[A retrospective study of postoperative adjuvant therapy following immunotherapy combined with targeted therapy and sequential curative surgical procedures for initially unresectable hepatocellular carcinoma]

Objective: To report the clinical efficacy of adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures in patients with initially unresectable hepatocellular carcinoma. Methods: This is a retrospective case series study. Data from 100 patients who underwent adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures with long-term survival were collected from December 2018 to December 2022 at the Faculty of Hepato-Pancreato-Biliary Surgery, First Medical Center, Chinese People's Liberation Army General Hospital. According to inclusion and exclusion criteria, 47 cases were included, among which patients who met the discontinuation criteria and maintained a drug-free tumor-free status. Thirty-nine male and eight female patients were included, with an age of (54.2±18.8)years(range:38 to 73 years) at initial diagnosis. At the time of initial diagnosis, 43 cases (91.5%) were classified as Barcelona Clinic Liver Cancer(BCLC) stage C. Survival curves were made using Kaplan Meier method. Results: Forty-seven patients underwent R0 resection, all achieved a drug-free tumor-free state through postoperative adjuvant therapy based on pathological examination results. Thirty-six patients(76.6%) maintained a drug-free tumor-free survival status for more than 6 months,28 patients(59.6%) for more than 12 months,and 8 patients(17.0%) for more than 24 months. The longest drug-free tumor-free survival in this cohort reached 48 months. The median follow-up time in this study was 32 months. After diagnosis, the overall survival rates at 1- and 3- years were 97.7%(95%CI:93.4% to 100%) and 90.7%(95%CI:82.5% to 99.8%). The postoperative recurrence-free survival rates at 1- and 3- years were 91.0%(95%CI:83.0% to 99.8%) and 71.3%(95%CI:58.7% to 86.5%). Conclusions: The adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical approach provides long-term survival benefits for patients with initially unresectable hepatocellular carcinoma. Standardized adjuvant therapy maybe sustain long-term tumor-free status,and achieve drug-free tumor-free survival.

[Analysis of the core knowledge level of chronic diseases in Chinese adults and related factors]

Objective: To understand the core knowledge level and influencing factors of chronic disease prevention and control in Adults in China, and to provide a scientific basis for formulating chronic disease prevention and control measures. Methods: In this study, cross-sectional survey and quota sampling were used to recruit 173 819 permanent residents aged 18 and above from 302 counties of adult chronic diseases and nutrition surveillance in China to conduct an online questionnaire survey, including basic information and core knowledge of chronic diseases. The scores of the core knowledge of chronic disease prevention and control were described by median and interquartile range, the Wilcoxon rank sum test or the Kruskal Wallis test was used for the inter-group comparison, and the correlation factors of the total score were analyzed by the multilinear regression model. Results: A total of 172 808 participants were surveyed in 302 counties and districts, of which 42.60%(73 623) were male and 57.40%(99 185) were female; The proportion of respondents aged 18-44, 45-59, and 60 years old and above was 54.74% (94 594), 30.91% (53 423) and 14.35% (24 791), respectively. The total score of the core knowledge of chronic prevention and control in the total population was 66(13), and the scores of different characteristic groups were different, and the differences were statistically significant: the eastern region had the highest score at 67(11) (H=840.66, P<0.01), the urban 66(12) was higher than the rural 65(14) (Z=-31.35, P<0.01), and the male 66(14) was lower than female 66(12) (Z=-11.66, P<0.01), 18-24 years old 64(13) was lower than other age groups(H=115.80, P<0.01), and undergraduate degree and above had the highest score compared to other academic qualifications, with 68(9) points(H=2 547.25, P<0.01). Multivariate analysis showed that eastern (t=27.42, P<0.01), central (t=17.33, P<0.01), urban (t=5.69, P<0.01), female (t=17.81, P<0.01), high age (t=46.04, P<0.01) and high education (t=57.77, P<0.01) had higher scores of core knowledge of chronic disease prevention and control than other groups, the scores of core knowledge of chronic disease prevention and control of professional and technical personnel (t=8.63, P<0.01), state enterprises and institutions (t=38.67, P<0.01), agriculture, forestry, animal husbandry, fishery and water conservancy production (t=5.30, P<0.01), production, transportation and commercial personnel (t=24.87, P<0.01), and other workers (t=8.89, P<0.01) were higher than those of non-employed people. Conclusion: There are differences in the total scores of the core knowledge of chronic disease prevention and control in different characteristics of people in China, and in the future, health education on the prevention and treatment of chronic diseases should be strengthened for specific groups to improve the knowledge level of residents.

[Expression of cation chloride cotransporter (NKCC1/KCC2) in brain tissue of children with focal cortical dysplasia type Ⅱ]

Objective: To investigate the expression of cation chloride cotransporter (NKCC1/KCC2) in the neurons from cerebral lesions of children with focal cortical dysplasia (FCD) type Ⅱ, to provide a morphological basis for revealing the possible mechanism of epilepsy. Methods: Eight cases of FCD type Ⅱ diagnosed at Beijing Haidian Hospital, Beijing, China and 12 cases diagnosed at Xuanwu Hospital, Capital Medical University, Beijing, China from February 2017 to December 2019 were included. The expression of NKCC1 and KCC2 in FCD type Ⅱa and FCD type Ⅱb was detected using immunohistochemistry and double immunohistochemical stains. The average optical density of NKCC1 in dysmorphic neurons and normal neurons was also determined using immunohistochemical staining in FCD type Ⅱa (10 cases). Results: The patients were all younger than 14 years of age. Ten cases were classified as FCD type IIa, and 10 cases as FCD type Ⅱb. NKCC1 was expressed in the cytoplasm of normal cerebral cortex neurons and KCC2 expressed on cell membranes. In dysmorphic neurons of FCD type Ⅱa, expression of NKCC1 increased, which was statistically higher than that of normal neurons (P<0.01). Aberrant expression of KCC2 in dysmorphic neurons was also noted in the cytoplasm. In the FCD Ⅱb type, the expression pattern of NKCC1/KCC2 in dysmorphic neurons was the same as that of FCD type Ⅱa. The aberrant expression of NKCC1 in balloon cells was negative or weakly positive on the cell membrane, while the aberrant expression of KCC2 was absent. Conclusions: The expression pattern of NKCC1/KCC2 in dysmorphic neurons and balloon cells is completely different from that of normal neurons. The NKCC1/KCC2 protein-expression changes may affect the transmembrane chloride flow of neurons, modify the effect of inhibitory neurotransmitters γ-aminobutyric acid and increase neuronal excitability. These effects may be related to the occurrence of clinical epileptic symptoms.

[Progress in research of regional longevity level]

Regional longevity refers to a phenomenon of population age distribution in which longevity level in a certain area is significantly higher than the surrounding area at a certain point or period of time, and its longevity level is among the best in the whole country. In recent years, experts and scholars both at home and abroad have carried out multi studies of the influencing factors of individual longevity, but there are still relatively less studies to evaluate regional longevity level. This paper introduces the domestic and foreign evaluation research of regional longevity in terms of evaluation indicators and results, research scales and data sources, and proposes some advice for the future development. First, making full use of population death surveillance data to evaluate regional longevity level. Second, adopting multi-dimensional composite indexes to comprehensively, dynamically evaluate and accurately depict the regional longevity levels and its spatio-temporal change trend. Third, transforming regional longevity level evaluation to regional health and longevity level evaluation to promote healthy population aging.

