Immune persistence after different polio sequential immunization schedules in Chinese infants

Trivalent oral poliovirus vaccine (tOPV) has been withdrawn and instead an inactivated poliovirus vaccine (IPV) and bivalent type 1 and type 3 OPV (bOPV) sequential immunization schedule has been implemented since 2016, but no immune persistence data are available for this polio vaccination strategy. This study aimed to assess immune persistence following different polio sequential immunization schedules. Venous blood was collected at 24, 36, and 48 months of age from participants who had completed sequential schedules of combined IPV and OPV in phase III clinical trials. The serum neutralizing antibody titers against poliovirus were determined, and the poliovirus-specific antibody-positive rates were evaluated. A total of 1104 participants were enrolled in this study. The positive rates of poliovirus type 1- and type 3-specific antibodies among the sequential immunization groups showed no significant difference at 24, 36, or 48 months of age. The positive rates of poliovirus type 2-specific antibody in the IPV-IPV-tOPV group at all time points were nearly 100%, which was significantly higher than the corresponding rates in other immunization groups (IPV-bOPV-bOPV and IPV-IPV-bOPV). Immunization schedules involving one or two doses of IPV followed by bOPV failed to maintain a high positive rate for poliovirus type 2-specific antibody.

Design and analysis of radio frequency window for the China Fusion Engineering Test Reactor ion cyclotron range of frequency heating system

The Ion Cyclotron Range of Frequency (ICRF) heating system of the China Fusion Engineering Test Reactor (CFETR) is intended to provide plasma heating with a minimum power output of 20 MW, which demands the Radio Frequency (RF) window to possess a higher performance requirement. This paper presents the design of an RF window for the CFETR ICRF heating system and focuses primarily on the design and confirmation of its electromagnetic performance. The RF window can be effectively matched in the operating frequency range and has an S11 of under -59 dB. The geometry of the cone type ceramics was optimized to reduce the surface tangential electric field distribution. An analysis of the electric field distribution of the RF window at 50 kV indicates that the pressure side was below 2.3 kV/mm and the vacuum side was below 1.3 kV/mm. Furthermore, a transmission line test bench with an open-terminated setup was constructed to conduct withstand voltage tests on the mockup, and the results showed that the mockup could withstand 62 kV for 2 s and 47 kV for 120 s.

[Hyperspectral imaging technology distinguishes between Puerariae Lobatae Radix and Puerariae Lobatae Caulis]

Puerariae Lobatae Radix, the dried root of Pueraria lobata, is a traditional Chinese medicine with a long history. Puerariae Lobatae Caulis as an adulterant is always mixed into Puerariae Lobatae Radix for sales in the market. This study employed hyperspectral imaging(HSI) to distinguish between the two products. VNIR lens(spectral scope of 410-990 nm) and SWIR lens(spectral scope of 950-2 500 nm) were used for image acquiring. Multi-layer perceptron(MLP), partial least squares discriminant analysis(PLS-DA), and support vector machine(SVM) were employed to establish the full-waveband models and select the effective wavelengths for the distinguishing between Puerariae Lobatae Caulis and Puerariae Lobatae Radix, which provided technical and data support for the development of quick inspection equipment based on HSI. The results showed that MLP model outperformed PLS-DA and SVM models in the accuracy of discrimination with full wavebands in VNIR, SWIR, and VNIR+SWIR lens, which were 95.26%, 99.11%, and 99.05%, respectively. The discriminative band selection(DBS) algorithm was employed to select the effective wavelengths, and the discrimination accuracy was 93.05%, 98.05%, and 98.74% in the three different spectral scopes, respectively. On this basis, the MLP model combined with the effective wavelengths within the range of 2 100-2 400 nm can achieve the accuracy of 97.74%, which was close to that obtained with the full waveband. This waveband can be used to develop quick inspection devices based on HSI for the rapid and non-destructive distinguishing between Puerariae Lobatae Radix and Puerariae Lobatae Caulis.

Non-enzymatic browning of wine induced by monomeric flavan-3-ols: A review

Non-enzymatic browning occurs widely in both white and red wines, and it has a huge impact on the color evolution and aging potential. Previous studies have proved that phenolic compounds, especially those with catechol groups, are the most important substrates involved in browning reactions of wine. This review focus on the current knowledge of non-enzymatic browning in wine resulting from monomeric flavan-3-ols. First, some relevant aspects of monomeric flavan-3-ols are introduced, including their structures, origins, chemical reactivities, as well as potential impacts on the organoleptic properties of wine. Second, the mechanism for non-enzymatic browning induced by monomeric flavan-3-ols is discussed, with an emphasis on the formation of yellow xanthylium derivatives, followed by their spectral properties and effects on the color change of wine. Finally, attentions are also be given to the factors that influence non-enzymatic browning, such as metal ions, light exposure, additives in winemaking, etc.

[Current status and hotspot of minimally invasive surgery for pancreatic head carcinoma]

With the improvement of laparoscopic equipment and surgical technology,pancreatic surgery has entered the "minimally invasive era".However,the use of minimally invasive pancreaticoduodenectomy in patients with pancreatic head cancer remains controversial.In recent years,China's pancreatic surgeons have been at the forefront of the world in terms of surgical technology,however,surgical philosophy, selection of indication,and perioperative management should be further stregthened. Additionally, the development of medical standards in various regions of China is seriously uneven,and minimally invasive pancreaticoduodenectomy still needs to be further standardized and popularized.Through this article,the author discusses the development status of minimally invasive surgery for pancreatic head cancer and related hot topics with fellow surgeons,in order to further improve the standard diagnosis and treatment of pancreatic cancer in China.

[Clinical and Laboratory Characteristics of Primary Autoimmune Hemolytic Anemia Patients with Negative Results of DAT by Tube Test But Positive Results by Microcolumn Gel Assay]

OBJECTIVE

To investigate the clinical features and laboratory characteristics of primary autoimmune hemolytic anemia (AIHA) patients with negative results of direct antiglobulin test (DAT) by tube test but positive results by microcolumn gel assay, in order to provide references for the diagnosis of these patients.

METHODS

59 patients diagnosed with primary AIHA in our hospital from January 2015 to December 2020 were retrospectively analyzed. According to the results of tube test and microcolumn gel assay, the cases were divided into 3 groups, and the clinical and laboratory characteristics of each group were compared.

RESULTS

The cases were grouped as follows: Group I, cases with negative results by both methods of DAT (n=5); Group II, cases with negative results by tube test but positive results by microcolumn gel assay (n=26); Group III, cases with positive results by both methods of DAT (n=28). There was no significant difference in age and sex between Group II and other groups, whereas the positive rate of anti-IgG + anti-C3d of Group II was lower than that in Group III (P=0.015). The main clinical manifestations of Group II were chest tightness, shortness of breath, fatigue, as well as yellow skin and sclera or dark urine, but the incidence rate of these symptoms was not significantly different from other groups. Anemia related indexes in Group II such as red blood cell (RBC) count and hemoglobin (Hb) were lower than the reference intervals, but there was no significant difference compared with other groups. Hemolysis related indexes in Group II such as reticulocyte (Ret) ratio, indirect bilirubin (IBIL), lactate dehydrogenase (LDH) and free-hemoglobin (F-Hb) were higher than the reference intervals, and the latter two items were signficantly higher than those in Group I (P=0.031 and P=0.036). Serum complement C3 and C4 in Group II were higher than those in Group III (P=0.010 and P=0.037).

CONCLUSION

Anemia severity of primary AIHA patients who were negative of DAT by tube test but positive by microcolumn gel assay was similar to those with negative or positive results by both DAT methods, but the mechanism and degree of complement system involved in hemolysis might be different. Results above may be helpful for laboratory diagnosis of this kind of patients.

