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Objective: To investigate the pathogen species, composition, and distribution characteristics of infectious keratitis pathogens in Shandong Province and its surrounding areas. Methods: In this cross-sectional study, patients with keratitis who underwent corneal sampling and microbiological culture at the Shandong Eye Hospital from January 1, 2018 to December 31, 2022 were included. Under topical anesthesia, the edge of the lesion was scraped by an experienced physician. The samples were inoculated on blood agar and Sabouraud dextrose agar plates, separately for bacterial and fungal culture and identification. If necessary, the samples were inoculated on a non-nutrient agar medium with Escherichia coli for Acanthamoeba culture. Bacterial isolates were identified using Vitek 2 compact or matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Fungal isolates were identified based on morphological characteristics or sent to a company for sequencing in cases of difficult identification. The epidemiological data of the patients, pathogen species and number (counting as 1 strain if the same strain was isolated from multiple corneal specimens of the same patient), culture positivity rate, and seasonal distribution were recorded. Differences in pathogen positivity rates among different seasons were analyzed using the chi-square test. Results: Among the 4, 024 patients with infectious keratitis during the study period, there were 2 510 males (62.3%) and 1 514 females (37.6%), aged from 46 days to 94 years. Positive microbial culture results were achieved in 2, 363 patients (58.7%), including 906 cases (38.3%) with bacterial positivity, 1 231 cases (52.1%) with fungal positivity, 28 cases (1.2%) with Acanthamoeba positivity, and 198 cases (8.4%) with mixed fungal and bacterial infections. A total of 2 561 strains were isolated, including 1 104 bacterial strains. The most common bacteria were coagulase-negative Staphylococcus spp. (623/1 104, 56.4%), followed by Streptococcus spp. (131/1 104, 11.9%) and Pseudomonas aeruginosa (68/1 104, 6.2%). The most common fungi were Fusarium spp. (634/1 429, 44.4%), followed by Aspergillus spp. (279/1 429, 19.5%) and Alternaria spp. (229/1 429, 16.0%). Bacterial keratitis was more common in summer and autumn, while fungal keratitis was more common in autumn and winter. Conclusions: Among infectious keratitis cases in Shandong Eye Hospital, Fusarium species were predominant fungal pathogens, while coagulase-negative Staphylococcus predominated in bacterial pathogens. Both fungal and bacterial corneal infections showed seasonal variations.

In order to explore the spatial differentiation characteristics and variation law of soil Cd content in a high geological background area, 14 421 topsoil samples were collected from topsoil in the karst area of Guiyang City. Global Moran's I index, cold hot spot analysis, semi-variance function, and Kriging interpolation were used to reveal the spatial structure and distribution law of soil Cd content. The influence of environmental factors on soil Cd content and its main controlling factors were analyzed through analysis of variance and geographic detector. The results showed that： ① The Cd content of karst surface soil in Guiyang varied from 0.03 to 1.36 mg·kg -1 , with an average of 0.440 mg·kg -1 , which was 1.77 times and 5.95 times the Guizhou soil Cd background value and Chinese soil Cd background value, respectively. The over-standard rate of soil Cd was 30%, which was 4.29 times that of 7% of soil Cd in China. ② There was a significant spatial positive correlation of soil Cd content, showing an aggregation trend in the global space, whereas in the local region, the northeast and southwest were hot spots, and the north was a cold spot. The nugget coefficient of soil Cd content was 10.37%, indicating that soil Cd was mainly affected by structural factors. ③ In terms of spatial distribution, soil Cd showed different accumulation trends. In some massive soils, such as Xifeng County, Xiuwen County, Qingzhen City, Huaxi District, and Nanming District, the soil ω （Cd）was less than 0.3 mg·kg -1 . The soil ω （Cd）was between 0.3 and 0.6 mg·kg -1 ,and soil Cd in Baiyun District, Wudang District, Guanshan Lake area, and Yunyan area as a whole lied within this range. The soil ω （Cd）between 0.6 and 0.9 mg·kg -1 was concentrated in the southwest of Qingzhen City, the south of Huaxi District, and the north of Kaiyang County, whereas soil ω （Cd） between 0.9 and 1.2 mg·kg -1 was mainly concentrated in the southwest of Qingzhen City. The extreme value of soil Cd content （ > 1.2 mg·kg -1 ） was mostly distributed in Kaiyang County, Xiuwen County, Qingzhen City, and Huaxi District. ④ The results of analysis of variance and geo-detector showed that different environmental factors had significant effects on the spatial differentiation of soil Cd, but their explanatory power on soil Cd content varied： stratum （0.176 5） > soil type （0.026 0） > organic matter （0.025 1） > altitude （0.010 5） > parent rock （0.007 3） > land use （0.006 4） > pH （0.001 3）, and the interaction between stratum and arbitrary environmental factors was the greatest. Therefore, stratum was the main factor affecting the spatial differentiation of soil Cd content.

The patient, a 66-year-old male, suffered from redness, blurred vision, photophobia, and tearing in the right eye after being injured by a wooden board. Anti-inflammatory treatment showed poor effectiveness. A 4 mm × 4 mm infiltrate with white deposits on the surface was observed in the central cornea of the right eye. Microscopic examination of corneal scrapings, fungal culture, and in vivo confocal microscopy all indicated fungal infection. The isolated strain was identified as Scedosporium apiospermum through microscopic morphology and confirmed as Petriella setifera by gene sequencing. The patient received corneal debridement combined with routine anti-inflammatory and antifungal treatment in the outpatient clinic. During the follow-up period, the condition continued to improve. Slit lamp examination at the revisit 40 days after the initial diagnosis revealed thinning of the corneal stroma, basic healing of the epithelium, and an increase in uncorrected visual acuity from 0.3 to 0.6.

Objectives: To observe the effects on cognitive function, sleep quality and hemodynamics in the patients with subjective cognitive decline (SCD) after treated with acupuncture at neck-Jiaji (EX-B 2) and tuina on the base of healthy lifestyle education and meta-memory training., Methods: Sixty SCD patients were randomly divided into an observation group (30 cases, 1 case dropped out) and a control group (30 cases, 3 cases dropped out). In the control group, the healthy lifestyle education and meta-memory training was performed, twice daily, 15 min each time; the 5-day intervention was delivered a week, lasting consecutively 4 weeks. On the base of the intervention as the control group, in the observation group, acupuncture at neck-Jiaji (EX-B 2) and tuina was conducted. First, one-finger pushing and plucking method of tuina was exerted on the neck region along the running courses of the bladder meridian of foot- taiyang and the governor vessel, for 10 min to 15 min; afterwards, acupuncture was delivered at bilateral neck-Jiaji (EX-B 2), from C 1 to C 7 ; and the needles were retained for 30 min. This intervention was given once daily, 5 times a week, for consecutive 4 weeks. Before and after treatment, the score of the mini-mental state examination (MMSE), the score of full scale memory quotient (FSMQ) were assessed by Wechsler memory scale-fourth edition (WMS-Ⅳ) and the score of the Pittsburgh sleep quality index (PSQI) was compared between the two groups. Using transcranial Doppler ultrasound, the hemodynamic indexes (the mean velocity [Vm] and pulsatility index [PI] of the left vertebral artery [LVA], the right vertebral artery [RVA] and the basilar artery [BA]) were determined in the two groups., Results: After treatment, the scores of MMSE and FSMQ increased compared with those before treatment in the two groups ( P <0.05, P< 0.001), PSQI score was lower ( P <0.05) and Vm of BA was higher ( P< 0.001) in the observation group when compared with those before treatment. The scores of MMSE and FSMQ, as well as Vm of BA were higher ( P <0.05, P <0.001), and PSQI score was decreased ( P <0.05) in the observation group when compared with the control group., Conclusions: The combined therapy of acupuncture at neck-Jiaji (EX-B 2) and tuina is more advantageous to improving cognitive function, relieving chronic emotional stress and ameliorating sleeping quality in the patients with subjective cognitive decline, which may be achieved by improving the blood supply of the basilar artery.

Heavy metal pollution in urban river sediments is an important threat to river ecosystem health. To explore the temporal and spatial distribution characteristics of heavy metals in river sediments of Kaifeng City, the surface sediments of rivers were sampled in 2015 and 2021, respectively, and the contents of Cd, Cr, Cu, Ni, Pb, and Zn in sediments at different periods were compared. The heavy metal pollution in the two periods was evaluated using the indices of geo-accumulation, bio-toxicity risk assessment, and potential ecological risk. The results showed that the content of heavy metals in river sediments of Kaifeng City in 2021 were decreased significantly compared with that in 2015. Cd, Cr, Cu, Ni, Pb, and Zn decreased by 94.42%, 18.4%, 85.7%, 45.19%, 75.61%, and 92.28%, respectively. The heavy metal content in the Huafei River and Huiji River was higher than that in other rivers in both periods. Correlation and principal component analyses showed that the heavy metal pollution sources of river sediments in Kaifeng City were highly similar, and human activities such as industrial layout, road traffic, and land use were the main pollution sources. However, the results showed that the main pollutants were different between the two sampling times. In 2015, Cd, Cr, Pb, and Zn were the main pollutants, and in 2021, Cd, Cu, Pb, and Zn were the main pollutants. The results of the geo-accumulation, bio-toxicity risk assessment, and potential ecological risk indices showed that the temporal and spatial differences in heavy metal pollution in river sediments in Kaifeng City were large. However, the heavy metal pollution of the Huiji River and Huafei River was still serious, with contents in the medium and high pollution levels, especially to Cd. The heavy metal treatment of rivers in Kaifeng City has a long way to go, and it is particularly necessary to strengthen the engineering treatment for key river sections and effectively monitor key pollution elements.

