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Objective: To investigate the protective effect of endogenous ω-3 polyunsaturated fatty acid (PUFA) against cisplatin-induced myelosuppression and the mechanism of reducing apoptosis in bone marrow nucleated cells using mfat-1 transgenic mice., Methods: The experimental animals were divided into 4 groups: wild-type mice normal control group, mfat-1 transgenic mice normal control group, wild-type mice model group and mfat-1 transgenic mice model group. The mice in the model group were injected intraperitoneally with 7.5 mg/kg cisplatin on day 0 and day 7 to construct a myelosuppression model, while the mice in the normal control group were injected intraperitoneally with an equal amount of saline, and their status was observed and their body weight was measured daily. Peripheral blood was taken after 14 day for routine blood analysis, and the content and proportion of PUFA in peripheral blood were detected using gas chromatography. Bone marrow nucleated cells in the femur of mice were counted. The histopathological changes in bone marrow were observed by histopathological staining. The apoptosis of nucleated cells and the expression level changes of apoptosis-related genes in the bone marrow of mice were detected by flow cytometry and fluorescence quantitative PCR., Results: Compared with wild-type mice, mfat-1 transgenic mice showed significantly increased levels of ω-3 PUFA in peripheral blood and greater tolerance to cisplatin. Peripheral blood analysis showed that endogenous ω-3 PUFA promoted the recovery of leukocytes, erythrocytes, platelets and haemoglobin in peripheral blood of myelosuppressed mice. The results of HE staining showed that endogenous ω-3 PUFA significantly improved the structural damage of bone marrow tissue induced by cisplatin. Flow cytometry and PCR showed that, compared with wild-type mice model group, the apoptosis rate of bone marrow nucleated cells in mfat-1 transgenic mice was significantly reduced ( P < 0.001), and the expression of anti-apoptotic genes Bcl-2 mRNA was significantly increased ( P < 0.01), while the expressions of pro-apoptotic genes Bax and Bak mRNA were significantly reduced ( P < 0.001, P < 0.05)., Conclusion: Endogenous ω-3 PUFA can reduce cisplatin-induced apoptosis in bone marrow nucleated cells, increase the number of peripheral blood cells and exert a protective effect against cisplatin-induced myelosuppression by regulating the expression of apoptosis-related genes.

Objective: The epidemiological characteristics of tuberculosis deaths among Chinese residents from 2006 to 2021 were analyzed, and the tuberculosis mortality rate from 2022 to 2027 was predicted to provide a reference for tuberculosis prevention and control in China. Methods: The data set of tuberculosis deaths from 2006 to 2021 was published regularly by the China CDC, and the crude mortality rate (CMR) and age-standardized mortality rates (ASMR) were calculated according to the population structure of China in 2000. The distribution characteristics of age, sex, region, and time of tuberculosis deaths were analyzed, the Joinpoint regression analysis model was used to analyze the changing trend, and the grey model was applied to predict CMR and ASMR from 2022 to 2027. Results: From 2006 to 2021, the CMR and ASMR of tuberculosis showed a downward trend among males and females, urban and rural areas, and all age groups, in a word, all the Chinese residents. Except for the age group ≥85 years old, the mortality trend was insignificant. In the eastern, central, or western regions. CMR and ASMR were significantly higher in males than in females.CMR and ASMR were significantly lower in urban areas than in rural areas. In general, active tuberculosis patients present a higher mortality rate. The CMR and ASMR in the western region were higher than those in the eastern and central regions and lower in the eastern region than in the central region, but the differences were less obvious. The ASMR of the eastern cities was lower than that of the central and western regions, and the ASMR of the central cities was higher than that of the western region from 2006 to 2009 and 2012 and lower than that of the western region in other years. The ASMR in the western countryside was higher than that in the eastern and central regions and lower in the eastern part than in the central region, but the difference was not obvious. The grey model prediction results show that the CMR (/100 000) of Chinese residents from 2022 to 2027 is 1.585, 1.471, 1.360, 1.250, 1.143, and 1.038, and the ASMR (/100 000) is 0.779, 0.653, 0.531, 0.411, 0.295 and 0.181, respectively. Conclusions: The CMR and ASMR of tuberculosis will continue to decline, and extraordinary achievements have been made in tuberculosis prevention and control in Chinese residents from 2006 to 2021 and, presumably, from 2022 to 2027. However, tuberculosis screening and treatment programs in the western region, men, the elderly population, and rural areas should be further strengthened, and targeted prevention and control measures should be formulated to reduce mortality.

The southwestern region of China is the largest exposed karst area in the world and serves as an important ecological security barrier for the upstream of Yangtze River and Pearl River. Different from the critical zone of non-karst areas, the epikarst, formed by an interwoven network of denudation pores, is the core area of karst critical zone. Water is the most active component that participates in internal material cycle and energy flow within the critical zone. We reviewed relevant research conducted in the southwestern region from three aspects: the characte-rization of critical zone structure, the hydrological processes of soil-epikarst system, and their model simulations. We further proposed potential research hotpots. The main approach involved multi-scale and multi-method integrated observations, as well as interdisciplinary collaboration. Precisely characterizing the eco-hydrological processes of the vegetation-soil-epikarst coupling system was a new trend in the future research. This review would provide scientific reference for further studies on hydrological processes in critical zones and regional hydrological water resource management in karst areas.

Objective: To investigate the early predictors of respiratory depression in patients with glufosinate poisoning, and provide reference for clinicians to make decisions. Methods: In March 2022, the clinical data of patients with glufosinate poisoning admitted to the intensive care unit of the Affiliated Xiangshan Hospital of Wenzhou Medical University from March 2018 to January 2022 were retrospectively analyzed. The patients were divided into respiratory depression group and non-respiratory depression group according to the occurrence of respiratory depression during hospitalization. The clinical data such as age, gender, past history, intake, initial treatment and laboratory examination were compared between the two groups. Multivariate logistic regression was used to analyze the predictors of respiratory depression in patients with glufosinate poisoning, and its predictive value was analyzed by receiver operating characteristic (ROC) curve. Results: A total of 34 patients with glufosinate poisoning were enrolled, including 13 patients in non-respiratory depression group and 21 patients in respiratory depression group. There were significant differences in intake, blood amylase and bicarbonate radical in arterial blood gas between the two groups ( P <0.05). Respiratory depression occurred at 6.5-48.0 h after ingestion, with a median of 15.0 (9.5, 24.0) h. Multivariate logistic regression analysis showed that the intake of glufosinate ( OR =1.440, 95% CI : 1.033-2.009, P =0.032) and bicarbonate radical in arterial blood gas ( OR =0.199, 95% CI : 0.040-0.994, P =0.049) were predictors of respiratory depression in patients with glufosinate poisoning, and the area under the curve (AUC) of ROC curves were 0.936 and 0.842. The optimal cut-off values were 15.0 g (sensitivity=95.2%, specificity=76.9%) and 17.6 mmol/L (sensitivity=71.4%, specificity=84.6%), respectively. Conclusion: The intake of glufosinate and bicarbonate radical in arterial blood gas have good prediction effects on the occurrence of respiratory depression in patients with glufosinate poisoning.

Objective: To compare the geographical differences and time trends of liver cancer incidence and mortality in different regions around the world so as to predict the future burden of liver cancer. Methods: The incidence and mortality data of liver cancer in different Human Development Index (HDI) countries from 2000 to 2020 were collected from the GLOBOCAN 2020 database. The joinpoint model and annual percent change (APC) were used to analyze the liver cancer global incidence and mortality as well as future epidemic trends from 2000 to 2020. Results: ASMR for male liver cancer was increased from 8.0/100, 000 in 2000 to 7.1/100,000 in 2015 (APC = -0.7, 95% CI : -1.2 ~ -0.3, P = 0.002), while ASMR for female liver cancer was increased from 3.0/100, 000 in 2000 to 2.8/100, 000 in 2015 (APC = -0.5, 95% CI : -0.8 ~ -0.2, P < 0.001). The ratio of male to female ASMR was 2.67:1 in 2000 and 2.51:1 in 2015, indicating a slight narrowing of the difference in mortality between men and women. In 2020, the global ASIR and ASMR for liver cancer were 9.5/100 000 and 8.7/100 000, respectively. Male ASIR and ASMR (14.1/100, 000 and 12.9/100, 000, respectively) were 2 ~ 3 times higher than females (5.2/100, 000 and 4.8/100, 000, respectively). There were significant differences between ASIR and ASMR in different HDI countries and regions ( P (ASIR) = 0.008, P (ASMR) < 0.001), and the distributions of ASMR and ASIR were very similar. New cases and deaths were expected to increase by 58.6% (143,6744) and 60.9% (133, 5 375) in 2040, with the number of cases and deaths increasing by 39,7003 and 37,4208 in Asia, respectively. Conclusion: ASMR due to liver cancer worldwide has had a downward trend between 2000 and 2015. However, the latest epidemiological status and predictions of liver cancer in 2020 indicate that prevention and control will still be a major challenge globally in the next 20 years.

