[Application of computational fluid dynamics in the evaluation of left ventricular function in cardiomyopathies and coronary disease]

Computational fluid dynamics (CFD) is an emerging technology applied in the field of cardiovascular medicine, which can obtain hemodynamic data by simulating the blood flow in the patient's heart for cardiac function assessment and disease diagnosis. Left ventricular function plays a key role in the occurrence and development of cardiomyopathies and coronary disease. CFD can reconstruct the left ventricular anatomic structures of patients to clarify pathophysiologic mechanisms and analyze hemodynamic parameters to evaluate left ventricular function, verify surgical efficacy, and guide surgical strategy, which has a positive effect on achieving early diagnosis and reducing mortality from cardiomyopathies and coronary disease. At present, there are still technical limitations in the large-scale clinical application of CFD, and various solutions are being developed and tested, and further improvement and refinement are needed.

[Antitumor effects of redox-responsive nanoparticles containing platinum（Ⅳ）in ovarian cancer]

Objectives: To explore the antitumor effects of redox-responsive nanoparticles containing platinum(Ⅳ)-NP@Pt(Ⅳ) in ovarian cancer. Methods: Redox-responsive polymer carriers were synthesized. Polymer carriers and platinum(Ⅳ)-Pt(Ⅳ) can self-assemble into NP@Pt(Ⅳ). Inductively coupled plasma mass spectrometry was performed to detect the platinum release from NP@Pt(Ⅳ) in reducing environment and the platinum content in ovarian cancer cells ES2 treated with cisplatin, Pt(Ⅳ) and NP@Pt(Ⅳ). The proliferation ability of the ovarian cancer cells were detected by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Cellular apoptosis was assessed by flow cytometry. Collection of primary ovarian cancer tissues from patients with primary high-grade serous ovarian cancer who were surgically treated at the Cancer Hospital of the Chinese Academy of Medical Sciences from October to December 2022. The high-grade serous ovarian cancer patient-derived xenograft (PDX) mice were intravenously injected with Cy7.5 labeled NP@Pt(Ⅳ) followed by in vivo imaging system. Mice were treated with PBS, cisplatin and NP@Pt(Ⅳ). Tumor volume and weight were measured in each group. Necrosis, apoptosis and cell proliferation of tumor tissues were detected by hematoxylin-eosin (HE) staining, TUNEL fluorescence staining and Ki-67 immunohistochemistry staining. Body weight and HE staining of heart, liver, spleen, lung and kidney of mice in each group were measured. Results: The platinum release of NP@Pt(Ⅳ) after 48 hours in reducing environment was 76.29%, which was significantly higher than that of 26.82% in non-reducing environment (P<0.001). The platinum content in ES2 cells after 4 hours and 7 hours of treatment with NP@Pt(Ⅳ) (308.59, 553.15 ng/million cells) were significantly higher than those of Pt(Ⅳ) (100.21, 180.31 ng/million cells) and cisplatin (43.36, 50.36 ng/million cells, P＜0.05). The half inhibitory concentrations of NP@Pt(Ⅳ) in ovarian cancer cells ES2, A2780, A2780DDP were 1.39, 1.42 and 4.62 μmol/L, respectively, which were lower than those of Pt(IV) (2.89, 7.27, and 16.74 μmol/L) and cisplatin (5.21, 11.85, and 71.98 μmol/L). The apoptosis rate of ES2 cells treated with NP@Pt(Ⅳ) was (33.91±3.80)%, which was significantly higher than that of Pt(Ⅳ) [(16.28±2.41)%] and cisplatin [(15.01±1.17)%, P＜0.05]. In high-grade serous ovarian cancer PDX model, targeted accumulation of Cy7.5 labeled NP@Pt(Ⅳ) at tumor tissue could be observed. After the treatment, the tumor volume of mice in NP@Pt(IV) group was (130±98) mm3, which was significantly lower than those in control group [(1 349±161) mm3, P<0.001] and cisplatin group [(715±293) mm3, P=0.026]. The tumor weight of mice in NP@Pt(IV) group was (0.17±0.09)g, which was significantly lower than those in control group [(1.55±0.11)g, P<0.001] and cisplatin group [(0.82±0.38)g, P=0.029]. The areas of tumor necrosis and apoptosis in mice treated with NP@Pt(Ⅳ) were higher than those in mice treated with cisplatin. Immunohistochemical staining revealed that there were low expressions of Ki-67 at tumor tissues of mice treated with NP@Pt(Ⅳ) compared with cisplatin. The change in body weight of mice in NP@Pt(Ⅳ) group was not significantly different from that of the control group [(18.56±2.04)g vs.(20.87±0.79)g, P=0.063]. Moreover, the major organs of the heart, liver, spleen, lung, and kidney were also normal by HE staining. Conclusion: Redox-responsive NP@Pt(Ⅳ), produced in this study can enhance the accumulation of cisplatin in ovarian cancer cells and improve the efficacy of ovarian cancer chemotherapy.

[Preliminary insights into the practice of hypoallergenic home visiting program]

Allergic diseases affect about 40% of the world's population. Environmental factors are important in the occurrence and development of allergic diseases. Dust mites are one of the most important allergens in the indoor environment. The World Health Organization proposes the "four-in-one, combination of prevention and treatment" treatment principle for allergic diseases, in which environmental control to avoid or reduce allergens is the first choice for treatment. Modern people spend much more time at home (including sleeping) than outdoors, and the control of the home environment is particularly critical. This practice introduces the hypoallergenic home visit program, which including home environment assessment, environmental and behavioral intervention guidance, and common household hypoallergenic supplies and service guidance for the patient's home environment. The real-time semi-quantitative testing of dust mite allergens, qualitative assessments of other indoor allergens, record of patients' household items and lifestyle, and precise, individualized patient prevention and control education will be conducted. The hypoallergenic home visit program improves the doctors' diagnosis and treatment data dimension, and becomes a patient management tool for doctors outside the hospital. It also helps patients continue to scientifically avoid allergens and irritants in the environment, effectively build a hypoallergenic home environment, reduce exposure to allergens in the home environment, and achieve the goal of combining the prevention and treatment of allergic diseases.

Dietary non-phytate phosphorus requirements for optimal productive and reproductive performance, and egg and tibial quality in egg-type duck breeders

Optimal dietary non-phytate phosphorus (NPP) is essential in poultry to maximise productive and reproductive performance, along with indices of egg and bone quality. This study aimed to establish the NPP requirements of egg-type duck breeders aged from 54 to 80 weeks on the following traits: egg production, egg incubation, egg quality, tibial characteristics, reproductive organ, plasma indices, and the expression of genes related to phosphorus absorption. Longyan duck breeders aged 54 weeks (n = 300) were randomly allotted to five treatments, each containing six replicates of 10 individually caged birds. Birds were fed corn-soybean meal-based diets containing 0.18, 0.25, 0.32, 0.38, and 0.45% NPP/kg for 27 weeks. The tested dietary NPP levels did not affect egg production or egg quality indices. The hatchling weight of ducklings increased (quadratic, P < 0.01) as dietary NPP level increased, and the highest value occurred with 0.25% NPP. The number of large yellow follicles (LYF), and the relative weights of LYF and ovary showed linear and quadratic responses to dietary NPP levels; the lowest number and relative weight of LYF occurred with 0.38% NPP, and the lowest ovarian weight was obtained with 0.25% NPP. There were no differences in tibial length, breaking strength, and mineral density in response to dietary NPP levels. In contrast, tibial content of Ca increased (linear, P < 0.01) with dietary NPP levels increasing from 0.18 to 0.45%, and the tibial content of P increased at 0.32% NPP and the higher dietary NPP levels. Plasma concentration of P showed a quadratic (P < 0.05) response to the dietary NPP levels, where the highest value was seen at 0.38% NPP. In conclusion, dietary NPP levels from 0.18 to 0.45% had no effects on egg production, and egg and tibial quality of duck breeders. The duck breeders fed a diet with 0.25% NPP showed the highest hatchling weight of their offspring, while those fed 0.38% NPP had the lowest number and relative weight of LYF. These results indicated that the diet with 0.25% NPP can be used in egg-type duck breeders to improve the hatchling weight of their offspring, without adverse effects on their productivity. The regression model indicated that the maximal hatchling weight of ducklings was obtained from duck breeders fed the diet with 0.30% NPP.

[Clinical presentation of acute primary angle-closure glaucoma during the 2019-nCoV epidemic of Omicron variants: a single-center retrospective study]

Objective: To investigate the clinical presentation pattern of acute primary angle-closure glaucoma (PACG) during the 2019 novel coronavirus (2019-nCoV) pandemic over the past three years, and its relationship with 2019-nCoV infections of Omicron variants in Guangdong province. Methods: Ecological study.Patients who were newly diagnosed with acute PACG from February 2020 to January 2023 at the Zhongshan Ophthalmic Center of Sun Yat-sen University were included in the study, and their basic information was collected. Patients were divided into the 2020 group (diagnosed between February 1st, 2020 and January 31st 2021), the 2021 group (diagnosed between February 1st, 2021 and January 31st 2022), and the 2022 group (diagnosed between February 1st, 2022 and January 31st 2023). The clinical presentation pattern of newly diagnosed acute PACG was observed and compared between groups. The daily number of newly diagnosed 2019-nCoV infections in Guangdong province was obtained from the Chinese Center for Disease Control and Prevention. The correlation between the daily number of newly diagnosed acute PACG and that of newly diagnosed 2019-nCoV infections during the epidemic period of Omicron variants between December 2022 and January 2023 was assessed. Results: The study included 1 048 patients with newly diagnosed acute PACG, with 235 for the 2020 group, 274 for the 2021 group, and 539 for the 2022 group. Our results showed that the average weekly number of newly diagnosed acute PACG patients in 2022 [8 (5, 11)] was significantly larger than that in 2020 (4.52±1.95, P<0.05) and 2021 (5.27±2.76, P<0.05). The average weekly number increased to 22.11±20.84 between December 2022 and January 2023. The total number of newly diagnosed acute PACG patients during this period was 199, which was 36.9% (199/539) of the total number of the same year and was 6.63 and 6.42 times as many as that in the same period (December and January) of 2020 and 2021. The proportion of patients with bilateral eye involvement during this period in 2022 was significantly higher than that in 2020 and 2021 (P<0.05). Further analysis found that 88.6% (109/123) of cases had a history of 2019-nCoV infection 2 (0, 3) days before the onset of acute PACG symptoms in average. The estimated daily number of acute PACG onset increased rapidly, peaked on December 23th, 2022, and then dropped gradually. This trend was similar to that of the daily number of new 2019-nCoV infections in Guangdong province. Changes of the daily number of new 2019-nCoV infections in Guangdong province had a positive correlation with the estimated daily number of acute PACG onset (r=0.84, P<0.001). Conclusion: A dramatic increase in the clinical presentation of acute PACG was observed at Zhongshan Ophthalmic Center between December 2022 and January 2023, which was the epidemic period of Omicron variants. There is a correlation between the trend of the estimated daily number of acute PACG onset and that of new 2019-nCoV infections of Omicron variants in Guangdong province, but the exact reason remains to be further studied. (This article was published ahead of print on the official website of Chinese Journal of Ophthalmology on August 31, 2023).