[Analysis of changes in self-efficacy and its influencing factors in type 2 diabetic patients after community-based self-management group intervention]

Objective: To analyze the changes in self-efficacy and its influencing factors in type 2 diabetic patients after community-based self-management group intervention. Methods: From August to November 2014, a 3-month community-based self-management intervention study of type 2 diabetes patients was implemented in Fangshan District, Beijing. 510 patients were recruited through posters, household inquiries and telephone notification and then were randomly divided into intervention group (260 patients) and control group (250 patients). Finally, 500 patients completed the study, including 259 in the intervention group and 241 in the control group. Self-efficacy score was measured through face-to-face interview at different time points, including pre-intervention, post-intervention, 2 years after the intervention and 5 years after the intervention, respectively. A two-level random coefficient model was fitted to analyze the long-term trend of self-efficacy and its relationship with group intervention. Results: Individual-level educational attainment, disease duration as well as their treatment plans had a positive correlation with self-efficacy of type 2 diabetic patients while gender and age did not affect their self-efficacy. Patients with junior middle school education, senior high school education and university and above education had 4.66 (P<0.05), 6.40 (P<0.05) and 11.02 (P<0.05) points higher than those with primary education, respectively. The self-efficacy of diabetic patients increased by 0.23 (P<0.05) for each additional course year. The effect of treatment plan on self-efficacy was mainly reflected in the self-efficacy of taking medication or insulin injection as prescribed and blood glucose monitoring. After controlling for the confounding factors, i.e., gender, age, disease duration, educational attainment, and treatment plan, self-efficacy scores at the post-intervention increased in both groups compared to those at the pre-intervention. The intervention group had 7.95 points higher than the control group (P<0.05). After the intervention, the self-efficacy scores of both groups decreased year by year while the intervention group declined faster, with 5.41 points (P<0.05) at 2 years after the intervention and 8.94 points (P<0.05) at 5 years after the intervention. Conclusion: Community-based self-management group intervention could improve the self-efficacy of type 2 diabetic patients while the self-efficacy decreases year by year in the absence of follow-up intervention.

[Clinical efficacy of transjugular intrahepatic portosystemic shunt for gastrointestinal hemorrhage in patients with idiopathic noncirrhotic portal hypertension]

Objective: To explore the medium-long term efficacy of transjugular intrahepatic portosystemic shunt (TIPS) for gastrointestinal hemorrhage in patients with idiopathic non-cirrhotic portal hypertension (INCPH). Methods: From March 2013 to July 2018, clinical data of 13 INCPH patients, including 5 males, 8 females,with gastrointestinal hemorrhage were retrospectively analyzed, who were diagnosed at the First Affiliated Hospital of Zhengzhou University, Anyang Fifth People' s Hospital and Yuncheng Central Hospital. All patients received TIPS treatment. The general information, postoperative survival rate, the incidence of rebleeding, shunt dysfunction rate, and incidence of hepatic encephalopathy were analyzed. Results: All 13 patients with INCPH completed TIPS successfully with an average age of 45±8 (33 to 59) years. The hepatic venous pressure gradient (HVPG) decreased from 20.0-26.0 (22.6±1.9) mmHg before procedure to 8.0-14.0 (9.4±3.2) mmHg after. The median follow-up time was 44±7 (31 to 53) months. One patient died of liver failure 27 months after TIPS. Hepatic encephalopathy occurred cumulatively in 1 case (1/13), 1 case (1/13) and 1 case (1/13) in 12, 24 and 36 months after TIPS. Stent restenosis occurred cumulatively in 2 cases (2/13), 3 cases (3/13) and 3 cases (3/13) in 12, 24 and 36 months after TIPS. Portal vein thrombosis occurred cumulatively in 2 cases (2/13), and no primary liver cancer developed. Conclusions: TIPS is safe and effective in the treatment of INCPH with gastrointestinal bleeding with favorable medium-long term outcome.

Propofol ameliorates acute postoperative fatigue and promotes glucagon-regulated hepatic gluconeogenesis by activating CREB/PGC-1α and accelerating fatty acids beta-oxidation

Postoperative fatigue (POF) is the most common and long-lasting complication after surgery, which brings heavy burden to individuals and society. Recently, hastening postoperative recovery receives increasing attention, but unfortunately, the mechanisms underlying POF remain unclear. Propofol is a wildly used general anesthetic in clinic, and inspired by the rapid antidepressant effects induced by ketamine at non-anesthetic dose, the present study was undertaken to investigate the anti-fatigue effects and underlying mechanisms of propofol at a non-anesthetic dose in 70% hepatectomy induced POF model in rats. We first showed here that single administration of propofol at 0.1 mg/kg ameliorated acute POF in hepatectomy induced POF rats. Based on metabonomics analysis, we hypothesized that propofol exerted anti-fatigue activity in POF rats by facilitating free fatty acid (FFA) oxidation and gluconeogenesis. We further confirmed that propofol restored the deficit in FFA oxidation and gluconeogenesis in POF rats, as evidenced by the elevated FFA utilization, acetyl coenzyme A content, pyruvic acid content, phosphoenolpyruvic acid content, hepatic glucose output and glycogen storage. Moreover, propofol stimulated glucagon secretion and up-regulated expression of cAMP-response element binding protein (CREB), phosphorylated CREB, peroxlsome prolifeator-activated receptor-γ coactivator-1α (PGC-1α), phosphoenolpyruvate carboxykinade1 and carnitine palmitoltransferase 1A. In summary, our study suggests for the first time that propofol ameliorates acute POF by promoting glucagon-regulated gluconeogenesis via CREB/PGC-1α signaling and accelerating FFA beta-oxidation.

[Evaluation on the quality of 236 National Demonstration Areas for comprehensive prevention and control of chronic diseases betweem 2017 and 2019]

Objective: To evaluate the quality of the National Demonstration Area for Comprehensive Prevention and Control of NCDs (referred to as "the Demonstration Area"). Methods: Based on the evaluation scores of the Demonstration Area field survey from 2017 to 2019, we counted the scores of each indicator, comparing the scores among indicators and regions. x±s was used to describe the scores. The 95%CI of the score was used to test the statistical difference among regions. Each score was converted into a hundred-mark system to compare the scores among indicators. Results: Of 236 Demonstration Areas, the total score was 83.5. The scores of the first-level indicator listed from high to low appeared as Integrating System of NCD Prevention and Control (92.8), Policy Perfection (90.3), Building Supportive Environment for NCD Prevention and Control (88.4), Implementation of Health Education and Health Promotion (87.4), Whole-course Management of NCDs (78.1), Innovation and Guidance (76.5), Surveillance and Evaluation (75.1). Total scores were higher in the east (259.2±18.8) comparing to the middle (243.2±15.2) or the west (245.4±19.7) regions. Conclusions: Substantial variations on the quality in the Demonstration Area existed across different regions in China. These disparities are important to the government when developing health policies and allocating resources. Whole-course Management of NCDs, Surveillance and Evaluation, and Innovation and Guidance in the Demonstration Area also needs to be improved.