[Recommendations on the diagnosis and treatment of osteoarthritis in China]

Osteoarthritis (OA) is the most common form of arthritis and the leading cause of old age disability, affecting an estimated 302 million people worldwide. OA is seriously overlooked in the world. The awareness of OA and the popularization of standardized diagnosis and treatment are all lacking. Knees, hips, and hands are the most commonly affected joints in OA. Based on the experience of diagnosis and treatment, consensus and guidelines, we formulated this diagnosis and treatment standard in order to standardize the diagnosis and treatment of OA. We hope that our standard can reduce misdiagnosis and mistreatment and improve the prognosis of OA.

[The concept of traditional chinese medicine:history, theory and empirical research]

The concept of traditional Chinese medicine has different connotations and extensions in different historical periods. This paper examines the formation and development of the concept of traditional Chinese medicine in the perspective of history, theory and empirical research, and explores the internal connection among different medical systems and between medicine and other disciplines. It attempts to re-define the connotation and extension of the concept of traditional Chinese medicine in the context of the new era, provide references for building the medical community of the Chinese nation and promote the standardization of Chinese medicine terminology, advance the cross-disciplinary construction and establishing a new medical system with the characteristics of openness and tolerance, in order to provide the solution, wisdom and power of traditional Chinese medicine for global health in the process of building a community of human health.

[Rethinking of surgical indications for pancreatic cystic tumors]

With the progress of imaging technology and the popularization of healthy examination, the detection rate of pancreatic cystic neoplasm(PCN) has increased significantly. PCN has complex disease spectrum, strong heterogeneity, and diverse surgical treatment strategies. Surgical timing and methods directly affect patients' prognosis. Therefore, how to identify malignant tumors and formulate reasonable treatment strategies are the keys to treat PCN. Many guidelines for clinical diagnosis and treatment of PCN have been released, but there are still many disputes about its surgical indications. Hence, fully assessing the surgical indications is of great significance to improve the PCN patients' prognosis. This paper deeply discusses on the surgical indications of PCN by reviewing the current clinical diagnosis, treatment and research progress of PCN, in order to standardize the diagnosis and treatment of PCN.

Impedance matching system using triple liquid stub tuners for high-power ion cyclotron resonance heating in EAST tokamak

Ion cyclotron resonance heating (ICRH), one of the main auxiliary methods, for high-power and long-pulse plasma heating had been developed in Experimental Advanced Superconducting Tokamak (EAST). An impedance matching system, one important part of ICRH, had been developed for high-power injection and transmitter protection by reducing the reflected power from the antenna. The input impedance in the outlet of the stub tuner can be measured by voltage-current probes installed on the coaxial transmission line between the antenna and triple liquid stub tuners, and the optimum liquid levels in the stub tuners can be calculated based on the input impedance. The calculation and adjustment process of the optimum liquid levels are described comprehensively in this article. Finally, impedance matching had been achieved between two shots during EAST experiments. In the near future, a real-time impedance matching system will be developed to prevent large variations of the ICRH antenna impedance and achieve steady-state and long-pulse operation with the ICRH system.

[Safety and efficacy of percutaneous mechanical thrombectomy through ipsilateral calf venous access in the treatment of entire-limb acute deep venous thrombosis]

Objective: To evaluate the safety and clinical efficacy of percutaneous mechanical thrombectomy (PMT) through ipsilateral calf venous access in the treatment of entire-limb acute deep vein thrombosis (DVT). Methods: From July 2017 to August 2020, the clinical data of patients with entire-limb acute DVT at Renji Hospital, School of Medicine, Shanghai Jiaotong University treated by AngioJet through ipsilateral calf venous access were analyzed retrospectively. All patients received rivaroxaban or warfarin anticoagulant therapy for at least 6 months after operation. Pressure gradient socks were given routinely after operation. All patients were followed up at 3, 6, 12 months and every year after operation. The primary end points were the 12-month primary patency rate and the incidence of post thrombotic syndrome (PTS). The secondary end points included the thrombus clearance rate, total complication rate, bleeding complication rate and the 12-month incidence of moderate to severe PTS. Results: A total of 31 patients were included in the study. The age ranged from 31 to 80 (63±14) years, including 16 males and 15 females, 23 left lower limb DVT and 8 right lower limb DVT. There were 15 cases treated through peroneal venous access, 6 cases through anterior tibial venous access and 10 cases through posterior tibial venous access. Moreover, 9 cases underwent combined catheter-directed thrombolysis, 25 cases underwent iliac vein percutaneous transluminal angioplasty (PTA), and 10 cases underwent iliac vein stenting. The thrombus clearance rate was grade Ⅱ in 19 cases (61.3%) and grade Ⅲ in 12 cases (38.7%). One patient (3.2%) with anterior tibial venous access developed hematoma at the puncture site, which was improved after pressure bandage, and there were no other bleeding and serious complications. All the 31 patients were followed up for at least 12 months, with an average follow-up period of (22±9) months. The 12-month primary patency rate was 77.4% (24/31). The 12-month incidence of PTS was 16.1% (5/31) and the incidence of moderate to severe PTS was 3.2% (1/31). Conclusions: PMT through ipsilateral calf venous access is safe and effective in the treatment of entire-limb acute DVT. Thrombus in the distal popliteal vein can be one-stage removed and the incidence of PTS is low. It is considered as the first choice of access for the endovascular treatment of entire-limb acute DVT.

[Epidemiological analysis of non-enterovirus 71 and non-coxsackievirus A16 enterovirus]

Enteroviruses (EV) are the most common pathogens in humans, often causing large-scale infectious diseases, such as: hand, foot and mouth disease, herpes angina, myocarditis, encephalitis, aseptic meningitis, acute flaccidity Paralysis and acute flaccid myelitis and other nervous system and cardiopulmonary diseases, and them often infect children under 5 years old, severely can cause fatal complications. In recent years, the prevalence of non-enteric virus A71 (EV71) and non-coxsackievirus A16 (CV-A16) enteroviruses has gradually increased, and the dominant strains of EVs have gradually changed. A timely grasp of the etiology, epidemiology, and molecular evolution characteristics of EVs is of great significance to the prevention and control of EVs. Therefore, this article reviews the current status of diseases caused by non-EV71 and non-CV-A16 enteroviruses and analysis the molecular epidemiology, in order to have a certain prompting effect on the prevention and control of EVs.

[The Chinese guidelines for the diagnosis and treatment of pancreatic neuroendocrine neoplasms (2020)]

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

[Trend analysis on morbidity and mortality of pancreatic cancer in China, 2005-2015]

Objective: To analyze the trend of morbidity and mortality of pancreatic cancer in China from 2005 to 2015 and estimate the related age, period and cohort effect, respectively. Methods: Joinpoint regression analysis was used to analyze the trend of morbidity rate and mortality rate of pancreatic cancer during 2005-2015 and calculate the annual percentage change and average annual percentage change based on the data in the annual report of China Cancer Registry. Population aged 20-84 years was fitted by the Age-Period-Cohort model to estimate the effect parameters of age, period and cohort. Results: The trend variations of the crude morbidity rate and crude mortality rate of pancreatic cancer were consistent. The morbidity rate of pancreatic cancer firstly increased before 2008 and then decreased. The morbidity rate and mortality rate of pancreatic cancer were higher in men than women, and higher in urban areas than in rural areas. From 2005 to 2015, the overall age-standardized morbidity rate of pancreatic cancer increased by 2.78% annually and the overall age standardized mortality rate of pancreatic cancer increased by 2.24% annually. The age standardized morbidity of pancreatic cancer in rural men changed more rapidly, with an average annual increase of 3.74%, and the age standardized mortality rate of pancreatic cancer in urban men changed more rapidly, with an average annual increase of 3.57%. The age effect on the morbidity and mortality of pancreatic cancer increased with age, and the effect was most obvious in age group 70-80 years, the period effect increased over time and the cohort effect decreased with year, but rebound or fluctuation was observed after 1976. Conclusions: The morbidity rate and mortality rate of pancreatic cancer in China increased slightly in past decades. Strategies on effective prevention and control of pancreatic cancer should be developed in the future.

