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Objective: To analyze the associations between factors in life course and physiological dysregulation in the middle-aged and elderly population in Zhoushan city of Zhejiang province, and the mediating roles of lifestyle and mental health., Methods: A total of 1553 island residents aged ≥45 years were enrolled from the Zhejiang Metabolic Syndrome Cohort Zhoushan Liuheng Sub-cohort. The demographic information, life course information, lifestyle, and mental health information of participants were documented, and blood samples were collected. The status of aging was evaluated by physiological dysregulation calculation model developed by authors previously. The Shapley value decomposition method was used to assess the cumulative and relative contribution of multiple factors in life course to the aging. Principal component analysis and hierarchical cluster analysis were used to classify subgroups. General linear regression model was used to assess the associations between the life course subgroups and physiological dysregulation, and the key factors associated with aging were finally identified. Logistic regression model, general linear regression model, and mediation analysis model were used to assess the complex associations between life course subgroups, key factors, unhealthy lifestyle, mental health, and aging., Results: Shapley value decomposition method indicated that eight types of life course factors explained 6.63%( SE =0.0008) of the individual physiological dysregulation variance, with the greatest relative contribution (2.78%) from adversity experiences in adulthood. The study participants were clustered into 4 subgroups, and subgroups experiencing more adversity in adulthood and having low educational attainment or experiencing more trauma and having poorer relationships in childhood had significantly higher levels of physiological dysregulation. Life course subgroups and key factors childhood trauma and health, adversity experience in adulthood, and lower education were positively associated with unhealthy lifestyles ( β =0.12-0.41, all P <0.05). In addition, life course subgroups and key factor adversity experience in adulthood were positively associated with psychological problems ( OR =2.14-4.68, all P <0.05). Unhealthy lifestyle scores showed a marginal significant association with physiological dysregulation ( β =0.03, P =0.055). However, no significant association was found between psychological problems and physiological dysregulation ( β= 0.03, P =0.748). The results of the mediation analysis model suggested that unhealthy lifestyles partially mediated the associations between life course subgroups, adversity experience in adulthood and physiological dysregulation, with the proportions mediated ranged from 3.9%-6.8%., Conclusion: Multiple life course factors contribute about 6.63% of the variance in physiological dysregulation in the middle aged and elderly population of the study area; subgroups with adverse life course experiences have higher levels of aging; and the association may be partially mediated by unhealthy lifestyles.

Objective: To conduct a comparative study of radiological and clinical outcomes between percutaneous transfacet screw (TFS) and pedicle screw (BPS) in oblique lateral lumbar interbody fusion (OLIF) for single-level lumbar spinal stenosis. Methods: A retrospective cohort study. Patients who underwent OLIF with TFS or BPS for the treatment of single-level lumbar spinal stenosis at Beijing Jishuitan Hospital from January 2019 to June 2022 were retrospectively analyzed. Radiological parameters and clinical indicators were compared between the two groups. Radiological parameters included preoperative, immediate postoperative (within 5 days), and 1-year postoperative measurements of disc height and segmental lordosis angle, as well as interbody fusion status at 1 year postoperatively. Clinical indicators included operative time, blood loss, length of hospital stay, complications, and Oswestry Disability Index (ODI), visual analogue scale (VAS) scores for back pain, and leg pain before and 1 year after surgery. Results: Four male and 10 female patients with an average age of (61.0±11.2) years underwent OLIF with TFS, while 9 male and 12 female patients underwent OLIF with BPS, with a mean age of (60.9±6.7) years. There was no statistically significant difference in preoperative disc height between the TFS and BPS groups ( P >0.05). The immediate postoperative disc height was (12.9±2.1) mm and it was (10.4±1.7) mm at 1-year follow-up in the TFS group; in the BPS group, it was (12.9±2.1) mm immediately postoperatively and (11.9±2.1) mm at 1-year follow-up; there was statistically significant difference between the two groups at 1-year follow-up ( P =0.037). The segmental lordosis angle showed no significant differences within each group or between the two groups at preoperative, immediate postoperative, or 1-year postoperative follow-up (all P >0.05). At 1-year postoperative follow-up, the fusion rates was 92.9%(13/14) in the TFS group and 95.2%(20/21) in the BPS group, with no statistically significant difference between the two groups ( P >0.05). The TFS group had a significantly shorter operative time and less blood loss compared to the BPS group [(164.3±33.9) minutes vs (191.7±31.8) minutes and (74.3±46.9) ml vs (124.8±54.0) ml, respectively] (both P <0.05). Both groups showed significant improvement in ODI and VAS scores at 1 year postoperatively compared to those preoperatively, but with no statistically significant difference was found between the groups (both P >0.05). Conclusions: OLIF with TFS fixation can effectively restore disc height and alleviate back and leg pain in patients with single-level lumbar spinal stenosis. Compared to the OLIF with BPS procedure, OLIF with TFS has shorter operative time and less blood loss.

Traditional spine surgery frequently encounters difficulties with inadequate surgical visualization and high risk.Robot-assisted spine surgery is quickly evolving,particularly in screw placement,providing three-dimensional imaging and precise positioning to optimize the surgical process. Robot-assisted systems can increase surgical precision,reduce operating time and radiation exposure,and improve patient prognosis. They also have strong image recognition and analysis capabilities,reducing intraoperative instability and fatigue and allowing remote manipulation.While robot-assisted spine surgery has demonstrated noteworthy advantages in regards to screw placement accuracy and reduced radiation exposure,its effects on operative time remain subject to debate,with cost being a significant hindrance to widespread implementation.Long-term clinical validation and studies of outcomes are necessary for the extensive use of robotic-assisted spine surgery.Future priorities include the enhancement of surgical navigation and imaging,integration of artificial intelligence,improvement of telesurgical capabilities,expansion of robotic functionality,and the development of policy guidance and clinical guidelines to accompany the growth of technology.Robot-assisted spine surgery enhances accuracy and safety,and is anticipated to assume an increasingly crucial role in spine surgery as technology advances and becomes more widely available.

Objective: To assess the levels of serum glycocalyx markers in the first 24 hours after cardiac arrest (CA) and investigate their relationship with 30-day outcomes. Methods: A retrospective cohort study was conducted on prospectively collected data from CA patients, who were admitted to the intensive care units of the Affiliated Hospital of Xuzhou Medical University and obtained return of spontaneous circulation for more than 24 hours between September 2021 and October 2022. Serum samples obtained at the 24-hour after CA were utilized to measure the levels of glycocalyx markers, including heparan sulfate (HS), hyaluronic acid (HA), and syndecan-1 (Sdc-1). Patients were allocated into good function (CPC1-2) and poor function (CPC3-5) groups on the basis of cerebral performance category (CPC) at 30 days post-CA. Logistic regression analysis was used to determine the association between serum glycocalyx markers and neurological outcomes. Patients were regrouped in light of 30-d mortality and Cox regression analysis was used to determine the association between serum glycocalyx markers and 30-d mortality. Results: A total of 71 patients were included in the study, including 31 (43.7%) females and 40 (56.3%) males, with an average age of (59.0±17.0) years. The poor function group ( n =49) demonstrated significantly elevated levels of HS and HA when compared to the good function group ( n =22) [HS: 2 461.0(1 623.0, 5 492.0) μg/L vs 1 492.0 (914.0, 2 550.0) μg/L, P =0.008; HA: 124.0(97.0, 365.0)μg/L vs 337.0(135.0, 1 421.0) μg/L, P =0.033]. Adjusted logistic regression analysis revealed that HS was independently associated with poor neurological outcome [odds ratio ( OR )=0.389, 95% confidence interval ( CI ): 0.182-0.828, P =0.014]. In the 30-day mortality analysis, the death group ( n =32) exhibited significantly higher levels of HS and HA when compared to the survival group ( n =39) [HS: 1 880.0(1 011.0, 3 554.0) μg/L vs 2 500.0(1 726.0, 6 276.0) μg/L, P =0.027; HA: 162.0(99.0, 537.0) μg/L vs 813.0(148.0, 1 531.0) μg/L, P =0.025]. Adjusted Cox regression analysis indicated that elevated levels of HS and HA were independent risk factors (HS: HR =1.697, 95% CI : 1.126-2.557, P =0.011; HA: HR =1.336, 95% CI : 1.047-1.705, P =0.020) for 30-day mortality. Conclusions: High level of serum HS in 24 hours after CA may serve as a potential predictive marker for both neurological function and 30-day mortality. However, high level of serum HA appears to primarily predict 30-day mortality. Sdc-1 does not seem to contribute to outcome prediction.

Objectives: This study aims to evaluate the correlation between differences in intraoperative jumping gaps and soft tissue changes around immediate implant placement and provisionalization (IIPP) in the maxillary anterior region. Results will provide a basis for clinical evaluation of the change trend and long-term stability of the labial soft tissue contours of patients with different jumping gaps., Methods: Thirty-two patients with single tooth loss in the maxillary aesthetic area were enrolled, and they all received immediate implant placement and restoration. All patients were divided into three groups: A, B, and C according to the size of the jumping gap, group A: horizontal defect dimension (HDD) ≤2 mm; group B: 2 mm3 mm. Geomagic studio 2013 was used to quantitatively analyze the contour volume of the soft tissue around the implant and the level of the labial gingival margin. The pink esthetic score (PSE) was used for the final aesthetic evaluation., Results: All implants had osseointegration within 6 months after the surgery. The average thickness of soft tissue contour volume changed by 0.62 mm±0.15 mm, and the average PES was 11.09±0.99. The changes in the gingival mucosa levels in the three groups at 6 months after operation were 0.45 mm±0.11 mm, 0.40 mm±0.12 mm, and 0.35 mm± 0.11 mm, respectively. The changes in the average thickness of the soft tissue contour volume in the three groups at 6 months after the operation were 0.77 mm±0.16 mm, 0.63 mm±0.17 mm, and 0.54 mm±0.11 mm. A moderate negative correlation was found between the jumping gap size and the gingival mucosa level, and the average thickness changed. No significant correlation was found between size of jumping gap and PES., Conclusions: Although the contour volume of the labial soft tissue continuously decreased within 6 months after IIPP in the maxillary anterior region, the surgical procedure can achieve a satisfactory aesthetic effect, and the level of soft tissue around the implant can be well maintained.