Objective: To investigate the effects of remimazolam versus propofol on postoperative recovery quality in elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy. Methods: A total of 108 elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy under general anesthesia in the Affiliated Cancer Hospital of Zhengzhou University from May to October 2022 were prospectively included. The participants were divided into two groups by the random number table method: remimazolam group (R group, n =54) and propofol group (P group, n =54). There were 54 cases in the R group, with 35males and 19 females, and aged (65.4±3.1) years. Meanwhile, there were 54 cases in the P group, with 33males and 21 females, and aged (64.5±3.0) years. Anesthesia was induced as follows: remimazolam 0.2-0.3 mg/kg and remifentanil 0.5-1.0 μg/kg were intravenously injected in R group, while propofol 1-2 mg/kg and remifentanil 0.5-1.0 μg/kg were intravenously injected in P group. Subsequently, anesthesia was maintained as follows: remimazolam 0.4-1.0 mg·kg -1 ·h -1 and remifentanil 0.05-0.2 μg·kg -1 ·min -1 were intravenously infused in group R, while propofol 4-10 mg·kg -1 ·h -1 and remifentanil 0.05-0.2 μg·kg -1 ·min -1 were intravenously infused in group P. Bispectral index (BIS) was maintained at 45-60 during operation. The main outcome measures were the 15-item quality of recovery (QoR-15) scores 1 day before surgery, 1 day and 3 days after surgery. Secondary outcome measures included mean arterial pressure (MAP), heart rate and pulse oxygen saturation (SpO 2 ) recorded 5 min before anesthesia induction (T 0 ), 1 min after induction (T 1 ), 1 min after endotracheal intubation (T 2 ), immediately after skin incision (T 3 ) and tracheal extubation (T 4 ). The incidence of bradycardia and hypotension and the frequency of application of vasoactive drugs during anesthesia were recorded. Restlessness score (RS) and Ramsay sedation scale during the awakening period were recorded. Emergence time, tracheal extubation time, duration of postanesthesia care unit (PACU) stay and postoperative length of hospital stay were recorded. The incidence of postoperative pulmonary infection and other complications were also recorded. Results: The QoR-15 scale scores [ M ( Q 1 , Q 3 )] of R group 1 day and 3 days after surgery were 114.0 (109.0, 118.3) and 131.0 (127.8, 133.0), which were higher than those of P group [106.0 (101.0, 112.0) and 127.0 (125.0, 129.3)] (both P <0.001). The incidence of bradycardia, hypotension and the frequency of application of vasoactive drugs of R group during anesthesia were 5.6% (3/54), 35.2% (19/54) and 27.8% (15/54), which were lower than those in P group [33.3% (18/54), 63.0% (34/54) and 55.6% (30/54), respectively] (all P <0.05). RS score during the awakening period in R group was 0.9±0.5, which was lower than that of P group (1.1±0.6) ( P =0.046). Emergence time, tracheal extubation time and postoperative length of hospital stay of R group were (15.4±4.9) min, (16.6±4.7) min and (11.6±1.4) d, which were shorter than those of P group [(26.2±6.4) min, (27.8±5.8) min and (12.6±1.3) d] (all P <0.05). There were no statistically significant differences in Ramsay scores during the awakening period, duration of PACU stay and the incidence of postoperative complications (all P >0.05). Conclusions: Both remimazolam and propofol can achieve satisfactory postoperative recovery quality in elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy. Remimazolam has more stable hemodynamics and lower incidence of adverse reactions.

In order to study the chemical characteristics and ion source of groundwater and further serve the scientific development and management of water resources in Shunping County. A total of 33 groups of karst water and 12 groups of pore water samples were collected systematically in Shunping County, and the hydrochemical types, composition characteristics, and main controlling factors of various types of groundwater were analyzed by using Gibbs diagram, ion ratio relation, and multivariate statistical analysis methods, and the contribution rates of various sources to groundwater solutes were evaluated. The results showed that the pore water and karst water in the study area were weakly alkaline, with TDS ranging from 245.89 to 430.00 mg·L -1 and 223.54 to 1347.80 mg·L -1 , respectively. The anion components of groundwater were mainly HCO 3 - and Ca 2+ . Groundwater in the study area could be grouped into PW1 and PW2 pore water and KW1, KW2, and KW3 karst water. PW1 and KW1 were HCO 3 -Ca·Mg type, PW2 was HCO 3 ·Cl-Ca·Mg type, KW2 was HCO 3 ·NO 3 -Ca·Mg type, and KW3 was SO 4 -Ca·Mg type with high salinity. The weathering of carbonate rock mainly composed of dolomite and silicate rock mainly composed of albiar and potassium feldspar were the main material sources of groundwater, and their contributions to each water body were 39.69% to 66.13% and 11.87% to 58.38%. Sewage discharge and fertilizer use in human activities had significant effects on KW2 groundwater and PW1, PW2, and KW1 groundwater, respectively. In addition, the contribution rate of atmospheric precipitation to each water body ranged from 1.09% to 7.94% on average.

At present, a large-scale relocation of industrial enterprises is taking place in major cities in China, and a large number of contaminated relocation sites are being generated, among which the heavy metal pollution is particularly serious. In order to analyze the pollution status, spatial distribution, and sources of heavy metals in the soil of a lead factory in Sanmenxia, the spatial variation and distribution characteristics of heavy metals in the soil were analyzed using geostatistics, and the main sources of heavy metals in the soil were analyzed using a PMF model. The results showed that the average values of As, Cd, Cu, Pb, Hg, and Ni in the soil far exceeded the background values of the soil environment in Henan province; the contents of As, Cd, Pb, and Hg exceeded the screening values of soil pollution risk; and the contents of As, Pb, and Hg exceeded the control values of soil pollution risk. The high-value area was located on the northern part of the slag yard; the Cr, Ni, and Cd high-value area was located in the north and south of the slag yard; the high-value As area was located in the slag yard between the southern area and the living quarters; the Cu and Pb high-value area was relatively scattered, mainly concentrated in the central part of the raw material storage area and furnace area; and Ni and Cd and Cu and Pb had the same spatial distribution characteristics. Based on the PMF model, it can be seen that there were three main sources of the seven heavy metals, and Cd was mainly from waste residue accumulation, with a contributing rate of 87.60%. Cu, Pb, and Hg were mainly soil parent material, with contribution rates of 92.50%, 75.20%, and 95.40%, respectively. Cr, Ni, and As were mainly raw material dust exhaust gas sources, with contribution rates of 80.80%, 83.30%, and 62.00%, respectively.

A case of keratitis caused by microsporidia infection was reported. A 57-year-old female patient, without any obvious predisposing cause, presented with eye redness, eye abrasion and vision loss for one year in the left eye. The patient was diagnosed with viral keratitis based on laboratory examinations and clinical symptoms two months ago in our hospital. He was given outpatient treatment for antivirus. Two months later, he was admitted to our hospital with worsened condition that presented with corneal ulcer. After admission, corneal scraping examination was performed for the detection of microsporidia with calcofluor white (CFW) and Ziehl-Neelsen staining, the smear revealed multiple oval spore-like structures, with acid-fast positive and showed blue fluorescence on potassium hydroxide with CFW stain, confirming a diagnosis of microsporidial keratitis in the left eye. Treatment: topical use of ofloxacin eye ointment and voriconazole eye drops was not effective, and then penetrating keratoplasty was performed, and the patient's condition was stable after surgery. At present, they are still in treatment and follow-up.

The purpose of this study was to investigate the effects of acute fear stress on the spatial memory and neuronal plasticity of medial prefrontal cortex (mPFC) neurons in mice, and to elucidate the mechanisms underlying mPFC plasticity and post-stress memory regulation. Male C57BL/6 mice (6 weeks old) were randomly divided into control group and stress group. Foot shock stress was applied to establish an acute fear stress model. Changes in spatial memory were examined by the Morris water maze test, and the dynamic changes in the spike encoding of pyramidal neurons and GABAergic neurons in the prelimbic cortex (PrL) and infralimbic cortex (IL) of mPFC were detected by whole-cell recording. The results showed that acute fear stress significantly enhanced the percentage of freezing and the number of freezing, reduced the average speed, decreased the escape latency during acquisition phase, extended the probing time in the first quadrant and shortened the probing time in the third quadrant during probe trial, increased inter-spike interval, energy barrier and absolute refractory period of GABAergic neurons in the PrL and pyramidal neurons in the IL, while decreased inter-spike interval, energy barrier and absolute refractory period of pyramidal neurons in the PrL and GABAergic neurons in the IL. These results suggest that acute fear stress can enhance the spatial memory of mice, elevate the excitability and function of the PrL, while deteriorate the excitability and function of the IL, and the underlying mechanism may involve the role of mPFC microcircuitry plasticity in spatial memory after stress.

Exploring the spatial distribution characteristics and variation law of soil pH and analyzing the impact of environmental factors on the spatial differentiation of soil pH are of great significance to the accurate management of soil pH and the sustainable utilization of soil resources in the complex mountainous environment of Anshun City. Based on 22 851 field sampling points, using the methods of global Moran's I index, cold and hot spot analysis, semi-variance function, and Kriging interpolation, the spatial structure characteristics and distribution law of soil pH in Anshun City were revealed from different angles, and the influence of environmental factors on its spatial differentiation was analyzed with the help of geographic detectors. The results showed that:① the variation range of topsoil pH value in Anshun City was 3.56-8.61, the mean value was 6.28, and the coefficient of variation was 16.33%. ② In the global space, soil pH showed aggregation distribution; in the local space, the west and northwest were hot spots, whereas the east and south were cold spots. The nugget coefficient (40.19%) showed that the spatial variability in soil pH was determined by both structural and random factors, but the role of structural factors was greater. ③ In terms of spatial distribution, soil pH mainly presented a patchy mosaic distribution pattern, in which slightly acidic soil (57.14%) was concentrated in the east, northeast, and south of Anshun City; neutral soil (30.13%) was concentrated in the west, northwest, and southeast; and strongly acidic soil (6.12%) and alkaline soil (6.45%) were embedded in slightly acidic soil and neutral soil, respectively, in a block structure. ④ The geo-detector analysis showed that the explanatory power of various environmental factors to the spatial variation in soil pH was ranked as soil type (9.4%)>soil forming parent rock (7.9%)>altitude (2.1%)>land use (1.8%)>slope (0.1%), in which the q value of the interaction between soil type and parent rock type and other factors was large. Therefore, soil type and parent rock type were the main controlling factors of soil pH spatial variation in Anshun City.

