[Application and advancement of digital teaching materials in teaching epidemiology]

This study aims at examining the application and development of digital teaching materials in the field of epidemiology, encompassing both China and international contexts. The research involved conducting search on websites and literature databases to assess the status of digital teaching materials in epidemiology, nationally and internationally. At present, in China, digital teaching materials used in epidemiology are primarily presented in the form of printed books with added QR codes, providing teaching resources such as videos and exercises. However, issues with the level of interactivity have been identified. In foreign countries, with stronger emphasis placed on personalization, interactivity, and the use of rich media technologies in the digital teaching materials, epidemiologically. Enhanced digitization regarding materials and learning outcomes is achieved through features such as real-time notes, interactive animations, and quizzes. These approaches are considered worth considering for adoption. This study provides valuable insights for the digital transformation of epidemiology education.

[Comparative study on the degradation rate and regulatory effects of two resorbable collagen membranes during the in vivo implantation]

Objective: To explore the differences in the performance and tissue repair promotion effects of small intestinal submucosa membrane (SIS membrane) and Bio-Gide resorbable collagen membrane (Bio-Gide membrane) by performing the subcutaneous implantation models in mice. Methods: For in vivo studies, we stablished membrane implantation models using 6-8 week-old male C57BL/6 mice. The degradation rates were explored through HE staining analysis at different time points (1, 3, 5, 7, 14 and 28 d, 3 mice/group/time point). The influences of the two membranes on local macrophages and neovasculum were evaluated by immunofluorescence detection of F4/80 and CD31, and the mobilization effects of the two membranes on local stem cells were evaluated by immunohistochemical detection of Ki67 and CD146. For in vitro studies, mice periodontal ligament stem cells (mPDLSCs) were co-cultured with these two membrane materials, and the cell morphologies were observed by scanning electron microscopy. In addition, the gene expressions of Ki67, Cxcl1, Ccl1, Tnfa were investigated by real-time fluorescence quantitative PCR (RT-qPCR). Results: The results of in vivo studies showed that by day 28, there was no significant difference in degradation rate between these two membrane materials [SIS degradation rate: (16.84±4.00) %, Bio-Gide degradation rate: (24.07±3.97) %, P=0.090], illustrating that both of them could maintain the barrier effects for more than one month. In addition, there was no significant difference in the infiltration number of local F4/80 positive macrophages between these two groups by the day 3 after implantation [SIS: (20.67±5.69) cells/visual field, Bio-Gide: (25.33±2.52) cells/visual field, P=0.292]. However, compared with the Bio-Gide membrane, SIS membrane significantly promoted local CD31+vascular regeneration [SIS: (4.67±1.15) cells/visual field, Bio-Gide: (1.00±1.00) cells/visual field, P=0.015] and CD146+stem cell recruitment [SIS: (22.33±4.16) cells/visual field, Bio-Gide: (11.33±2.52) cells/visual field, P=0.025]. The RT-qPCR results also showed that SIS membrane promoted the gene expression of Cxcl1 (SIS vs Bio-Gide P<0.001) in mPDLSCs, but had no effect on the gene expression of Tnfa (SIS vs Bio-Gide P=0.885). Conclusions: SIS membrane showed a similar degradation rate compared with Bio-Gide membrane, and there was no significant difference in the effects of these two membranes on local inflammation or macrophages. Therefore, both of these membranes could meet the barrier effects required by guided tissue regeneration.

Biotoxicity of Halide Perovskites in Mice

Halide perovskites are crystalline semiconductors with exceptional optoelectronic properties, rapidly developing toward large-scale applications. Lead (II) (Pb2+ ) is the core element used to prepare halide perovskites. Pb2+ can displace key 2+ elements, including calcium, zinc and iron, that regulate vital physiological functions. Sn2+ can replace Pb2+ within the perovskite structure and, if accidentally dispersed in the environment, it readily oxidizes to Sn4+ , which is compatible with physiological functions and thus potentially safe. The 3+ salt bismuth (III) (Bi3+ ) is also potentially safe for the same reason and useful to prepare double perovskites. Here, this work studies the biotoxicity of Pb, Sn, and Bi perovskites in mice for the first time. This work analyses histopathology and growth of mice directly exposed to perovskites and investigate the development of their offspring generation. This study provides the screening of organs and key physiological functions targeted by perovskite exposure to design specific studies in mammalians.

[A prospective study of the perforator evaluation and eccentric design of anterolateral thigh flap based on superficial fascial perforators assisted by modified computed tomography angiography]

Objective: To explore the preoperative whole perforator evaluation and intraoperative eccentric design of anterolateral thigh flap (ALTF) based on superficial fascial perforators by modified computed tomography angiography (CTA), and the clinical effects were observed. Methods: A prospective observational study was adopted. Twelve patients with oral and maxillofacial tumors and 10 patients with open injury of the upper limb with large soft tissue defects were hospitalized in the Department of Hand & Microsurgery and Department of Oral & Maxillofacial Surgery of Affiliated Hospital of Binzhou Medical University from January 2021 to July 2022, with 12 males and 10 females, aged from 33 to 75 years, an average age of 56.6 years. The wounds of the patients with oral and maxillofacial tumors were reconstructed by ALTF after the extensive tumor resection and radical cervical lymph node dissection in the same stage; the wounds of the patients with skin and soft tissue defect on the upper limb were covered by ALTF in stage Ⅱ after debridement in stage Ⅰ. After debridement, the area of wound was 3.5 cm×3.5 cm-25.0 cm×10.0 cm and the area of the required flap area was 4.0 cm×4.0 cm-23.0 cm×13.0 cm. Modified CTA scan was performed on the donor site of ALTF before the operation, with the parameters of modified CTA being set to mainly reduce the tube voltage and tube current, and increase the contrast dose and the dual phase scan. The acquired image data were sent to GE AW 4.7 workstation and adopted the volume reconstruction function for visual reconstruction and evaluation of the whole perforator. The information of perforator and source artery was marked on the body surface before operation according to the above evaluation. During the operation, an eccentric flap centered on the visible superficial fascia whole perforator was designed and cut according to the desired flap area and shape. The donor sites of the flap were repaired by direct sutures or full-thickness skin grafts. The total radiation dose was compared between the modified CTA scan and the traditional CTA scan. The distribution of outlet point of perforator of double thighs, the length and direction of superficial fascia perforators based modified CTA were recorded. The type, number, and origin of the target perforator, distribution of of outlet point of perforator, and the diameter, course, and branch of the source artery observed before the operation were compared with those observed during the operation. The healing of donor site wound and the survival of flaps in recipient site were observed after operation. The texture and appearance of flap, oral and upper limb functions, and the functions of femoral donor sites were followed up. Results: The total radiation dose of modified CTA scan was lower than that of the traditional CTA scan. A total of 48 perforators of double thighs were observed, among which, 31 (64.6%) perforators went outward and downward, 9 (18.8%) perforators went inward and downward, 6 (12.5%) perforators went outward and upward, and 2 (4.2%) perforators went inward and upward, and the average length of superficial fascia perforators was 19.94 mm. The preoperative observed type, number, and source of the perforator, the distribution of the outlet point of the perforator, diameter, course, and branches of the source artery were basically consistent with the intraoperative exploration. The types of 15 septocutaneous (including musculoseptocutaneous) perforators and 10 musculocutaneous perforators observed before the operation was consistent with intraoperative exploration. The distance between the mark of the surface perforator point and the actual exit point of the perforator during operation was (0.38±0.11) mm. All flaps survived without vascular crisis. The donor site wounds of 5 cases of skin grafting and 17 cases of direct suturing wounds healed well. The postoperative follow-up was 2 months to 1 year, with an average of 8.2 months, the flaps were soft and slightly bloated; the function of diet and mouth closing was accessible in patients with oral and maxillofacial tumors, the speech function was mildly impaired in patients with tongue cancer, but they could complete basic oral communication; the wrist and elbow joints and forearm rotation function were not significantly limited in patients with upper limb soft tissue injuries; there was no obvious tightness in the donor sites, and the function of the hip and knee joints was not limited. Conclusions: The whole perforator and even the subcutaneous perforator of the donor site of ALTF can be evaluated by modified CTA, and the flap can be used in oral or maxillofacial reconstruction and repair of skin and soft tissue defects of upper limbs to achieve good results. By clarifying the type, number, and source of the perforator, the distribution of the outlet point of the perforator, diameter, course, and branches of the source artery before the operation, the eccentric design of the ALTF based on the superficial fascia perforator was realized. This study has strong guiding value.

[Imaging findings of supratentorial embryonal tumor with multilayered rosettes in children]

We analyzed and summarized the imaging characteristics and clinical data of seven pediatric supratentorial embryonal tumors with multilayered rosettes (ETMR). There were four boys and three girls aged from two to six years old. Pediatric supratentorial ETMR often presented large cystic and solid mass, calcification, significant mass effect and mild peritumoral edema. The solid part often showed heterogeneous mild enhancement. In combination with the location of tumor and age of onset, the typical imaging manifestations of supratentorial ETMR in children are valuable for accurate diagnosis.

Effects of emamectin benzoate on pharmacokinetic profiles, bioavailability, and serum biochemical indices in crucian carp (Carassius carassius) following oral administration with multiple dosage levels

The aim of this investigation was to explore the effect of three different dose levels of emamectin benzoate (EMB) (50, 200, and 500 μg/kg bw) on pharmacokinetic characterizations, tissue distribution patterns, absolute bioavailability, and serum biochemical indices in crucian carp following oral administration at 22 ± 2°C, respectively. We further calculated the relevant parameters by detecting the concentration of EMB in the crucian carp by the ultra-HPLC detection method. The results showed that C _max , AUC, and T _1/2z after oral administration showed a dose-dependent increase in plasma. Secondly, EMB has a long mean flow time (MRT) (51.88, 67.04, and 78.00 h, respectively). In conclusion, the elimination of the drug is slow, and the higher dose used, the slower elimination is. The distribution in various tissues of crucian carp was analyzed. The order of EMB levels in tissues of crucian carp was liver > gill > kidney > muscle plus skin > plasma. As for pharmacokinetic parameters in tissues, C _max , AUC, and T _1/2z in tissues had a similar pattern as that in plasma. The absolute oral bioavailability of EMB (F%) in crucian carp was calculated to be approximately 52.70%. The serum biochemical indices including ALT and AST in experimental groups exhibited significant differences (P < 0.05) compared with the control group while ALB, ALP, TP, T-CHO, BUN, GRE, and GLU were not significantly different to the control group (P > 0.05). Briefly, EMB has the characteristic of quick absorption and slow elimination in crucian carp with a high bioavailability by PO route in crucian carp.