The traditional Chinese medicine Aralia elata (Miq.) Seem., also known as Aralia mandshurica , has the effect of "tonifying Qi and calming the mind, strengthening the essence and tonifying the kidneys, and dispelling wind and invigorating blood circulation". It is used in the treatment of neurasthenia, Yang deficiency and Qi deficiency, kidney Qi deficiency, spleen Yang deficiency, water-dampness stagnation, thirst, and bruises. Aralia elata saponins are the main components for the pharmacological effects. From the perspective of modern pharmacological science, Aralia elata has a wide range of effects, including anti-myocardial ischaemia and alleviation of secondary myocardium ischemic reperfusion injury by regulating ionic homeostasis, anti-tumor activity by inhibiting proliferation, promoting apoptosis and enhancing immunity, hypoglycemia and lipid lowering effects by regulating glucose and lipid metabolism, and hepato-protective, neuroprotective, anti-inflammatory/analgesic effects. The studies on pharmacological mechanisms of Aralia elata will be conducive to its development and application in the future. This article reviews the research progress of Aralia elata domestically and internationally in the last two decades and proposes new directions for further research.

As a good passivation agent for heavy metals, modified biochar has been widely used in environmental remediation. In order to explore the effects of different modification methods on arsenic (As) and cadmium (Cd) passivation in soil by biochar, this study used co-precipitation and impregnation pyrolysis to prepare iron-modified biochar. Through adsorption experiments and soil culture experiments, the properties of biochar, adsorption capacity, and the As and Cd passivation ability in soil were analyzed. The results showed that both modification methods could increase the iron (Fe) content and zero charge point of biochar, and the Fe minerals supported by Fe-modified biochar (FeBC-1) prepared by co-precipitation were mainly Fe 3 O 4 , FeO(OH), and γ -Fe 2 O 3 . The Fe-modified biochar (FeBC-2) prepared by impregnation pyrolysis mainly consisted of α -Fe 2 O 3 and γ -Fe 2 O 3 . FeBC-1 showed strong adsorption and removal ability for As and Cd, with a removal rate of 21.40%-34.14%, which could significantly promote the conversion of non-obligate adsorbed As to residual As in soil, whereas FeBC-2 only had a good adsorption effect on As. The adsorption capacity of BC, FeBC-1, and FeBC-2 for Cd were proportional to their CEC. The adsorption and removal effect of BC on Cd was better than that of FeBC-1 and FeBC-2, which could significantly promote the conversion of soil acid-soluble Cd to stable residue Cd.

Objective: To investigate the prevalence, risk factors, duration and outcome of delirium in intensive care unit (ICU) patients., Methods: A prospective observational study was conducted for critically ill patients admitted to the department of critical care medicine, the Affiliated Hospital of Guizhou Medical University from September to November 2021. Delirium assessments were performed twice daily using the Richmond agitation-sedation scale (RASS) and confusion assessment method of ICU (CAM-ICU) for patients who met the inclusions and exclusion criteria. Patient's age, gender, body mass index (BMI), underlying disease, acute physiologic assessment and chronic health evaluation (APACHE) at ICU admission, sequential organ failure assessment (SOFA) at ICU admission, oxygenation index (PaO 2 /FiO 2 ), diagnosis, type of delirium, duration of delirium, outcome, etc. were recorded. Patients were divided into delirium and non-delirium groups according to whether delirium occurred during the study period. The clinical characteristics of the patients in the two groups were compared, and risk factors for the development of delirium were screened using univariate analysis and multivariate Logistic regression analysis., Results: A total of 347 ICU patients were included, and delirium occurred in 57.6% (200/347) patients. The most common type was hypoactive delirium (73.0% of the total). Univariate analysis showed statistically significant differences in age, APACHE score and SOFA score at ICU admission, history of smoking, hypertension, history of cerebral infarction, immunosuppression, neurological disease, sepsis, shock, glucose (Glu), PaO 2 /FiO 2 at ICU admission, length of ICU stay, and duration of mechanical ventilation between the two groups. Multivariate Logistic regression analysis showed that age [odds ratio (OR) = 1.045, 95% confidence interval (95%CI) was 1.027-1.063, P < 0.001], APACHE score at ICU admission (OR = 1.049, 95%CI was 1.008-1.091, P = 0.018), neurological disease (OR = 5.275, 95%CI was 1.825-15.248, P = 0.002), sepsis (OR = 1.941, 95%CI was 1.117-3.374, P = 0.019), and duration of mechanical ventilation (OR = 1.005, 95%CI was 1.001-1.009, P = 0.012) were all independent risk factors for the development of delirium in ICU patients. The median duration of delirium in ICU patients was 2 (1, 3) days. Delirium was still present in 52% patients when they discharged from the ICU., Conclusions: The prevalence of delirium in ICU patients is over 50%, with hypoactive delirium being the most common. Age, APACHE score at ICU admission, neurological disease, sepsis and duration of mechanical ventilation were all independent risk factors for the development of delirium in ICU patients. More than half of patients with delirium were still delirious when they discharged from the ICU.

Iliotibial band syndrome (ITBS), as an overused injury of the lower extremities, has developed into a common cause of lateral knee pain. At present, the treatment of ITBS includes drug therapy, muscle strength training, physical therapy, and surgical treatment. Among these methods, physical therapy, drug therapy, and surgical treatment can only alleviate the symptoms of patients. As a safe and effective treatment, lower limb muscle strength training can improve patients' muscle strength, correct abnormal gait, and reduce the recurrence rate of the disease by paying attention to the dynamic changes of patients' recovery process. At present, the pathogenesis of ITBS remains unclear, and the treatment methods are not unified. It is necessary to further study the biomechanical factors related to the lower extremities and develop more scientific and comprehensive muscle strength training methods.

Objective: To analyze the factors influencing pulmonary infections in elderly neurocritical patients in the intensive care unit (ICU) and to explore the predictive value of risk factors for pulmonary infections., Methods: The clinical data of 713 elderly neurocritical patients [age ≥ 65 years, Glasgow coma score (GCS) ≤ 12 points] admitted to the department of critical care medicine of the Affiliated Hospital of Guizhou Medical University from 1 January 2016 to 31 December 2019 were retrospectively analyzed. According to whether or not they had HAP, the elderly neurocritical patients were divided into hospital-acquired pneumonia (HAP) group and non-HAP group. The differences in baseline data, medication and treatment, and outcome indicators between the two groups were compared. Logistic regression analysis was used to analyze the factors influencing the occurrence of pulmonary infection. The receiver operator characteristic curve (ROC curve) was plotted for risk factors and a predictive model was constructed to evaluate the predictive value for pulmonary infection., Results: A total of 341 patients were enrolled in the analysis, including 164 non-HAP patients and 177 HAP patients. The incidence of HAP was 51.91%. According to univariate analysis, compared with the non-HAP group, mechanical ventilation time, the length of ICU stay and total hospitalization in the HAP group were significantly longer [mechanical ventilation time (hours): 171.00 (95.00, 273.00) vs. 60.17 (24.50, 120.75), the length of ICU stay (hours): 263.50 (160.00, 409.00) vs. 114.00 (77.05, 187.50), total hospitalization (days): 29.00 (13.50, 39.50) vs. 27.00 (11.00, 29.50), all P < 0.01], the proportion of open airway, diabetes, proton pump inhibitor (PPI), sedative, blood transfusion, glucocorticoids, and GCS ≤ 8 points were significantly increased than those in HAP group [open airway: 95.5% vs. 71.3%, diabetes: 42.9% vs. 21.3%, PPI: 76.3% vs. 63.4%, sedative: 93.8% vs. 78.7%, blood transfusion: 57.1% vs. 29.9%, glucocorticoids: 19.2% vs. 4.3%, GCS ≤ 8 points: 83.6% vs. 57.9%, all P < 0.05], prealbumin (PA) and lymphocyte count (LYM) decreased significantly [PA (g/L): 125.28±47.46 vs. 158.57±54.12, LYM (×10 9 /L): 0.79 (0.52, 1.23) vs. 1.05 (0.66, 1.57), both P < 0.01]. Logistic regression analysis showed that open airway, diabetes, blood transfusion, glucocorticoids and GCS ≤ 8 points were independent risk factors for pulmonary infection in elderly neurocritical patients [open airway: odds ratio (OR) = 6.522, 95% confidence interval (95%CI) was 2.369-17.961; diabetes: OR = 3.917, 95%CI was 2.099-7.309; blood transfusion: OR = 2.730, 95%CI was 1.526-4.883; glucocorticoids: OR = 6.609, 95%CI was 2.273-19.215; GCS ≤ 8 points: OR = 4.191, 95%CI was 2.198-7.991, all P < 0.01], and LYM, PA were the protective factors for pulmonary infection in elderly neurocritical patients (LYM: OR = 0.508, 95%CI was 0.345-0.748; PA: OR = 0.988, 95%CI was 0.982-0.994, both P < 0.01). ROC curve analysis showed that the area under the ROC curve (AUC) for predicting HAP using the above risk factors was 0.812 (95%CI was 0.767-0.857, P < 0.001), with a sensitivity of 72.3% and a specificity of 78.7%., Conclusions: Open airway, diabetes, glucocorticoids, blood transfusion, GCS ≤ 8 points are independent risk factors for pulmonary infection in elderly neurocritical patients. The prediction model constructed by the above mentioned risk factors has certain predictive value for the occurrence of pulmonary infection in elderly neurocritical patients.

In unicompartmental replacement surgery, there are a wide variety of commercially available unicompartmental prostheses, and the consistency of the contact surface between the common liner and the femoral prosthesis could impact the stress distribution in the knee after replacement in different ways. Medial tibial plateau fracture and liner dislocation are two common forms of failure after unicompartmental replacement. One of the reasons is the mismatch in the mounting position of the unicompartmental prosthesis in the knee joint, which may lead to failure. Therefore, this paper focuses on the influence of the shape of the contact surface between the liner and the femoral prosthesis and the mounting position of the unicompartmental prosthesis on the stress distribution in the knee joint after replacement. Firstly, a finite element model of the normal human knee joint was established, and the validity of the model was verified by both stress and displacement. Secondly, two different shapes of padded knee prosthesis models (type A and type B) were developed to simulate and analyze the stress distribution in the knee joint under single-leg stance with five internal or external rotation mounting positions of the two pads. The results showed that under a 1 kN axial load, the peak contact pressure of the liner, the peak ACL equivalent force, and the peak contact pressure of the lateral meniscus were smaller for type A than for type B. The liner displacement, peak contact pressure of the liner, peak tibial equivalent force, and peak ACL equivalent force were the smallest for type A at 3° of internal rotation in all five internal or external rotation mounting positions. For unicompartmental replacement, it is recommended that the choice of type A or type B liner for prosthetic internal rotation up to 6° should be combined with other factors of the patient for comprehensive analysis. In conclusion, the results of this paper may reduce the risk of liner dislocation and medial tibial plateau fracture after unicompartmental replacement, providing a biomechanical reference for unicompartmental prosthesis design.