[Analysis of families with fetal congenital abnormalities but negative prenatal diagnosis by whole exome sequencing]

Objective: To evaluate the value of whole exome sequencing (WES) in prenatal clinical application. Methods: A total of 1 152 cases of congenital abnormal [including structural malformation, nuchal translucency (NT) thickening and intrauterine growth restriction] with traditional prenatal diagnosis [including G-band karyotype analysis and chromosome microarray analysis (CMA)] negative were analyzed. The congenital abnormal fetuses were divided into retrospective group and prospective group according to the time of WES detection, that is whether the pregnancy termination or not. According to the specific location of fetal malformation and their family history, the cohort was divided into subgroups. The clinical prognosis of all fetuses were followed up, and the effect of WES test results on pregnancy decision-making and clinical intervention were analyzed. According to the follow-up results, the data of fetuses with new phenotypes in the third trimester or after birth were re-analyzed. Results: Among 1 152 families who received WES, 5 families were excluded because of nonbiological parents. Among the remaining 1 147 families, 152 fetuses obtained positive diagnosis (13.3%,152/1 147), including 74 fetuses in the retrospective group (16.1%,74/460) and 78 fetuses in the prospective group (11.4%,78/687). In fetuses with negative CMA and G-band karyotype analysis results but new phenotypes in the third trimester or after birth, the positive rate by WES data re-analysis was 4.9% (8/163). A total of 34 (21.3%, 34/160) fetuses were directly affected by the corresponding positive molecular diagnosis. Among 68 cases of live births with diagnostic variation grade 4, 29 cases (42.7%, 29/68) received appropriate medical intervention through rapid review of WES results. Conclusions: WES could increase the detection rate of abnormal fetuses with negative G-banding karyotype analysis and CMA by 13.3%. Prenatal WES could guide pregnancy decision-making and early clinical intervention. It might be an effective strategy to pay attention to the special follow-up of the third trimester and postnatal fetus and to re-analyze the WES data.

[Survey of Oncomelania hupensis in national schistosomiasis surveillance sites of Guangxi Zhuang Autonomous Region from 2015 to 2019]

OBJECTIVE

To investigate the distribution characteristics of Oncomelania hupensis in Guangxi Zhuang Autonomous Region, so as to provide insights into the assessment of the risk of schistosomiasis transmission and the scientific formulation of the schistosomiasis surveillance strategy.

METHODS

From 2015 to 2019, a total of 19 national schistosomiasis surveillance sites were assigned in Guangxi Zhuang Autonomous Region, including 4 fixed sites and 15 mobile sites. Snail survey was performed by means of systematic sampling in combination with environmental sampling, and the infection of Schistosoma japonicum was detected by the crushing method combined with loop-mediated isothermal amplification (LAMP) assay.

RESULTS

From 2015 to 2019, snail habitats were detected at areas of 17 040 to 39 527 m², including 6 214 m² emerging snail habitats and 16 563 m² re-emerging snail habitats. The overall mean density of living snails was 0.019 2 snails/0.1 m² and the occurrence of frames with snails was 1.11% in the national schistosomiasis surveillance sites; however, no S. japonicum infection was identified in snails. The area of snail habitats increased by 121.46% in the national surveillance sites in 2019 as compared to that in 2015; however, 50.34% (Z = -0.422, P > 0.05) and 42.85% (χ² = 130.41, P < 0.01) reductions were seen in the overall means density of living snails and the occurrence of frames with snails. All snail habitats were distributed in the 4 fixed surveillance sites, and were mainly found in ditches, paddy fields and dry lands, with weeds as the primary vegetation type.

CONCLUSIONS

There are still risk factors leading to re-emergent transmission of schistosomiasis in Guangxi Zhuang Autonomous Region, such as local snail spread, and the monitoring of schistosomiasis remains to be reinforced to further consolidate the achievements of schistosomiasis elimination in the region.

[Epidemiological and pathogenic characteristics of cases with severe and fatal hand, foot, and mouth disease caused by other enterovirus in Hebei province, 2013-2017]

Objective: To understand the epidemiological characteristics of cases with severe and fatal hand, foot, and mouth disease (HFMD) caused by other enterovirus in Hebei province, 2013-2017. Genetic characteristics of the main pathogen cosackie virus A6 (CoxA6) were also analyzed to further clarifying the characteristics and rules of genetic evolution on this virus. Methods: Descriptive epidemiological methods were used to analyze the distribution of severe and fatal cases with HFMD caused by other enterovirus in Hebei, 2013-2017. The VP1 sequences of CoxA6 were phylogenetically analyzed, using the Mega 5.2 software package. Results: A total of 86 severe and fatal cases with HFMD caused by other enterovirus were reported, accounting for 1.12%, comparing to all the HFMD caused by other enterovirus. Cases began to rise in April, and peaked in May-July. 65.12% of the cases occurred in children between 1 and 5 years old. The sex ratio between male and female was 1.39∶1. A total of 93.02% of the cases were children outside the child care settings. A total of 39 positive strains were identified, with positive isolation rate as 45.35%. Phylogenetic analysis on the VP1 sequences of CoxA6 strains in this study revealed that CoxA6 strains belonged to sub-genotypes D3a and D3b. Conclusions: Severe and fatal HFMD cases that caused by other enterovirus in Hebei province was with seasonal feature, consistent with the overall trend of this disease, 2013-2017. No new evolutionary branch appeared in the CoxA6 strain.

[Clinical application and efficacy of TIPS combined with AngioJet mechanical thrombectomy for liver cirrhosis with extensive portal vein thrombosis]

Objective: To assess the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with AngioJet mechanical thrombectomy for liver cirrhosis with extensive portal vein thrombosis. Methods: From March 2018 to April 2019, a total of 11 patients with liver cirrhosis and extensive portal vein thrombosis were treated by TIPS combined with AngioJet mechanical thrombectomy, including 6 males and 5 females, with the age of 37-71 (46±9) years old, 3 cases of Child-Pugh grade A, 8 cases of grade B and 0 cases of grade C. The intraoperative immediate thrombus clearance rate, perioperative complication rate, postoperative thrombus recurrence rate, rebleeding rate, the incidence of hepatic encephalopathy and the rate of stent patency of all cases were collected and analyzed. Results: All the patients were treated successfully. The immediate complete thrombus clearance (grade Ⅲ) rate of portal vein trunk was 9/11, and grade Ⅱ was 2/11, The average dose of urokinase was 30-60 (40±5) ten thousand U, slight puncture point bleeding occurred in 3 cases, and recurrence of PVT in portal vein trunk occurred in 1 case with Ⅱ grade clearance rate after operation, rebleeding occurred in 1 case, hepatic encephalopathy occurred in 2 cases, the primary patency rate of stents was 9 cases. Conclusion: TIPS combined with AngioJet mechanical thrombectomy can treat the liver cirrhosis with extensive portal vein thrombosis effectively and safely, and postoperative portal vein patency rate and intrahepatic shunt patency rate are high.

[Application of real-time image fusion technique in transjugular intrahepatic portosystemic shunt]

Objective: To assess the feasibility and value of real-time image fusion technique guiding the procedure of transjugular intrahepatic portosystemic shunt(TIPS). Methods: From July 2017 to May 2018,a total of 48 consecutive patients complicated by portal venous hypertension due to cirrhosis who underwent TIPS were prospectively allocated into two groups that 27 cases underwent normal TIPS and 21 cases underwent image fusion guided TIPS. There were 25 males and 23 females with a mean age of 29-74(51±10) years. The differences of portal vein(PV) between image fusion angiographyand digital subtraction angiography(DSA), and the times of puncture PV, X-ray exposure dose and exposure time and contrast agent amount of all cases were collected and analyzed. Results: The longitudinal and traverse difference of PV between image fusion angiography and DSA were 1.7-2.5(2.1±0.2) mm and 0.9-1.8(1.4±0.3) mm, respectively.The times of puncture PV, X-ray exposure time and dose, and contrast agent amount between normal TIPS group and image fusion guided TIPS group were 1-7(3.8±0.6) times vs 1-3(2.0±0.6) times, 41-63(53±8)min vs 27-42(35±5) min, 513-787(644±96) mGy vs 357-524(423±59) mGy,102-196(151±23) ml vs 87-145(105±14) ml(all P<0.05), respectively. Conclusions: There are minor differences between image fusion angiography of PV and DSA. Real-time image fusion guided TIPS is feasible and valuable to reduce intraprocedural X-ray exposure time and dose and contrast agent amount of TIPS.