[Current status of influencing factors for postoperative anastomotic leakage in low rectal cancer]

The incidence of anastomotic leakage, a common and serious postoperative complication of low rectal cancer, remains high. Clarifying the risk factors for anastomotic leakage in patients with low rectal cancer after surgery can help guide clinical treatment and help patients improve their prognosis. The current literature suggests that the risk factors affecting the occurrence of anastomotic leakage after low rectal cancer include three aspects: (1) individual factors: male gender, high body mass index, malnutrition, smoking, alcoholism, and metabolic diseases; (2) tumor factors: the lower margin of tumor <5 cm from the anal verge, tumor diameter >2.5 cm, late tumor stage, high level of tumor markers and preoperative intestinal obstruction; (3) surgical factors: long operative time (>180 min), intraoperative bleeding (≥70 ml), more than 2 cartridges of stapling for anastomosis, contamination of the operative field, epidural analgesia and intraoperative hypothermia. Notably, the surgical approach (laparoscopic, open and hand-assisted laparoscopic surgery) was not a factor influencing the occurrence of postoperative anastomotic leakage in low rectal cancer. The findings on the effects of receiving neoadjuvant therapy, gut microbiota,intestinal bowel preparation, insufficient time for preoperative antibiotic prophylaxis, left colonic artery dissection, intraoperative blood transfusion, pelvic drainage, transanal drainage and combined organ resection, and postoperative diarrhea on postoperative anastomotic leakage in low rectal cancer are controversial. However, clinical workers can still take measures to reduce the risk of anastomotic leakage according to the above risk factors by making a good assessment before surgery, actively avoiding them during and after surgery, and taking measures for each step, so as to bring maximum benefits to patients.

[Health hazards and hearing loss risk assessment of workers exposed to noise in an automobile manufacturing enterprise]

Objective: To investigate the current situation of occupational exposure to noise among noise workers in an automobile manufacturing enterprise in Tianjin, understand the impact of noise on workers＇ nervous system and hearing, and assess the risk of hearing loss among noise workers. Methods: In May 2021, 3516 workers in an automobile manufacturing enterprise were investigated by using a self-made questionnaire＂Noise Workers Questionnaire＂ and cluster sampling method. The occupational noise hygiene survey and occupational hazards detection were carried out in their workplaces. They were divided into noise exposure group and non-noise exposure group according to whether they were exposed to noise or not. The general characteristics, hearing and nervous system symptoms of the two groups of workers were compared, and the risk of hearing loss was assessed. Results: There were 758 workers in the noise exposure group, aged (26±5) years old, with a working age of 3.0 (2.0, 6.0) years exposed to noise. 2758 workers in the non-noise exposure group, aged (25±6) years old, with a working age of 2.0 (1.0, 4.0) years. There were statistically significant differences in the distribution of workers＇education level, working age and memory loss between the two groups (χ(2)=37.98, 38.70, 5.20, P<0.05). The workers in the noise exposure group showed a decreasing trend of insomnia, dreaminess, sweating and fatigue with the increase of working age (χ(2trend)=6.16, 7.99, P<0.05). The risk classification of binaural high-frequency hearing loss for workers in all noise positions until the age of 50 and 60 was negligible, the risk of occupational noise deafness was low for workers in stamping and welding noise positions until the age of 60. Conclusion: The occupational noise exposed to automobile manufacturing workers may cause certain harm to their nervous and auditory systems. Noise protection measures should be taken to reduce the risk of hearing loss and occupational noise deafness.

[Real-world study on the efficacy and prognostic predictive biomarker of patients with metastatic non-small cell lung cancer treated with programmed death-1/programmed death ligand 1 inhibitors]

Objective: To describe the actual efficacy of programmed death-1 (PD-1)/ programmed-death ligand 1 (PD-L1) inhibitors in patients with metastatic non-small cell lung cancer (NSCLC) and explore potential prognostic predictive biomarkers. Methods: Patients with metastatic NSCLC who were treated with PD-1/PD-L1 inhibitors at Cancer Hospital, Chinese Academy of Medical Sciences from January 2016 to December 2019, either as monotherapy or in combination with other agents, were consecutively enrolled into this study. We retrospectively collected the data of demographics, clinical information and pathologic assessment to evaluate the therapeutic efficacy and conduct the survival analysis. Major endpoint of our study is progression-free survival (PFS). Secondary endpoints include objective response rate (ORR), disease control rate (DCR) and overall survival (OS). Results: The ORR of 174 patients who underwent PD-1/PD-L1 inhibitor was 28.7%, and the DCR was 79.3%. Immune-related adverse events (irAEs) occurred in 23 patients (13.2%). Brain metastasis, line of treatment, and treatment patterns were associated with the ORR of metastatic NSCLC patients who underwent immunotherapy (P<0.05). After a median follow-up duration of 18.8 months, the median PFS was 10.5 months (ranged from 1.5 to 40.8 months) while the median OS was not reached. The 2-year survival rate was estimated to be 63.0%. The pathologic type was related with the PFS of metastatic NSCLC patients who underwent immunotherapy (P=0.028). Sex, age, brain metastasis and autoimmune diseases were associated with OS (P<0.05). Analysis of the receptor characteristic curve (ROC) of neutrophil/lymphocyte ratio (NLR) predicting ORR of immunotherapy in metastatic NSCLC showed that the areas under the curve of NLR before immunotherapy (NLR(C0)), NLR after one cycle of immunotherapy (NLR(C1)) and ΔNLR were 0.600, 0.706 and 0.628, respectively. Multivariate logistic regression analysis showed that NLR(C1) was an independent factor of the ORR of metastatic NSCLC patients who underwent immunotherapy (OR=0.161, 95% CI: 0.062-0.422), and the efficacy of combination therapy was better than that of single agent (OR=0.395, 95% CI: 0.174-0.896). The immunotherapy efficacy in patients without brain metastasis was better than those with metastasis (OR=0.291, 95% CI: 0.095-0.887). Multivariate Cox regression analysis showed that NLR(C1) was an independent influencing factor of PFS of metastatic NSCLC patients after immunotherapy (HR=0.480, 95% CI: 0.303-0.759). Sex (HR=0.399, 95% CI: 0.161-0.991, P=0.048), age (HR=0.356, 95% CI: 0.170-0.745, P=0.006) were independent influencing factors of OS of metastatic NSCLC patients after immunotherapy. Conclusions: PD-1/PD-L1 inhibitors are proved to be efficacious and have tolerable toxicities for patients with metastatic NSCLC. Patients at advanced age could still benefit from immunotherapy. Brain metastasis is related to compromised response. Earlier application of immunotherapy in combination with other modalities enhances the efficacy without elevating risk of irAEs. NLR(C1) is an early predictor of clinical outcome. The OS of patients younger than 75 years may be improved when treated with immunotherapy.

[Noise exposure and its impact on health in an auto parts manufacturing enterprise]

Objective: To learn about the noise exposure and health status of workers and analyze factors that may affect the health outcomes of workers in an auto manufacturing enterprise in Tianjin City. Methods: In September 2020, occupational hygiene survey, noise exposure level detection and occupational health examination data collection were carried out in an auto parts manufacturing enterprise. Chi square test and unconditional logistic regression analysis were used to analyze the health effects of noise exposure and hearing loss of 361 noise exposure workers. Results: The rates of over-standard noise exposure, hearing loss and hypertension were 69.39% (34/49) , 33.24% (120/361) and 11.36% (41/361) , respectively. There were upward trends on age and noise-working years for hearing loss and hypertension rates (χ(2)=-5.95, -6.16, -2.81, -2.74, P<0.05) . Unconditional logistic regression analysis showed that age>35 years old, noise exposure length of service >10 years and noise L(EX, 8 h)>85 dB (A) were risk factors for hearing loss (OR=3.57, 95%CI: 1.09, 11.75; OR=4.05, 95%CI: 1.97, 8.25; OR=1.75, 95%CI: 1.00, 3.05; P=0.036, 0.001, 0.047) . Conclusion: This company has a high rate of job noise exceeding the standard, and noise-exposed workers have more serious hearing loss. Age, noise exposure and high noise exposure are risk factors for hearing loss.

An Investigation of Toxic Metal Levels (Pb, Cd, Cr, As, Hg) in Dried Porphyra and Laminaria Collected from Coastal Cities, China

This investigation was aimed at determining the concentration levels of five toxic heavy metals (lead, cadmium, chromium, arsenic, and mercury) in dried Porphyra and Laminaria samples from coastal city of China. Inductively coupled plasma-mass spectrometry (ICP-MS) was used for determination of lead, cadmium and total arsenic. Atomic fluorescence spectrometry was used for mercury, and liquid chromatography coupled with ICP-MS was used for arsenic speciation. The mean concentrations of lead, cadmium, chromium, total arsenic, and mercury were 0.96 ± 0.03 mg/kg, 2.62 ± 0.07 mg/kg, 1.64 ± 0.08 mg/kg, 36.67 ± 0.53 mg/kg, and 7.56 ± 0.42 μg/kg for Porphyra samples and 0.61 ± 0.03 mg/kg, 0.48 ± 0.02 mg/kg, 3.78 ± 0.56 mg/kg, 43.85 ± 1.42 mg/kg, and 46.61 ± 2.02 μg/kg for Laminaria samples. The results were comparable with previous similar research. The potential health risk assessment was conducted by comparing the calculated weekly intakes of toxic metals from Porphyra and Laminaria with provisional tolerable weekly intake. Consumption of these seaweeds does not seem to pose a risk for the consumers' health regarding their content of heavy metals. However, the potential health risk of cadmium should not be overlooked for consumers with high intake of Porphyra.