[Ultrasound-guided percutaneous transluminal angioplasty in the treatment of arteriovenous fistula immaturation: day surgery mode and clinical efficacy]

Objective: To summarize the clinical effect of ultrasound-guided percutaneous transluminal angioplasty (PTA) in the treatment of arteriovenous fistula (AVF) immaturation under day surgery mode. Methods: The clinical data was retrospective analyzed of patients with AVF immaturation who were treated by ultrasound-guided PTA under day surgery mode from November 2016 to June 2019 in Renji Hospital. The basic information, lesion location, puncture approach, number and diameter of balloon used were counted. The primary and secondary patency rates were calculated at 6 and 12 months after operation. Results: In all of the 21 patients, 11 patients were male and 10 patients were female. The mean age was (52.6±12.9) years old. There were 20 of the 21 patients who were treated successfully. One patient had AVF reconstruction with vascular rupture, and the complication rate was 4.8% (1/21). The length of hospitalization was (1.05±0.71) days, and the cost was (11 487.7±4 401.4) yuan. The follow-up time was (19.7±8.3) months. The 6-month and 12-month primary patency rate were 70% and 55%, and the 6-month and 12-month secondary patency rate were both 90%. Conclusion: Ultrasound-guided PTA in the treatment of AVF immaturation under day surgery mode is safe and effective, which has a high technical success rate and good patency rate for AVF maturation.

[Textual research on Zhuru Tang]

Zhuru Tang( from the Effective Prescriptions for Universal Relief) listed in the Catalogue of Ancient Classical Formulas( The First Batch) by the State Administration of Traditional Chinese Medicine,is usually used to treat stomach fever and vomiting. The first step of the research and development of the classic formula compound preparations is to follow the principle of the ancient method,comb through the literature of all dynasties,and then investigate the historical evolution of the prescription,the evolution of formula significance and the clinical application. Based on this principle,we searched the Chinese Medical Classics Database and relevant literature materials to conduct textual research on the history,evolution of formula significance,clinical application,decocting method,as well as the basis and processing of traditional Chinese medicine from the perspectives of " recipe" and " medicine",in order to provide reference for the development and research of Zhuru Tang.

[Analysis of clinical, pathological features and therapeutic treatments in predicting prognosis of elderly glioblastomas]

Objective: This study was designed to investigate prognostic factors and the potential relationship between the expression of Ki67 and IDH of glioblastoma in the elderly (≥ 65 years old) and the clinical factors such as gender, the KPS score and treatments including surgical resection, radiotherapy and chemotherapy and the prognosis of such patients. Methods: Fifty-four elderly patients (≥ 65 years old) with glioblastoma admitted to the First Affiliated Hospital of Zhengzhou University from 2013 to 2018 were enrolled in this study. The expression of Ki67 was detected by immunohistochemical SP method and the mutation of IDH was detected by Sanger sequencing. Finally, statistical analysis was performed to determine whether Ki67, the mutation of IDH, gender, the KPS score and the extent of resection, radiotherapy and chemotherapy were associated with the clinical prognosis of the patients. Results: Of the 54 elderly patients with glioblastoma, none was detected with IDH mutation. Univariate analysis showed that Ki67(P=0.033), the KPS score (P=0.008), the extent of resection (P<0.001) were factors influencing the prognosis of elderly patients with glioblastoma. Patients receiving postoperative adjuvant radiotherapy (P=0.002) and chemotherapy (P=0.034) had longer survival time. There was no significant correlation between gender (P=0.467) and prognosis. Multivariate analysis demonstrated that radiotherapy (OR 2.446, P=0.009) and the extent of resection (OR 6.976, P<0.001) were independent prognostic factors. Conclusions: No IDH mutation was detected in all the patients in this study, indicating that IDH mutation is indeed rare in elderly glioblastoma, which suggests that geriatric population often harbor a molecular phenotype with poor prognosis. Ki67, KPS score, the extent of resection, radiotherapy and chemotherapy were the factors influencing the prognosis of patients.

[Expression and influencing factors of hepcidin in classical paroxysmal nocturnal hemoglobinuria]

目的

研究铁调素在经典型阵发性睡眠性血红蛋白尿症（PNH）患者血清中的表达及其影响因素。

方法

以2016年3月至2017年3月36例经典型PNH患者为研究对象，采用ELISA方法检测血清铁调素水平，并结合患者铁稳态状况和临床资料，分析经典型PNH患者血清铁调素水平与血清铁蛋白（SF）、可溶性转铁蛋白受体、C反应蛋白、EPO、网织红细胞绝对值、网织红细胞血红蛋白等血液学参数的相关性。

结果

36例经典型PNH患者血清铁调素水平为32.03（23.11，118.48）µg/L，明显低于正常对照组的181.42（106.80，250.53）µg/L（z=−5.107，P<0.001）。其中，铁蛋白正常经典型PNH患者血清铁调素水平为56.41（44.60，95.06）µg/L，经典型PNH伴缺铁组血清铁调素水平为23.75（21.77，30.35）µg/L，均低于正常对照组；而经典型PNH伴铁蛋白升高组血清铁调素水平为336.19（304.19，375.08）µg/L，高于正常对照组、铁蛋白正常经典型PNH组及经典型PNH伴缺铁组。多重线性回归分析显示SF、转铁蛋白饱和度和血清白蛋白水平是经典型PNH患者血清铁调素水平的独立影响因素。

结论

经典型PNH患者血清铁调素水平减低，其表达主要受铁代谢因素影响。

Feasibility of Using Seaweed (Gracilaria coronopifolia) Synbiotic as a Bioactive Material for Intestinal Health

The market contains only limited health care products that combine prebiotics and probiotics. In this study, we developed a seaweed-based Gracilaria coronopifolia synbiotic and verified the efficacy by small intestinal cells (Caco-2). We also developed a functional material that promotes intestinal health and prevents intestinal inflammation. G. coronopifolia was used as a red seaweed prebiotic, and Bifidobacterium bifidums, B. longum subsp. infantis, B. longum subsp. longum, Lactobacillus acidophilus, and L. delbrueckii subsp. bulgaricus were mixed for the seaweed's synbiotics. G. coronopifolia synbiotics were nontoxic to Caco-2 cells, and the survival rate was 101% to 117% for a multiplicative effect on cell survival. After cells were induced by H₂O₂, the levels of reactive oxygen species (ROS) increased to 151.5%, but after G. coronopifolia synbiotic treatment, decreased to a range between 101.8% and 109.6%. After cells were induced by tumor necrosis factor α, the ROS levels increased to 124.5%, but decreased to 57.7% with G. coronopifolia symbiotic treatment. G. coronopifolia synbiotics could effectively inhibit the production of ROS intestinal cells under oxidative stress (induced by H₂O₂ and tumor necrosis factor α (TNF-α)), which can reduce the damage of cells under oxidative stress. Functioning of intestinal cells could be improved by inhibiting the production of inflammatory factor substances (interleukin 8) with G. coronopifolia symbiotic treatment. Also, gastrointestinal diseases may be retarded by a synbiotic developed from G. coronopifolia to promote intestinal health and prevent intestinal inflammation.

