[Intelligent rehabilitation platform in intensive care unit]

As the development of rehabilitation medicine and critical care medicine, intensive care rehabilitation has become the focus of attention. With the development of artificial intelligence, wearable devices and non-contact multimodal behavior perception devices can collect and transmit patients' vital signs continuously, and establish large databases and formulate rehabilitation strategies intelligently. Wearable devices, exoskeleton robots, position management beds, rehabilitation robots, virtual reality can be used in the implementation of rehabilitation in ICU. The whole process rehabilitation mode which combined intelligent rehabilitation with sequential remote home management might be a new work mode of intensive care rehabilitation in the future.

[Analysis of the common respiratory viruses in children with acute respiratory infection in a hospital in Lanzhou City from 2021 to 2022]

To explore the situation of 8 common respiratory pathogens in children with acute respiratory infection (ARI) from 2021 to 2022.The retrospective study selected 8 710 ARI patients from September 2021 to August 2022 in the Maternal and Child Health Hospital of Gansu Province as the study object, patients aged 0 to 17 years old, including 5 048 male children and 3 662 female children. Indirect immunofluorescence was used to detect 8 common respiratory pathogens, including influenza virus A (FluA), influenza virus B (FluB), parainfluenza virus (PIV), respiratory syncytial virus (RSV), adenovirus (ADV), Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP), and Coxsackie virus group B (CoxB) IgM antibodies. χ2 test was used to analyze the results. The results showed that 1 497 of 8 710 children with ARI were positive, with a positive rate of 17.19%. The detection rate of MP among 8 common respiratory pathogens was 11.34%, accounting for 66.0%, followed by FluB, CoxB, PIV, RSV, ADV, FluA and CP, accounting for 13.83%, 9.55%, 6.01%, 2.61%, 1.47%, 0.40% and 0.13%, respectively. Respiratory tract viruses (FluA, FluB, RSV, ADV, PIV, CoxB) accounted for 33.86%.There were significant differences in the detection rates of PIV, ADV and MP among children of different genders (χ2=6.814, 5.154 and 17.784, P<0.05). The detection rate of school-age children (6-17 years old) was the highest, accounting for 33.27% (184/553). The detection rates of 8 common respiratory pathogens in patients with ARI were higher in spring and winter and lower in summer and autumn. To sum up, from 2021 to 2022, MP and FluB infection were dominant in ARI patients in our hospital. The peak period of 8 common respiratory pathogens was in spring and winter. The physical examination rate of 8 common respiratory pathogens in ARI patients aged 6-17 years old was the highest.

Quantifying traffic-related carbon emissions on elevated roads through on-road measurements

Vehicles generally move smoothly and with high speeds on elevated roads, thereby producing specific traffic-related carbon emissions in contrast to ground roads. Hence, a portable emission measurement system was adopted to determine traffic-related carbon emissions. The on-road measurement results revealed that the instantaneous emissions of CO2 and CO from elevated vehicles were 17.8% and 21.9% higher than those from ground vehicles, respectively. Based on it, the vehicle specific power was confirmed to exhibit a positive exponential relationship with instantaneous CO2 and CO emissions. In addition to carbon emissions, carbon concentrations on roads were simultaneously measured. The average CO2 and CO emissions on elevated roads in urban areas were 1.2% and 6.9% higher than those on ground roads, individually. Finally, a numerical simulation was performed, and the results verified that elevated roads could deteriorate the air quality on ground roads but improve the air quality above them. What ought to be paid attention to is that the elevated roads present varied traffic behaviour and cause particular carbon emissions, indicating that comprehensive consideration and further balance among the traffic-related carbon emissions are necessary when building elevated roads to alleviate the traffic congestion in urban areas.

[Emphasis on Post-ICU Syndrome]

With the development of technology and medicine, the mortality rate of intensive care unit (ICU) has declined significantly, and more and more professionals in the medical field are also aware that the disability rate of ICU survivors remains high. More than 70% of ICU survivors have Post-ICU Syndrome (PICS), which is mainly manifested by cognitive, physical, and mental dysfunction, which seriously affects the quality of life of survivors and their caregivers. The COVID-19 pandemic has brought a series of problems such as shortage of medical staff, restricted family visits, and lack of personalized care, which have brought unprecedented challenges to the prevention of PICS and the care of patients with severe COVID-19. In the future, the treatment of ICU patients should change from reducing short-term mortality to improving long-term quality of life of patients, from disease-centered to health-centered, and to practice " the health promotion, the prevention, the diagnosis, the control, the treatment, and the rehabilitation " six-in-one concept to promote comprehensive health care with pulmonary rehabilitation.

Spatial-temporal distribution and pedestrian exposure assessment of size-fractionated particles on crosswalk of urban intersection

Vehicles tend to produce more pollutants especially particles at an urban intersection than other segments. Meanwhile, pedestrians at an intersection are inevitably exposed to high particle level and suffered from the health problem. Especially, some particles can deposit in different thoracic areas of the respiratory system and cause serious health problems. Hence, in this paper, the particles from 0.3 to 10 μm in 16 channels were measured to compare the spatio-temporal characteristics of them on the crosswalk and the roadside. Based on the roadside of fixed measurements, submicron particles (< 1 μm) are discovered to have a high relation with traffic signal and exhibit a bimodal distribution pattern in the green phase. On the crosswalk of mobile measurements, submicron particles present decreasing trend along the crosswalk while crossing. Additionally, mobile measurements were conducted across six time intervals that correspond to different pedestrian's journey when passing the crosswalk. The results showed that all size particles in the first three journeys present high concentrations than that in other journeys. Furthermore, pedestrian exposure to all 16 channel particles was assessed. The total and regional deposition fractions of these particles in different sizes and age groups are determined. What ought to be paid attention to is that these real-world measurement results contribute to advancing the understanding of pedestrian exposure to size-fractionated particles on crosswalk and assisting the pedestrian to make better informed choice so as to limit particle exposure in these pollution hotspots.

Ultrasound-Guided Vacuum-Assisted Excision to Treat Intraductal Papilloma

BACKGROUND

To evaluate the value of ultrasound-guided vacuum-assisted excision (US-guided VAE) in the treatment of intraductal papillomas, including intraductal papillomas with atypical ductal hyperplasia (ADH), and to evaluate the lesion characteristic features affecting the local recurrence rate.

MATERIALS AND METHODS

Between August 2011 and December 2020, 91 lesions of 91 patients underwent US-guided VAE and were diagnosed with intraductal papilloma with or without ADH. The recurrence rate of intraductal papilloma was evaluated on follow-up US. The lesion characteristic features were analyzed to identify the factors affecting the local recurrence rate.

RESULTS

The local recurrence rate of intraductal papillomas removed by US-guided VAE was 7.7% (7/91), with the follow-up duration 12-92 months (37.4 ± 23.9 months). Of the 91 patients, five cases diagnosed as intraductal papilloma with ADH did not recur, with the follow-up time 12-47 months (26.4 ± 14.4 months). There were no malignant transformation in all 91 cases during the follow-up period. All 7 patients recurred 7-58 months (22.8 ± 19.2 months) after US-guided VAE. There were no significant differences between the non-recurrence and recurrence groups in terms of age, side, distance from nipple, lesion size, BI-RADS category, with ADH, or history of excision (p > 0.05).

CONCLUSIONS

US-guided VAE is an effective method for the treatment of intraductal papilloma, including intraductal papilloma with ADH. It avoids invasive surgical excision, but regular follow-up is recommended to prevent recurrence or new onset due to multifocality. Any suspicious lesions during the follow-up should be actively treated.

