[Investigation and analysis on the detection of IgG antibodies against the rubella virus among rural childbearing-age women in preconception period in Yunnan Province from 2013 to 2019]

A study was conducted on rural women of childbearing age aged 20-49 who underwent the National Free Preconception Health Examination Project (NFPHEP)in Yunnan Province from 2013 to 2019. Descriptive analysis was conducted to determine the negative rate of IgG antibodies against the rubella virus and its differences among various socio-demographic characteristics. Among the 1 511 203 study subjects, the negative rate of IgG antibodies against the rubella virus was 24.36%. Only 2.64% of the population had received rubella virus vaccine. The negative rate of IgG antibodies among rural childbearing-age women in the preconception period in Yunnan Province decreased with age and educational level (Ptrend<0.001). The negative rate of IgG antibodies in ethnic minority women of childbearing age in the preconception period (25.19%) was higher than that of Han women (23.88%). Among the 22 ethnic groups with over 1 000 participants, the negative rates of IgG antibodies in women of childbearing age from the Blang (32.85%), Bouyei (31.03%), Zhuang (31.01%), and Miao (30.70%) ethnic groups were higher than those of women from other ethnic groups. Among the 16 states (cities) in Yunnan Province, the negative rate of IgG antibodies in pregnant women of childbearing age in Wenshan Zhuang and Miao Autonomous Prefecture (38.06%) and Lincang City (32.63%) was higher than that in other states (cities). The negative rate of serum IgG antibodies in women who reported having received rubella virus vaccine (18.60%) was lower than that in other non-vaccinated populations (24.52%). The proportion of rural women of childbearing age in Yunnan Province who were susceptible to the rubella virus before pregnancy was still high. It is necessary to promote rubella vaccination among people susceptible to rubella, especially pregnant women, to prevent rubella virus infection and reduce the incidence rate and disease burden of rubella people.

Catalpol inhibits hepatic stellate cell activation by reducing the formation and changing the contents of hepatocyte-derived extracellular vesicles

Hepatic stellate cell (HSC) activation is the central event in hepatic fibrosis. The cross-talk between HSCs and hepatocytes, which is mediated by extracellular vesicles (EVs), affects HSC activation. This study aimed to investigate whether Catalpol (CTP) attenuated hepatic fibrosis via modulating EVs. Mice were injected intraperitoneally with CCl4 for 4 weeks to induce hepatic fibrosis. They were gavaged with CTP daily. Mouse serum EVs were isolated and identified using nanoparticle tracking analysis and transmission electron microscopy. Mouse hepatocytes (AML12) and primary HSCs were used to investigate the cell-to-cell crosstalk. The autophagosome-autolysosome fusion was determined using the autophagic flux assay. Hepatic fibrosis was attenuated by CTP, with a decrease of the myofibroblast marker, alpha-smooth muscle actin. The CTP treatment lowered the serum EVs. The co-culture of HSCs and the EVs derived from the CTP-treated mice or hepatocytes reduced HSC proliferation and the expressions of ACTA2 and Col1a1. After the CCl4 treatment, the autophagosomes in AML12 cells were increased, while the autolysosomes were reduced. The decrease of autophagic cargo receptor SQSTM1 in the CTP group suggested that autophagic degradation was sustained. After inhibiting the endogenous Rac1-GTP of hepatocytes, the co-culture of EVs and HSCs reduced Rac1-GTP. The Rac1-GTP level in serum EVs from the CTP-treated mice was reduced in vivo. CTP inhibited autophagy in hepatocytes by reducing Rac1-GTP and thus affect the amount of Rac1-GTP in hepatocyte-derived EVs and the formation of EVs, which attenuated hepatic fibrosis via inhibiting HSC activation.

[Recognition of the membrane anatomy-based laparoscopic assisted right hemicolectomy]

Although it has become a consensus in the field of colorectal surgery to perform radical tumor treatment and functional protection under the minimally invasive concept, there exist many controversies during clinical practice, including the concept of embryonic development of abdominal organs and membrane anatomy, the principle of membrane anatomy related to right hemicolectomy, D3 resection, and identification of the inner boundary. In this paper, we analyzed recently reported literature with high-level evidence and clinical data from the author's hospital to recognize and review the membrane anatomy-based laparoscopic assisted right hemicolectomy for right colon cancer, emphasizing the importance of priority of surgical dissection planes, vascular orientation, and full understanding of the fascial space, and proposing that the surgical planes should be dissected in the parietal-prerenal fascial space, and the incision should be 1 cm from the descending and horizontal part of the duodenum. The surgery should be performed according to a standard procedure with strict quality control. To identify the resection range of D3 dissection, it is necessary to establish a clinical, imaging, and pathological evaluation model for multiple factors or to apply indocyanine green and nano-carbon lymphatic tracer intraoperatively to guide precise lymph node dissection. We expect more high-level evidence of evidence-based medicine to prove the inner boundary of laparoscopic assisted radical right colectomy and a more rigorous consensus to be established.

[Investigation of ABO and RhD blood groups in childbearing age people in rural areas of Yunnan Province]

The participants in this study were 20-49 years old rural childbearing age people who received the National Free Preconception Health Examination Project (NFPHEP) in Yunnan Province during 2013 to 2019. The proportion of ABO and RhD blood groups among different ethnic groups and different areas were calculated. The proportion of 2 748 131 participants with blood group A phenotype was highest (32.60%), followed by O (30.60%), B (27.33%) and AB (9.47%). In the RhD blood system, the proportion of the RhD positivity (RhD+) and RhD negativity (RhD-) group were 99.29% and 0.71% respectively. The proportions blood groups were significantly different among ethnic groups and areas (all P<0.001). Among 18 ethnic groups with more than 3 000 participants, Yao (42.75%), Bouyei (40.58%) and Dai (40.37%) ethnic groups had higher proportion of blood group O phenotype than other ethnic groups. Wa ethnic groups had highest proportion of the A (40.15%) and AB phenotypes (11.23%). Miao ethnic group (34.70%) and Lahu ethnic group (34.42%) had higher proportion of blood group B phenotype than other ethnic groups. Wa ethnic group had the highest proportion of RhD-group (1.88%). In all 16 prefectures of Yunnan, the proportion of blood group O phenotype was highest in Xishuangbanna Dai Autonomous Prefecture (40.27%). Baoshan city (36.39%), Lincang city (36.22%) and Dali Bai autonomous prefecture (36.06%) had higher proportion of blood group A phenotype than other regions. Diqing Tibetan Autonomous Prefecture (30.83%) and Qujing city (30.48%) had higher proportion of blood group B phenotype than other areas, while Zhaotong city had a highest proportion of blood group AB phenotype (11.19%). The proportion of RhD-group was highest in Honghe hani and Yi nationality autonomous prefecture(1.37%). The A RhD+(39.36%), A RhD-(0.78%), AB RhD+(11.03%), AB RhD-(0.20%) and O RhD-(0.48%) blood groups were higher proportion in Wa ethnic group than in other ethnic groups (P<0.001).