Objective: To investigate the effect of ultrasonic parameter settings on maximum temperatures in the drilling site and penetration time and determine the most suitable parameters for efficient and safe robot-based ultrasonic bone drilling in spinal surgery. Methods: Five adult bovine thoracic and lumbar vertebrae specimens (T 10 -L 6 ) were cut into 10 mm thick slices. A total of 50 slices were obtained. Among them, 30 and 20 slices were used for cancellous bone experiments and cortical bone experiments, respectively. In the cancellous bone experiment, the slices were randomly divided into three groups, corresponding to different feed rates of 0.8 mm/s, 1.6 mm/s, and 2.4 mm/s, respectively, with 10 slices in each group. The cancellous part of each slice was drilled 9 times with different output powers from 20% (48 W) to 100% (120 W). In the cortical bone experiment, the slices were randomly assigned into two groups, corresponding to a different feed rate (0.8 mm/s and 1.6 mm/s). Drilling was performed on the cortical part of each slice 4 times with different output power, which increased from 70% (84W) to 100% (120 W). All experiments were conducted at room temperature of 25 ℃. Maximum temperature and penetration time were recorded. The maximum grinding temperature and penetration time of cancellous bone and cortical bone under different output power and feed rate were compared. Results: At the same feed rate, the maximum temperature of the cancellous bone decreased as output power increased. There were statistically significant differences in the maximum temperature between the output powers of 120 W and 24 W under different feed rates(61.2 ℃±9.4 ℃ vs 70.9 ℃±5.7 ℃, 59.2 ℃±7.1 ℃ vs 69.5 ℃±10.7 ℃, 55.5 ℃±5.5 ℃ vs 69.2 ℃±9.3 ℃, all P <0.05). At the premise of the same output power, there was no significant difference in the maximum temperature among different feed rates (all P >0.05). At the feed rate of 0.8 mm/s, the maximum temperature of cortical bone decreased as the output power increased. The maximum temperature at the output power of 120 W was significantly lower than that of 84 W ( P =0.048). However, at the feed rate of 1.6 mm/s, the maximum temperature could not be significantly lowered by the increase in output power ( P >0.05). Under the same output power, the maximum temperature at the feed rate of 1.6 mm/s were all significantly lower than those of 0.8 mm/s (all P <0.05). The penetration time of cancellous bone did not decrease significantly with the increase in the output power (all P >0.05) while it decreased significantly as the feed rate increased (all P <0.05). Regarding cortical bone at the feed rate of 0.8 mm/s, the increase in output power could not shorten the penetration time ( P >0.05); at the feed rate of 1.6 mm/s, the penetration time at the output power of 120 W was significantly shorter than that of 96 W ( P =0.008). With the same output power, the penetration time at the feed rate of 1.6 mm/s were significantly shorter than those at 0.8 mm/s (all P <0.05). There was no statistical difference in the penetration failure rate among different feed rates with the same output power (all P >0.05). The penetration failure rate was 0 when the output power of cancellous bone was 48 W and above and the output power of cortical bone were 108 W and 120 W. Conclusions: The maximum temperature of vertebral cancellous bone and the cortical bone is primarily influenced by the output power and the feed rate, respectively; the penetration time of cancellous bone and the cortical bone is affected by the feed rate and both of feed rate and output power, respectively. The most suitable parameters are output power of 120 W and feed rate of 2.4 mm/s for cancellous bone and output power of 120 W and feed rate of 1.6 mm/s for cortical bone.

Chronical hyperuricemia, a severe metabolic disease characterized by increased serum uric acid, urea nitrogen, and creatinine, has a positive correlation with the risks of gouty arthritis, diabetes, hypertension, and kidney damage. Abnormal purine metabolism and reduced uric acid excretion are the major causes of hyperuricemia, which, thus, points to a potential strategy of preventing from or delaying the progress of hyperuricemia-related diseases and its complications by effectively controlling the serum uric acid level. Increasing evidence has revealed that Chinese medicines alleviate hyperuricemia through regulating intestinal flora, which plays a pivotal role in regulating metabolites, including uric acid level. The disease treatment with traditional Chinese medicine is based on syndrome differentiation, and Chinese medicines often have multiple effects and a wide range of targets. In this review, we summarized the anti-hyperuricemia effects and mechanisms of active compounds in Chinese medicines, single Chinese medicinal herbs, and Chinese medicinal prescriptions in regulating the uric acid level via intestinal flora and metabolites, which will be helpful for further study and application of Chinese medicines in hyperuricemia treatment.

Objective: To investigate the ultrasonographic findings and genetic testing methods for fetuses carrying copy number variants (CNVs) of 7q11.23 region., Methods: Prenatal cases with 7q11.23 microdeletion/microduplication detected by single nucleotide polymorphism array (SNP array) from January 2016 to June 2020 were retrospectively analyzed, including fetal ultrasound, chromosomal karyotype, SNP array, pregnancy outcome and follow-up. Literature on 7q11.23 CNVs identified upon prenatal diagnosis was also reviewed., Results: Five fetuses were found with 7q11.23 CNVs, including 3 microdeletions and 2 microduplications. Of them, 4 had ultrasonographic anomalies. The karyotypes of all fetuses were normal. Of three 7q11.23 microdeletions, two were de novo, while the remaining one couple did not accept parental verification. Of two 7q11.23 microduplications, one was de novo and the another was inherited from a phenotypic normal father. Three 7q11.23 microdeletions and one de novo 7q11.23 microduplication were electively aborted. One fetus carrying paternally inherited 7q11.23 microduplication was delivered full term. Follow-up found the infant had a normal phenotype., Conclusion: Fetuses with 7q11.23 microdeletions or microduplications showed phenotypic heterogeneity. SNP array can accurately detect 7q11.23 CNVs, thereby provide accurate information for prenatal diagnosis and genetic counseling.

Objective: To investigate the clinical effect of the radical resection with a proximal incisal edge length of 20-25 mm and 30-35 mm in Siewert type Ⅱ advanced esophagogastric junction adenocarcinoma, to shorten the minimum safe distance of the proximal incisal edge to 20-25 mm. Methods: A retrospective cohort study method was used. The clinical data of 166 patients with Siewert type Ⅱ advanced esophagogastric junction adenocarcinoma who underwent total gastrectomy from January 2017 to August 2020 in the Department of Gastrointestinal Surgery, Heji Hospital Affiliated to Changzhi Medical College were retrospectively collected. According to the proximal incisal edge length, the patients were divided into two groups: the proximal incisal edge length of 20-25 mm group (69 cases) and 30-35 mm group (97 cases). The perioperative conditions and the 6-month follow-up after the operation were compared between the two groups. Results: There was no statistically significant difference in baseline information between the patients in the two groups ( P >0.05). The operations of both groups were completed. The intraoperative operation time of the proximal incisal edge length of 20-25 mm group was shorter than that in the proximal incisal edge length of 30-35 mm group ((172±24)and(206±27)min, P <0.001). There were no significant differences in the amount of intraoperative blood loss, the treatment of the diaphragm during the operation and the positive rate of intraoperative freezing of the upper incisal edge between the patients in the two groups (all P >0.05). And there was no significant differences in the first exhaust time, gastric tube removal time, first feeding time and hospital stay after the operation of the two groups (all P >0.05). There was no significant differences in the incidence of anastomotic leakage, anastomotic stenosis, reflux esophagitis and intestinal obstruction after the operation between the patients in the two groups (all P >0.05). And there was no anastomotic leakage case among the 69 cases in the proximal incisal edge length of 20-25 mm group. Postoperative pathological treatment showed no significant differences in the vascular tumor thrombus and nerve infiltration between the two groups (both P >0.05). During the 6-month follow-up, there was no death or tumor recurrence in the two groups, and there was no significant difference in body weight loss at 6 months after the operation between the two groups ( P =0.178). Conclusion: When radical resection of Siewert type Ⅱ advanced esophagogastric junction adenocarcinoma is performed, it is feasible to shorten the minimum safe distance of the proximal incisal edge to 20-25 mm under the premise of ensuring R0 resection. The operation time is shortened. Due to the shortening the incisal edge distance, the anastomotic tension is decreased, and the incidence of postoperative anastomotic leakage is also reduced.

Objective: To study the effect of curcumin on enterocyte apoptosis and its protective effect on intestinal mucosal barrier in septic rats., Methods: Eighty-seven 3-month male Sprague-Dawley (SD) rats were divided into Sham group, model group and curcumin group by random number table method, with 29 rats in each group. The septic rat model was reproduced by cecal ligation and puncture (CLP). 4 mL dimethyl sulfoxide solution were intraperitoneally injected in both Sham group and model group, 200 mg/kg curcumin dissolved by 4 mL dimethyl sulfoxide solution were intraperitoneally injected in curcumin group 10 minutes after operation. The blood samples (15 rats in each group) were collected 2, 12, 24 hours after operation, and the levels of serum procalcitonin (PCT), tumor necrosis factor-α (TNF-α), D-lactic acid and diamine oxidas (DAO) were tested by enzyme linked immunosorbent assay (ELISA). The ileum tissues were collected 12 hours, 24 hours after operation in three groups, water content was tested by weighting, pathologic structure was observed by light microscope, the enterocyte apoptosis was tested by terminal deoxynucleotidyl transferase-mediated dUTP-nick end labeling method (TUNEL). The 7-day survival rate was observed in three groups (14 rats in each group)., Results: The serum levels of PCT, TNF-α, D-lactic acid and DAO were higher in model group at 2, 12, 24 hours after operation than those in Sham group, PCT, TNF-α levels were significantly higher in model group than those in Sham group 2 hours after operation [PCT (μg/L): 1.89±0.17 vs. 0.10±0.02, TNF-α (ng/L): 216.51±1.47 vs. 85.25±8.20, both P < 0.01], D-lactic acid, DAO levels were significantly higher in model group than those in Sham group 12 hours after operation [D-lactic acid (mg/L): 40.53±7.76 vs. 11.29±1.28, DAO (ng/L): 1 120.40±302.35 vs. 330.02±81.28, both P < 0.01]. Compared with model group, the levels of serum PCT, TNF-α, D-lactic acid and DAO were lower in curcumin group 2, 12, 24 hours after operation, the statistical difference appeared from 12 hours after operation [PCT (μg/L): 5.37±0.44 vs. 8.67±0.64, TNF-α (ng/L): 211.12±4.31 vs. 313.30±18.46, D-lactic acid (mg/L): 29.74±1.41 vs. 40.53±7.76, DAO (ng/L): 810.71±201.41 vs. 1 120.40±302.35, all P < 0.05], curcumin group had lower water content in ileum tissues 12 hours, 24 hours after operation [(68.34±0.68)% vs. (70.55±0.87)%, (69.41±0.59)% vs. (71.69±0.87)%, both P < 0.05]. The pathologic structures of intestinal villus were normal in Sham group, however, in model group intestinal villus were atrophic, edematous and shorten 12 hours after operation, it was further exacerbated 24 hours after operation. Compared with model group, the pathologic structures of intestinal villus in curcumin group were relived 12 hours, 24 hours after operation. The number of apoptotic enterocytes were significantly increased in model group compared with Sham group 24 hours after operation (cells: 25.48±6.10 vs. 4.00±2.04, P < 0.05), and the number of apoptotic enterocytes was lower in curcumin group than that in model group at the same time (cells: 15.48±3.75 vs. 25.48±6.10), the difference was statistically significant (both P < 0.05). Seven-day survival rate was significantly lower in curcumin than that in model group [42.9% (6/14) vs. 50.0% (7/14)], however, the difference was not statistically significant (P > 0.05)., Conclusions: Curcumin can protect the intestinal mucosal barrier by inhibiting enterocyte apoptosis in septic rats.