[Analysis of genomic SSRs in Pueraria lobata and P. thomsonii and establishment of DNA identity card for different germplasms of P. thomsonii of Jiangxi province]

The type and frequency of simple sequence repeats( SSRs) in the genomes was investigated using the DNA sequence data of Pueraria lobata and P. thomsonii. Based on these SSRs,20 pairs of SSR primers were designed and 5 high polymorphism primer pairs were selected to analyze genetic diversity of 9 cultivars of P. thomsonii in Jiangxi province. The results showed that the 5 pairs of primers could generate 16 polymorphic alleles bands. The average polymorphism information content( PIC) of each SSR primer pair was 0. 600 7.According to the genetic similarity coefficients,the 9 cultivars of P. thomsonii can be classified into 6 germplasms. This study established DNA identity cards with 5 pairs of SSR primers for different germplasm resources of P. thomsonii in Jiangxi province,which provided reference information for the selection of fine germplasms of P. thomsonii and the theoretical basis for the study of Dao-di herbs.

Ion cyclotron emission diagnostic system on the experimental advanced superconducting tokamak and first detection of energetic-particle-driven radiation

A passive and noninvasive diagnostic system based on high-frequency B-dot probes (HFBs) has been designed and developed for the measurement and identification of ion cyclotron emission (ICE) in the Experimental Advanced Superconducting Tokamak (EAST). Details of the hardware components of this system including HFBs, direct current blockers, radio frequency splitters, filters, and power detectors as well as data acquisition systems are presented. A spectrum analyzer is used in addition to the ordinary speed acquisition card for data registration and analysis. The reliability of a HFB based diagnostic system has been well validated during the 2018 spring experiments on the EAST. ICE signals corresponding to fundamental cyclotron frequency of hydrogen ions and harmonics of deuterium ions were observed in experiments where deuterium plasmas were heated with deuterium neutral beams. The field dependence of ICE has been verified by recent experiments with three different background magnetic fields. The observed ratio of the ICE frequency is consistent with the ratio of the magnetic field intensity within measurement errors of a few percent.

Feather evolution from knotted barbules to hooked and unhooked barbules and its finite element analysis

Experiments involving scanning electron microscopy of the microstructure of barbules and optical microscopy of knotted barbules were conducted: the behaviour of knotted barbules, and their evolution to form a branch of hooked barbules and unhooked barbules were analysed. A growth model for a feather plume was proposed. MATLAB™ 2-d contour microstructures of sectioned knotted feathers and three-dimensional structural models of barbules were established, moreover, these were analysed using the finite element method. The response under load of different parts of the barbules was obtained. The results showed that there were stress concentrations in feather barbules. The study laid a foundation for finding the internal and external causes of the evolutionary transition of knotted barbules.

[Diffusion tensor imaging and visual evoked potentials in pediatric patients with sellar region lesions]

Objiective: To evaluate the prognosis of visual function and the impact of surgery in pediatric patients with sellar mass lesions, as evidenced by diffusion tensor imaging (DTI) and visual evoked potentials. Methods: Twenty patients with sellar mass lesions were included in the study. DTI and visual evoked potentials were obtained before and after surgery. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated for both optic nerves. DTI parameters and visual evoked potential amplitudes were compared for all patients to assess the correlation between DTI parameters and visual function. Results: The 20 patients were divided into two groups according the relationship between the lesions and the optic chiasm. The FA values increased significantly after operation, while the ADC values decreased (P<0.05). And the average amplitude of visual evoked potentials after operation was significantly higher than before operation (P<0.05). Conclusions: DTI assessments of the affected sides, with the resulting FA and ADC values, may help to estimate the visual improvement produced by surgical therapy in the early postoperative period. Surgical removal can improve visual function dramatically.

[Clinical Features and Laboratory Data Analysis of Glucose-6- Phosphate Dehydrogenase Deficiency]

OBJECTIVE

To explore clinical features and laboratory data of glucose-6-phosphate dehydrogenase（G6PD）deficiency and to investigate the relationship between them.

METHODS

Clinical data of 43 patients with G6PD deficiency was analyzed, the statistical method was applied to investigate the relationship between clinical features and laboratory data.

RESULTS

Among 43 patients，neonatal jaundice occurred as the first symptom in 10 cases，while acute hemolytic anemia occurred as the first symptom in 23 cases. The major clinical symptoms of G6PD deficiency included icteric skin and/or sclera，dark urine，fever，gastrointestinal symptoms，fatigue and lethargy. Symptoms of 26 patients were caused by obvious inducement，including fava beans（61.5%），infection（34.6%）and miocardial infarction（3.8%）. All of 43 patients showed decreased G6PD activity，while the level of their indirect serum bilirubin（IBIL）was positively correlated with reticulocyte percentage（Ret%，r=0.5881，P=0.013） and mean corpuscular volume（MCV，r=0.6854，P=0.0024）. Patients with neonatal jaundice as the first symptom，showed higher level of Ret%（P<0.01）and MCV（P<0.001）and low RBC count（P<0.01）and low Hb level（P<0.01）. as compard with patients with acute hemolytic anemia as first symptome.

CONCLUSION

Neonatal jaundice and acute hemolytic anemia are common clinical features of G6PD deficiency. Laboratory results of IBIL，Ret% and MCV have auxiliary value to evaluate the severity of hemolysis induced by G6PD deficiency. Patients with neonatal jaundice as their first symptom show more severe hemolysis than those only suffered from acute hemolytic anemia.

[Value of fibrinogen to albumin ratio on predicting spontaneous recanalization of infarct-related artery in patients with acute ST-segment elevation myocardial infarction]

Objective: To investigate the value of fibrinogen to albumin ratio (FAR) at admission on predicting spontaneous recanalization of infarct-related artery (IRA) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: Clinical data from 255 acute STEMI patients ((61.1±11.2) years old, 189 males) who underwent emergency coronary angiography within 12 hours in our hospital from December 2015 to April 2018 were retrospectively analyzed. The acute STEMI patients were divided into non-spontaneous recanalization group (thrombolysis in myocardial infarction (TIMI) flow grade 0-1, 203 cases) and spontaneous recanalization group (TIMI flow grade 2-3, 52 cases). Multivariate logistic regression analysis was used to evaluate related factors of IRA spontaneous recanalization. The receiver operating characteristic (ROC) curve was used to evaluate the value of FAR in predicting spontaneous coronary recanalization. Results: There was no significant difference in age,gender, hypertension, diabetes, smoking,systolic blood pressure,diastolic blood pressure,heart rate, duration of chest pain, type of infarction, infarct-related artery, door-to-balloon time, and drug used before admission between non-spontaneous recanalization group and spontaneous recanalization group (all P>0.05). The FAR and high-sensitivity C-reactive protein levels were significantly lower in the spontaneous recanalization group than in the non-spontaneous recanalization group (8.20±1.85 vs. 11.02±2.75, P<0.001; (6.87±3.36) g/L vs. (8.51±3.72) g/L, P=0.004). Multivariate logistic regression analysis showed that FAR (OR=0.492, 95%CI 0.354-0.686, P<0.001), serum uric acid (OR=0.994, 95%CI 0.989-0.999, P=0.018) and high-sensitivity C-reactive protein (OR=0.774, 95%CI 0.614-0.975, P=0.030) were independent negative correlation with spontaneous recanalization of infarct-related artery in patients with acute STEMI. The ROC curve showed that the area under the curve of FAR predicting spontaneous recanalization of infarct-related artery in patients with acute STEMI was 0.807 (95%CI 0.630-0.758, P<0.001), and the diagnostic threshold was 9.26, the sensitivity was 76.9%, the specificity was 75.9%. Conclusion: The level of admission FAR has certain predictive value for spontaneous recanalization of infarct-related arteries in patients with acute STEMI.