[Evaluation of the efficacy of TIPS in 27 patients with hepatic sinus obstruction syndrome in the near and medium term]

Objective: intrahepatic portocaval shunt (TIPS) in the treatment of hepatic sinusoidal obstruction syndrome (HSOS). Methods: A retrospective analysis was performed on 27 patients with HSOS who were treated with TIPS in our center from July 2018 to July 2020. The changes of portal vein pressure (PVP), portal vein pressure gradient (PPG) and liver function were observed, so as to evaluate the efficacy. Paired t test was adopted to evaluate the quantitative parameters, while χ (2) test was used to analyze qualitative parameters, with P < 0.05 as statistical difference. Results: PVP decreased from (4.41 ± 0.18) kPa before shunt to (2.69 ± 0.11) kPa after shunt (t = 82.41, P < 0.001), PPG decreased from (3.23 ± 0.18) kPa before shunt to (1.46 ± 0.23) kPa after shunt (t = 32.41, P < 0.001). The liver function improved significantly after operation. After 24 months of follow-up, 3 patients developed stent restenosis and recanalized after balloon dilation. Three patients developed hepatic encephalopathy, which was improved after drug treatment. One patient underwent liver transplantation due to liver failure. Conclusion: TIPS is effective in the treatment of HSOS in the short and medium term, and can provide time for liver transplantation patients to wait for liver source.

[Diagnosis and treatment procedures and health management for patients with hereditary angioedema]

As a recognized rare and highly fatal disease, hereditary angioedema (HAE) is difficult to diagnose and characterized by recurrent edema involving the head, limbs, genitals and larynx, etc. Diagnosis of HAE is not difficult. However, low incidence and lack of clinical characteristics lead to difficulty of doctors on timely diagnosis and correct intervention for HAE patients. Therefore, it is crucial to improve the awareness of this disease and prevent its recurrence. for HAE patients. In view of absent cognition of doctors and the general public on HAE, patients often suffer from sudden death or become disabled due to laryngeal edema which cannot be treated in time. Thus, based on the Internet mobile terminal platform, the team set up an all-day rapid emergency response system which is provided for HAE patients by setting up "one-click help". The aim is to offer optimization on overall management of HAE and designed the intelligent follow-up management to provide timely assistance and specialized suggestion for patients with acute attacks.

[Effects and clinical significance of NLRP3 inflammasome activated by IL-17A in CRSwNP]

Objective: To investigate the effects and clinical significance of NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome activated by interleukin (IL)-17A in chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: Patients underwent nasal endoscopic surgery in the Third Affiliated Hospital of Sun Yat-sen University from January 2020 to December 2021 were collected, including 28 CRSwNP (including 19 males and 9 females, aged 19 to 67 years), 22 chronic rhinosinusitis without nasal polyps (CRSsNP) and 22 controls. qRT-PCR was used to detect the expressions of IL-17A, NLRP3, IL-1β and IL-18 in the three groups, and their correlations were analyzed. The positions of IL-17A, NLRP3 and IL-18 in nasal polys were analyzed by immunofluorescence. Western Blotting and ELISA were employed to detect the expression of NLRP3, IL-1β and IL-18 in the human nasal epithelial cells after using IL-17A stimulation or IL-17A receptor inhibitor. Immunofluorescence was used to observe the NLRP3, IL-1β, and IL-18 protein expression after IL-17A stimulating human nasal epithelial cells, and after the use of IL-17A receptor inhibitor and NLRP3 inhibitor MCC950. The correlations between NLRP3, IL-1β, IL-18 and CT scores, nasal endoscopic scores, visual analogue scale (VAS) scores, and sino-nasal outcome test (SNOT) 22 scores of CRSwNP patients were analyzed. SPSS 20.0 software was used for statistical analysis. Results: The expressions of IL-17A, NLRP3, IL-1β and IL-18 in the tissues of CRSwNP patients were significantly higher than those in CRSsNP group(P=0.018,P<0.001,P=0.005, P=0.016) and the control group(all P<0.001). IL-17A was positively correlated with the expression of NLRP3, IL-1β, and IL-18(r ralue was 0.643,0.650,0.629,respectively, all P<0.05). IL-17A, NLRP3, and IL-18 were co-localized in the epithelial propria of polyp tissue. IL-17A stimulated the expressions of NLRP3, IL-1β, and IL-18 in human nasal epithelial cells. After the use of IL-17A receptor inhibitor, the expressions of NLRP3, IL-1β, and IL-18 were significantly down-regulated. After the use of NLRP3 inhibitor MCC950, IL-17A was significantly down-regulated to promote the expression of NLRP3, IL-1β, and IL-18. The expressions of NLRP3, IL-1β and IL-18 were positively correlated with CT, nasal endoscopy, VAS, and SNOT22 scores in patients with CRSwNP. Conclusions: IL-17A promotes the release of IL-1β and IL-18 by activating the NLRP3 inflammasome and aggravates the severity of the disease in CRSwNP.

[Signal transducer and activator of transcription 3 and cancer associated fibroblasts jointly generate chemo-resistance and affect prognosis in epithelial ovarian cancer]

Objective: To investigate the mechanism of signal transducer and activator of transcription 3 (STAT3) and cancer associated fibroblasts (CAF) jointly generate chemo-resistance in epithelial-ovarian cancer and their effect on prognosis. Methods: A total of 119 patients with high-grade ovarian serous cancer who received surgery in Cancer Hospital of Chinese Academy of Medical Sciences from September 2009 to October 2017 were collected. The clinico-pathological data and follow-up data were complete. Multivariate Cox regression model was used to analyze the prognostic factors. Ovarian cancer tissue chips of patients in our hospital were prepared. EnVision two-step method immunohistochemistry was used to detect the protein expression levels of STAT3, the specific markers of CAF activation, fibroblast activating protein (FAP), and type Ⅰ collagen (COL1A1) secreted by CAF. The relationship between the expression of STAT3, FAP, COL1A1 protein and drug resistance and prognosis of ovarian cancer patients was analyzed, and the correlation between the expression of three proteins was analyzed. These results were verified through the gene expression and prognostic information of human ovarian cancer tissues collected in the GSE26712 dataset of gene expression omnibus (GEO) database. Results: (1) Multivariate Cox regression model analysis showed that chemotherapy resistance was an independent risk factor for overall survival (OS) of ovarian cancer (P<0.001). (2) The expression levels of STAT3, FAP, and COL1A1 proteins in chemotherapy resistant patients were significantly higher than those in chemotherapy sensitive patients (all P<0.05). Patients with high expression of STAT3, FAP, and COL1A1 had significantly shorter OS than those with low expression (all P<0.05). According to the human ovarian cancer GSE26712 dataset of GEO database, patients with high expression of STAT3, FAP, and COL1A1 also showed shorter OS than patients with low expression (all P<0.05), the verification results were consistent with the detection results of ovarian cancer patients in our hospital. (3) Correlation analysis showed that the protein level of STAT3 was positively correlated with FAP and COL1A1 in our hospital's ovarian cancer tissue chips (r=0.47, P<0.001; r=0.30, P=0.006), the analysis of GEO database GSE26712 dataset showed that the expression of STAT3 gene and FAP, COL1A1 gene were also significantly positively correlated (r=0.31, P<0.001; r=0.52, P<0.001). Conclusion: STAT3 and CAF could promote chemotherapy resistance of ovarian cancer and lead to poor prognosis.

[The expression and significance of protease activated receptor 2 in ovarian epithelial carcinoma]

Objective: To investigate the expression and significance of protease activated receptor 2 (PAR2) in ovarian epithelial carcinoma. Methods: PAR2 mRNA expression levels in 410 cases of epithelial ovarian carcinoma and 88 cases of human normal ovary were analyzed from cancer Genome Atlas (TCGA) database and tissue genotypic expression database (GTEx). Immunohistochemical (IHC) staining of PAR2 protein was performed in 149 patients with ovarian cancer who underwent primary surgical treatment at Cancer Hospital of Chinese Academy of Medical Sciences. Then the relationship between mRNA/protein expression of PAR2 and clinicopathological features and prognosis was analyzed. Gene functions and related signaling pathways involved in PAR2 were studied by enrichment analysis. Results: The mRNA expression of PAR2 in epithelial ovarian carcinoma was significantly higher than that in normal ovarian tissue (3.05±0.72 vs. 0.33±0.16, P=0.004). There were 77 cases showing positive and 19 showing strong positive of PAR2 IHC staining among the 149 patients, accounting for 64.4% in total. PAR2 mRNA/protein expression was closely correlated with tumor reduction effect and initial therapeutic effect (P<0.05). Survival analysis showed that the progression free survival time (P=0.033) and overall survival time (P=0.011) in the group with high PAR2 mRNA expression was significantly lower than that in the low PAR2 mRNA group. Multivariate analysis showed tumor reduction effect, initial therapeutic effect were independent prognostic factors on both progression-free survival and overall survival (P<0.05). The progression-free survival (P=0.016) and overall survival (P=0.038) of the PAR2 protein high expression group was significantly lower than that of the low group. Multivariate analysis showed PAR2 expression, initial treatment effect and chemotherapy resistance were independent prognostic factors on both progression-free survival and overall survival (P<0.05). Based on Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG), PAR2 target genes were mainly enriched in function related to intercellular connection, accounting for 40%. Gene enrichment analysis (GSEA) showed that the Wnt/β-catenin signaling pathway (P=0.023), the MAPK signaling pathway (P=0.029) and glycolysis related pathway (P=0.018) were enriched in ovarian cancer patients with high PAR2 mRNA expression. Conclusions: PAR2 expression is closely related to tumor reduction effect, initial treatment effect and survival of ovarian cancer patients. PAR2 may be involved in Wnt/β-catenin signaling pathway and intercellular connection promoting ovarian cancer invasion and metastasis.