In China, the incidence of liver cancer remains high. Approximately 80% of diagnosed patients are in the intermediate and advanced stages, with a high recurrence rate and poor prognosis after surgery. Therefore, substantially reducing the incidence and mortality has always been a major clinical challenge for liver cancer. In recent years, immune checkpoint inhibitor therapy represented by programmed death protein 1 (PD-1) antibody is gradually innovating the traditional paradigm of tumor treatment, but the beneficiary population in liver cancer patients is relatively limited. With the rapid development of high-throughput sequencing, proteomics and immunomics and other fields, the demand for precision medicine continues to increase. Tumor vaccines, especially derived from neoantigens, have shown promising therapeutic effects in malignant solid tumors such as melanoma and non-small cell lung cancer due to their immunogenicity. Combining the latest research reports at home and abroad, this paper emphasis on whether tumor vaccines can effectively treat or even cure liver cancer.

Objective: To investigate the blood pressure change in patients with acute ischemic stroke (AIS) and hypertension treated with cinepazide maleate injection. Methods: This was a subgroup analysis of post-marketing clinical confirmation study of cinepazide maleate injection for acute ischemic stroke: a randomized, double-blinded, multicenter, placebo-parallel controlled trial, which conducted in China from August 2016 to February 2019. Eligible patients fulfilled the inclusive criteria of acute anterior circulation ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 7-25. The primary endpoints were mean blood pressure of AIS patients treated with cinepazide maleate or control, which were assessed during the treatment period (14 days), and the proportion of the patients with normal blood pressure was analyzed after the treatment period. Furthermore, a subgroup analysis was performed to investigate a possible effect of the history of hypertension on outcomes. Results: This analysis included 809 patients with hypertension. There was no significant difference in patients blood pressure and the proportion of patients with normal blood pressure (60.5% vs. 59.0%, P >0.05) between cinepazide maleate group and control group. Conclusion: Administration of cinepazide maleate injection does not affect the management of clinical blood pressure in patients with AIS.

Objective: To investigate the clinical characteristics, differential diagnosis, treatments and prognosis of facial nerve hemangioma and schwannoma at genicular ganglion, so as to provide reference for clinical diagnosis and treatments of facial nerve tumor at genicular ganglion. Methods: Clinical data of 13 patients with facial nerve tumors at genicular ganglion confirmed by postoperative pathology in the Ninth People's Hospital affiliated to Shanghai Jiaotong University School of Medicine from March 2018 to April 2020 were retrospectively analyzed, including seven cases of hemangioma and six cases of schwannoma. There were eight males and five females. Their ages ranged from 20 to 65, with an average age of 40. The course of disease ranged from 3 to 118 months, with an average of 52 months. All the patients underwent preoperative HRCT of the temporal bone and facial nerve dynamic contrast-enhanced(DCE) MRI examinations. All the patients had detailed surgical procedures and at least one-year postoperative follow-up. Results: On HRCT of the temporal bone, (4/7) hemangioma at geniculate ganglion showed characteristic honeycomb appearance, while 6/6 schwannoma and 3/7 hemangiomas showed expansive bone changes. On DCE-MRI, geniculate ganglion hemangioma (7/7) showed characteristic "point-to-surface" enhancement, and schwannoma (6/6) showed characteristic "face-to-surface" enhancement. For five hemangioma-patients with HB-Ⅱ-Ⅳ before surgery, the facial nerve anatomy was completely preserved through transcanal endoscopic approach(TEA), and the facial nerve function improved one year after surgery (two cases of HB-I, two cases of HB-Ⅱ, and one case of HB-Ⅲ). For two patients, with preoperative facial nerve function HB-Ⅴ-Ⅵ, since their tumors was inseparable from the nerves, they were performed with facial nerve anastomosis during the surgery, and the facial nerve function was improved to HB-Ⅳ level one year after surgery. For six patients with meningioma whose facial nerve function was greater than or equal to HB-Ⅲ, based on the preoperative hearing level, the involved segments, and duration of facial paralysis, three of them were conducted surgeries through middle cranial fossa approach, one by translabyrinthine approach, and one via mastoid approach. Two patients among them with complete facial paralysis over three years preoperatively were not performed facial nerve anastomosis after total resections of the tumors, and there was no improvement in facial nerve function one year after surgery. Three patients underwent facial nerve anastomosis after total tumor resections, and their facial nerve function was HB-Ⅲ in one patient, HB-Ⅳ in two patients one year after surgery. One patient (preoperative HB-Ⅲ) had a normal hearing level preoperatively, and the tumor involved the labyrinth segment. To protect the hearing, partial tumor was resected through the middle cranial fossa approach, and facial nerve function improved to HB-Ⅱ one year after surgery. Conclusions: Temporal bone HRCT combined with DCE-MRI are useful for the differential diagnosis of hemangioma and schwannoma at geniculate ganglion and provide references for preoperative clinical decision makings. It is extremely necessary to select the appropriate surgical approach based on the patient's hearing and involved segments. For geniculate ganglion hemangioma, early surgery can improve the possibilities of anatomical integrity of facial nerve, thereby improving facial nerve function postoperatively.TEA is a kind of surgical method worth consideration, with the characteristics of minimally invasive, favorable postoperative features, and so on. For schwannoma, one-stage functional reconstruction of the facial nerve is recommended during the resection of the tumors because of the inevitable damage to the anatomical integrity of the facial nerve.

Golgi protein 73 (GP73) is a transmembrane protein on the Golgi apparatus and can be cut and released into the blood. In recent years, an increasing number of clinical studies have shown that the elevated serum GP73 level is closely related to liver diseases. And thus GP73 is expected to be used as a new serum marker for assessing progress of chronic liver diseases. Herein, the clinical application of serum GP73 in chronic hepatitis, liver fibrosis, liver cirrhosis and hepatocellular carcinoma with different etiologies was reviewed based on available literatures; and a research outlook in this field is made.

Objectives: To study the effect of gap junction blockers, quinine (QUIN) and carbenoxolone (CBX), on hippocampal ripple energy expression in rats with status epilepticus (SE)., Methods: A total of 24 rats were randomly divided into four groups: model, QUIN, valproic acid (VPA), and CBX ( n =6 each). A rat model of SE induced by lithium-pilocarpine (PILO) was prepared. The QUIN, VPA, and CBX groups were given intraperitoneal injection of QUIN (50 mg/kg), VPA by gavage (200 mg/kg), and intraperitoneal injection of CBX (50 mg/kg) respectively, at 3 days before PILO injection. Electroencephalography was used to analyze the change in hippocampal ripple energy before and after modeling, as well as before and after chloral hydrate injection to control seizures., Results: Ripple expression was observed in the hippocampal CA1, CA3, and dentate gyrus regions of normal rats. After 10 minutes of PILO injection, all groups had a gradual increase in mean ripple energy expression compared with 1 day before modeling, with the highest expression level before chloral hydrate injection in the model, VPA and CBX groups ( P <0.05). The QUIN group had the highest expression level of mean ripple energy 60 minutes after PILO injection. The mean ripple energy returned to normal levels in the three intervention groups immediately after chloral hydrate injection, while in the model group, the mean ripple energy returned to normal levels 1 hour after chloral hydrate injection. The mean ripple energy remained normal till to day 3 after SE in the four groups. The changing trend of maximum ripple energy was similar to that of mean ripple energy., Conclusions: The change in ripple energy can be used as a quantitative indicator for early warning of seizures, while it cannot predict seizures in the interictal period. Gap junction blockers can reduce ripple energy during seizures.

The cross combination of dry-method(network pharmacology analysis) and wet-method(high-resolution mass spectro-metry with antioxidation experiment) was used to predict antioxidant quality markers(Q-markers) of Hippophae tibetana. Ultra-high performance liquid chromatography coupled with hybrid quadrupole-orbitrap mass spectrometry(UPLC-Q-Exactive Orbitrap-MS) was developed to rapidly separate and identify the chemical constituents in H. tibetana. Then in DPPH free radicals and superoxide anion scavenging experiment, the antioxidant activity of the four different polar parts with extracts of petroleumether, ethyl acetate, n-butanol and water was evaluated. Network pharmacology method was used for functional enrichment and pathway analysis to screen antioxidant-related components and preliminarily explain the mechanism of action. On this basis, multi-source information was integrated to predict the antioxidant Q-markers. The results showed that 51 components in H. tibetana were identified, including 18 flavonoids, 14 terpenoids, 6 alkaloids, 4 coumarins and phenylpropanoids, 3 volatile components and 2 polyphenols. The antioxidant capacity of different fractions: ethyl acetate &gt; n-butanol &gt; water &gt; petroleum ether. The medicine mainly acted on PI3 K-Akt and FoxO signaling pathways to perform antioxidant effects through flavonoids such as quercetin, luteolin and kaempferol. According to the results of dry-method and wet-method, quercetin, luteolin and kaempferol, the representatives of poly-hydroxy flavone, may be the antioxidant Q-markers of H. tibetana. In this study, with the antioxidant Q-markers of H. tibetana as an example, an investigation model of predicting Q-marker was discussed based on the ternary system of composition, function and informatics, providing a scientific basis for the establishment of quality evaluation standards for H. tibetana.