[Expression of autophagy-related proteins in cortical nodules of tuberous sclerosis complex]

Objective: To investigate the expression of LC3B, p-AMPKα and p27 in cortical tuberous sclerosis complex (TSC). Methods: Nineteen specimens of surgically resected TSC cortical tubers were collected at Xuanwu Hospital, Capital Medical University, from 2014 to 2017. The expression of the three proteins in the lesions and the adjacent relatively normal regions was detected by immunohistochemical staining (EnVision two-step method). Results: LC3B was mainly expressed in the dysmorphic neuron and giant cell in TSC cortical tubers and in the adjacent relatively normal neurons, and the expression was diffuse or perinuclear cytoplasmic. There was no significant difference in the average optical density between abnormal cells and neurons adjacent to the lesions (0.343±0.195 vs. 0.419±0.088, P>0.05). p-AMPKα was localized in the cytoplasm of dysmorphic neurons and giant cell in TSC cortical tubers. The average optical density of abnormal cells in the lesions was significantly higher than that of neurons adjacent to the lesions (0.306±0.123 vs. 0.233±0.654, P<0.05). P27 showed nuclear positivity, mainly expressed in the neurons and glial cells close to TSC cortical tubers, while the positive rate in the abnormal cells in TSC cortical tubers was low (15/19 vs. 7/19, P<0.05). Conclusion: There is no significant decrease in the level of autophagy in dysmorphic neurons and giant cells in TSC cortical tubers, which may be related to the compensatory mechanism of AMPK signaling pathway, but without activation of downstream p27.

Accumulation of Multiple Mutations In Vivo Confers Cross-Resistance to New and Existing Integrase Inhibitors

Bictegravir (BIC) and cabotegravir (CAB) are the latest available HIV integrase inhibitors in clinical trials. The combination of major integrase inhibitor substitutions G140S/Q148H has been shown to confer high-level resistance to the approved integrase inhibitors raltegravir (RAL) and elvitegravir (EVG) but not necessarily dolutegravir (DTG). We assayed recombinant viruses made from patient-derived RNA extracts for resistance phenotype for a panel of viruses containing G140S/Q148H with additional accessory substitutions. The accumulation of multiple integrase substitutions confers high-level resistance to all 5 integrase inhibitors. There is extensive cross-resistance between DTG, BIC, and CAB (r = 0.96-0.97).

[Research on supervision strategy of physical examination institutions after abolishing administrative approval]

Objective: To follow the principle of adapting to the constantly updated laws and regulations of the state, put forward the supervision strategy of occupational health inspection institutions under the new situation, and standardize the practice of inspection institutions. Methods: The work of supervision and inspection was carried out in the provincial occupational health inspection institutions for five consecutive years. Result: Occupational health inspection institutions generally have non-standard work of occupational health inspection, deviations in understanding the relevant laws, regulations, policies and standards of occupational diseases, incomplete coverage of the assessment forms used in previous supervision and inspection, and insufficient refinement of the scores, only considering the basic conditions for occupational health inspection, but not from the level of quality management and discipline construction. As a result, some occupational health inspection institutions have backward instruments and equipment, poor ability and low level of practitioners, and inaccurate results of occupational health inspection, which bring hidden dangers to the health of employers and workers. Conclusion: According to the results of supervision and inspection of occupational health inspection institutions in the province, the common problems are summarized and analyzed, and the supervision strategies of occupational health inspection institutions under the new situation are put forward in accordance with the principle of adapting to the constantly updated laws and regulations of the state.

Prevalence of Human Immunodeficiency Virus-1 Integrase Strand Transfer Inhibitor Resistance in British Columbia, Canada Between 2009 and 2016: A Longitudinal Analysis

Background

Integrase strand transfer inhibitors (INSTIs) are highly efficacious and well tolerated antiretrovirals with fewer adverse side-effects relative to other classes of antiretrovirals. The use of INSTIs raltegravir, elvitegravir, and dolutegravir has increased dramatically over recent years. However, there is limited information about the evolution and prevalence of INSTI resistance mutations in clinical human immunodeficiency virus populations.

Methods

Human immunodeficiency virus-1-positive individuals ≥19 years were included if they received ≥1 dispensed prescription of antiretroviral therapy (ART) in British Columbia between 2009 and 2016 (N = 9358). Physician-ordered drug resistance tests were analyzed and protease inhibitor (PI), reverse-transcriptase inhibitor (RT), and INSTI resistance were defined as having ≥1 sample with a combined, cumulative score ≥30 by Stanford HIV Drug Resistance Algorithm version 7.0.1.

Results

Although most ART-treated individuals were tested for PI and RT resistance, INSTI resistance testing lagged behind the uptake of INSTIs among INSTI-treated individuals (11% in 2009; 34% in 2016). The prevalence of INSTI resistance was relatively low, but it increased from 1 to 7 per 1000 ART-treated individuals between 2009 and 2016 (P < .0001, R² = 0.98). Integrase strand transfer inhibitor resistance mutations increased at integrase codons 66, 97, 140, 148, 155, and 263.

Conclusions

The prevalence of INSTI resistance remains low compared with PI and RT resistance in ART-treated populations but is expanding with increased INSTI use.

[The MRI analysis of 220 cases of placenta previa complicated with placenta accrete or not]

Objective: To investigate the diagnostic value of MRI for placenta previa complicated with placenta accreta or not. Methods: A total of 220 placenta previa patients were diagnosed by prenatal ultrasound and MRI in The Second Affiliated Hospital of Wenzhou Medical University from May 2014 to May 2017.The MRI images of 220 placenta previa patients suspicious of placenta previa were interpreted by two radiologists who majored on gynecological radiology. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of two radiologists in diagnosis of placenta accreta were calculated respectively. Kappa test were used to verify the consistency between two doctors, as well as their MRI diagnosis and pathological results. The diagnostic value of MRI and pathological were assessed by Chi-square test and receiver operating characteristic (ROC)curve. Results: The 220 patients were all confirmed with placenta previa by surgical pathology.Out of 220, 71 cases were diagnosed as placenta accreta, and 149 cases were diagnosed without placenta accreta. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value with physician A and physician B were 90.1%/84.5%, 88.6%/89.9%, 89.1%/88.2%, 79.0%/80.0% and 95.0%/92.4%, respectively.The consistency between MRI diagnosis and pathological results was excellent in physician A (κ=0.759), and good in physician B (κ=0.734). However, the sensitivity, specificity and accuracy of diagnosis between two physicians had no significant difference (all P>0.05). The area under the curve (AUC) of ROC in physician A and B were 0.858 and 0.847 (P=0.980). Conclusion: MRI is feasible for patients with placenta previa, as the sensitivity, specificity and accuracy of MRI are high in assessing whether placenta previa complicated with placenta accreta or not.