Emergence of Antifungal Resistant Subclades in the Global Predominant Phylogenetic Population of Candida albicans

Candida albicans remains the most common species causing invasive candidiasis. In this study, we present the population structure of 551 global C. albicans strains. Of these, the antifungal susceptibilities of 370 strains were tested. Specifically, 66.6% of the azole-nonsusceptible (NS)/non-wild-type (NWT) strains that were tested belonged to Clade 1. A phylogenetic analysis, a principal components analysis, the population structure, and a loss of heterozygosity events revealed two nested subclades in Clade 1, namely, Clade 1-R and Clade 1-R-α, that exhibited higher azole-NS/NWT rates (75.0% and 100%, respectively). In contrast, 6.4% (21/326) of the non-Clade 1-R isolates were NS/NWT to at least 1 of 4 azoles. Notably, all of the Clade 1-R-α isolates were pan-azole-NS/NWT that carried unique A114S and Y257H double substitutions in Erg11p and had the overexpression of ABC-type efflux pumps introduced by the substitution A736V in transcript factor Tac1p. It is worth noting that the Clade 1-R and Clade 1-R-α isolates were from different cities that are distributed over a large geographic span. Our study demonstrated the presence of specific phylogenetic subclades that are associated with antifungal resistance among C. albicans Clade 1, which calls for public attention on the monitoring of the future spread of these clones. IMPORTANCE Invasive candidiasis is the most common human fungal disease among hospitalized patients, and Candida albicans is the predominant pathogen. Considering the large number of infected cases and the limited alternative therapies, the azole-resistance of C. albicans brings a huge clinical threat. Here, our study suggested that antifungal resistance in C. albicans could also be associated with phylogenetic lineages. Specifically, it was revealed that more than half of the azole-resistant C. albicans strains belonged to the same clade. Furthermore, two nested subclades of the clade exhibited extremely high azole-resistance. It is worth noting that the isolates of two subclades were from different cities that are distributed over a large geographic span in China. This indicates that the azole-resistant C. albicans subclades may develop into serious public health concerns.

High-Risk Breast Lesions Diagnosed by Ultrasound-Guided Vacuum-Assisted Excision

PURPOSE

The aim of this study was to analyze the role of ultrasound-guided vacuum-assisted excision (US-guided VAE) in the treatment of high-risk breast lesions and to evaluate the clinical and US features of the patients associated with recurrence or development of malignancy.

MATERIALS AND METHODS

Between April 2010 and September 2021, 73 lesions of 73 patients underwent US-guided VAE and were diagnosed with high-risk breast lesions. The incidence of recurrence or development of malignancy for high-risk breast lesions was evaluated at follow-up period. The clinical and US features of the patients were analyzed to identify the factors affecting the recurrence or development of malignancy rate.

RESULTS

Only benign phyllodes tumors on US-guided VAE showed recurrences, while other high-risk breast lesions that were atypical ductal hyperplasia (ADH), lobular neoplasia (atypical lobular hyperplasia/lobular carcinoma in situ), radial scar, and flat epithelial atypia did not show recurrences or malignant transformation. The recurrence rate of the benign phyllodes tumor was 20.8% (5/24) in a mean follow-up period of 34.3 months. The recurrence rate of benign phyllodes tumor with distance from nipple of less than 1 cm was significantly higher than that of lesions with distance from nipple of more than 1 cm (75% vs. 10%, p < 0.05).

CONCLUSIONS

Benign phyllodes tumors without concurrent breast cancer could be safely followed up instead of surgical excision after US-guided VAE when the lesions were classified as BI-RADS 3 or 4A by US.

Gefitinib improves severe bronchorrhea and prolongs the survival of a patient with lung invasive mucinous adenocarcinoma: A case report

BACKGROUND

Lung invasive mucinous adenocarcinoma (LIMA), formerly referred to as mucinous bronchioloalveolar carcinoma, is a rare disease that usually presents as bilateral lung infiltration, is unsuitable for surgery and radiotherapy, and shows poor response to conventional chemotherapy.

CASE SUMMARY

We report a 56-year-old Chinese man with a history of smoking and epidermal growth factor receptor mutation-positivity who was initially misdiagnosed as severe pneumonia, but was ultimately diagnosed as a case of invasive mucinous adenocarcinoma of the lung by computed tomography -guided percutaneous lung biopsy. Bronchorrhea and dyspnea were improved within 24 h after initiation of gefitinib therapy and the radiographic signs of bilateral lung consolidation showed visible improvement within 30 d. After more than 11 months of treatment, there is no evidence of recurrence or severe adverse events.

CONCLUSION

Although the precise mechanism of the antitumor effects of gefitinib are not clear, our experience indicates an important role of the drug in LIMA and provides a reference for the diagnosis and treatment of this disease.

[Advances and Application of Genomics in Chronic Obstructive Pulmonary Disease]

Chronic obstructive pulmonary disease (COPD) is a common and frequently-occurring disease in the department of respiratory medicine,the pathogenesis of which involves both environmental factors and genetic factors.In recent years,with the application of new methods such as genome-wide association study,researchers have discovered a large number of gene mutations associated with lung function and COPD,providing a new perspective on the pathogenesis of COPD and potential therapeutic targets.This article reviews the research achievements and application progress of genomics in COPD.

Measuring the impact of an exogenous factor: An exponential smoothing model of the response of shipping to COVID-19

Following the outbreak of the COVID-19 pandemic, various lockdown strategies restrained global economic growth bringing a significant decline in maritime transportation. However, the previous studies have not adequately recognized the specific impacts of COVID-19 on maritime transportation. In this study, a series of analyses of the Baltic Dry Index (BDI), the China Coastal Bulk Freight Index (CCBFI) and of container throughputs with and without the impact of COVID-19 were carried out to assess changing trends in dry bulk and container transportation. The results show that global dry bulk transportation was largely affected by lockdown policies in the second month during COVID-19, and BDI presented a year-on-year decrease of approximately 35.5% from 2019 to 2020. The CCBFI showed an upward trend in the second month during COVID-19, one month ahead of the BDI. The container throughputs at Shanghai Port, the Ports of Hong Kong, the Ports of Singapore and the Ports of Los Angeles from 2019 to 2020 presented the largest year-on-year drops of approximately 19.6%, 7.1%, 10.6% and 30.9%, respectively. In addition, the authors developed exponential smoothing models of BDI, CCBFI, and container transportation, and calculated the percentage prediction error between the observed and predicted values to examine the impact of exogenous effects on the shipping industry due to the outbreak of COVID-19. The results are consistent with the conclusions obtained from the comparison of BDI, CCBFI, and container transportation during the same period in 2020 and 2019. Finally, on the basis of the findings, smart shipping and special support policies are proposed to reduce the negative impacts of COVID-19.

Characterizing the variation of particles in varied sizes from a container truck in a port area

The transportation of container trucks in urban areas not only frequently causes traffic jams but also produces severe air pollution. With regard to this consideration, measurements of particle concentrations and traffic volume on different polluted days were carried out to discover the varied characteristics of particles from container truck transportation in the port area. Based on the original data, descriptive statistics were performed firstly to reveal the statistical characteristics of particle number concentrations (PNC). The Kolmogorov-Smirnov test as well as the Anderson-Darling test was adopted to identify the "best-fit" distributions on PNC data while the corresponding maximum likelihood estimation was conducted to estimate the parameters of the identified distribution. Additionally, the Pearson correlation analysis and principal component analysis were performed respectively to reveal the relationships between traffic volume and PNC. The results showed that on a hazy day, PNC levels in the morning were generally higher than those in the afternoon, while on a non-hazy day, the results were opposite. Particles in all sizes on a non-hazy day and larger than 0.5 μm on a hazy day were verified to fit the lognormal distribution. In contrast to the particles below 2 μm, the particles above 2 μm exhibited higher correlations with the traffic flow of a container truck in the morning on a hazy day. These results indicate the importance of reducing air pollution from a container truck and provide policymakers with a foundation for possible measures in a port city.