Epikarst is the core area of karst critical zone, with important hydrologic regulation and storage function. However, the effects of karst development degree on hydrologic characteristics of epikasrt is still unclear. We used geophysical exploration and hydrogeological techniques, combined with the dynamic monitoring of moisture and water levels, to quantify the karst development degrees and their hydrologic characteristics on slope lands. We analyzed the responses of soil-epikarst systems to rainfall. Results showed that geophysical exploration technology could be well applied to the detection of surface-subsurface structures in the karst areas. The average thickness of soil and surface karst zone on the slope was less than 0.63 m and 2.60 m, respectively. The slopes of strong-karstification characterized by high apparent resistivity, well-developed joint fractures, and strong permeability (0.73 m·d -1 ). Such a result indicated that epikarst could regulate precipitation. The responses of soil moisture had a larger rainfall threshold (>20.50 mm·d -1 ) and the water level was determined by rainfall amount. In contrast, the slope with weak-karstification had low apparent resistivity and weak permeability (0.07 m·d -1 ). Moisture and water level were sensitive to rainfall. Karst channels were developed locally at 240-300 cm with a permeability coefficient of up to 432 mm·d -1 . Obvious preferential flow was observed in extreme rainfall events on this slope, which could induce flood disaster in the adjacent depression. Our results would provide scientific basis for further research on water resources regulation, management, and eco-hydrology in karst areas of southwest China.

Objective: To verify the accuracy and effectiveness of Goldengate high-throughput deafness gene chip in detecting the patients with enlarged vestibular aqueduct syndrome(EVAS), and to provide a reference for genetic detection strategy of EVAS. Methods: From August 2016 to February 2018, 15 patients with EVAS and 60 normal controls were detected by Goldengate high-throughput deafness detection chip developed by our team, and the results were verified by Sanger sequencing. SLC26A4 gene sequencing was carried out in all the patients with EVAS. Results: 12/15 of patients with EVAS were detected mutations of SLC26A4 gene. Nine mutations were detected by chip detection and SLC26A4 gene direct sequencing, seven of which were detected by both methods. The chip could detect 93.33%(28/30) of the allele information provided by SLC26A4 gene direct sequencing. In addition to SLC26A4 gene, mutations of GJB2 , PCDH15 , TMC1 , MYO6 and mitochondrial genes were detected in 15 patients with EVAS. These results were verified by Sanger sequencing. Conclusion: Goldengate high-throughput deafness gene chip possesses the traits of wide coverage and high accuracy, which can be used as a preliminary detection method for patients with EVAS.

Objective: To study the effect of advanced maternal age (AMA) on the development of hippocampal neural stem cells in offspring rats., Methods: Ten 3-month-old and ten 12-month-old female Sprague-Dawley rats were housed individually with 3-month-old male rats (1:1, n=20), whose offspring rats were assigned to a control group and an AMA group. A total of 40 rats were randomly selected from each group. Immunofluorescence assay and Western blot were used to localize and determine the levels of protein expression of Nestin and doublecortin (DCX) on day 7 as well as neuronal nuclear antigen (NeuN) and glial fibrillary acidic protein (GFAP) on day 28 (n=8 for each marker). Immunofluorescence assay was also used to localize the hippocampal expression of polysialylated isoforms of neural cell adhesion molecule (PSA-NCAM) on day 14 (n=8 for each marker)., Results: According to the Western blot results, the AMA group had significantly lower protein expression of DCX than the control group (P<0.05), while there were no significant differences in the protein expression of Nestin, NeuN, and GFAP between the two groups (P>0.05). According to the results of immunofluorescence assay, the AMA group had significantly lower protein expression of Nestin, DCX, and PSA-NCAM in the hippocampal dentate gyrus (DG) region than the control group (P<0.05), while there were no significant differences in the above indices in the hippocampal CA1 and CA3 regions between the two groups (P>0.05). The AMA group had significantly higher expression of NeuN in the hippocampal CA1 region than the control group (P<0.01), while there were no significant differences in the expression of NeuN in the hippocampal DG and CA3 regions between the two groups (P>0.05). The AMA group had significantly lower expression of GFAP in the hippocampal CA1, CA3, and DG regions than the control group (P<0.05)., Conclusions: AMA may cause inhibition of proliferation, survival, and migration of hippocampal neural stem cells. AMA may also affect their differentiation into neurons and astrocytes, which will eventually lead to developmental disorders of hippocampal neural stem cells in offspring rats.

Hepatocellular carcinoma(HCC) is a common malignant tumor in China, which seriously threatens people's health and lives. In recent years, immunotherapy has provided new options for the treatment of HCC. Various emerging immunotherapy techniques, such as cell immunotherapy, tumor vaccines, oncolytic viruses and immune checkpoint inhibitors, are also gradually advancing to clinical applications. Immunotherapy for HCC should target the different immune characteristics of HCC patients and develop different individualized treatment strategies. In the process of formulating strategies, attention should be paid to key issues such as reversing the exhaustion of T cells, break through HCC immunosuppressive microenvironment, improving the immunotherapy specificity, enhancing the immune response of anti-HCC with adjuvant, timely and accurate evaluation of efficacy and safety, etc. In conclusion, individualization, specificity, safety and efficiency are the inevitable development trend of immunotherapy for HCC.

Objective: To analyze the quadrivalent influenza vaccine intention of 718 health care workers (HCWs) in the Pearl River Delta region from 2015 to 2017. Method: In May 2018, 718 HCWs from the department related to the diagnosis and treatment of influenza in 17 hospitals (6 tertiary hospitals, 5 secondary hospitals and 6 primary hospitals) from Guangzhou, Jiangmen, Zhuhai and Dongguan were selected by using stratified sampling method. Questionnaire survey and face-to-face interview were used to collect the information of influenza vaccination, the intention of the quadrivalent influenza vaccine, the acceptance of free and required vaccination policies, and recommendations for increasing influenza vaccination intentions from 2015 to 2017. The multivariate logistic regression was used to analyze factors associated with the vaccination intention. Results: A total of 718 HCWs were surveyed and 147 of them were interviewed face to face. Among them, the vaccination rate of primary hospitals [17.39%(40/230)] was higher than that of other hospitals (χ(2)=15.80, P< 0.05). If the vaccine could be free, 84.82% (609/718) of HCWs would like to be vaccinated. The multivariate logistic regression showed that the factors, HCWs who were aged ≥50 years ( OR= 3.44, 95 %CI :1.43-8.28), worked in department of prevention and health care ( OR= 2.35, 95 %CI :1.16-4.75), learned about the quadrivalent influenza vaccine ( OR= 2.94, 95 %CI :2.08-4.18), knowed that HCWs are priority ( OR= 2.33, 95 %CI :1.56-3.48), and had a history of trivalent influenza vaccination from 2015 to 2017 ( OR= 4.70, 95 %CI :3.08-7.15), were associated with the vaccination intention. Conclusion: HCWs in the Pearl River Delta region had weak inclination of getting quadrivalent influenza vaccine. HCWs who were age (≥50 years old), worked in department of prevention and health care, learned about the quadrivalent influenza vaccine, knowed that HCWs are priority, and had a history of trivalent influenza vaccination from 2015 to 2017 were factors positively associated with the vaccination intention.

Objectives: The aim of the study was to determine whether there was gender difference in clinical manifestations and comorbidities in the patients with Spondyloarthritis (SpA) in China. Methods: 346 patients fulfilling ASAS criteria for SpA were recruited from the Third Affiliated Hospital of Sun Yat-sen University, including 280 males and 66 females. A comparison was conducted in terms of age at onset, disease course, family history, HLA-B27 positivity, clinical manifestations, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), the bath ankylosing spondylitis disease activity index (BASDAI) and AS disease activity score (ASDAS), and comorbidities between male and female patients. Results: Compared with female patients, male patients were younger at disease onset (22±7 vs 27±9, P< 0.001),had higher rates of morning stiffness (74.3%), and higher scores of CRP and ASDAS-CRP ( P< 0.010, P= 0.014). However, no significant gender difference was observed in other clinical parameters like clinical manifestations, family history, HLA-B27 positivity, BASDAI, and BASFI and treatment. Male SpA patients had a higher prevalence of Hepatitis B virus (HBV) infection (26.2%) than that of female patients (8.3%), and a higher prevalence of osteoporosis (30.5% vs 14.3%, P< 0.01), especially with a lower lumbar T score. Logistic regression analysis reviewed that limited weight ( OR= 0.94, P< 0.001), high ASDAS-CRP ( OR= 1.58, P= 0.006) and male ( OR= 8.02, P= 0.004) are more inclined to have osteoporosis. Conclusion: Compared with female patients, male patients were younger at disease onset and higher scores of CRP and ASDAS-CRP. No significant gender difference was observed in clinical manifestations, family history, HLA-B27 positivity, BASDAI, and BASFI and treatment. Male SpA patients had a higher prevalence of HBV infection and osteoporosis than female patients. Comorbidities should be paid more attention in the patients with SpA.