[Analysis on medical care seeking of local and non-local pulmonary tuberculosis patients reported in Beijing, 2016-2021]

Objective: To analyze the medical care seeking of local and non-local pulmonary tuberculosis (TB) patients in Beijing from 2016 to 2021 and provide evidence for TB prevention and control in Beijing. Methods: The reported pulmonary TB data from 2016 to 2021 were collected from tuberculosis management information system and standard code management system of Chinese information system for disease control and prevention. The map data were obtained from the Institute of Geographic Sciences and Natural Resources Research. Excel 2016, SPSS 19.0, Python 3.9 and ArcGIS 10.6 softwares were used for data analysis and visualization for the inter-provincial mobility and inter-district mobility of pulmonary TB patient's medical care seeking in Beijing. Results: Among the reported pulmonary TB patients in Beijing from 2016 to 2021, 35.27%(24 307/68 926) were from 30 provinces (autonomous regions, municipalities) and Xinjiang Production and Construction Corps. The top 5 provinces with pulmonary TB patients medical care seeking in Beijing were Hebei (39.58%,9 620/24 307), Shanxi (8.82%,2 145/24 307), Inner Mongolia Autonomous Region (8.66%,2 105/24 307), Heilongjiang (6.95%,1 690/24 307) and Henan (6.88%,1 672/24 307). Patients from these 5 provinces accounted for 70.89% (17 232/24 307) of total pulmonary TB patients from other provinces. The pulmonary TB patients from other provinces mainly flowed to Tongzhou district of Beijing, accounting for 46.72% (11 356/24 307). These pulmonary TB patients mainly visited grade Ⅲ (A) hospitals, such as Beijing Chest Hospital of Capital Medical University with the highest proportion of 44.76% (10 880/24 307). Among pulmonary TB patients with current residence in Beijing, those sought medical care in other districts accounted for 55.06% (24 566/44 619). The outflow and inflow of TB cases' medical care seeking occurred in 16 districts of Beijing. The median proportion of cross district medical care seeking in 16 districts was 59.30% (56.05%, 65.13%). The inflow of the medical care seeking in Tongzhou, Haidian and Xicheng district was greater than the outflow, and the outflow was greater than the inflow in the other 13 districts. The pulmonary TB patients in Beijing mainly went to Beijing Chest Hospital in Tongzhou for medical care seeking, accounting for 42.18%(18 822/44 619). Conclusions: The proportions of non-local pulmonary TB patients seeking medical care in Beijing from 2016 to 2021 and local pulmonary TB patients seeking medical care in other districts in Beijing were high, and the hospitals where non-local pulmonary TB patients and local pulmonary TB patients sought medical care respectively belonged to grade Ⅲ (A) and municipal designated medical institutions of TB.

[Anatomical elucidation and histological study of pelvic autonomic nerve-plane based female fresh cadaver]

Objective: To investigate the rationality of nerve-plane sparing radical hysterectomy (NPSRH) for cervical cancer by observing the anatomical and histological characteristics of pelvic autonomic plane based on fresh cadaver. Methods: From October 2015 to September 2020, 14 fresh female cadavers were anatomically and histologically studied in the Laboratory of Anatomy and Embryology Department, Peking Union Medical College, Chinese Academy of Medical Sciences. The median age of the specimens was 79 years (range: 67 to 92 years). Twenty-eight hemi-pelvic specimens were obtained from 14 fresh female cadavers. NPSRH procedures were simulated in 8 hemi-pelvic cavities to prove its feasibility. Detailed dissection was conducted to recognize nerve plane and to observe the distribution of pelvic nerves in 10 hemipelvis. In the other 10 hemipelvis, whole parametrium tissue was taken from the crossing of ureter and the uterine artery to the ureterovesical entrance and be embedded, then continuous section was performed, and was stained by hematoxylin-eosin staining (HE) to observe the relationship of nerves and vessels. Immunohistochemical staining of S100, tyrosine dehydrogenase (TH), and vasoactive intestinal peptide (VIP) were performed to count and distinguish sympathetic and parasympathetic nerves, respectively. Results: (1) The pelvic autonomic nerve-plane was completely preserved in 7 of 8 hemipelvis by simulating NPSRH. (2) After detailed dissection in 10 hemipelvis, it was found that hypogastric nerve, pelvic splanchnic nerve, and their confluence of inferior hypogastric plexus were distributed in a planar statelocating in the ureteral mesentery and its caudal extension. This nerve plane showed a cross relationship with deep uterine vein and its branches. The bladder branches and vesical venous plexus were closely related to the inferior hypogastric plexus. The middle vesical vein and inferior vesical vein were intact in 7 of 10 hemipelvis, and either vesical vein was missing in 3 of them. It was observed that the vesical venous plexus communicated with the deep uterine vein trunk on the medial side of the nerve plane in 6 hemipelvis, while flowed into the deep uterine vein on the lateral side of the nerve plane in 2 hemipelvis, and in the other 2 hemipelvis it directly flowed into the internal iliac vein. (3) It was revealed that autonomic nerves were continuously distributed beneath the ureteral with sagittal plane by HE staining. The average nerve content below the ureteral width was 70.9% of the total in nerve plane by S100 staining. TH and VIP staining showed that the average number of sympathetic fibers was 13.5 and parasympathetic fibers was 8.2, reminding sympathetic predominated. Conclusion: Pelvic autonomic nerves are mainly distributed within the mesangial plane below the ureter, which provides an anatomic justification for NPSRH.

[The expression profile and potential regulatory mechanism of ACE2 in chronic rhinosinusitis with nasal polyps]

Objective: To preliminarily analyze the expression of angiotensin-converting enzyme 2 (ACE2) and to investigate its potential regulatory mechanism in chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: Patients underwent nasal endoscopic surgery in the Third Affiliated Hospital of Sun Yat-sen University from February 2020 to May 2021 were selected, including 17 males and 6 females, aging from 23 to 66 years old. Expression of ACE2 was evaluated via immunohistochemical staining in controls with non-chronic rhinosinusitis, non-eosinophilic CRSwNP (non-ECRSwNP), and eosinophilic CRSwNP (ECRSwNP) tissue, respectively. Correlations between ACE2 and the indicated Th1/Th2-related cytokines (IFN-γ, IL-4, IL-5, IL-13, IL-25, IL-33, TSLP and periostin) were analyzed based on GSE72713 dataset. Protein-protein interaction (PPI) network was constructed via string database, immune infiltration of GSE72713 dataset was evaluated using cibersort algorithm. ACE2 was comprehensively analyzed by microRNA regulatory network, gene set enrichment analysis (GSEA) and pharmacological analysis. Statistical analysis was performed using GraphPad 7.0 and SPSS 20.0 software. Results: ACE2 was up-regulated in non-ECRSwNP compared with ECRSwNP. Microarray analysis showed that ACE2 was positively correlated with IFN-γ while inversely correlated with IL-5, IL-13 and periostin significantly. Analysis of immune infiltration suggested that ACE2 expression correlated positively with the number of M1 macrophage while negatively with M2 macrophage. GSEA demonstrated that interferon-related signaling pathways were up-regulated in non-ECRSwNP, and miRNA-200B/miRNA-200C/miRNA-429 pathways targeting ACE2 were enriched in ECRSwNP. Results of pharmacological analysis indicated that ampicillin was able to promote the expression of ACE2 whereas acetaminophen could down regulated the expression of ACE2. Conclusion: Expression pattern of ACE2 is varied in non-ECRSwNP and ECRSwNP, which may be related to the different infiltration of indicated cytokines and different regulatory pathways of miRNA.

[Clinical characteristics and CBS gene analysis of 13 cases with classic homocystinuria]

Objective: To analyze the clinical features and CBS gene variants of 13 patients with classic homocystinuria, and the strategies of individual treatment and prevention were explored. Methods: The general information, clinical manifestations, laboratory tests, cranial images, CBS gene variants, diagnosis and therapeutic strategies of 13 patients with classic homocystinuria admitted to the Department of Pediatrics of Children's Hospital Affiliated to Zhengzhou University and Peking University First Hospital from November 2013 to June 2021 were analyzed retrospectively. Results: There were 13 patients diagnosed at the age of 10 days to 14 years, 6 were male and 7 were female. There were 3 patients detected by newborn screening and received treatment at the asymptomatic stage. There were 10 patients clinically diagnosed at the age of 5 to 14 years. Their symptoms appeared at age of 1 to 6 years. The major clinical manifestations were marfanoid features, lens dislocation and (or) myopia, developmental delay, osteoporosis, and cardiovascular diseases. Brain magnetic resonance imaging showed asymmetric infarcts in 4 patients and hypomyelination in 1 case. Increased blood methionine, plasma total homocysteine and urinary total homocysteine with normal urinary methylmalonic acid were found in 13 patients. The biochemical features were consistent with classic homocystinuria. Totally 18 variants were identified in CBS gene of 13 patients, 10 variants were novel and 8 were reported. only 1 patient was partially responsive to vitamin B₆ treatment, while 12 cases were non-responsive. They were mainly treated with low methionine diet and betaine supplement. Three vitamin B₆ non-responsive cases received liver transplantation at age of 3, 8 and 8 years, respectively. Their blood methionine and total homocysteine returned to normal within a week after liver transplantation. One patient died. Prenatal diagnosis was performed for a fetus when the mother was pregnant again. Two pathogenic CBS gene variants were identified from the amniocytes as same as the proband. Conclusions: The clinical manifestations of classic homocystinuria are complex and variable. Blood amino acid analysis, serum or urine total homocysteine assay and gene analysis are critical for its diagnosis. There were 10 novel CBS gene varients were identified expanding the CBS gene varient spectrum. Liver transplantation is an effective treatment. Prenatal diagnosis is important to prevent classic homocysteinuria.