[Clinical diagnosis of alcoholic hepatitis in Tongliao City, Inner Mongolia]

Objective: To explore the current status of alcoholic hepatitis diagnosis by clinicians' in China. Methods: Clinical data of inpatients confirmed with alcohol-associated liver disease diagnosed at Tongliao Infectious Disease Hospital of Inner Mongolia from June 1, 2018 to May 31, 2019 were retrospectively analyzed. The consistency of clinical diagnosis of alcoholic hepatitis was judged according to the diagnostic criteria recommended by the National Institute of Alcohol Abuse and Alcoholism (USA), and then the alcoholic hepatitis severity assessment model recommended by international guidelines, including Maddrey discriminant function, Model for end-stage liver disease, and Glasgow alcoholic hepatitis score and ABIC scores (age, total bilirubin, international normalized ratio and creatinine) were applied to evaluate this group of cases. Results: Among 79 cases with alcohol-associated liver disease, 75 were males and 4 were females, age ranged between 27~75 (51.1±8.8) years. Alcohol consumption varied from 60 g/d to 600g/d, with an average consumption of 148.8 ± 76.6 g/d. The alcohol consumption duration ranged from 4 to 50 [average (23.9 ± 9.6)] years. According to the initial discharge diagnosis, there were 47 and 32 cases in alcoholic hepatitis and alcoholic liver cirrhosis group, respectively. The mean erythrocyte volume, serum alanine aminotransferase, aspartate aminotransferase and total bilirubin were increased in alcoholic liver cirrhosis than alcoholic hepatitis group, while albumin and total cholesterol were lowered in alcoholic liver cirrhosis than alcoholic hepatitis group, and coagulation indexes were significantly extended. Alpha-fetoprotein of both groups were in the normal range; however, it was significantly higher in the alcoholic hepatitis group than the alcoholic cirrhosis group. The 10 cases in the alcoholic cirrhosis group met the definition and diagnosis of alcoholic hepatitis defined by the National Institute of Alcohol Abuse and Alcoholism (USA), but there was no case in the alcoholic hepatitis group. Among the 10 diagnosed cases of alcoholic hepatitis, 5, 6, 1 and 3 cases met the diagnostic criteria of Maddrey discriminant function, Model for end-stage liver disease, Glasgow alcoholic hepatitis score, and ABIC score for severe alcoholic hepatitis, respectively. The Maddrey discriminant function, ABIC score, and Glasgow alcoholic hepatitis score within the Model for end-stage liver disease scores> 20 points had 5, 1, and 3 cases, respectively. Conclusion: Alcoholic hepatitis is over-diagnosed by clinicians. Alcoholic hepatitis patients have the base of liver cirrhosis who meet the diagnostic criteria of National Institute of Alcohol Abuse and Alcoholism (USA). Patients with Model for end-stage liver disease score > 20 points have good consistency with Maddrey discriminant function score ≥ 32 points, and both can be used to evaluate the alcoholic hepatitis patient clinical severity.

[Relationship between triglyceride-glucose index and non-alcoholic fatty liver disease]

Objective: To explore the relationship between triglyceride-glucose index (TyG) and non-alcoholic fatty liver disease (NAFLD). Methods: 25 535 cases who participated in the health check-ups at the First Hospital of China Medical University from January 2019 to December 2019 were selected as the eligible subjects. Logistic regression analysis and receiver operating characteristic curve were used to analyze the relationship between TyG index and NAFLD risk and its diagnostic value for NAFLD. Results: NAFLD prevalence was gradually increased with the increase of the TyG index. After adjusting for other potential influencing factors, compared with the first quarter of TyG in patient with NAFLD, the OR (95%CI) in the second, third, and fourth quarter were 1.677 (1.495 ~ 1.881), 2.707 (2.397 ~ 3.057) and 4.049 (3.482 ~ 4.710), respectively. Receiver operating characteristic curve analysis showed that the best cut-off value of TyG index for the diagnosis of NAFLD was 6.9, and the area under the curve was 0.816. The sensitivity and specificity were 77.66% and 70.51%, respectively. The combined application of TyG and ALT levels had higher diagnostic value. Conclusion: TyG, as a simple and convenient biosynthetic index, is closely related to the NAFLD. In addition, when the TyG index is ≥6.9, it has a high diagnostic value for NAFLD.

[Clinical and imaging characteristics of patients with primary cardiac angiosarcoma]

Objective: To investigate the clinical, cardiac imaging characteristics and prognosis of patients with primary cardiac angiosarcoma. Methods: The clinical data of 14 patients hospitalized with primary cardiac angiosarcoma from January 2001 to December 2017 in Peking Union Medical College Hospital were collected and analyzed. Metastatic cardiac angiosarcoma was not included in this study. Patients were followed up post discharge per telephone call or clinical visit. Results: Of the 14 patients, 8 were males and 6 were females, average age was 48 years. The main clinical symptoms were shortness of breath (8/14), hemoptysis (6/14), fever (5/14), chest pain (4/14) and cough (3/14). Imaging examinations showed that the tumors of 8 patients were located in the right heart and 6 in the pericardial cavity. Tumors in the right heart often infiltrate the atrial wall and cause pericardial effusion (7/8). Tumors in the pericardium were characterized by recurrent bloody pericardial effusion (6/6), prone to progressive constrictive pericarditis (3/6), pericardial fluid cytology was often negative (6/6). MRI showed heterogeneous high signal intensity (cauliflower aspect) on T2-weighted image and heterogeneous enhancement with a"sunray" aspect at the perfusion study. At the time of diagnosis, 8 patients developed lung or adrenal metastasis (8/14). The median survival was only 305 days. Conclusions: Primary cardiac angiosarcoma is a rare disease with non-specific clinical manifestation and poor prognosis. Imaging examinations may help diagnosis. The high invasiveness and the easy-to-metastasis feature of the tumor contribute to the poor prognosis of cardiac angiosarcoma.

[Dasatinib combined with multi-agent chemotherapy regimen in newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia: a prospective study from a single center]

目的

评价达沙替尼联合多药化疗方案在Ph染色体阳性急性淋巴细胞白血病（Ph⁺ ALL）患者中的疗效及安全性。

方法

前瞻性、单臂、开放的临床研究。2016年1月至2018年4月中国医学科学院血液病医院收治的30例初诊成人Ph⁺ ALL患者入组。采用多药化疗方案，标准诱导化疗为期4周，自诱导化疗第8天开始口服达沙替尼（商品名依尼舒，正大天晴药业集团股份有限公司产品）100 mg/d，持续应用至整体治疗结束。有条件和意愿进行移植者，可进行异基因造血干细胞移植或自体造血干细胞移植。

结果

所有30例患者在诱导治疗4周后均达到血液学完全缓解（HCR），累积完全分子学反应（MCR）率为70.0％（21/30）。中位随访时间为37.8（32.0～46.6）个月。3年总生存（OS）率为68.1％，3年无血液学复发生存（HRFS）率为61.6％。63.3％的患者在治疗3个月时达到主要分子学反应（MMR）（其中有43.3％患者达到MCR）。6个月时60.0％的患者达到MCR，达到MCR的患者具有更好的OS（P＝0.004）、HRFS（P＝0.049）和EFS（P＝0.001）。15例（50.0％）患者在第1次HCR期内进行移植，移植组患者HRFS（P＝0.030）和EFS（P＝0.010）优于化疗组。

结论

达沙替尼联合多药化疗方案治疗初诊Ph⁺ALL安全有效。

临床试验注册

ClinicalTrials.gov，NCT02523976。

[Anatomical study on the feasibility of a new self-guided pedicle tap]

OBJECTIVE

To evaluate the accuracy and safety of pedicle screw placement using a new self-guided pedicle tap.

METHODS

According to the anatomical characteristics of the pedicle, a new self-guided pedicle tap was developed. Six adult spinal specimens including 4 males and 2 females were selected and tapped thread on the right and left sides of each pair of pedicles from the same segment T₁ to L₅ with traditional taps (control group) and new self-guided pedicle taps (experimental group), respectively. And the pedicle screws were placed. The screwing time was recorded and compared between two groups. CT scanning was completed to observe the accuracy and safety of the screw placement according to the Heary classification of imaging results.

RESULTS

The screwing time of thoracic and lumbar vertebrae in the experimental group were (5.87±1.25) min and(5.45±1.67) min, respectively. While those in the control group were (6.12±1.69) min and (6.22±2.13) min, respectively. Then there was no significant difference in screwing time of thoracic and lumbar vertebrae between two groups (P>0.05). The Heary grade of the pedicle screw showed that Heary gradeⅠand Heary gradeⅠ+Ⅱwere respectively 86 (84.31%) and 96 (94.12%) in the experimental group, 72 (71.29%) and 84 (83.17%) in control group, and the difference between two groups was statistically significant (P<0.05).

CONCLUSION

The new self-guided pedicle tap can accurately and safely insert the thoracolumbar pedicle screw, with low cost, easy operation, and good clinical application value.

[Clinical analysis of 30 patients with atypical glandular hyperplasia or malignant transformation in foci of adenomyosis]

Objective: To explore the clinical characteristics of patients with pre-malignant or malignant transformation in ectopic endometrium of adenomyosis. Methods: A retrospective study was performed on 4 818 patients received surgical treatment in Peking Union Medical College Hospital and pathologically confirmed as adenomyosis from January 2010 to October 2016. The clinical features and prognosis of 30 patients among these with pre-malignant or malignant transformation in ectopic endometrium were reviewed. Results: A total of 4 818 patients pathologically diagnosed with adenomyosis. Among these,30 (0.62%,30/4 818) patients were diagnosed with pre-malignant or malignant transformation in foci of adenomyosis, including 16 (0.33%, 16/4 818) of atypical endometrial hyperplasia and 14 (0.29%, 14/4 818) of endometrioid carcinoma. The average age of 30 patients was (50.8±3.0) years (range: 27-65 years). Patients with atypical hyperplasia in foci of adenomyosis coexist with 13 cases of endometrioid carcinoma in situ, 1 case of borderline serous papilloma in eutopic endometrium, 1 case of atypical hyperplasia in eutopic endometrium, and 1 case of normal eutopic endometrium. Fourteen patients with endometrioid carcinoma in foci of adenomyosis coexist with endometrioid carcinoma in situ. Among the 27 patients with pre-malignant or malignant transformation in adenomyosis and coexisting with endometrioid carcinoma in situ, 23 of them were in International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰa (85%, 23/27), 2 in stage Ⅰb (7%, 2/27), and 2 in stage Ⅲa (7%, 2/27). Seven percent (2/27) of patients had deep myometrial infiltration, and 7% (2/27) of patients had lymphovascular space invasion. The median follow-up time was 60 months (range: 32-104 months), and there were no recurrence or death. Conclusions: The incidence of atypical glandular hyperplasia or malignant transformation in foci of adenomyosis is rare, and it may be closely related to endometrial disease in situ. Pre-malignant or malignant change in foci of adenomyosis seems not to increase the risk of deep myometrial invasion, lymphovascular space invasion, and recurrence or mortality in patients of adenomyosis with endometrial adenocarcinoma.