[Effects of exogenous nitrogen addition on litter decomposition and nutrient release in a temperate desert]

A litterbag decomposition experiment was carried out in southern Gurbantunggut Desert, with four nitrogen treatments: N₀(0 g N·m^-2·a^-1), N₅(5 g N·m^-2·a^-1), N₁₀(10 g N·m^-2·a^-1) and N₂₀(20 g N·m^-2·a^-1). The aims were to examine the effects of exogenous nitrogen addition on decomposition rate and nutrient release of Tamarix ramosissima, Salicornia europaea and their mixture. Results showed that decomposition rates were significantly different among litter types. After 345 days, the decomposition rates of T. ramosissima, S. europaea and their mixture under different treatments were 0.64-0.70, 0.84-0.99 and 0.71-0.81 kg·kg^-1·a^-1, respectively. Both mono- and mixed-litters exhibited nutrient release during decomposition process, with the release rates being 60.6%-67.4%, 56.7%-62.6%, 57.4%-62.3%, 46.8%-63.0% for N, and 51.9%-77.9%, 59.9%-74.7%, 53.0%-79.9%, 52.3%-76.4% for P, respectively for the N₀, N₅, N₁₀ and N₂₀ treatments. Nitrogen addition did not affect litter decomposition rate. The dynamics of N and P during decomposition of different litter types showed different responses to nitrogen addition. Nitrogen addition inhibited N and P releases of S. europaea litter and P release of the mixed litter, but did not affect the nutrient release of T. ramosissima. The results suggested that nitrogen input would not promote litter decomposition in temperate desert ecosystems, but might retard the nutrient returning to soil system.

Characteristics and prognostic significance of genetic mutations in acute myeloid leukemia based on a targeted next-generation sequencing technique

To explore the characteristics and prognostic significance of genetic mutations in acute myeloid leukemia (AML), we screened the gene mutation profile of 171 previously untreated AML patients using a next‐generation sequencing technique targeting 127 genes with potential prognostic significance. A total of 390 genetic alterations were identified in 149 patients with a frequency of 87.1%. Younger age and high sensitivity to induction chemotherapy were associated with a lower number of mutations. NPM1 mutation was closely related to DNMT3A and FLT3‐internal tandem duplication (FLT3‐ITD) mutations, but mutually exclusive with ASXL1 mutation and CEBPA^{double mutation}. In univariate analysis, ASXL1 or TET2 mutation predicted shorter overall survival (OS) or relapse‐free survival (RFS), DNMT3A, FLT3‐ITD, or RUNX1 mutation predicted a higher likelihood of remission‐induction failure, whereas NRAS mutation or CEBPA^{double mutation} predicted longer OS. Concurrent DNMT3A, FLT3‐ITD, and NPM1 mutations predicted shorter OS. Hypomethylation agents could improve the OS in patients with DNA methylation‐related mutations. According to multivariate analysis, TET2 mutation was recognized as an independent prognostic factors for RFS. In summary, our study provided a detailed pattern of gene mutations and their prognostic relevance in Chinese AML patients based on targeted next‐generation sequencing screening.

Eu(III)-coordination polymer: inhibitory activity on cervical cancer via inducing ROS mediated apoptosis

Under the hydrothermal reaction condition, we prepared a new 3D Eu(III)-based coordination polymer (CP) [Eu(H₂-DHBDC)_0.5(DHBDC)_0.5 (H₂O)₂] _n ·H₂O (1, H₄-DHBDC = 2,5-dihydroxy-1,4-terephthalic acid). Furthermore, we assessed the inhibitory influence on cervical cancer cells of this compound. First, for testing the anti-viability of the compound against cervical cancer cells, the cell counting kit-8 (CCK-8) assay was carried out. Then, reactive oxygen species (ROS) detection kit was used to determine the ROS accumulation in the cervical cancer cells. Finally, after the Annexin V-FITC/PI apoptosis assay was finished, it was used for apoptotic cervical cancer cells after treated with compound. From the results of the software of pose scoring and molecular docking, we can see that the compound may bind to p91 by the functional side-chain of the ligand, which provided potential regulatory mechanisms for the compound.

[Significance of micropapillary histopathological subtype of thyroid carcinoma]

Objective: To study the clinical and pathologic factors of papillary thyroid microcarcinoma (PTMC) and its significance as a histopathologic subtype of papillary thyroid carcinoma (PTC). Methods: A retrospective study of 719 patients with non-high-risk PTMC who underwent surgery for the first time in the Peking University People's Hospital from January 2007 to June 2019 was conducted, the relationship between clinicopathologic factors and lymph node metastasis, and the expression of four tumor markers CK19, HMBE1, Galectin-3 and CD56 by immunohistochemistry were evaluated. Some comparisons were made with PTC. Results: The peak patients' age was 40-49 years for both non-high-risk PTMC and PTC; the lymph node metastasis rate was higher in the 30-39 years age group than the 50-59 years age group (P<0.05); the lymph nodes metastasis rate was significantly higher for multiple lesions than for single lesion (P<0.05). Lymph node metastasis rate of PTMC with capsular invasion was significantly higher than those without (P<0.05). There was no significant correlation between lymph node metastasis of PTMC and patients' gender, tumor location, tumor size, and lymphocytic thyroiditis. The expression rates of CK19, HMBE1 and Galectin-3 both in PTMC and PTC were 100%, and the expression rates of CD56 were 25.6% (85/332) and 20.0% (70/350) respectively. Conclusion: As the main pathologic subtype of PTC, a variety of clinicopathologic factors of PTMC are related to lymph node metastasis, and it is highly recommended to pay close attention to PTMC. The expression of tumor marker CD56 alone cannot be used as a basis to exclude PTMC and PTC.

MicroRNA-153 impairs hippocampal synaptic vesicle trafficking via downregulation of synapsin I in rats following chronic cerebral hypoperfusion

Chronic cerebral hypoperfusion (CCH) promotes the development of Alzheimer's pathology. However, whether and how CCH impairs the synaptic vesicle trafficking is still unclear. In the present study, we found that the hippocampal glutamatergic vesicle trafficking was impaired as indicated by a significant shortened delayed response enhancement (DRE) phase in CA3-CA1 circuit and decreased synapsin I in CCH rats suffering from bilateral common carotid artery occlusion (2VO). Further study showed an upregulated miR-153 in the hippocampus of 2VO rats. In vitro, overexpression of miR-153 downregulated synapsin I by binding the 3'UTRs of SYN1 mRNAs, which was prevented by its antisense AMO-153 and miRNA-masking antisense oligodeoxynucleotides (SYN1-ODN). In vivo, the upregulation of miR-153 elicited similar reduced DRE phase and synapsin I deficiency as CCH. Furthermore, miR-153 knockdown rescued the downregulated synapsin I and shortened DRE phase in 2VO rats. Our results demonstrate that CCH impairs hippocampal glutamatergic vesicle trafficking by upregulating miR-153, which suppresses the expression of synapsin I at the post-transcriptional level. These results will provide important references for drug research and treatment of vascular dementia.

Habitat-specific environmental factors regulate spatial variability of soil bacterial communities in biocrusts across northern China's drylands

Biocrusts are common biotic components in dryland ecosystems worldwide, they contain diverse soil organisms and effectively enhance soil stability and perform a series of key ecological functions. However, the geographical pattern of microbial communities in biocrusts is rarely assessed, despite it is closely related to the spatial variation of ecosystem functions in drylands. We assessed soil bacterial communities in biocrusts across four ecosystems (Gobi, desert, desert steppe and grassland) in a precipitation gradient (16-566 mm yr^-1) in northern China. Bacterial OTU number and phylogenetic diversity did not linearly increase with decreasing aridity, they were significantly lower in Gobi and similar among desert, desert steppe and grassland. Soil bacterial community composition in Gobi and desert were different than those in desert steppe and grassland, and they were similar between Gobi and desert, this suggests the key role of habitat in structuring soil bacterial communities. The geographic pattern of soil bacterial communities was strongly influenced by both geographic distance and environmental factors. The first explanatory factor for the geographic variation of bacterial community dissimilarity differed among four ecosystems, being aridity in Gobi and desert, precipitation in desert steppe, and soil inorganic nitrogen in grassland. The geographic pattern of the bacterial functional group profile showed a similar pattern with community composition across four ecosystems, and the groups of containing mobile elements and gram negative bacteria were more abundant in drier habitats of Gobi and desert. Our results reveal the non-linear changes in diversity, composition and functional group of soil bacterial communities in biocrusts across the precipitation gradient from hyper-arid to semi-humid regions, and suggest that the geographic distance and habitat-specific environmental factors determine the distribution of soil bacterial communities in different ecosystems.