Effects of dietary inclusion of cassava starch-extraction-residue meal on egg production, egg quality, oxidative status, and yolk fatty acid profile in laying ducks

This study was designed to evaluate the effects of different dietary levels of cassava starch extraction residue meal (CReM) on egg production, egg quality, oxidative status, egg yolk fatty acid profile, and hepatic expression of fatty acid metabolism-related genes. In total, 288 Longyan laying ducks aged 21 wk with similar BW were randomly assigned to 4 dietary treatments, each consisting of 6 replicates of 12 birds. The birds were fed a typical corn-soybean meal diet, which contained 0% (control), 5%, 10%, and 15% CReM, mainly replacing wheat bran, and the experiment lasted for 16 wk. The tested CReM levels did not show significant effects on the egg production, nonmarketable egg percentage, egg weight, daily egg mass, and FCR (g feed: g egg), but daily feed intake was reduced with increased CReM level (linear P < 0.001, quadratic P < 0.05). Yolk color increased (linear and quadratic, P < 0.01) with the increase in CReM level, but the Haugh unit, yolk proportion, albumen proportion, shell proportion, eggshell thickness, and eggshell strength were unaffected. Yolk contents of C11:0 and C12:0 (linear, quadratic, P < 0.01) and total saturated fatty acids increased, and the C22:1 level decreased (linear P < 0.01, quadratic P < 0.05) with the increase in CReM level, but the total monounsaturated fatty acids, the individual and total polyunsaturated fatty acids and n−6 and n−3 fatty acids, triglycerides, and total cholesterol in egg yolk were not affected. Hepatic gene expression revealed a significant increase in peroxisome proliferators-activated receptors γ (linear, quadratic, P < 0.001), but the expression of fatty acid synthase, sterol regulatory element binding protein 1 and apolipoprotein A1 genes were unaffected by CReM level. In conclusion, the results of the current study indicated that the CReM could be included up to 15% in laying duck diets without negative effects on the egg-laying rate, egg quality, and oxidative status. Dietary inclusion of CReM increased the yolk content of total saturated fatty acids and SOD activity in the liver.

[A case of diffuse anterior retinoblastoma]

A female patient presented with redness and visual acuity loss in the left eye for more than 4 months. Ophthalmic examination revealed a large number of gray-white masses and lesions with fuzzy boundaries on the iris surface. Retinoblastoma was diagnosed after enucleation.

[Correlation analysis of smell and taste loss with COVID-19 outbreak trend based on big data of internet]

Objective: To analyze the correlation between loss of smell/taste and the number of real confirmed cases of coronavirus disease 2019 (COVID-19) worldwide based on Google Trends data, and to explore the guiding role of smell/taste loss for the COVID-19 prevention and control. Methods: "Loss of smell" and "loss of taste" related keywords were searched in the Google Trends platform, the data were obtained from Jan. 1 2019 to Jul. 11 2021. The daily and newly confirmed COVID-19 case number were collected from World Health Organization (WHO) since Dec. 30 2019. All data were statistically analyzed by SPSS 23.0 software. The correlation was finally tested by Spearman correlation analysis. Results: A total of data from 80 weeks were collected. The retrospective analysis was performed on the new trend of COVID-19 confirmed cases in a total of 186 292 441 cases worldwide. Since the epidemic of COVID-19 was recorded on the WHO website, the relative searches related to loss of smell/taste in the Google Trends platform had been increasing globally. The global relative search volumes of "loss of smell" and "loss of taste" on Google Trends was 10.23±2.58 and 16.33±2.47 before the record of epidemic while 80.25±39.81 and 80.45±40.04 after (t value was 8.67, 14.43, respectively, both P<0.001). In the United States and India, the relative searches for "loss of smell" and "loss of taste" after the record of epidemic were also much higher than before (all P<0.001). The correlation coefficients between the trend of weekly new COVID-19 cases and the Google Trends of "loss of smell" in the global, United States, and India was 0.53, 0.76, and 0.82 respectively (all P<0.001), the correlation coefficients with Google Trends of "loss of taste" was 0.54, 0.78, and 0.82 respectively (all P<0.001). The lowest and highest point of loss of smell/taste search curves of Google Trends in different periods appeared 7 to 14 days earlier than that of the weekly newly COVID-19 confirmed cases curves, respectively. Conclusions: There is a significant positive correlation between the number of newly confirmed cases of COVID-19 worldwide and the amount of keywords, such as "loss of smell" and "loss of taste", retrieved in Google Trends. The trend of big data based on Google Trends might predict the outbreak trend of COVID-19 in advance.

[Analysis of 53 cases of transjugular liver biopsy]

Objective: To investigate the practicability and safety of transjugular liver biopsy (TJLB). Methods: Data of 53 cases with transjugular liver biopsy from June 2015 to June 2020 were collected. LABS-100 was used in all patients who underwent transjugular liver biopsy. Among them, 45 cases and eight were biopsied via hepatic vein and intrahepatic segment of the inferior vena cava. The surgical indications, related complications, and postoperative pathological diagnosis were analyzed and summarized. Results: TJLB was successful in all patients, with an average of 2.8 punctures per case. Satisfactory liver tissue and histopathological diagnosis was obtained in all patients. Two cases developed a cervical hematoma that was improved spontaneously, and one patient developed an intrahepatic hematoma that was improved after conservative treatment. Conclusion: TJLB is a practical and safe method for patients with contraindications to percutaneous liver biopsy.

[A comparative study of artificial intelligence nasal polyp classification based on whole-slide imaging and JESREC diagnostic criteria]

Objective: To explore the types and clinical characteristics of chronic rhinosinusitis with nasal polyps (CRSwNP) based on artificial intelligence and whole-slide imaging (WSI), and to explore the consistency of the diagnostic criteria of the Japanese epidemiological survey of refractory eosinophilic chronic rhinosinusitis (JESREC) in Chinese CRSwNP patients. Methods: The data of 136 patients with CRSwNP (101 males and 35 females, aging 14 to 70 years) who underwent endoscopic sinus surgery from 2018 to 2019 in the Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University were analysed retrospectively. The preoperative clinical characteristics of patients were collected, such as visual analogue scale (VAS) of nasal symptoms, peripheral blood inflammatory cell count, total immunoglobulin E (IgE), Lund-Kennedy score and Lund-Mackay score. The proportion of inflammatory cells such as eosinophils, lymphocytes, plasma cells and neutrophils were calculated on the WSI of each patient through artificial intelligence chronic rhinosinusitis evaluation platform 2.0 (AICEP 2.0), and the specific type of nasal polyps was then obtained as eosinophilic CRSwNP (eCRSwNP) or non-eosinophilic CRSwNP (non-eCRSwNP). In addition, the JESREC diagnostic criteria was used to classify the nasal polyps, and the classification results were compared with the current gold standard for nasal polyps diagnosis (pathological diagnosis based on WSI). The accuracy, sensitivity and specificity of the diagnostic criteria of JESREC were evaluated. The data were expressed in M (Q₁, Q₃) and statistically analyzed by SPSS 17.0. Results: There was no significant difference between eCRSwNP and non-eCRSwNP in age distribution, gender, time of onset, total VAS score, Lund-Kennedy score or Lund-Mackay score. However, there was a significant difference in the ratio of nasal polyp inflammatory cells (eosinophils 40.5% (22.8%, 54.7%) vs 2.5% (1.0%, 5.3%), neutrophils 0.3% (0.1%, 0.7%) vs 1.3% (0.5%, 3.6%), lymphocytes 49.9% (39.3%, 65.9%) vs 82.0% (72.8%, 87.5%), plasma cells 5.1% (3.6%, 10.5%) vs 13.0% (7.4%, 16.3%), χ² value was 9.91, 4.66, 8.28, 5.06, respectively, all P<0.05). In addition, eCRSwNP had a significantly higher level of proportion of allergic symptoms (nasal itching and sneezing), asthma, peripheral blood eosinophil and total IgE (all P<0.05). The overall accuracy, sensitivity and specificity of the JESREC diagnostic criteria was 74.3%, 81.3% and 64.3%, respectively. Conclusions: The eCRSwNP based on artificial intelligence and WSI has significant high level of allergic symptoms, asthma, peripheral blood eosinophils and total IgE, and the percentages of inflammatory cells in nasal polyps are different from that of non-eCRSwNP. The JESREC diagnostic criteria has good consistency in our research.

