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Aim: To evaluate the association between CYP2C19, CYP3A4 and ABCC2 polymorphisms and voriconazole plasma concentrations in Uygur pediatric patients with allogeneic hematopoietic stem cell transplantation. Materials & methods: High performance liquid chromatography–mass spectrometry was employed to monitor voriconazole concentrations. First-generation sequencing was performed to detect gene polymorphisms. Results: Voriconazole concentrations of normal metabolizers were significantly higher than those of intermediate (p

Purpose The effectiveness and tolerability of lacosamide (LCM) among Chinese children and adolescents with refractory epilepsy has not yet been established. Therefore, the objective of this study was to assess the effectiveness and tolerability of LCM among children and adolescents with refractory epilepsy in Xinjiang, Northwest China. Methods Effectiveness was assessed by measuring changes in seizure frequency at 3, 6 and 12 months compared with baseline. Patients that achieved ≥ 50% reduction in the frequency of all seizures per month, relative to baseline, were considered to be responders. Results 105 children and adolescents with refractory epilepsy were enrolled in the study. The responder rates were 47.6%, 39.2%, and 31.9%, respectively at 3, 6, and 12 months. Seizure freedom rates were 32.4%, 28.9%, and 23.6% at 3, 6, and 12 months, respectively. The retention rates at 3, 6, and 12 months were 92.4%, 78.1%, and 69.5%, respectively. The maintenance dose of LCM within the responder group (8.2 ± 4.5 mg·kg− 1·d− 1) was significantly higher compared to the non-responder group (7.3 ± 2.3 mg·kg− 1·d− 1) (p Conclusion This real-world study of children and adolescents validated that LCM was both an effective and well-tolerated treatment option for the treatment of refractory epilepsy.

Evaluation of the zoonotic risk of animal SARSr-CoVs is important for future disease preparedness. However, there are misconceptions regarding the risk of animal viruses.

Diabetic foot ulcers infected with microorganisms increase the risk of amputation. The presence of drug-resistant bacteria in diabetic foot ulcers creates a big challenge during the treatment. The objective of the present study was to determine the bacterial prevalence and antibiotic resistance among bacteria isolated from Chinese patients with diabetic foot ulcers. The present study studied the microbial colonization of diabetic foot ulcers of patients from a single center in China. Wound swabs from 89 patients with diabetic foot ulcers were collected and the presence of microorganisms detected. The isolated microorganisms were subjected to antibiotic susceptibility testing by the disk diffusion method. Of 89 patients, 56 (62.9%) were male and 33 (37.1%) were female, the mean age of patients was 53.2±5.4 years, the mean duration of diabetes was 14.8±2.9 years, the mean random blood sugar was 301±87 mg/dl, mean HbA1c was 7.9±1.4%. Patients with Wanger ulcer grade III (36.0%; P=0.034) and patients within the weight range of 51-75 kg (59.6%; P=0.012) were significantly higher. The prevalence rate of diabetic foot ulcers was 11.3%. Among 153 microorganisms, gram-positive bacteria (52.3%) were more prevalent than gram-negative bacteria (44.4%). Most of the patients with polymicrobial infection were classified to have Wanger III ulcer grade diabetic foot ulcers. Staphylococcus aureus (38.2%) was the most predominant bacteria isolated followed by Staphylococcus epidermidis (29.2%) and Escherichia coli (28.1%). Most of the gram-positive and gram-negative bacteria were resistant to dicloxacillin (73.8%, P=0.021) and cefotaxime (50%), respectively and ~53.4% of the isolates were multi-drug resistance isolates, 61.8% of the Staphylococcus aureus were identified as methicillin-resistant Staphylococcus aureus and 61.8% of the gram-negative bacteria were extended-spectrum β-lactamase producers. Staphylococcus aureus and Escherichia coli were the predominant gram-positive and gram-negative bacteria isolated, respectively. Penicillin resistance was significantly higher among the gram-negative bacteria (P=0.019). Staphylococcus aureus and Escherichia coli were the predominant gram-positive and gram-negative bacteria isolated and levofloxacin and nitrofurantoin were the most effective antibiotics among the gram-positive and gram-negative bacterial isolates, respectively.

The impact of individual patient variables on drug metabolism is particularly important for antiseizure medication, and lacosamide has not been studied in Chinese pediatric patients with epilepsy. This study evaluated the effects of dose, age, sex, medication time, seizure type, and concomitant enzyme-inducing antiseizure medications (EIASMs) on the plasma concentration of lacosamide.A total of 500 pediatric patients from two hospitals in China were enrolled in this study. Lacosamide plasma concentration was processed using an ultra-performance liquid chromatography assay. Efficacy was evaluated based on the four-grade therapeutic effect criteria developed by the first National Epilepsy Academic Conference of the Chinese Medical Association.The responder rate to lacosamide therapy was 72.2% (361/500). There was a weaker relationship between the lacosamide daily dose and lacosamide plasma concentration (r = 0.238). Lacosamide plasma concentrations of patients ranged from 1.5 to 19.7 µg/mL, with a mean of 6.9 ± 3.2 µg/mL. The study results showed a significant contribution of age, body mass index, epilepsy duration, medication time, and EIASMs to the lacosamide plasma concentration (p 0.05). Patients taking concomitant EIASMs with lacosamide had a significantly lower mean lacosamide plasma concentration (5.9 ± 2.6 µg/mL) than patients taking concomitant non-EIASMs (7.5 ± 3.5 µg/mL, p 0.001).To ensure the clinical efficacy and safety of lacosamide therapy in pediatric patients, it is necessary to monitor the plasma concentration.