Objective: To investigate the clinical features of fetuses with Wolf-Hirschhorn syndrome(WHS) and explore the diagnostic methods and prenatal ultrasound characteristics and provide evidence for prenatal genetic counseling., Methods: We retrospectively analyzed 5 cases of WHS fetuses diagnosed from March 2016 to February 2020, and analyzed the results of chromosomal karyotype analysis and chromosomal microarray analysis (CMA) of the fetuses., Results: Five cases of WHS were detected by CMA, four cases were detected by karyotype analysis. Prenatal ultrasound revealed 4 abnormalities, of which 3 had intrauterine growth restriction, and only 1 had abnormalities of the maxillofacial region. The sequence of the fragments was 4p16.3p16.1 with a loss of 6.5 Mb, 4p16.3p15.32 with a loss of 15.6 Mb combined with 2p25.3 increased by 906kb, 4p16.3p15.31 with a loss of 20.4 Mb, 4p16.p15.1 with a loss of 35 Mb and 4p16.3p14 with a loss of 37 Mb., Conclusion: Fetal growth restriction may be one of the early manifestations of WHS. Absence of fetal facial abnormality by prenatal ultrasound screening cannot exclude WHS. Karyotype analysis may miss the diagnosis of WHS, while combined CMA techniques can improve the diagnostic accuracy.

Ozone pollution has recently become a severe air quality issue in the Beijing-Tianjin-Hebei region. Due to the lack of a precursor emission inventory and complexity of physical and chemical mechanism of ozone generation, numerical modeling still exhibits significant deviations in ozone forecasting. Owing to its simplicity and low calculation costs, the time series analysis model can be effectively applied for ozone pollution forecasting. We conducted a time series analysis of ozone concentration at Shangdianzi, Baoding, and Tianjin sites. Both seasonal and dynamic ARIMA models were established to perform mid- and long-term ozone forecasting. The correlation coefficient R between the predicted and observed value can reach 0.951, and the RMSE is only 10.2 μg·m -3 for the monthly average ozone prediction by the seasonal ARIMA model. The correlation coefficient R between the predicted and observed value increased from 0.296-0.455 to 0.670-0.748, and RMSE was effectively reduced for the 8-hour ozone average predicted by the dynamic ARIMA model.

Bioactive peptides play important roles in promoting human health, such as lowering blood pressure, blood sugar and blood lipid, anti-obesity, and anti-cancer. Thus, exploring functional bioactive peptides and developing efficient production technologies are of crucial importance. Herein, we review the development of function discovery and production technology for natural bioactive peptides. Presently, the top-down and bottom-up approaches are mainly used for the function discovery and production of natural active peptides. The top-down approach includes the direct extraction and identification for functional discovery, and the direct extraction, enzymatic hydrolysis and microbial fermentation for production. The bottom-up approach includes the polypeptide modification and database mining for functional discovery, and the chemical synthesis, enzyme synthesis, recombinant expression and cell-free synthesis for production. The top-down approach is usually associated with complicated process, lower efficiency, higher cost, harder quality control, and uncertain functionality, while the bottom-up approach is more suitable for the development of peptide drugs but difficult to be used for functional foods. With the technology development of sequencing and mass spectrometry, it is easier to obtain the proteomic information of various organisms at the molecular level. Based on the proteomic information, the top-down and bottom-up approaches can be combined to overcome the disadvantages of using these two approaches alone, thus providing a new strategy for the rapid development and production of natural active peptides.

Objective: To investigate the influence of the preoperative factors on the segmental range of motion (ROM) during long-term follow-up after artificial cervical disc replacement (ACDR), so as to further improve the selection of surgical indications for ACDR. Methods: Retrospective analysis was performed on 71 patients with cervical degenerative diseases who underwent single-segment Bryan ACDR in Beijing Jishuitan Hosptial from December 2003 to December 2008, and a 10-year clinical follow-up was conducted. Among the patients, 44 were males and 27 were females, with a mean age of (45±8) years at operation. The mean follow-up time was (129±14) months. Preoperative and follow-up imaging evaluation including measurement of the segmental range of motion (ROM) by cervical X-ray, and preoperative height of intervertebral space was measured by cervical lateral X-ray. According to CT and coronal reconstruction, the grade of paravertebral ossification (PO) was assessed. Clinical symptoms assessment including the Japanese Orthopaedic Association scoring (JOA), the Neck Disability Index (NDI) evaluation was performed preoperatively. Multivariate logistic regression analysis was used to analyze the influencing factors of the range of motion of the surgical segment during follow-up. The best cut-off value was calculated by receiver operating characteristic (ROC) curve. Results: The preoperative and follow-up ROM at the operated segment was 9.7°±4.5° and 8.7°±5.4°, respectively ( P >0.05). Univariate analysis revealed that the postoperative segmental ROM was not significantly correlated with the factors including the surgical level, gender, age, and preoperative clinical diagnosis (1: Radiculopathy; 2: Myelopathy; 3: Mixed type), preoperative segmental ROM, preoperative JOA score and preoperative NDI score (all P >0.05), and was significantly correlated with imaging diagnosis (1: cervical disc herniation; 2: degenerative cervical stenosis), preoperative PO grade (both P <0.05). The multi-factor analysis showed that preoperative segmental ROM ( OR =1.228, 95% CI :1.012-1.489, P <0.05) and PO grade ( OR =0.190, 95% CI : 0.085-0.424, P <0.05) had significance in the overall test, but imaging diagnosis had no significance in the overall test ( P >0.05). The optimal cutoff value of preoperative segmental ROM and PO grade was 9.185° and grade 2.5 assessed by ROC curve, and the area under the ROC curve was 0.86 and 0.72, respectively. Conclusions: ACDR surgery can achieve satisfactory long-term effects for patients with nerve root type, spinal cord type and mixed type cervical degenerative diseases, and effectively retain the overall ROM of the cervical spine and the ROM of replacement segments. Patients with good preoperative segmental ROM and lower PO levels have a greater chance of obtaining good segmental ROM in the long-term postoperatively.

Three cases with age-related cerebral small vessel disease and normal pressure hydrocephalus in the Department of Neurology of Sun Yat-sen University were retrospectively reviewed. All the patients exhibited gait disturbance, cognitive impairment and urinary incontinence. Meanwhile, the Craniocerebral imaging demonstrated cerebral small vessel disease and communicating hydrocephalus. The cerebralspinal fluid (CSF) Aβ42 levels decreased, and apolipoprotein E (APOE) genotypes were ε3/ε4,ε3/ε3,ε2/ε3, respectively. After treatment in an all-cause individualized manner, the symptoms of 3 patients were stable or improved.

Objective: To assess the impact of confined placental mosaicism (CPM) on non-invasive prenatal testing (NIPT) and pregnancy outcomes., Methods: Copy number variation sequencing (CNV-seq) and single nucleotide polymorphism array (SNP-array) were carried out on placental specimen sampled from eight pregnancies with confirmed false-positive NIPT results. The impact of CPM on NIPT and pregnancy outcomes were analyzed based on the laboratory tests and clinical characteristics., Results: Five of the eight cases with false-positive NIPT results were proven to be CPM involving trisomy 9, 13, 21, 22, and X, respectively. The mosaic ratios for different placental regions have varied from 4% to 80%. Two fetuses with confirmed CPM showed fetal growth restriction (FGR) and additional ultrasound abnormalities, 1 fetus showed only FGR. The remaining two fetuses showed normal growth., Conclusion: NIPT is highly sensitive to CPM, whilst CPM is an important cause for false-positive NIPT result. CPM may be associated with FGR. Investigation of the presence of CPM is important for both pre- and post-test genetic counseling and management of the pregnancy.

Objective: To evaluate the efficacy of non-invasive prenatal screening (NIPS) for fetal sex chromosome anomalies., Methods: A retrospective analysis was carried out for 20 802 women undergoing NIPS screening. For 165 cases suspected for fetal sex chromosomal anomalies, the results of invasive prenatal diagnosis were obtained., Results: Among the 165 cases suspected for fetal sex chromosome anomalies, 129 have accepted invasive prenatal diagnosis, and 45 were confirmed, which yielded a positive predictive value of 34.88%. These included 16 cases of 47,XYY, 10 cases of 47,XXY, 6 cases of 45,X/46,XX, 5 cases of 47,XXX, 3 cases of 45,X, 1 case of 45,X/46,X,i(X)(q10), 1 case of 45,X/46,X,del(X)(q22), 1 case of 46,X,del(X)(q22), 1 case of 46,X,del(X)(p11) and 1 case of Xp22.31 1.2 Mb deletion., Conclusion: NIPS has limited value for detecting fetal sex chromosome anomalies. Karyotyping analysis combined with other diagnostic techniques can offer effective prenatal diagnosis for suspected cases.