Idiopathic hypogonadotropic hypogonadism (IHH) is often caused by hyposecretion of gonadotropin and consequently affects male fertility. The patient with IHH has a smaller penis and testes with spermatogenic dysfunction. At present, IHH is treated mainly with hCG, hMG, GnRH, and their different combinations. However, due to the lack of large-sample evidence, it is not yet clear which therapy is the best option. This article presents an overview of our experience in the treatment of IHH in the last decade and a review of relevant literature, aiming at a deeper insight into this male disease.

The enhanced aerobic denitrification capability of the mixed strains YH01+YH02 in utilizing potassium nitrate, and the dynamic changes in the microbial community component during the period of operation, were evaluated. The microbial community in different stages of the SBR was analyzed by using high-throughput sequencing technology after inoculation with YH01+YH02. The results showed that the NO 3 - -N, TN, and COD removal efficiencies increased by 12.1%, 9.2%, and 9.4%, respectively. The relative abundances of the microbes in the microbial community increased at the genus level, and the diversity in the microbial community decreased after enhancement. Principal component analysis and UPGMA analysis revealed that the period of SBR operation was roughly divined into four phases. The relative abundances of Delftia and Acidovorax increased during the period of operation, and YH01+YH02 exhibited excellent compatibility with the SBR ecosystem and played an important part in aerobic denitrification.

This study focused on bedrock outcrops, a very common habitat in karst region of southwest China. To reveal the responses of plant transpiration to natural rainfall and continuous drought, two tree species typical to this habitat, Radermachera sinica and Triadica rotundifolia, were selected as test materials. A rainout shelter was used to simulate continuous drought. The sap flow dynamics were monitored using the method of Granier's thermal dissipation probe (TDP). Our results showed that sap flow density increased to different degrees after rain in different stages of the growing season. Sap flow density of the deciduous species T. rotundifolia was always higher than that of the semi-deciduous species R. sinica. After two months without rainfall input, both species exhibited no obvious decrease in sap flow density, indicating that rainfall was not the dominant source for their water uptake, at least in the short-term. Based on the regression relationships between sap flow density and meteorological factors before and after rainfall, as well as at different stages of continuous drought, we found that the dynamics of meteorological factors contributed little to plant transpiration. The basic transpiration characteristics of both species were not changed in the circumstance of natural rainfall and short-term continuous drought, which would be closely related to the special water storage environments of bedrock outcrops and the reliance on deep water sources by tree species.

This study was aimed to investigate the effect and mechanism of Zhenwu Tang on AVP-V2R-AQP2 pathway in NRK-52E cells in vitro . Forty eight male SD rats were randomly divided into eight groups with 6 animals in each group. Distilled water or 22.68 g·kg⁻¹·d⁻¹ Zhenwu Tang(calculated by raw drug dosage meter) was given by gavage. Blood samples were collected by cardiac puncture， and the medicated serum was centrifuged from the blood by 3 000 r·min⁻¹. NRK-52E cells were treated with different medicated serum or dDAVP. The condition of cell proliferation was detected by RTCA. The distribution of V2R and AQP2 in cells were detected by immunofluorescence. The expression of V2R， PKA and AQP2 were detected by Western blot and AQP2 mRNA level was detected by real-time PCR. Results showed that the level of AQP2 mRNA( P <0.01) and protein expression of V2R， PKA and AQP2( P <0.05， P <0.01， P <0.05) of Z7d group which was treated with Zhenwu Tang medicated serum for 24 h were significantly higher than that of normal rat serum group. And the expression level of V2R， p-AQP2 and AQP2( P <0.01， P <0.05， P <0.01) of Z7d+dDAVP group were significantly increased comparing to normal rat serum group. The results indicate that the applying of Zhenwu Tang medicated serum could increase the expression level of V2R， PKA and AQP2 which exist in AVP-V2R-AQP2 pathway in NRK-52E， and there is synergistic effect between Zhenwu Tang medicated serum and dDAVP. So the pathway of AVP-V2R-AQP2 may be one of the mechanism for which Zhenwu Tang regulate balance of water transportation., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

With the development of the binary structure of karst landforms, surface water is largely drained with rapid loss of nutrients. However, the pathway and mechanism of nutrient loss remain elusive. From a three-dimensional (vegetation-soil-epikarst system) perspective of a critical zone in karst area, this study conducted rainfall induced runoff and nitrogen loss monitoring during monsoon in karst shrub slopes. Isotope-based (D and 18 O) hydrograph separation method was applied to partition the ratio of 'old' and 'new' water in main hydrological path. The main results were summarized as follows. Deep percolation and interflow were the dominant hydrological pathways, accoun-ting for 71% and 9% of total rainfall amount, respectively. In contrast, surface runoff occupied less than 2%. Both deep percolation and interflow were dominated with 85% and 61% of old water, respectively. The highest nitrate concentration occurred in deep percolation (1.97 mg·L -1 ), while the highest ammonium nitrogen concentration occurred in interflow (1.18 mg·L -1 ). Deep percolation contributed 89.4% of total nitrogen loss, which was significantly higher than that of surface runoff and interflow. Old water ratio showed a significant positive correlation with nitrate nitrogen concentration, ammonium nitrogen concentration, and total nitrogen loss, suggesting it might be the main agent driving nitrogen migration for the whole soil-epikarst system in karst hillslopes. The results would provide scientific basis for rational allocating water resources and developing nutrient loss control technology in karst region of southwestern China.

The traditional hydrology method, stable hydrogen and oxygen isotope technology, and rainfall simulation method were combined to investigate the hydrological function of small experimental plots (2 m×1.2 m) of contrasting architecture in Northwest Guangxi dolomite area. There were four typical catenary soils along the dolomite peak-cluster slope, which were the whole-sand, up-loam and down-sand, the whole loam, up-clay and down-sand soil types, respectively. All the experimental plots generated little amounts of overland runoff and had a high surface infiltration rate, ranging from 41 to 48 mm·h -1 , and the interflow and deep percolation were the dominant hydrological progress. The interflow was classified into interflow in soil clay A and C according to soil genetic layers. For interflow in soil clay A, matrix flow was generated from the whole-sand, up-loam and down-sand, up-clay and down-sand soil types, but preferential flow dominated in the whole-loam soil type. As for interflow in soil clay C, preferential flow dominated in the whole-loam, up-clay and down-sand, up-loam and down-sand soil types. The soils were shallow yet continuously distributed along the dolomite slope. The difference of hydrological characteristics in soil types with different architectures mainly existed in the runoff generation progress of each interface underground. It proved that the a 3-D perspective was needed to study the soil hydrological functions on dolomite slope of Northwest Guangxi, and a new way paying more attention on underground hydrological progress should be explored to fully reveal the near-surface hydrological processes on karst slope.

Karst regions, which account for about 15% of the terrestrial surface area, are characte-rized by specific hydrogeological structure different from most non-karst regions. Thus, many research methods that are used in non-karst regions cannot be directly used in karst regions. This issue is especially relevant to research on plant water sources. In this paper, origins and possible solutions to the common problems associated with research on water sources used by karst plant species were reviewed. Four questions were addressed: 1) why is it important to determine plant water source in karst regions? 2) Why are stable isotopes used? 3) What are the challenges associated with using stable isotopes in karst regions? 4) What are the probable solutions for these challenges? This review emphasized the advantages of using stable isotope techniques to identify sources of water used by karst plant species and the challenges associated with satisfying the prerequisites of this method. It is suggested that sources of water used by plant species in karst regions need not to be divided into specific depths and the method of identifying sources of water used by plant species based on their hydrologic properties was much applicable.