[A nationalsurveyandresults analysisof seizure prophylaxis after aneurismal subarachnoid hemorrhage]

Investigate theclinical practice of seizure prophylaxis after aneurysmal subarachnoid hemorrhage in Chinese neurosurgeons.Aquestionnaire for this theme was designed and was sent to respondents through the internet.From July 2021 to October 2021, atotal of forty-three eligible questionnaires were collected. All responders come from affiliated hospitals of medical schools in China. Each of these hospitals admitted more than one hundred patients with aneurysmal subarachnoid hemorrhage per year. Only 9.3% (4/43) of responders disagree with the prophylactic use of anticonvulsants. 86.04% (37/43) of responders perform seizure prophylaxis in clinical practice. Sodium valproate is the most commonly used regimen; 94.59% (35/37) of responders who perform prophylaxis chose this drug. The medication period differs sharply fromlessthan 3 daystolongerthan 14 daysamong different hospitals. The use of EEG was insufficient in Chinese patients. A low seizure rate was reported according to the feedback from Chinese neurosurgeons.In China, seizure prophylaxis after subarachnoid hemorrhage was not yet standardized. Clinicians' mastery of relevant knowledge is still not enough. Carrying out high-quality clinical research can help justify the use of anticonvulsants, which could also positively impact rational drug use.

Conversion efficiency of multi-keV L-shell-band X-ray emission

This study explored the influence of foil thickness, laser pulse width, and laser intensity to optimize the multi-keV X-ray conversion efficiency of a sandwiched (CH/Sn/CH) planar target under laser irradiation at the Shenguang II laser facility. The X-ray photon field values were measured using a set of elliptically bent crystal spectrometers and the conversion efficiencies (ξ_x) of photon energies were in the range of 3.7-4.3 keV. The experimental results indicate that the X-ray yields of 3.7 to 4.3 keV radiation strongly depend on the laser pulse width, target thickness, and laser intensity. The results also demonstrate that three-layer thin foils can provide an efficient multi-keV X-ray source because they can change the distribution of emitted multi-keV X-rays and target dynamics versus nanosecond laser pulses to produce large, hot, and underdense plasma. However, the underdense plasma produced as a rarefaction wave causes the overdense plasma generated by the laser pulse to expand. Therefore, the laser parameters and foil thickness must be carefully optimized to produce an efficient 3.7 to 4.3 keV X-ray source. Otherwise, the rarefaction waves from both sides of the thin foil may suppress multi-keV X-ray emission. This study represents an important advancement in the development of an efficient multi-keV L-shell-band X-ray source.

Inositol-Requiring Kinase 1 Regulates Apoptosis via Inducing Endoplasmic Reticulum Stress in Colitis Epithelial Cells

BACKGROUND

Endoplasmic reticulum stress (ERS) has been studied as critical factor during occurrence and development of ulcerative colitis (UC). However, the role of ERS in inflamed UC remains unclear.

AIMS

The purpose of this study was to analyze the role of inositol-requiring kinase 1 (IRE-1), a major regulator of ER, in regulating ERS and cell viability.

METHODS

In UC mucosa tissue, IRE-1, BiP, XBP-1s, CHOP caspase-12 and GADD34 mRNA were assayed by qRT-PCR. Then, human normal colon epithelial cell line (NCM-460) and colon fibroblast cell line (CCD-33Co) were cultured, and downregulated or upregulated IRE-1 expression. ERS was induced with 100 ng/mL of Interleukin 6 (IL-6). CCK8 assay was performed to analyze cell proliferation. Flow cytometry analysis was conducted to detect the apoptosis. Western blot assay was used to examine ERS markers.

RESULTS

IRE-1, BiP, XBP-1s, caspase-12 and CHOP mRNA were highly expressed in UC mucosa tissue, and the expression of GADD34 mRNA significantly decreased. These results show that ERS-induced unfolded protein response was enhanced in UC mucosa tissue. In cells, silencing the expression of IRE-1 could suppress cell proliferation and promote apoptosis through activating unfolded protein response, while the over-expression of IRE-1 had the opposite effect. IL-6 could induce ERS and cells apoptosis. Furthermore, we demonstrated that shRNA IRE-1 could enhance the inhibition of IL-6 on cells viability.

CONCLUSIONS

Inhibition of IRE-1 enhanced unfolded protein response and cells apoptosis and IL-6-induced ERS and suggested that IRE-1 might be a potential target of UC.

[Screening and analysis of Treponema pallidum specific antibody among childbearing age people in rural areas of Yunnan province, 2013-2017]

Objective: To determine the prevalence, epidemiological characteristics, and related factors of syphilis infection among rural childbearing age people to promote medical interventions on pre-pregnancy aristogenesis and syphilis infection in Yunnan province. Methods: The subjects in this study were 18-49-year-old rural couples of childbearing age from the National Free Preconception Health Examination Project in Yunnan province during 2013-2017. The descriptive study was carried out to determine the positive rate of Treponema pallidum specific antibody (TPsAb) and related sociodemographic characteristics. Results: The overall positive rate of TPsAb was 0.38% (8 204/2 160 455) in 2 160 455 rural childbearing age people in Yunnan. The positive rate of TPsAb was 0.39% (4 019/1 040 981) in men,higher than that in women (0.37%,4 185/1 119 474). The positive rate of TPsAb was highest in the age group 45-49 years (0.70%,158/22 511). The positive rate of TP antibody in the minority ethnic groups and Han ethnic groups appeared the same (0.38%). However,the highest positive rate of TPsAb was 0.77% (461/60 153) in Hani ethnic group among all the 17 minority ethnic groups. People with education level of primary education had the highest anti-TP positive rate (0.54%,2 327/431 275). The positive rate of TPsAb appeared the highest in Zhaotong (0.73%, 2 049/281 614) area among all the 16 prefectures of the province. The positive rate of TPsAb in the population from the impoverished regions (0.50%,2 963/590 039) was higher than in other disadvantaged areas (0.34%, 3 115/929 368) or areas with average income (0.33%,2 126/641 048). Significant differences appeared in the positive rate of TPsAb among populations of different ages, ethnic, education level, and economic level groups (trend χ² test, P<0.001). Conclusions: The positive rate of TP antibody in rural childbearing age people in Yunnan was related to multi factors,including sex,age,ethnic group,education level,area, residence, and local economic situation. The positive rate of TPsAb was higher in men than in women. And people with elder age, lower education level, being Hani or Lahu ethnic group, and Zhaotong areas had higher TPsAb positive rates and higher syphilis infection risk.