Objective: To investigate the prevalence and affecting factors of laryngopharyngeal reflux disease（LPRD） in otolaryngology head and neck surgery in Chongqing,and to provide a basis for the clinical diagnosis and therapy of LPRD. Methods: Multi-center cross-sectional survey method and systematic sampling method were used to select patients at fifteen hospitals in Chongqing from August to November in 2019. Then reflux symptom index（RSI） was investigated. At the same time, the information of the relevant dietary habits, including smoking and drinking, spicy diet, high-fat diet, and satiety was collected. Moreover, the factors related to LRPD（gender, age, symptoms, diet and lifestyle） were analyzed. Results: The composition ratio of LPRD was 11.90%（385/3234） in 3234 effective questionnaires and 385 positive ones. The composition ratio was 12.55%（173/1378） in men and 11.42%（212/1856） in women. The difference between the two groups was statistically significant（ P <0.05）. The difference in composition ratio among different age groups was statistically significant（ P <0.05）, with the highest composition ratio between 40 and 59 years old（170/1390）. Constant throat-clearing（symptom 2） and globus sensation（symptom 8） were most correlated with LPRD. Logistic regression analysis showed that spicy diet, over eating, and smoking were highly related to LPRD. Conclusion: Globus sensation and constant throat-clearing are the most common symptoms in LPRD patients. Spicy diet, over eating, and smoking are risk factors for LPRD., 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.)

Objective: To investigate the role of the differential piRNA NU13 derived from piwil2-induced cancer stem-like cells (piwil2-iCSCs) in regulating biological behaviors of Wilms tumor cells (G401)., Objective: The expressions of piRNA NU13 and NOP56 were detected in Wilms tumor cell line G401 using RT-qPCR. G401 cells were transfected with piRNA NU13 mimics and inhibitor for its over-expression and inhibition, and the transfection efficiency was verified with RT-qPCR. The changes in proliferation of G401 cells after transfection were detected using CCK8 assay, and cell apoptosis was analyzed using flow cytometry. Wound healing assay and Transwell assay were performed to examine the changes in migration and invasion abilities of the transfected cells. The binding of NOP56 and piRNA NU13 was detected using dual luciferase experiment. The protein expressions of MMP2, MMP9, BAX, Bcl2, and NOP56 in the cells were detected with Western blotting., Objective: RTqPCR showed that the expression of piRNA NU13 decreased significantly in human Wilms tumor G401 cells as compared with that in renal tubular epithelial cell line HK2 ( P < 0.05), and NOP56 was highly expressed in G401 cells and Wilms tumor tissues ( P < 0.05). Over-expression of piRNA NU13 significantly suppressed the proliferation, migration and invasion of G401 cells, promoted cell apoptosis ( P < 0.05), inhibited the expression of MMP2, MMP9 and Bcl2, and enhanced the expression of BAX ( P < 0.05). The results of dual luciferase experiment showed that piRNA NU13 did not bind to NOP56 directly but regulated the expression of NOP56 in an indirect manner., Objective: piRNA NU13 is down-regulated and NOP56 is highly expressed in Wilms tumor. piNU13 may regulate the expression of NOP56 indirectly to inhibit the proliferation, migration and invasion and promote apoptosis of Wilms tumor cells in vitro .

Objective: To analysis the income and expenditure of HIV-positive pregnant women and the catastrophic health expenditure of their households in high AIDS endemic areas in Liangshan prefecture. Methods: From December 2018 to January 2019, a total of 250 pregnant women were recruited from 2 of 17 counties in Liangshan Prefecture, including 133 HIV-positive pregnant women and 117 HIV-negative pregnant women. The data, including basic information of pregnant women, basic information of the family, annual family income in 2017, annual family health expenditure in 2017, and maternal and child-related expenditure in 2017, were collected for analyzing the incidence of catastrophic health expenditure in the family. Results: The average annual income and average annual health expenditure of HIV-positive pregnant women households were 7 000 CNY and 2 000 CNY, while those of HIV-negative pregnant women households were 10 000 CNY and 3 000 CNY, respectively. Based on the criteria of 15%, 25% and 40%, the incidence of catastrophic health expenditure of HIV-positive pregnant households was 39.10%, 33.83% and 27.82%, with average differences of 34.84%, 31.17% and 26.65%, respectively, while that of HIV-negative pregnant women households was 38.46%, 33.33% and 23.93%, with average differences of 31.68%, 28.35% and 24.22%, respectively. Conclusion: The incidence of catastrophic health expenditure of pregnant households in high AIDS endemic areas in Liangshan prefecture is high. The incidence of HIV-positive families is slightly higher than that of HIV-negative families. We suggest that medical insurance compensation in Liangshan prefecture should be improved to reduce the impact of catastrophic health expenditure.

There were significant differences in the working efficiency and mechanism of constructed wetlands between low temperature and suitable temperature conditions. This study designed a horizontal subsurface flow constructed wetland (HFCW) and a vertical subsurface flow constructed wetland (VFCW) to explore their performance differences in advanced treatment of sewage based on contaminant degradation analysis including the removal of organic matters, total nitrogen (TN), and total phosphorus (TP), as well as the analysis of microbial community structure. The results showed that when the COD concentration of influent was between 37.50 to 80.00 mg·L -1 , the concentration of total nitrogen and total phosphorus were within the first level A criteria specified in the discharge standard of pollutants for municipal wastewater treatment plant at the continuous flow of 2 m 3 ·d -1 :①Both HFCW and VFCW showed stable degradation ability of organic matter in influent and good resistance to high organic load. ②Supplementation of the carbon source significantly improved the nitrogen removal efficiency of two subsurface flow constructed wetlands. HFCW achieved the average removal rate of TN at 76.01%, and the average removal rate of TN by VFCW reached 71.69% after the carbon addition. In contrast, dosage of an external carbon source showed limited effect on phosphorus removal. Furthermore, it worked more effectively for performance improvement of HFCW than that of VFCW. ③The analysis of microbial community structure in wetland substrate and plant rhizosphere samples revealed that Proteobacteria, Firmicutes, and Verrucomicrobia were the dominant phylum in two series of wetland samples. For the dominant microbiota at the genus level, there were more significant differences in microbial community structure in wetland substrate samples than that in plant rhizosphere samples. Hydrogenophaga , Erysipelothrix , and Devosia contributed the most to the differences between the microbial communities of HFCW and VFCW. Overall, the species diversity and abundance of microbial samples from VFCW was higher than those from HFCW.

Objective: To explore the influencing factors on perinatal mortality of pregnant women with HIV infection to reduce the mother-to-child transmission in Sichuan province. Methods: In this study, 4 786 perinatal infants of the HIV-infected pregnant women were included. Related data on perinatal epidemiology was reported by all the 183 medical and health care institutions where the HIV prevention of mother-to-child transmission program was initiated in 2005-2016. Univariate χ (2) test and multivariate logistic regression methods were used to analyze the perinatal mortality outcomes and influencing factors. Results: The overall perinatal mortality rate was 25.7‰ (123/4 786) among HIV-infected pregnant women, with annual downwarding trend (trend χ (2)=32.220, P =0.000). Perinatal mortality rate appeared the highest ( χ (2)=4.130, P =0.042), with more fetal deaths and stillbirths and less early neonatal death within 7 days in Liangshan county ( χ (2)=29.626, P =0.000). Results from the multivariate logistic regression analysis showed that fewer pregnant numbers would contribute to the, lower perinatal mortality rate (1-2 pregnancies OR =0.417, 95 %CI : 0.184-0.943; 3-4 pregnancies OR =0.447, 95 %CI : 0.223-0.895). Perinatal deaths were more likely to be prevented if LPV/r protease inhibitor-based triple antiviral therapy was provided ( OR =0.530, 95 %CI : 0.285- 0.986) or delivery was taken place in the hospital (hospital of municipal-level and above OR =0.222, 95 %CI :0.098-0.499; county-level hospital OR =0.282, 95 %CI : 0.166-0.480; township-level hospital OR =0.134, 95 %CI : 0.031-0.586) among HIV-infected pregnant women. However, premature delivery or neonatal asphyxia would increase the risk of perinatal mortality (premature delivery OR =8.285, 95 %CI : 5.073-13.533; neonatal asphyxia OR =9.624, 95 %CI : 4.625-20.028). Conclusions: The perinatal mortality rate of HIV-infected pregnant women appeared significantly higher than that in the province or the whole country. Strategies involving LPV/r-based triple antiviral therapy, promotion of hospital delivery, reducing the incidence rates of premature deliveries and neonatal asphyxia, should be strengthened.

Objective: To evaluate the effectiveness of the nose ring drain (NRD) in treatment of severe diabetic foot infection., Methods: The clinical data of 35 patients with severe diabetic foot infection who were treated with NRD between June 2017 and June 2019 were analyzed retrospectively. There were 24 males and 11 females with an average age of 54.5 years (range, 28-82 years). All of them were type 2 diabetic patients. The diabetes duration was 3-20 years, with an average of 9.4 years. The diabetic foot duration was 4 months to 2 years, with an average of 1.16 years. There were 16 cases of left foot and 19 cases of right foot. According to Wagner's grading, there were 11 cases of grade 2, 20 cases of grade 3, and 4 cases of grade 4, all of which were moderate and severe infection of diabetic foot wound. Postoperative wounds were treated with "nibble-like" debridement until the patient's epidermis regenerated and healed. During the treatment process, the indexes of bacterial culture type of wound secretions, duration of antibiotic therapy, wound healing method, healing time, amputation rate, and other indicators were analyzed and summarized., Results: All 35 patients were followed up 3-6 months, with an average of 4.5 months. Postoperative bacterial culture of wounds showed that 5 cases of Staphylococcus aureus , 4 cases of Pseudomonas aeruginosa , 5 cases of Escherichia coli , 3 cases of Enterobacter cloacae , 3 cases of coagulase-negative Staphylococcus , and 15 cases of other types were detected. The duration of antibiotic therapy ranged from 3 to 15 days, with an average of 9.1 days. The wound was autolytically healed without skin grafting, and the healing time was 62-82 days, with an average of 72.3 days. During the follow-up, 3 cases (8.6%) had amputation due to the patient's poor blood glucose control, which led to a large spread of infection. In addition, among the other patients with wound healing, there was no recurrence of wound infection or new ulcer on the original surface., Conclusion: The NRD is a simple operation for treatment of severe diabetic foot infection, which can effectively control wound infections and promote wound healing and regeneration without skin grafting.