Objective: To observe the efficacy and safety of S(+)-ketamine combined with sufentanil for patient-controlled intravenous analgesia (PCIA) in elderly patients undergoing laparoscopic radical resection of rectal cancer and explore its impact on patients' early recovery. Methods: One hundred and ten patients undergoing laparoscopic radical resection of rectal cancer in Affiliated Cancer Hospital of Zhengzhou University from December 2020 to March 2021, were divided into two groups ( n =55) using a random number table: group S received PCIA, with continuous infusion of S(+)-ketamine combined with sufentanil, while group C received PCIA, with continuous infusion of sufentanil. PCIA was initiated at the end of the surgery, and the formulations were as follows: group S, S(+)-ketamine (1.44 mg/kg), sufentanil (1.05 μg/kg), ketorolac tromethamine (2.0 mg/kg) and tropisetron (5 mg), in 100 ml of normal saline; group C: sufentanil (1.50 μg/kg), ketorolac tromethamine (2.0 mg/kg) and tropisetron (5 mg), in 100 ml of normal saline. Postoperative visual analogue scale (VAS) and Ramsay sedation scale were recorded at 6, 12, 24, 36, 48 h after the surgery. The incidence of remedial analgesia, the effective compressions number of PCI during 48 h after the operation. Time to first ambulation, time to first anal exhaust, time to resume oral feeding were recorded. The occurrence of adverse effects was compared between the two groups. Results: A total of 10 patients were excluded during the study, including 4 cases of conversion to laparotomy, 3 cases of dropping out of the study, and 3 cases with operation time more than 4 hours. Finally, 50 cases in group S and 50 cases in group C completed the study. There were no significant differences in VAS scores and Ramsay sedation sores at all time points between two groups (all P >0.05). Likewise, there were also no significant differences in the number of remedial analgesia and effective compressions of PCIA during 48 h after the operation between the two groups (both P >0.05). The total dosage of sufentanil consumption in group S [(64±9) μg] was lower than that in group C [(95±12) μg] within 48 h of PCIA, with a statistically significant difference ( P <0.001). Time to first ambulation in group S was (1.1±0.2) d, which was shorter than that in group C [(1.6±0.5) d], and the difference was statistically significant ( P <0.001). Likewise, time to first anal exhaust in group S [(1.3±0.4) d] was shorter than that in group C [(1.8±0.6) d], with a statistically significant difference ( P <0.001). Additionally, time to resume oral feeding in group S was (2.5±0.6) d, which was shorter than that in group C [(3.1±0.7) d], and there was a statistically significant difference ( P <0.001). The incidence of nausea, vomiting and pruritus in group S were 4.0%, 2.0% and 0, which were lower than that in group C (16.0%, 10% and 8.0%, respectively), with statistically significant differences (all P <0.05). No case with psychiatric symptoms was found in both groups. Conclusion: When used for postoperative intravenous analgesia in elderly patients undergoing laparoscopic radical resection of rectal cancer, S(+)-ketamine combined with sufentanil can provide satisfactory analgesic effects, decrease total consumption of sufentanil and the incidence of adverse effects, and thus facilitate patients' early recovery.

Objective: To evaluate the efficacy of two-lung ventilation with different tidal volume assisted by CO 2 pneumothorax for airway management in patients undergoing radical esophagectomy using combined thoracoscopic and laparoscopic approach. Methods: One hundred and eighty patients undergoing radical esophagectomy using combined thoracoscopy and laparoscopy under general anesthesia from the Affiliated Cancer Hospital of Zhengzhou University between February and September 2019 were randomly divided into three groups (group V 1 , V 2 , V 3 , n =60) according to the tidal volume (TV) used. The TVs of group V 1 -V 3 were 4, 5, 7 ml/kg during thoracoscopic surgery, respectively. All the patients were intubated with a single-lumen endotracheal tube and underwent two-lung ventilation assisted by continuous positive pressure CO 2 pneumothorax in group V 1 , V 2 and V 3 , with the CO 2 pressure of 10 mmHg (1 mmHg=0.133 kPa) and the frequency of 20 times/min. Mean arterial pressure (MAP) and heart rate (HR) were recorded before thoracoscopic surgery (T 1 ), 30 minutes after thoracoscopic surgery (T 2 ), at the end of thoracoscopic surgery (T 3 ), after thoracoscopic surgery and 30 minutes after two-lung intermittent positive pressure ventilation, respectively. The results of arterial blood gas were collected at T 1 , T 2 , T 3 and T 4 . Recovery time from anesthesia, consciousness recovery time, and lung collapse condition were recorded. Results: At T 2 , the value of MAP in group V 1 was (81±10) mmHg, which was higher than those of group V 2 [(69±7) mmHg] and group V 3 [(71±8) mmHg], with a statistically significant difference ( F= 9.270, P <0.05). Meanwhile, at T 2 , the value of HR in group V 1 was (83±7) times/min, which was higher than those of group V 2 [(68±6) times/min] and group V 3 [(71±7) times/min], and there was a statistically significant difference ( F =23.460, P <0.05). However, at T 2 , the values of arterial partial pressure of oxygen (PaO 2 ) in three groups were (262±16), (249±16) and (241±20) mmHg, respectively, with no statistically significant difference ( F =1.929, P >0.05). At T 3 , the value of arterial partial pressure of carbon dioxide (PaCO 2 ) in group V 3 was (46±5) mmHg, which was lower than those of group V 1 [(63±9) mmHg] and V 2 [(62±10) mmHg], with a statistically significant difference ( F =20.890, P <0.05). Moreover, at T 3 , the value of pH in group V 3 was (7.35±0.04), which was higher than those of group V 1 (7.28±0.04) and V 2 (7.32±0.04), and there was a statistically significant difference ( F= 9.309, P <0.05). Additionally, the satisfaction rates of lung collapse in group V 3 was 57.1%, which was lower than those of group V 1 (94.7%) and group V 2 (96.3%), with a statistically significant difference (χ²=7.601, P <0.05). There was no statistical significance in the time of awakening and consciousness recovery among three groups ( F =1.020 and 1.110, both P> 0.05). Conclusion: The two-lung ventilation with 5 ml/kg tidal volume assisted by CO 2 pneumothorax has advantages in terms of hemodynamics and surgical field exposure, and is more suitable as the appropriate dose for respiratory management in patients undergoing radical resection of esophageal cancer using combined thoracoscopic and laparoscopic approach.

Objective: To analyze the related factors affecting the success of frozen-thawed embryo transfer (FET). Methods: A total of 563 couples treated in the Reproductive Medicine Center of Guangdong Hospital of Traditional Chinese Medicine from January 2017 to March 2020 were selected as subjects. A total of 736 FET cycles were included to analyze the live birth outcomes of FET. Pregnancy outcomes, pregnancy complications and embryo status of patients between the live birth group and the non-live birth group were compared. A multivariate logistic regression model was used to evaluate the association between the 15 candidate factors and live birth outcomes for identifying independent factors associated with the live birth outcomes of the FET. Results: Among the enrolled subjects, the men were (33±5) years old at sperm extraction while the women were (31±4) years old at ovum pick-up (OPU) and (32±4) years old at embryo transfer (ET) and their infertility duration were (3.5±2.6) years. There were 333 (45.2%) live birth cycles and 403 (54.8%) non-live birth cycles in the 736 FET cycles. Pregnancy complications occurred in 49 cases (14.7%) of the live birth group. The age of the women at ET ((31±4) vs (32±4) years), the age of the women at OPU ((30±4) vs (32±4) years) and the age of the men at sperm extraction ((33±4) vs (34±5) years) in the live birth group were all lower than those in the non-live birth group. The infertility duration was shorter ((3.2±2.2) vs (3.6±2.8) years), and the proportion of primary infertility was higher ((63.1%, 210 cases) vs (49.6%, 200 cases)) in the live birth group ( P <0.05) than those in the non-live birth group. Multivariate logistic regression analyses showed that the age of woman at ET ( OR (95% CI ): 0.50 (0.27-0.92), P =0.026), the types of infertility (0.62 (0.43-0.88), P =0.008), the numbers of optimal embryos transferred (1.60(1.11-2.31), P =0.012), and the types of embryos transferred (2.43 (1.46-4.01), P =0.001) were statistically significant related factors for live birth outcome of FET. Conclusion: The age of the woman at ET, the types of infertility, the numbers of optimal embryos transferred and the types of embryos transferred are associated factors for the outcomes of live birth after FET.

Objective: To analyze the clinical features and evaluate the prognoses of Pythium keratitis. Methods: It was a retrospective study. The clinical characteristics, confocal microscopic image characteristics, treatment and curative effect of 6 cases of Pythium keratitis identified by DNA sequencing from June 2017 to June 2019 were reviewed retrospectively. Results: Among the 6 patients, there were 4 males and 2 females. All cases were monocular. The age was (58.7±11.3) years (range, 52 to 72 years). Keratopathy under a slit lamp was characterized by a dry ulcer surface, burr signs, satellite foci and pseudopodia around the ulcer. An elevated lesion was observed in 2 patients, and no obvious immune ring structure was observed in all patients. Confocal microscopy did not reveal any specific characteristics of Pythium infection. All patients did not respond well to antifungal drugs and received keratoplasty. Three patients had postoperative recurrence. The recurrence time was 4-6 days after the first operation and 2-3 days after the second operation. Two patients underwent two and three corneal transplants, respectively, after recurrence, but evisceration was required finally. Conclusions: Pythium keratitis is rare and can hardly be distinguished from common fungal infections in clinical manifestations and auxiliary examinations. The disease progresses rapidly, the rates of recurrence and evisceration after keratoplasty are both high, and DNA sequencing is the key to identifying the etiology, which should be paid more attention. (Chin J Ophthalmol, 2021, 57: 589-594) .

Objective: To observe the application of three different kinds of endotracheal intubation in the combined thoracoscopic and laparoscopic esophagectomy. Methods: one hundred and eighty patients undergoing combined thoracoscopic and laparoscopic esophagectomy under general anesthesia from the Affiliated Cancer Hospital of Zhengzhou University from February to September 2019 were randomly divided into three groups which include: double-lumen endotracheal intubation group (group S, n =60),single-lumen endotracheal intubation group (group D, n =60) and Coopdech occlusion of bronchial catheter combined with a single-lumen endotracheal intubation group (group C, n =60). The arterial blood samples were collected immediately after endotracheal intubation (T 0 ), 30 min after artificial pneumothorax (single lung ventilation) (T 1 ), 30 min after artificial pneumothorax (double lung ventilation) (T 2 ), and 30 min after extubation (T 3 ) to detect arterial blood gas. Patients' heart rate (HR), blood oxygen partial pressure (PaO 2 ), blood carbon dioxide partial pressure (PaCO 2 ) and airway pressure(Paw) were recorded at T 0 -T 3 .Completion time of endotracheal intubation, carbon dioxide intrathoracic inflation pressure, degree of lung collapse and incidence of postoperative 3-day pneumonia in three groups were recorded. The bronchoalveolar lavage fluid (BALF) of patients at T 0 , T 2 and the end of the operation (T 4 ) were collected to detect the levels of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) in BALF by enzyme-linked immunosorbent assay (ELISA). Results: A total of 14 patients were excluded during the operation, of which 9 cases lasted longer than 6 hours, 3 cases had arrhythmia during the operation and 2 cases lasted less than 1 hour. Finally, 56 cases in group S, 54 cases in group D and 56 cases in group C completed the experiment. The satisfaction rates of lung collapse in group S, group D and group C were 85.7% (48/56), 100.0% (54/54), 89.2% (50/56), respectively, with no statistically significant difference (χ²=1.308, P >0.05). The intrathoracic inflation pressure of carbon dioxide in group D was (10.2±2.2) mmHg (1 mmHg=0.133 kPa), which was higher than (5.1±3.4) mmHg in group S and (5.6±3.1) mmHg in group C, the difference was statistically significant ( F =-9.303, P< 0.05). The incidence of postoperative 3-day pneumonia in group D was 14.8%, which was lower than 39.3% in group S and 17.8% in group C, the difference was statistically significant (χ²=8.300, P< 0.05). At T 4 , the value of TNF-α in group D was (122.4±4.4) ng/L, which was lower than that in group S and group C, (257.9±6.3) and (185.8±5.6) ng/L, with statistically significant difference ( F =69.020, P <0.05). At T 4 , the value of IL-6 in group D was (175.4±4.9) ng/L, which was lower than that of patients in group S and group C, (289.6±6.8) and (226.2±4.4) ng/L, with statistically significant difference ( F =59.750, P <0.05). At T 4 , the value of IL-8 in group D was (303.1±7.2) ng/L, which was lower than in group S and group C, (595.4±22.1) and (436.8±10.9) ng/L, with statistically significant difference ( F =55.359, P <0.05). Conclusion: All the three endotracheal intubations can produce satisfactory ventilation effect in the combined thoracoscopic and laparoscopic esophagectomy, however, single-lumen endotracheal intubation has less effect on lung injury.