We aimed to evaluate the effect of the ABCC2 1249GA (rs2273697) and -24CT (rs717620) polymorphisms on lacosamide (LCM) plasma concentrations, and the efficacy of LCM in Uygur pediatric patients with epilepsy.We analyzed 231 pediatric patients with epilepsy, among which 166 were considered to be LCM-responsive. For drug assays, 2-3 mL of venous blood was collected from each patient just before the morning LCM dose was administered (approximately 12 h after the evening dose, steady-state LCM concentrations). The remaining samples after routine therapeutic drug monitoring were used for genotyping analysis. The chi-squared test and Fisher's exact test were utilized for comparative analysis of the allelic and genotypic distribution of ABCC2 polymorphisms between the LCM-resistant and -responsive groups. Student's t-test or Mann-Whitney U test was conducted to analyze differences in plasma LCM concentration among pediatric epilepsy patients with different genotypes.Patients with the ABCC2 1249GA GA genotype (0.7 ± 0.3 μg/mL per kg/mg) and AA genotype (0.5 ± 0.3 μg/mL per kg/mg) showed significantly (p0.001) lower LCM concentration-to-dose (CD) ratios than patients with the GG genotype (1.0 ± 0.4 μg/mL per kg/mg). Moreover, patients with the ABCC2 -24CT CT genotype (0.6 ± 0.2 μg/mL per kg/mg) and TT genotype (0.6 ± 0.3 μg/mL per kg/mg) presented a significantly (p0.001) lower LCM CD ratio than patients with the CC genotype (1.1 ± 0.4 μg/mL per kg/mg).The ABCC2 1249GA (rs2273697) and ABCC2 -24CT (rs717620) polymorphisms can affect plasma LCM concentrations and treatment efficacy among a population of Uygur pediatric patients with epilepsy, causing these patients to become resistant to LCM. In clinical practice, ABCC2 polymorphisms should be identified before LCM treatment, and then the dosage should be adjusted for pediatric epilepsy patients accordingly.

This study has developed and validated a novel LC-MS/MS assay method to quantify perampanel in pediatric patients with epilepsy in Xinjiang, China. Our assay reduces current specimen volume requirements and decreases the turnaround time for results. Samples were separated by gradient elution and then injected into the mass spectrometer with a total run time of 3 min per sample. The ions from the analytes were detected using multiple reactions by monitoring transitions of m/z 350.2-219.0 for perampanel and m/z 359.1-323.1 for the internal standard, as precursor ion and product ion, respectively. The peak area ratios of perampanel with internal standard within the plasma samples were linear in the concentration range of 0.1-3.2 μg/mL (y = 2.87x + 0.61; r

SARS-CoV-2 induced marked lymphopenia in severe patients with COVID-19. However, whether lymphocytes are targets of viral infection is yet to be determined, although SARS-CoV-2 RNA or antigen has been identified in T cells from patients. Here, we confirmed that SARS-CoV-2 viral antigen could be detected in patient peripheral blood cells (PBCs) or postmortem lung T cells, and the infectious virus could also be detected from viral antigen-positive PBCs. We next prove that SARS-CoV-2 infects T lymphocytes, preferably activated CD4 + T cells in vitro. Upon infection, viral RNA, subgenomic RNA, viral protein or viral particle can be detected in the T cells. Furthermore, we show that the infection is spike-ACE2/TMPRSS2-independent through using ACE2 knockdown or receptor blocking experiments. Next, we demonstrate that viral antigen-positive T cells from patient undergone pronounced apoptosis. In vitro infection of T cells induced cell death that is likely in mitochondria ROS-HIF-1a-dependent pathways. Finally, we demonstrated that LFA-1, the protein exclusively expresses in multiple leukocytes, is more likely the entry molecule that mediated SARS-CoV-2 infection in T cells, compared to a list of other known receptors. Collectively, this work confirmed a SARS-CoV-2 infection of T cells, in a spike-ACE2-independent manner, which shed novel insights into the underlying mechanisms of SARS-CoV-2-induced lymphopenia in COVID-19 patients.

Background Previous research regarding the humanistic care ability of Chinese medical professionals was limited to small groups of nurses or students. More systemic analyses involving more general medical professionals are scarce and urgently needed. Objective To survey the sense and ability of humanistic care on medical professionals in China and to identify the potential influencing factors. Methods A novel scale of humanistic care indicators was developed. Based on the new scale, a questionnaire was designed, tested and used to survey a total of 928 medical professionals recruited from three hospitals in the Chinese Western city Chongqing. Chi-square test was used for single factor analyses. For multiple factor analyses, multivariate logistic regression was performed. Results Our selected group of medical professionals scored nearly 4 or above on a 1-5 scale for all our query items related to the sense and ability of humanistic care. The main factors affecting humanistic care ability of medical professionals in Chongqing include gender, nature of department/division, modes of employment and participation in humanistic care ability training and so on. Conclusions In general, the participants in our study group had a humanistic care ability score lower than the aimed value, suggesting that the ability of humanistic care of these medical professional was not satisfactory. The study also shows that one effective way to enhance the humanistic care ability is to provide more targeted training.

PURPOSE P-glycoprotein, encoded by ABCB1 (or MDR1), may contribute to drug resistance in epilepsy by limiting gastrointestinal absorption and brain access to antiseizure medications (ASMs). The study aimed to evaluate the impact of ABCB1 polymorphisms on lacosamide (LCM) serum concentrations in Uygur pediatric epileptic patients. METHODS The serum concentrations of LCM were determined by ultra-performance liquid chromatography, and the ABCB1 polymorphism was analyzed via polymerase chain reaction-fluorescence staining in situ hybridization. The chi-squared test and Fisher's exact test were used to analyze the allelic and genotypic distributions of ABCB1 polymorphisms between the drug-resistant and drug-responsive patient groups. Differences in steady-state and dose-corrected LCM serum concentrations between different genotypes were analyzed using the One-Way Analysis of Variance (ANOVA) and Mann-Whitney test. RESULTS A total of 131 Uygur children with epilepsy were analyzed, and of them, 41 demonstrated drug resistance. The frequency of the GT genotype of ABCB1 G2677T/A was significantly higher in the drug-resistant group than that in the drug-responsive group (p < 0.05, OR = 1.966, 95% CI = 1.060-3.647). Patients with the G2677T/A- AT genotype had a statistically significantly lower concentration-to-dose (CD) value than patients with the G2677T/A-GG genotype (mean: 0.6 ± 0.2 vs 0.8 ± 0.5 μg/ml per mg/kg, p < 0.001). Significantly lower LCM serum concentrations were observed in ABCB1 C3435T CT and TT genotype carriers than those in the CC carriers (p = 0.008 and p = 0.002), and a significantly lower LCM CD value was observed in ABCB1 C3435T CT genotype carriers than that in the CC carriers (p = 0.042). CONCLUSION ABCB1 G2677T/A and C3435T polymorphisms may affect LCM serum concentrations and treatment efficacy in Uygur pediatric patients with epilepsy, leading to drug resistance in pediatric patients.