[Clinical features and laboratory data analysis of decreased glycosylated hemoglobin related to hemolytic disease]

Objective: To compare the effects of different hemolytic diseases on the level of glycosylated hemoglobin (HbA(1c)) to further explore the relationship between HbA(1c) and laboratory indexes to disclose implications of HbA(1c) in hemolytic diseases. Methods: The distribution of 192 decreased HbA(1c) cases in 4 categories of hemolytic diseases was analyzed. Laboratory indexes related to hemolysis were tested and analyzed in each kind of disease, and relationship between laboratory indexes and HbA(1)c was statistically explored. Results: Diagnoses of decreased HbA(1c) cases mainly included erythrocyte membranopathies (88 cases), immunohemolytic anemia (72 cases), hemoglobinopathy (4 cases) and erythrocyte enzymopathy (5 cases). The distribution of HbA(2) and normal HbF subjects in immunohemolytic anemia and hemoglobinopathy was significantly different from those of HbA(2) and / or abnormal HbF subjects (41.7% vs 22.0%, χ(2)=5.574, P=0.018; 0.7% vs 7.3%, P=0.031). Compared with non-hemolytic disease patients, those who suffered from 4 categories of hemolytic diseases showed lower HbA(1c) level and higher reticulocyte percentage (Ret), indirect bilirubin (IBIL) and free hemoglobin (F-Hb). Different levels of Ret, reticulocyte hemoglobin content (Ret-He), mean corpuscular volume (MCV), IBIL and F-Hb among the 4 kinds of diseases were observed, but the causes of the differences were not the same. HbA(1c) was negatively correlated with other laboratory indexes in erythrocyte membranopathies and immunohemolytic anemia. Conclusions: Hemolytic disease resulted in false lower HbA(1c), but impact of difference on HbA1c between different diseases was not significant. HbA(1c) was closely connected to laboratory indexes related to hemolysis, which might have potential implications for hemolytic diseases such as erythrocyte membranopathies and immunohemolytic anemia.

[The effect of para-aortic lymph node metastasis on the resectability of pancreatic cancer]

Pancreatic cancer has poor prognosis and lymph node metastasis is a poor prognostic factor in patients with resectable pancreatic cancer. The metastatic prevalence of para-aortic lymph node (PALN) ranges from 9.1% to 26.5% and it is listed as the distant metastatic group in pancreatic cancer. Nevertheless, it is controversial whether PALN metastasis is the contraindication of surgery in resectable pancreatic cancer for the shortage of level Ⅰ evidence.This study concluded that PALN metastasis indicated poor prognosis in patients with pancreatic cancer, but some patients with PALN metastases could benefit from surgery and their survival could be much improved after the combination of surgery and adjuvant therapy. Therefore, it is not wise to refuse surgery for all pancreatic cancer patients with PALN metastasis and the clinicians can cautiously choose the patients to do surgery. Besides, there are mainly retrospective studies rather than prospective and multicenter studies to explore the prognosis of pancreatic cancer patients with PALN metastasis. Thus, more prospective and multicenter studies are needed to decide whether PALN metastasis is an independent prognostic factor in patients with resectable pancreatic cancer.

[Current diagnosis and treatment progress of small pancreatic neuroendocrine neoplasm]

Small(≤2 cm)pancreatic neuroendocrine neoplasm(pNEN) is a very special subgroup of pNEN featuring a small size, concealed pathogenesis, indolent course and remarkable heterogeneity.Differences in its diagnosis and interventional criteria have evolved from routine pNEN.During recent years, the incidence of small pNEN has increased sharply, while optimal management strategy of this subgroup still remains controversial.In this paper, the biological characteristics, pathological classification, diagnosis, intervention indication and therapeutic principles of small pNEN are reviewed based on recent researches, and current situations of diagnosis and treatment of small pNEN are summarized.

[(68)Ga-exendin-4 PET-CT for the localization of occult insulinomas: a prospective cohort study]

Objective: To explore the accuracy in localizing occult insulinomas with Glucagon-like peptide-1 receptor(GLP-1R) PET-CT with (68)Ga-exendin-4. Methods: In this prospective cohort study, patients with biochemically proven endogenous hyperinsulinemic hypoglycemia and negative contrast-enhanced CT with pancreatic perfusion scans were enrolled consecutively at Department of Nuclear Medicine, Peking Union Medical College Hospital from February 2014 to June 2018.There were 37 males and 32 females, with age of (43.2±17.9)years. (68)Ga-exendin-4 PET-CT, MRI and endoscopic ultrasound(EUS) were done before elective surgery. Sensitivity, specificity, accuracy, positive predictive value(PPV) and negative predictive value(NPV) of the above imaging modalities were calculated. Results: A total of 69 patients were recruited. Thirty-two patients were diagnosed with insulinomas at histology. Four patients with positive (68)Ga-exendin-4 PET-CT findings did not undergo surgery so far. Twenty-eight patients were proven to be noninsulinoma induced hyperinsulinemic hypoglycemia. Five patients were unknown of etiology of hypoglycemia. The sensitivity, specificity, accuracy, PPV and NPV of (68)Ga-exendin-4 in localizing occult insulinomas were 96.9%(31/32), 100%(30/30), 98.3%(59/60), 100%(29/29), 96.8%(30/31), respectively.The sensitivity, specificity, accuracy, PPV and NPV of MRI were 74.1%(20/27), 9/11, 76.3%(29/38), 90.9%(20/22), 9/16, respectively. The sensitivity, specificity, accuracy, PPV and NPV of EUS were 75.0% (15/20), 2/2, 77.3%(17/22), 15/15, and 2/7. Conclusion: (68)Ga-exendin-4 PET-CT has a high sensitivity, specificity and accuracy for detection of occult insulinoma, which shows superiority to MRI and EUS.

[The clinical and laboratory characteristics of congenital pyruvate kinase deficiency]

Clinical data of 19 patients with congenital pyruvate kinase deficiency were analyzed. Insufficient pyruvate kinase confirmed the diagnosis. Laboratory parameters of hemolysis were summarized. In cases of neonatal hyperbilirubinemia and unexplained hemolytic anemia, pyruvate kinase activity and next generation sequencing test may help the early diagnosis.

[Experience and reflection of diagnosis and treatment in insulinomas]

The insulinoma, which is the most common pancreatic neuroendocrine tumor, can be misdiagnosed and mistreated easily.Recently, the misdiagnosis rate has decreased significantly owing to the establishment of diagnosis and treatment system.However, the misconception about its diagnosis and treatment still exists because the diagnosis and treatment level varies greatly among different centers.This article aims to summarize the experience in the diagnosis and treatment of insulinoma in Peking Union Medical College Hospital, and introduce the qualitative and localization diagnosis, surgical and interventional treatment and perioperative management about insulinoma, so as to standardize the diagnosis and treatment procedure in China.

[Investigation and analysis of the activities of daily living of the aged at home in western China]

OBJECTIVE

To investigate the current situation of the activities of daily living (ADL) of the aged at home in western China, and to analyze its influencing factors so that we can improve the quality of life and pension services of elderly people.

METHODS

The elderly people who came from Qinghai Province, Ningxia Autonomous Region, Xinjiang Uygur Autonomous Region, Shanxi Province, Guizhou Province, Guangxi Province, Sichuan Province, Yunnan Province and Chongqing were surveyed by questionnaires. Logistic regression model was used to analyze the influencing factors of ADL.