Objective: To investigate the clinical chacteration and molecular pathology of Waardenburg syndrome type 2 in seven families, and provide genetic diagnosis and hereditary counseling for family members. Method: Clinical data of seven families with WS2（14 patients）were collected. Peripheral blood samples of the probands and related family members were collected and genomic DNA was extracted. The coding sequences of microphthalmia associated transcription factor (MITF), sex-determining region Y-box 10(SOX10), snail family zinc finger 2 (SNAI2) and endothelin receptor type B（EDNRB）were analyzed by polymerase chain reaction and DNA sequencing. Then the raw data was analyzed. Result: The most common manifestations of WS2 are sensorineural hearing loss(10/14,71.4%), freckle(7/14, 50.0%)，heterochromia iridis(6/14, 42.9%) and premature greying(5/14,35.7%). All the deafness phenotype is congenital, bilateral profound sensorineural hearing loss. Freckles phenotype is different from cutaneous pigment abnormalities of WS in Westerners. The heterozygous mutation, c.328C>T in exon 3 of the MITF gene was detected in the proband and all patients of pedigree 2. However, no pathological mutation of the relevant genes (SOX10,SNAI2 and EDNRB) was detected in other pedigrees. Conclusion: There are obvious variations in clinical features of WS, while freckles may be a special subtype of cutaneous pigment disturbances. The MITF gene mutation, R110X,is therefore considered the disease causing mutation in pedigree WS02.However, there are novel disease causing genes or copy number variations in Waardenburg syndrome type 2, which require further research., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Using stable isotope techniques, water sources and water use efficiencies of Eucalyptus urophylla ×E. grandis (exotic tree species) and Liquidambar formosana (native tree species, as a reference) were studied in a typical karst artificial forest, and the risk of drought stress of the plantation was discussed. The results showed that the isotope value of shallow soil water (0-50 cm) had obvious gradient features and was similar to the recent rain, while that of deep water was more stable and different from the shallow soil water. The soil water content in wet season (May and September) was higher than in dry season (October), and was higher in upslope than in downslope segment. The main water source of L. formosana was shallow soil water, which corresponded to high water use efficiency in different seasons. The main water sources for E. urophylla ×E. grandis on the upper slope and downslope segments were both shallow soil water in wet season, however, the sum of average water using the proportion of deep soil water increased for the downslope segment in the end of wet season. In dry season, E. urophylla ×E. grandis on the downslope segment mainly used shallow soil water, while it used deeper soil water on the upslope segment when soil water was relatively low. Meanwhile, the water use efficiency of E. urophylla ×E. grandis was lower compared with L. formosana, which revealed E. urophylla ×E. grandis did not get enough water supply under drought stress. The above results indicated that E. urophylla ×E. grandis would encounter high risk of water stress if extreme drought events happened in karst regions in the coming future.

Vegetation types restrict soil structure and heterogeneous processes of elements, which result in difference in spatial distribution of soil nutrients. In this study, the differences in contents of soil nutrients, TN, TP, TK, and soil organic matter (SOM) among different vegetation types were analyzed, and the accuracy of ordinary kriging, regression model and regression model based on vegetation type in predicting soil nutrients was compared. The results showed that, TN, TK and SOM were significantly (P<0.05) correlated to vegetation type, and TP had no significant correlation with vegetation type (P=0.390). TN and SOM had significant difference between shrubbery and arable land. TK had significant difference between arbor and scrub-grassland, shrubbery and arable land, and scrub-grassland and arable land, respectively. In a non-continuous typical small karst catchment, because of high spatial heterogeneity of terrain, the accuracy of multivariate linear regression model based on the real terrain factors of various points was considerably higher than that of ordinary kriging prediction method considering the locations of the known points and prediction points. Moreover, the regression model based on vegetation type improved the prediction accuracy of the TN.

Based on three manually excavated trenches (projection length of 21 m, width of 1 m) along a typical Karst hillslope, the changing trends for soil-bedrock structure, average water content of soil profile and soil-bedrock interface water content along each individual trench were studied. The effect of irregular bedrock topography on soil moisture distribution was discussed. The results showed that the surface topography was inconsistent with the bedrock topography in the Karst hill-slopes. The bedrock topography was highly irregular with a maximum variation coefficient of 82%. The distribution pattern of soil profile of moisture was significantly affected by the underlying undulant bedrock. The soil water content was related to slope position when the fluctuation was gentle, and displayed a linear increase from upslope to downslope. When the bedrock fluctuation increased, the downslope linear increasing trend for soil water content became unapparent, and the spatial continuity of soil moisture was weakened. The soil moisture was converged in rock dents and cracks. The average water content of soil profile was significantly positively correlated with the soil-bedrock interface water content, while the latter responded more sensitively to the bedrock fluctuation.

Objective: To isolate and identify the chemical constituents from Polygonum paleaceum., Methods: Chemical constituents were isolated and purified by column chromatography on silica gel,Sephadex HL-20 and macroporous resin etc. The chemical structures were identified by MS,NMR and spectral analysis., Results: Ten compounds were isolated and their structures were elucidated as ethyl chlorogenate( 1),methyl chlorogenate( 2), kaempferol-3-O-α-L-rhamnopyranoside( 3), (-)-epicatechin( 4), paleaceolactoside( 5), protocatechuic acid( 6), kaempferol( 7), gallic acid( 8), chlorogenic acid( 9) and isoquercitrin( 10)., Conclusion: Compounds 1,3,6,7 and 10 are isolated from this plant for the first time.

Through in situ observation and indoor tests, the hydrochemical characteristics of a typical karst watershed at three different time scales (diurnal, single storm, and seasonal scales) from June 2013 to March 2014 were investigated, and their influencing factors were analyzed. The results showed that the diurnal variations of the hydrochemistry exhibited a regular changing pattern resulting from the shifting of the main vegetation physiological activity from photosynthesis in the day to respiration in the night. At single storm scale, however, the hydrochemical processes were mainly determined by the number of consecutive rainless days and rainfall intensity, while the diurnal scale effect was weakened. As to the seasonal scale, the overall hydrochemical processes showed quick responses to rainfall events although they responded more quickly in the rainy season than in the dry season. The temperature and the yearly rainfall distribution regime were the two main influencing factors at this scale.

Objective: To investigate clinical curative effects of gluteal muscle contracture release combined with insertion of gluteus maximus tendo-chilles lengthening with Z-shaped in treating severe gluteal muscles contracture., Methods: From 2006 May to 2011 May, 20 patients (35 sides) with severe gluteal muscle contracture were collected, including 12 males and 8 females, aged from 8 to 34 years old with an average of 13 years old; the courses of disease ranged from 3 to 21 years. All patients manifested abnormal gait at different degree, knees close together cannot squat,positive syndrome of Ober, positive test of alice leg. Gluteus contracture fascia release were performed firstly in operation, then insertion of tendo-chilles lengthening with Z-shaped were carried out. Preoperative and postoperative gait, and knee flexion hip extensor squat test, cross leg test, adduction and internal rotary activity of hip joint, stretch strength and motor ability after hip abduction were observed and compared., Results: Twenty patients were followed up for 1 to 5 years. Gluteus maximus were released thoroughly, and snapping hip was disappeared, Ober syndrome were negative. There was significant differences in knee flexion hip extensor squat test, adduction and internal rotary activity of hip joint,stretch before and after operation (P<0.01). Gluteus muscle strength was protected,stretch strength and motor ability of hip joint were recovered well. Among them,31 cases got excellent results and 4 good., Conclusion: For severe gluteal muscles contracture,insertion of gluteus maximus tendo-chilles lengthening with Z-shaped performed after gluteus contracture fascia release could release gluteal muscle contracture to the greatest extent and obtain postoperative curative effect without resection of normal hip muscle fibers and destroy joint capsule.

Objective: To investigate the method of medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus., Methods: From January 2010 to December 2013,31 patients with medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus, including 18 males and 13 females ranging in age from 26 to 58 years old with a mean of 37 years old. The time between injury and operation was 1 to 8 days with an average of 4.5 days. According to AO classification, 7 fractures were type A1, 3 fractures were type A2, 6 fractures were type A3, 2 fractures were type B1, 4 fractures were type B2, 2 fractures were type B3, 4 fractures were type C, 3 fractures were type C2. No patients had any signs of radial nerve injury. The results were evaluated with DASH (disability of arm-shoulder-hand) Questionnaire by the American Academy of Orthopedic Surgeons (AAOS) which 0 indicated normal upper extremity function, and 1 to 100 indicated varying degrees of damage to the function of the upper extremties., Results: There was no neurologic complication or postoperative wound infection in this series. The followed-up period ranged form 8 to 15 months (means 11 months) postoperatively. The clinical outcomes were evaluated with DASH Questionnaire, the score before operation was 76.2±11.8, the final follow-up score was 8.2±7.4, the final follow-up score was significant higher than before operation (P<0.01). The function of the upper extremities recovered satisfactorily., Conslusion: The method of medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus can avoid iatrogenic radial nerve injury effectively.

Surface soil water-physical properties play a decisive role in the dynamics of deep soil water. Knowledge of their spatial variation is helpful in understanding the processes of rainfall infiltration and runoff generation, which will contribute to the reasonable utilization of soil water resources in mountainous areas. Based on a grid sampling scheme (10 m x 10 m) and geostatistical methods, this paper aimed to study the spatial variability of surface (0-10 cm) soil water content, soil bulk density and saturated hydraulic conductivity on a typical shrub slope (90 m x 120 m, projected length) in Karst area of northwest Guangxi, southwest China. The results showed that the surface soil water content, bulk density and saturated hydraulic conductivity had different spatial dependence and spatial structure. Sample variogram of the soil water content was fitted well by Gaussian models with the nugget effect, while soil bulk density and saturated hydraulic conductivity were fitted well by exponential models with the nugget effect. Variability of soil water content showed strong spatial dependence, while the soil bulk density and saturated hydraulic conductivity showed moderate spatial dependence. The spatial ranges of the soil water content and saturated hydraulic conductivity were small, while that of the soil bulk density was much bigger. In general, the soil water content increased with the increase of altitude while it was opposite for the soil bulk densi- ty. However, the soil saturated hydraulic conductivity had a random distribution of large amounts of small patches, showing high spatial heterogeneity. Soil water content negatively (P < 0.01) correlated with the bulk density and saturated hydraulic conductivity, while there was no significant correlation between the soil bulk density and saturated hydraulic conductivity.