BACKGROUND: The coronavirus disease 2019 (COVID-19), infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a severe outbreak throughout the world. The host immunity of COVID-19 patients is unknown. METHODS: The routine laboratory tests and host immunity in COVID-19 patients with different severity of illness were compared after patient admission. RESULTS: A total of 65 SARS-CoV-2–positive patients were classified as having mild (n = 30), severe (n = 20), and extremely severe (n = 15) illness. Many routine laboratory tests, such as ferritin, lactate dehydrogenase, and D-dimer, were increased in severe and extremely severe patients. The absolute numbers of CD4(+) T cells, CD8(+) T cells, and B cells were gradually decreased with increased severity of illness. The activation markers such as HLA-DR and CD45RO expressed on CD4(+) and CD8(+) T cells were increased in severe and extremely severe patients compared with mild patients. The costimulatory molecule CD28 had opposite results. The percentage of natural Tregs was decreased in extremely severe patients. The percentage of IFN-γ–producing CD8(+) T cells was increased in both severe and extremely severe patients compared with mild patients. The percentage of IFN-γ–producing CD4(+) T cells was increased in extremely severe patients. IL-2R, IL-6, and IL-10 were all increased in extremely severe patients. The activation of DC and B cells was decreased in extremely severe patients. CONCLUSION: The number and function of T cells are inconsistent in COVID-19 patients. The hyperfunction of CD4(+) and CD8(+) T cells is associated with the pathogenesis of extremely severe SARS-CoV-2 infection. FUNDING: This work was funded by the National Mega Project on Major Infectious Disease Prevention (2017ZX10103005-007) and the Fundamental Research Funds for the Central Universities (2019kfyRCPY098).

Background: Coronavirus Disease-2019 (COVID-19) has caused considerable morbidity and mortality. Hence, there is an urgency to find effective treatment. Tocilizumab, an inhibitor of IL-6, has been widely proposed as a treatment of severely ill patients without robust evidence supporting its use. Methods: In this multicentre, retrospective, cohort study, we included 5,235 adult patients who were admitted to 3 hospitals in Wuhan, China with confirmed COVID-19 from January 20 to March 18, 2020 . 65 patients in tocilizumab group and 130 patients in non-tocilizumab group were propensity score matched at a ratio of 2:1 based on age, sex, and comorbidities. Detailed demographic data, comorbidities, radiological and laboratory parameters, complications and treatments were compared between tocilizumab group and non-tocilizumab group. Furthermore, univariable and multivariable Logistic and Cox regression models were used to explore the risk of complications and in-hospital death associated with tocilizumab. Findings: During the follow-up, patients in non-tocilizumab group were more likely to develop into death (42 [32·31%] vs 14 [21·54%]). After adjusting for confounding, the detected risk for in-hospital death was lower in the tocilizumab group versus the non-tocilizumab group (HR=0·47; 95% CI=0·25-0·90; p=0·023). In the multivariable logistic regression model, use of tocilizumab was associated with a lower risk of ARDS (OR=0 · 23; 95% CI=0·11-0·45; p

Background: Multiple organ damage and abnormal inflammation caused by COVID-19 have previously been reported in hospitalized patients. It remains unclear whether these patients can return to a healthy individual three months after discharge and whether there are related sequelae. Methods: We followed up 95 severe/critical patients and 51 mild/moderate ones who recovered from COVID-19 and were discharged from hospital for 3 months. For comparison, 28 asymptomatic COVID-19 recovered individuals and 42 uninfected healthy donors (HDs) were included. At the visit, patients were interviewed and subjected to quality-of-life evaluation (St. George respiratory questionnaire [SGRQ]), pulmonary function tests, chest CT imaging, laboratory examination, detection of immune cells, and cytokine profiling. Findings: At three months, all recovered patients tested negative for nucleic acid of SARS-CoV-2, and most were positive for serum SARS-COV-2 IgG, but few were still positive for serum IgM. The SGRQ scores for the quality-of-life were higher in recovered patients, especially those who had had severe/critical disease. Laboratory test revealed that CRP, LDH and D-dimer, three prevalent risk factors for COVID-19 prognosis in the acute phase, did not recover to the level of uninfected HDs in the convalescence. Immune cells virtually returned to normal levels in patients who recovered from COVID-19, but some pro-inflammatory cytokines, especially chemokines and factors related to vascular injury and angiogenesis, did not return to the level of HDs, and this was especially true of severe/critical recovered patients. CT of the lungs showed that ground-glass opacity (GGO) still lingered as the main manifestation, followed by strip-like fibrosis. Artificial intelligence (AI) analysis indicated that the lesions were most prominent in the lower lobe of right lung, and were mainly found in recovered severe/critical individuals. Abnormal lung function was mainly manifested as restrictive ventilation dysfunction and lowered diffusion capacity, which was more pronounced in severe/critical COVID-19 recovered patients. Overall, the recovery status of the patients varied with the severity of the disease. Interpretation: Decreased physical quality of life, respiratory sequelae (restrictive ventilatory dysfunction, diffusion capacity disorder, and chest CT abnormalities), vascular injury and aberrant cytokine profiles still existed three months after discharge, and were more frequent and conspicuous in severe/critical COVID-19 rehabilitation patients compared to their mild/moderate and asymptomatic counterparts. Trial Registration: This project was registered on the Clinical Trials website (No. NCT04456101) Funding: This study was supported in part by the National Natural Science Special Foundation of China (82041018, 81800094), National Major Science and Technology Projects of China (CN):2019ZX09301001, Ministry of Science and Technology of the People's Republic of China (CN):2020YFC0844300, and the Fundamental Research Funds for the Central Universities, HUST: 2020kfyXGYJ011. Declaration of Interests: The authors have no conflict of interest or financial relationships to disclose. All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Ethics Approval Statement: The protocol used in this project has been reviewed and approved by the institutional review boards of Medical Ethics Committee of Wuhan Union Hospital (NO.0271-01). All participants or their surrogates signed informed consent.