RESULTS

A total of 7 175 aged people living in the western China were surveyed. In the study, 78.86% of the aged at home could independently live. 12.32% of the aged were of mild dysfunction. 6.27% of the aged had moderate dysfunction. And 2.55% of the aged suffered severe dysfunction. Multiple Logistic analyses indicated that age, educational level, economic income, body mass index and disease were the factors that affected their ADL. The risk of decreased ADL in the 60-69 and 70-79year-old groups were 0.221 (95%CI: 0.190-0.258) and 0.353 (95%CI: 0.305-0.409) times that of the elderly over the age of 80. Compared with illiterate seniors,the risks of decline in ADL of primary school, junior high school, secondary or high school, college or undergraduates, postgraduates or above were 0.299 (95%CI: 0.140-0.637), 0.312 (95%CI: 0.146-0.663), 0.238 (95%CI: 0.112-0.510), 0.226 (95%CI: 0.105-0.484), and 0.238 (95%CI: 0.110-0.514) times. The declines in the risk of ADL for elderly people with quite difficult economic conditions, slight difficulty and breaking even were 2.720 (95%CI: 2.015-3.672), 2.344 (95%CI: 1.816-3.027), and 1.542 (95%CI: 1.215-1.957) times of the economically abundant people. Compared with those with a body mass index (BMI)≥28, the risk of ADL reduction for BMI<18.5 was 1.577 (95%CI: 1.142-2.179) times. And the ADL of the elderly with no disease was at the risk of falling 0.685 (95%CI: 0.602-0.779) times that of an elderly person with the disease.

CONCLUSION

The activities of daily living of age at home of western China are not high, and affected by many factors, such as age, educational level and so on. With the increasing of the elderly, maintaining and improving the ADL are the problems and challenges that we are faced with.

[The expression of KLK7 in pancreatic cancer and the effects on the biological behavior of pancreatic cancer cells]

Objective: To investigate the expression of KLK7 in pancreatic cancer and its clinical significance. Methods: Immunohistochemistry was used to detect the expression of KLK7 protein in pancreatic cancer tissue microarray with 92 samples. Statistical analysis of the relationship between KLK7 and clinicopathological characteristics was finished. Pancreatic cancer cell lines were infected with lentiviuses in order to get cells with KLK7 stable overexpression.KLK7-siRNA was transfected into pancreatic cancer cells to knock down KLK7.Cell proliferation and chemosensitivity were detected by CCK-8 assay; Cell invasion and migration abilities were detected by Transwell assay. At the same time, subcutaneous xenograft tumor models were established in nude mice to observe the effect of KLK7 on tumor growth in nude mice. Data were statistically analyzed by rank sum test, χ(2) test and Logistic regression analysis. Results: The expression level of KLK7 in pancreatic cancer tissues was higher than that in paired adjacent tissues (P<0.05). KLK7 expression was correlated with vascular invasion(χ(2)=7.535, P<0.05). Further univariate and multivariate analysis showed that KLK7 expression was an independent risk factor for vascular invasion of pancreatic cancer(χ(2)=7.535, P<0.05). The overexpression of KLK7 in pancreatic cancer cell lines BxPC-3 and CFPAC can increase their proliferation abilities, reduce the chemosensitivity and promote their migration and invasion behaviour; The results of in vivo experiments showed that the volume of subcutaneously transplanted tumors in the overexpressing KLK7 group was significantly larger than that in the control group (t=4.479, P<0.05). The group of overexpressing KLK7 showed greater tumor weight than the control group(t=2.831, P<0.05). Conclusions: The expression level of KLK7 in pancreatic ductal adenocarcinoma was higher than that in paired adjacent tissues and it is an independent risk factor for vascular invasion of pancreatic cancer.KLK7 can promote the proliferation of pancreatic cancer cells, reduce the chemosensitivity and increase the invasion and migration of pancreatic cancer cells.

Accumulation of High Levels of Monocytic Myeloid-Derived Suppressor Cells Enhances Graft Survival in Almost-Tolerant Kidney Transplant Recipients

BACKGROUND

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of immature cells that suppress immune responses during organ transplantation and participate in mediating long-term graft survival and immune tolerance in animal transplant models. However, their role in regulating transplant tolerance in human subjects is not well understood. In the present study, we investigated the role of MDSCs in mediating long-term graft survival in almost-tolerant kidney transplant recipients (ATKTRs) and the mechanism(s) responsible for increasing MDSC numbers in these recipients.

METHODS

Peripheral blood mononuclear cells (PBMCs) from whole blood samples were collected from 30 ATKTRs (graft survival, > 10 years after kidney transplant [KTx]) treated with low doses of immunosuppressive drugs and with stable kidney function, 10 short-term graft survival kidney transplant recipients (STKTRs; graft survival, ∼1-3 years post-KTx) with stable kidney function, and 10 healthy donors (HDs). MDSC and regulatory T cell (Tregs) levels were analyzed using multicolor flow cytometry in PBMCs.

RESULTS

ATKTRs had significantly higher levels of monocytic MDSCs (P < .001) and CD4⁺CD25⁺FoxP3⁺ Tregs than STKTRs and HDs. Furthermore, the M-MDSC levels correlated positively with the survival rates, estimated glomerular filtration rates (eGFRs) of grafts, and the levels of CD4⁺CD25⁺FoxP3⁺ Tregs in ATKTRs.

CONCLUSIONS

Accumulation of high levels of MDSCs was observed in ATKTRs. Changes in MDSC levels may play important roles in mediating transplant tolerance and regulating Tregs. Therefore, we propose that MDSCs may be potentially used for recognizing tolerant transplant recipients and guiding dosage reduction for immunosuppressive drugs for KTx.

[The progress of Chinese surgery in 2017]

The article outlined the speeches of Surgeon Branch during the Annual Scientific Conference of Chinese Medical Association in 2018.From the perspectives of inheritance, innovation, standardization and improvement, it summarizes the major progress of Chinese surgery in 2017 and introduces the objectives and action plans of Chinese Medical Association Branch of Surgery this year.

N-Methylcytisine Ameliorates Dextran-Sulfate-Sodium-Induced Colitis in Mice by Inhibiting the Inflammatory Response

This study aimed to investigate the anti-inflammatory effects of N-methylcytisine (NMC) in a dextran sulfate sodium (DSS)-induced colitis model and explore its possible mechanisms. Experimental colitis was induced by administering the mice with 5% DSS for 7 days. Different doses of NMC (1, 4 and 16 mg/kg) and 5-aminosalicylic acid (100 mg/kg) were given orally once every day for 7 days. The protective effect of NMC was evaluated using the disease activity index, colon length and results of histopathological examination. The possible mechanisms of NMC were explored by evaluating the expression levels of tumour necrosis factor-α, interleukin-1β and interleukin-6 (IL-6) using ELISA and analysing the protein expression levels of nuclear factor (NF)-κB p65, p-NF-κB p65, p-IκB, IκB, IκB kinase (IKK) and p-IKK using western blots. Results demonstrated that the oral administration of NMC attenuated the DSS-induced clinical symptoms and pathological damage. In addition, NMC treatment significantly reduced myeloperoxidase activity and level of pro-inflammatory cytokines. Further studies revealed that NMC blocked the activation of NF-κB by inhibiting IκB and IKK phosphorylation. These findings suggested that NMC exerts anti-inflammatory effects on DSS-induced colitis, and its mechanism may be related to the suppression of NF-κB activation. Thus, NMC may have potential therapeutic value in the treatment of colitis.

[Design and implementation of supply security monitoring and analysis system for Chinese patent medicines supply in national essential medicines]

The supply of Chinese patent medicine is influenced by the price of raw materials (Chinese herbal medicines) and the stock of resources. On the one hand, raw material prices show cyclical volatility or even irreversible soaring, making the price of Chinese patent medicine is not stable or even the highest cost of hanging upside down. On the other hand, due to lack of resources or disable some of the proprietary Chinese medicine was forced to stop production. Based on the micro-service architecture and Redis cluster deployment Based on the micro-service architecture and Redis cluster deployment, the supply security monitoring and analysis system for Chinese patent medicines in national essential medicines has realized the dynamic monitoring and intelligence warning of herbs and Chinese patent medicine by connecting and integrating the database of Chinese medicine resources, the dynamic monitoring system of traditional Chinese medicine resources and the basic medicine database of Chinese patent medicine.