MicroRNA-153 impairs presynaptic plasticity by blocking vesicle release following chronic brain hypoperfusion

Background

Chronic brain hypoperfusion (CBH) is closely related to Alzheimer’s disease (AD) and vascular dementia (VaD). Meanwhile, synaptic pathology plays a prominent role in the initial stage of AD and VaD. However, whether and how CBH impairs presynaptic plasticity is currently unclear.

Methods

In the present study, we performed a battery of techniques, including primary neuronal culture, patch clamp, stereotaxic injection of the lentiviral vectors, morris water maze (MWM), dual luciferase reporter assay, FM1–43 fluorescence dye evaluation, qRT-PCR and western blot, to investigate the regulatory effect of miR-153 on hippocampal synaptic vesicle release both in vivo and in vitro. The CBH rat model was generated by bilateral common carotid artery ligation (2VO).

Results

Compared to sham rats, 2VO rats presented decreased field excitatory postsynaptic potential (fEPSP) amplitude and increased paired-pulse ratios (PPRs) in the CA3-CA1 pathway, as well as significantly decreased expression of multiple vesicle fusion-related proteins, including SNAP-25, VAMP-2, syntaxin-1A and synaptotagmin-1, in the hippocampi. The levels of microRNA-153 (miR-153) were upregulated in the hippocampi of rats following 2VO surgery, and in the plasma of dementia patients. The expression of the vesicle fusion-related proteins affected by 2VO was inhibited by miR-153, elevated by miR-153 inhibition, and unchanged by binding-site mutation or miR masks. FM1–43 fluorescence images showed that miR-153 blunted vesicle exocytosis, but this effect was prevented by either 2′-O-methyl antisense oligoribonucleotides to miR-153 (AMO-153) and miR-masking of the miR-153 binding site in the 3′ untranslated region (3’UTR) of the Snap25, Vamp2, Stx1a and Syt1 genes. Overexpression of miR-153 by lentiviral vector-mediated miR-153 mimics (lenti-pre-miR-153) decreased the fEPSP amplitude and elevated the PPR in the rat hippocampus, whereas overexpression of the antisense molecule (lenti-AMO-153) reversed these changes triggered by 2VO. Furthermore, lenti-AMO-153 attenuated the cognitive decline of 2VO rats.

Conclusions

Overexpression of miR-153 controls CBH-induced presynaptic vesicle release impairment by posttranscriptionally regulating the expression of four vesicle release-related proteins by targeting the 3’UTRs of the Stx1a, Snap25, Vamp2 and Syt1 genes. These findings identify a novel mechanism of presynaptic plasticity impairment during CBH, which may be a new drug target for prevention or treatment of AD and VaD.

Overexpression of tripartite motif containing 26 inhibits non-small cell lung cancer cell growth by suppressing PI3K/AKT signaling

It has been reported that tripartite motif containing 26 (TRIM26) is involved in the tumorigenesis of some cancers, but its function in non-small cell lung cancer (NSCLC) is still unclear. In this study, we found that TRIM26 was markedly down-regulated in both of NSCLC tumor tissues and cell lines. Additionally, high expression of TRIM26 in NSCLC patients predicted a positive index for patients' overall survival. What is more, overexpression of TRIM26 significantly suppressed NSCLC cell growth. Our further studies indicated that overexpression of TRIM26 inhibited the phosphorylation of PI3K p85 and AKT. And overexpressed TRIM26 regulated cell cycle-related genes' expression, including downregulating CDK4, Cyclin A, Cyclin D1, Cyclin D3, and Cyclin E, and upregulating p27 expression. Finally, we found that TRIM26 up-regulated PTEN expression by stabilizing PTEN protein in NSCLC cells. Collectively, our present study indicated that TRIM26 was decreased in NSCLC and overexpression of TRIM26 inhibited NSCLC cell growth by suppressing PI3K/AKT pathway, which suggested that TRIM26 could be as a potential target for the treatment of NSCLC in the future.

Unilateral Tissue Expander/Implant Two-Stage Breast Reconstruction with the Assistance of Three-Dimensional Surface Imaging

BACKGROUND

In China, traditional preoperative planning of unilateral breast reconstruction mainly depends on anthropometric measurement and visual assessment. Thus, the lack of objective assessment of breast volume and shape would likely result in suboptimal reconstruction outcomes. Three-dimensional surface imaging (3D-SI), which could provide objective measurement data of the breast, may be a promising solution to this problem.

METHODS

A retrospective review of patients undergoing tissue expander (TE)/implant breast reconstruction without any mammoplasty surgery on the contralateral sides in our hospital from August 2013 to May 2018 was performed. All the patients underwent unilateral mastectomy with immediate or delayed insertion of TE, followed by an exchange of a silicone gel implant without contralateral procedures. 3D images were obtained at the time of preoperation, the routine expansion visit, and post-exchange of implant. The breast volume measured by 3D-SI served as a guide to conduct the surgery management, such as in deciding the total volume of expansion and guiding the final implant size selection. 3D-SI also provided objective data to evaluate the final outcomes of the reconstruction.

RESULTS

Fifty-one patients were included in this study, in which eighteen patients underwent immediate TE insertion and thirty-three patients underwent delayed TE insertion. The ptosis degree of contralateral breasts was assessed as follows: forty-four were normal, and seven showed mild ptosis. The average expansion degree was controlled at 161.6% ± 14.1% compared to the contralateral breasts. The volume of implants exchanged had a strong linear correlation with the 3D volume of the contralateral breasts at the end of expansion (P < 0.01). The mean time of follow-up was 9.1 ± 6.6 months. There was only one patient who experienced TE leakage with secondary infection and received TE exchange. For the immediate reconstruction group, the overall breast symmetry improved at the completion of implant exchange (P < 0.01), with an average asymmetry of 5.3% ± 4.0% compared with 10.6% ± 6.1% initially. For the delayed reconstruction group, the reconstructed side achieved good volume symmetry to the contralateral side (P > 0.05). There was no significant difference in breast basal width between bilateral breasts post-reconstruction (P > 0.05).

CONCLUSION

3D-SI serves as a valuable adjunct by providing accurate 3D volume of breasts within TE/implant breast reconstruction in Chinese patients without obvious breast ptosis, which could facilitate surgeons to achieve good reconstructive outcomes.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

[Systematic evaluation of neuromuscular blocking agents on prognosis of patients with moderate to severe acute respiratory distress syndrome]

Objective: To evaluate the prognostic impact of neuromuscular blocking agents (NMBA) on patients with acute respiratory distress syndrome (ARDS). Method: Online search of MEDLINE, Embase, Web of Science, CNKI, CBM and other Chinese databases for randomized controlled trials (RCTs) of NMBA in patients with ARDS from January 1994 to June 2019 was done, and literature was selected according to inclusion and exclusion criteria. The patients were divided into NMBA group and non-NMBA group according to whether NMBA was adopted or not. The prognostic indicators (ICU mortality, 28 d mortality, 90 d mortality) and NMBA-related complications (ICU acquired muscle weakness, barometric injury, pneumothorax) of the patients in the two groups were mainly analyzed. Meta-analysis of the data was performed using RevMan 5.0 software. Results: A total of 6 RCTs were included, and 1 502 patients were enrolled, including 761 in the NMBA group and 741 in the no-NMBA group. The 90-day mortality in the NMBA group and no-NMBA group were 38.8% and 42.6%, OR=0.87 (95%CI: 0.70-1.07, P=0.190); the 28-day mortality rates were 32.5% and 36.5%, OR=0.71 (95%CI: 0.45-1.11, P=0.130); ICU mortality rates were 31.8% and 43.8%, OR=0.60 (95%CI: 0.41-0.88, P=0.009). Conclusion: NMBA can reduce the ICU mortality of moderate to severe ARDS patients, but not reduce 28-day and 90-day mortality.