[Clinical applications of transcrestal around detached sinus floor elevation technique using osteotomes and sequential drills with stops]

Sinus floor elevation was needed in 11 patients having 15 implant sites with the residual bone height (RBH) was less than 10 mm in the posterior maxillary region from Feb to May 2017. The RBH ranged from 3.10 to 8.34 mm [averaged (6.18±1.60) mm]. RBH<6 mm was observed in 40% implant sites (6 implant sites) and RBH≥6 mm was observed in 60% implant sites (9 implant sites). The thickness of the sinus floor membrane correspond to the implant site measured by cone beam CT (CBCT) ranged from 0.50 to 4.24 mm [averaged (1.21±0.92) mm]. Sequential drills with stops were used to perforate the cortical bone of the sinus floor firstly, then the transcrestal around detached sinus floor elevation technique (TADSFET) was carried with osteotomes. Anorganic bovine bone was used as the augmentation material.Fifteen implants were placed in 15 implant sites. CBCT pictures showed that there was a smooth and continuous tent-shaped apophysis on each lifted site and no air fluid level was observed in the sinus immediately after operation. The mean elevated height of the 15 implant sites was (7.83±1.57) mm (ranged from 5.94 to 11.01 mm). The mean follow-up time was 7.91 months (7-10 months). The survival rate was 100% during the follow up period.

[Value of non-invasive models of liver fibrosis in judgment of treatment timing in chronic hepatitis B patients with ALT < 2×upper limit of normal]

Objective: To investigate the value of non-invasive liver fibrosis models, FIB-4, S index, aspartate aminotransferase to platelet ratio index(APRI), globulin-platelet(GP)model, aspartate aminotransferase/platelet/gamma-glutamyl transpeptidase/alpha-fetoprotein(APGA), and platelet/age/phosphatase/alpha-fetoprotein/aspartate aminotransferase(PAPAS), in the diagnosis of marked liver fibrosis in chronic hepatitis B(CHB)patients with ALT < 2×upper limit of normal(ULN), as well as treatment timing for this population. Methods: A total of 389 CHB patients with ALT < 2×ULN who were admitted to Beijing Ditan Hospital and whose treatment timing was difficult to judge were enrolled. Transdermal liver biopsy was performed to obtain pathological results, and routine serological tests were performed, including routine blood test, serum biochemical parameters, hepatitis B virus(HBV)markers, and HBV DNA. According to liver pathology, the patients were divided into non-marked liver fibrosis group(S < 2)with 324 patients and marked liver fibrosis group(S≥2)with 65 patients. The non-invasive models for predicting liver fibrosis was established with reference to original articles. SPSS 19.0 software was used for statistical analysis, and the receiver operating characteristic(ROC)curve was used to compare the value of different non-invasive models in predicting marked liver fibrosis in this population. Results: All the non-invasive models had a certain diagnostic value for liver fibrosis degree in these patients, and the areas under the ROC curve for APRI, FIB-4, APGA, S index, PAPAS, and GP model were 0.718, 0.691, 0.758, 0.729, 0.673, and 0.691, respectively. APGA had the largest area under the ROC curve(0.758, 95% CI 0.673-0.844), and gamma-glutamyl transpeptidase was significantly positively correlated with liver fibrosis degree. Conclusion: The non-invasive models of liver fibrosis can identify marked liver fibrosis in CHB patients with ALT < 2×ULN in whom it is difficult to judge treatment timing and help to determine treatment timing for them. APGA model has the highest value and can reduce the need for liver biopsy to the certain degree.

[Application of right jugular vessels to build extracorporeal membrane oxygenation for treating the critically ill children]

OBJECTIVE

To summarize the experience in applying a technique of inserting a cannula through right internal jugular vein and common carotid artery to build extracorporeal membrane oxygenation (ECMO) for critically ill children.

METHOD

The data of critically ill patients received ECMO support through right internal jugular vein and common carotid artery between December 2011 and December 2015 from Children's Hospital of Fudan University were analyzed retrospectively.The data included diagnosis, age, body weight, time of cannula and ECMO running, complication and prognosis.

RESULT

In total 28 patients received ECMO support, 3 patients of post-cardiac surgery with transthoracic cannula were excluded.Twenty-five patients inserted cannula through neck vessels were enrolled, 15 boys and 10 girls, the median age was 1.8 years (range, 1 d-13 years), the median weight was 12.0 (2.8-50.0) kg.All the cannula sites were right internal jugular vein and right common carotid artery, before cannula use 5 patients had been inserted central vein tube and 3 patients with blood filter tube in right internal jugular vein, in one case cannula was applied during cardiopulmonary resuscitation.V-A ECMO had been built for all the cases successfully, the median operation time was (45±26) min.The pump flow was 80-150 ml/(kg·min), the median duration of ECMO support was 153(14-567) h. Sixteen (64%) patients weaned off ECMO successfully, 15(60%) survived to hospital discharge.About the complication of cannula, six patients developed cannula site bleeding, and two patients required re-fixation of cannula, one patient's external jugular vein had been hurt and sutured for bleeding.

CONCLUSION

Application of right jugular vessels to build ECMO is easy and safe for treating the sick children. The skill should be proficient to assure ECMO run and reduce the complications.

Genetic effect of an A/G polymorphism in the HSP70 gene on thermotolerance in chicken

Studying thermotolerance is important for the prevention of thermostress in chickens. This study aimed to analyze the effect of mutations in the heat shock protein 70 (HSP70) gene on chicken thermotolerance. The C.-69A>G SNP in the 5'-flanking region of the HSP70 gene was genotyped in Lingshan and White Recessive Rock (WRR) chickens. Association of this SNP with thermotolerance traits revealed it to be significantly associated with CD4+/CD8+, and potentially associated with heterophil-to-lymphocyte ratio in WRR chickens exposed to thermoneutral temperature (15°C). Online prediction detected a putative myeloid zinc finger protein 1 binding factor in the C.-69A>G mutation. Under acute thermostress, mRNA levels of HSP70 in individuals with different C.-69A>G genotypes varied in the heart, leg muscle, and liver tissues. The HSP70 protein was expressed at higher levels in individuals with the GG genotype than in those with the AA genotype. In heart and liver, protein expression of HSP70 in individuals with the GG genotype was significantly higher than in those with the AA genotype. In leg muscle, protein expression was higher in birds with the GG genotype than in those with the AA and AG genotypes. Luciferase activity of the GG genotype was significantly higher than that of the AA genotype, suggesting that the C.-69A>G SNP regulates HSP70 gene expression. These results indicate that the C.-69A>G SNP in the 5'-flanking region of the HSP70 gene might affect chicken thermotolerance and that the GG genotype might be advantageous for the prevention of thermostress.

From splashing to bouncing: The influence of viscosity on the impact of suspension droplets on a solid surface

We experimentally investigated the splashing of dense suspension droplets impacting a solid surface, extending prior work to the regime where the viscosity of the suspending liquid becomes a significant parameter. The overall behavior can be described by a combination of two trends. The first one is that the splashing becomes favored when the kinetic energy of individual particles at the surface of a droplet overcomes the confinement produced by surface tension. This is expressed by a particle-based Weber number We_{p}. The second is that splashing is suppressed by increasing the viscosity of the solvent. This is expressed by the Stokes number St, which influences the effective coefficient of restitution of colliding particles. We developed a phase diagram where the splashing onset is delineated as a function of both We_{p} and St. A surprising result occurs at very small Stokes number, where not only splashing is suppressed but also plastic deformation of the droplet. This leads to a situation where droplets can bounce back after impact, an observation we are able to reproduce using discrete particle numerical simulations that take into account viscous interaction between particles and elastic energy.