Effects of maternal and progeny dietary selenium supplementation on growth performance and antioxidant capacity in ducklings

This study evaluated the effects of selenium (Se) supplementation in maternal and offspring diets on performance and antioxidant capacity of ducklings aged from 0 to 2 wk. A total of 144 female Longyan duck breeders aged 22-wk were allotted into 2 treatments and fed a control diet or a 0.16 mg Se/kg supplemented diet. At 40-wk, 120 offspring from each treatment were divided into 2 groups, with 6 replicates of 10 birds. Using a 2 × 2 factorial design, ducklings from each maternal dietary treatment were assigned to a control diet or a 0.16 mg Se/kg supplemented diet from hatch to 2-wk. Compared with Se-deficient diet, maternal diet supplemented with 0.16 mg Se/kg increased the BW of hatchlings (P < 0.01). There were interactions between maternal and progeny diet with 0.16 mg Se/kg in BW of ducklings aged 2 wk and BW gain (BWG) as ducklings from maternal Se/progeny none treatment had the lightest BW and BWG (P < 0.01). Maternal diet with 0.16 mg Se/kg decreased plasma concentration of uric acid and insulin-like growth factor 1 (P < 0.01), and progeny diet supplemented with 0.16 mg Se/kg increased the activities of glutathione peroxidase 3 (GPx3) in plasma and glutathione peroxidase 1 in erythrocyte (P < 0.01). Maternal diet with 0.16 mg Se/kg increased (P < 0.05) the hepatic activity of total superoxide dismutase (T-SOD). Progeny diet supplemented with 0.16 mg Se/kg increased (P < 0.01) hepatic activity of GPx3 and decreased (P < 0.01) the hepatic concentration of malondialdehyde. Interactions were detected between maternal and progeny diet with 0.16 mg Se/kg in hepatic activity of T-SOD and maternal and progeny diet supplemented with Se displayed the highest hepatic activity of T-SOD (P < 0.05). Overall, Se supplementation in the diet of duck breeders and offspring increased the antioxidant capacity of ducklings. Maternal Se supplementation increased the BW of hatchlings, whereas maternal and progeny dietary Se supplementation did not affect the BWG of ducklings aged from 0 to 2 wk. Se supplementation with additional 0.16 mg/kg in the diet of duck breeders and offspring displayed beneficial effects particularly on the antioxidant capacity in ducklings.

Application of Sarcosaprophagous Insects to Estimate the Postmortem Interval in 11 Cases

Abstract

Objective To test the feasibility and accuracy of with sarcosaprophagous insects postmortem interval （PMI） estimation with sarcosaprophagous insects and provide references for estimation practice. Methods Eleven cases confirmed by the detection results, with complete entomological evidence were selected. The insect species, estimation results and true results involved in the cases were statistically analyzed and compared. Results Thirteen species of insects were found at the criminal scene, including Chrysomya megacephala （Fabricius）, Chrysomya rufifacies （Macquart）, Chrysomya nigripes （Aubertin）, Lucilia sericata （Meigen）, Hydrotaea spinigera Stein, Muscina stabulans （Fallén）, Sarcophagid （species were not identified）, Megaselia scalaris （Loew）, Hermetia illucens （Linnaeus）, Saprinus splendens （Paykull）, Creophilus maxillosus （Linnaeus）, Dermestes maculatus （De Geer） and Necrobia ruficollis （Fabricius）. The PMI of all eleven cases was within the range of estimated PMI. The estimated results of 72.73% cases were on the same day of the true results. Conclusion Sarcosaprophagous insects can estimate the PMI simply and conveniently. In cases where the PMI is within the time range of one generation of flies or beetles, the estimation results are relatively accurate. However, the estimation is less accurate when the PMI is beyond the time range.

Estimation of dietary tryptophan requirement for laying duck breeders: effects on productive and reproductive performance, egg quality, reproductive organ and ovarian follicle development and serum biochemical indices

This study aimed to determine the dietary tryptophan (Trp) requirement for laying duck breeders. A total of 504 Longyan duck breeders (body weight: 1.20 ± 0.02 kg) aged 22 wk were randomly allocated to 6 treatments, each with 6 replicates of 14 ducks. During the next 16 wk, birds were fed the basal diet with total Trp contents of 1.00, 2.00, 3.00, 4.00, 5.00 and 6.00 g/kg, respectively. Dietary Trp levels increased egg production, egg mass and feed intake of duck breeders from 22 to 37 wk (P < 0.05), and there were linear and quadratic effects of Trp level (P < 0.05). The feed conversion ratio (FCR) quadratically decreased with dietary Trp levels (P < 0.05). Dietary Trp levels decreased (P < 0.05) egg albumen height and Haugh unit at wk 8 or 12, and the responses were linear and quadratic (P < 0.05). The body weight of breeders, absolute and relative weight of oviduct, number and total weight of preovulatory follicles (POF), and its proportion relative to ovarian weight were increased (P < 0.05), and the responses were linear (P < 0.01) and quadratic (P < 0.001). Ovarian weight increased quadratically (P < 0.05), and the mean weight of POF increased (P < 0.05), linearly and quadratically. The proportion of small yellow follicles relative to ovary weight decreased (P < 0.01) linearly and quadratically. At wk 16 of the trial period, the serum albumin content and alanine aminotransferase activity decreased (P < 0.05) and the creatinine content increased (P < 0.01) linearly and quadratically. The Trp requirements were estimated to be 3.14 g/kg for optimizing egg production, 2.93 g/kg for egg mass, and 2.92 g/kg for FCR. Overall, dietary Trp levels (1 to 6 g/kg) affected productive performance, egg quality, reproductive organ and ovarian follicle development, and serum biochemical indices of layer duck breeders, and a diet containing 2.9 to 3.1 g Trp per kg feed was adequate during the laying period (22 to 37 wk of age).

[Plasm trimethylamine-N-oxide level and association with lesion severity in coronary heart disease patients with type 2 diabetes mellitus]

Objective: To investigate the association between trimethylamine-N-oxide (TMAO) and the degree of coronary atherosclerosis in coronary heart diseases (CHD) patients with type 2 diabetes mellitus. Methods: Consecutive patients, who underwent coronary angiography due to suspected CHD in Beijing Hospital from November 2016 to January 2018, were screened in this cross-sectional study. According to blood glucose level, previous medical history and coronary angiography results, they were divided into CHD without type2 diabetes mellitus(CHD-nDM) group and CHD with type2 diabetes mellitus(CHD-DM) group. Plasma TMAO levels in each group were measured by LC-MS/MS. Spearman correlation analysis was used to evaluate the correlation between TMAO and the number of diseased vessels and Gensini scores. Multivariate logistic regression was used to analyze the correlation between TMAO and high Gensini scores. Results: A total of 590 patients were enrolled in the study, including 238 patients in CHD-DM group and 352 patients in CHD-nDM group. Patients were older, body mass index, blood pressure level, prevalence of history of hypertension and statins use were higher in CHD-DM group than in CHD-nDM group (all P<0.05). The proportion of patients with multivessel disease (2 or more vessels) was also higher in CHD-DM group than in CHD-nDM group (P<0.001). Gensini score was higher in CHD-DM group than in CHD-nDM group (P<0.05). Fasting blood glucose, glycosylated hemoglobin and urea were significantly higher, while low-density lipoprotein cholesterol and hemoglobin were significantly lower in CHD-DM group than in CHD-nDM group (all P<0.05). The levels of TMAO was significantly higher in CHD-DM group than in CHD-nDM group (P<0.001). Spearman correlation analysis showed that TMAO was positively correlated with the number of diseased vessels, Gensini score, age and blood glucose level (r=0.178, 0.189, 0.260, 0.111, respectively, all P<0.01). Multivariate logistic regression analysis showed that, TMAO level was still positively correlated with high Gensini score in CHD-DM group (OR=2.25, 95%CI 1.16-4.38, P=0.017), but not in CHD-nDM group (OR=1.29, 95%CI 0.72-2.31, P=0.386) after adjusting for age, sex, body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, triglyceride, history of hypertension, hyperlipidemia, smoking and statin use. Conclusions: In CHD patients with tupe 2 diabetes mellitus, the plasma TMAO level is significantly increased and is independent and positively correlated with the degree of coronary artery disease.

[Evaluation of safety of two inactivated COVID-19 vaccines in a large-scale emergency use]

Objective: To evaluate the safety of two inactivated COVID-19 vaccines in a large-scale emergency use. Methods: Based on the "Vaccination Information Collection System", the incidence data of adverse reactions in the population vaccinated with the inactivated COVID-19 vaccines developed by Beijing Institute of Biological Products Co., Ltd and Wuhan Institute of Biological Products Co., Ltd, respectively, in emergency use were collected, and the relevant information were analyzed with descriptive epidemiological and statistical methods. Results: By December 1, 2020, the vaccination information of 519 543 individuals had been collected. The overall incidence rate of adverse reactions was 1.06%, the incidence rate of systemic adverse reactions was 0.69% and the incidence rate of local adverse reactions was 0.37%. The main systemic adverse reactions included fatigue, headache, fever, cough and loss of appetite with the incidence rates of 0.21%, 0.14%, 0.06%, 0.05% and 0.05%, respectively; the main local adverse reactions were injection site pain and injection site swelling with the incidence rates of 0.24% and 0.05%, respectively. Conclusion: The two inactivated COVID-19 vaccines by Beijing Institute of Biological Products Co., Ltd and Wuhan Institute of Biological Products Co., Ltd showed that in the large-scale emergency use, the incidence rate of general reactions was low and no serious adverse reactions were observed after the vaccinations, demonstrating that the vaccines have good safety.