[Application of superficial inferior epigastric artery flaps to repair oral and maxillofacial defects with the aid of digital three-dimensional reconstruction technique]

Objective: To explore the application value of digital three-dimensional(3D) reconstruction technology in the repair of oral and maxillofacial defects with superficial inferior epigastric artery (SIEA) flap. Methods: Twelve cases of oral cancer patients, including 8 males and 4 females; aged (57.4±12.6) years, were selected from the Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Bengbu Medical College from January 2018 to October 2019 and were proposed to repair with SIEA flap. There were 10 cases of squamous cell carcinoma, one case of adenoid cystic carcinoma and 1 case of mucinous epidermal carcinoma. The data were imported into AW4.7 software for post-processing. The left or right dominant donor area was selected to clarify the origin, diameter, alignment, and location of penetration point of the flap blood supply, and digital 3D reconstruction technology was used to guide the flap preoperative design. Results: Eleven cases were repaired by SIEA flap in 12 patients, one case was repaired by superficial iliac artery flap because the source artery was undiscovered, one case had venous vascular crisis after surgery, and the rest of the flap survived. In 11 patients repaired with SIEA flap, there was no significant difference between the preoperative SIEA diameter measured by CTA [(1.0±0.3) mm] and the actual measured value [(1.1±0.3) mm] (P>0.05). The follow-up was 6 to 12 months, with an average of 10 months, and the donor-receiver areas were all healed in phase Ⅰ. No obvious complications occurred, and the abdominal scar was hidden. Conclusions: In the SIEA flap repair oral and maxillofacial defect reconstruction surgery, the use of digital 3D reconstruction technology can objectively reflect the diameter and the location of the superficial artery of the abdominal wall before surgery, effectively reduce the difficulty and risk of flap surgery.

Overexpressing microRNA-34a overcomes ABCG2-mediated drug resistance to 5-FU in side population cells from colon cancer via suppressing DLL1

Colon cancer side population (SP) cells are a small subset of cancer cells that have cancer stemness capacity and enhanced drug resistance. ABCG2 is a multidrug resistance-related protein in SP cells and has been demonstrated to be regulated by Notch signalling pathway. Recently, microRNAs are reported to play a critical role in SP cell fate. However, their role in ABCG2-mediated drug resistance in colon cancer SP cells remains unclear. In the current study, the different expressions of miR-552, miR-611, miR-34a and miR-5000-3p were compared within SP and non-SP cells, which were separated from human colon cancer cell lines (SW480 and LoVo). We found that miR-34a was significantly down-regulated in SP cells and that overexpressing miR-34a overcame drug resistance to 5-fluorouracil (5-FU). The luciferase reporter assay indicated that miR-34a negatively regulated DLL1, a ligand of Notch signalling pathway, via binding with 3'-untranslated region of its messenger RNA. In addition, overexpressing miR-34a overcame ABCG2-mediated resistance to 5-FU via DLL1/Notch pathway in vitro, and suppressed tumour growth under 5-FU treatment in vivo. In conclusion, our findings suggest that miR-34a acts as a tumour suppressor via enhancing chemosensitivity to 5-FU in SP cells, which provides a novel therapeutic target in chemotherapy-resistant colon cancer.

[Study on the hydrodynamic mechanisms of the radial arterial blood pressure variation in response to arm elevation]

Objective: To analyze the mechanism of invasive blood pressure change in radial artery caused by arm elevation by observing pressure, velocity and diameter of radial artery. Methods: Twenty-six hemodynamically stable hepatobiliary surgery patients admitted to the intensive care unit from June to December 2018 after general anesthesia in Tsinghua Changgung Hospital were selected. When the arm was raised, the invasive blood pressure was recorded, and the inner diameter and blood flow velocity of the radial artery were measured by Doppler ultrasound. The data following a normal distribution were compared with paired t test. Results: After arm elevation for 30 s, systolic blood pressure of radial artery decreased and diastolic blood pressure increased significantly((107±16) mmHg vs (120±17) mmHg, (75±6) mmHg vs (71±9) mmHg, t=25.0, -12.6, both P<0.05), but there was no significant difference in mean arterial pressure ((87±10) mmHg vs (87±11) mmHg, t=1.1, P>0.05). The peak velocity, end-diastolic velocity and resistance index of the radial artery increased significantly, and the transverse and longitudinal inner diameters of the radial artery decreased significantly after the arm was elevated for 30 s (t=-63.4, -14.6, -22.5, 31.4, 25.3, all P<0.01). Conclusions: Kinetic pressure compensation and vascular resistance compensation may be the main mechanism of radial artery pressure change when the arm is elevated. Arm elevation can be used as a vascular resistance response test clinically.

[Mitochondrial encephalopathy, lactic acidosis and stroke-like episodes / myoclonus epilepsy with ragged-red fibers /Leigh overlap syndrome caused by mitochondrial DNA 8344A>G mutation]

OBJECTIVE

Mitochondrial deoxyribonucleic acid (mtDNA) 8344 A>G (m.8344A>G) mutation is the common mutation associated with mitochondrial myoclonus epilepsy with ragged-red fibers (MERRF) syndrome. Herein we report a rare case with mitochondrial encephalopathy, lactic acidosis and stroke-like episodes/MERRF/Leigh (MELAS/MERRF/Leigh) overlap syndrome caused by m.8344A>G mutation.

