were detected using real-time fluorescence quantitative PCR and ELISA.

RESULTS

Compared with the control group, the proportion of Treg in peripheral blood was decreased significantly in observation group (P<0.05), the proportion of Th17 cells was increased significantly (P<0.05), and Treg/Th17 was decreased significantly (P<0.05). Compared with the control group, the expressions of IL-10 and TGF-β1 mRNA and protein in peripheral blood of patients were significantly down-regulated in observation group, while the expressions of Th17 cytokines IL-17 and IL-23 mRNA and protein were significantly increased (P<0.05).

CONCLUSION

The proportion of Th17 and increased cytokine level suggested the inflammatory level was higher in IBD patients. The down regulations of Treg and cytokine suggested that the immunosuppression function was down-regulated in IBD patients, and the disproportionality might be one of the mechanisms of IBD.

A genome-wide association study of heat stress-associated SNPs in catfish

Heat tolerance is a complex and economically important trait for catfish genetic breeding programs. With global climate change, it is becoming an increasingly important trait. To better understand the molecular basis of heat stress, a genome-wide association study (GWAS) was carried out using the 250 K catfish SNP array with interspecific backcross progenies, which derived from crossing female channel catfish with male F1 hybrid catfish (female channel catfish × male blue catfish). Three significant associated SNPs were detected by performing an EMMAX approach for GWAS. The SNP located on linkage group 14 explained 12.1% of phenotypical variation. The other two SNPs, located on linkage group 16, explained 11.3 and 11.5% of phenotypical variation respectively. A total of 14 genes with heat stress related functions were detected within the significant associated regions. Among them, five genes-TRAF2, FBXW5, ANAPC2, UBR1 and KLHL29- have known functions in the protein degradation process through the ubiquitination pathway. Other genes related to heat stress include genes involved in protein biosynthesis (PRPF4 and SYNCRIP), protein folding (DNAJC25), molecule and iron transport (SLC25A46 and CLIC5), cytoskeletal reorganization (COL12A1) and energy metabolism (COX7A2, PLCB1 and PLCB4) processes. The results provide fundamental information about genes and pathways that is useful for further investigation into the molecular mechanisms of heat stress. The associated SNPs could be promising candidates for selecting heat-tolerant catfish lines after validating their effects on larger and various catfish populations.