[Adrenocortical oncocytic tumors: a clinicopathological analysis of 44 cases]

Objective: To study the clinicopathological features of adrenocortical oncocytic tumors (ACOT) and to compare the diagnostic values of Lin-Weiss-Bisceglia (LWB) score and Helsinki score. Methods: Forty-four cases of ACOT diagnosed at Beijing Friendship Hospital, China from March 2008 to July 2019 were histologically analyzed to evaluate their malignant potential (benign versus malignant) according to two scoring criteria. Immunohistochemical studies (EnVision method) were also used. Results: There were 23 males and 21 females with an average age of 46 years. Histologically, the tumor cells were arranged in trabecular, chrysanthemum-shaped, glandular and microcapsule structures, while clear cells were rare or absent. Most of the tumor cells were moderately atypical, and intranuclear inclusion bodies were conspicuous. Immunohistochemical staining showed that tumor cells were positive for Melan A, inhibin, Syn and calretinin. The average proliferation index was 3% in benign ACOT, about 5% in ACOT of malignant potential, and>20% in malignant ACOT. According to the LWB score, 61.4% (27/44) of the tumors were on the left side and had multiple lesions. The percentage of benign ACOT was 59.1% (26/44), malignant potential 6.8% (3/44), malignant 34.1% (15/44), respectively. Among the 15 malignant ACOT, the mitotic figures>5/50 HPF were found in 13 cases, necrosis in 11 cases and capsule invasion in 10 cases. According to the Helsinki score, 65.9% (29/44) of the tumors were benign, and 34.1% (15/44) were malignant. There was no significant difference between the two scoring standards (P>0.05). During the follow-up of 9 to 144 months, 31 patients survived without disease and 13 patients relapsed or had metastasis. Conclusions: ACOT more likely be benign than malignant. The left side is more common. Malignant tumors are prone to recurrence and metastasis. The morphological parameters (high mitotic index, necrosis, and capsular invasion) in the LWB scoring standards combined with immunohistochemical parameters (Ki-67) in the Helsinki score are helpful for the diagnosis of malignant ACOT and are important predictors of poor prognosis.

Benchmark Experiment to Prove the Role of Projectile Excited States Upon the Ion Stopping in Plasmas

We report on a precision energy loss measurement and theoretical investigation of 100  keV/u helium ions in a hydrogen-discharge plasma. Collision processes of helium ions with protons, free electrons, and hydrogen atoms are ideally suited for benchmarking plasma stopping-power models. Energy loss results of our experiments are significantly higher than the predictions of traditional effective charge models. We obtained good agreement with our data by solving rate equations, where in addition to the ground state, also excited electronic configurations were considered for the projectile ions. Hence, we demonstrate that excited projectile states, resulting from collisions, leading to capture-, ionization-, and radiative-decay processes, play an important role in the stopping process in plasma.

The application of reduced dietary crude protein levels supplemented with additional amino acids in laying ducks

This study was aimed at studying use of reduced dietary crude protein (CP) level supplemented with additional amino acids in laying ducks. A total of 720 Jingjiang ducks (50 wk) were randomly assigned to 5 treatments and fed 5 basal diets with CP levels at 17.5, 16.5, 15.5, 14.5, or 13.5%, with additional amino acids added to each diet for 12 wk. Each treatment had 6 replicates of 24 ducks each. Dietary CP levels affected (P < 0.05) egg production and mass of laying ducks, and there was a linear and quadratic decrease with decreasing CP levels (P < 0.05). Dietary CP levels did not affect egg weight and feed conversion ratio (FCR), but egg weight decreased linearly (P < 0.05); FCR increased linearly and quadratically (P < 0.05) with decreasing CP levels. There were no significant differences in egg quality among the different CP levels (P > 0.05). Ovarian weight, total and mean weight of preovulatory follicles, and total weight of small yellow follicles (SYF) were decreased by dietary CP levels (linear, P < 0.01 and quadratic, P < 0.05). The oviductal weight decreased linearly (P < 0.05), and the number of SYF decreased linearly and quadratically with decreasing CP levels (P < 0.05). The serum estradiol content decreased linearly with dietary CP levels (P < 0.05). The serum contents of luteinizing hormone, prolactin, and progesterone decreased (P < 0.05), linearly and quadratically (both P < 0.01) with decreasing CP levels. The serum contents of creatinine (CRE), triglycerides (TG), total cholesterol (TC), and alanine aminotransferase (ALT) activity were affected (P < 0.05) by different dietary CP levels. The total protein content increased linearly (P < 0.05), TC content increased quadratically (P < 0.05), and contents of albumin, CRE, TG, and phosphorus, and activities of aspartate aminotransferase and ALT increased linearly and quadratically (both P < 0.05) with decreasing CP levels. Overall, reduced dietary CP levels with addition of amino acids affected the laying performance, the development of reproductive organs and ovarian follicles, serum hormones, and biochemical indices of laying ducks. Dietary CP levels can be reduced to 14.5% with additional amino acid supplementation for 12 wk in laying ducks without negative effect on laying performance and egg quality.

[Application and status of digestive endoscopy in the overall management of portal hypertension-related esophagogastric variceal bleeding]

Portal hypertension-related esophagogastric variceal bleeding (EVB) is deadly. Therefore, multidisciplinary management involving hepatologists, digestive endoscopy, radiological intervention, and/or surgery is necessary. Digestive endoscopy is the core of the multidisciplinary approach to the overall management of portal hypertension. It plays an important role in the early warning, emergency treatment, and the prevention of the initial and re-bleeding of portal hypertension accompanied by esophagogastric varices. In addition, gastroscopy with endoscopic ultrasound scanning can enhance the management capabilities of ectopic varices.

Effects of capsaicin on laying performance, follicle development, and ovarian antioxidant capacity in aged laying ducks

The present study was conducted to evaluate the effects of dietary addition of capsaicin (CAP) on egg production performance, follicular development, and ovarian antioxidant capacity in laying ducks. Three hundred seventy eight 58-wk-old laying ducks were randomly divided into 3 treatments, each treatment consisted 6 replicates, with 12 individually caged laying ducks per replicate. Ducks fed a basal diet served as control, the other 2 groups of ducks were fed the same diet containing 150 mg/kg CAP but in the manner of feed restriction (pair-fed) or ad libitum fed. The experiment lasted for 8 wk. The results showed that the dietary supplementation with CAP under conditions of ad libitum feeding increased feed intake (P < 0.001) and tended (P < 0.1) to increase egg production and egg weight in laying ducks but had no effects on daily egg mass and feed conversion ratio. The relative weight of large yellow follicles from the 2 CAP-supplemented groups at 64 wk of age were significantly higher than that of the controls (P = 0.01). The relative weight of the small yellow follicles in the CAP free-fed group was significantly higher than that of the other 2 groups (P < 0.01). Capsaicin supplementation under ad libitum feding conditions tended to increase the number of dominant follicles in laying ducks (P = 0.06). The ovarian mRNA expression of genes related to calcium signaling (TRPV4, ATP2A2, ITPR1, and CaM) in the CAP ad libitum fed groups were significantly higher than those of the other 2 groups (P < 0.05). The ovarian mRNA expression of CDK1 in CAP free-fed ducks was significantly higher than that of the other 2 groups (P = 0.01). Capsaicin supplementation significantly increased the plasma glutathione peroxidase activity (P < 0.01) in comparison with the control group but reduced the malondialdehyde content in the ovaries of laying ducks (P < 0.01). The results of this study indicates that dietary supplementation of CAP increased feed intake and improved egg production performance probably by activating calcium signaling pathway and improving redox status.

[Efficacy and safety of laparoscopic radical hysterectomy for early cervical adenocarcinoma]

Objective: To investigate the efficacy and safety of laparoscopic radical hysterectomy for early cervical adenocarcinoma. Methods: A retrospective observational study was performed by reviewing medical records of patients with staging Ⅰb1-Ⅱa2 International Federation of Gynecology and Obstetrics (FIGO, 2009) cervical adenocarcinoma who underwent laparoscopic or abdominal radical hysterectomy from 2007 to 2017 in the Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences. The difference among clinicopathologic characteristics, surgery-related parameters and complications, and prognosis were analyzed between the laparoscopic group and abdominal group. Results: Two hundreds and ninety-three patients were included with 88 cases in laparoscopic group and 205 cases in abdominal group. （1） There was no significant difference in clinicopathologic characteristics between the two groups （all P>0.05）, including age, body mass index, menopause status, history of abdominal surgery, clinical stage, tumor diameter, neoadjuvant chemotherapy, differentiation, lymph-vascular space invasion, positive of surgical margin, parametrial invasion, and lymph node metastasis. But the abdominal group showed a higher proportion of deep stromal invasion (38.5% vs 25.0%, P<0.05). No significant difference was observed between two groups with number of lymph nodes resected, urinary catheter retention, short-term surgical complications (including ureteral injury, ileus, infection, hydronephrosis and poor wound healing), and long-term complications (including voiding dysfunction, defecation dysfunction and lower limb edema； all P>0.05）. （2） The laparoscopic group was significantly associated with a longer operation time [(260±51) minutes vs (244±53) minutes, P<0.05], but less bleeding (100 ml vs 300 ml, P<0.01), shorter hospital stay [(13±5) days vs (16±8) days, P<0.01] and lower incidence of lymphedema (12.5% vs 27.8%, P<0.01). （3） The 5-year progression-free survival (PFS; 85.7% vs 86.4%, P=0.971) and 5-year overall survival (OS; 91.4% vs 93.0%, P=0.657) of laparoscopic group were comparable to that of abdominal group. （4） Multivariate analysis demonstrated that lymph node metastasis (HR=2.44, 95%CI: 1.16-5.15, P=0.019) was independent poor prognostic factors related to PFS, while adenosquamous carcinoma (HR=2.54, 95%CI: 1.02-6.35, P=0.046), lymph-vascular space invasion (HR=3.86, 95%CI: 1.60-9.33, P=0.003) and lymph node metastasis (HR=5.92, 95%CI: 2.45-14.34, P<0.01) were independent poor prognostic factors related to OS. The laparoscopy surgery was not an independent poor prognostic factor (P=0.396). Conclusion: The laparoscopic radical hysterectomy for early cervical adenocarcinoma has comparable prognosis to abdominal radical hysterectomy with a higher surgery quality.