Objective: To evaluate the effect of combined use of stanazolol (ST) on the final adult height (FAH) in girls with idiopathic central precocious puberty (ICPP) and apparently decreased linear growth during gonadotropin-releasing hormone analog (GnRHa) therapy., Method: Sixty-three girls with ICPP and decreased velocity of growth of height (HV<4 cm/yr) during GnRHa therapy were divided into 3 groups based on the following types of interventions:group 1 (n = 20), GnRHa+ST [25-30 µg/(kg·d) every 3-month followed by 3-month discontinuation], group 2 (n = 21), GnRHa+recombinant human growth hormone [rhGH, 1-1.1 U/(kg·w)], group 3 (n = 22), GnRHa alone.HV, the advancement of bone age (BA) for chronological age (CA) (ΔBA/ΔCA) and FAH were compared among groups., Result: (1)Total duration of ST combination therapy was (12.22 ± 3.62) months, while total duration of combination of rhGH was (13.22 ± 6.80) months. (2)HV increased significantly in both group 1 [ (2.79 ± 0.60) cm/yr vs. (6.27 ± 1.98) cm/yr, P < 0.01] and in group 2 [(2.80 ± 0.50) cm/yr vs. (6.25 ± 1.98) cm/yr, P < 0.01] during combined therapy, but maintained at low levels in group 3 [(3.95 ± 1.10) cm/yr vs. (3.34 ± 0.95) cm/yr, P > 0.05].No significant differences of ΔBA/ΔCA were found among the three groups [0.25(0.11∼0.28), 0.22(0.15∼0.31),0.19(0.10∼0.32), P > 0.05]. (3)FAH was significantly higher than predicted adult height (PAH) before combined therapy, as well as higher than target height (THt) in both group 1 [(156.25 ± 2.90) cm vs. (150.78 ± 3.70) cm, P < 0.01, (156.25 ± 2.90) cm vs. (153.94 ± 2.62) cm, P < 0.01], and in group2 [ (157.33 ± 4.69) cm vs. (152.61 ± 3.92) cm, P < 0.01, (157.33 ± 4.69) cm vs. (154.39 ± 4.72) cm, P = 0.01].In group 3, FAH was similar to PAH [(153.88 ± 2.6) cm vs. (152.54 ± 5.86) cm, P > 0.05], and was less than THt [(153.88 ± 2.6) cm vs. (155.60 ± 4.52) cm, P = 0.02]. (4)In girls treated with ST, no hirsutism, clitorism or hoarse voice was recorded.No polycystic ovary syndrome was found by B-mode ultrasound., Conclusion: Intermittent combined use of low dose ST therapy can increase HV and thus improve FAH in girls with ICPP and apparently decreased linear growth during GnRHa therapy.

A total of 163 soil samples (0-20 cm layer) were collected from the grid sampling plots (80 m x 80 m) in Huanjiang Observation and Research Station of Karst Ecosystem in a small catchment in Karst cluster-peak depression area, South China. By using classical statistics and geostatistics, the spatial heterogeneity of mineral components (SiO2, Fe2O3, CaO, MgO, Al2O3, MnO, and TiO2) in the soils were studied. The contents of the seven soil mineral components in the study area differed greatly, being in the order of SiO2 > Al2O3 > CaO > MgO > Fe2O3 > TiO2 > MnO, and the variance coefficients also varied obviously, in the order of CaO > MgO > Fe2O3 > TiO2 > SiO2 > Al2O3 > MnO. The seven mineral components accounted for 69.4% of the total soil mass. The spatial patterns and the fittest models of the seven soil mineral components differed from each other. All the seven soil mineral components had a strong spatial autocorrelation, with shorter variation ranges and stronger spatial dependence. The Kriging contour maps indicated that the distribution patterns of soil SiO2, Fe2O3, Al2O3, MnO, and TiO2 were similar, being higher in south and east, lower in north and west, higher in depression, and lower in slope, while the distribution patterns of soil CaO and MgO were in adverse. Natural conditions (vegetation, bare rock rate, slope degree, and slope aspect, etc. ) and human disturbance were the most important factors affecting the spatial patterns of the soil mineral components.

Objective: To study the clinicopathologic features and differential diagnosis of splenic B-cell marginal zone lymphoma (SMZL) involving bone marrow., Methods: The clinical and pathologic features of 22 patients with SMZL were retrospectively studied. Immunophenotypic analysis was carried out by flow cytometry and immunohistochemistry. Immunoglobulin heavy chain rearrangement study was performed using polymerase chain reaction-based method., Results: Villous lymphocytes were found in peripheral blood smears of 11/18 of the patients. In bone marrow aspirates, lymphocytosis (> 20%) was demonstrated in 15 cases (15/18) and villous lymphocytes in 6 cases (6/18). Flow cytometry showed CD19(+) CD20(+) FMC7(+) CD22(+) CD10(-) CD2(-) CD3(-) CD7(-) in 18 cases. Bone marrow biopsies of all the 22 patients revealed various degrees and patterns of neoplastic infiltration, as follows: mild (4 cases, 18.2%), moderate (11 cases, 50.0%) or severe (7 cases, 31.8%); intrasinusoidal (16 cases, 72.7%), interstitial (14 cases, 63.6%), nodular (11 cases, 50.0%) or diffuse (1 case, 4.5%). Reactive germinal center formation (CD23(+) bcl-2(-)) was found in 2 cases (91.0%). Immunohistochemical study showed the following results: CD20(+) PAX5(+) CD3(-) CD5(-) CD10(-) cyclin D1(-) CD23(-) CD43(-) Annexin A1(-) CD11C(-) CD25(-) in all the 22 cases, CD38(+) in 2 cases (9.1%) and CD138(+) in 2 cases (9.1%)., Conclusions: Different and overlapping patterns of bone marrow involvement are observed in SMZL. As the histologic and immunophenotypic features are not specific to SMZL, distinction from other types of mature B-cell lymphomas is necessary.

Objective: To explore treatment methods for patients with severe aplastic anemia (SAA) failing in immunosuppressive therapy (IST)., Methods: Totally 62 SAA patients failing in IST were treated by integrative medicine (IM). The treatment course was divided into three stages: the critical emergency stage, the improvement stage, and the recovery stage. In the critical emergency stage, patients were treated with Lingyang Yigui Decoction (LYD, consisting of 1.2 g antelope horn, 6 g coptis chinensis, 12 g stir-baked Fructus Gardeniae, 30 g rehmannia rhizoma, 50 g lalang grass rhizome, 9 g amur corktree bark, 12 g Cortex Moutan, 9 g ass-hide gelatin, 30 g red date, 6 g prepared licorice root, etc.) and Erzhi Busui Decoction (EBD, consisting of 120 g glossy privet fruit, 100 g eclipta prostrata, 24 g prepared Gold Theragran, 12 g fructus lycii, 90 g rehmannia rhizoma, 60 g astragalus, 9 g Angelica sinensis, 9 g ass-hide gelatin, 30 g honeysuckle flower, 12 g lotus plumule, and so on) alternatively, one dose daily, decocted twice, taken in two portions. Meanwhile, 50 mg Testosterone Propionate was intramuscularly injected every other day to the improvement stage. Those with fever were treated with LYD by adding 60 g gypsum, 60 g common anemarrhena, 30 g dandelion, 30 g bittersweet herb, 30 g blackend swallowwort root and rhizome, 15 g hemsley rockvine root tuber, and so on. In the improvement stage patients were treated with Jixueteng Compound (Jixueteng Zhengyang Decoction was administered to those of Shen-yang deficiency syndrome: consisting of 100 g spatholobus suberectus, 60 g astragalus, 3 g red ginseng, 12 g psoralea corylifolia, 18 g dodder seed, 12 g angelica, 18 g Herba Epimedii, 6 g common fenugreek seed, 24 g Gold Theragran, 30 g glossy privet fruit, 30 g eclipta prostrata, 6 g dried human placenta, and so on). Meanwhile, 50 mg Testosterone Propionate was intramuscularly injected every other day. Jixueteng Yijing Decoction was administered to those of Shen-yin deficiency syndrome: consisting of 100 g glossy privet fruit, 100 g eclipta prostrata, 90 g rehmannia rhizoma, 30 g spatholobus suberectus, 12 g dodder seed, 6 g psoralea corylifolia, 30 g prepared Gold Theragran, 9 g ass-hide gelatin, 9 g fructus lycii, 24 g Salvia miltiorrhiza, 30 g astragalus, 6 g angelica, and so on), one dose daily, decocted twice, taken in two portions. The treatment lasted to the recovery stage. The medication was gradually reduced to the follow-ups of drug discontinuance. Results After 6 -57 months of treatment, 12 patients (accounting for 19.4%) were basically cured, 14 (22.6%) relieved, 8 (12. 9%) markedly improved, 28 (45.2%) ineffectively, with the total effective rate of 54. 8%. Totally 23 patients had the body temperature ranging 37.6-38.5 degrees C at the first visit to our hospital. They took 2 h- 6 days to have pyretolysis ( <37.5 degrees C) after treatment. Twenty patients with body temperature higher than 38.5 degrees C took 4 h - 5 days to have pyretolysis after treatment. Totally 26 patients suffering from IST induced abnormalities of liver and renal functions (ALT, AST, BUN, and Cr) at the first visit were treated by IM for 2 months. They were restored to the normal levels in 25 cases., Conclusions: The treatment of SAA failing in IST had its specificity. The staging targeted treatment is in line with its pathophysiology. The key points for its treatment might be lie in the improvement and protection of hematopoietic microenvironment of bone marrows. The antisepsis and anti-inflammation of Chinese herbs hindered its aggravating tendency.