[Rituximab combined with short-course and intensive regimen for Burkitt leukemia: efficacy and safety analysis]

目的

探讨利妥昔单抗联合短疗程、高强度方案治疗成人Burkitt白血病患者的疗效和安全性。

方法

收集2006年1月30日至2018年9月12日中国医学科学院血液病医院收治的11例Burkitt白血病患者病例资料，分析统计患者的临床特征、完全缓解（CR）率、总生存率、无复发生存率及不良事件。

结果

11例患者中位年龄34（15~54）岁，其中男6例，女5例。发病时中位WBC 12.28（2.21~48.46）×10⁹/L，HGB 113（74~147）g/L，PLT 35（13~172）×10⁹/L，乳酸脱氢酶2 721（803~17 370）U/L，外周血中位原始细胞比例0.40（0.03~0.76），骨髓中位原始细胞比例0.840（0.295~0.945）。10例患者接受利妥昔单抗联合短疗程、高强度化疗，其中2例患者巩固化疗后行自体造血干细胞移植。所有治疗患者1个疗程CR率为100%，4年总生存率为90%，4年无复发生存率为90%。所有治疗患者中，只有1例患者在诱导化疗中出现肿瘤溶解综合征，经血液透析等治疗后肾功能恢复。无治疗相关性死亡病例。

结论

利妥昔单抗联合短疗程、高强度方案治疗成人Burkitt白血病疗效及安全性均较为理想。

[Discussion on the curative effect and mechanisms of berberine in rats with non-alcoholic fatty liver]

Objective: To observe the curative effects of berberine in rats with high-fat diet induced non-alcoholic fatty liver and to further explore its possible mechanism. Methods: Twenty-six Sprague-Dawley rats (120-160 g) were randomly divided into 3 groups: control group (n = 8), model group (n = 10) and treatment group (n = 8). Rats in the control group were fed with regular diet, and the model group and the treatment group were fed a high-fat diet. At the 12th week, two rats in the in the model group were sacrificed to verify whether model was successful established. Subsequently, treatment group rats were given a gavage of berberine at a dose of 150 mg·kg(-1)·d(-1) for 4 weeks, and the control and the model group rats were given the same dose of normal saline. Rats were sacrificed at week 16th. HE staining was used to observe the changes in the intestinal mucosa of rats. Sudan black B staining was used to observe the fatty changes in liver. Immunohistochemical staining was used to observe the expression level of occludin protein in the intestinal epithelium. A real-time 16S rDNA PCR method was used to measure the number of escherichia coli, bacteroides and faecalibacterium prausnitzii in the feces of rats. Results: Model group had a higher serum levels of endotoxin (0.288 ± 0.045) and tumor necrosis factor (TNF)-α (1.07 ± 0.11) than the control group (0.192 ± 0.049, 0.94 ± 0.07) (P < 0.05). Berberine intervention had significantly reduced endotoxin (0.213 ± 0.025) and TNF-α level (0.93 ± 0.07) (P < 0.05). The expression level of occludin protein was significantly lower in the intestinal mucosa of model group than that of control group (0.166 ± 0.014), and berberine had promoted the expression of occludin protein in intestinal mucosa (0.055 ± 0.009), but the difference was not statistically significant (P > 0.05). At the same time, compared with the model group (7.29 ± 0.47), the number of bacteroidetes in the control group (9.49 ± 0.59) was decreased, while the number of bacteroidetes in the treatment group was increased (9.77 ± 0.87). The number of escherichia coli (6.92 ± 0.77) and faecalibacterium prausnitzii (8.70 ± 0.62) in the model group were increased than control group (5.42 ± 0.63, 9.49 ± 0.59), while the number of escherichia coli (6.34 ± 0.71) and faecalibacterium prausnitzii (9.77 ± 0.87) (P < 0.05) was reduced with the intervention of berberine. Conclusion: Berberine could effectively protect the intestinal barrier function in rats with NAFLD and the possible mechanism of action behind it may be the regulation of intestinal flora.

[Application of absorbable hemostatic fluid gelatin in anterior cervical subtotal vertebral resection and fusion]

OBJECTIVE

To explore the hemostatic effect of absorbable hemostatic fluid gelatin in single anterior cervical subtotal corpectomy and decompression fusion (ACCF) .

METHODS

From August 2014 to February 2018, 44 patients with single anterior cervical corpectomy decompression and fusion were selected and divided into two groups：22 cases in experimental group including 10 males and 12 females with an average age of (55.6±9.7) years old, were treated by hemostasis with absorbable hemostasis fluid gelatin; 22 cases in control group including 11 males and 11 females with an average age of (54.4± 11.1) years old were treated by hemostasis with traditional hemostasis method. The operation time, decompression time, intraoperative hemorrhage, postoperative negative pressure drainage, postoperative neurological improvement rate (JOA%) , postoperative bone fusion time, postoperative titanium mesh subsidence rate, postoperative hematoma and other postoperative complications were compared between the two groups.

RESULTS

The operative time of the experimental group (83.1±19.2) min was significantly shorter than that of the control group (89.5±17.0) min (P<0.05) ; the decompression time of the spinal canal in the two groups was (52.4±13.7) , (56.1±14.6) min, with a statistically significant difference (P=0.001) ; the amount of bleeding in the two groups was (49.9±12.4) , (90.6±36.7) ml, with a statistically significant difference (P<0.05) ; the total amount of drainage in the negative pressure drainage ball after operation in the two groups was (42.5±18.3) , (60.0±22.8) ml, the difference was statistically significant (P<0.05) . There was no statistically significant difference in the improvement rate of nerve function between the two groups at 1 week after operation, and the improvement rate of nerve function in the experimental group was better than that in the control group at 3 and 6 months after operation. In the two groups, bone fusion was obtained 6 months after operation, no obvious titanium mesh subsidence was found in 3 months after operation, no acute hematoma, CSF leakage and other postoperative complications were found.

CONCLUSION

Absorbable hemostatic fluid gelatin has a significant hemostatic effect in ACCF operation, can maintain a good operation field, can reduce the decompression time of spinal canal, reduce the amount of bleeding during operation and the amount of bleeding after operation. It is a more effective and safe hemostatic material than the traditional hemostatic method.

[Interpretation of the guidelines for multidisciplinary treatment of epistaxis of the British Academy of Rhinology]

SummaryEpistaxis is a common condition that can be associated with significant morbidity, and it places a considerable burden on our healthcare system. In China, a draft guidelines for diagnosis and treatment of epistaxis was released in 2015. In UK, a national audit of management for epistaxis was promulgated in 2016, followed by multidisciplinary consensus recommendations on the hospital management of epistaxis in 2017. Here, we compared the management of diagnosis and treatment for epistaxis between China and UK in five clinical aspects, including initial assessment, cautery, intranasal agents, antithrombotic therapy and hematological factors, as well as surgery and radiological intervention. The results demonstrate that the management recommendations in UK combined a wide-ranging review of the relevant literature with established and rigorous methods of guideline generation, while the guidelines in China is more specific on the procedures of diagnosis and treatment for epistaxis. The current discussion provides perspectives to improve the guidelines for epistaxis in China.

[Myeloid/lymphoid neoplasms with eosinophilia and FGFR1 rearrangement: 5 cases report and literatures review]

目的

分析罕见疾病伴嗜酸性粒细胞增多和FGFR1重排的髓系/淋系肿瘤（即8p11骨髓增殖综合征，EMS）的临床特征、诊断及治疗。

方法

总结中国医学科学院血液病医院2014年1月至2018年5月收治的5例确诊EMS患者的临床表现、实验室特征、诊治经过及转归。

结果

5例EMS患者外周血白细胞计数均明显升高，伴有嗜酸性粒细胞绝对值增高（均值18.89×10⁹/L）；骨髓髓系极度增生，原始细胞均<5%，嗜酸性粒细胞比例增高（均值17.24%）。5例患者染色体核型各不相同，但FISH检查均存在FGFR1基因重排。发病至确诊平均时间为4.8个月，中位生存期仅14个月。

结论

EMS是一种罕见病，恶性程度高，对常规化疗反应差，生存期短，且易发生误诊漏诊，细胞遗传学及分子生物学检查有助于早期诊断。

[A single-center, randomized controlled trial of PEG-rhG-CSF and common rhG-CSF to promote neutrophil recovery after induction chemotherapy in newly diagnosed acute myeloid leukemia]

目的

比较初诊急性髓系白血病（AML）患者诱导化疗后骨髓抑制期应用聚乙二醇化重组人G-CSF（PEG-rhG-CSF）与普通重组人G-CSF（rhG-CSF）促进中性粒细胞或白细胞恢复的时间。同时比较两种药物对患者感染发生率、住院时间的影响。

方法

采用前瞻性随机对照研究方法，将2014年8月至2017年12月间符合入组条件的初诊AML患者诱导治疗后按1∶1比例随机分成两组：PEG-rhG-CSF组和rhG-CSF组。对比分析两组患者中性粒细胞计数（ANC）或WBC恢复时间、感染发生率和住院时间。

结果

共入组初诊AML患者60例，PEG-rhG-CSF组30例，rhG-CSF组30例。两组患者除性别构成外，在年龄、化疗方案、化疗前ANC、WBC、诱导化疗疗效方面差异均无统计学意义（P值均>0.05）。PEG-rhG-CSF组患者与rhG-CSF组患者的ANC、WBC恢复中位时间分别为19（14~35）d、19（15~26）d，差异无统计学意义（t=0.580，P=0.566）。PEG-rhG-CSF组、rhG-CSF组患者骨髓抑制期感染的发生率分别为90.0%、93.3%，差异无统计学意义（P=1.000）。两组患者的中位住院时间分别为20.5（17~49）d、21（19~43）d，差异无统计学意义（P=0.530）。

结论

AML患者诱导治疗后应用PEG-rhG-CSF与rhG-CSF无论在ANC或WBC恢复时间，还是在感染的发生率及住院时间均相当。

[Therapeutic effect and imaging study of directional bone cement guide for the treatment of thoracolumbar vertebral compression fractures]

OBJECTIVE

To evaluate the therapeutic effects and bone cement distribution of unilateral percutaneous kyphoplasty (PKP) with oriented bone cement injector for thoracolumbar osteoporotic vertebral compression fractures (OVCFs).