[Spatial and Temporal Characteristics of Air Quality and Cause Analysis of Heavy Pollution in Northeast China]

Northeastern China experiences severe atmospheric pollution, with an increasing occurrence of heavy haze episodes. Based on ground monitoring data, satellite products and meteorological products of atmospheric pollutants in northeast China from 2013 to 2017, the characteristics of spatial and temporal distribution of air quality and the causes of heavy haze events in northeast China were discussed. It was found that the "Shenyang-Changchun-Harbin" city belt was the most polluted area in the region on an annual scale. The spatial distribution of air quality index (AQI) values had a clear seasonality, with the worst pollution occurring in winter, an approximately oval-shaped polluted area around western Jilin Province in spring, and the best air quality occurring in summer and most of autumn. The three periods that typically experienced intense haze events were Period I from late-October to early-November (i. e., late autumn and early winter), Period Ⅱ from late-December to January (i. e., the coldest time in winter), and Period Ⅲ from April to mid-May (i. e., spring). During Period I, strong PM_2.5 emissions from seasonal crop residue burning and coal burning for winter heating were the dominant reasons for the occurrence of extreme haze events (AQI>300). Period Ⅱ had frequent heavy haze events (200 < AQI < 300) in the coldest months of January and February(200 < AQI < 300), which were due to high PM_2.5 emissions from coal burning and vehicle fuel consumption, a lower atmospheric boundary layer, and stagnant atmospheric conditions. Haze events in Period Ⅲ, with high PM₁₀ concentrations, were primarily caused by the regional transportation of windblown dust from degraded grassland in central Inner Mongolia and bare soil in western Jilin Province. Local agricultural tilling could also release PM₁₀ and enhance the levels of windblown dust from tilled soil.

A target-group-change couple with mass defect filtering strategy to identify the metabolites of "Dogel ebs" in rats plasma, urine and bile

"Dogel ebs" was known as Sophora flavescens Ait., a classical traditional Chinese Mongolian herbal medicine, which had the effects on damp-heat dysentery, scrofula, and syndrome of accumulated dampness toxicity. Although the chemical constituents have been clarified by our previous studies, the metabolic transformation of "Dogel ebs" in vivo was still unclear. To explore the mechanism of "Dogel ebs," the metabolites in plasma, bile, and urine samples were investigated. A fast positive and negative ion switching technology was used for the simultaneous determination of flavonoids and alkaloids in "Dogel ebs" in a single run. And a target-group-change coupled with mass defect filtering strategy was utilized to analyze the collected data. 89 parent compounds and 82 metabolites were characterized by high-performance liquid chromatography with quadrupole exactive Orbitrap mass spectrometry. Both phase I and phase II metabolites were observed and the metabolic pathways involved in oxidation, demethylation, acetylation, and glucuronidation. 69 metabolites of "Dogel ebs," including three hydroxyls bonding xanthohumol, formononetin-7-O-glucuronide, 2'-hydroxyl-isoxanthohumol decarboxylation metabolite, oxysophocarpine dehydrogen, 9α-hydroxysophoramine-O-glucuronide, etc. were reported for the first time.

Bayesian empirical likelihood and variable selection for censored linear model with applications to acute myelogenous leukemia data

This paper develops the Bayesian empirical likelihood (BEL) method and the BEL variable selection for linear regression models with censored data. Empirical likelihood is a multivariate analysis tool that has been widely applied to many fields such as biomedical and social sciences. By introducing two special priors to the empirical likelihood function, we find two obvious superiorities of the BEL methods, that is (i) more precise coverage probabilities of the BEL credible region and (ii) higher accuracy and correct identification rate of the BEL model selection using an hierarchical Bayesian model, vs. some current methods such as the LASSO, ALASSO and SCAD. The numerical simulations and empirical analysis of two data examples show strong competitiveness of the proposed method.

[Preoperative evaluation of sentinel lymph node biopsy using contrast-enhanced ultrasonography in early breast cancer patients and the involved disturbing factors]

Objective: To explore the preoperative evaluation of sentinel lymph node (SLN) biopsy using contrast-enhanced ultrasonography (CEUS) in early breast cancer patients and the involved disturbing factors. Methods: Eighty-three female early breast cancer patients who underwent concurrent surgery in the Affiliated Cancer Hospital of Zhengzhou University between January 2017 and May 2018 were enrolled. CEUS was used to seek SLN and determine lymph node metastasis after signature of preoperative informed consent. Rapid pathological examination was used to determine whether metastasis existed in SLN. The sensitivity, specificity, accuracy, the differences between CEUS and pathological results, and the involved disturbing factors were evaluated. Results: A total of 212 SLNs were detected by CEUS and SLN biopsy with an average of 2.6 SLNs detected per patient, including 39 SLNs with cancer metastasis (18.4%) and 173 SLNs without cancer metastasis (81.6%). Among the 83 patients, 29 patients were predicted SLN-positive preoperatively utilizing CEUS (including 21 cases with SLN pathological metastasis and 8 cases with non-metastasis), 54 patients were predicted SLN-negative (including 5 cases with SLN pathological metastasis and 49 cases with non-metastasis). The preoperative evaluation of SLN utilizing CEUS were performed with a sensitivity of 80.8% (21/26), specificity of 86.0% (49/57), positive predictive value of 72.4% (21/29), and negative predictive value of 90.7% (49/54), positive likelihood ratio of 5.75, negative likelihood ratio of 0.22, and the accuracy of 84.3% (70/83), respectively. The area under the ROC curve (AUC) was 0.834 (95% CI: 0.736-0.906). The primary tumor mean size of SLN-negative group predicted preoperatively utilizing CEUS was (1.78±0.14) cm, and that of the SLN positive group was (2.64±0.19) cm. The difference between the two groups was (0.86±0.24) cm with statistical significance (P=0.000 6). The SLN mean size of SLN-negative group (141 SLNs) was (1.41±0.05) cm and that of SLN-positive group (71 SLNs) was (1.69±0.07) cm. The difference between the two groups was (0.28±0.09) cm with statistical significance (P=0.002 8). Conclusions: Preoperative CEUS possesses the predictive value for SLN metastasis in early breast cancer. The predicted results may be influenced by the primary tumor size and the SLN size.

miR-361-5p suppresses lung cancer cell lines progression by targeting FOXM1

Lung cancer is the most common type of cancer and the leading cause of death in worldwide. MicroRNAs are known to be key players in a variety of biological processes, including tumorigenesis. In present study, we investigated the effect of miR-361-5p on lung cancer progression. We found that miR-361-5p was down-regulated in lung cancer. Overexpression of miR-361-5p suppressed lung cancer proliferation and invasion. Mechanistically, FOXM1 was identified as a direct target of miR-361-5p. Furthermore, miR-361-5p inhibits EMT-like phenotype through down-regulation of FOXM1 expression in lung cancer cells. In conclusion, our results indicated that miR-361-5p acts as a tumor suppressor in lung cancer.

[A nationwide online questionnaire survey of the understanding and implementation of pulmonary rehabilitation at all levels of medical institutions in China in 2017]

Objective: To analyze the implementation and understanding of pulmonary rehabilitation in medical personnel at all levels of medical institutions nationwide. Methods: We used WeChat and e-channels to disseminate e-questionnaires including personal basic information and the implementation of hospital pulmonary rehabilitation (including the setting up of hospital rehabilitation, pulmonary rehabilitation-related treatment, and the composition of pulmonary rehabilitation teams), and awareness of pulmonary rehabilitation (including doctors' understanding of lung rehabilitation status, pathways, prospects, and obstacle factors). Finally, the analysis of the data was performed using SPSS 20.0 for statistical analysis. The frequency distribution and composition ratio were used to describe the distribution of each question item. Comparison among groups according to the unit level of the respondents was performed by chi-square test. P<0.05 was considered statistically significant. Results: A total of 921 medical staff from all over the country completed the survey, covering the entire country including Taiwan Province and a total of 32 provinces, municipalities, autonomous regions, and municipalities directly under the Central Government. 88.1% of medical personnel reported that their hospitals had rehabilitation departments, the difference being statistically significant (P=0.001). Doctors could understand that the most important ways of pulmonary rehabilitation knowledge were the following: expert lectures (559, 60.69%), professional literature (541, 58.74%), professional books (442, 47.99%), pulmonary rehabilitation conference (392, 42.56%), the difference being statistically significant (all P<0.05).Among the factors that impeded the implementation of pulmonary rehabilitation, the top four were lack of talent (690, 74.92%), lack of education (645, 70.03%), lack of policy support (603, 65.47%), and lack of related equipments (578, 62.76%). Conclusions: The lower the level of the hospitals, the poor the implementation and cognitive status of pulmonary rehabilitation. Promoting the training of pulmonary rehabilitation personnel and strengthening the academic exchange of pulmonary rehabilitation were good ways to strengthen the implementation of pulmonary rehabilitation and improve the understanding of pulmonary rehabilitation.