Characterization of HSP70 and its expression in tissue: correlation with physiological and immune indices in goose (Anser cygnoides) serum

We cloned the goose heat shock protein 70 gene (HSP70), to determine its sequence variation and elucidate its mRNA expression. We designed primers to amplify the entire goose HSP70 sequence. We used 10 commercial Wuzong goslings in a heat-stress experiment. We collected tissue samples for RNA extraction and quantitative real-time polymerase chain reaction (qRT-PCR). We analyzed the variation in expression of goose HSP70 before and after heat stress. We constructed a DNA pool from six different species, for single nucleotide polymorphism (SNP) screening. We detected 18 SNPs and selected three of these SNPs for correlation analysis with biological and immune traits in 200 Wuzong geese. We showed that T+237C was significantly correlated with the serum corticosterone level, whereas T+1122C was significantly correlated with the heterophil to lymphocyte ratio. Goose HSP70 contained no introns. The results of qRT-PCR analysis revealed significant gender differences in the expression of goose HSP70 at 40°C but not at 25°C; moreover, in general, expression was significantly higher at 40°C than at 25°C. With the exception of the leg muscle and cerebellum, HSP70 expression was significantly higher in male geese than in female geese. Our results indicate that goose HSP70 plays an important role in response to severe heat stress.

Effects of different anesthetic approaches on postoperative complications in HIV-infected patients

The aim of this study was to investigate the effects of three different methods of anesthesia on patients with human immunodeficiency virus (HIV) infection, which could lead to an improvement in postoperative outcomes in these patients. A total of 90 patients undergoing an operation while being treated for an HIV infection were included in this study. Patients were divided into three groups (N = 30/group) based on the type of anesthesia administered: general anesthesia, local anesthesia, and combined spinal epidural anesthesia (CSEA). The effects of local infiltration of anesthesia and peripheral nerve block local anesthesia were examined in the local anesthesia group. The CSEA group examined the effects of spinal anesthesia in HIV-infected patients. We compared the vital signs of the three groups during the preoperative period, at incision, and during the postoperative recovery period. The CSEA group had a significantly higher mean preoperative CD4(+) T lymphocyte count compared with the general anesthesia and local anesthesia groups (P < 0.05). We found that the three kinds of anesthesia methods administered to HIV-infected patients could be used with considerable safety and can be selected according to the clinical need and type of surgical procedure.

Changes of peripheral-type benzodiazepine receptors in the penumbra area after cerebral ischemia-reperfusion injury and effects of astragaloside IV on rats

This study investigated the changes in peripheral benzodiazepine receptors (PBRs) in the penumbra after cerebral ischemia-reperfusion injury, and examined the effects of astragaloside IV (AST) on PBRs in rats. Sixty Sprague-Dawley rats were divided into a sham operation group, a model group, and three AST treatment groups. Cerebral ischemic models were induced by the clue-blocked method. Neurological deficits were examined. The animals were sacrificed after 2 h of ischemia and 24 h of reperfusion, and mitochondria from the penumbra were purified. PBR density (Bmax) and affinity were measured by radioligand assays. Mitochondrial [(3)H]PK11195 binding was correlated with neurological deficits in rats. Compared to the model group, the 10 mg/kg AST group, 40 mg/kg AST group, and 100 mg/kg AST group had fewer neurological deficits. The effects in the 40 mg/ kg group did not significantly differ from the effects in the 100 mg/ kg group. Compared to the model group, the 10 mg/kg AST group, 40 mg/kg group, and 100 mg/kg group had a decreased Bmax in the penumbra. The Bmax decreased in the 40 mg/kg AST group and in the 100 mg/kg AST group compared with the 10 mg/kg group. The Bmax and neurological deficits in the 40 mg/kg did not significantly differ from those in the 100 mg/kg group. By contrast, the AST-treated rats showed no significant changes in the binding parameter equilibrium dissociation constant compared with those in the sham operation group and the model group. AST protects ischemic brain tissue by inhibiting PBR expression after cerebral ischemia.

Alteration of HSF3 and HSP70 mRNA expression in the tissues of two chicken breeds during acute heat stress

This study aimed to estimate changes in HSF3 and HSP70 mRNA expression in stress-sensitive tissues of 2 chicken breeds during acute heat stress. Lingshan chickens (LSC) and White Recessive Rock (WRR) (24 chickens of each breed) were randomly divided into 4 groups (0, 2, 3, and 6 h of heat treatment). With increasing heat treatment time, both HSF3 and HSP70 expression first declined and then showed a significant increase in both breeds. However, HSP70 expression decreased in the heart following 6 h of heat treatment, whereas HSF3 expression continued to increase. After 2 h of heat treatment, HSF3 expression was significantly higher in the brain and leg muscle of LSC compared to WRR (P < 0.05, P < 0.01). In comparison, HSP70 expression was significantly higher in the liver and leg muscle of WRR compared to LSC (P < 0.01, P < 0.05). After 3 h of heat treatment, HSF3 expression was significantly higher in the brain and leg muscle of LSC compared to WRR (P < 0.01). In comparison, HSP70 expression was significantly higher in the liver and heart of LSC compared to WRR (P < 0.01). These results indicate that the expression of HSF3 and HSP70 mRNA in LSC and WRR exhibit species-specific and tissue-specific differences during heat treatment.

Effect of intracoronary tirofiban on platelet alpha-granule membrane protein and myocardial perfusion level during emergency percutaneous coronary intervention

This study aimed to investigate the effect of intracoronary application of tirofiban on platelet alpha-granule membrane protein (GMP-140) and myocardial perfusion levels during emergency percutaneous coronary intervention (PCI). A total of 70 patients who accepted emergency PCI treatment were randomly divided into tirofiban and control groups. We determined GMP-140 and troponin I (cTnI) levels before and 12 h after surgery, as well as N-terminal pro-brain natriuretic peptide levels 1 and 7 days after surgery in the two groups. The results showed that GMP-140 and cTnI levels were significantly (P < 0.01) lower in the tirofiban group than in the control group 12 h after operation (17.99 ± 1.01 vs 24.56 ± 1.96 μg/L and 50.96 ± 2.20 vs 58.69 ± 2.34 ng/mL, respectively). The D-value of the N-terminal pro-brain natriuretic peptide levels between 1 and 7 days after operation was significantly higher in the tirofiban group than in the control group (894.19 ± 90.91 vs 829.50 ± 84.18 pg/mL; P < 0.01). The intracoronary application of tirofiban during emergency PCI clearly reduced the GMP-140 level, inhibited the activation function of platelets, improved myocardial perfusion, and helped recover cardiac function in patients.

Dense suspension splat: monolayer spreading and hole formation after impact

We use experiments and minimal numerical models to investigate the rapidly expanding monolayer formed by the impact of a dense suspension drop against a smooth solid surface. The expansion creates a lacelike pattern of particle clusters separated by particle-free regions. Both the expansion and the development of the spatial inhomogeneity are dominated by particle inertia and, therefore, are robust and insensitive to details of the surface wetting, capillarity, and viscous drag.

Impact dynamics of granular jets with noncircular cross sections

Using high-speed photography, we investigate two distinct regimes of the impact dynamics of granular jets with noncircular cross sections. In the steady-state regime, we observe the formation of thin granular sheets with anisotropic shapes and show that the degree of anisotropy increases with the aspect ratio of the jet's cross section. Our results illustrate the liquidlike behavior of granular materials during impact and demonstrate that a collective hydrodynamic flow emerges from strongly interacting discrete particles. We discuss the analogy between our experiments and those from the Relativistic Heavy Ion Collider, where similar anisotropic ejecta from a quark-gluon plasma have been observed in heavy-ion impact.