METHODS

The clinical data of 211 patients (211 vertebrae) with thoracolumbar osteoporotic compression fractures underwent PKP between July 2016 to July 2018 were retrospectively analyzed. All punctures were performed unilaterally:102 patients in observation group used oriented bone cement injector including 30 males and 72 females with an average age of (68.4±8.9)years old; 109 patients in regular group used traditional bone cement injector including 32 males and 77 females with an average age of (70.4±9.2) years old. The two groups were compared in terms of duration of operation, cement volume, visual analogue scale(VAS), Oswestry Disability Index(ODI), distribution of bone cement, bone cement leakage and Cobb angle modified rate.

RESULTS

There were no significant difference in gender, age and fracture vertebra between the two groups(P>0.05). No significant difference was found between two groups in duration of operation, cement volume, VAS, ODI and Cobb angle(P>0.05). In observation group, 10 cases occurred cement leakages, with leakage rate of 9.80%; and in regular group, 11 cases occurred cement leakage, with leakage rate of 10.09%. There was no significant difference in the cement leakage rate between two groups(P>0.05). In observation group, proportion rate of I-IV degree in cement distribution was 60.78%, 19.61%, 9.80%, 9.80%, respectively; while 39.45%, 22.93%, 22.93%, 14.68% in regular group. The I degree of cement cross-filling rate was better in observation group than in regular group(P<0.05). There was no significant difference between two groups in II degree distribution rate of bone cement(P>0.05). From T10 to L₅, I degree bone cement distribution rate of both groups showed decline trend. The I degree cement cross-filling rate in L₁-L₅ was 50% in observation group and 30.23% in regular group(P<0.05).

CONCLUSIONS

Oriented bone cement injector can control the direction of bone cement dispersion and achieve effective distribution of bilateral bone cement using unilateral puncture and satisfactory surgical results. It is feasible and effective for unilateral PKP treatment of OVCFs.

[The preliminary study on the combined application model of serum miRNAs in the diagnosis of pneumoconiosis]

Objective: To explore the role of serum microRNA (miRNAs) levels in the detection of pneumoconiosis, and to establish a combined application model of multiple serums miRNAs for pneumoconiosis diagnosis. Methods: 152 cases were selected in the case group and the control group respectively. The TaqMan Low Density Array method was used to screen out the candidate miRNAs for early screening of pneumoconiosis, and RT-qPCR was used to verify. According to the area under the curve (AUC) , the sensitivity and specificity of the candidate indicators were investigated. The logistic regression model was established by the two-class logistic regression model. Results: The expression of 7 candidate miRNAs in the serum of pneumoconiosis patients was significantly different (P<0.05) . The receiver operating curve (ROC) of the above 7 miRNAs was analyzed, miRNA-21, miRNA-200c, miRNA-16, miRNA-206, miRNA-155, miRNA-29a had statistical significance, and their ROC-AUC is 0.629~0.932. Logistic regression model was: logitP=13.769+0.536×miRNA-21-0.878×miRNA-200C-0.012×miRNA-16-0.111×miRNA-206+0.117×miRNA-155-1.192×miRNA-29a. Conclusion: Multiple serum miRNAs combined application models may be used for the diagnosis of pneumoconiosis patients.

Polaronic effect in the x-ray absorption spectra of La1-x Ca x MnO3 manganites

X-ray absorption spectroscopy (XAS) is performed to study changes in the electronic structures of colossal magnetoresistance (CMR) and charged ordered (CO) La_1-x Ca _x MnO₃ manganites with respect to temperature. The pre-edge features in O and Mn K-edge XAS spectra, which are highly sensitive to the local distortion of MnO₆ octahedral, exhibit contrasting temperature dependence between CMR and CO samples. The seemingly counter-intuitive XAS temperature dependence can be reconciled in the context of polarons. These results help identify the most relevant orbital states associated with polarons and highlight the crucial role played by polarons in understanding the electronic structures of manganites.

[Impact of duration of antibiotic therapy on the prognosis of patients with acute myeloid leukemia who had Gram-negative bloodstream infection in consolidation chemotherapy]

目的

分析巩固化疗期间伴发革兰阴性菌（G⁻菌）血流感染的急性髓系白血病（AML）患者抗感染疗程对感染转归的影响。

方法

回顾性分析2010年9月至2016年1月入组“依据危险度分层对急性髓系白血病优化治疗的研究”临床试验的591例AML（非急性早幼粒细胞白血病）患者的血流感染资料，将其中巩固化疗期间发生G⁻菌血流感染且持续发热时间<7 d的114例次血流感染（89例患者）纳入研究，分析抗感染疗程对感染转归的影响。

结果

114例次血流感染发生时，患者中位ANC为0（0~5.62）×10⁹/L，中性粒细胞缺乏（粒缺）持续的中位时间为9（3~26）d，抗感染治疗的中位时间为7（4~14）d。抗感染疗程≤7 d与>7 d组比较，停药后3 d内再发热比例、再次发生相同菌株血流感染比例分别为1.2%对3.0%、18.5%对21.2%，差异均无统计学意义（P=0.522，OR=0.400，95%CI 0.024~6.591；P=0.741，OR=0.844，95%CI 0.309~2.307）。同时，两组患者均未发生7 d及30 d内感染相关死亡。且倾向性评分平衡患者特征及用药差异因素后，抗感染疗程≤7 d较>7 d组再次发生相同菌株血流感染比例仍无明显增高（P=0.525，OR=0.663，95%CI 0.187~2.352）。

结论

对于巩固化疗期间伴发G⁻菌血流感染的AML患者，若发热时间<7 d，敏感抗菌药物治疗7 d后停药并不增加停药后3 d内再发热，粒缺期再次出现相同菌株血流感染及感染相关7 d、30 d内死亡风险。提示短疗程抗感染方案可以成为巩固化疗伴发G⁻菌血流感染AML患者感染控制情况下合理的治疗选择。

Analysis of Genetic Polymorphism and Genetic Distance of 19 Autosomal STR Loci in Jiangsu Han Population

OBJECTIVES

To investigate the distribution of alleles in 19 autosomal short tandem repeat （STR） loci in Jiangsu Han population.

METHODS

Goldeneye^® 20A kit was used to detect 9 025 samples. Genetic analysis was performed on typing data of 19 autosomal STR loci, and genetic distance with other 17 populations was analyzed.

RESULTS

All the 19 autosomal STR loci were consistent with the Hardy-Weinberg equilibrium （P>0.05）, with the heterozygosity 0.616 1-0.916 3, probability of match 0.012 8-0.202 6, discrimination power 0.797 4-0.987 2, probability of paternity exclusion 0.310 8-0.828 8, and polymorphic information content 0.561 7-0.913 6. The cumulative discrimination power and cumulative probability of exclusion were 0.999 999 999 999 999 998 434 1 and 0.999 999 989, respectively. The Jiangsu Han population had close genetic distances with the Han population in Tianjin, Hunan and Jilin, and significant difference with Han population in Aletai region in Xinjiang （P<0.05）.

CONCLUSIONS

The STR allele polymorphism data and population genetic parameters of Jiangsu Han population can provide data support for the forensic application of these STR loci in Jiangsu Han population.

[Expression of C-fos in nasopharyngeal carcinoma and the relationship with chemosensitivity and prognosis]

Objective:To investigate the expression of C-fos in patients with nasopharyngeal carcinoma(NPC), and analyze the relationship between the expression of C-fos and the clinical characteristics, chemosensitivity and prognosis. Method:Clinical and follow-up data of 75 NPC patients was analyzed retrospectively. The expression of C-fos was detected by immunohistochemical assay, and chemosensitivity was detected by ATP bioluminescent anticancer drug sensitivity detection technology. The relationship between them was studied.Result:The expression of C-fos in NPC was statistically higher than that in the control nasopharyngeal mucosa(P<0.001). It was found that C-fos had no statistical relationship with the gender, age, pathologic type, clinical stage of tumor classification, lymph node status, metastasis status and overall stage of NPC patients(P>0.05). NPC had different chemosensitivity with 8 anticancer drugs(P<0.001).There was a significant difference in chemosensitivity of paclitaxel between the high expression of C-fos group and the low expression of C-fos group(P=0.036). The rate of tumor progression was significantly higher in NPC patients with high expression of C-fos than in the low expression group(P=0.014).There was no significant difference in overall survival between the two groups(P=0.076). Conclusion:C-fos is highly expressed in NPC tissues, and the high expression of C-fos in NPC tissues may be related to tumor progression and resistance to paclitaxel.

[Primary antifungal prophylaxis with posaconazole plays a pivotal role during chemotherapy of acute myeloid leukemia]

Objective: To evaluate the incidence of invasive fungal infections (IFI) and usage of intravenous antifungal drugs during remission induction chemotherapy in patients with acute myeloid leukemia (AML) under primary antifungal prophylaxis with posaconazole. Methods: Clinical records from newly diagnosed AML patients above 15 years old in one single center from February 2014 to January 2016 were retrospectively reviewed and analyzed, excluding acute promyelocytic leukemia. The incidence of IFI and usage of intravenous antifungal drugs were investigated between control group (not receiving any broad spectrum antifungal prophylaxis) and treatment group (receiving posaconazole as primary prophylaxis). Results: A total of 147 newly diagnosed AML patients were enrolled. Of them, 81 received prophylaxis with posaconazole, and 66 did not receive broad-spectrum antifungal treatment. 7 IFI occurred in posaconazole group, and all were possible cases; 19 IFI occurred in control group (3 proven, 4 probable, 12 possible). The incidence of IFI was significantly lower in treatment group than that in control group (8.6% vs 28.8%, χ(2)=10.138, P=0.001). Usage of intravenous antifungal drugs was significantly decreased in posaconazole group (18.5% vs 50.0%, χ(2)=16.390, P<0.001). Conclusion: Prophylaxis with posaconazole coulf prevent IFI and reduce usage of intravenous antifungal drugs significantly during remission induction chemotherapy in AML patients.