Following acute infection, individuals COVID-19 may still shed SARS-CoV-2 RNA. However, limited information is available regarding the active shedding period or whether infectious virus is also shed. Here, we monitored the clinical characteristics and virological features of 38 patients with COVID-19 (long-term carriers) who recovered from the acute disease, but still shed viral RNA for over 3 months. The median carrying history of the long-term carriers was 92 days after the first admission, and the longest carrying history was 118 days. Negative-positive viral RNA-shedding fluctuations were observed. Long-term carriers were mostly elderly people with a history of mild infection. Infectious SARS-CoV-2 was isolated from the sputum, where high level viral RNA was found. All nine full-length genomes of samples obtained in March–April 2020 matched early viral clades circulating in January–February 2020, suggesting that these patients persistently carried SARS-CoV-2 and were not re-infected. IgM and IgG antibodies and neutralizing-antibody profiles were similar between long-term carriers and recovered patients with similar disease courses. In summary, although patients with COVID-19 generated neutralizing antibodies, they may still shed infectious SARS-CoV-2 for over 3 months. These data imply that patients should be monitored after discharge to control future outbreaks.

Better understanding of the role of vegetation and soil on hydraulic resistance of overland flow requires quantitative partition of their interaction. In this paper, a total of 144 hydraulic flume experiments were carried out to investigate the hydraulic characteristics of overland flow. Results show that hydraulic resistance is negatively correlated with Reynolds number on non-simulated vegetated slopes, while positively on vegetated slopes. The law of composite resistance agrees with the dominant resistance, depending on simulated vegetation stem, surface roughness, and discharge. Surface roughness has greater influence on overland flow resistance than vegetation stem when unit discharge is lower than the low-limited critical discharge, while vegetation has a more obvious influence when unit discharge is higher than the upper-limited critical discharge. Combined effects of simulated vegetation and surface roughness are unequal to the sum of the individual effects through t-test, implying the limitation of using linear superposition principle in calculating overland flow resistances under combined effect of roughness elements.

Objective Programmed death-1 (PD-1), an important immunosuppressive molecule, plays a key role in tumor-cell-mediated immune escape. In the present study, we evaluated the effect of PD-1 gene polymorphisms on the risk of developing epithelial ovarian cancer (EOC) and patients' outcomes. Methods A case–control study was performed in 620 EOC patients and 620 control women. Survival data were available for 258 patients who received platinum-based chemotherapy after cytoreductive surgery. Results There were significant differences in the genotype and allele distribution frequencies of the PD-1.1 A/G between cases and controls (P=0.028 and P=0.02, respectively). Compared with the AA genotype, AG and GG genotypes may significantly decrease the risk of developing EOC (OR=0.71, 95%CI=0.54–0.94; OR=0.68, 95%CI=0.50–0.94, respectively). We did not find a significant difference in the genotype distribution frequency of the PD-1.5 C/T between cases and controls (P=0.096), but the frequency of T alleles was significantly lower in the EOC cases than that in the controls (P=0.033). Compared to the carriers with C alleles, the carriers with T alleles were at a significantly decreased risk of developing EOC (OR=0.82, 95%CI=0.69–0.98). Survival analysis showed that the two polymorphisms were not associated with patients' outcomes. Conclusions PD-1 gene polymorphisms may be involved in the development of EOC, but not associated with its clinical outcome in EOC patients among northern Chinese women.

The up-and-coming high-efficiency video coding (HEVC) offers superior compression performance compared to the previous-generation video compression standard H.264/AVC. The rate control is the most important coding tool for compressed data transmission because of the time-varying transmission bandwidth. Based on a wide range of offline data analyses and statistics, this paper presents a rapid rate control scheme that has low computational complexity for HEVC applications within electronic devices. Experimental results demonstrate that the presented scheme can perform HEVC under time-varying bit-rate conditions.

High-efficiency video coding (HEVC) is the emerging video coding standard, which provides a coding bit-rate reduction of up to 50% compared to the previous-generation video compression standard, H.264/AVC. A wide variety of video coding applications are applied in mobile devices; they suffer from the limited time-amending transmission bandwidth during data transmission. We present a low-hardware-complexity HEVC ME design that is not only aware of transmission bandwidth changes but capable of acceptable coding performance. In comparison with the HEVC test model (HM-16.6), the introduced HEVC ME scheme with rate-control capability can be realized in VLSI.

Microstructural features and defects arising from selective laser melting (SLM) determine the in-service performance of additively manufactured near-net-shape components. Here the grain type, shape, size and distribution were characterized using electron backscattered diffraction (EBSD). High-resolution synchrotron radiation X-ray computed tomography (CT) was used to quantify the population, morphology and dimensions of porosity and lack of fusion defects. For SLM Ti-6Al-4V alloy, the larger-sized defects in comparison with the α grains are more important for crack initiation, typically leading to poor fatigue resistance and a pronounced variation in fatigue life. The fatigue strength was then evaluated in terms of the defect population using a combination of the statistics of extremes and the Murakami model. Finally, an extended Kitagawa-Takahashi fatigue diagram was established within the framework of defect-tolerant design, which includes a classical safe-life region and the defect-determined lifetime in the finite life region.