Estimation of dietary manganese requirement for laying duck breeders: effects on productive and reproductive performance, egg quality, tibial characteristics, and serum biochemical and antioxidant indices

This study was aimed at estimating the dietary manganese (Mn) requirement for laying duck breeders. A total of 504 Longyan duck breeders (body weight: 1.20 ± 0.02 kg) aged 17 wk were randomly allocated to 6 treatments. The birds were fed with a basal diet (Mn, 17.5 mg/kg) or diets supplemented with 20, 40, 80, 120, or 160 mg/kg of Mn (as MnSO₄·H₂O) for 18 wk. Each treatment had 6 replicates of 14 ducks each. As a result of this study, dietary Mn supplementation did not affect the productive performance of laying duck breeders in the early laying period (17–18 wk), but affected egg production, egg mass, and feed conversion ratio (FCR) from 19 to 34 wk (P < 0.05), and there was a linear and quadratic effect of supplement level (P < 0.05). The proportion of preovulatory ovarian follicles increased (P < 0.01) linearly and quadratically, and atretic follicles (weight and percentage) decreased (P < 0.05) quadratically with dietary Mn supplementation. The density and breaking strength of tibias increased (quadratic; P < 0.05), the calcium content of tibias decreased (linear, quadratic; P < 0.01), and Mn content increased (linear, quadratic; P < 0.001) with increase in Mn. The addition of Mn had a quadratic effect on serum contents of estradiol, prolactin, progesterone, luteinizing hormone, and follicle-stimulating hormone (P < 0.001). Dietary Mn supplementation decreased serum contents of total protein (linear, P < 0.05), glucose (quadratic, P < 0.05), total bilirubin, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and calcium (linear, quadratic; P < 0.05). The serum total antioxidant capacity and total and Mn-containing superoxide dismutase activities increased (linear, quadratic; P < 0.001), and malondialdehyde content decreased (linear, quadratic; P < 0.001) in response to Mn supplemental levels. The dietary Mn requirements, in milligram per kilogram for a basal diet containing 17.5 mg/kg of Mn, for Longyan duck breeders from 19 to 34 wk of age were estimated to be 84.2 for optimizing egg production, 85.8 for egg mass, and 95.0 for FCR. Overall, dietary Mn supplementation, up to 160 mg/kg of feed, affected productive performance, tibial characteristics, and serum biochemical and antioxidant status of layer duck breeders. Supplementing this basal diet (17.5 mg/kg of Mn) with 85 to 95 mg/kg of additional Mn was adequate for laying duck breeders during the laying period.

Neuropilin1, a novel independent prognostic factor and therapeutic target in triple-negative breast cancer

Triple-negative breast cancer (TNBC) is the most aggressive breast cancer, and thus, has limited treatment options. Neuropilin1 (NRP1) is a multi-functional transmembrane protein that interacts with a number of signaling receptors and plays an important role in cancer progression. Previous studies demonstrated that the expression of NRP1 is activated and promotes the progression of breast cancer particularly in TNBC compared to other molecular subtypes; however, whether or not the level of NRP1 expression is related to the progression of TNBC warrants further study. In the current study, we determined the expression and function of NRP1 and evaluated the clinical significance of NRP1 in patients with TNBC. In addition, we determined whether or not an NRP1 antagonist potentiates the inhibitory effects of paclitaxel (PTX) in patients with TNBC. In our clinical study, NRP1 had higher expression in TNBC tissues than non-TNBC tissues at the same stage, and NRP1 was an independent prognostic factor. Specifically, the high expression of NRP1 was associated with shorter survival in TNBC patients. In addition, TNBC cells treated with NRP1 antagonist significantly potentiated the effect of PTX on cell proliferation, cell migration, and apoptosis. Our findings suggest that NRP1 expression can act as an independent prognostic factor for TNBC patients, and the combination of PTX and an NRP1 antagonist may be an effective treatment regimen for TNBC.

Decreased expression of GBA3 correlates with a poor prognosis in hepatocellular carcinoma patients

Beta-glucosidase (GBA), also known as acid β-glucosidase, exhibits an activity of glucosylceramidase (EC 3.2.1.45). Three main isoforms of β-glucosidases have been identified in mammals: GBA1, GBA2, and GBA3. The deficiency of these enzymes leads to glucosylceramide accumulation, resulting in Gaucher's disease. The present study is focused on the cytosolic β-glucosidase, GBA3, and its relationship with hepatocellular carcinoma (HCC). The expression of GBA3 mRNA in HCC was evaluated first using the TCGA database, and then by immunohistochemistry using tissue microarrays of 328 clinically characterized HCC samples and 151 non-tumor liver controls. Moreover, the presence of a correlation between GBA3 expression and clinicopathological characteristics of patients was examined. The obtained results indicated that the expression of GBA3 mRNA was significantly lower in HCC than in the adjacent non-tumor liver tissues. The expression of GBA3 was inversely related to the number of tumors (p=0.041), tumor size (p<0.001), Edmondson grade (p=0.007), microvascular invasion (p=0.049), patient status (p<0.001), and α-fetoprotein level (p<0.001). Patients exhibiting low GBA3 expression had a shorter survival time than those with high expression (p<0.001). In conclusion, the decreased GBA3 expression is strongly associated with a poor prognosis in HCC patients, and GBA3 may be a potential therapeutic target for HCC.

[Current situation of initial female fertility evaluation in assisted reproductive institutions in China in 2019]

The evaluation of female fertility at first diagnosis is an important premise and basis for determining the treatment scheme of assisted reproduction. In this study, a survey was conducted among 13 assisted reproductive institutions in China to understand the evaluation indicators and detection methods of female fertility at first diagnosis in various institutions, and provide a basis for reasonable selection of indicators. The survey showed that the indicators of female fertility evaluation at first diagnosis among assisted reproductive institutions included general health indicators, ovarian reserve indicators, and uterine conditions, etc. The selection of indicators was considerably consistent, but the detection methods were quite different. Therefore, it is necessary to choose the detection method with better validity and less harm.

The effects of dietary Se on productive and reproductive performance, tibial quality, and antioxidant capacity in laying duck breeders

This study evaluated the optimal concentrations of dietary Se for the productive and reproductive performance, tibial quality, and antioxidant status in duck breeders aged 23 to 49 wk. In total, 432 Longyan duck breeders aged 22 wk were allotted randomly to 6 treatments, each with 6 replicates of 12 individually caged birds. The experiment lasted for 27 wk, and birds were fed corn-soybean meal-based diets containing 0.11, 0.19, 0.27, 0.35, 0.43, or 0.51 mg Se/kg, respectively. The tested dietary Se levels did not affect egg production and tibial quality of duck breeders. The Se contents of the shell, yolk or albumin, whole egg, and the fertility of set eggs increased in a linear and quadratic manner (P < 0.05) in response to the increased dietary Se level, whereas the yolk malondialdehyde (MDA) and embryonic mortality decreased. The activities of glutathione peroxidase 3 (Gpx3) in plasma and Gpx1 in the erythrocytes and livers of breeder ducks increased in a linear and quadratic manner (P < 0.05) in response to increased dietary Se levels, whereas the total superoxide dismutase (T-SOD) activity increased and the MDA concentration decreased in the liver. The activity of Gpx3 in the plasma and Gpx1 in the erythrocytes and livers of newly hatched ducklings increased linearly (P < 0.01) with the increase in Se level, whereas the T-SOD activity and MDA concentration did not change. In conclusion, diets containing 0.27 mg Se/kg led to the highest egg fertility and hatchability in Longyan duck breeders, and using levels >0.19 mg Se/kg diet enhanced the antioxidant capacity in breeders and their offspring. The regression model indicated that dietary Se levels 0.19, 0.27, 0.28, 0.24, and 0.30 mg/kg are optimal levels to obtain maximum Se deposition efficiency in eggs, egg fertility, Gpx1 activity in erythrocytes and liver in duck breeders, and plasma activity of Gpx3 in newly hatched ducklings, respectively.

Effects of ${\rm \small L}$-methionine on growth performance, carcass quality, feather traits, and small intestinal morphology of Pekin ducks compared with conventional ${\rm \small {DL}}$-methionine

The research studied the effects ofl-methionine (l-Met) on growth performance, carcass quality, feather traits, and small intestinal morphology of Pekin ducks compared with conventionaldl-methionine (dl-Met). A total of 1080, 1-day-old male Pekin ducks were randomly allotted to 9 groups with 6 replicate pens of 20 birds each. During the starter phase (1 to 14 d), ducks were fed a basal diet (Met, 0.30%) or that supplemented with dl-Met or l-Met at 0.05, 0.10, 0.15, or 0.20% of feed. During the grower phase (15 to 35 d), ducks were fed a basal diet (Met, 0.24%) or that supplemented with dl- Met or l-Met at 0.04, 0.08, 0.12, or 0.16% of feed. Compared with ducks fed the basal diet, supplementation with either dl- Met or l-Met increased the body weight (BW) of ducks at days 14 and 35, increased average daily gain (ADG) and average daily feed intake (ADFI), decreased F:G at the starter phase, and increased ADG over the whole 35-d period (P < 0.05). The efficacy of l-Met compared to dl- Met was 140.1% for 14-d BW, 137.6% for ADG and 121.0% for F:G for days 1 to 14. Ducks fed diets supplemented with l-Met had greater proportion of leg muscle, higher than in ducks provided with dl- Met (P < 0.05). The breast muscle proportion was enhanced with dl- Met rather than l- Met supplementation (P < 0.01). The back feathers score and fourth primary wing feather length were increased with dl- Met or l-Met supplementation (P < 0.01), and there was increased efficacy of l-Met relative to dl- Met for back feathers score (153.1%). Dietary dl- Met or l- Met supplementation increased villus height of ileal mucosa of ducks at days 14 and 35 (P < 0.01). Overall, dietary l-Met or dl- Met supplementation affected the growth performance of ducks during the starter phase, and improved the feather traits and small intestinal morphology. The efficacy of l-Met to dl- Met ranged from 120 to 140% for growth performance of young ducks (1 to 14 d) and was 153% for the feather traits of ducks (35 d).