Progression-dependent transport heterogeneity of breast cancer liver metastases as a factor in therapeutic resistance

Metastatic disease is a major cause of mortality in cancer patients. While many drug delivery strategies for anticancer therapeutics have been developed in preclinical studies of primary tumors, the drug delivery properties of metastatic tumors have not been sufficiently investigated. Therapeutic efficacy hinges on efficient drug permeation into the tumor microenvironment, which is known to be heterogeneous thus potentially making drug permeation heterogeneous, also. In this study, we have identified that 4 T1 liver metastases, treated with pegylated liposomal doxorubicin, have unfavorable and heterogeneous transport of doxorubicin. Our drug extravasation results differ greatly from analogous studies with 4 T1 tumors growing in the primary site. A probabilistic tumor population model was developed to estimate drug permeation efficiency and drug kinetics of liver metastases by integrating the transport and structural properties of tumors and delivered drugs. The results demonstrate significant heterogeneity in metastases with regard to transport properties of doxorubicin within the same animal model, and even within the same organ. These results also suggest that the degree of heterogeneity depends on the stage of tumor progression and that differences in transport properties can define transport-based tumor phenotypes. These findings may have valuable clinical implications by illustrating that therapeutic agents can permeate and eliminate metastases of "less resistant" transport phenotypes, while sparing tumors with more "resistant" transport properties. We anticipate that these results could challenge the current paradigm of drug delivery into metastases, highlight potential caveats for therapies that may alter tumor perfusion, and deepen our understanding of the emergence of drug transport-based therapeutic resistance.

Factor V Leiden and Thermolabile Methylenetetrahydrofolate Reductase in Extreme Old Age

Both factor V Leiden and the C677T methylenetetrahydrofolate reductase (MTHFR) gene mutation are associated with premature vascular disease, and yet are found at surprisingly high allele frequencies in European populations, 2.7% and 35% respectively. We have investigated the prevalence of these mutations in 87 UK residents over the age of ninety, to look for any evidence of their association with premature death.

Five factor V Leiden heterozygotes were found, giving an allele frequency of 2.9%, similar to that in the general UK population. The frequency of the thermolabile C677T MTHFR mutation was 36% with 11% homozygotes, again similar to that in the UK population; these genotypes are in Hardy-Weinberg equilibrium, suggesting that there is not strong selection against the homozygous state. One person was both heterozygous for factor V Leiden and homozygous for the C677T mutation. This study suggests that neither factor V Leiden nor thermolabile MTHFR are risk factors for premature death.

Quadrichromatic LED based mobile phone camera visible light communication

A quadrichromatic light-emitting diode (QLED) based visible light communication for mobile phone camera is proposed to improve data rate and enhance illumination effect at the same time. Different from color intensity modulation (CIM), we propose and use color ratio modulation (CRM) in CMOS image sensor based visible light communication to improve data rate. According to the spectral power distribution (SPD) of the QLED and the spectral response of the complementary-metal-oxide-semiconductor (CMOS) image sensor, color multiple-input multiple-output (CMIMO) channel model is set up first to obtain optimal 16-CRM constellation design. Taking full consideration of the high quality of color rendering index (CRI), tunable color temperature (CT), we design a specific data packet structure to realize illumination requirements. A decoding strategy is also addressed for demapping at the receiver. The experimental results demonstrate that the proposed scheme can realize a downlink data rate of 13.2kbit/s, meanwhile, the optical signal source is illumination compatible.

Kinetics and equilibrium adsorption study of selenium oxyanions onto Al/Si and Fe/Si coprecipitates

Inappropriate treatments for the effluents from semiconductor plants might cause the releases and wide distributions of selenium (Se) into the ecosystems. In this study, Al/Si and Fe/Si coprecipitates were selected as model adsorbents as they often formed during the wastewater coagulation process, and the removal efficiency of selenite (SeO₃) and selenate (SeO₄) onto the coprecipitates were systematically examined. The removal efficiency of SeO₃ and SeO₄ was highly related to surface properties of Al/Si and Fe/Si coprecipitates. The surface-attached Al shell of Al/Si coprecipitates shielded a portion of negative charges from the core SiO₂, resulting in a higher point of zero charge than that of Fe/Si coprecipitates. Thus, adsorption of SeO₃/SeO₄ was favorable on the Al/Si coprecipitates. Adsorptions of both SeO₃ and SeO₄ on Al/Si coprecipitates were exothermic reactions. On Fe/Si coprecipitates, while SeO₃ adsorption also showed the exothermic behavior, SeO₄ adsorption occurred as an endothermic reaction. The kinetic adsorption data of SeO₃/SeO₄ on Al/Si and Fe/Si coprecipitates were described well by the pseudo-second-order kinetic model. SeO₄ and SeO₃ adsorption on Fe/Si or Al/Si were greatly inhibited by the strong PO₄ ligand, whereas the weak ligand such as SO₄ only significantly affected SeO₄ adsorption. The weakest complex between SeO₄ and Al was implied by the essentially SeO₄ desorption as SeO₄/PO₄ molar ratios decreased from 0.5 to 0.2. These results were further confirmed by the less SeO₄ desorption (41%) from Fe/Si coprecipitates than that from Al/Si coprecipitates (78%) while PO₄ was added sequentially.

[Establishment of β-aminopropionitrile-induced aortic dissection model in C57Bl/6J mice]

Objective: To establish the mouse aorta dissection (AD) model through drinking water containing β-aminopropionitrile (BAPN). Methods: Forty 3-week-old C57B1/6J male mice were divided into four groups according to randomized block design: control, 0.2, 0.4 and 0.8 g·kg(-1)·d(-1) BAPN groups (dissolving respective dose of BAPN in the drinking water, n=10 each group). Arterial systolic blood pressure and heart rate were measured weekly in conscious, restrained mice using a noninvasive computerized tail-cuff system. Mice those died of rupture of aortic dissecting aneurysm during the study were autopsied and the aorta was examined. After 4 weeks, survived mice were sacrificed by an overdose of sodium pentobarbital and the whole aorta was harvested and analyzed. Results: The incidence of AD and the mortality of ruptured AD was 0 and 0 in control group, 30% (3/10) and 20% (2/10) in 0.2 g·kg(-1)·d(-1) BAPN group, 50% (5/10) and 40% (4/10) in 0.4 g·kg(-1)·d(-1) BAPN group, 90% (9/10) and 70% (7/10) in 0.8 g·kg(-1)·d(-1) BAPN group (both P<0.05 vs. control group). The incidence of AD and the mortality of ruptured AD increased in proportion to BAPN concentration increase. In 0.8 g·kg(-1)·d(-1) BAPN group, 7 mice died of dissecting aneurysm rupture during the experiment, among which 5 dissecting aneurysms were mainly located in the thoracic aorta and 2 dissecting aneurysms in abdominal aorta. The diameters of thoracic aorta and abdominal aorta were (1.38±0.19) and (1.23±0.13) mm in control group, (2.43±1.56) and (1.30±0.26) mm in 0.2 g·kg(-1)·d(-1) BAPN group, (2.45±1.28) and (1.30±0.31) mm in 0.4 g·kg(-1)·d(-1) BAPN group, (2.87±0.57) and (1.95±0.81) mm in 0.8 g·kg(-1)·d(-1) BAPN group (both P<0.05 vs. control group). The diameters of thoracic aorta and abdominal aorta in mice also increased in proportion with BAPN concentration increase. Furthermore, blood-filled false lumen formation and elastic fibers fragmentation were evidenced in hematoxylin-eosin stained and Vitoria blue-Sirius red stained aortic cross-sections of mice in the 0.8 g·kg(-1)·d(-1) BAPN group. Conclusion: BAPN treatment induced aortic dissection model in C57Bl/6J mice can serve as a useful wild-type mouse model for the mechanism and pharmaceutical studies of AD.

[Comparison of Bacteria ERIC-PCR Fingerprints of Index Fingers and Contactants]

OBJECTIVES

To explore the bacteria relevance between index fingers and contactant' surfaces （mobile phone touch screen and desktop of personal office table）.

METHODS

Bacteria were collected from the index fingers, mobile phone touch screen and desktop of personal office table of 10 volunteers. Enterobacterial repetitive intergenic consensus （ERIC）-PCR fingerprint was established by PCR amplification technique of metagenome.

RESULTS

There were 7 volunteers' ERIC-PCR fingerprints of index fingers matched that took from the mobile phone touch screens, and different from each other. There were 3 volunteers' ERIC-PCR fingerprints of index fingers matched that took from desk top of personal office table, and other 7 volunteers' ERIC-PCR fingerprints did not match perfectly with that took from desk top of personal office table, but had at least one similar band for both.

CONCLUSIONS

The bacteria on index finger shows individual specificity, which on mobile phone touching screen and personal desktop may be a new biological sample of forensic identification.