METHODS

The clinical and imaging data of the patient were collected and an open muscle biopsy was carried out. We further employed molecular genetic analyses to detect mtDNA mutation in the proband and his mother. And then a clinical and neuroimaging follow-up was performed.

RESULTS

This patient was a 25-year-old male, who developed exercise intolerance since the age of 6. At age 10, he suffered from acute episodes of hemianopia, and cranial magnetic resonance imaging (MRI) showed occipital stroke-like lesions and cranial magnetic resonance spectroscopy (MRS) revealed a lactate peak corresponding to the lesion. After that the patient presented slowly progressive psychomotor decline. He had myoclonic seizures and cerebellar ataxia since the age of 12. At age 21, he was admitted to our hospital because of confusion and cranial MRI revealed symmetrical lesions in bilateral posterior putamen, thalami and midbrain. Then repeated MRI showed progression of original lesions and new frontal multiple stroke-like lesions. Symptomatic and rehabilitation treatment relieved his condition. Follow-up cranial MRI at age 24 showed the lesions in basal ganglia and thalami diminished, and the midbrain lesions even completely vanished. Muscle pathology indicated the presence of numerous scattered ragged-red fibers (RRF), suggestive of a mitochondrial disorder. Polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) detected the m.8344A>G mutation of the MT-TK gene encoding mitochondrial transfer RNA for lysine in the patient's blood. Next generation sequencing (NGS) of the whole mitochondrial genome identified that the proportion of m.8344A>G was 90%, and no other mtDNA mutation was detected. Sanger sequencing further identified this mutation both in the proband and his mother's blood, although the mutation load was much lower in his mother's blood with approximately 10% heteroplasmy.

CONCLUSION

The present study is the first to describe a patient with m.8344A>G mutation in association with the MELAS/MERRF/Leigh overlap syndrome, which expands the phenotypic spectrum of the m.8344A>G mutation.

Critical properties of the two-dimensional q-state clock model

We perform the state-of-the-art tensor network simulations directly in the thermodynamic limit to clarify the critical properties of the q-state clock model on the square lattice. We determine accurately the two phase transition temperatures through the singularity of the classical analog of the entanglement entropy, and provide extensive numerical evidences to show that both transitions are of the Berezinskii-Kosterlitz-Thouless (BKT) type for q≥5 and that the low-energy physics of this model is well described by the Z_{q}-deformed sine-Gordon theory. We also determine the characteristic conformal parameters, especially the compactification radius, that govern the critical properties of the intermediate BKT phase.

Long noncoding RNA XIST enhances ethanol-induced hepatic stellate cells autophagy and activation via miR-29b/HMGB1 axis

Activation of hepatic stellate cells (HSCs) is a prominent driver of liver fibrogenesis, including alcoholic liver fibrosis (ALF). Furthermore, autophagy contributes to HSCs activation. This study aims to investigate the role and the mechanisms of long noncoding RNA XIST in regulating HSCs autophagy and activation. Human HSC cells (LX-2) were treated with 100 mmol/L ethanol to mimic HSCs activation. The HSCs activation was evaluated by determining cell viability and protein levels of fibrosis markers α-smooth muscle actin (α-SMA) and collagen type 1 α1 (CoL1A1). The autophagy was evaluated by measuring autophagy markers Beclin-1 and LC3-II. The interaction among XIST, miR-29b, and high-mobility group box-1 (HMGB1) were analyzed using luciferase reporter assay, qRT-PCR, and western blot. Lentiviruses targeting sh-XIST (LV-sh-XIST) were injected into ALF model mice via tail vein to elucidate the in vivo role of XIST in ALF injury. XIST was upregulated in ethanol-activated LX-2 cells. Furthermore, XIST served as a competitive endogenous RNA of miR-29b to facilitate HMGB1 expression, and thus enhanced ethanol-induced HSCs autophagy and activation. Further in vivo assay showed that downregulation of XIST by LV-sh-XIST alleviated ALF injury in ALF model mice. Collectively, XIST enhances ethanol-induced HSCs autophagy and activation via miR-29b/HMGB1 axis.

Elliptically bent crystal x-ray spectrometer for time-resolved laser plasma experiments

Measuring time-resolved spectra is crucial in inertial confinement fusion and radiation source development experiments. An elliptically bent crystal spectrometer is designed to measure X-rays in the range of 2.5-11.0 keV, which was achieved using four different lattice spacings of 0.8512, 0.6687, 0.4246, and 0.2749 nm with spectral resolution E/δE of ∼500. The X-rays emitted from a source at one focus of the ellipse undergo Bragg reflection off a crystal and pass through the second focus of the ellipse to a streak camera slit with 18-mm length and 80-μm width to generate a time-resolved spectrum. An alignment method for the time-resolved spectrometer was developed with the straight line connecting the centers of the two small holes on the fabricated substrate being the axis of the ellipse, thus allowing the spacing between the source and the elliptical crystal to be tuned to couple with the streak camera. The time-resolved spectrometer's performance was experimentally tested at the Shenguang II laser facility. The results indicate that its performance is close to that predicted theoretically.

[Preliminary study of the arm equilibrium pressure to predict the effect of fluid challenge on urine output in oliguric intensive care unit patients]