Objective: To explore the correlation between single nucleotide polymorphisms (SNPs) of interleukin-28B (IL-28B) gene and the susceptibility to primary hepatocellular carcinoma (HCC)., Methods: A total of 300 histologically confirmed HCC cases (from November 2001 to April 2010) and 310 healthy controls with no history of chronic hepatitis B or hepatocellular carcinoma (2009-2010) were selected from a hospital in Guilin and a hospital in Beijing for this case-control study.139 HCC patients in the case group had complete clinical tracking data. All the subjects were Han Chinese, with no age or gender restrictions.2 ml peripheral blood samples were drawn from each subject with informed consent. SNP of rs12972991, rs4803223, rs8099917 and rs12979860 four loci in IL-28B gene were analyzed by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF)., Results: The frequencies of C allele at rs12972991, G allele at rs8099917 and G allele at rs4803223 were 6.7% (40/598), 7.9% (47/598) and 10.0% (59/588) respectively in case group; all higher than the corresponding frequencies in control group, separately 2.9% (18/618), 4.1% (25/616) and 3.6% (21/608). The differences were statistically significant (χ2=9.542, 7.858, 20.736, P values all<0.05). The above alleles could increase the risk of HCC, and the OR (95%CI) values were separately 1.67 (1.13-2.46), 1.49 (1.08-2.06) and 2.91 (1.79-4.72). The genotype frequencies of AC+CC at rs12972991, GT+GG at rs8099917, GA+GG at rs4803223 were 13.0% (39/299), 14.7% (44/299) and 19.0% (56/296) respectively in case group; while the frequencies were lower in control group, separately 5.8% (18/309), 8.1% (25/308) and 6.6% (20/304). The differences were statistically significant (χ2=9.319, 6.557, 20.948, P values all<0.05). These genotypes may increase the risk of HCC, and the adjusted OR (95%CI) values were 2.24 (1.31-3.83), 1.81 (1.14-2.88) and 2.90 (1.78-4.70), respectively. The stratified analysis of the clinical data indicated that the frequency of genotype GA+GG at rs4803223 was 50.0% (13/26) in patients of tumor thrombosis in portal vein (TTPV), higher than the frequency of genotype AA (21.1%, 23/109). The difference was statistically significant (χ2=8.965, P=0.003)., Conclusion: The results suggested that IL-28B gene polymorphisms was correlated to the susceptibility to HCC in Chinese Han ethnic population. Among them, GA + GG genotype at rs4803223 could increase the risk of TTPV in HCC patients.

Objective: To study the level of brain-derived neurotrophic factor (BDNF) in the microenvironment of the neuron-astrocyte co-culture system by Mg2+-free-induced seizure-like discharge and analyze the source of BDNF., Methods: Hippocampal neurons (N) of fetal rats and astrocytes (AST) of neonatal rats were purified and divided into four groups, included control N (Con N) group, Mg2+-free treated N (Mg2+-free N) group, control N+AST co-culture (Con N+AST) group and Mg2+-free treated N+AST co-culture (Mg2+-free N+AST) group. The Mg2+-free treated groups were exposed to Mg2+-free media for 3 hrs to induce a repeated spontaneous seizure-like discharge. The level of BDNF in each group at different time points was measured using ELISA., Results: The cellular morphous of AST changed in the Mg2+-free N+AST group at 48 hrs. Neuronal epileptiform activity was observed in the Mg2+-free media at 3 hrs, and continued to exist until the microenvironment returned to normal for 72 hrs. The BDNF level increased at 24 hrs and 48 hrs in the Con N+AST group compared with the control N group (P<0.05). Compared with Con N+AST group, BDNF level increased at 12, 24 and 48 hrs in the Mg2+-free N+AST group, especially at 12 and 24 hrs (P<0.01). There were no significant differences in the level of BDNF between the Con and Mg2+-free N groups. Compared with Mg2+-free N group, BDNF level increased at 24 hrs in the Mg2+-free N+AST group (P<0.05)., Conclusions: The results of the experiment suggest that BDNF in the Con N+AST group might be excreted from both N and AST, but chiefly from N. Activated AST may be the main source for increasing BDNF in the Mg2+-free N+AST group.

Objective: To analyze the clinical features and prognosis of the primary myelodysplastic syndrome with myelofibrosis (MDS-MF) patients and to improve the cognition of MDS-MF., Methods: Four hundred and sixty-six primary MDS patients with bone marrow (BM) biopsy were divided into two groups according to whether BM associated with fibrosis, the clinical features and prognosis of the two groups were analyzed retrospectively., Results: 167 (35.8%) MDS cases revealed myelofibrosis, of which MF-1 123 cases (26.4%), MF-2 40 cases (8.6%), MF-3 4 cases (0.9%). The proportion of hepatosplenomegaly in MDS-MF group was significantly higher than in MDS without MF group, the difference had statistical significance (P = 0.031). The proliferation of BM biopsy in MDS-MF group was significantly more active than in MDS without MF group. The number of blasts, megakaryocytes and abnormal megakaryocytes in MDS-MF group were significantly higher than in MDS without MF group, the differences had statistical significance (P < 0.05). Among the 345 patients who had available results of cytogenetic analysis, 121 cases were MDS-MF patients, the proportion of middle and high-risk prognostic group according to IPSS karyotype prognosis groups in MDS-MF group were significantly higher than in MDS without MF group, the differences had statistical significance (P = 0.047). The median survival was 17 (1 - 60) months in MDS-MF group, and was 32 (1 - 62) months in MDS without MF group. The difference had statistical significance (P = 0.001). Myelofibrosis had independent prognostic significance by multi-variable analysis (P = 0.019)., Conclusion: The myelofibrosis in MDS is main the proliferation of reticular fiber. The proliferation of reticular fiber is closely related with the number of blast cells, the proliferation and developmental abnormalities of megakaryocytes and the karyotype. The prognosis of MDS-MF patients is poor.

Objective: To assess the utility of serum steroids measurement in monitoring the treatment of children with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD)., Method: Nineteen Patients with CAH 21OHD aged (3.67±1.54) years treated with hydrocortisone and fluorocortisone replacement were followed up at an intervals of 0.33 - 1.0 years over a period of (1.47±0.7) years. At each visit, roentgenograms of the hands and wrists were taken, fasting peripheral blood were collected to test serum dehydroepiandrosterone sulfate, progesterone, 17-hydroxyprogesterone (17-OHP), androstenedione (Δ4-A), testosterone, free testosterone, estrone, and estradiol concentrations at 8 AM in the morning before the first dose of glucocorticoid. Then the patients were classified as being in "Good Control" or in "Poor Control" based on clinical criteria including signs of androgen excess, growth velocity and bone age increment at each interval. Comparisons were carried out between the serum steroid concentrations of the two groups. The receiver operating characteristic (ROC) curves were used to determine the cut-off values for diagnosing "Poor Control"., Result: Both of serum Δ4-A and 17-OHP concentrations were higher in "Poor Control" group than those in "Good Control" group [5.95 (2.23-11.2) nmol/L versus 1.05 (1.05-9.89) nmol/L, t=2.19; 13.85 (6.06-20) µg/L versus 3.67 (0.42-21.1) µg/L, t=2.17; P<0.05, respectively]. The ROC curves for serum Δ4-A concentrations, serum 17-OHP concentrations, serum Δ4-A in combination with 17-OHP concentrations were constructed with areas under the ROC curves (95%CI) of 0.76 (0.62, 0.90), 0.75 (0.62, 0.88), 0.69 (0.54, 0.84), P<0.05, respectively. Serum Δ4-A of 3.9 nmol/L had 0.78 of sensitivity and 0.75 of specificity in diagnosing "Poor Control". Serum 17-OHP of 7.1 µg/L has 0.67 of sensitivity and 0.71 of specificity in diagnosing "Poor Control"., Conclusion: Each of serum 17-OHP or/and Δ4-A concentration was of significance in diagnosing "Poor Control" during the glucocorticoid replacement treatment of CAH 21OHD, with the diagnostic efficacy being serum Δ4-A concentration, serum 17-OHP concentration and serum Δ4-A in combination with 17-OHP concentration in descending order. Serum Δ4-A and 17-OHP concentrations may be used as the biochemical indicators to monitor the therapy of CAH 21OHD.