Knockdown of MicroRNA-1 in the Hippocampus Ameliorates Myocardial Infarction Induced Impairment of Long-Term Potentiation

BACKGROUNDS/AIMS

It has been reported that myocardial infarction (MI) is a risk factor for vascular dementia. However, the molecular mechanism remains largely unknown.

METHODS

MI mice were generated by ligation of the left coronary artery (LCA) for 4 weeks. Passive and active avoidance tests were performed to evaluate the cognitive ability of MI mice. A theta-burst stimulation (TBS) protocol was applied to elicit long-term potentiation (LTP) of the perforant pathway-dentate gyrus synapse (PP-DG). Western blot analysis was employed to assess protein levels.

RESULTS

In this study, we demonstrated that after 4 weeks of MI, C57BL/6 mice had significantly impaired memory. Compared with the sham group, in vivo physiological recording in the MI group revealed significantly decreased amplitude of population spikes (PS) with no effect on the latency and duration of the stimulus-response curve. The amplitude of LTP was markedly decreased in the MI group compared with the sham group. Further examination showed that the expression of the TBS-LTP-related proteins BDNF, GluA1 and phosphorylated GluA1 were all decreased in the MI group compared with those in the sham group. Strikingly, all these changes were prevented by hippocampal stereotaxic injection of an anti-miR-1 oligonucleotide fragment carried by a lentivirus vector (lenti-pre-AMO-1).

CONCLUSION

MI induced cognitive decline and TBS-LTP impairment, and decreased BDNF and GluA1 phosphorylation levels from overexpression of miR-1ated were involved in this process.

[The clinic experience of implantable diaphragm pacer in a patient with high cervical spinal cord injury and literature review]

Objective: To report the use of implantable diaphragm pacer (IDP) in a patient with high cervical spinal cord injury(HCSCI). Methods: A 14-year-old male patient, who suffered from a HCSCI at C2 neurological level and had been on a ventilator for 2 years, received IDP in August 2017 at China Rehabilitation Research Center. A systematic literature review was performed on IDP in patients with HCSCI in Pubmed, CNKI, and Wanfang databases, using the keywords: phrenic nerve and electrical stimulation and spinal cord injury; IDP and spinal cord injury; breathing pacemaker system and spinal cord injury. All fields were covered from 1970/01/01 to 2018/01/01 in Pubmed, from 1981/01/01 to 2018/01/01 in CNKI, and from 1900/01/01to 2018/01/01 in Wanfang. Results: No spontaneous breathing was observed preoperatively in the patient. The electrical response of phrenic nerves was intact on the right, but unresponsive on the left. We got started with the IDP at 4 weeks after surgery. The threshold voltage of the right hemidiaphragm pacing was 0.1 V and at the level of 0.7 V with an optimal effect. No significant diaphragmatic contraction was found at left side with the extent up till 0.7 V. The maximum tidal volume was 840 ml when electrical stimulation was given at an intensity of 0.7 V bilaterally. The bilateral stimulation voltage at 0.1-0.2 V, pacing frequencies at 9 beats/min in bed, or at 12 beats/min on wheelchair, were set to maintain the tidal volume at the level of (435±32) ml. After 2-week adaptive training, the patient could wean from the ventilator for 12 hours and had a normal blood gas analysis. At 6 week after surgery, with the aid of IDP, the patient could get out in wheelchair for outdoor activities. By literature review, we found 78 English papers, including 6 clinical trials, 10 reviews, and 11 Chinese papers, consisting of 8 reviews, 1 study in animal, and 2 news reports. Extensive contents, such as preoperative evaluation, preoperative preparation, surgical procedures, complications, surgical outcomes, and animal model studies of IDP were involved. The indications of IDP reported by literature were: (1) central alveolar hypoventilation; (2) Sleep apnea syndrome (Biot's respiration); (3) Respiratory failure induced by brainstem injury or disease; (4) Respiratory failure induced by spinal cord injury or disease above C3 level. Conclusion: Our case study confirmed the therapeutic effect of IDP on patients with respiratory failure caused by HCSCI.

Litter decomposition in hyper-arid deserts: Photodegradation is still important

Photodegradation due to litter exposure to solar UV radiation is presumed to contribute to the surprisingly fast decomposition in some arid and semi-arid regions; however, few studies have directly examined photodegradation effects in hyper-arid regions (annual precipitation <150mm) and its dependence on precipitation. Three litters with different initial qualities (low vs high C:N) were decomposed under full spectrum sunlight (UV radiation) and UV filtering from solar radiation at three sites with contrasting precipitation amounts (144mm, 76mm and 16mm) for 2.5years. UV radiation increased mass loss and litter decomposition rates by 23-70%. UV photodegradation effects (UVE) on litter decomposition rate differed among experimental sites, with significantly stronger effects in less arid sites (144mm and 76mm) than more arid site (16mm). High-quality litter (low C:N ratio) showed the fastest decomposition rate, and UVE was also affected by litter quality, but no consistent trend was observed. Litter N loss was greatest in full sunlight and the linear relationships between C and N contents was not changed by UV filtering over time. UV radiation increased C loss of all fractions, and hemicellulose and cell solubles showed significant contributions to litter mass loss. Our findings suggest that UV photodegradation can increase mass loss and nutrient release by the positive priming effects on microbial decomposition in hyper-arid regions, although UVE differed among three sites with contrasting precipitation amounts.

TGFβ induced factor homeobox 1 promotes colorectal cancer development through activating Wnt/β-catenin signaling

Colorectal cancer (CRC) is one of the most common cancers, but the mechanisms underlying its initiation and progression are largely unknown. TGIF1 (TGFB induced factor homeobox 1) is a transcriptional corepressor that belongs to the three-amino acid loop extension (TALE) superclass of atypical homeodomains. It has been reported that TGIF1 is highly expressed in mammary cancer and non-small cell lung cancer and can enhance tumor progression. However, the role of TGIF1 in colorectal cancer remains unknown. Here, we report that TGIF1 is significantly upregulated in colorectal cancers, and its high expression predicts poor prognosis. Overexpression of TGIF1 markedly promotes the proliferation of colorectal cancer cells both in vivo and in vitro. In addition, TGIF1 activates Wnt/β-catenin signaling, and the homeodomain is indispensable for Wnt activation and β-catenin interaction. Taken together, our results suggest that TGIF1 is a novel colorectal tumor promoter and indicate that TGIF1 enhances colorectal cancer tumorigenesis through activating Wnt signaling.

MicroRNA-195 prevents dendritic degeneration and neuron death in rats following chronic brain hypoperfusion

Impaired synaptic plasticity and neuron loss are hallmarks of Alzheimer’s disease and vascular dementia. Here, we found that chronic brain hypoperfusion (CBH) by bilateral common carotid artery occlusion (2VO) decreased the total length, numbers and crossings of dendrites and caused neuron death in rat hippocampi and cortices. It also led to increase in N-terminalβ-amyloid precursor protein (N-APP) and death receptor-6 (DR6) protein levels and in the activation of caspase-3 and caspase-6. Further study showed that DR6 protein was downregulated bymiR-195overexpression, upregulated bymiR-195inhibition, and unchanged by binding-site mutation and miR-masks. Knockdown of endogenousmiR-195by lentiviral vector-mediated overexpression of its antisense molecule (lenti-pre-AMO-miR-195) decreased the total length, numbers and crossings of dendrites and neuron death, upregulated N-APP and DR6 levels, and elevated cleaved caspase-3 and caspase-6 levels. Overexpression ofmiR-195using lenti-pre-miR-195prevented these changes triggered by 2VO. We conclude thatmiR-195is involved in CBH-induced dendritic degeneration and neuron death through activation of the N-APP/DR6/caspase pathway.