[Characteristics and prognosis in adult acute myeloid leukemia patients with MLL gene rearrangements]

Objective: To analyze the clinical and laboratory characteristics, and prognosis of adult acute myeloid leukemia (AML) patients with MLL gene rearrangements. Methods: The medical records of 92 adult AML patients with MLL gene rearrangements from January 2010 to December 2016 were retrospectively analyzed. Results: 92 cases (6.5%) with MLL gene rearrangements were identified in 1 417 adult AML (Non-M(3)) patients, the median age of the patients was 35.5 years (15 to 64 years old) with an equal sex ratio, the median WBC were 21.00(0.42-404.76)×10(9)/L, and 78 patients (84.8%) were acute monoblastic leukemia according to FAB classification. Eleven common partner genes were detected in 32 patients, 9 cases (28.1%) were MLL/AF9(+), 5 cases (15.6%) were MLL/AF6(+), 5 cases (15.6%) were MLL/ELL(+), 2 cases (6.3%) were MLL/AF10(+), 1 case (3.1%) was MLL/SETP6(+), and the remaining 10 patients' partner genes weren't identified. Of 92 patients, 83 cases with a median follow-up of 10.3 (0.3-74.0) months were included for the prognosis analysis, the complete remission (CR) rate was 85.5% (71/83), the median overall survival (OS) and relapse free survival (RFS) were 15.4 and 13.1 months, respectively. Two-year OS and RFS were 36.6% and 29.5%, respectively. Of 31 patients underwent allogeneic hematopoietic stem-cell transplantation (allo-HSCT), two-year OS and RFS for patients received and non-received allo-HSCT were 57.9% and 21.4%, 52.7% and 14.9%, respectively (P<0.001). Among patients with partner genes tested, 9 of 32 cases (28.1%) were MLL/AF9(+), the median follow-up was 6.0(4.1-20.7) months. 3 patients with MLL/AF9 underwent allo-HSCT. 23 cases (71.9%) were non- MLL/AF9(+), the median follow-up was 7.8 (0.3-26.6) months. 14 patients (60.1%) with non-MLL/AF9 underwent allo-HSCT. One-year OS for patients with MLL/AF9 and non-MLL/AF9 were 38.1% and 55.5%, respectively (P=0.688). Multivariate analysis revealed that high WBC (RR=1.825, 95% CI 1.022-3.259, P=0.042), one cycle to achieve CR (RR=0.130, 95% CI 0.063-0.267, P<0.001), post-remission treatment with allo-HSCT (RR=0.169, 95% CI 0.079-0.362, P<0.001) were independent prognostic factors affecting OS. Conclusions: AML with MLL gene rearrangements was closely associated with monocytic differentiation, and MLL/AF9 was the most frequent partner gene. Conventional chemotherapy produced a high response rate, but likely to relapse, allo-HSCT may have the potential to further improve the prognosis of this group of patients.

[Genetic Polymorphism of 30 InDel Loci in Han Population from Jiangsu Province]

OBJECTIVES

To investigate the genetic information of 30 insertion/deletion （InDel） loci in Han population from Jiangsu Province, and to explore the application values of Investigator® DIPplex kit for guiding the forensic analysis in Han population from Jiangsu Province.

METHODS

The autosomal InDel loci of 305 unrelated healthy Han individuals from Jiangsu Province were genotyped and analysed by Investigator® DIPplex kit, and the allelic frequencies and forensic parameters of 30 InDel loci were statistically analysed.

RESULTS

The distribution of 30 InDel loci in Han population from Jiangsu Province conformed to Hardy-Weinberg equilibrium. The minor allele frequencies of 21 InDel loci were above 0.3. The polymorphism information content ranged from 0.089 to 0.375, while the discrimination power distributed from 0.093 to 0.500. The paternity exclusion in duo cases and trio cases were 0.047-0.250 and 0.046-0.219, respectively. The linkage disequilibrium analysis of 30 InDel loci showed that all loci were independent from each other. The combined discrimination power was 1-7.369×10⁻⁸, whereas the combined mean exclusion chance in duo cases was 0.998 933 978, in trio cases was 0.997 806 392. The F_st values were all less than 0.06 except HLD118 and other four loci, which showed small differences between groups.

CONCLUSIONS

The InDel loci of Investigator® DIPplex kit can be used as complementary genetic markers for the cases associated with forensic genetics.

[Protective effect of Saccharomyces boulardii against intestinal mucosal barrier injury in rats with nonalcoholic fatty liver disease]

Objective: To investigate the protective effect of Saccharomyces boulardii against intestinal mucosal barrier injury in rats with nonalcoholic fatty liver disease (NAFLD). Methods: A total of 36 healthy male Sprague-Dawley rats with a mean body weight of 180±20 g were randomly divided into control group, model group, and treatment group, with 12 rats in each group, after adaptive feeding for 1 week. The rats in the control group were given basic feed, and those in the model group and treatment group were given high-fat feed. After 12 weeks of feeding, the treatment group was given Saccharomyces boulardii (75×10⁸ CFU/kg/d) by gavage, and those in the control group and model group were given isotonic saline by gavage. At the 20th week, blood samples were taken from the abdominal aorta to measure the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), intestinal fatty acid binding protein (IFABP), tumor necrosis factor-α (TNF-α), and endotoxins. The liver pathological changes, intestinal histopathological changes, and expression of occludin in the intestinal mucosa were observed. Fecal samples were collected to measure the changes in Escherichia coli and Bacteroides. A one-way analysis of variance and the SNK test were used for comparison between multiple groups, and the rank sum test was used as the non-parametric test. Results: Compared with the control group, the model group had significantly higher body weight, liver mass, and liver index (P < 0.05), and compared with the model group, the treatment group had significant reductions in body weight, liver mass, and liver index (P < 0.05). The model group had significant increases in TG, ALT, and AST compared with the control group (P < 0.05), the treatment group had a significant reduction in AST compared with the model group (P < 0.05), and the treatment group had slight reductions in TG and ALT compared with the model group (P > 0.05). Compared with the control group, the model group had significant increases in the levels of endotoxin, TNF-α, and IFABP (P < 0.05), and the treatment group had significant reductions in the levels of endotoxin, TNF-α, and IFABP (P < 0.05). Liver tissue staining showed that the model group had significantly increased hepatocyte steatosis compared with the control group (P < 0.05), and that the treatment group had significantly reduced hepatocyte steatosis compared with the model group (P < 0.05). The intestinal villi in the control group had ordered arrangement and a complete structure; in the model group, the intestinal villi were shortened with local shedding and a lack of ordered arrangement; compared with the model group, the treatment group had mild edema and ordered arrangements of the intestinal villi. The model group had a significantly reduced level of occludin protein compared with the control group (P < 0.05), and the treatment group had a slight increase compared with the model group. The model group had a significantly increased number of Escherichia coli and a significantly reduced number of Bacteroides compared with the control group (P < 0.05), and the treatment group had a significantly reduced number of Escherichia coli and a significantly increased number of Bacteroides compared with the model group (P < 0.05). Conclusion: High-fat diet can successfully induce NAFLD in rats, and intervention with Saccharomyces boulardii can reduce body weight and improve hepatocyte steatosis. Saccharomyces boulardii can reduce endotoxemia in NAFLD rats and thus alleviate inflammatory response. Saccharomyces boulardii can also adjust the proportion of Escherichia coli and Bacteroides in the intestine of NAFLD rats.

[Effect of curcumin on intestinal mucosal mechanical barrier in rats with non-alcoholic fatty liver disease]

Objective: To investigate the effect of curcumin on intestinal mucosal mechanical barrier in rats with non-alcoholic fatty liver disease. Methods: A total of 30 male Sprague-Dawley rats were equally divided into normal control group, model group, and curcumin intervention group. The rats in the model group and the curcumin intervention group were given high-fat feed for 16 weeks, and those in the curcumin intervention group were given curcumin 200 mg/kg/day by gavage once a day after 8 weeks of high-fat feeding. The rats were sacrificed at the end of week 16. A light microscope was used to observe pathological changes in the liver, an electron microscope was used to observe the tight junction of the intestinal mucosa, an automatic biochemical analyzer was used to measure the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), chromogenic substrate Limulus amebocyte lysate assay was used to measure plasma lipopolysaccharide (LPS) level, spectrophotometric method was used to measure the activity of serum diamine oxidase, ELISA was used to measure the serum level of tumor necrosis factor-α (TNFα), and immunohistochemistry was used to measure the expression of the tight junction protein occludin. One-way ANOVA test and SNK-q test were used for statistical analysis. Results: Under the light microscope, the control group had no hepatocyte steatosis, the model group had significant hepatocyte steatosis and inflammatory cell infiltration, and the curcumin intervention group had reduced hepatocyte steatosis and inflammatory cell infiltration. Under the electron microscope, the control group had a clear and complete structure of the tight junction of the intestinal mucosa and normal structures of mitochondria and endoplasmic reticulum; in the model group, the structure of the tight junction of the intestinal mucosa was destroyed, the intercellular space was widened, the desmosomes had a loose structure, there was edema in some mitochondria, and the endoplasmic reticulum was dilated; the curcumin intervention group had improvements in the structure of tight junction of the intestinal mucosa, intercellular space, edema in the mitochondria, and dilation of the endoplasmic reticulum. Compared with the control group, the model group had significant increases in the serum levels of AST, ALT, DAO, TNFα, and LPS (q = -15.918, -14.402, -33.700, -8.944, and -10.832, P < 0.05); compared with the model group, the curcumin intervention group had significant reductions in the serum levels of AST, ALT, DAO, TNFα, and LPS (q = 10.457, 7.752, 18.802, 5.202, and 4.279, P < 0.05). In the control group, occludin showed a linear distribution along the top of small intestinal mucosal epithelial cells. The model group had a significant reduction in positive staining compared with the control group, and the curcumin intervention group had a significant increase in positive staining compared with the model group. The relative expression of occludin was 0.29±0.03 in the control group, 0.12±0.02 in the model group, and 0.21±0.02 in the curcumin intervention group (P < 0.05). Conclusion: Intestinal mucosal mechanical barrier is impaired in rats with NAFLD. Curcumin can reduce such damage, and its mechanism of action may be related to up-regulating the expression of occludin in the intestinal mucosa and reducing the levels of TNFα and LPS.

[Prognostic significance of flow cytometric minimal residual disease in acute myeloid leukemia during aplasia]

Objective: To investigate the impact of minimal residual disease (MRD) by multiparameter flow cytometry (MPFC) during aplasia on efficacy and prognosis of de novo acute myeloid leukemia (AML) (non M(3)) patients. Methods: The MRD data by 8-color MPFC during aplasia (day 14-15 of induction therapy) in 85 de novo AML (non M(3)) patients and the MRD impact on efficacy and prognosis were retrospectively analyzed. Results: Data of 85 patients, including 42 males (49.4%) and 43 females (50.6%) , were collected, with a median age of 35 (15-54) years. The median MRD by MPFC during aplasia was 0.58% (0-81.11%) , and 70 (82.4%) patients achieved complete remission (CR) after first induction chemotherapy. The cutoff of MRD by receiver operating characteristic (ROC) analysis was 2.305% (Se= 0.867, Sp=0.800) . The CR rate after one course was significantly higher in patients with MRD<2.305% [96.6% (56/58) ]than in patients with MRD≥2.305%[51.9% (14/27) ] (χ(2)=22.348, P<0.001) ; no significant difference with respect to relapse-free survival rate (χ(2)=1.08, P=0.299) or overall survival rate (χ(2)=0.42, P=0.516) could be demonstrated for the comparison of the two groups. Multivariates analysis showed MRD divided by 2.305% was the only independent prognostic factor for CR after one course (OR= 21.560, 95% CI 4.129-112.579, P<0.001) . Conclusion: Flow cytometric MRD divided by 2.305% during aplasia could be a predictor of efficacy after first induction therapy in AML patients.