[Influencing factors of postoperative acute kidney injury in patients undergoing cardiac surgery]

Objective: To analyze the influencing factors of acute kidney injury (AKI) in patients after cardiac surgery using levosimendan or dobutamine, and explore the effect of positive inotropic drugs on AKI. Methods: The clinical data of 417 patients undergoing cardiac surgery from January to June 2018 in Beijing Anzhen Hospital and treated with levosimendan or dobutamine during perioperative period were retrospectively reviewed and collected. Patients were divided into AKI group and non-AKI group according to whether AKI occurred. Univariate logistic regression analysis was used to analyze the factors related to the occurrence of AKI. The statistically significant factors (P<0.05) were further included in the multivariate logistic regression analysis. Results: Totally, 417 patients were enrolled in the study, with a mean age of (58.2±10.4) years old and a male rate of 65.0% (n=271), and the AKI incidence rate was 25.2% (105/417). Univariate logistic regression analysis showed that male, chronic kidney disease, high serum creatinine level in preoperative period, aortic obstruction time ≥ 120 minutes and extracorporeal circulation time ≥ 120 minutes were risk factors for AKI (all P<0.05). Vasodilator and levosimendan treatment during perioperative period were protective factors (P<0.05). Multivariate logistic regression analysis showed that chronic kidney disease (OR=17.291, 95%CI: 4.335-68.960, P<0.001) and high serum creatinine level (OR=1.097, 95%CI: 1.074-1.121, P<0.001) in preoperative period were independent risk factors for AKI. Perioperative application of levosimendan (OR=0.533, 95%CI: 0.288-0.984, P=0.044) was an independent protective factor. Conclusions: Risk factors for AKI after cardiac surgery include chronic kidney disease and high serum creatinine level in preoperative period. The use of levosimendan during preoperative period has the potential effect to protect against AKI.

Effects of dietary lysine on productivity, reproductive performance, protein and lipid metabolism-related gene expression in laying duck breeders

This study investigated whether dietary lysine (Lys) affects productive performance and expression of genes related to protein and lipid metabolism in laying duck breeders. Longyan duck breeders (n = 540, 19 wk of age) were randomly assigned to 6 groups with 6 replicates of 15 birds each. Breeders were fed diets with 6 total Lys levels (6.4, 7.2, 8.0, 8.8, 9.6, and 10.4 g/kg) for 26 wk duration. Egg production, egg weight, egg mass, feed conversion ratio, hatchability, hatchling weight, albumen weight, eggshell weight, yolk weight, and yolk proportion increased with dietary Lys levels (P < 0.05). Dietary Lys level had a linear (P < 0.05) and quadratic (P < 0.05) effects on maternal hepatic expression of mechanistic target of rapamycin, eukaryotic translation initiation factor 4E binding protein 1, ubiquitin conjugating enzyme E2K (UBE2K), cathepsin B (CTSB), and quadratically (P < 0.05) increased the concentrations of plasma Lys, leucine, threonine, and tryptophan in duck breeders. In contrast, maternal dietary Lys suppressed expression of proteasome 26S subunit, UBE2K, and CTSB in the liver of hatchlings. Moreover, relative expression of peroxisome proliferator-activated receptors alpha, carnitine palmitoyltransferase 1A, and very low density apolipoprotein-II increased linearly (P < 0.05) and quadratically (P < 0.05), and that of VLDL receptor (VLDLR) decreased quadratically (P < 0.05) in the liver of duck breeders with increasing dietary Lys levels; hepatic triglyceride and cholesterol contents were reduced. Maternal dietary Lys suppressed hepatic expression of VLDLR in the hatchlings. A diet containing 8.6 g Lys/kg promoted protein turnover and lipid metabolism in laying duck breeders, which positively reflected in the productivity and reproductive performance.

Estimation of dietary zinc requirement for laying duck breeders: effects on productive and reproductive performance, egg quality, tibial characteristics, plasma biochemical and antioxidant indices, and zinc deposition

This study evaluated the effects of different dietary zinc (Zn) levels on productive and reproductive performance, egg quality, tibial characteristics, plasma biochemical and antioxidant indices, and zinc deposition in laying duck breeders. A total of 504 Longyan duck breeders aged 21 wk were randomly allocated to 6 treatments and fed a basal diet (Zn, 27.7 mg/kg) or that basal diet supplemented with Zn (as ZnSO₄·H₂ O) at 10, 20, 40, 80, or 160 mg Zn per kg of feed for 20 wk. Each group had 6 replicates of 14 ducks each. Dietary Zn supplementation affected (P < 0.05) the egg production, FCR, and shell thickness of laying duck breeders from 21 to 40 wk, and there was a quadratic (P < 0.05) effect between them. Dietary Zn supplementation affected (P < 0.05) and quadratically (P < 0.001) increased the breaking strength, density, and dry defatted weight of tibias. Alkaline phosphatase, calcium, phosphorus, total superoxide dismutase, glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) activities or content in plasma were affected (P < 0.05), and quadratically (P < 0.01) changed by dietary Zn levels. Dietary Zn supplementation affected (P < 0.01) and increased the Zn deposition in egg yolk (linear, P < 0.05; quadratic, P < 0.001) and tibia (linear, P < 0.05). The dietary Zn requirements, in mg/kg for a basal diet containing 27.7 mg/kg Zn, for Longyan duck breeders from 21 to 40 wk of age were estimated to be 65.4 for optimizing egg production, 68.6 for FCR, 102 for hatchling BW, 94.7 for eggshell thickness, 77.2 for tibial breaking strength, 81.4 for tibial density, 78.9 for tibial dry defatted weight, 69.5 for plasma GSH-Px activity, 72.4 for plasma MDA content, and 94.6 for Zn content in tibia. Overall, dietary Zn supplementation, up to 160 mg/kg feed, affected the productive performance, eggshell thickness, tibial characteristics, plasma antioxidant status, and Zn deposition of layer duck breeders. Supplementing this basal diet (27.7 mg/kg Zn) with 70 to 80 mg/kg additional Zn was adequate for laying duck breeders during the laying period.

Dietary curcumin enhances intestinal antioxidant capacity in ducklings via altering gene expression of antioxidant and key detoxification enzymes

The study investigated the effects of dietary curcumin supplementation on tissue distribution of curcumin and its metabolites, intestinal antioxidant capacity, and expression of detoxification-related genes in ducks. A total of 720 one-day-old male Cherry Valley Pekin ducklings (initial BW 58.6 ± 0.1 g) were randomly assigned to 4 dietary groups each with 6 replicates of 30 ducks using a single factorial arrangement design. Ducks in the control group were fed a basal diet and the remainder were fed the basal diet supplemented with 200, 400, or 800 mg/kg curcumin. The experiment lasted for 21 D. Curcumin was present at 13.12 to 16.18 mg/g in the cecal digesta, 75.50 to 575.40 μg/g in jejunal mucosa, 35.10 to 73.65 μg/g in liver, and 7.02 to 7.88 μg/mL in plasma. The jejunal and hepatic contents of curcumin increased significantly (P < 0.05) in response to supplementation with 400 and 800 mg/kg of curcumin respectively, compared with 200 mg curcumin/kg group. There was a linear (P < 0.001) effect of dietary curcumin on relative abundance of SOD1, GPX1, CAT, HO-1, and Nrf2 transcripts, and a quadratic (P < 0.001) increase in the activities of GSH-Px and T-AOC in jejunal mucosa. The expression of CYP1A4, CYP2D17 increased and CYP1B1, CYP2A6 decreased linearly (P < 0.001) with dietary curcumin concentrations. In addition, dietary curcumin increased gene expression of GST, MRP6, and ABCB1 in jejunal mucosa. In conclusion, dietary supplementation with 200 to 800 mg/kg curcumin enhanced the accumulation of curcumin and its metabolites in jejunum as well as increasing the antioxidant capacity and detoxification potential, which play major roles in the protection of duck intestines against damage.

[Clinical characteristics and related factors of somatization symptoms in outpatients with psychiatric disorders of the department of cardiology in general hospitals]

Objective: To explore the clinical characteristics and related factors of somatization symptoms in outpatients with psychiatric disorders of the cardiology department in general hospital. Methods: Cross-sectional survey method was used in this study. From August 2017 to September 2018, 508 outpatients of our department with suspected mental disorders, who complained of physical discomfort and screened by the "Three Questions" method recommended by the Chinese Expert Consensus on Psychological Prescriptions of Cardiovascular Patients in 2014, were consecutively included. General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Patient Health Questionnaire-15 (PHQ-15) and self-made general demographic questionnaire (including age, sex, marital status, educational level, occupation, duration of disease, clinical diagnosis and the process of medical treatment for the main somatic symptoms in recent one year) were used to investigate these patients, under the assistance of unified training psychological consultants. The detection rate of anxiety and depression, the degree and distribution of somatization symptoms in outpatients with mental disorders were analyzed, and the related factors affecting the occurrence of somatization symptoms were screened by multivariate logistic regression. Results: The selected patients were (51.3±10.1) years old, of which 37.8% (192/508) were males and 62.2% (316/508) were females. The total detection rate of anxiety/depression was 86.8% (441/508), and the detection rate of somatization symptoms was 93.1% (473/508). The number of positive symptom items in PHQ-15 was 8.0±2.7, and the detection rate of anxiety/depression was 78.6% (372/473) in patients with somatization symptoms. There were significant differences in the proportion of women, the average number of outpatient visits and hospitalizations in the past one year, GAD-7 score and PHQ-9 score among the patients with mild, moderate and severe somatization symptoms (all P<0.05). PHQ-15 score was positively correlated with GAD-7 score (r=0.524 5, P<0.001) and PHQ-9 score (r=0.574 9, P<0.001) in patients with somatization symptoms. Stepwise logistic regression analysis showed that total scores of PHQ-9 (OR=8.020, 95%CI 3.470-18.930, P<0.001) and GAD-7 (OR=6.526, 95%CI 2.903-13.045, P<0.001) and female (OR=4.440, 95%CI 1.059-9.073, P=0.011) were related factors of somatizations. Conclusions: The incidence of somatization symptoms is high in patients with psychological disorders in outpatients of cardiology department in general hospital. Anxiety, depression and gender are the main related risk factors of somatization symptoms in this patient cohort. Degree of anxiety and depression increased in proportion to the severity of somatization symptoms. Anxiety, depression and female is related to somatization symptoms.