Objective: To investigate the effects of patient-controlled intravenous analgesia with butorphanol versus sufentanil on early postoperative rehabilitation following radical laparoscopic nephrectomy. Methods: One hundred patients undergoing radical laparoscopic nephrectomy in Affiliated Cancer Hospital of Zhengzhou University from September 2018 to February 2020 were divided into two groups ( n =50) using a random number table: butorphanol patient-controlled intravenous analgesia group (group A) and sufentanil patient-controlled intravenous analgesia group (group B). Patient-controlled intravenous analgesia (PCIA) was performed at the end of surgery. The formulation of group A was butorphanol (0.15 mg/kg) and ketorolac tromethamine (180 mg) using the physiological saline at a dilution of 100 ml. The formulation of group B was sufentanil (1.5 μg/kg) and ketorolac tromethamine (180 mg) using the physiological saline at a dilution of 100 ml. At the time points of 4, 8, 24, 48 h after operation (T(1), T(2), T(3), T(4)), VAS scores at rest and cough were recorded. The incidence of remedial analgesia, the number of pressings during 48 h after the operation, the postoperative anal exhaust recovery time of the patients were recorded. Quality of recovery-40(QoR-40) scores were recorded at T(3) and T(4). Adverse reactions were recorded. Results: There was no significant difference in VAS scores at rest and cough at T(1), T(2), T(3) and T(4) between two groups (all P >0.05). There was no significant difference in the incidence of remedial analgesia and the number of pressings during 48 h after the operation between two groups (all P >0.05). The postoperative anal exhaust recovery time of the patients in group A was (32±6) h, which was lower than that in group B with statistically significant difference [(40±5) h, t =7.937, P <0.01]. The QoR-40 total scores in group A were higher than those in group B at T(3) and T(4), which were (185.8±2.5) vs (170.7±2.7), (194.8±1.9) vs (183.6±2.6), and the differences were statistically significant ( t =28.878, 25.025, all P <0.01). The incidence of nausea, retching/vomiting, respiratory depression and itch during 48 h after the operation in group A were 10%, 6%, 2%, 2%, which were lower than that in group B (32%, 20%, 14%, 18%), with statistically significant difference (χ(2)=7.294, 4.322, 4.891, 5.983, all P <0.05). Conclusion: PCIA with butorphanol or sufentanil can provide satisfactory analgesia for patients undergoing radical laparoscopic nephrectomy, but butorphanol can promote postoperative rehabilitation with fewer adverse reactions.

Objective: To analyze the effects of desflurane and sevoflurane anesthesia on postoperative recovery after long lasting tumor surgery. Methods: One hundred and sixty patients undergoing endoscopic radical esophagectomy and gastrectomy (80 cases of each surgical type) from November 2019 to March 2020 at Henan Cancer Hospital, were randomized into 4 groups( n= 40): group CS (esophageal cancer+sevoflurane anesthesia), group DS (esophageal cancer+desflurane anesthesia),group CW (stomach cancer+sevoflurane anesthesia) and group DW (gastric cancer+desflurane anesthesia). General anesthesia was induced by intravenous agents in all four groups, which were maintained by inhaled anesthetic during the operation. The mean arterial pressure (MAP), heart rate (HR), and surplus pulse O(2) (SpO(2)) immediately before induction (T(1)), the moment of operation begin (T(2)), operation end (T(3)) and extubation (T(4)) were recorded. Also, the duration required for inhalation anesthetic alveolar concentration reaching 0.5 minimum alveolar concentration (MAC) during induction, the alveolar anesthetic concentration at the beginning of the operation, the duration required for XMAC (patients specific alveolar concentration) declining to 0.5 MAC on recovery period, and the duration of alveolar concentration of 0.5 MAC declining to 0.2 MAC were determined. Additionally, the durations of spontaneous breathing recovery, eyes opening, extubation and recovery of consciousness were recorded. Finally, restlessness score (RS) during recovery period was used to evaluate postoperative agitation. Results: Compared with group CS and group CW, no significant differences in MAP, HR, SpO(2) in group DS and group DW at T(1) to T(4) were found (all P> 0.05). The durations required for inhalation anesthetic alveolar concentration reaching 0.5 MAC were (5.6±1.3), (5.8±2.1), (3.5±1.5) and (3.8±1.0) min in group CS, group CW, group DS and group DW, where the durations in group DS and group DW were significantly shorter than those in group CS and group CW ( F= 32.538, P< 0.05). The durations of alveolar concentration of 0.5 MAC declining to 0.2 MAC were (6.4±2.2), (7.0±1.5), (4.2±2.2) and (4.1±1.5) min in group CS, group CW, group DS and group DW, and the durations in group DS and group DW were significantly shortened as compared with group CS and group CW ( F= 42.113, P< 0.05). Compared with group CS and group CW, group DS and group DW required significantly shorter time for spontaneous breathing recovery, eye opening,extubation, and directional force recovery after operation (all P< 0.05). Conclusions: Both desflurane and sevoflurane anesthesia can achieve satisfactory anesthesia depth during long lasting tumor surgery. Desflurane can shorten the recovery time and early extubation, and improve the quality of recovery.

To analyze the predictive value of serum intact parathyroid hormone (iPTH) and alkaline phosphatase (ALP) on all-cause and cardiovascular mortality in maintaining hemodialysis (MHD) patients. A total of 224 MHD patients were prospectively investigated and followed up for 2 years. Serum iPTH levels were not associated with all-cause death and cardiovascular death ( HR =1.001, 95% CI 1.000-1.004, P =0.048) . The level of serum ALP was associated with cardiovascular death ( HR =1.002, 95% CI 1.000-1.004, P =0.033) . ALP≥106 IU/L was an independent risk factor for cardiovascular death in MHD patients ( P <0.05) . The joint variable was correlated with mortality in MHD patients ( HR =1.002, 95% CI 1.000~1.004, P =0.033) , that equal or over 37.28 was an independent risk factor for mortality ( P <0.05).

A pot experiment was conducted to evaluate the growth response and vegetation restoration prospect of seedlings of five oak species for the phytoremediation of lead/zinc (Pb/Zn) mine tailings. Seedlings of Quercus imbricaria, Q. coccinea, Q. pagoda, Q. shumardii, Q. fabri were transplanted into pots containing Pb/Zn mine tailings to comparatively examine their biomass, root morphology, absorption and transfer characteristics of nutrient elements and heavy metals 30 months later. The results showed that all the seedlings could survive in the Pb/Zn tailings after 30 months. The biomass of Q. coccinea and Q. fabri decreased in Pb/Zn tailings compared with the control, while no significant difference were found for other three species. Compared with the control, root biomass was increased to some extent in Pb/Zn tailings except Q. coccinea. The lateral root morphological parameters were reduced only for Q. coccinea . Under heavy metal stress, nutrient concentrations of root and stem of oak seedlings did not change compared with the control. Generally, the concentrations of heavy metals in plant tissues were low, and the values of bioconcentration factor (BCF) and translocation factor (TF) were less than 1. Q. pagoda could accumulate more Cd, with concentrations of 22.4 and 15.1 mg·kg -1 in leaf and stem, respectively, and could translocate more Cd from root to shoot with TF of 2.3. Our results suggested that the seedlings of tested oak species could be used as the potential species for contaminated soil. Q. shumardii had the highest tole-rance with a low BCF and TF, implying that they were better potential candidates for afforestation and ecological restoration of mine tailings.

As a natural plant source of artemisinin,a first-line drug against malaria,Artemisia annua directly affects the extraction process of artemisinin and the source of artemisinin. At present,traditional breeding methods combined with tissue culture are often used to breed high-yield artemisinin-containing new varieties of A. annua. However,the breeding method has the disadvantages of low efficiency and continuous selection. In this study,heavy ion beam irradiation technology was used to observe the specific germplasm resources of A. annua,and the morphological characteristics,agronomic traits and artemisinin content were used as indicators to observe the selection materials and materials. The cultivated new varieties were compared with trials and regional trials. In addition,the new variety of A. annua was identified by SRAP molecular marker technology. The results showed that the new variety of A. annua, &quot; Kehao No.1&quot;,had an average yield of 235. 0 kg of dry leaf per mu,which was more than 20% higher than that of the control. Especially,the average artemisinin content was 2. 0%,which was 45% higher than that of the control,and the &quot; Kehao No.1&quot; has high anti-white powder disease,high-yield and high-quality new varieties. Therefore,mutagenic breeding of heavy ion beam irradiation can significantly improve the yield and artemisinin content of the &quot; Kehao No. 1&quot; and it has a good promotion value.