Metallic components fail mostly due to fatigue cracks, and thus a suitable non-destructive detection is necessarily planned to ensure the operation safety. Among the requisite parameters, a fatigue crack growth (FCG) model might be the most important input, which is frequently acquired from well-defined and expensive fracture mechanics experiments. By correlating the uniaxial tensile properties (UTP) with cyclic plastic parameters and developing a unified fatigue crack closure factor U suitable for broad stress ratios, a novel FCG model of improved LAPS (iLAPS) was formulated in terms of linear damage accumulation and Rice-Kujawski-Ellyin field. Results show that the newly-developed iLAPS model can simulate the entire crack growth region as like modified NASGRO does. For open-reported structural materials available with both UTP and FCG data, it is found that current iLAPS predictions are well agreed with experimental results and are also better than original LAPS.

Experimental study on the ultrasonic, Fenton law separate and composite handle direct blue-B2RL dyeing wastewater of main influence factors and treatment effect. Experimental results show that ultrasonic Fenton recombination method > Fenton> ultrasound treatment effect alone . Complex legal pH values, while ultrasonic-Fenton ultrasonic radiation dosing the amount of H2O2 and time and other factors were studied to determine the best experimental conditions.The best experimental conditions is :the dosing the amount of H2O2 3ml/L, pH=3.

At present, carbon finance business is single relatively in Chinese Commercial Banks, commercial bank little involved in intermediate business of the intermediary business for carbon trading and carbon financial derivatives, should expand carbon finance business under intermediate business actively, such as: as the consultant and training division of CDM project, guide and train the enterprise to develop the action of project investment correctly; as Carbon Bank, provide customers with carbon asset management services comprehensively; provide customer services with carbon trading factoring, carbon emission guarantee, carbon fund hosting and credit enhancement and other services; design and develop the carbon financial derivatives related of carbon emissions and so on. The paper will analyze the innovation of carbon finance under intermediate business in commercial bank.

Experimental study on the manganese sand, magnetite, quartz sand, ceramsite, volcanic rock in northeast China five different filter material of groundwater, and the effects of biological iron and manganese removal. Test results show that the effect of 4 kinds of filter material in addition to iron and manganese in turn is: manganese sand > magnetite > quartz sand > ceramsite.

To investigate the performance of fully- and semi-distributed hydrologic models in simulating the process of transformation from rainfall to runoff in mountain areas, the fully-distributed models Basin Pollution Calculation Center (BPCC) and HEC-HMS are calibrated for the Zhenjiangguan watershed located in the upper stream of Minjiang River Southwest China using stream-flow observations at the basin outlet. Semi-automatical optimization method is implemented to both models to improve simulated results by removing artificial errors. Based on the consistency of the simulated hydrographs with the observed ones, the statistical coefficients such as the relative error, the probability distribution and the correlation coefficient, are further introduced to evaluate quantitatively the performance of the two models. Analyses indicate that the hydrographs simulated by the BPCC are relatively closer to the observed ones than those simulated by the HEC-HMS in view of the spatial heterogeneity in terrain, soil texture, land cover and meteorological conditions in mountain areas.

The purpose of this descriptive study was to survey and compare. A sample of 32 people who have a developmental disability were asked to complete five questionnaires (i.e., demographics, sexual orientation, sexual history, recalled childhood gender identity and adult gender identity). Comparisons were made regarding their sexual orientation and gender identity, as well as differences based on their diagnosis that may not have been related to their developmental disability. One case study was presented to aid in better understanding of a transgendered individual. Research results showed that most subjects perceived themselves as heterosexual (87%), followed by those that saw themselves as bisexual or questioning (9.7%) and lastly those that reported that they were interested in same sex partners (3.2%). No differences were found for diagnostic category. Four subjects scored within the range to indicate that they had gender identity dysphoria (GID). Again, no differences were found for diagnostic category. Interesting findings resulted when comparisons were made to other measures and to other studies. It is proposed that it is good practice for professionals to rule out the possibility of ambivalence about gender and sexual issues caused by social and life experiences, especially regarding abuse and the lack of information/education. However, their identities, gender identity and/or sexual identity, must be honored as we do with the general population.

Four typical types of green shrubs of Beijing (Euonymus japonicus, Buxus microphylla, Berberis thunbergii cv. atropurpurea, Taxus cuspidate cv. nana) were selected to study their capacities in adsorbing and arresting PM2.5 using both field observations and air chamber simulations. Concurrently, in order to analyze the pollution characteristics of Beijing in winter and spring, the PM2.5 concentrations of December 2012 to May 2013 were collected. Experimental results showed that: From the gas chamber experiments, the ability to adsorb and arrest PM2.5 was in the order of Berberis thunbergii cv. atropurpureaBuxus microphyllaTaxus cuspidate cv. nanaEuonymus japonicus, mainly due to the differences in leaf characteristics; Outside measurement results showed that the ability to adsorb and arrest PM2.5 was ranked as Buxus microphyllaBerberis thunbergii cv. atropurpureaTaxus cuspidate cv. nanaEuonymus japonicus. Chamber simulation and outdoor observation showed that Buxus microphylla and Berberis thunbergii cv. atropurpurea had strong ability to adsorb and arrest PM2.5; Meanwhile, the slight differences between the chamber simulation and outdoor observation results might be related to plant structure. Compared to tree species, the planting condition of shrub species was loose, and it greened quickly; By analyzing the Beijing PM2.5 concentration values in winter and spring, it was found that the PM2.5 concentration was particularly high in the winter of Beijing, and evergreen shrubs maintained the ability to adsorb and arrest PM2.5.