Asymmetries in core-collapse supernovae from maps of radioactive 44Ti in Cassiopeia A

Asymmetry is required by most numerical simulations of stellar core-collapse explosions, but the form it takes differs significantly among models. The spatial distribution of radioactive (44)Ti, synthesized in an exploding star near the boundary between material falling back onto the collapsing core and that ejected into the surrounding medium, directly probes the explosion asymmetries. Cassiopeia A is a young, nearby, core-collapse remnant from which (44)Ti emission has previously been detected but not imaged. Asymmetries in the explosion have been indirectly inferred from a high ratio of observed (44)Ti emission to estimated (56)Ni emission, from optical light echoes, and from jet-like features seen in the X-ray and optical ejecta. Here we report spatial maps and spectral properties of the (44)Ti in Cassiopeia A. This may explain the unexpected lack of correlation between the (44)Ti and iron X-ray emission, the latter being visible only in shock-heated material. The observed spatial distribution rules out symmetric explosions even with a high level of convective mixing, as well as highly asymmetric bipolar explosions resulting from a fast-rotating progenitor. Instead, these observations provide strong evidence for the development of low-mode convective instabilities in core-collapse supernovae.

Still water: dead zones and collimated ejecta from the impact of granular jets

When a dense granular jet hits a target, it forms a large dead zone and ejects a highly collimated conical sheet with a well-defined opening angle. Using experiments, simulations, and continuum modeling, we find that this opening angle is insensitive to the precise target shape and the dissipation mechanisms in the flow. We show that this surprising insensitivity arises because dense granular jet impact, though highly dissipative, is nonetheless controlled by the limit of perfect fluid flow.

A rapidly spinning supermassive black hole at the centre of NGC 1365

Broad X-ray emission lines from neutral and partially ionized iron observed in active galaxies have been interpreted as fluorescence produced by the reflection of hard X-rays off the inner edge of an accretion disk. In this model, line broadening and distortion result from rapid rotation and relativistic effects near the black hole, the line shape being sensitive to its spin. Alternative models in which the distortions result from absorption by intervening structures provide an equally good description of the data, and there has been no general agreement on which is correct. Recent claims that the black hole (2 × 10(6) solar masses) at the centre of the galaxy NGC 1365 is rotating at close to its maximum possible speed rest on the assumption of relativistic reflection. Here we report X-ray observations of NGC 1365 that reveal the relativistic disk features through broadened Fe-line emission and an associated Compton scattering excess of 10-30 kiloelectronvolts. Using temporal and spectral analyses, we disentangle continuum changes due to time-variable absorption from reflection, which we find arises from a region within 2.5 gravitational radii of the rapidly spinning black hole. Absorption-dominated models that do not include relativistic disk reflection can be ruled out both statistically and on physical grounds.

Telomerase assay in renal cancer

Telomeres are repeating sequences located at each end of eukaryotic chromosomes. These sequences function to protect chromosome positioning and replication (1-3). In vertebrates, telomere DNA consists of tandem repeats of TTAGGG, 10-15 kb pairs long (4). In most normal cells, DNA replication during mitosis results in the loss of telomere sequences 50-100 bp at the 5' ends of DNA termini (1,5). This sequence loss is mandated by the end-replication-splicing problem (Fig. 1). Thus, telomeres progressively shorten with age in somatic cells in culture and in vivo. In contrast, cancer cells and malignant cell lines retain telomere length despite repeated mitosis (6). This is believed to be an essential component of immortalization for most cells. Fig. 1. End-replication problem. As the replication fork proceeds from left to right, the leading strand proceeds to replicate one strand of original DNA (see B). The direction of the lagging strand is opposite to the direction of the replication fork and relies on the ligation of Okazaki fragments, which are primed with short stretches. Most RNA primer is never replaced with DNA (see C). Consequently, each round of replication produced a daughter chromosome. These are deficient in the sequences corresponding to the original 3' ends.

QSAR studies on imidazopyrazine derivatives as Aurora A kinase inhibitors

Aurora kinases have emerged as attractive targets for the development of novel anti-cancer agents. A combined study of molecular docking, pharmacophore modelling and 3D-QSAR was performed on a series of imidazo [1, 2-a] pyrazines as novel Aurora kinase inhibitors to gain insights into the structural determinants and their structure-activity relationship. An ensemble of conformations based on molecular docking was used for PHASE pharmacophore studies. The developed best-fitted pharmacophore model was validated by diverse chemotypes of Aurora A kinase inhibitors and was consistent with the structural requirements for the docked binding mechanism. Subsequently, the pharmacophore-based alignment was used to develop PHASE and comparative molecular similarity indices analysis (CoMSIA) 3D-QSAR models. The best CoMSIA model showed good statistics (q (2 )= 0.567, r (2 )= 0.992), and the predictive ability of the model was validated using an external test set of 13 compounds giving a satisfactory prediction ([Formula: see text]). The 3D contour maps provided insight into the binding mechanism and highlighted key structural features that are essential to the inhibitory activity. Based on the PHASE and CoMSIA 3D-QSAR results, a set of novel Aurora A inhibitors were designed that showed excellent potencies.

Underwater bubble pinch-off: transient stretching flow

At the point of pinch-off of an underwater air bubble, the speed of water rushing in diverges. Previous studies that assumed radial flow throughout showed that the local axial shape is two smoothly connected, slender cones that transition very slowly (logarithmically) to a cylindrical segment. Our simulations show that even with initially radial flow, a transient vertical flow develops with comparable speeds. Bernoulli pressure draws water into the singularity region while incompressibility forces it away from the neck minimum, generating significant vertical flows that rapidly slenderize and symmetrize the collapse region. This transition is due to a different mechanism, occurring much faster than previously expected. Vertical flows dictate the neck shape evolution.

Molecular analysis of an additional case of hybrid sterility in rice (Oryza sativa L.)

Hybrid sterility hinders the exploitation of the heterosis displayed by japonica × indica rice hybrids. The variation in pollen semi-sterility observed among hybrids between the japonica recipient cultivar and each of two sets of chromosome segment substitution lines involving introgression from an indica cultivar was due to a factor on chromosome 5 known to harbor the gene S24. S24 was fine mapped to a 42 kb segment by analyzing a large F(2) population bred from the cross S24-NIL × Asominori, while the semi-sterility shown by the F(1) hybrid was ascribable to mitotic failure at the early bicellular pollen stage. Interestingly, two other pollen sterility genes (f5-Du and Sb) map to the same region (Li et al. in Chin Sci Bull 51:675-680, 2006; Wang et al. in Theor Appl Genet 112:382-387, 2006), allowing a search for candidate genes in the 6.4 kb overlap between the three genes. By sequencing the overlapped fragment in wild rice, indica cultivars and japonica cultivars, a protein ankyrin-3 encoded by the ORF2 was identified as the molecular base for S24. A cultivar Dular was found to have a hybrid-sterility-neutral allele, S24-n, in which an insertion of 30 bp was confirmed. Thus, it was possible to add one more case of molecular bases for the hybrid sterility. No gamete abortion is caused on heterozygous maternal genotype with an impaired sequence from the hybrid-sterility-neutral genotype. This result will be useful in understanding of wide compatibility in rice breeding.

Impact of a viscous liquid drop

We simulate the impact of a viscous liquid drop onto a smooth dry solid surface. As in experiments, when ambient air effects are negligible, impact flattens the falling drop without producing a splash. The no-slip boundary condition at the wall produces a boundary layer inside the liquid. Later, the flattening surface of the drop traces out the boundary layer. As a result, the eventual shape of the drop is a "pancake" of uniform thickness except at the rim, where surface tension effects are significant. The thickness of the pancake is simply the height where the drop surface first collides with the boundary layer.

Could changes in arterioles impede the perivascular drainage of interstitial fluid from the cerebral white matter in leukoaraiosis?