[Histologic classification and prognosis factors in phyllodes tumors of breast]

Objective: To study the relationship between morphological characteristics, grading, diagnosis and prognosis in phyllodes tumors (PT) of the breast. Methods: A retrospective study was carried out on 83 PTs diagnosed between 1999 and 2003 that were classified semi-quantitatively according to the WHO recommendation. Follow-up data was available for some cases, and Cox regression analysis was used to evaluate factors affecting metastasis and recurrence. Results: All cases were classified into the benign (57.8%), borderline (28.9%) and malignant (13.3%). The overall recurrence rate for the 72 cases with follow-up data was 20.8% (15/72), and was 17.5% (7/40) in benign, 22.7% (5/22) in borderline and 3/10 in malignant PT, respectively, with no significant difference (P>0.05). The median interval between the initial diagnosis and the first recurrence was 24 months. Lung or bone metastases occurred in 1/22 borderline and 3/10 malignant PT patients 5 years post-surgery. The mitotic count and the degree of stromal cell atypia were significantly correlated with recurrence (P=0.001 and P=0.006). Multivariate analysis showed that severe stromal cell atypia was an independent predictor of recurrence-free survival in PT [HR=6.40 (95% CI=1.378 to 29.732), P=0.018]. Conclusions: Each parameter in the histological grading of PT may have different prognostic value, and markedly increased mitotic count and were predictive of relapse.

[Efficacy of intra-aortic balloon counterpulsation in patients with acute myocardial infarction according to the type of revascularization: a meta-analysis]

OBJECTIVE

To evaluate the effects of intra-aortic balloon counterpulsation (IABP) on mortality in patients with acute myocardial infarction according to the type of revascularization.

METHODS

Recruited randomized controlled trials of IABP compared with no-IABP controls in acute myocardial infarction patients from January 1970 to May 2015 were searched from Medline, Embase and Cochrane Library, according to inclusion criteria and exclusion criteria. These data were analyzed using the methods recommended by the Cochrane Collaboration's software RevMan 5.0. Revascularization included thrombolytic therapy, percutaneous coronary intervention (PCI), or coronary artery bypass grafting.

RESULTS

(1) Eleven randomized controlled trials were enrolled for analysis with 1 102 patients in IABP group, 1 123 in no-IABP control group. (2) Compared with no-IABP control group, IABP could not significantly decrease the in-hospital or 30 day mortality (OR=0.84, 95%CI 0.65-1.09, P=0.20). (3)Compared with no-IABP control group, IABP could not significantly decrease the in-hospital or 30 day mortality in thrombolytic patients(OR=0.64, 95%CI 0.25-1.61, P=0.34), in PCI patients (OR=0.89, 95%CI 0.68-1.18, P=0.42), and in coronary artery bypass grafting patients(OR=0.46, 95%CI 0.13-1.63, P=0.23). (4)The difference reached borderline signiicance between no-IABP control group and IABP group in patients using IABP before PCI(OR=0.47, 95%CI 0.22-1.00, P=0.05), but not in case of after PCI(OR=1.33, 95%CI 0.63-2.79, P=0.45).

CONCLUSIONS

IABP does not decrease the in-hospital or 30 day mortality of acute myocardial infarction patients who received thrombolytic therapy, PCI, or coronary artery bypass grafting. But IABP might decreases the in-hospital or 30 day mortality in patients when used before PCI.

[Clinical characteristics of infants with allergic proctocolitis: a retrospective study of 96 cases]

OBJECTIVE

To study the clinical characteristics of hospitalized infants with allergic proctocolitis, and to provide a scientific basis for early diagnosis and effective treatment of allergic proctocolitis.

METHODS

The clinical data of 96 infants with allergic proctocolitis between September 2011 and March 2013 were reviewed retrospectively. Descriptive analysis was performed to assess the clinical characteristics of allergic proctocolitis.

RESULTS

The most common clinical manifestation was diarrhea in the 96 infants. The electronic colonoscopy results indicated that 40% of the infants had multiple small nodules, 26% showed focal erythema and brittle mucous membranes, 25% showed multiple superficial erosion, and 9% showed ulcers with surface exudates. The affected areas included the sigmoid colon (87%), rectum (24%), descending colon (13%), and transverse colon ascending colon and ileocecal junction (8%). Histopathologic examination showed eosinophilic infiltration of mucosal layers, the condition of which was mild to moderate in 89% and severe and extremely severe in 12% of the infants. To treat the allergic proctocolitis, mothers and infants were suggested to avoid allergenic foods; 43% of them continued breastfeeding, 45% switched to highly hydrolyzed protein formula, and 13% were prescribed amino acid-based elemental formula. All infants were in complete remission at discharge.

CONCLUSIONS

As the clinical manifestations of allergic proctocolitis in infants lack specificity, the electronic colonoscopy and mucosal histopathologic examination are helpful for early and differential diagnosis. The best treatment is to avoid allergenic foods. Formula-feeding infants should be prescribed highly hydrolyzed protein formula or amino acid-based elemental formula.

A study of the coupling relationship between concrete surface temperature and concrete surface emissivity in natural conditions

Land surface emissivity (LSE) has already been recognized as a crucial parameter for the determination of land surface temperature (LST). There is an ill-posed problem for the retrieval of LST and LSE. And laboratory-based emissivity is measured in natural constant conditions, which is limited in the application in thermal remote sensing. To solve the above problems, the coupling of LST and LSE is explored to eliminate temperature effects and improve the accuracy of LES. And then, the estimation accuracy of LST from passive remote sensing images will be improved. For different land surface materials, the coupling of land surface emissivity and land surface temperature is various. This paper focuses on studying concrete surface that is one of the typical man-made materials in urban. First the experiments of measuring concrete surface emissivity and concrete surface temperature in natural conditions are arranged reasonably and the suitable data are selected under ideal atmosphere conductions. Then to improve the determination accuracy of concrete surface emissivity, the algorithm worked on the computer of Fourier Transform Infrared Spectroradiometer (FTIR) has been improved by the most adapted temperature and emissivity separation algorithm. Finally the coupling of concrete surface temperature and concrete surface emissivity is analyzed and the coupling model of concrete surface temperature and concrete surface emissivity is established. The results show that there is a highest correlation coefficient between the second derivative of emissivity spectra and concrete surface temperature, and the correlation coefficient is -0.925 1. The best coupling model is the stepwise regression model, whose determination coefficient (R2) is 0.886. The determination coefficient (R2) is 0.905 and the root mean squares error (RMSE) is 0.292 1 in the validation of the model. The coupling model of concrete surface temperature and concrete surface emissivity under natural conditions provides a new approach for improving the estimation accuracy of LST from passive remote sensing images.

[Clinical effect of triple therapy combined with Saccharomyces boulardii in the treatment of Helicobacter pylori infection in children]

OBJECTIVE

To evaluate the clinical effect of proton pump inhibitor-based triple therapy combined with Saccharomyces boulardii in the treatment of Helicobacter pylori (Hp) infection among children in terms of Hp eradication rate and incidence of adverse events.

METHODS

A prospective randomised controlled study was conducted on 240 children with a confirmed diagnosis of Hp infection. These patients were randomized into triple therapy (n=120) and probiotics groups (n=120). The triple therapy group received amoxicillin [40 mg/(kg·d), Tid], clarithromycin [15 mg/(kg·d), Bid] and omeprazole [0.7-0.8 mg/(kg·d), Qd], while the probiotics group received Saccharomyces boulardii (250 mg, Bid) in addition to triple therapy. The course of treatment was 14 days in both groups. The adverse events in subjects were recorded by their parents during treatment. Hp eradiation was evaluated by (13)C breath test at 4 weeks after treatment, and the eradication rate and incidence of adverse events were compared between the two groups.

RESULTS

The Hp eradication rates were 75.8% (91/120) in the triple therapy group and 85% (102/120) in the probiotics group (P>0.05). Compared with the triple therapy group, the probiotics group had nonsignificantly lower incidence of nausea, vomiting, and abdominal pain (P>0.05) and significantly lower incidence of stomatitis, constipation and diarrhea (P<0.05).