Evergreen broad-leaved forest (EBF), bamboo forest (BF) and mixed conifer and broadleaved forest (MF) were selected as objects of study on Jinyun Mountain from May to October 2012. The main contents were to analyze the rainfall process and nitrogen input of atmospheric rainfall, throughfall and stemflow. The results showed that: (1) During the research period, the total precipitation was 564. 88 mm, and throughfall of EBF, BF and MF were 74.0%, 85.0% and 71.6% of rainfall, respectively, and stemflow were EBF (1.9%), BF(10.3%) and MF (1.6%), respectively. The relationship between throughfall, stemflow and atmospheric rainfall could be described by a significant linear equation (P0.05), and both throughfall rate and stemflow rate had an obvious logarithmic function relationship with atmospheric rainfall (P0.05). (2) The concentration of NO3(-) and NH4(+) of throughfall and stemflow were higher than those of atmospheric rainfall, of which the three typical forests ranked as MFEBFBF. The total inorganic nitrogen input of throughfall and stemflow were EBF (14.93 kg x hm(-2)), BF (15.31 kg x hm(-2)) and MF (18.93 kg x hm(-2)), respectively. (3) There was a significant linear relationship between inorganic nitrogen input and throughfall, stemflow for three typical forest stands (P0.05).

Fogs and hazes broke out many times in winter and spring of 2012-2013 in Beijing, inducing severe pollution of respirable particulate matters (PM10). As a fine particle component in PM10, PM2.5 would cause more severe air pollution if the proportion of PM2.5 to PM10 is high. Based on this, 30 monitoring stations recording the concentration of PM2.5 and PM1.0 all over Beijing were selected, and the contamination characteristics of particulate matters were analyzed, which further served to determine the characteristics of temporal and spatial pollution variations of PM2.5 and PM10. The distribution of PM2.5 and PM10 mass concentration in winter and spring in Beijing were derived by the Original Kriging interpolation method, and it was depicted from the figure that the concentration of particulate matters gradually increased from the northern mountain area to the southern part of Beijing; in the central urban area, the particulate concentration of the western region was generally higher than that of the eastern region, with certain differences between urban and rural area within some local areas. Monthly variation curve of PM2.5 and PM10 mass concentration showed single peak-valley pattern: the maximum was in January and the minimum was in April; daily variation indicated a good correlation between PM2.5 and PM10, both of which were significantly influenced by meteorological conditions; diurnal variation curve showed a double peak-valley type. Meteorological factors such as daily average temperature (degrees C), relative humidity (%), wind speed (wind scale), precipitation (mm) were chosen and their individual relationships with concentrations of PM10 and PM2.5 were investigated using Spearman rank correlation analyses. It was demonstrated that the concentrations of PM10 and PM2.5 were positively correlated with temperature and relative humidity, respectively, and strongly negatively correlated with wind speed; wind speed and relative humidity were two key factors affecting the distributions of PM2.5 and PM10 concentration.

Expression of murine calcium-activated chloride channel family member 3 (mCLCA3) has been reported to be increased in the airway epithelium of asthmatic mice challenged with ovalbumin (OVA). However, its role in asthmatic airway inflammation under no OVA exposure has not yet been clarified.mCLCA3 plasmids were transfected into the airways of normal BALB/c mice. mCLCA3 expression and airway inflammation in mouse lung tissue were evaluated. Cell differentials and cytokines in bronchoalveolar lavage fluid (BALF) were analyzed. The expression of mCLCA3 protein and mucus protein mucin-5 subtype AC (MUC5AC) were analyzed by Western blotting. The mRNA levels of mCLCA3, MUC5AC and interleukin-13 (IL-13) were determined quantitatively.mCLCA3 expression was not detected in the control group while strong immunoreactivity was detected in the OVA and mCLCA3 plasmid groups, and was strictly localized to the airway epithelium. The numbers of inflammatory cells in lung tissue and BALF were increased in both mCLCA3 plasmid and OVA groups. The protein and mRNA levels of mCLCA3 and MUC5AC in the lung tissue were significantly increased in the mCLCA3 plasmid and OVA groups compared to the control group. The level of IL-13, but not IL-4, IL-5, IFN-γ, CCL2, CCL5 or CCL11, was significantly increased compared with control group in BALF in the mCLCA3 plasmid and OVA groups. The level of IL-13 in the BALF in the mCLCA3 plasmid group was much higher than that in the OVA group (P0.05). The level of mCLCA3 mRNA in lung tissue was positively correlated with the levels of MUC5AC mRNA in lung tissue, IL-13 mRNA in lung tissue, the number of eosinophils in BALF, and the content of IL-13 protein in BALF. The level of IL-13 mRNA in lung tissue was positively correlated with the number of eosinophils in BALF and the level of MUC5AC mRNA in lung tissue.These findings suggest that increased expression of a single-gene, mCLCA3, could simulate an asthma attack, and its mechanism may involve mCLCA3 overexpression up-regulating IL-13 expression.

To study the effects of bone marrow MSCs transplantation on the apoptosis of alveolar wall cells and the expression of Bcl-2 and Bax of lung tissue in papain and Co60-induced pulmonary emphysema rats.Female Lewis rats were randomly divided into three groups: control group, emphysema group, emphysema + MSCs transplantation group. Rats were sacrificed at days 14 and 28 after treatment. Morphologic analysis of the lung tissue was performed. The apoptosis of the lung cells was assessed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. The expression of Bcl-2 and Bax were determined by immunohistochemical staining.Emphysematous changes of the lung tissue were observed in emphysema group and emphysema + MSCs transplantation group. However, the emphysematous change in emphysema + MSCs transplantation group was improved compared with the emphysema group. There was significant difference in the number of alveolar counted per unit area (MAN), mean alveoli area (MAA) and mean linear interval(MLI) between emphysema group and emphysema + MSCs transplantation group. The apoptotic index of the alveolar wall cells in emphysema + MSCs transplantation group was less than that in the emphysema group. The percentage of Bcl-2 positive cells in emphysema + MSCs transplantation group was significantly higher than that in the emphysema group. The percentage of Bax positive cells in emphysema + MSCs transplantation group was significantly lower than that in the emphysema group. The ratio of Bcl-2/Bax of emphysema + MSCs transplantation group was significantly higher than that in the emphysema group.Bone marrow MSCs transplantation inhibits the apoptosis of alveolar wall cells, upregulates the expression of Bcl-2 and downregulates the expression of Bax. This may be part of the reason that bone marrow MSCs transplantation improves the papain and Co60-induced pulmonary emphysema.