Objective: To evaluate whether arm equilibrium pressure (Parm) is helpful to predict the effect of fluid load in improving oliguria in intensive care unit(ICU) patients. Methods: Hemodynamically stable patients [mean artery pressure (MAP)>65 mmHg (1 mmHg=0.133 kPa), heart rate (HR)<120 beats/min, lactic acid<2 mmol/L] with urine output (UO)<0.5 ml·kg(-1)·h(-1) for 3 consecutive hours were enrolled. The fluid loading was performed by infusion of ringer's lactate 500 ml within 30 minute after baseline hemodynamic data were recorded. The positive renal response was defined as UO increased more than 0.5 ml·kg(-1)·h(-1) 1 hour after fluid challenge, otherwise was negative. Results: A total of 30 oliguric ICU patients were enrolled including 17 males and 13 females with median age (54.2±16.3) years. After fluid load, patients' HR decreased[(84±13)beat/min vs. (80±10) beat/min, P<0.01], central venous pressure (CVP) increased[(7.0±2.4)mmHg vs. (8.8±2.6) mmHg, P<0.01], 30s Parm [(33.4±5.3) mmHg vs. (35.4±5.8) mmHg, P<0.01] and 60s Parm [(26.9±4.5) mmHg vs. (28.7±5.0) mmHg, P<0.01] increased, and UO [(18.5±8.8)ml/h vs. (64.1±38.3)ml/h, P<0.01] increased significantly, while MAP and lactic acid did not change (P>0.05). There were eighteen renal responders and 12 patients did not response. In responding group, MAP[(78.1±10.7) mmHg vs. (91.2±11.7) mmHg, P<0.01], 30s Parm[(30.4±3.8) mmHg vs. (38.0±3.7) mmHg, P<0.01] and 60s Parm [(24.3±2.5) mmHg vs. (30.8±4.0) mmHg, P<0.01] before fluid load were lower than those in negative group. HR, CVP, lactic acid, age and body weight were comparable between two groups (P>0.05). After volume loading, MAP, 30s and 60s Parm in positive group were still lower than those in negative group (P<0.05), while HR, CVP and lactic acid were similar (P>0.05). Correlation analysis showed that baseline 30s Parm (r=-0.75, P<0.01), 60s Parm (r=-0.69, P<0.01), and MAP (r=-0.46, P<0.05) were negatively correlated with 1 h UO after fluid load, but HR and CVP were not (P>0.05). The receiver operating curve (ROC) showed that 30s Parm had the largest area under curve (AUC) of 0.94 (95% CI 0.84-1.05, P<0.01), which 35.5 mmHg was the best threshold with sensitivity 94.4% and specificity 91.7%(likelihood ratio 11.37). Conclusion: In hemodynamically stable oliguric ICU patients, if Parm is lower than normal reference value, volume expansion is more likely to increase UO. Thus Parm can be used to predict the effect of fluid loadon UO.

[Experts consensus on the management of the right heart function in critically ill patients]

To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle. (2) Right heart function management is a key step of the hemodynamic therapy in critically ill patients. (3) Fluid resuscitation means the process of fluid therapy through rapid adjustment of intravascular volume aiming to improve tissue perfusion. Reversed fluid resuscitation means reducing volume. (4) The right ventricle afterload should be taken into consideration when using stroke volume variation (SVV) or pulse pressure variation (PPV) to assess fluid responsiveness.(5)Volume overload alone could lead to septal displacement and damage the diastolic function of the left ventricle. (6) The Starling curve of the right ventricle is not the same as the one applied to the left ventricle,the judgement of the different states for the right ventricle is the key of volume management. (7) The alteration of right heart function has its own characteristics, volume assessment and adjustment is an important part of the treatment of right ventricular dysfunction (8) Right ventricular enlargement is the prerequisite for increased cardiac output during reversed fluid resuscitation; Nonetheless, right heart enlargement does not mandate reversed fluid resuscitation.(9)Increased pulmonary vascular resistance induced by a variety of factors could affect right heart function by obstructing the blood flow. (10) When pulmonary hypertension was detected in clinical scenario, the differentiation of critical care-related pulmonary hypertension should be a priority. (11) Attention should be paid to the change of right heart function before and after implementation of mechanical ventilation and adjustment of ventilator parameter. (12) The pulmonary arterial pressure should be monitored timingly when dealing with critical care-related pulmonary hypertension accompanied with circulatory failure.(13) The elevation of pulmonary aterial pressure should be taken into account in critical patients with acute right heart dysfunction. (14) Prone position ventilation is an important measure to reduce pulmonary vascular resistance when treating acute respiratory distress syndrome patients accompanied with acute cor pulmonale. (15) Attention should be paid to right ventricle-pulmonary artery coupling during the management of right heart function. (16) Right ventricular diastolic function is more prone to be affected in critically ill patients, the application of critical ultrasound is more conducive to quantitative assessment of right ventricular diastolic function. (17) As one of the parameters to assess the filling pressure of right heart, central venous pressure can be used to assess right heart diastolic function. (18). The early and prominent manifestation of non-focal cardiac tamponade is right ventricular diastolic involvement, the elevated right atrial pressure should be noticed. (19) The effect of increased intrathoracic pressure on right heart diastolic function should be valued. (20) Ttricuspid annular plane systolic excursion (TAPSE) is an important parameter that reflects right ventricular systolic function, and it is recommended as a general indicator of critically ill patient. (21) Circulation management with right heart protection as the core strategy is the key point of the treatment of acute respiratory distress syndrome. (22) Right heart function involvement after cardiac surgery is very common and should be highly valued. (23) Right ventricular dysfunction should not be considered as a routine excuse for maintaining higher central venous pressure. (24) When left ventricular dilation, attention should be paid to the effect of left ventricle on right ventricular diastolic function. (25) The impact of left ventricular function should be excluded when the contractility of the right ventricle is decreased. (26) When the right heart load increases acutely, the shunt between the left and right heart should be monitored. (27) Attention should be paid to the increase of central venous pressure caused by right ventricular dysfunction and its influence on microcirculation blood flow. (28) When the vasoactive drugs was used to reduce the pressure of pulmonary circulation, different effects on pulmonary and systemic circulation should be evaluated. (29) Right atrial pressure is an important factor affecting venous return. Attention should be paid to the influence of the pressure composition of the right atrium on the venous return. (30) Attention should be paid to the role of the right ventricle in the acute pulmonary edema. (31) Monitoring the difference between the mean systemic filling pressure and the right atrial pressure is helpful to determine whether the infusion increases the venous return. (32) Venous return resistance is often considered to be a insignificant factor that affects venous return, but attention should be paid to the effect of the specific pathophysiological status, such as intrathoracic hypertension, intra-abdominal hypertension and so on. Consensus can promote right heart function management in critically ill patients, optimize hemodynamic therapy, and even affect prognosis.

Inhibition of autophagy reverses alcohol-induced hepatic stellate cells activation through activation of Nrf2-Keap1-ARE signaling pathway

BACKGROUND

Numerous documents have indicated a critical role of autophagy in alcoholic liver fibrosis (ALF), but few papers have reported its function in hepatic stellate cells (HSCs) activation. The current study aimed to investigate the regulation effect of autophagy in HSCs activation, in further to explore the underlying mechanism involved.

METHODS

HSC-T6 cells were treated with ethanol, 3-MA (autophagy inhibitor) or rapamycin (autophagy inducer), and cells were also transfected with si-Nrf2 or si-Keap1. Moreover, ALF animal model was established and Nrf-2^(-/-), Keap1 ^(-/-) mice were purchased. The level of autophagy, the expression of α-SMA and CoL1A1, and Nrf2 antioxidant response were evaluated in stellate cells and livers.