Objective: To compare the expression patterns of microRNA (miRNA) between 144 Uygur and Han women with endometrial carcinoma and to investigate their clinical significance., Methods: Taqman miRNA low-density array was used to compare miRNA profiles between Uygur and Han women with non-endometrioid endometrial carcinoma (NEEC). Five miRNAs were further analyzed in the 144 endometrial cancers including 62 Uygur and 82 Han samples via real-time PCR to determine their expression patterns., Results: MiRNA expression profiles revealed that many miRNAs overexpressed or downregula-ted in one ethnic group, but did not express or changed slightly in the other ethnic group. Further detection in the 144 endometrial cancers showed that miR-141, miR-200a, and miR-205 overexpressed in both ethnic groups. In Uygur endometrioid endometrial carcinoma (EEC), tumors with miR-141/200a overexpression tended to be more aggressive in behavior, whereas in the Han group, EEC with miR-200a overexpression was relative mild. However, the NEEC with miR-200a overexpression also had aggressive clinicopathologic features in the Han women. MiR-145 and miR-143 expressed differentially between Uygur and Han groups, they overexpressed in the former and decreased in the latter ( P <0.05). In the Uygur women miR-145/143 increased significantly in NEEC and there was a trend that NEEC exhibiting favorable clinicopathologic factors had higher miR-145 expression, and was statistically significant in tumors with myometrial invasion less than 1/2 thickness ( P =0.042). By contrary, miR-145/143 decreased in Han group and EEC with worse clinicopathologic variables had lower expression although without statistical significance. NEEC in Han group had no such tendency., Conclusion: Uygur and Han women might have different miRNA expression profiles. MiR-141/200a/205 overexpressed in endometrial carcinomas and miR-141/200a might behave differently between these two ethnic groups as well as in EEC and in NEEC. Although miR-145/143 showed inverse expression patterns between Uygur and Han women with endometrial cancer, they all exerted tumor suppression effect on endometrial cancer.

As important precursors of near-surface ozone, secondary organic aerosols (SOAs), and volatile organic compounds (VOCs) play an important role in photochemical reactions and fine particle formation. In this study, real-time VOCs were measured continuously by Syntech Spectras GC955 analyzers at the regional background site of the North China Plain from September 1 to 27, 2017. The VOC concentration levels, compositions, spatiotemporal variations, and the ozone formation potential during the observation period were investigated. The potential sources of initial VOCs indicated from the diagnostic ratios were further studied. The averaged total mixing ratio of VOCs was 12.53×10 -9 . Among all measured VOC species, alkanes were the most abundant species, which accounted for 65.3% of the total concentrations, followed by alkenes (26.7%) and aromatics (6.5%). In addition, the total OH radical loss rate of VOCs ( L ·OH ) was 5.2 s -1 . In particular, the contribution of C4-C5 alkenes to L ·OH was as high as 61%, followed by C2-C3 alkenes, with a 12.8% contribution of L ·OH . The average ozone formation potential of VOCs was 36.5×10 -9 . Among all the measured VOC species, alkenes were the most abundant species, which accounted for 71.2%. Among alkenes, the contribution of C4-C5 alkenes was the most prominent. Although the concentration of alkanes in Shangdianzi was much higher than other VOC species, the ozone formation potential was lower. Diagnostic ratios and source implications suggested that Shangdianzi was affected mainly by biomass/biofuel/coal burning, with substantially elevated benzene levels during the observation period, whereas a slight influence of traffic-related emissions was observed.

Objective: To compare the efficacy of different thalassemia screening strategies used for the couple of pre-pregnancy., Methods: A total of 1 159 couples were recruited in Chongqing health center for women and children from January 2019 to June 2019. Routine blood test, hemoglobin test and thalassemia gene test were performed for all the coulpes. The efficacy of thalassemia screening strategies were compared. Strategy 1: Hemoglobin was tested if the woman's MCV <80 fl and/or MCH <27 pg, and test for thalassemia genes was required further according to the result of hemoglobin test. If the woman was a thalassemia carrier, it is recommended that the man would receive the corresponding thalassemia gene test, and if the man carried the same type of thalassemia gene, so it meant positive. Strategy 2: the woman's blood cut-off value was MCV<82 fl and/or MCH<27 pg, and the follow-up procedure was the same as strategy 1. Strategy 3: If both of cople showed MCV (<80 fl) and/or MCH (<27 pg), the couple would be tested for hemoglobin electrophoresis, and if both of the couple showed abnomal result of hemoglobin electrophoresis, the couple would be tested for thalassemia gene. If the couple carried the same thalassemia gene, it meant positive. Strategy 4: If one of the couple or both of them showed MCV (<80 fl) and/or MCH (<27 pg), the couple would be tested for hemoglobin electrophoresis, if the couple showed MCV (<80 fl) and/or MCH (<27 pg) and/or the abnormal result of hemoglobin test, genetic test for thalassemia test were performed., Results: A total of 15 couples were thalassemia positive. According to the ROC curve, the area under the curve of strategy 2 was the largest but the cost was the highest. The area under the curve of strategy 4 was slightly less than that of strategy 2, but the cost was lower., Conclusion: Strategy 4 is recommended in the case of high degree of male cooperation and strategy 2 is recommended in the case of low degree of male cooperation.

Objective We propose a deep learning network-based method for recognizing and locating diatom targets with interference by complex background in autopsy. Method The system consisted of two modules: the preliminary positioning module and the accurate positioning module. In preliminary positioning, ZFNet convolution and pooling were utilized to extract the high-level features, and Regional Proposal Network (RPN) was applied to generate the regions where the diatoms may exist. In accurate positioning, Fast R-CNN was used to modify the position information and identify the types of the diatoms. Results We compared the proposed method with conventional machine learning methods using a self-built database of images with interference by simple, moderate and complex backgrounds. The conventional methods showed a recognition rate of diatoms against partial background interference of about 60%, and failed to recognize or locate the diatom objects in the datasets with complex background interference. The deep learning network-based method effectively recognized and located the diatom targets against complex background interference with an average recognition rate reaching 85%. Conclusion The proposed method can be applied for recognition and location of diatom targets against complex background interference in autopsy.

Objective: To observe the effect of low-frequency electrical acupoint stimulation on gastrointestinal motility in patients undergoing radical gastrectomy, and its impact on regulation of inflammatory response, so as to evaluate its clinical value., Methods: A total of 177 patients undergoing radical gastrectomy were randomly divided into conventional group ( n ＝43), low-frequency electrical acupoint stimulation (LEAS) group ( n ＝45), fast track surgery (FTS) group ( n ＝46) and FTS＋LEAS group ( n ＝43). Patients of the conventional group received conventional treatment (pre-surgical mechanical bowel preparation, post-surgical fasting, and indwelling abdominal drainage tube, etc.). Patients in the LEAS group were treated by low-frequency electrical stimulation at bilateral Zusanli (ST36), Shangjuxu(ST37), Xiajuxu(ST39) and Sanyinjiao(SP6) for 30 min, once daily from 1 day after the operation to first postoperative flatus. FTS group was given fast track surgery treatment, such as preoperative education, preoperative nutritional support, early oral feeding, early removal of abdominal drainage tube, etc. The FTS＋LEAS group was given low-frequency electrical acupoint stimulation on the basis of the FTS treatment. Levels of white blood cells (WBC), neutrophils (N), C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) at 1, 3, and 6 d after the operation in the 4 groups were assayed. The first postoperative flatus and defecation time were recorded., Results: After the treatment, the first postoperative flatus and defecation time in the LEAS, FTS and FTS＋LEAS groups were significantly shorter than those of the conventional group ( P <0.05), and the first flatus time of the FTS＋LEAS group was even earlier than that of the FTS group ( P <0.05). No significant differences were found among the 3 groups in the postoperative defecation time ( P >0.05). The CRP levels in the 4 groups on 3 and 6 d after operation were higher than those on the 1st postoperative day, and the highest level was on 3 d after the operation. Compared with the conventional group, CRP level on 3 d and CRP and IL-6 levels on 3 and 6 d in the LEAS and FTS＋LEAS groups were significantly lower ( P <0.05). Compared with the LEAS group, the levels of N, CRP on 3 d and the levels of N, CRP, IL-6 on 6 d in the FTS group were significantly increased ( P <0.05). Compared with the FTS group, the level of CRP on 3 d and the levels of N, CRP, IL-6 on 6 d in the FTS＋LEAS group were significantly decreased ( P <0.05)., Conclusion: FTS combined with LEAS is superior to simple FTS or LEAS treatment in shortening the first flatus and defecation time and promoting the recovery of gastrointestinal motility function in patients undergoing radical gastrectomy, which may be associated with its effect in alleviating postoperative inflammatory responses.

Objective: explore the expression of miR-155-5p in Wilms tumor and its effect in regulating the proliferation, migration and apoptosis of Wilms tumor cells., Methods: Specimens of tumor tissues and paired adjacent tissues were obtained from 40 patients with Wilms tumor for detection of the expression levels of miR-155-5p using RT-qPCR. Wilms tumor cell line G401 was transfected with miR-155-5p mimics and miR-155-5p inhibitor to induce miR-155-5p over-expression and its inhibition, respectively, and the changes in the cell proliferation, migration and apoptosis were assessed using cell counting kit-8 (CCK-8), wound healing assay and fl ow cytometry., Results: RT-qPCR showed that the expression of miR-155-5p decreased significantly in Wilms tumor tissues as compared with normal kidney tissues and was significantly associated with TNM stage ( P < 0.05). In G401 cells, over-expression of miR-155-5p significantly inhibited the cell proliferation and migration and promoted cell apoptosis ( P < 0.05), and down-regulation of miR-155-5p obviously enhanced the proliferation and migration and suppressed apoptosis of the cells ( P < 0.05)., Conclusions: miR-155-5p is down-regulated in Wilms tumor and its expression level is correlated with TNM stage. miR-155-5p participates in the progression of Wilms tumor by inhibiting the proliferation and migration and promoting apoptosis of the tumor cells, and may serve as a novel biomarker for diagnosis, therapy and prognostic evaluation of Wilms tumor.

A gas chromatographic fingerprint combined with chemical pattern recognition was successfully developed and applied to assess the quality consistency of 20 Chenxianghuaqi tablets. Volatile components from the 20 Chenxianghuaqi tablets were extracted with ethanol under ultrasonic conditions. n -Octadecane was used as the internal standard to calculate the amounts of the three main components and to confirm the relative peak areas of the other components. Gas chromatographic fingerprints of the 20 Chenxianghuaqi tablets were established. There were 11 common peaks in the fingerprints, and the similarity of each batch of samples was obtained. Ten common peaks were identified by gas chromatography-mass spectrometry, with reference comparison. The obtained fingerprints were used for the chemical pattern recognition, including hierarchical cluster analysis and the principal component analysis. Different batches of Chenxianghuaqi tablets could be differentiated effectively, and major markers that led to differences among the sample batches were identified. The method proposed in this study is comprehensive and reliable, and it can be used as a valuable reference to evaluate and control the quality of Chenxianghuaqi tablets.