Objective: To explore the effects of dexmedetomidine combined with propofol or sevoflurane general anesthesia on stress and postoperative quality of recovery (QoR-40) in patients undergoing laparoscopic surgery. Methods: Two hundreds patients with laparoscopic gastrointestinal tumor resection (100 cases of gastric tumor and 100 cases of colon tumor) from March 2016 to January 2018 at Henan Cancer Hospital,were randomly divided into 4 groups( n= 50): group SP (gastric neoplasm + propofol anaesthesia), group SS (gastric tumor + sevoflurane anaesthesia), group CP (colon tumor+ propofol anaesthesia), and group CS (colon tumor + sevoflurane anaesthesia). The four groups were all induced by dexmedetomidine, etomidate, sufentanil and cisatracurium. The patients in group SP and group CP were administered with propofol, and the patients in group SS and group CS were given general anesthesia with sevoflurane. The results of the operation and the quality of recovery were compared. The heart rate, mean arterial pressure change, norepinephrine, epinephrine and cortisol were measured in T0 (before anesthesia started), T1 (30 min after surgery), T2 (10 min after tracheal catheter extraction), T3 (24 h after surgery), T4 (postoperative 48 h), respectively. The postoperative recovery quality after operation was evaluated by QoR-40. Results: There were no significant differences in operation time, bleeding volume and other operation conditions between each group (all P> 0.05), and also no significant differences in heart rate and mean arterial pressure from T0 to T4 time points (all P> 0.05). There were significant differences in the levels of norepinephrine and cortisol among the four groups at T1 and T2 time points ( F= 54.135,140.733,12.037, 21.644,all P< 0.05). The levels of norepinephrine and cortisol in SP group at T1 and T2 time points were less than SS group (all P< 0.05). Similar, those in CP group were less than CS group ( P< 0.05). However, there was no significant difference among the 4 groups at other time points (all P> 0.05). The scores of VAS and RS in SP group were (0.9±0.4) and (0.8±0.4), which were lower than that of SS group(1.4±0.5,1.4±0.5,all P< 0.05).At the same time, the time of regain consciousness was (9.3±1.4) min, which was also lower than SS group [(10.1±1.4)min, P< 0.05]. The scores of VAS and RS in CP group were (0.8±0.5) and (0.8±0.4), which were lower than that of CS group(1.4±0.5,1.4±0.4,all P< 0.05).At the same time, the time of regain consciousness was (9.2±1.2)min,which was also lower than CS group [(10.1±1.2)min, P< 0.05]. The recovery quality scores of the SP and CP group were (164±11) and (168±11) after 24 hours, which were greater than that of the SS and CS group(146±10, 143±12, all P< 0.05). Conclusion: Dexmedetomidine combined with propofol in laparoscopic surgery can effectively suppress intraoperative stress, reduce postoperative pain and agitation, and improve the quality of postoperative recovery.

To research the correlation between accumulation of triterpenoids and expression of key enzymes genes in triterpenoid biosynthesis of Alisma orientale,the study utilized UPLC-MS/MS method to detect eight triterpenoids content in the tuber of A. orientale from different growth stages,including alisol A,alisol A 24 acetate,alisol B,alisol B 23 acetate,alisol C 23 acetate,alisol F,alisol F 24 acetate and alisol G,and then the Real time quantitative PCR was used to analyze the expression of key enzymes genes HMGR and FPPS in triterpenoid biosynthesis. Correlation analysis showed that there was a significant positive relation between the total growth of these eight triterpenoids and the average relative expression of HMGR and FPPS(HMGR: r = 0. 998,P<0. 01; FPPS: r = 0. 957,P<0. 05),respectively. Therefore,the study preliminarily determined that HMGR and FPPS genes could regulate the biosynthesis of triterpenoids in A. orientale,which laid a foundation for further research on the biosynthesis and regulation mechanism of triterpenoids in A. orientale.

Objective: To evaluate the effects of penehyclidine hydrochloride on the nuclear factor erythroid 2-related factor 2/antioxidant responsive element (Nrf2/ARE) signaling pathway during endotoxin-induced acute lung injury(ALI) in neonate rats. Methods: Forty 7-day-old Wistar rats weighing 12-18 g were randomly divided into 4 groups ( n= 10) using a random number table: normal saline group(NS group), acute lung injury(ALI group), penehyclidine hydrochloride group(PHC group) and penehyclidine hydrochloride+ Nrf2 siRNA plasmid group(PNS group). The ALI model was induced with intraperitoneal endotoxin (5.0 mg/kg) in groups ALI, PHC and PNS. In groups PHC and PNS, penehyclidine hydrochloride (2.0 mg/kg) was injected intraperitoneally at 1 h before ALI respectively, while the equal volume of normal saline was administered in groups NS and ALI. The animal of PNS group were inhaled adenovirus packaging of Nrf2-siRNA three times (one time a day) before modeling. At 4 h after endotoxin injection, the rats were sacrificed. The lungs were collected to determine the wet/dry(W/D) lung weight ratio. The expression of Nrf2 and heme oxygen and enzyme 1(HO-1) were determined by Western blotting, contents of tumor necrosis factor-alpha(TNF-α),interleukin10 (IL-10)were determined by enzyme-linked immunosorbent assay(ELISA). The cell apoptosis were determined by transferase-mediated deoxyuridine triphosphate-biotin nick end labeling(TUNEL),and the apoptotic index was calculated. Results: The W/D ratio in NS, ALI, PHC and PNS groups were (4.2±0.1), (9.6±0.7), (6.5±0.6), (8.3±1.3) respectively. The apoptotic index were (3.7±0.5)%, (31.5±3.2)%, (17.6±4.2)%, (28.1±3.5)%respectively.The contents of TNF-α were (10.3±1.6), (98.5±8.5), (68.5±6.7), (89.9±8.5) pg/ml respectively. The contents of IL-10 were (7.9±0.6), (102.8±9.3), (72.5±5.8), (97.7±9.1) pg/ml respectively.The expression of Nrf2 were (23.2±7.6), (79.8±13.0), (155.5±16.7), (12.0±3.3) respectively. The expression of HO-1 were (31.7±8.6), (90.8±10.3), (147.6±22.5), (61.4±9.7) respectively. There were statistically significant differences among different groups ( F= 86.013, 154.897, 328.810, 374.198, 333.965, 125.274, all P< 0.05). Compared with group NS, the W/D ratio, apoptotic index and the contents of TNF-α, IL-10 increased, the expression of Nrf2 and HO-1 up-regulated in group ALI and group PHC (all P< 0.05). Compared with group ALI, the W/D ratio, apoptotic index and the contents of TNF-α, IL-10 decreased, the expression of Nrf2 and HO-1 up-regulated in group PHC (all P< 0.05). Compared with group ALI, no significant differences were found in the W/D ratio, apoptotic index and the contents of TNF-α, IL-10 in group PNS(all P> 0.05), while the expression of Nrf2 and HO-1 down-regulated in group PNS (all P< 0.05). Compared with group PHC, the W/D ratio,apoptotic index and the contents of TNF-α,IL-10 increased, the expression of Nrf2 and HO-1 down-regulated in group PNS (all P< 0.05). Conclusion: Nrf2/ARE signaling pathway is involved in the reduction of ALI by penehyclidine hydrochloride in neonate rats.

Objective: To investigate the effects of dexmedetomidine on perioperative stress and postoperative pain in patients with radical resection of esophageal cancer under combined thoracoscope and laparoscope. Methods: In this prospective study, one hundred patients undergoing radical resection of esophageal cancer in Affiliated Cancer Hospital of Zhengzhou University from January 2016 to October 2017, were randomly divided into control group (group C) and dexmedetomidine group (group D), n =50. All patients were anaesthetized (induced and maintained) with intravenous target-controlled infusion(TCl) of propofol and remifentanil, and intermittent intravenous injection of cisatracuriumbesylate. Bispectral index(BIS) was used to monitor the depth of anesthesia and maintained between 45-60 during operation.All patients received sufentanil (0.3 μg/kg) 30 min before the end of the operation and then received intravenous analgesia pump for postoperative patient controlled analgesia(PCA). Patients in group D received intravenous infusion of dexmedetomidine(1 μg/kg) 20 min before anesthesia induction, followed by intravenous pumping of dexmedetomidine(0.2 μg·kg(-1)·h(-1)) intraoperatively.Postoperative intravenous patient-controlled analgesia(PCA) was performed in all patients, with background doses of sufentanil 0.04 μg· kg(-1)·h(-1) for patients in group C, and sufentanil 0.025 μg·kg(-1)·h(-1) plus dexmedetomidine 0.1 μg· kg(-1)·h(-1) for patients in group D. The operation time, liquid input and output during operation, the number of PCA pressings after operation were recorded. At these time points: T(0)(the day before operation), T(1)(immediate before anesthesia induction), T(2)(1 h after emergence), T(3)(24 h after operation), T(4)(3 d after operation), T(5)(7 d after operation), T(6)(one month after operation), T(7)(3 months after operation) and T(8)(6 month after operation) , venous blood samples of patients were collected for detection of epinephrine, norepinephrine and corticosterone. The pain visual analogue scale(VSA) was used to assess pain levels in patients at T(2), T(3), T(4), T(5), T(6), T(7), T(8). Results: The age, sex ratio, body mass index (BMI) and ASA grading ratio in two groups were not significantly different(all P >0.05). There were no Significant differences in operation time, liquid input and blood output between group C and group D(all P >0.05). Within 24 h after operation, the sufentanil consumption in group D[(35.86±8.65)μg]was significantly less than that in group C[(59.53±15.26) μg, t =7.061, P <0.05], and the number of PCA pressing in group D(2.15±1.38) was obviously less than that in group C(5.85±2.16, t =4.971, P <0.05). Compared with group C, serum norepinephrines in group D was significantly less ( t =13.276, 16.027, 14.319, 12.771, 12.296, respectively; all P <0.05) at T(1), T(2), T(3), T(4), T(5).And there were no difference between these two groups at T(0), T(6), T(7), T(8)(all P >0.05). Serum epinephrine in group D were significantly lower than them in group C at T(2), T(3), T(4), T(5) ( t =6.153, 8.774, 9.127, 8.409, respectively; all P <0.05), but there were no difference between these two groups at T(0), T(1), T(6), T(7), T(8)(all P >0.05). Serum corticosterone in group D were sharply less than them in group C at T(2), T(3), T(4), T(5) ( t =16.364, 15.306, 12.153, 12.592, respectively; all P <0.05), but at T(0), T(1), T(6), T(7), T(8), there were no difference between these two groups (all P >0.05). Compared with group C, the number of patients with postoperative pain(VAS score≥4) in group D was obviously less at T(6), T(7), T(8)(10 vs 20, 4 vs 12, 3 vs 10; χ(2)=4.762, 4.762, 4.332, respectively; all P <0.05). Conclusion: Perioperative application of dexmedetomidine can effectively decrease the perioperative stress response, obviously cut down the perioperative opioid consumption, and prevent the transition from postoperative acute pain to chronic pain in patients with radical resection of esophageal cancer under combined thoracoscope and laparoscope.

Objective: To evaluate the effect of dexemdetomidine on perioperative inflammatory response and cellular immune in patients undergoing radical operation of thoracoscopic lung cancer. Methods: One hundred and twenty patients undergone radical operation of thoracoscopic lung cancer were randomly divided into control group(group B) and dexemdetomidine group(group A), 60 patients in each group. They were all implemented one-lung ventilation. In group A, dexmedetomidine at a loading dose of 1.0 μg/kg was intravenously infused starting from 20 min before anesthesia induction, followed by continuous infusion of 0.5 μg·kg(-1)·h(-1) until 20 min before the end of operation. The equal volume of normal saline was given in group B. venous blood samples were collected for determination of the serum concentrations of TNF-α, IL-6 and IL-8. peripheral blood T-lymphocyte subsets(CD(3)(+), CD(4)(+), CD(8)(+), CD(4)(+)/CD(8)(+)) and NK cell were also detected at 30 min before anesthesia induction(T(0)), at the end of operation(T(1)), 12 h after operation(T(2)) and 24 h after operation(T(3)). Results: Compared with the T(0, )the plasma concentration of TNF-α , IL-6 and IL-8 were increased( P <0.05). The levels of CD(3)(+) and CD(4)(+), CD(4)(+)/CD(8)(+) ratio and NK cells were decreased in both groups at T(1)-T(3)( P <0.05). Compared with group B, the plasma concentration of TNF-α , IL-6 and IL-8 were decreased more obviously in group A( P <0.05). The levels of CD(3)(+) and CD(4)(+), CD(4)(+)/CD(8)(+) ratio and NK cells were significantly increased in group A at T(1)-T(3)( P <0.05). Conclusion: Dexemdetomidine can decrease perioperative inflarnmatory response and improve cellular immune function in the patients undergoing radical operation of thoracoscopic lung cancer.