In Japan, Saireito and Onpi-to are widely used Japanese herbal medicine in the treatment of chronic kidney disease (CKD), which is a world-wide public health issue. In this review, it has been discussed the beneficial effects of Japanese herbal medicine, including Sairei-to and Onpi-to on multifarious renal damage in progression of CKD, such as mesangial lesion, inflammatory cell infiltration, cytokine expression, reactive oxygen species release, and aldosterone disorder, and then to clarify the mechanism of these herbs at molecular level by examining the effects on various injurious factors. Both Saireito and Onpi-to are effective agents for delaying the progression of CKD.

Primary liposarcoma of the pleura is extremely rare. The first case report in China was described.The clinical data of a case of primary liposarcoma of the pleura diagnosed in this hospital were reported, and the pertinent literature was reviewed.A total of 17 cases of primary liposarcomas of the pleura, including the case reported herein, had been described in international literature. Primary pleural liposarcomas occur predominantly in males and older patients, and the myxoid histological subtype is common. The most common symptoms are chest pain and shortness of breath. Radiographic and surgical evaluation are important for its diagnosis. Surgical resection with adjuvant radiation therapy is recommended for the disease.More data are required for the treatment and prognostic evaluation of the primary liposarcoma of the pleura.

To screen primary aldosteronism cases with ARR (aldosterone/plasma renin activity, ARR) from patients with hypertension, and to evaluate the diagnosis value of ARR in primary aldosteronism cases and analysis the clinical characters of primary aldosteronism cases.Nine hundred and two patients with hypertension were collected, the plasma aldosterone concentration to plasma renin activity ratio were detected by radio-immunity method, after that, ARR were calculated. Retrospective analysis was made of clinical data in 126 primary aldosteronism cases, which ARR were over 25.One hundred and twenty-six cases (14%) were diagnosed as primary aldosteronism, and of them, 49 cases had hypokalemia. 25 patients received surgical operation and the rate of efficiency and cure of surgery treatment were 100% and 48%, respectively. The rate of efficiency and cure of drug treatment was 89% and 24% respectively.Primary aldosteronism affects over 10% of patients with hypertension in China. Patients with hypertension and most patients with treatment-resistant hypertension should undergo screening for primary aldosteronism with ARR. A high ARR is a positive screening test result, a finding that warrants confirmatory testing.

To study the effects of glucocorticoid on airway mucus secretion in asthma.Twenty-four BALB/c mice were randomly divided into 3 equal groups: asthma group [ovalbumin (OVA) and aluminum hydroxide were injected intraperitoneally on day 0 and day 14 so as to establish mouse asthma model and aerosol inhalation of OVA PBS was conducted for 30 min on the days 21, 22, and 24], asthma + dexamethasone group (OVA and aluminum hydroxide were injected intraperitoneally on days 0 and 14, aerosol inhalation of OVA PBS was conducted for 30 min on the days 21, 22, and 24, and dexamethasone was injected intraperitoneally 1 hour before the aerosol inhalation), and control group (aerosol inhalation of PBS was conducted instead). Twenty-fours hours after the last exposure the mice were anesthetized deeply and their left lungs were excised to collect the bronchoalveolar lavage fluid (BALF) to calculate the numbers of total cells and eosinophils, then Alcian blue/periodic acid-Schiff staining and immunohistochemistry of the air passage were conducted to measure the expression levels of MUC5AC mRNA and protein and interleukin-4 (IL-4) mRNA.The numbers of total cells in the BALF of the asthma group were (12.50 +/- 0.14) x 10(9)/L and (1.12 +/- 0.10) x 10(9)/L respectively, both significantly higher than those of the control group, (6.49 +/- 0.05) x 10(9)/L and (0.05 +/- 0.02) x 10(9)/L respectively (both P0.01), and were significantly higher than those of the asthma + dexamethasone group, (6.68 +/- 0.03) x 10(9)/L and (0.06 +/- 0.01) x 10(9)/L respectively too (both P0.01). The levels of MUC5AC mRNA, MUC5AC protein, and IL-4 mRNA of the asthma group were 0.5341 +/- 0.303, 0.1906 +/- 0.0008, and 0.6265 +/- 0.0932 respectively, all significantly higher than those of the control group (0.1994 +/- 0.0128, 0.1194 +/- 0.0007, and 0.2389 +/- 0.0289 respectively, all P0.01), and those of the asthma + dexamethasone group (0.2729 +/- 0.0345, 0.1456 +/- 0.0003, and 0.2424 +/- 0.0260, all P0.05). The MUC5AC protein expression and mRNA expression, and IL-4 mRNA expression of the asthma group were 0.1906 +/- 0.0008, 0.5341 +/- 0.0303, and 0.6265 +/- 0.0932 respectively, all significantly higher than those of the control group (0.1194 +/- 0.0007, 0.1994 +/- 0.0128, and 0.2398 +/- 0.0289 respectively, all P0.01). The MUC5AC protein expression and mRNA expression, and IL-4 mRNA expression of the asthma + dexamethasone group were 0.1456 +/- 0.0003, 0.2729 +/- 0.0345, and 0.2424 +/- 0.0260 respectively, all significantly lower than those of the asthma group (all P0.01). The MUC5AC protein expression and mRNA expression of the asthma + dexamethasone group were still significantly higher than those of the control group (both P0.01), however, the IL-4 mRNA expression of the asthma + dexamethasone group was not significantly different from that of the control group (P0.05).Relieving the inflammation, glucocorticoid may play a role in the treatment of excessive mucus production through down-regulating the expression of MUC5AC and of IL-4.