[Design and implementation of data checking system for Chinese materia medica resources survey]

The Chinese material medica resources (CMMR) national survey information management system has collected a large amount of data. To help dealing with data recheck, reduce the work of inside, improve the recheck of survey data from provincial and county level, National Resource Center for Chinese Materia Medical has designed a data checking system for Chinese material medica resources survey based on J2EE technology, Java language, Oracle data base in accordance with the SOA framework. It includes single data check, check score, content manage, check the survey data census data with manual checking and automatic checking about census implementation plan, key research information, general survey information, cultivation of medicinal materials information, germplasm resources information the medicine information, market research information, traditional knowledge information, specimen information of this 9 aspects 20 class 175 indicators in two aspects of the quantity and quality. The established system assists in the completion of the data consistency and accuracy, pushes the county survey team timely to complete the data entry arrangement work, so as to improve the integrity, consistency and accuracy of the survey data, and ensure effective and available data, which lay a foundation for providing accurate data support for national survey of the Chinese material medica resources (CMMR) results summary, and displaying results and sharing.

[Design and implementation of mobile terminal data acquisition for Chinese materia medica resources survey]

In this paper, a data acquisition system based on mobile terminal combining GPS, offset correction, automatic speech recognition and database networking technology was designed implemented with the function of locating the latitude and elevation information fast, taking conveniently various types of Chinese herbal plant photos, photos, samples habitat photos and so on. The mobile system realizes automatic association with Chinese medicine source information, through the voice recognition function it records the information of plant characteristics and environmental characteristics, and record relevant plant specimen information. The data processing platform based on Chinese medicine resources survey data reporting client can effectively assists in indoor data processing, derives the mobile terminal data to computer terminal. The established data acquisition system provides strong technical support for the fourth national survey of the Chinese materia medica resources (CMMR).

[Design and implementation of data reporting system for Chinese materia medica resources survey]

The collection, summary and sharing of all kinds of survey data are one of the main tasks and achievements in the national census of Chinese materia medica resources organized and implemented by the State Administration of Traditional Chinese Medicine. It is a key link in the implementation of the national census of Chinese materia medica resources. Based on the client / server architecture, the data reporting system for Chinese materia medica resources survey has been established for reporting system application model of geospatial data service based on Web implementation, through the SOA framework, to achieve the data collection summary of the seven aspects of the local data configuration, data reporting, data verification, data reporting, PDA data import and export, APP data import, track instrument data import. The system services include the general investigation, the focus of investigation, specimen information, herbs sample information, market research, germplasm survey, traditional knowledge survey of these seven aspects of the 312 indicators of the report, serving the Chinese materia medica resource survey of field survey data collection and internal data collation. The system provides the technical support for the national census of Chinese materia medica resources, improves the efficiency of the census of Chinese materia medica resources, and is conducive to the long-term preservation of the data of Chinese materia medica resources census, the transformation and sharing of the results.

[Opportunities and challenges in the development of pancreatic surgery]

Pancreatic surgery is characteristic of various and complicated diseases and difficult surgeries. Pancreatic surgeons are required to grasp the new concept, apply new techniques and comprehend the study trends of pancreatic diseases. Otherwise, pancreatic surgeons should fully realize the opportunities and challenges resulted from application of new concept and techniques as well as learning new concept and techniques. Meanwhile, they should grasp the updating guidelines and research progress, intensively promote the development of prospective multicenter research involved in multidisciplinary team, and then promote the rapid development of pancreas surgery in China.

[Analysis on regional distribution characteristics and changing trend of Chinese patent medicine industry]

Through the collection and collation of the industrial sales output values of Chinese patent medicines in 31 provinces of China from 2005 to 2014,the regional distribution characteristics and changing trend of Chinese patent medicine industry in the past ten years were analyzed by using the descriptive statistical analysis method in statistics.The results showed that the industrial sales output values of Chinese patent medicines in Jilin, Shandong, Jiangxi, Sichuan and Guangdong accounted for the largest proportion of the country, while Ningxia accounted for only 0.04% of the whole country. Anhui Province had the largest fluctuations in data, and its coefficient of variation was as high as 102.03%.The average annual growth rate of the industrial sales output value of Chinese patent medicines was lowest in Ningxia, only －1.09%.Based on the statistical analysis of the industrial sales output value of Chinese patent medicines in four major economic regions, the data concentration trend was as follows： east> west> central> northeast; the data fluctuation trend was northeast> central> west> east, and the average annual growth rate from large to small was northeast> central> west> east.This study was conducive to understand the differencesin the industrial sales output value of Chinese patent medicines among various provinces and economic regions,and to lay the foundation for the correct understanding and in-depth exploration of the factors that may affect the industrial sales output value of Chinese patent medicines.This study has reference value for the management and economic research of traditional Chinese medicine resources.

[Design and implementation of information management system for Chinese materia medica resources survey]

By means of the established Information Management System for Chinese materia medica resources survey, the national, provincial and county level organization, personnel and the implementation of the program of Chinese materia medica resources survey, and the survey team of medicinal plant investigation, photos, Chinese herbal medicine market survey, the traditional Chinese materia medica resources knowledge survey, germplasm resources investigation and the data collation and summary specimen have been realised. Throughout the whole working process of the fourth national Chinese materia medica resources survey, it is ensured that all data were no missing, no repeat, and well stored and managed. The Information Management System can improve the standardization degree of Chinese materia medica resources survey, and maintain the continuity.

[Bit1 mediates the malignant behaviors in pancreatic cancer and its potential clinical significance]

Objective: To investigate the potential role of Bit1 in the pathogenesis of pancreatic ductal cancer cells(PDAC) and its potential clinical application value. Methods: Real-time PCR and Western blot were employed to detect the expression of Bit1 in six pancreatic cancer cells, then the tool cells were selected to further study the function of Bit1.PolyHEMA was used to monitor the suspended cell culture condition in vitro.The invasion and migration abilities of pancreatic cancer cells were detected through Transwell assay. Western blot and confocal assay were used to explore the potential mechanism of Bit1 in the process of metastasis.The expression of Bit1 was detected through tissue microarray, the potential relationship between Bit1 and other clinical factors were analyzed. Results: The results of real-time PCR and Western blot indicated that the expression of Bit1 was highest in the PANC1 cells and lowest in the Mia paca2 cells (gene: 3.13±0.40 vs. 1.00±0.35, protein: 1.77±1.00 vs. 0.23±0.45). The shBit1 PANC1 and Bit1-OE(over expression) Mia paca2 cells were successfully constructed.Bit1 over expression could promote the anoikis rate of Mia paca2 cells, and Bit knockdown could inhibit the anoikis incidence.Bit1 over expression suppressed the motility and invasion of Mia paca2 cells, but Bit1 knockdown could accelerate the migration and invasion ability of PANC1 cells.Bit1 could potentially affect pancreatic cancer cells' malignant behaviors through epithelial-mesenchymal transition process.Bit1 expression was significantly associated with pancreatic cancer's neural invasion (P<0.05). Conclusions: Bit1 could affect the anoikis incidence of pancreatic cancer, Bit1 negatively affect the migration and invasion abilities of PDAC, the EMT process was potentially involved in the whole modulation process.Bit1 expression is associated with neural invasion in pancreatic cancer patients.

[Exploration and research on comprehensive evaluation model of Chinese patent medicines supply in national essential drugs]

Chinese medicine prices often have sharp rise or fall, and even the impact of short-term price rise on the quality of feed can't be ignored.On the other hand, the production of traditional Chinese medicine is strictly subject to resource constraints, so much of the industrial production due to lack of or prohibited use of resources must bestopped. Based on 203 Chinese patent medicines in the National Essential Drugs (2012 Edition), the factors that influence the supply of essential drugs of traditional Chinese medicine were analyzed and seven indicators for the supply of essential medicines were designed in this paper. According to the Chinese herbal medicine resources survey and dynamic monitoring service system data, a multi-index comprehensive evaluation model based on radar chart analysis was proposed, providing a holistic and overall evaluation of the supply situation of essential drugs of traditional Chinese medicine. The evaluation results were concise, clear and intuitive. In this paper, Jiuwei Qianghuo Wan and Ganmao Qingre Keli were taken as the examples to prove that the proposed comprehensive evaluation method is concise, clear, intuitive, credible and practical.