The development of orally administrated heparin drugs requires a systematic understanding of the interaction between heparin and gut flora. The in vivo distribution of fluorescein-labeled heparin that is orally administrated by mice was observed using fluorescein microscopy. In addition, the stability of heparin in simulated gastric and intestinal fluids, as well as the in vitro degradation of heparin by gut flora were detected by HPLC. The results show that orally administrated heparin was mainly distributed in the gastrointestinal tract of mice, and exerted structural stability under the condition of simulated gastric and intestinal fluids in vitro. However, heparin could be degraded by intestinal flora cultured in medium containing heparin. In order to further study the effect of orally administrated heparin on intestinal flora in mice, the fecal microbiota 16S rRNA fragment of C57BL/6J mice was tested by the Illumina Mi-Seq high-throughput sequencing technology. Compared with the gut flora of mice that orally administrated by saline, the biodiversity of gut flora in mice with orally administrated heparin was decreased. The difference of microflora structure was not significant at the phylum level, and the relative abundance of Alistipes, Parasutterella and Akkermansia was increased at the genus level, and the relative abundance of Bilophila, Enterorhabdus, Ruminiclostridium, Prevotellaceae&#95;UCG&#95;001, Ruminiclostridium-9, Bacteroides, Lachnoclostridium, Candidatus, Saccharimonas, Intestinimonas and Dubosiella was reduced. These findings indicate that heparin could influence the gut flora of mice. In addition, no obvious toxic and side effects were found in mice that orally administrated heparin, suggesting the safety of orally administrated heparin.

Objective: To explore the effect and influencing factors of customized sound on tinnitus. Method: 303 patients with tinnitus who received customized sound therapy for 6 months were enrolled in this study. Tinnitus handicap inventory (THI) was used to evaluate the treatment effect before treatment, 1 month, 2 months, 3 months, 4 months, 5 months and 6 months after treatment, and the influencing factors of sound treatment effect were analyzed. Result: The THI score decreased at the 1, 2, 3, 4, 5 and 6 months after treatment ( P <0.01), compared with that before treatment. Gender, tinnitus type and presence or absence of voice allergy had no effect on THI score before treatment and 6 months after treatment ( P >0.05). Conclusion: Customized sound therapy can reduce the score of THI in tinnitus patients, which supports that sound therapy can reduce the negative impact and disturbances produced by tinnitus, and its curative effect is not affected by gender, tinnitus type and presence or absence of voice allergy.., 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.)

Objective: To determine the origin of supernumerary small marker chromosomes (sSMCs) carried by two fetuses., Methods: Single nucleotide polymorphism array (SNP-array) and fluorescence in situ hybridization (FISH) analysis were carried out on cells cultured from the amniotic fluid samples., Results: SNP-array analysis showed both fetuses to be arr[hg19]22q11.1q11.21(16 888 899-18 649 190)×4, with a duplicated 1.7 Mb region (16 888 899-18 649 190) leading to partial tetrasomy of 22q11.1-22q11.21. FISH confirmed that both fetuses were 47,XN,+mar.ish idic(22)(q11.2) (RP11-958H20 ++),which suggested a diagnosis of Cat-eye syndrome (CES). The appearance of abortuses were consistent with the diagnosis of CES., Conclusion: Two fetuses with CES were diagnosed by genetic testing. The latter has provided a basis for genetic counseling.

Objective: To investigate the transcriptome profile of genital tubercles (GTs) in male SD rats and explore the mechanism of hypospadias induced by Di (2-ethylhexyl) phthalate (DEHP)., Methods: Forty time-pregnant SD rats were randomly divided into 4 equal groups, namely GD16 group and GD19 group (in which the male GTs were collected on gestation day[GD]16 and GD19 for RNA-seq, respectively), control group and DEHP exposure group (with administration of oil and 750 mg/kg DEHP by gavage from GD12 to GD19, respectively).In the control and DEHP exposure groups, the GTs were collected from the male fetuses on GD19.5, and scanning electron microscopy and HE staining were used to observe the morphological changes.The differentially expressed genes (DEGs) in the GTs were screened using lllumina HiSeq 2000 followed by GO and KEGG enrichment analyses to characterize the transcriptome profile.Immunofluorescence assay was performed to verify the DEGs (Mafb) identified by RNA-seq results.Immunofluorescence assay and Western blotting were used to examine the expression levels of Mafb in the penile tissue., Results: A total of 1360 DEGs were detected in the GTs between GD16 group and GD19 group by RNA-seq.Among these genes, 797 were up-regulated and 563 were down-regulated.These DEGs were mainly enriched in the cell adhesion plaque signaling pathway, axon guidance signaling pathway, and extracellular matrix receptor signaling pathway.Compared with that in GD16 group, Mafb was significantly up-regulated in GD19 group, which was consistent with the sequencing results.Mafb and β-catenin were significantly down-regulated in DEHP-exposed group compared with the control group ( P &lt; 0.01)., Conclusions: Mafb expression increases progressively with the development of GTs in male SD rats.DEHP exposure causes significant down-regulation of Mafb and β-catenin, suggesting that β-catenin signaling pathway that affects Mafb is related to DEHP-induced hypospadias in SD rats.

Meteorological conditions have important impact on the diffusion and transport of air pollutants, thus separating and quantifying the impact of meteorological factors is a prerequisite for evaluation of air pollution control measures. Using observation data on SO 2 , NO, NO 2 , NO x , CO, PM 2.5 , PM 1 , and PM 10 as well as meteorological factors at the Chaoyang site, an urban site in Beijing, we evaluated the impact of meteorological conditions and control measures on air quality in Beijing during APEC 2014 (from 15 October to 30 November, 2014) by the multiple linear regression method. The simulation performance of a multivariate linear regression model based on the parameters of meteorological factors for predicting pollutant concentration assuming constant emission conditions were ideal, produced a range of determination coefficient ( R 2 ) of 0.494-0.783. Our results suggested that air pollution control measures reduced the concentration of SO 2 , NO, NO 2 , NO x , CO, PM 2.5 , PM 1 , and PM 10 by 48.3%, 53.5%, 18.7%, 40.6%, 3.6%, 34.8%, 28.8%, and 40.6%, while meteorological conditions reduced the concentration of SO 2 , NO, NO 2 , NO x , CO, PM 2.5 , PM 1 , and PM 10 by 1.7%, -2.8%, 18.7%, 4.5%, 18.6%, 27.5%, 30.6%, and 35.6%. The combination of meteorological factors and control measures has significantly improved the air quality in Beijing during the APEC period. Control measures played a leading role in the reduction of SO 2 and nitrogen oxides, and meteorological factors played a leading role in the reduction of CO. Meteorological factors and control measures made roughly equal contributions to the reduction of particulate matter. We also used the relative weight method to study the contribution of meteorological factors to the pollutant concentration. The results showed that the decisive meteorological factors on the concentrations of different pollutants were different.

We explored the improved method to prepare decellularized kidney scaffold and provide experimental basis for kidney tissue engineering and renal pathology and toxicology in vitro research. We perfused rat kidneys with PBS (group control) and prepared the decellularized kidney scaffolds with sodium dodecyl sulfate (SDS) (group S), Triton X-100 combined with SDS (group TS), and Triton X-100 combined with SDS after repeated freezing and thawing (group FTS) in different flow velocity. Meanwhile we measured their fluid distributions and vascular resistance. We examined the degree of decellularization of acellular scaffolds by HE, DAPI staining and DNA quantification. We examined the retention of main composition and structural integrity of decellularized scaffolds by Masson, PAS and immunohistochemical staining. We also detected the ultrastructure, cytotoxicity and the level of growth factor of the scaffolds by scanning electron microscope, MTT and ELISA, respectively. The results showed that the time of decellularization in group FTS was less than that in group S and TS. The vascular resistance of scaffolds decellularized at 10 mL/min flow velocity was lower. The fluid distribution in groups S, TS and FTS was different from that in control group. No residual cell was detected by HE and DAPI staining. DNA content was less than 50 ng/mg. Masson, PAS and immunohistochemical staining results showed that there was extracellular collagen, polysaccharide, type I collagen, type IV collagen, fibronectin and laminin in the decellularized scaffolds, and the scanning electron microscope result showed the scaffolds had the honeycomb structure. The cytotoxicity level of decellularized scaffolds was between grade 0 to 1. The level of VEGF, EGF, IGF-1 and PDGF-BB in group FTS were significantly higher than those in group S and TS. In concluding, combining freeze-thawing with perfusion can produce more ideal and effective whole organ decellularized scaffold of rat kidney, and make a foundation for the study of kidney tissue engineering and in vitro pathology and toxicology of kidney.

As a natural extract from turmeric, curcumin has extensive pharmacological effects, such as anti-tumor, anti-inflammation, anti-oxidative stress, anti-microbial, immunoregulation and so on. In recent years, an increasing number of basic and clinical researches have shown that curcumin takes therapeutic effects on various diseases, such as gastrointestinal diseases, cardiovascular diseases, autoimmune diseases, neuropsychiatric diseases and so on. Many of the pharmacological effects and mechanisms of curcumin are associated with protective effects of intestinal mucosal barrier. It can protect intestinal mucosal barrier through mutiple pathways, including anti-inflammation, anti-oxidative stress, anti-bacterial, anti-apoptosis, regulating intestinal microecology and intestinal immune response and so on. This paper summarizes the protective effects of curcumin on intestinal barrier function and the mechanism, in order to provide new ideas for diagnosis and treatment of intestinal dysfunction.

Objective: To investigate the effect of Piwil2-induced cancer stem-like cell (Piwil2-iCSC)-derived exosomes on the proliferation,migration and invasion of human umbilical cord blood-derived mesenchymal stem cells (hucMSCs)., Methods: Piwil2-iCSC-derived exosomes were isolated by ultracentrifugation and identified using transmission electron microscopy,nanoparticle tracking analysis and Western blotting.Exosome uptake assay was used to identify the pathway that Piwil2-iCSCderived exosomes utilized.HucMSCs were divided into control group,PBS intervention group and exosome intervention group,and CCK-8 assay,wound healing assay,Transwell assay,Western blotting and cell karyotype analysis were used to observe the proliferation,migration,invasion,expression levels of MMP2 and MMP9 proteins,and chromosome structure of hucMSCs., Results: The diameter of Piwil2-iCSC-derived exosomes ranged from 50 nm to 100 nm,and most of them were oval or spherical capsules rich in CD9,CD63 and Piwil2 proteins.Exosomal uptake assay showed that the exosomes executed theirs functions after entering the cells.Compared with the control cells and PBS-treated cells,hucMSCs treated with the exosomes showed significantly increased number of proliferating cells ( P &lt;0.05) with accelerated healing rate ( P &lt;0.05 at 24 h; P &lt;0.01 at 48 h),increased invasive cells ( P &lt;0.01),enhanced protein expressions of MMP2( P &lt;0.05 vs PBS group; P &lt;0.01 vs control group) and MMP9( P &lt;0.05),but their karyotype still remained 46XY without any abnormalities., Conclusions: Piwil2-iCSC-derived exosomes can promote the proliferation,migration and invasion but does not cause cancer-like heterogeneity changes in hucMSCs.