RESULTS

Ethanol treatment in cultured cells increased autophagy, oxidative stress level and promoted HSCs activation. Inhibition of autophagy reversed alcohol-induced HSCs activation and suppressed HSCs oxidative stress. Nrf2-Keap1-ARE pathway was involved in HSCs activation and oxidative stress regulated by autophagy. In addition, through in vivo study, we found that inhibition of autophagy could alleviate alcoholic fatty liver injury in ALF model mice and Nrf2 signaling was involved in autophagy regulated HSCs activation.

CONCLUSION

These data implicated mechanisms underlying autophagy in regulating the fibrogenic response in HSCs activation.

[The impact of different occlusion time on forearm equilibrium pressure and the correlation with systemic hemodynamics]

Objective: To observe the changes of arm equilibrium pressure (P(arm)) in different occlusion time, the reference range of P(arm) in hemodynamic stable patients, and to explore the relationship between P(arm) and systemic hemodynamic parameters. Methods: Mechanically ventilated postoperative abdominal surgery patients who admitted to ICU with stable hemodynamic status were enrolled. After hemodynamic data were recorded, arm stop-flow maneuvers were performed to measure P(arm). At 10, 20, 30, 40, 50, 60 seconds after occlusion, arterial pressure were measured twice within 5 minutes and recorded as the average value. Results: Thirty patients were included. The P(arm) decreased gradually with the prolongation of the occlusion time.The value was not stable within 60 s, but the reducing extent was not obvious after 40s. The 95% reference range of P(arm) 30 s was 23-44 mmHg(1 mmHg=0.133 kPa) and P(arm) 60 s was 19-35 mmHg. P(arm) at 30 s and 60 s were positively correlated with systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, central venous pressure (all P<0.001), but not heart rate and pulse pressure. Linear regression analysis showed that P(arm) at 10 s, 20 s, 30 s only had linear correlation with diastolic arterial pressure (10 s, β=0.504, P=0.001; 20 s, β=0.297, P=0.005; 30 s, β=0.231, P=0.015), and P(arm) at 40 s, 50 s, 60 s were linear correlation with diastolic arterial pressure (40 s, β=0.220, P=0.004; 50 s, β=0.210, P=0.004; 60 s, β=0.213, P=0.004) and central venous pressure (40 s, β=0.516, P=0.018; 50 s, β=0.513, P=0.01; 60 s, β=0.472, P=0.023). Conclusion: In mechanically ventilated postoperative abdominal surgery patients with stable hemodynamic status, P(arm) decreases when occlusion time is prolonged, which is not stable within 60 s occlusion. Arterial blood pressure and central venous pressure are positively correlated with P(arm).

Gapless Spin-Liquid Ground State in the S=1/2 Kagome Antiferromagnet

The defining problem in frustrated quantum magnetism, the ground state of the nearest-neighbor S=1/2 antiferromagnetic Heisenberg model on the kagome lattice, has defied all theoretical and numerical methods employed to date. We apply the formalism of tensor-network states, specifically the method of projected entangled simplex states, which combines infinite system size with a correct accounting for multipartite entanglement. By studying the ground-state energy, the finite magnetic order appearing at finite tensor bond dimensions, and the effects of a next-nearest-neighbor coupling, we demonstrate that the ground state is a gapless spin liquid. We discuss the comparison with other numerical studies and the physical interpretation of this result.

Metastasis-associated gene 1 expression in human medulloblastoma and its association with invasion and metastasis in medulloblastoma Daoy cell lines

This study aims to investigate the expression of metastasis-associated gene 1 (MTA1) in human medulloblastoma, and its significance in the invasion and metastasis in a medulloblastoma cell line. Positive expression rate of MTA1 protein in medulloblastoma and adjacent normal tissues collected from 29 medulloblastoma patients was detected by immunohistochemistry assay in vivo. In in vitro experiments, Daoy cells were transfected with MTA1-targeted small interfering RNA (siRNA, MTA1-siRNA group), niRNA (MTA1-niRNA group), and plasmid vectors (control group). Transfection efficiency was evaluated by PT-PCR and western blot; cell adhesion, migration, and invasion capacity was assessed by adhesion assays, scratch assays, and transwell chamber invasion assays, respectively. Results indicated that the positive expression rate of MTA1 protein in the medulloblastoma tissues was higher as compared with that of the adjacent normal tissues (P < 0.05). In addition, mRNA and protein expression of MTA1 in the MTA1-siRNA group was lower than that in the control and MTA1- niRNA groups (P < 0.05). Adhesion, migration, and invasion capacity of Daoy cells in the MTA1-siRNA group was inhibited as compared with the control and MTA1-niRNA groups (P < 0.05). In conclusion, MTA1 expression was increased in medulloblastoma cells, while MTA1 knockdown in medulloblastoma cells inhibited MTA1 expression. In addition, MTA1 knockdown inhibited the adhesion, migration, and invasive capabilities of medulloblastoma cells. It is possible that MTA1 can serve as a biomarker and a potential therapeutic target for medulloblastoma.

Fine structure of the entanglement entropy in the O(2) model

We compare two calculations of the particle density in the superfluid phase of the O(2) model with a chemical potential μ in 1+1 dimensions. The first relies on exact blocking formulas from the Tensor Renormalization Group (TRG) formulation of the transfer matrix. The second is a worm algorithm. We show that the particle number distributions obtained with the two methods agree well. We use the TRG method to calculate the thermal entropy and the entanglement entropy. We describe the particle density, the two entropies and the topology of the world lines as we increase μ to go across the superfluid phase between the first two Mott insulating phases. For a sufficiently large temporal size, this process reveals an interesting fine structure: the average particle number and the winding number of most of the world lines in the Euclidean time direction increase by one unit at a time. At each step, the thermal entropy develops a peak and the entanglement entropy increases until we reach half-filling and then decreases in a way that approximately mirrors the ascent. This suggests an approximate fermionic picture.