AIMS

Leukoaraiosis (LA) is the increase in fluid in cerebral white matter with hyperintensity on T2-weighted MR imaging that occurs in 25% of individuals over 65 years of age and in Alzheimer's disease. Age, hypertension, diabetes mellitus and cardiac disease are the major risk factors for LA. Ischaemia is considered to be the cause of LA, but the aim of the present study is to assess whether changes in arterioles in LA could impede perivascular lymphatic drainage of interstitial fluid from the cerebral white matter.

METHODS

We quantified arteriolosclerosis and immunohistochemical changes in the extracellular matrix in arterioles of cerebral white matter in 20 hypertension autopsy cases with LA and in 10 controls.

RESULTS

The ratio of the area immunoreactive for collagen types I, III, V and VI to the cross-sectional area of arterioles was significantly higher in LA patients compared with controls (P < 0.001). Changes were observed in collagen IV and laminin. The walls of white matter arterioles in LA were significantly thicker (P < 0.01), and lumina were significantly smaller (P < 0.01). Arterioles had a significantly higher sclerotic index [1 - (internal/external diameter)] in LA than in adjacent cortex or control white matter (P < 0.01).

CONCLUSIONS

Our results show that thickening and sclerosis of the walls of arterioles in cerebral white matter in LA are associated with the accumulation of extracellular matrix components. Although these changes may result in decreased perfusion, they could also impede perivascular lymphatic drainage of interstitial fluid from white matter in LA.

Hypertension and TIA

Transient ischemic attack is a medical emergency because early stroke risk after transient ischemic attack is high. Hypertension is the most important modifiable risk factor for stroke and transient ischemic attack. The aims of this review are to provide a summary of the current knowledge concerning the relationship between blood pressure and transient ischemic attack, as well as outline issues regarding diurnal variation and the potential of chronotherapy (timing medications to accord with diurnal patterns of blood pressure). There is a strong relationship between hypertension and the incidence of transient ischemic attack and the subsequent short-term risk for stroke. Ambulatory blood pressure monitoring is a reliable diagnostic and monitoring tool for hypertension and provides additional information about diurnal variation in blood pressure. Different diurnal blood pressure patterns may confer variable stroke risk. Patients with stroke commonly have abnormal diurnal blood pressure patterns and this may relate, in part, to autonomic nervous system dysfunction. However, blood pressure patterns have not been systematically studied in patients with transient ischemic attack. Blood pressure remains poorly controlled in a large proportion of patients after transient ischemic attack and under-treatment and poor adherence are important factors. Chronotherapy for blood pressure may result in more effective blood pressure control. More research is needed in this area. Hypertension is strongly associated with transient ischemic attack. Diurnal blood pressure patterns may influence subsequent stroke risk after transient ischemic attack and more evidence is needed to inform clinical practice to improve blood pressure management for transient ischemic attack patients.

Asymmetric disconnection of an underwater air bubble: persistent neck vibrations evolve into a smooth contact

The disconnection of an underwater bubble illustrates how slight initial asymmetries can prevent the formation of a finite-time singularity. Creating a singularity by focusing a finite amount of energy dynamically into a vanishingly small amount of material requires that the initial condition be perfectly symmetric. In reality, imperfections are always present. We show a slight azimuthal asymmetry in the initial shape of the bubble neck excites vibrations that persist over time. As a result, the focusing singularity is generically preempted by a smooth contact.

Force balance at the transition from selective withdrawal to viscous entrainment

We simulate the evolution of the steady-state interface in the selective withdrawal regime. Selective withdrawal ends when the upward pull exerted by the viscous flow in the withdrawing liquid layer overcomes the downward force due to surface tension. The lower-layer dynamics are unimportant. The dominant contribution to the surface-tension force comes from the large area where the interface is weakly deflected, instead of the small area where the surface is most distorted. A scaling estimate based on this idea yields results that agree quantitatively with both simulations and previous experiments.

Influence of grape seed proanthocyanidin extract in broiler chickens: effect on chicken coccidiosis and antioxidant status

Grape seed proanthocyanidin extract (GSPE) has been widely used as a human food supplement for health promotion and disease prevention. However, there was little information regarding its application in animal nutrition. The aim of the current study is to determine the effect of GSPE at different concentrations on chicken performance, and the status of antioxidant/oxidant system after the Eimeria tenella infection. In the first experiment, GSPE incorporated in the diet at 5, 10, 20, 40, and 80 mg/kg significantly decreased mortality and increased weight gain after the E. tenella infection, and the protective effect of GSPE was dose-dependent. The lowest mortality and the greatest growth gains were recorded in the group of birds fed with GSPE between 10 to 20 mg/kg. In the second experiment, 12 mg/kg of GSPE supplementation in the diet significantly reduced the mortality and lesion scores in birds after the infection with 5 x 10(4) and 1 x 10(5) oocysts of E. tenella. The weight gains also improved significantly. After the oral infection with 5 x 10(4) and 1 x 10(5) of E. tenella, analysis of the status of antioxidant/oxidant system revealed that plasma NO increased significantly from 7.11 to 21.31 micromol/L, plasma superoxide dismutase (SOD) decreased from 126.55 to 111.14 U/mL, and malondiadehyde increased, suggesting oxidative stress was increased in circulation. However, supplementation of 12 mg/kg GSPE reduced the level of plasma NO from 21.31 to 14.73 micromol/L and increased plasma SOD activities from 111.14 to 133.27 U/mL. The effects of incorporation of GSPE into the poultry diet on the concentration of plasma NO, malondiadehyde, and SOD indicated that the lower concentration of dietary GSPE was able to restore the balance of antioxidant/oxidant system that was exerted by the oxidative stress after the parasite infection. The current results suggested GSPE can act as an antioxidant in diet to improve the performance of broiler chickens and remedy the clinical symptoms caused by the oxidative stress of E. tenella infection.

Bridging dielectric fluids by light: a ray optics approach

Rayleigh-Plateau instability is known to impose a stability limit for the length of a liquid bridge in weightless conditions. This fundamental limit may be exceeded by using a light field to form and stabilize dielectric fluid bridges (A. Casner, J.P. Delville, Europhys. Lett. 65, 337 (2004)). Using both new experimental data as well as a new theoretical approach, we show that both the size and the stability of such light-sustained dielectric bridge can be qualitatively explained. We present a ray optics model that encompasses the competition between surface tension effects and optical radiation pressure arising from total internal reflection inside the bridge. A critical power below which a liquid bridge can no longer be sustained by light is predicted and confirmed experimentally. The observed power dependence of the bridge diameter also agrees with the proposed stabilization mechanism.

The 5S rDNA related repetitive sequences in the sex chromosomes of the spiny eel (Mastacembelus aculeatus)

The karyotype of the spiny eel (Mastacembelus aculeatus) has highly evolved heteromorphic sex chromosomes. X and Y chromosomes differ from each other in the distribution of heterochromatin blocks. To characterize the repetitive sequences in these heterochromatic regions, we microdissected the X chromosome, constructed an X chromosome library, amplified the genomic DNA using PCR and isolated a repetitive sequence DNA family by screening the library. All family members were clusters of two simple repetitive monomers, MaSRS1 and MaSRS2. We detected a conserved 5S rDNA gene sequence within monomer MaSRS2; thus, tandem-arranged MaSRS1s and MaSRS2s may co-compose 5S rDNA multigenes and NTSs in M. aculeatus. FISH analysis revealed that MaSRS1 and MaSRS2were the main components of the heterochromatic regions of the X and Y chromosomes. This finding contributes additional data about differentiation of heteromorphic sex chromosomes in lower vertebrates.