[Expression and localization of transmembrane protein CMTM2 in human testis and sperm]

OBJECTIVE

To study the expression of transmembrane protein CMTM2 in the testis and sperm of adult males and to approach the potential function of the protein in the male reproductive system.

METHODS

The expression of CMTM2 in human testis and sperm was confirmed by Western blot. Immunohistochemical staining was used for detecting CMTM2 localization in the testis tissue, TRITC-CMTM2 and FITC-Hoechst double immunofluorescence staining was performed to examine the subcellular localization of CMTM2 in the human sperm before and after acrosome reaction, that is, immunofluorescent staining was used for detecting CMTM2 localization in both the testis and sperm before and after the acrosome reaction.

RESULTS

CMTM2 was presented in both human testis and sperm. In the testis, CMTM2 immunoreactive particles were observed mainly in the membrane of the different stages of spermatogenic cells. In the human sperm, its immunoreactivity was restrictively localized to the posterior head where sperm-egg fusion occurred, and the CMTM2 localization was not affected by sperm acrosome reaction. CMTM2 was widely expressed in seminiferous tubules of the human testis, mainly in the cell membranes of spermatogenic cells, which was consistent with the previous reports. The immunofluorescence performed on frozen human testis slides showed similar findings with immunohistochemistry, which gave weight to the localization of CMTM2 in the cell membranes of spermatogenic cells at different stages. TRITC-CMTM2 and FITC-Hoechst double immunofluorescence staining was performed to examine the subcellular localization of CMTM2 in the human sperm before and after acrosome reaction. CMTM2 was localized at the posterior head of sperm before and after acrosome reaction. The localization and expression of CMTM2 were not affected by sperm acrosome reaction.

CONCLUSION

Expression of CMTM2 in the male reproductive system of the adult human exhibits cell- and region-specific patterns, which suggests that they may play an important role in spermatogenesis and sperm-egg fusion. The expression of CMTM2 in the male reproductive system of the adult human exhibits cell- and region-specific patterns, which suggests that they may play an important role in spermatogenesis and sperm-egg fusion. However, it still remains to be further elucidated about the definite role of CMTM2 in male reproductive system and the process of spermatogenesis. And in vitro fertilization experiments are needed to confirm the role of CMTM2 in fertilization in future.

[The application of short stent in root of aorta for the treatment of Stanford type A aortic dissection]

Objective: To explore the effect of implanting short stent in root of aorta for the treatment of Stanford type A aortic dissection. Methods: Clinical data of 39 patients with Stanford type A aortic dissection who underwent surgical procedure at the Department of Cardiovascular Surgery of Luoyang Central Hospital Affiliated to Zhengzhou University, between January 2013 and December 2015 were retrospectively analyzed. There were 31 males and 8 females aged 27 to 75 (49.3±10.3) years. All patients received short stent implanting in aortic root, total arch replacement and stented elephant trunk implantation were performed at the same time. Results: All the operations were successfully performed. Two patients died during hospitalization. Four patients underwent reexploration for postoperative bleeding. Postoperative mortality was 5.1%(2/39). Follow-up duration was 3 to 24 months, with a median time of 14 months. One patient died of lung infection, gastrointestinal bleeding and renal faliure during follow-up. Conclusion: Patients with aortic intimal tear located at higher root of aorta may be suitable for short stent implanting, and the procedure has satisfactory clinical outcomes.

[Correlation between miR-1178 expression and clinicopathological significance in human pancreatic cancer]

Objective: To test the expression of miR-1178 in pancreatic cancer and study its clinicopathological significance and mechanism. Methods: The expression of miR-1178 in 87 paired paraffin pancreatic ductal adenocarcinoma specimens and adjacent non- cancerous pancreatic tissue diagnosed by Pathology Department of Peking Union Medical College Hospital was detected by hybridization in situ. The relationship between the expression of miR-1178 and clinicopathological characters was analyzed.miR-1178 mimics and inhibitor were used to further detect the close relationship among miR-1178 and cancer invasion. Establish a nude mice subcutaneously transplanted tumor model, 4 weeks after vaccination for tumor volume and weight measurement.Student t-test, rank sum test, and χ(2) test was used respectively to compare the data between two groups. Cox regression was adopted to improve the single factor and multiple factors analysis. Results: The results of hybridization in situ showed the expression of miR-1178 was increased in 72 cases with pancreatic cancer compared to that in paired normal pancreatic tissues (50/72 vs. 11/72, χ(2)=43.26, P<0.05). miR-1178 expression was positively associated with tumor lymph node stage (χ(2)=4.189, P=0.041). Univariate and multivariate analysis revealed that miR-1178 was an independent adverse prognostic indicator for patients with pancreatic cancer (HR=2.364, 95%CI: 1.114-5.019, P=0.025). Transwell assay indicated the over-expression of miR-1178 increased the number of AsPC-1 cells that penetrated the ECM-coated membrane (177.0±19.8 vs. 119.7±15.9)(χ(2)=8.21, P<0.05). For the in vivo experiment, overexpression of miR-1178 significantly promoted tumor growth, compared with control group (tumor volume: (5 122.4±760.2)mm(3) vs. (1 976.8±601.8)mm(3), t=2.413, P<0.05; tumor weight: (1.55±0.21)g vs. (0.67±0.17)g, t=2.960, P<0.05). Over-expression of miR-1178 down-regulated the expression of Stub1 and elevated the expression of FAK/MMP-9 signal pathway(P<0.05). Conclusions: MiR-1178 is overexpressed in pancreatic cancer, and is effective for predicting patients' prognosis. MiR-1178 regulate Stub1/FAK/MMP-9 signal pathway and promote the invasion of AsPC-1 cells.

Neuroprotective Effects of Lycium barbarum Polysaccharide on Focal Cerebral Ischemic Injury in Mice

Increasing evidence demonstrates inflammation contributes to neuronal death following cerebral ischemia. Lycium barbarum polysaccharide (LBP) has been reported to prevent scopolamine-induced cognitive and memory deficits. We recently indicated that LBP exerts neuroprotective effect against focal cerebral ischemic injury in mice via attenuating the mitochondrial apoptosis pathway. The aim of this study was to investigate the neuroprotective effects of LBP against the behavioral dysfunction induced by focal cerebral ischemia injury in mice. Following 7 successive days of pretreatment with LBP (10, 20 and 40 mg/kg) and nimodipine (4 mg/kg) by intragastric gavage, mice were subjected to middle cerebral artery occlusion (MCAO). Following reperfusion, cerebral blood flows, the total power of the spontaneous EEG, and morphological changes were estimated. Learning and memory ability, and motor coordination were determined by Morris water maze task, rotarod and grip test. Western blot analysis, Real-Time fluorogenic PCR assays, and immunofluorescence staining were used to examine the expression of proinflammatory mediators and activation of microglia. The present study showed that LBP pretreatment significantly enhanced regional cortical blood flow and the total power of the spontaneous EEG, improved memory and motor coordination impairments, and inhibited over-activation of microglia and astrocytes after MCAO. Further study demonstrated LBP suppressed MCAO-induced activations of P65 NF-κB and P38 MAPK, and prevented up-regulations of proinflammatory mediators in hippocampus. Our data suggest that LBP can exert functional recovery of memory and motor coordination deficits and neuroprotective effect against cerebral ischemic injury in mice.