[Prediction of outcome in acute myeloid leukemia by measurement of WT1 expression as a basic marker of minimal residual disease]

Objective: To probe the potential utility of Wilms tumor 1 (WT1) as a marker of minimal residual disease (MRD) in acute myeloid leukemia (AML) to estimate the relapse-predicting cut-off value. Methods: Quantitative assessment of bone marrow WT1 mRNA level was preformed using real-time quantitative reverse transcription polymerase chain reaction (RQ-RT-PCR) assay. The expression levels of WT1 dynamically measured with RQ-RT-PCR were retrospectively analyzed in 121 AML cases (not including acute promyelocytic leukemia) achieving complete remission (CR) after induction therapy followed by consolidation therapy. By comparing WT1 levels of patients with different post-therapy outcomes, the investigators used the receiver operating characteristic (ROC) curve to determine WT1 threshold so as to predict their clinical relapses. Then prognoses and the significance of intervention were analyzed between WT1 positive and negative patients according to the cut-off value of WT1. Results: According to ROC curve, WT1 level higher than 2.98% predicted the possibility of relapse. For simplicity and clinical application, 3.00% was used as the cut-off value of WT1 level for relapse. WT1 levels in 41 patients at diagnosis were detected, meanwhile 3 patients whose WT1 levels at diagnosis below 3.00% were excluded, then the median WT1 level of the rest 38 patients at diagnosis was 44.09% (range 7.19%-188.06%) . The median WT1 level in remission was 0.48% (352 samples, range 0-8.41%) . The median WT1 level at diagnosis was higher than that in remission. Excluding the 3 patients with WT1 level at diagnosis under 3.00%, the relapse rate of WT1 positive group (>3.00% during consolidation phase and follow-up) and WT1 negative group (≤3.00%) was 70.0% (14/20) and 12.2% (12/98) respectively (P<0.001) . The median time from WT1 positivity to clinical relapse was 58 days. Conclusions: WT1 expression level above 3.00% was associated with markedly high risk of relapse, which could be as a useful marker for monitoring MRD following consolidation therapy.

[Clinical analysis of pelvic abscess with endometriosis]

Objective: To investigate the clinical features, diagnosis and treatments of pelvic abscess with endometriosis. Methods: A retrospective analysis was performed on 129 cases of pelvic abscess in Peking Union Medical College Hospital from January 2000 to January 2016. Among them, 34 women with endometriosis were divided into the study group and the others were in the control group. The clinical characteristics, therapeutic regimens and outcomes were compared. Results: (1) General conditions: there were no statistic differences between the two groups in age, WBC, serum CA(125), intrauterine device in use, pelvic inflammatory disease history; while incidence rates of dysmenorrhea (65%, 22/34) and infertility (21%, 7/34) in the study group were higher than those in the control group (all P<0.05). (2) Clinical manifestations: fever, abdominal pain and pelvic mass were the main symptoms in two groups. The incidence rates of septic shock were 12% (4/34) in the study group and 2% (2/95) in the control group (P<0.05). (3) Treatment: treatment with puncture all failed in the study group (7/7) and surgeries were required. In contrast, there was only 1/19 treatment failure with puncture in the control group. The puncture failure rates were statistically significant (P<0.05). Compared with the study group and the control group, there were significant differences (P<0.05) in the operation time of laparoscopic surgery [(76±41) versus (53±21) minutes] and of laparotomy [(168±58) versus (116±35) minutes], intra-operative blood loss of laparoscopic surgery [(216±296) versus (43±36) ml] and of laparotomy [(448±431) versus (145±24) ml]. Conclusions: Pelvic abscess in women with endometriosis is more severe and refractory to antibiotics and puncture treatment. Active surgical intervention is required. Although surgical procedures are often difficult, prognosis is comparatively satisfied.

Encapsulated PC 12 Cell Transplants into Hemiparkinsonian Monkeys: A Behavioral, Neuroanatomical, and Neurochemical Analysis

Four cynomolgus monkeys were trained on a hand reaching task and then rendered hemiparkinsonian with an intracarotid injection of n-methyl 4 phenyl 1,2,3,6, tetrahydropyridine (MPTP). Performance on this task with the limb contralateral to the MPTP injection was significantly impaired following the lesion. Three monkeys received implants of polymer-encapsulated containing PC12 cells into the caudate nucleus and putamen. One monkey received identical implants of empty capsules and served as a control. After a transient improvement, limb use in the control monkey dissipated and returned to post-MPTP disability. Two of the three PC12 cell grafted monkeys recovered performance on the hand reach task to near normal levels for up to 6.5 mo posttransplantation. Capsules retrieved from the monkeys who recovered limb function postimplantation contained numerous viable PC12 cells that continued to release levodopa, basal dopamine, and potassium evoked dopamine. In contrast, capsules retrieved from the PC12 cell-grafted monkey which did not recover limb use on the hand reach task contained few cells which secreted negligible or undetectable levels of levodopa and dopamine. Interestingly, functional disability was not reinstated following removal of the capsules. Neuroanatomical and neurochemical evaluation of the grafted striatum did not reveal a host-derived sprouting response of catecholaminergic or indolaminergic fibers. These data indicate that xenografts of PC12 cells can survive for up to 6.5 mo in nonimmunosuppressed monkeys when immunoisolated via polymer encapsulation. Moreover, these cells continue to secrete high levels of levodopa and dopamine and induce recovery of motor function in parkinsonian nonhuman primates.

Development and characterization of microsatellite markers for Solen grandis using Illumina sequencing approach

Solen grandis is an important economic and overexploited bivalve species. In order to perform its fine-scale genetic analyses, 105 pairs of microsatellites with polymorphism were identified through Illumina Hiseq platform and bioinformatic assembly technology in this study. The estimated fragment size ranged from 100 to 268 bp and the number of alleles per locus varied between 2 and 23. Observed and expected heterozygosities varied from 0.0667 to 1.0000 and 0.0966 to 0.9492, respectively. Fourteen loci deviated significantly from Hardy-Weinberg equilibrium after Bonferroni correction. These microsatellite markers developed in this study would be helpful for future genetic studies on S. grandis and closely related species.

[Clinical features and prognosis in CD10(-) pre-B acute lymphoblastic leukemia]

目的

分析CD10阴性的前B急性淋巴细胞白血病（CD10⁻pre B-ALL）患者的临床特征和预后。

方法

对6例成人CD10⁻ pre B-ALL患者的临床和实验室资料进行回顾性分析，结合文献复习明确该类型患者的临床特征及预后。

结果

CD10⁻pre B-ALL占ALL的1.5%（6/409），占B-ALL的1.8%（6/343），占pre B-ALL的11.5%（6/52）。6例患者均为男性，中位年龄为33.5岁，起病时中位WBC为101.78×10⁹/L，所有患者均伴有MLL-AF4融合基因表达。5例患者经1个疗程诱导化疗即获得完全缓解（CR），1例患者经3个疗程化疗后才获得CR。2例患者在CR₁期行异基因造血干细胞移植（allo-HSCT），1例患者CR后短期内即复发，在CR₂期行allo-HSCT。1例患者正在等待移植。2例未移植患者1例复发死亡，1例尚处于缓解状态。

结论

CD10⁻pre B-ALL是一类具有独特临床特征的成人ALL亚型，发生率较低，常见于男性，起病时白细胞水平较高，MLL-AF4融合基因表达率高，常规化疗具有较高的缓解率，但易复发，allo-HSCT有可能改善其预后。

An instrument for measuring scintillators efficiently based on silicon photomultipliers

An instrument used for measuring multiple scintillators' light output and energy resolution was developed. The instrument consisted of a light sensor array which was composed of 64 discrete SiPMs (Silicon Photomultipliers), a corresponding individual channel readout electronics system, and a data processing algorithm. A Teflon grid and a large interval between adjacent SiPMs were employed to eliminate the optical cross talk among scintillators. The scintillators' light output was obtained by comparing with a reference sample with known light output. Given the SiPM temperature dependency and the difference among each SiPM, a temperature offset correction algorithm and a non-uniformity correction algorithm were added to the instrument. A positioning algorithm, based on nine points, was designed to evaluate the performance of a scintillator array. Tests were performed to evaluate the instrument's performance. The uniformity of 64 channels for light output measurement was better than 98%, the stability was better than 98% when temperature varied from 15 °C to 40 °C, and the nonlinearity under 511 keV was better than 2%. This instrument was capable of selecting scintillators and evaluating the packaging technology of scintillator arrays with high efficiency and accuracy.

[Endoplasmic reticulum stress in INS-1-3 cell associated with the expression changes of MODY gene pathway]

Objective: To profile the gene expression changes associated with endoplasmic reticulum stress in INS-1-3 cells induced by thapsigargin (TG) and tunicamycin (TM). Methods: Normal cultured INS-1-3 cells were used as a control. TG and TM were used to induce endoplasmic reticulum stress in INS-1-3 cells. Digital gene expression profiling technique was used to detect differentially expressed gene. The changes of gene expression were detected by expression pattern clustering analysis, gene ontology (GO) function and pathway enrichment analysis. Real time polymerase chain reaction (RT-PCR) was used to verify the key changes of gene expression. Results: Compared with the control group, there were 57 (45 up-regulated, 12 down-regulated) and 135 (99 up-regulated, 36 down-regulated) differentially expressed genes in TG and TM group, respectively. GO function enrichment analyses indicated that the main enrichment was in the endoplasmic reticulum. In signaling pathway analysis, the identified pathways were related with endoplasmic reticulum stress, antigen processing and presentation, protein export, and most of all, the maturity onset diabetes of the young (MODY) pathway. Conclusion: Under the condition of endoplasmic reticulum stress, the related expression changes of transcriptional factors in MODY signaling pathway may be related with the impaired function in islet beta cells.