Objective: To investigate the tumor-suppressing effect of microRNA-218 (miR-218) in osteosarcoma (OS) and explore its molecular mechanism., Methods: We examined the expression levels of miR-218 in 68 pairs of OS and adjacent tissue samples using qRT-PCR. Cultured human OS cell line Saos-2 was transfected with miR-218 mimics or anti-miR-218 mimics, and the cell apoptosis was assessed using CCK-8 assay, annexin V-FITC staining and Western blotting. We also analyzed the potential functional targets of miR-218 in Saos-2 cells using luciferase assay, qRT-PCR and Western blotting., Results: The expression level of miR-218 was lowered by at least 8 folds in OS tissues as compared with the adjacent tissues. In cultured Saos-2 cells, transfection with miR-218 mimics for 24, 36, and 48 h resulted in a significant reduction in the cell viability, while transfection with anti-miR-218 mimics significantly increased the cell viability. The cells transfected with miR-218 mimics showed an obviously enhanced expression of cleaved poly(ADP-ribose) polymerase (C-PARP) as compared with the cells transfected with anti-miR-218 mimics and the control cells. Flow cytometry demonstrated obviously increased apoptosis of the cells following miR-218 mimics transfection. We identified the oncogene B lymphoma mouse Moloney leukemia virus insertion region 1 (BMI-1) as a specific target of miR-218 in Saos-2 cells. BMI-1 expressions at both the mRNA and protein levels were significantly reduced in Saos-2 cells overexpressing miR-218 but increased in the cells with miR-218 knockdown as compared to the control cells. Luciferase reporter assay indicated that miR-218 directly inhibited the expression of BMI-1 via binding to its 3'-UTR in OS cells., Conclusion: miR-218 can promote OS cell apoptosis and plays the role as a tumor suppressor by down-regulating BMI-1.

Objective: To investigate the effect of the single lumen endobronchial tube and the double lumen endobronchial tube on ventilation and lung injury in patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy. Methods: Sixty patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy were divided into single lumen endobronchial tube group (D group, n =30) and double lumen endobronchial tube group (S, n =30) according to the random number table. Blood samples were harvested at the moment of tracheal intubation (T(0)), after artificial pneumothorax (one lung ventilation) 30 min (T(1)), after artificial pneumothorax (one lung ventilation) 90 min (T(2)), artificial pneumothorax over (double lung ventilation) 30 min (T(3)) and after extubation 30 min (T(4)) for arterial blood gas analysis. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO(2)), oxygen tension (PaO(2)), carbon dioxide partial pressure (PaCO(2)) and airway pressure (PAW) were recorded at T(0)-T(4). The incidences of pneumonia of two groups were record at 3 days after operation. Results: There were no obvious differences in HR, MAP, SpO(2), PaO(2), PaCO(2) between two groups at T(0)-T(4) ( P >0.05). Compared with T(0), the levels of HR and PaO(2) were increased remarkably at T(1)-T(3) ( P <0.05), the levels of PaCO(2) were increased remarkably at T(1)-T(4) ( P <0.01), and the levels of Paw were increased remarkably at T(1)-T(3) ( P <0.01). Compared with S group, the levels of Paw were decreased remarkably at T(1)-T(2) (29.5±3.7 vs 21.3±2.1, P =0.001; 30.7±4.8 vs 20.3±2.3, P =0.001). There were no obvious differences in the levels of TNF-α, IL-6, IL-8 in Bronchoalveolar Lavage Fluid (BALF) between two groups at T(0) ( P >0.05). Compared with T(0), the levels of TNF-α, IL-6, IL-8 in BALF were increased remarkably at T(3), T(5) ( P <0.05). Compared with S group, the levels of TNF-α, IL-6, IL-8 in D group in BALF were decreased remarkably at T(3), T(5) ( P <0.05). Compared with S group, the incidence of pneumonia in D group were decreased remarkably at 3 days after operation (4(13.3%) vs 11(36.7%), P =0.017). Conclusion: The ventilation effect of the single lumen endobronchial tube on lung injury for patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy is the same as that of the double lumen endobronchial tube, however the single lumen endobronchial tube has less injury on the lung.

Neck shoulder pain or lumbocrural pain caused by intervertebral disc degeneration (IDD) could seriously affect the qualities life of patients. Current treatments mainly focus on alleviating pain and the symptoms of nerve compression, which could not radically stop the process of intervertebral disc degeneration, but conversely lead to high recurrence rate. In recent years, scholars have turned to study the biological treatment for repair and rebuild the intervertebral disc by biological molecular therapy, gene therapy, cell therapy and tissue engineering to solve the problem of intervertebral disc degeneration, while most of the above methods are still in animal experiments or in vitro experiments and the clinical application is still a long way to go.

The spectral uncertainty of terrestrial objects causes a certain degree of spectral differences among feature spectra, which affects the accuracy of object recognition and also impacts the object recognition of spectral angle mapper algorithm (SAM). The spectral angle mapper algorithm is based on the overall similarity of the spectral curves, which was widely used in the classification of hyperspectral remotely sensed information. The spectral angle mapper algorithm does not take the spectral uncertainty of terrestrial objects into account while calculating the spectral angle between the spectral curves, and therefore does not tend to correctly identify the target objects. The applicability of the spectral angle mapper algorithm is studied for the spectral uncertainty of terrestrial objects and a modified SAM is proposed in this paper. In order to overcome the influence of the spectral uncertainty, the basic idea is to set a spectral difference value for the test spectra and the reference spectra and to calculate the spectral difference value based on derivation method according to the principle of minimum angle between the test spectra and the reference spectra. By considering the impact of the spectral uncertainty of terrestrial objects, this paper uses five kaolinite mineral spectra of USGS to calculate the spectral angle between the five kalinite mineral spectra by using local band combination and all bands to verify the improved algorithm. The calculation results and the applicability of the spectral angle mapper algorithm were analyzed. The results obtained from the experiments based on USGS mineral spectral data indicate that the modified SAM is not only helpful in characterizing and overcoming the impact of the spectral uncertainty but it can also improve the accuracy of object recognition to certain extent especially for selecting local band combination and has better applicability for the spectral uncertainty of terrestrial objects.

Ferric ion modified attapulgite (Fe/ATP) was prepared by impregnation and its structure and morphology were characterized. The toxicity characteristic leaching procedure (TCLP) was used to evaluate the effect of Cadmium( Cd) stabilization in soil with the addition of attapulgite (ATP) and Fe/ATP. The stabilization mechanism of Cd was further elucidated by comparing the morphologies and structure of ATP and Fe/ATP before and after Cd adsorption. Fe/ATP exhibited much better adsorption capacity than ATP, suggesting different adsorption mechanisms occurred between ATP and Fe/ATP. The leaching concentrations of Cd in soil decreased by 45% and 91% respectively, with the addition of wt. 20% ATP and Fe/ATP. The former was attributed to the interaction between Cd2 and --OH groups by chemical binding to form inner-sphere complexes in ATP and the attachment between Cd2+ and the defect sites in ATP framework. Whereas Cd stabilization with Fe/ATP was resulted from the fact that the active centers (--OH bonds or O- sites) on ATP could react with Fe3+ giving Fe--O--Cd-- bridges, which helped stabilize Cd in surface soil. What'more, the ferric oxides and metal hydroxides on the surface of ATP could interact with Cd, probably by the formation of cadmium ferrite. In conclusion, Fe/ATP, which can be easily prepared, holds promise as a potential low-cost and environmental friendly stabilizing agent for remediation of soil contaminated with heavy metals.

Objective: To investigate the effect of occlusal reconstruction on blood flow velocity and cerebral oxygen saturation in patients with malocclusion., Methods: Thirty-three patients with malocclusion treated with occlusal reconstruction in Department of Stomatology, Medical School of Huzhou Normal College from Feb 2011 to Oct 2013 were enrolled in the study. The systolic peak flow velocity (vs), end-diastolic peak flow (vd) , mean peak flow velocity (vm) of middle cerebral artery and the oxygen saturation (rScO2) in the brain were detected at rest or chewing status by using transcranial Doppler color ultrasonography and near-infrared spectroscopy, respectively., Results: In rest state, vm was significantly increased on 3 months after treatment, while vs and vd were significantly increased on 6 months after treatment and rScO2 were increased on 12 months after treatment (P<0.05). In chewing state, vs, vm, and rScO2 were increased on 3 months after treatment, and vd was increased on 6 months after treatment (P<0.05)., Conclusion: Occlusal reconstruction can increase blood flow velocity of middle cerebral artery and cerebral oxygen saturation and improve oxygen supply of the brain in patients with malocclusion.

Objective: To construct human phage single-chain antibody (scFv) library against breast cancer, and to identify anti-HER2 specific antibodies from the human phage display scFv library to offer a stronger affinity sequence targeting HER2 for fusion protein targeting HER2 and CXCR4., Methods: Total RNA was extracted from the adjacent lymphatic tissue harvested from breast cancer patients. The variable regions of the whole antibody were amplified by using RT-PCR and were cloned into the vector pCANTAB-5E through a linker. The products were electroporated into competent E.coli TG1 cells. Recombinant phages specific for breast cancer cells were enriched in SKBR-3 after four rounds. The antigen-positive clones were selected by ELISA and immunohistochemistry., Results: The fragment of VH and VL were about 375 and 330 bp and were linked in vitro to form scFv of 750 bp that was resistant to the breast cancer HER2 single strand. A fusion phage display library that contained total of 2.48×10(8) pfu /ml was established. ELISA and immunohistochemical results confirmed that the antibody has a strong affinity with HER2 antigen in breast cancer tissue. Compared to human IgG antibody, a scFv phage library against human breast cancer was successfully constructed with high capacity. The scFv was highly specific to HER2 antigen and the sequencing results indicated that VL and VH genes were highly homologous with the variable region of human antibody., Conclusion: This strategy may achieve new targeted antibody resistant to the breast cancer for clinical treatment and provide a carrier that uses HER2 as a target of the fusion protein for anti-tumor therapy.