Objective: To explore the hematopathologic features of T-cell large granular lymphocytic leukemia (T-LGLL)., Methods: A retrospective analysis of the clinical presentation, bone marrow morphology, immunophenotyping and T-cell receptor gene rearrangement status were performed in 19 patients with T-LGLL., Results: Of 19 patients, the most frequent hematological abnormalities were anemia and neutropenia (16/19 and 17/19 patients, respectively). Large granular lymphocytes (LGLs) were observed in 17 of 19 peripheral blood smears and 15 of 19 bone marrow aspirate specimens. Lymphocytosis (> 0.2) was present in 17 of 19 patients in their bone marrow aspirate specimens. Bone marrow biopsy specimens revealed lymphocytosis in 16 cases, with a mild to moderate increase of lymphocytes observed in 12 cases (12/16). The pattern of lymphoid distribution was interstitial in bone marrow sections. Intravascular distribution was seen in 8 cases. Lymphoid nodules were present in 4 cases. Flow cytometery showed an immunophenotype of CD3(+) CD4(-) CD8(+) CD56(-) CD57(+) of the tumor cells in 13 cases. Of the other 6 cases, the immunophenotypes included CD8(-) (1 case), CD56(+) (2 cases) and CD57(-) (3 cases). Immunohistochemistry showed CD3+ (10/10), CD57+ (3/3), CD8+ (6/7), TIA-1+ (6/7), granzyme B+ (4/7), perforin + (1/7), CD4- (4/4) and CD56- (9/9). Clonal T-cell receptor γ gene rearrangement by PCR was detected in 12 cases (12/17)., Conclusions: Hematopathologic features of most T-LGLL are distinct. Morphologic, immunophenotypic and molecular analysis of both peripheral blood and bone marrow specimens are essential and complementary in the diagnosis and differential diagnosis of T-LGLL.

Objective: To study the clinicopathologic features of aggressive natural killer cell leukemia (ANKL)., Methods: The clinical and pathologic features were analyzed in 10 patients with ANKL. The complete blood count, peripheral blood smears, bone marrow aspirates and bone marrow biopsies were studied. Immunophenotypic analysis was carried out by flow cytometry and immunohistochemistry. T-cell receptor (TCR) γ gene rearrangement was studied by PCR method., Results: The most frequent hematologic abnormalities observed were anemia (7 cases) and thrombocytopenia (9 cases). Large granular lymphocytes were found on peripheral blood smears of 6 patients. In bone marrow aspirates, lymphocytosis (> 20.0%) was demonstrated in 8 cases and large granular lymphocytes in 6 cases. Bone marrow biopsies revealed various degrees of neoplastic infiltration, as follows: mild (5 cases), moderate (3 cases) and severe (2 cases). The neoplastic cells were mainly interstitial in distribution in 8 cases and diffuse in 2 cases. Hemophagocytosis was observed in 4 cases. Flow cytometry showed CD2+ sCD3- CD4- CD56+ CD57- in all cases, CD7+ in 9 cases, CD16+ in 5 cases, CD8+ in 4 cases and CD5+ in 1 case. Immunohistochemistry performed in 8 cases showed the following results: cCD3+ in 4 cases, CD56+ in 6 cases, TIA-1+ in 6 cases, granzyme B+ in 4 cases and perforin+ in 2 cases. PCR study revealed germline TCRγ gene configuration in all cases., Conclusions: ANKL is a highly aggressive NK cell-derived lymphoid neoplasm. Comprehensive morphologic, immunophenotypic and molecular analysis are essential in arriving at a correct diagnosis. ANKL needs to be distinguished from other types of NK-cell and T-cell lymphomas.

Geostatistis methods were adopted to analyze the spatial pattern of Sitodiplosis mosellana (Diptera: Cecidomyiidae) at its different development periods and of its egg parasitoids mixed population (Tetrastichus sp. and Platygaster error; Hymoneptera: Eulophidae and Platygastridae). The aggregated spatial arrangements for S. mosellana cocoon, adult, and larva and for egg parasitoids mixed population could be well described by spherical model, spherical-exponential model, linear sill model, and spherical-exponential model, respectively. The spatial dependence range of S. mosellana cocoon, adult at initial emergence period, adult at peak emergence period, and larva, and of egg parasitoids mixed population was 53.6, 190.6, 154.1, 4.2 and 280.3 m, and the aggregation intensity was 30.5%, 95.6%, 96.3%, 14.9% and 95.3%, respectively. The simulated maps of the spatial distribution produced by Kriging model could intuitively analyze the dynamic changes of S. mosellana at its different development periods and of egg parasitoids mixed population from the two aspects of time and space.

This paper studied the profile distribution characters of 137Cs and soil organic carbon (SOC) on the Karst slopes and in the fissures in typical peak-cluster depression in Northwest Guangxi, aimed to approach the applicability of 137Cs method on Karst slopes and the implication of 37Cs for the characteristics of slope soil erosion. In all test profiles, there was a significant correlation between 137Cs and SOC, indicating that both of them might have the same loss pathway. On the slopes under secondary forests, 137Cs mainly existed within the depth 0-24 cm. On the upper middle and middle slope sites, 137Cs had an exponential decrease with depth, indicating no or slight surface erosion; while on the foot slope site, the distribution pattern of 137Cs indicated severer erosion. On the slopes with cultivated lands, 137Cs distributed uniformly within the plough layer. In the upper middle and middle slopes profiles, 137Cs mainly existed in the depth around 15 cm and far less than the background value, indicating severe soil erosion; while in foot slope profiles, 137Cs was aggraded to the depth 45 cm. A discontinuous distribution of 137Cs in the profiles was detected on the foot slopes under secondary forests, on the upper middle and foot slopes of cultivated lands, and in the fissures, indicating that the soil particles on Karst slopes had a trend of losing with rainwater to the underground, but the loss quantity was negligible, compared with surface erosion.

Objective: To study the clinical manifestations of germinoma in children with precocious puberty and to evaluate the diagnostic value of serum levels of β-human chorionic gonadotropin (β-hcG) combined with detections of β-hcG in cerebrospinal fluid (CSF)., Method: Twelve male children with germinomas confirmed by pathology from Jan. 2005 to Dec. 2009, aged from 4.2 to 10.2 years, were enrolled in this study. Patients were classified into two groups according to tumor locations: intracranial group and non-intracranial group. Levels of β-hcG in serum as well as in CSF were detected before the initiation of therapy. Age and gender matched 5 children undergoing lumbar puncture for other diseases were set as control group for the determinations of β-hcG in CSF. Levels of β-hcG and testosterone in serum and CSF were compared between intracranial group and non-intracranial group, and levels of β-hcG in CSF were compared between non-intracranial group and control group., Result: The 12 children showed elevated serum levels of testosterone: 10.43 (1.70-254.00) µg/L, 11 children had testicular volume > 4 ml, while response to LHRH stimulation tests were low; 6 children had gynecomastia. Serum levels of β-hcG were elevated in both intracranial and non-intracranial group and no significant differences were found between groups 63.75 (8.50-309.50) IU/L vs. 59.00 (25.10-71.77) IU/L, P = 0.644. No correlations were found between serum levels of β-hcG and ages, tumor locations, and courses of the patients. Levels of β-hcG in CSF were significantly higher in intracranial group than that in non-intracranial group 488.99 (17.30-1048.53) IU/L vs. 1.20 (1.20-1.50) IU/L, P = 0.009. Children with non-intracranial germinomas had similar levels of β-hcG in CSF as that in control group (P = 0.571)., Conclusion: The main clinical manifestations in boys suffered from germinoma included pseudo-precocious puberty, disproportionate testicular volume and gynecomastia. Detection of serum levels of β-hcG combined with β-hcG levels in CSF may be useful for determination of the locations of germinomas in children with precocious puberty.

Soil samples were collected from the grassland, shrub land, secondary forest, and original forest on the hill slope in a typical karst peak-cluster depression area of northwest Guanxi, with the spatiotemporal heterogeneity of soil physical properties investigated by classical statistics, and the formation causes of the heterogeneity analyzed by redundancy analysis (RDA). In 0-15 cm soil layer, the clay (< 0.002 mm) and silt (0.002-0.05 mm) contents of shrub land and original forest had significant differences with those of grassland and secondary forest, respectively, but the clay, silt, and sand (0.05-2.0 mm) contents had no significant differences between grassland and secondary forest. No significant difference was observed in the soil sand content among the four land types, but the soil bulk density of grassland was significantly different from that of other three land types. The soil clay content of grassland increased with increasing elevation, while that of the other three land types was the highest on medium slope, and had no significant differences for the same land types among different slope locations. The soil clay content in different layers of 0-30 cm had a greater variation extent in original forest (14.55%) than in grassland (7.12%), shrub land (11.24%), and secondary forest (13.77%), and the soil particle size composition was greatly affected by the disturbance of human activities. Soil organic carbon (SOC) and vegetation type were the dominant factors affecting the soil physical properties, and the bare rock ratio had greater effects on soil sand content.