CONCLUSIONS

Triple therapy combined with Saccharomyces boulardii cannot significantly increase Hp eradication rate, but can significantly reduce the incidence of stomatitis, constipation, and diarrhea during treatment.

Expression of IGFBP-6 in a proliferative vitreoretinopathy rat model and its effects on retinal pigment epithelial cell proliferation and migration

AIM

To investigate the expression of insulin-like growth factor binding protein-6 (IGFBP-6) in a proliferative vitreoretinopathy (PVR) model and its effects on proliferation and migration in retinal pigment epithelial (RPE) cells.

METHODS

A PVR Wistar rat model was established by the intravitreal injection of RPE-J cells combined with platelet-rich plasma (PRP). The expression levels of IGFBP-6 were tested by ELISA. ARPE-19 cell proliferation was evaluated by the MTS method, and cell migration was evaluated by wound healing assays.

RESULTS

The success rate of the PVR model was 89.3% (25/28). IGFBP-6 was expressed at higher levels in the vitreous, serum and retina of rats experiencing advanced PVR (grade 3) than in the control group (vitreous: 152.80±15.08ng/mL vs 105.44±24.81ng/mL, P>0.05; serum: 93.48±9.27ng/mL vs 80.59±5.20ng/mL, P<0.05; retina: 3.02±0.38ng/mg vs 2.05±0.53ng/mg, P<0.05). In vitro, IGFBP-6 (500ng/mL) inhibited the IGF-II (50ng/mL) induced ARPE-19 cell proliferation (OD value at 24h: from 1.38±0.05 to 1.30±0.02; 48h: from 1.44±0.06 to 1.35±0.05). However, it did not affect basal or VEGF-, TGF-β- and PDGF-induced cell proliferation. IGFBP-6 (500ng/mL) reduced the IGF-II (50ng/mL)-induced would healing rate [24h: from (43.91±3.85)% to (29.76±2.49)%; 48 h: from (66.09±1.67)% to (59.88±3.43)%].

CONCLUSION

Concentrations of IGFBP-6 increased in the vitreous, serum, and retinas only in advanced PVR in vivo. IGFBP-6 also inhibited IGF-II-induced cell proliferation in a not dose or time dependent manner and migration. IGFBP-6 participates in the development of PVR and might play a protective role in PVR.

Detection of acute cerebral hemorrhage in rabbits by magnetic induction

Acute cerebral hemorrhage (ACH) is an important clinical problem that is often monitored and studied with expensive devices such as computed tomography, magnetic resonance imaging, and positron emission tomography. These devices are not readily available in economically underdeveloped regions of the world, emergency departments, and emergency zones. We have developed a less expensive tool for non-contact monitoring of ACH. The system measures the magnetic induction phase shift (MIPS) between the electromagnetic signals on two coils. ACH was induced in 6 experimental rabbits and edema was induced in 4 control rabbits by stereotactic methods, and their intracranial pressure and heart rate were monitored for 1 h. Signals were continuously monitored for up to 1 h at an exciting frequency of 10.7 MHz. Autologous blood was administered to the experimental group, and saline to the control group (1 to 3 mL) by injection of 1-mL every 5 min. The results showed a significant increase in MIPS as a function of the injection volume, but the heart rate was stable. In the experimental (ACH) group, there was a statistically significant positive correlation of the intracranial pressure and MIPS. The change of MIPS was greater in the ACH group than in the control group. This high-sensitivity system could detect a 1-mL change in blood volume. The MIPS was significantly related to the intracranial pressure. This observation suggests that the method could be valuable for detecting early warning signs in emergency medicine and critical care units.

[Effects of deep plowing and mulch in fallow period on soil water and yield of wheat in dryland]

A field test was carried out in Qiujialing Village, Wenxi, Shanxi from 2009 to 2011 to study the soil water movement of 0-300 cm layer, yield formation and water use efficiency (WUE) of wheat with deep plowing and mulching the whole ground immediately (no mulch as control) 15 days and 45 days after harvest. The results indicated that deep plowing and mulch in fallow period could improve soil water storage of the 100-180 cm layer before sowing, the soil water storage efficiency in fallow period, and soil water storage from pre-wintering stage to booting stage. Compared with deep plowing 15 days after wheat harvest, deep plowing 45 days after wheat harvest did better in improving soil water storage and water use efficiency, as well as ear number and yield, which was more conducive in the year with more precipitation. Generally, deep plowing and mulching after raining during fallow period could benefit the soil water storage and conservation, thus would be helpful to improve wheat yield in dryland.

Expression of IGFBP‑6 in proliferative vitreoretinopathy rat models and its effects on retinal pigment epithelial‑J cells

Proliferative vitreoretinopathy (PVR) is one of the most common causes for failed retinal detachment surgeries. The aim of the present study was to investigate the role of insulin‑like growth factor‑binding protein‑6 (IGFBP‑6) in PVR using rat models and its effects on retinal pigment epithelial‑J (RPE‑J) cells. PVR Wistar rat models were administered intravitreal injection of RPE‑J cells (1x106/5 µl) combined with platelet‑rich plasma (1x107/5 µl). The concentration of IGFBP‑6 in the vitreous and serum of rats was tested by an enzyme‑linked immunosorbent assay and the expression of IGFBP‑6 mRNA in the liver and retina of rats was determined by quantitative polymerase chain reaction (qPCR). The expression of IGFBP‑6 mRNA in the RPE‑J cells stimulated by vitreous or serum from PVR patients or normal volunteers was also determined by qPCR. The proliferation of RPE‑J cells was evaluated by the 3‑(4,5‑dimethylthiazol‑2‑yl)‑5‑(3‑carboxymethoxyphenyl)‑2‑(4‑sulfophenyl)‑2H‑tetrazolium, inner salt (MTS) method. The success rate of PVR rat model induction at the 8th week was 89.5% (34/38). The concentration of IGFBP‑6 in the vitreous and serum of PVR rats was significantly higher than that of the control group (P<0.05). The expression of IGFBP‑6 mRNA in the retina of PVR rats was also significantly higher compared with the control group (P<0.05). The vitreous from PVR patients and donors significantly stimulated the expression of IGFBP‑6 mRNA in the RPE‑J cells (P<0.05). IGFBP‑6 only inhibited IGF‑II‑stimulated proliferation but not the basal level of proliferation or the PDGF/VEGF‑stimulated RPE‑J cell proliferation. Thus, the trends and effects of IGFBP‑6 provide the possibility of PVR therapeutic targets, with the vitreous representing a significant environmental factor in the progression of PVR.

Effect of subsoiling in fallow period on soil water storage and grain protein accumulation of dryland wheat and its regulatory effect by nitrogen application

To provide a new way to increase water storage and retention of dryland wheat, a field study was conducted at Wenxi experimental site of Shanxi Agricultural University. The effect of subsoiling in fallow period on soil water storage, accumulation of proline, and formation of grain protein after anthesis were determined. Our results showed that subsoiling in fallow period could increase water storage in the 0–300 cm soil at pre-sowing stage and at anthesis stage with low or medium N application, especially for the 60–160 cm soil. However, the proline content, glutamine synthetase (GS) activity, glutamate dehydrogenase (GDH) activity in flag leaves and grains were all decreased by subsoiling in fallow period. In addition, the content of albumin, gliadin, and total protein in grains were also decreased while globulin content, Glu/Gli, protein yield, and glutelin content were increased. With N application increasing, water storage of soil layers from 20 to 200 cm was decreased at anthesis stage. High N application resulted in the increment of proline content and GS activity in grains. Besides, correlation analysis showed that soil storage in 40–160 cm soil was negatively correlated with proline content in grains; proline content in grains was positively correlated with GS and GDH activity in flag leaves. Contents of albumin, globulin and total protein in grains were positively correlated with proline content in grains and GDH activity in flag leaves. In conclusion, subsoiling in fallow period, together with N application at 150 kg·hm⁻², was beneficial to increase the protein yield and Glu/Gli in grains which improve the quality of wheat.