In the present paper, the authors use permanent scatterers synthetic aperture radar interferometry (PS-InSAR) technique and 29 acquisitions by Envisat during 2003 to 2009 to monitor and analyze the spatial-temporal distribution and mechanism characterize of land subsidence in Beijing plain area. The results show that subsidence bowls have been bounded together in Beijing plain area, which covers Chaoyang, Changping, Shunyi and Tongzhou area, and the range of subsidence has an eastward trend. The most serious regional subsidence is mainly distributed by the quaternary depression in Beijing plain area. PS-Insar results also show a new subsidence bowl in Pinggu. What's more, the spatial and temporal distribution of deformation is controlled mainly by faults, such as Liangxiang-Shunyi fault, Huangzhuang-Gaoliying fault, and Nankou-Sunhe fault. The subsidence and level of groundwater in study area shows a good correlation, and the subsidence shows seasonal ups trend during November to March and seasonal downs trend during March to June along with changes in groundwater levels. The contribution of land subsidence is also influenced by stress-strain behavior of aquitards. The compaction of aquitards shows an elastic, plastic, viscoelastic pattern.

Objective: To understand the key risk factors of schistosomiasis transmission in Jingzhou City, so as to provide the evidence for improving the treatment of these risk factors., Methods: Each village of six counties was investigated and 3 environments were surveyed each village for the distribution of Oncomelania snails and animal stools in the field. The results were analyzed and the risk factors of schistosomiasis transmission were assessed., Results: The density of living snails was 0.43 snails per 0.1 m2, the frequency of the frames with snails was 9.12%, and no schistosome infected snails were found. All of the animal stools collected from the field were from bovines. The schistosome positive rate of animal stools was 37.50% (3/8) among the environments, and the schistosome infection rate of stools was 8.11% (3/37). The schistosome infection rate of animal stools was 0 near the residence living sites, and the positive rates were 12.50% and 8.33% in the ditches and slopes, respectively (chi2 = 0.07, P > 0.05)., Conclusions: Bovine is still the main infectious source of schistosomiasis, i.e. the main risk factor of the disease transmission. Therefore, the strategy of controlling bovine should be strengthened.

Polymorphous low-grade adenocarcinoma is a rare salivary gland tumor with lower rate of local and regional metastasis and rare distant metastasis. The prognosis is relatively good. This paper reported a case of palatal polymorphous low-grade adenocarcinoma with cervical lymph node and distant metastasis, and discussed clinical characteristics, differential diagnosis, treatment, prognosis based on literature review.

Objective: To analyze the distribution of pathogenic bacterium of the fungal keratitis patients for providing the data of clinical diagnosis and treatment., Methods: From July 2005 to December 2010 in Shandong Eye Hospital there were 352 smears of corneal ulcers and corneal tissue exemplar removed in surgery from fungal keratitis patients. The all exemplars were cultured with the Sabouraud dextrose agar culture media in 28°C under the humidor for 7 days. The strains was identified according to the appearance of fungal colonies, mycelium, spore shape, spore arrangement and fungal shape. And there did the retrospective analyses about the positive rate of fungal culture, genus distribution, seasonal distribution and sources of patients, sex ratio, age distribution and occupation. etc., Results: There were 334 stock positive fungal culture in 352 cultured specimens from fungal corneal ulcers, the positive rate was 94.9%. There were 187 positive culture from 203 corneal scraping exemplars, the positive rate was 92.1%; there were 147 positive culture from 149 corneal tissue removed in surgery, the positive rate was 98.7%. The Fusarium strains was most common in all isolated strain, 211 (63.2%). The Aspergillus was secondly 47 (14.1%). The character of seasonal distribution of culture positive strain: the 48 strains (14.4%) were cultivated from January to March; the 48 strains (14.4%) were cultivated from April to June; the 64 strains were cultivated (19.2%) from July to September; the 174 strains (52.0%) were cultured from October to December, the ratio were 1:1:1.3:3.6 quarterly (χ(2) = 3.360, P = 0.339). The incidence of fungal keratitis were higher in the autumn and winter than in spring and summer. The ratio of the male and the female was 2.04:1 in 334 culture-positive patients; the mean age was (48 ± 22) years old. The 217(65%) came from farmer in the developed group, and the other 117 cases came from other occupations (35%). The 289 (87%) cases came from Shandong Province in 334 positive patients, the 45 cases (13%) came from other province of Province. Chi-square test method was used to analysis the differences of incidence of fungal keratitis among the four seasons using SPSS11.5., Conclusions: The Fusarium is the most important pathogen in fungal keratitis in Shandong Province. The high positive culture rate of fungal keratitis specimens plays an important role in clinical diagnosis and treatment.

A new oxidation system of Fenton-like system (ZVI/EDDS/Air) has been developed to degrade 2,4-chlorophenols (2,4-DCP) in aqueous solution. The influences of initial conditions, i. e., EDDS concentration, iron dosage, aeration rate, 2,4-DCP concentration and pH as well as reaction temperature on the degradation of 2,4-DCP were studied. The results demonstrated that this ZVI/EDDS/Air system was able to effectively degrade 2,4-DCP in aqueous solution, and the degradation of 2,4-DCP conforms to the pseudo-first-order reaction kinetics equation. Removal of above 99% 2,4-DCP was achieved in ZVI/EDDS/Air system at room temperature and pressure after 1 h reaction when the initial conditions were 2,4-DCP 100 mg x L(-1), EDDS 0.80 mmo x L(-1), ZVI 20 g x L(-1), aeration rate 2 L x (min x L)(-1). Compared with ZVI/EDTA/Air system, ZVI/EDDS/Air system showed higher efficiency in the degradation of 2,4-DCP at ambient circumstance and was more environmentally benign.

Concentrations and spatial distribution of PFOS and PFOA in surface water from East Lake in Wuhan, Hubei, China were studied. The total concentration of PFCs ranged from 31.1 to 237 ng x L(-1), and the mean value was 115 ng x L(-1), revealing lake-wide contamination in East Lake. PFOS and PFOA were detected in all samples with maximum values of 132 ng x L(-1) and 158 ng x L(-1), respectively, whereas the mean values of PFOS and PFOA were 60.4 and 55.0 ng x L(-1), respectively. The highest concentrations of PFOS and PFOA were found in the eastern area of lake, followed by the southern area of lake, and the western and northern areas of East Lake were the least contaminated regions. The specific distribution and composition profile of PFOS and PFOA, and the lack of significant correlation between PFOS and PFOA, suggested that there were various sources of PFCs. The PFOS concentrations at 30 sample sites (63%) were greater than 43 ng x L(-1), which was used to estimate an avian wildlife value for PFOS. The PFOA concentrations at 20 sample sites (42%) were greater than 40 ng x L(-1), which was a health-based guidance level recommended by the State of New Jersey for PFOA.

Objective: To investigate key techniques and intervention in reducing birth defects., Method: Down's syndrome (DS), trisomy-18 (Edwards syndrome, ES), neural tube defects (NTD), Duchenne muscular dystrophy (DMD), spinal muscular atrophy (SMA), thalassemia, and glucose-6-phosphate dehydrogenase deficiency (G6PD) were chosen as target disease. From Jan. 2007 to Dec. 2009, the condition of intake folic acid were investigated in 5004 pregnant women in Panlong District and Wuhua District of Kunming City. All of the 27 660 pregnant women undergoing prenatal examination were enrolled into the study from the First People's Hospital of Yunnan Province, the Second People's Hospital of Yunnan Province, the First People's Hospital of Qujing City, the Second People's of Qujing City, Qujing Women and Children's Hospital, People's Hospital of Lincang City, Kunming Maria Women's Hospital, Maternal and Infant's Care Unit of Panlong District of Kunming City, Maternal and Infant's Hospital of Dali City. The screening was performed on serum of those pregnant women at 8 - 20(+6) gestational weeks. Prenatal cytogenetic analysis and fetal ultrasonograpy were performed on the high risk or indicated women after genetic counseling. DNA analysis was administered on those women with family or childbearing history of DMD, SMA, thalassemia, or G6PD. Outcome of pregnancy was followed up to evaluate the effect of intervention., Results: Approximately 30.10% (1506/5004) of pregnant women were administered by oral folic acid during perinatal period. Two thousand three hundred and thirteen women with high risks of DS, ES, or NTD fetuses were observed among 27 660 undergoing maternal serum screening. Two thousand and ninety-six pregnant women including two twins pregnant women were performed cytogenetic analysis. Other 67 pregnant women at high risk of DMD, SMA, thalassemia, and G6PD accepted genetic counseling and prenatal gene analysis. Two thousand one hundred and sixty-three pregnant women (2165 fetuses) underwent prenatal examination. One hundred and two cases chromosome abnormalities, 17 cases NTD, 4 cases DMD, 1 cases α-thalassemia major were found. All of the 91 fetuses with major birth defects were terminated after genetic counseling. Another affected DS fetus in a twin pregnancy dead intrauterine at 24 gestational weeks. Thirty-two women bearing fetuses with balanced translocations or inversions continued their pregnancies. Totally 2071 normal term fetuses were born in the prenatal diagnosis group. Two fetuses with normal chromosome were lost within 1 week after amniocentesis. Four affected DS fetuses were born from their high risk mothers who refused further prenatal diagnosis service. In a random sampling follow-up cohort of 5000 mothers at low risk, none of affected child suffering target diseases was found. The DS detection rate of maternal serum screening was 84% (27/32), with the false positive rate was 6.153% (1702/27 660)., Conclusions: Folic acid intake before conception and in the first trimester would reduce the risk of birth defects, only 1/3 reproductive women took folic acid actively. Maternal serum screening could effectively detect high risk of DS, ES and NTD. The genetic counseling is critical in women at high risk or who had family history of inherited disorders. The prenatal screening and diagnosis combined with routine obstetric care could reduce the incidence of major birth defects, which should become prenatal care strategy in our country.

Objective: To investigate GNE gene mutations in 5 Chinese patients with distal myopathy with rimmed vacuoles (DMRV)., Methods: Five patients with typical clinical and pathological features of DMRV were studied. All the 11 coding exons and the flanking intron sequences of GNE gene were amplified by PCR and sequenced. Four family members of case 5 were also examined for GNE gene mutations., Results: All the patients were identified to have different GNE gene mutations: Cases 1-4 had complex heterozygous mutations and case 5 had homozygous mutation. Six reported mutations had been identified, including 1 nonsense mutation (p.R8X) and 5 missense mutations (p.D176V, p.I298T, p.A591T, P.A631V, and p.V696M). A novel mutation (c.317T>C, p.I106T) was identified in case 2., Conclusion: This is the first report of p.R8X, p.I298T, p.A591T and p.V696M mutations in GNE gene in Chinese population, and a novel mutation p.I106T was identified. These findings further expand the clinical and genetic spectrum of DMRV in China.