Effects of stathmin 1 silencing by siRNA on sensitivity of esophageal cancer cells Eca-109 to paclitaxel

We investigated the effects of stathmin 1 (STMN1) silencing by small interfering (siRNA) on the sensitivity of esophageal cancer cells Eca-109 to paclitaxel. STMN1 siRNA was transiently transfected into Eca-109 cells. The effects of transfection were detected by quantitative polymerase chain reaction and western blotting. The effects of STMN1 silencing by siRNA on the sensitivity of esophageal cancer cells Eca-109 to paclitaxel was tested by MTT and colony formation assays. Hoechst 33258 nuclear staining was used to investigate the differences in Eca-109 cell apoptosis induced by paclitaxel. STMN1 siRNA was successfully transfected and the expression of STMN1 was inhibited. The sensitivity of STMN1 siRNA-transfected Eca-109 cells to paclitaxel was significantly increased (P < 0.01). The apoptosis of Eca-109 cells significantly increased following treatment with paclitaxel (P < 0.01). STMN1 silencing by siRNA may enhance the sensitivity of esophageal cancer cells Eca-109 to paclitaxel and induce apoptosis.

ABCG2-meditated multidrug resistance and tumor-initiating capacity of side population cells from colon cancer

BACKGROUND

Recent studies have reported that the presence of cancer stem cells (CSCs) has major implications in the treatment of cancer and is responsible for tumor relapse. In the current study, we identified and characterized colon CSC-like side population (SP) cells from colon cancer tissue.

MATERIALS AND METHODS

The colon cancer samples were subjected to fluorescence-activated cell sorting (FACS) based on Hoechst 33342 dye exclusion for the purification of SP cells. The sorted SP cells were subjected to further characterization by immunofluorescence, real-time polymerase chain reaction (RT-PCR), multidrug resistance, and sphere formation assays.

RESULTS

We identified a fraction of 3.3% of SP cells in the colon cancer cell samples, which was reduced to 0.6% upon treatment with verapamil. The sorted SP cells showed high positivity with regard to CD133, CD44, CD147, and EpCAM, by fluorescence microscopic analysis. Further, these SP cells were highly resistant to multidrug treatment due to overexpression of the multidrug resistance 1 (MDR1) transporter protein ABCG2.

CONCLUSION

Our findings suggest that the overexpression of ABCG2 and the expression of stem cell surface markers are collectively responsible for chemotherapy failure, tumor recurrence, and invasion in colon cancer.

Tensor renormalization group study of classical XY model on the square lattice

Using the tensor renormalization group method based on the higher-order singular value decomposition, we have studied the thermodynamic properties of the continuous XY model on the square lattice. The temperature dependence of the free energy, the internal energy, and the specific heat agree with the Monte Carlo calculations. From the field dependence of the magnetic susceptibility, we find the Kosterlitz-Thouless transition temperature to be 0.8921(19), consistent with the Monte Carlo as well as the high temperature series expansion results. At the transition temperature, the critical exponent δ is estimated as 14.5, close to the analytic value by Kosterlitz.

Potentiometric pH sensors based on chemically modified electrodes with electropolymerized metal-tetraaminophthalocyanine

Potentiometric pH sensors based on polymer film were prepared by electropolymerization of the monomer nickel(II)-4,4',4'',4'''-tetraaminophthalocyanine (NiTAPc) or copper(II)-4,4',4'',4'''-tetraaminophthalocyanine (CuTAPc) on glassy carbon (GC) electrodes. The polymer of metal tetraaminophthalocyanine (p-MTAPc) film coated electrodes show a slope of 55 +/- 1 mV/pH (at 20 degrees C) and nearly Nernstain potentiometric response to pH over the range of pH 1-13. The electrodes possess good potential reproducibility and high selectivity, and are useful sensing devices in pH determination and end-point indication of acid-base potentiometric titration.

Stretched inverse opal colloid crystal substrates-induced orientation of fibroblast

Recently, there has been increasing interest in studying the interaction between mammalian cells and nanometer-sized structures. However, the effect of nanostructures on cell behavior, such as cell morphology and alignment, is still largely unknown. Inverse opal colloid crystal substrates, which can be stretched to produce nano-scale pore structures of different degrees of orientation, serve as a convenient model system to study the effect of nanotopography on cell morphology and cell alignment. In this work, we fabricated inverse opal colloidal crystal films that were either unstretched or stretched to three, four or six times their original length, producing pore structures of increasing degree of orientation. Human dermal fibroblast-fetal (HDF-f) cells were seeded and cultured on these four types of substrates. The results from fluorescence microscopy and scanning electron microscopy indicated that cells showed the highest degree of alignment when cultured on inverse opal colloid crystal films that were stretched the most (six times original length). The results also demonstrated that the orientation of nanostructures could affect both the morphology and growth direction of fibroblasts. The ability to control the direction of cell growth through the engineering of nanostructures could have important applications in tissue engineering, especially for tissues with anisotropic structures, such as cardiac muscle, blood vessel, tendon and ligament.

Second renormalization of tensor-network states

We propose a second renormalization group method to handle the tensor-network states or models. This method dramatically reduces the truncation error of the tensor renormalization group. It allows physical quantities of classical tensor-network models or tensor-network ground states of quantum systems to be accurately and efficiently determined.

Biotransformation of pantoprazole by the fungusCunninghamella blakesleeana

To investigate the biotransformation of pantoprazole, a proton-pump inhibitor, by filamentous fungus and further to compare the similarities between microbial transformation and mammalian metabolism of pantoprazole, four strains of Cunninghamella (C. blakesleeana AS 3.153, C. echinulata AS 3.2004, C. elegans AS 3.156, and AS 3.2028) were screened for the ability to catalyze the biotransformation of pantoprazole. Pantoprazole was partially metabolized by four strains of Cunninghamella, and C. blakesleeana AS 3.153 was selected for further investigation. Three metabolites produced by C. blakesleeana AS 3.153 were isolated using semi-preparative HPLC, and their structures were identified by a combination analysis of LC/MS(n) and NMR spectra. Two further metabolites were confirmed with the aid of synthetic reference compounds. The structure of a glucoside was tentatively assigned by its chromatographic behavior and mass spectroscopic data. These six metabolites were separated and quantitatively assayed by liquid chromatography-ion trap mass spectrometry. After 96h of incubation with C. blakesleeana AS 3.153, approximately 92.5% of pantoprazole was metabolized to six metabolites: pantoprazole sulfone (M1, 1.7%), pantoprazole thioether (M2, 12.4%), 6-hydroxy-pantoprazole thioether (M3, 1.3%), 4'-O-demethyl-pantoprazole thioether (M4, 48.1%), pantoprazole thioether-1-N-beta-glucoside (M5, 20.6%), and a glucoside conjugate of pantoprazole thioether (M6, 8.4%). Among them, M5 and M6 are novel metabolites. Four phase I metabolites of pantoprazole produced by C. blakesleeana were essentially similar to those obtained in mammals. C. blakesleeana could be a useful tool for generating the mammalian phase I metabolites of pantoprazole.