This present study was to investigate the metabolism and excretion of characteristic polyphenols such as flavonoids and coumarins in urine and feces of rats after intragastric administration of ethanol extracts of Citri Reticulatae Pericarpium Viride and Citri Reticulatae Pericarpium. The urine and feces of rats were collected after intragastric administration of 70% ethanol extracts of Citri Reticulatae Pericarpium Viride and Citri Reticulatae Pericarpium. Rapid resolution liquid chromatography coupled with quadrupole tandem mass spectrometry (RRLC-QqQ-MSn) was applied to compare the contents of polyphenols in ethanol extract, urine and feces. By comparing with reference substance, 30 polyphenols were identified from the ethanol extracts of Citri Reticulatae Pericarpium Viride and Citri Reticulatae Pericarpium, including flavone glycosides, flavones, flavonone glycosides, flavonones, flavonol glycosides, polymethoxyflavones, coumarins, and limonoids and so on. The detection of various types of compounds showed differences in contents between the intestinal metabolism and excretion in the feces after systemic circulatory metabolism and renal excretion. The results showed that the polymethoxyflavones and flavonones were primarily excreted through urine, and the flavonone glycosides and limonoids were primarily excreted through feces. However, coumarins were hardly detected in feces and urine, indicating that coumarins may be metabolized in the body., 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.)

Objective: To analyze the pathological characteristics of superficial infiltrating squamous cell carcinoma of endoscopic submucosal dissection (ESD)., Methods: 187 cases of invasive squamous cell carcinoma after ESD operation were collected from 2016 Jan 31 to 2017 Dec 31. The tumor differentiation, invasion depth, infiltrative growth pattern (INF), tumor budding, angiovascular lymphatic invasion and margin were determined. The pathological diagnosis of endoscopic biopsy and surgical operation after ESD were searched., Results: The patients were aged from 42 to 83 years old, including 147 males and 40 females. 9.1% patients had carcinoma/intraepithelial neoplasia in other sites, among which gastric adenocarcinoma was the most common one. Well, moderately and poorly differentiated squamous cell carcinoma accounted for 0.5%, 41.7% and 15.0%, respectively, while the remaining 42.8% cases were microinvasion and were difficult to be graded. Mucosa lamina propria, muscularis mucosa and submucosa invasion accounted for 39.6%, 32.6% and 27.8%, respectively. Submucosa infiltration <200 μm (SM1) accounted for 9.1% and submucosa infiltration ≥200 μm (SM2) accounted for 18.7%. Lymphatic vessel invasion was related to the depth of tumor invasion, tumor budding, INF. The invasion rate of lymphatic vessels increased with the increase of infiltration depth and the grade of tumor budding. The lymphatic invasion rate in INFb/c group was higher than that in INFa group. There was no statistical difference in the incidence of lymphatic vessel invasion between well/moderately differentiated squamous cell carcinoma and poorly differentiated squamous cell carcinoma. Multivariate analysis showed that tumor budding was an independent risk factor for lymphatic vessel invasion. The complete resection occupied 69.5% (130 cases), while most of incomplete resection cases (57 cases) were involved by low-grade intraepithelial neoplasia. 69 cases had biopsy after ESD, among which there were 46 cases (66.67%) with no recurrence, 19 cases (27.54%) with recurrence, and 4 cases (5.80%) occurring in other sites. There was no statistical difference in recurrent rate between the complete resection (28.3%, 13/46) and the incomplete resection (31.6%, 6/19, P >0.05)., Conclusions: Tumor invasion depth, INF, tumor budding andlymphatic vessel invasion should all be disclosed for the ESD specimen pathological report. Tumor budding was an independent risk factor for lymphatic vessel invasion., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).)

Objective: To evaluate the feasibility of hepatitis C virus (HCV) infection by survey methods based on big data of hospital. Methods: Inpatients data of anti-HCV was collected in 2016 and 2011. Patient's data related to Department of Liver Diseases were excluded. The research population was divided into Surgical and Non-surgical Department. The characteristics of the two groups were analyzed and the changing trends of anti -HCV positive rate in different years was compared and analyzed. Results: Patients in the surgical and non-surgical department of hospital were equally distributed across gender, urban and rural areas, and region, but the distribution of patients in surgical departments were relatively equal in all age groups. The positive rate of anti -HCV in hospitalized patients in 2016 was 0.82%, and anti -HCV positive rate was 0.58% in surgical department of 1~55 years old. Among them, anti-HCV was positive in 0.06% who underwent surgical procedure at the age of ≤25 (born after 1993 and screened for hepatitis C antibody), which was significantly lower than those in other age groups were. The anti -HCV positive rate of patients (all age groups) was lower in 2016 than that in 2011(0.75% vs. 0.97%). The anti-HCV positive rates of surgical department in both years had a decreasing trend with age. Conclusion: The prevalence rate of anti-HCV, among patients population of operation departments, might reflect the prevalence rate of HCV infection among general population. Using the convenience of hospital data acquisition, we might dynamically understand the change of HCV infection.

Objective: To evaluate the long-term efficacy and influencing factors of cervical artificial disc replacement (CADR) for patients with cervical spondylotic radiculopathy (CSR)., Methods: The data of 29 CSR patients who underwent Bryan artificial disc replacement between December 2003 and December 2007 and followed up more than 10 years were retrospectively analysed. There were 16 males and 13 females with an average age of 54.1 years (range, 40-70 years). The disease duration was 2-144 months (mean, 19.2 months). CT and MRI were performed before operation to identify the compression segments (C 3, 4 in 2 cases, C 4, 5 in 6 cases, C 5, 6 in 18 cases, C 6, 7 in 3 cases) and the compression factors. According to the compression factor, the patients were divided into 2 groups: 14 patients with cervical disc herniation were in the group A and 15 patients combined with osteophyte were in the group B. There was no significant difference in gender, age, disease duration, and compressed level between 2 groups ( P >0.05). The radiographic and clinical evaluation indexes were recorded before operation and at last follow-up. The radiographic evaluation indexes included the global cervical and segmental range of motion (ROM), loss of ROM (ROM<3°) at last follow-up, Cobb angle and incidence of local kyphosis, paravertebral ossification (PO) grading. The clinical evaluation indexes included neck disability index (NDI) and overall efficacy (Odom's score)., Results: All patients were followed up 121-153 months (mean, 130 months). The results of radiographic evaluation indexes showed that within group comparison, except that the Cobb angle of the operated level was significantly decreased ( P <0.05) in both 2 groups, there was no significant difference in global cervical ROM and segmental ROM between preoperation and last follow-up ( P >0.05). Except that the loss of ROM (ROM<3°) at last follow-up and high-grade PO at last follow-up in group B were significantly higher than those in group A ( P <0.05), there was no significant difference in other radiographic evaluation indexes between 2 groups ( P >0.05). The results of clinical evaluation indexes showed that the NDI was significantly improved in both groups ( P <0.05) at last follow-up. There was no significant difference in the NDI at preoperation and at last follow-up, the decline of NDI at last follow-up, and the overall efficacy evaluated by Odom's score between 2 groups ( P >0.05). The excellent and good rate of overall efficacy reached 100% in both groups., Conclusion: CADR has satisfied long-term efficacy in treating CSR. The maintenance of segmental mobility was better in patients with disc herniation than in patients with disc herniation and osteophyte.

Objective: To evaluate the influence of carpentry of Bryan disc, including artificial disc coverage ratio and shell angular, on long-term efficacy and complications cervical artificial disc replacement. Methods: To retrospectively analyze the clinical data of 86 patients who underwent Bryan disc replacement in Beijing Jishuitan Hospital between 2003 and 2007 (including 101 operated segments). All the patients were followed-up for more than 10 years. Mean age of the patients was (53±9) years, including 51 males and 35 females, and 71 patients underwent single-level and 15 patients underwent two-level artificial disc replacement. Artificial disc coverage ratio and shell angular were measured on postoperative natural X-ray. According to the perfectness of carpentry including 2 parameters (postoperative shell kyphosis and artificial disc coverage ratio smaller than 95%), operated levels were divided into 2 groups: 43 levels in the optimal group and 58 levels in the suboptimal group. Radiographic indexes were evaluated preoperatively and at the last follow-up, included the segmental range of motion(ROM), segmental COBB's angle, the occurrence of segmental mobility lost, segmental kyphosis and the high grade paravertebral ossification(PO). Clinical indexes including Japanese Orthopaedic Association (JOA) score, neck disability index (NDI) and Odom's criteria were evaluated preoperatively and at the last follow-up. The improvement of JOA score, NDI% decline and the satisfaction rate of Odom's criteria were calculated too. The continuous data were analyzed by independent sample t test. The grading data were analyzed by Mann-Whitney test. Results: The mean age of the optimal group was (52±7) years, including 23 males and 14 females; the mean age of the suboptimal group was (54±10) years, including 28 males and 21 females.The baseline data of two groups were comparable. There were significant differences in the segmental ROM, the segmental COBB's angle, the occurrence of segmental mobility lost, segmental kyphosis and the high grade PO between the two groups at the last follow-up ( t =5.608, 3.812, χ(2)=15.097, 18.334, 27.141, all P <0.05). The improvement rate of JOA score was 69%±39% and 66%±44%, the NDI% decline was 14%±8% and 11%±8%, the satisfaction rate of Odom's criteria was 97.3% and 83.7% in optimal group and suboptimal group, respectively; there was no significant difference in the up-mentioned indexes between the two groups( t =0.307, 1.483, Z =0.989, all P >0.05). Conclusion: The carpentry of prosthesis will influence the occurrence of segmental mobility lost, segmental kyphosis, and high grade PO with cervical artificial disc replacement in the long run. It is suggested that the artificial disc coverage smaller than 95% and the shell kyphosis should be avoided.