To study the chemical constituents of Bauhinia glauca subsp. pernervosa, eleven phenolic acids were isolated from a 95% ethanol extract by using a combination of various chromatographic techniques including column chromatography over silica gel, ODS, MCI, Sephadex LH-20, and semi-preparative HPLC. By spectroscopic techniques including 1H NMR, 13C NMR, 2D NMR, and HR-ESI-MS, these compounds were identified as isopropyl O-beta-(6'-O-galloyl)-glucopyranoside (1), ethyl O-beta-(6'-O-galloyl)-glucopyranoside (2), 3, 4, 5-trimethoxyphenyl-(6'-O-galloyl)-O-beta-D-glucopyranoside (3), 3, 4, 5-trimethoxyphenyl-beta-D-glucopyranoside (4), gallic acid (5), methyl gallate (6), ethyl gallate (7), protocatechuic acid (8), 3, 5-dimethoxy-4-hydroxybenzoic acid (9), erigeside C (10) and glucosyringic acid (11). Among them, compound 1 is a new polyhydroxyl compound; compounds 2, 10, and 11 were isolated from the genus Bauhinia for the first time, and the other compounds were isolated from the plant for the first time. Compounds 6 and 8 showed significant protein tyrosine phosphatase1B (PTP1B) inhibitory activity in vitro with the IC50 values of 72.3 and 54.1 micromol x L(-1), respectively.

Objective: To summarize the sustained dynamic release characteristics of fibrin glue enwrapping cisplatin., Methods: In this in vivo study, 20 patients received fibrin glue enwrapping cisplatin placed into the abdominal cavity while another 20 patients received cisplatin as the control group. Their peripheral blood and urine samples were collected at a regular interval to determine the concentrations and the pharmacokinetic parameters of cisplatin., Results: The peak peripheral blood concentration of cisplatin in the study group was significantly lower than that in the control group [(192.2 ± 33.5) vs (1077.6 ± 176.6) µg/L, P < 0.01]. And the peak urine concentration of cisplatin was significantly lower in the study group than that in the control group [(18.6 ± 8.7) vs (55.8 ± 12.7) µg/L, P < 0.01]. The elimination half-life of cisplatin was 23.32 h and 13.93 h respectively in the study and control groups. The elimination half-life and the area under the curve in peripheral blood and urine samples of the study group were significantly longer than those of the control group (P < 0.01)., Conclusion: The fibrin glue enwrapping cisplatin has the excellent in vivo characteristics of sustained dynamic release. Thus it may prolong the retention of cisplatin in abdominal cavity and lower its concentration in peripheral blood.

Objective: To compare the clinical, pathological, laboratory test and follow-up data between familial and sporadic patients with distal myopathy with rimmed vacuoles (DMRV) and discuss the characteristics of this disorder in Chinese population., Methods: The clinical and pathological features, laboratory data and follow-up results of 33 sporadic and 4 familial cases of pathologically confirmed DMRV were summarized and compared retrospectively., Results: The patients age, onset age, or disease duration showed no significant difference between sporadic and familial cases; the onset pattern and affected muscle groups were also similar, but the sporadic cases showed more frequent dysmorphic features than the familial cases. The patients showed mild to moderate elevation of the muscle enzymes by one to three folds, and the familial patients had more significant elevation than the sporadic ones. No correlation was found between the disease duration and the level of muscle enzymes. The pathological findings were similar between the cases, and Gomori staining showed rimmed vacuoles and inclusion bodies without inflammatory cell infiltration. Follow-up results of 29 cases showed no significant difference between the two groups. The disease was slowly progressive and severely affected the quality of life of the patients, but did not produce obvious effect on the life expectancy., Conclusion: The clinical, pathological and laboratory data of Chinese DMRV patients are basically similar to those of Japanese cases. Sporadic cases tend to show more dysmorphic features than the familial ones, and occasional sporadic cases have early disease onset in early childhood.

The aim of the study is to explore the effects of luteolin preconditioning on hepatic ischemia/reperfusion injury in rats and its mechanism, and investigate the effects of the change of heme oxygenase-1 (HO-1) activity on hepatic ischemia/reperfusion injury. Sprague-Dawley rats were divided into 5 groups randomly: control, model, luteolin, luteolin + zinc protoporphyrin (ZnPP, an inhibitor of HO-1) and hemin groups (n = 8 for each group). The rats in control, model and hemin groups received a standard chow daily. The rats in luteolin and luteolin + ZnPP groups received a chow supplemented with luteolin (200 mg/kg) daily. After 4 weeks, ZnPP (25 μmol/kg) and hemin (20 μmol/kg) were injected hypodermically 6 h before ischemia/reperfusion in luteolin + ZnPP and hemin groups, respectively. Portal vein and hepatic artery supplying the middle and left hepatic lobe were clamped with an atraumatic vascular clip for induction of partial hepatic ischemia in all rats except control group. After the 60 min of hepatic ischemia, a 60-minute reperfusion period was initiated by removal of the arterial clip. The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were detected in serum, and the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in serum and liver were measured with assay kit. The expression of HO-1 protein and activity of HO-1 were examined in liver. The results showed that the luteolin and hemin pretreatment led to significant decreased levels of AST and ALT in serum, increased activity of SOD and decreased content of MDA in serum and liver compared with model group (P < 0.01). In addition, the expression of HO-1 protein and activity of HO-1 were elevated in luteolin and hemin groups (P < 0.01). ZnPP markedly increased the levels of AST and ALT in serum, and decreased the activities of SOD and HO-1, elevated MDA content in liver when compared with those in luteolin group (P < 0.01). Cytoplasmic vacuolation and swelling of hepatocytes were revealed in the model group after ischemia/reperfusion. Treatments with luteolin and hemin markedly relieved the liver structural changes. These results suggest that HO-1 protects rat liver from ischemia/reperfusion injury, and luteolin reduces the content of MDA and increases the activity of SOD and the expression of HO-1, which indicate that luteolin can elevate the antioxidation in rat liver, and thus protects rat liver from ischemia/reperfusion injury.

Aim: To construction of eukaryotic expression vector of murine Ccr2 and establishment of its stable transfected RAW264.7 cell line., Methods: The whole coding region of murine Ccr2 mRNA was amplified by PCR and was inserted into a vector pEGFP-N1. The recombinant pEGFP-N1/Ccr2was transfected into RAW264.7 cells by Lipofectamine 2000 reagent. The stable transfected RAW264.7 cells were screened by G418-media. The expression of Ccr2 on the membrane of the stable transfected cells was identified by RT-PCR, Western blot and flow cytometry. The fusion protein CCR2-EGFP was located by a converted fluorescence microscope., Results: The recombinant plasmid pEGFP-N1/Ccr2 was successfully constructed and the stably transfected RAW264.7 cells was established. Both RT-PCR and Western blot revealed the higher expression of Ccr2 in the stably transfected RAW264.7 cells. Under the fluorescence microscope, the CCR2 was located on the membrane of RAW264.7 cells., Conclusion: The recombinant pEGFP-N1/Ccr2 has been constructed successfully and has been stably expressed in RAW264.7 cells.

Objective: To analyze the risk factors affecting the glomerular filtration rate (GFR) in type 2 diabetic patients without albuminuria., Methods: A total of 131 type 2 diabetic patients with normal urinary albumin excretion rate (UAER) were divided into normal GFR group and decreased GFR group. The factors relevant to GFR were analyzed by multiple factors regression., Results: Age, course of diabetes, systolic blood pressure, prevalence of hypertension, the level of serum creatinine (SCr), blood urea nitrogen (BUN) and uric acid (UA) were significantly higher in decreased GFR group than in normal GFR group. Multivariate regression showed that SCr, age, systolic blood pressure, and UA were negatively correlated to GFR., Conclusion: Reduced GFR occurs in some type 2 diabetic patients without albuminuria. SCr, age, systolic blood pressure and UA are the major factors related to decreased GFR. The degree of early renal damage in diabetic patients can be better evaluated by combining GFR and UAER.

Objective: To investigate the diagnostic value of capsule endoscopy (CE), CT enterography (CTE), ileocolonoscopy and small bowel follow through (SBFT) for small bowel Crohn's disease (CD)., Methods: Fifty-seven consecutive patients with CD underwent ileocolonoscopy, CTE, CE, and SBFT. It included the presence of the following symptoms and signs: abdominal pain, weight loss, diarrhea, fever and positive fecal occult blood test. The location and the characteristics of intestinal and extra-intestinal lesions detected by four techniques were compared. The proportions of patients with positive findings using each examination were compared., Results: Of the 57 patients, 50 underwent ileocolonoscopy, terminal ileum lesion was found in 33 patients (66.00%), the remaining 17 (34.0%) were normal; among 34 patients who had CTE, 29 of small bowel lesion were found (85.29%); CE were performed in 27 patients, due to prolonged gastric transit one time, the capsule did not reach the cecum in one patient during battery lifetime. CE showed small bowel lesion in 26 patients (96.30%); SBFT was performed in 39 patients and 26 of small bowel lesion were detected (66.67%). CE had the highest diagnostic yield for CD and ileocolonoscopy had the lowest, and there were statistically significant difference among the 4 examinations (P = 0.006). The combined positive rates of two methods were: CE + CTE 92.86% (13/14), SBFT + CTE 90.91% (20/22), CE + ileocolonoscopy 95.65% (22/23), CE + SBFT 100% (17/17), ileocolonoscopy + CTE 89.66% (26/29), ileocolonoscopy + SBFT 77.78% (28/36), but there were no significant differences between each two examinations., Conclusion: CE, CTE have a higher yield in depicting mild to moderate finding of CD than SBFT. CE is better for assessing early mucosal disease, whereas CTE is better for detecting transmural and extraluminal abnormalities. Most important, CE plus CTE may depict nonobstructive CD of the small bowel when conventional techniques such as ileocolonoscopy or SBFT have negative or inconclusive finding. CE provides us explanations for the symptoms of patients, decision to follow up or therapy.

One-dimensional (1-D) photonic crystals(PCs)with liquid crystals (LCs) are promising in various applications such as filters, low-threshold lasers, optical switch. In the present paper, the authors investigated the transmission spectrum of 1-D PCs with LCs for defect layer at different voltages ranging from 0 to 10 V. The tunable spectral range was about 50 nm, FWHM of the transmission peak was 18 nm and the band gap was nearly 400 nm. Furthermore, we presented a kind of polarization insensitive LC photonic crystal, and designed a 1-D LC photonic crystal device that has double LC layers with zero twisted angle. Double LC layers have a function of compensation for both polarization components of incident light, which makes the original two transmission peaks in the band gap to incorporate to one, and enhances the light intensity and filter performance.