Progress in diagnosis and treatment of cholestasis

Cholestasis can be considered a clinically frequent syndrome caused by complicated factors. Although investigation of cholestasis has been carried out at molecular biology level its pathogenesis can be more clearly recognized. However, the diagnosis and management of intrahepatic cholestasis has not improved. How to identify the pathophysiological and pharmacological targets of cholestatic liver disease is a challenging issue facing clinicians, pathophysiologists and pharmacologists.

Identification and pathogenicity of Vibrio ponticus affecting cultured Japanese sea bass, Lateolabrax japonicus (Cuvier in Cuvier and Valenciennes)

AIMS

To rapidly determine the causative agent of mass death in Lateolabrax japonicus in Zhelin Bay of Guangdong Province in China in April 2004.

METHODS AND RESULTS

Thirty-six strains, numbered sequentially from RP01 to RP36, were isolated from six diseased fish. All of the strains were identified as being of the same vibrio species according to the results of universal primer PCR combined with DGGE (UPPCR-DGGE). RP30 was one of these strains that was randomly selected and analysed by using a morphological, physiological and biochemical plate, Biolog GN2 Microplate System and API 20E system. Furthermore, RP30' 16S rDNA was sequenced and aligned in Genbank. Its virulence to Lateolabrax japonicus (Cuvier in Cuvier and Valenciennes) was also tested. RP30 is most closely related to four Vibrio ponticus strains (99.3% similarity). LD50s were 2.5 (x103 CFU per fish for intraperitoneal inoculation (IP) and 3.2 (x103 CFU per fish for intramuscular inoculation (IM), respectively.

CONCLUSIONS

The investigated pathogenic agent of Lateolabrax japonicus (Cuvier in Cuvier and Valenciennes) was V. ponticus.

SIGNIFICANCE AND IMPACT OF THE STUDY

UPPCR-DGGE is very helpful in epidemiologic investigation. Interestingly, this is the first report that V. ponticus infects cultured marine fish. DGGE was likewise first introduced to epidemiologic investigation of fish disease.

Cloning of pro-oncogene pim-3 cDNA and its effect on apoptosis of hepatocellular carcinoma cells

AIM: To clone rat pim-3 cDNA and construct its eukaryotic expressing plasmid, and to investi-gate the expression of pim-3 and its effect on the apoptosis in SMMC-7721 cells.

METHODS: Total RNA was isolated from rat skeletal muscle tissues with TRIzol method. pim-3 cDNA was obtained by reverse transcription-polymerase chain reaction (RT-PCR) and constructed into eukaryotic expression vector pEGFP-N₂, which expressed green fluorescent protein. The recombinant pEGFP-N₂/pim-3 was then transformed into E. coli JM109 host bacteria. After identified by restriction endonuclease digestion and sequencing, plasmid pEGFP-N₂/pim-3 was transfected into SMMC-7721 cells by liposome mediation. Fluorescent microscopy was used to examine the expression of pim-3 gene, and the biological behaviors of the transfected cells were tested by flow cytometry and MTT colorimetric assay.

RESULTS: Restriction enzyme digestion analysis and sequencing showed that the recombinant plasmid of rat pim-3 was correctly constructed; Flow cytometry showed the apoptosis rate was 3.48% in the cells transfected with the recombinant plasmid pEGFP-N₂/pim-3, 10.74% in those transfected with the plasmid pEGFP-N₂, and 11.01% in those without transfection. There were signicant differences between the recombinant plasmid transfected group and the other two control groups (both P < 0.05). Fluorescent microscopy and MTT showed that pim-3 was expressed in SMMC-7721 cells and the apoptosis of the transfected cells was significantly inhibited.

CONCLUSION: pim-3 gene is successfully cloned, and it can induce apoptosis of hepatocellular carcinoma cells.

[Surveillance of filariasis in some vulnerable areas in Guangxi after filariasis elimination]

OBJECTIVE

To explore the measures for continuing surveillance of filariasis.

METHODS

Selecting some vulnerable spots for focal surveillance, double-slide biood sampling for microfilaria examination, dissecting vectors for detecting the mosquitoes infected with filarial larva, using IFAT for detecting antifilarial antibody.

RESULTS

27,938 persons were examined for microfilaria and 4,454 mosquitoes were dissected for filaria larva, all were negative. 3,606 serum samples were examined for antifilarial antibody average positive rate was 1.35%(0.39-4.97%).

CONCLUSION

The results of surveillance showed that the achievement of filariasis control in Guangxi after filariasis elimination is consolidated.

[Study on dissolution rate of injection of microencapsulated compound megestrol acetate]

Dissolution rate of megestrol acetate in the injection of microencapsulated compound megestrol acetate was determined by the first derivative spectrum amplitude method. The experimental results reveal that t50 of the microencapsulated sample (I) is about 60.16 d, while the broken microencapsulated sample (II) is about 15.89 d and the unmicroencapsulated sample (III) about 15.87 d. The difference is regarded as of obvious significance (P less than 0.01). The values of the dissolution rate were linear with the parameters of rabbits and women both in vivo.

[A study of blood rifampin concentration in smoking and non-smoking healthy individuals and in patients with tuberculosis]

The serum rifampin level after smoking was estimated by various times in 10 smoking healthy and 30 smoking tuberculosis inpatients compared with 10 non-smoking healthy and 29 non-smoking tuberculosis inpatients, with equal dose of 600 mg rifampin. The concentration of the rifampin was calculated by range matrix analysis area under the curve (Auc.) The Auc0-8 of the healthy and smokers were 75.75 and 110.38 mg.h/L respectively, while in the tuberculosis group, the Auc0-8 of smokers and non-smokers were 30.17 and 43.26 mg h/L respectively. The above figures as compared with the smoking and non-smoking group was decreased by varying degrees in Auc. The difference is significant statistically (P value less than 0.05).