To study effects of a combined regime of auricular-plaster and body acupuncture in treatment of cervical spondylosis of vertebral artery type and make a preliminary revelation of the mechanism.Ninety-two patients were randomly divided into 2 groups, the treatment group (n = 56) received the combined regime of auricular-plaster and body acupuncture, and the control group (n = 36) received treatment with body acupuncture. Clinical symptoms and signs, therapeutic effect and some indexes about vertebrobasilar hema-kinetics and hema-rheology were investigated before and after treatment.The treatment group was better than the control group in the clinical overall effective rate (89.29%) and the clinically control rate (17. 85%), and in improving the following indexes, including dizziness and headache, the vertebrobasilar volume and rate of blood flow etab and IR (P0.05).A combined regime of auricular-plaster and body acupuncture ameliorates not only main signs but also some indexes about vertebrobasilar hema-kinetics and hema-rheology. This treatment is an effective therapy for cervical spondylosis of vertebral artery type both in Malaysia and in China.

To study the influence of interleukin-13 (IL-13) on the gob-5, a member of Ca(2+)-activated Cl(-) channel and mucin gene MUC5AC expression in lungs of a murine asthmatic model, and to investigate their effects on the pathogenesis of asthma.Forty-five male BALB/c mice were randomly divided into a control group, an asthmatic group and an IL-13 group. Expression of gob-5 mRNA, MUC5AC mRNA and MUC5AC protein in the lungs were detected by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical assay respectively.No gob-5 mRNA expression in the lung was detected in the control group, while it was positive in the asthmatic group. The gob-5 mRNA in the lung of the IL-13 group and the asthmatic group was 1.246 +/- 0.008 and 1.136 +/- 0.007 respectively (P0.01). In the asthmatic group, both MUC5AC mRNA (0.161 +/- 0.011) and protein expression (7 mice positive) increased compared with the control group (0.070 +/- 0.004 and 2 mice positive, respectively) (P0.01 and 0.05, respectively). IL-13 increased the expression of MUC5AC mRNA (0.250 +/- 0.014) and protein (13 mice positive) in the lung of the asthmatic group, and there was a significant difference between the IL-13 group and either the control group (0.070 +/- 0.004 and 2 mice positive, respectively) or the asthmatic group (0.161 +/- 0.011 and 7 mice positive, respectively, all P0.05). There was a significant association between gob-5 mRNA expression and MUC5AC mRNA expression in both the IL-13 group and the asthmatic group (r = 0.986 and 0.961, respectively, both P0.05).IL-13 is a critical cytokine in the pathogenesis of asthma, and gob-5 may be one of the important genes in inducing airway mucus overproduction of asthma.

To study the inhibitory effects of ciglitazone, a synthetic ligand of peroxisome proliferator-activated receptors (PPAR), on human lung cancer growth in vitro and in vivo and its mechanisms.Human lung cancer A549 cells cultured in vitro were treated with different concentrations of ciglitazone. The proliferative activity and cell cycle of A549 cells were determined by MTT assay and flow cytometry. Expression of PPARgamma protein was detected by Western blot. A549 cells (1 x 10(6) cells/nude mouse) were inoculated subcutaneously into nude mice, which were randomly divided into two groups, 10 in each: control group (group A) and ciglitazone treated group (group B). When the tumors grew to a size with diameter around 1 cm, ciglitazone 100 microl (100 micromol/L) was intratumorally injected every other day in group B mice. A total of 15 injections were given. Mice in group A were similarly treated with normal saline. One month later, tumors were excised and weighed. Expression of cyclin D1 and p21 protein were detected by immunohistochemistry and Western blot.Growth of A549 cells was significantly inhibited in group B in a dose-dependent and time-dependent fashion as compared with that in group A. Most of the ciglitazone-treated cells arrested in G(1)/G(0) phase and the expression of PPARgamma protein was markedly up-regulated. The tumor weights in group A was (2.79 +/- 0.33) g and that in group B was (1.51 +/- 0.40) g, with an inhibition rate of 47.0%. The expression level of cyclin D1 in group A was significantly higher than that in group B, while the expression level of p21 protein in group A was significantly lower than that in group B.Ciglitazone can effectively inhibit the growth of human lung cancer A549 and induce its differentiation by cell cycle arrest via PPARgamma activation.

To investigate the role of nuclear factor kappa B (NF-kappaB) decoy oligodeoxynucleotides (ODNs) in the process of differential regulation of the lung cancer cells A549 by ciglitazone.NF-kappaB decoy ODNs were transfected into A549 cells with Lipofect AMINE 2000, and electrophoretic mobility shift assay (EMSA) was performed to investigate the activation of NF-kappaB, while the level of mdr1 was observed by Western blot. When ciglitazone was added, the proliferation was observed by growth curve and the differentiation of cells was observed by flow cytometry, and the expression of cyclinD1 was observed by Western blot.EMSA showed that the decoy ONDS-decreased the activation of NF-kappaB in A549, and Western blot showed that the decoy ONDS decreased the level of mdr1. Ciglitazone significantly inhibited the growth and induced the differentiation of A549 cells that were transfected with NF-kappaB decoy ODNs. There were more cells arrested in G(1)/G(0) phase and the expression of cyclinD1 was markedly down-regulated as compared to the control cells.NF-kappaB decoy ODNs could enhance the effects of ciglitazone on proliferative suppression and differential induction of A549 cells.

To study the expressions of peroxisome proliferator activated receptor alpha (PPAR-alpha) and hypoxia-inducible factor-1alpha (HIF-1alpha) during different hypoxia states in lung cancer cell A549, and to investigate the mechanism of HIF-1alpha induced PPARalpha expression.Firstly, lung cancer cells (A549) were divided into four groups: group A (control group); group B (hypoxia 24 h); group C (hypoxia 48 h); group D (hypoxia 72 h). The mRNA and protein of PPAR-alpha and HIF-1alpha were detected by RT-PCR and Western-blot on different groups. Secondly, the lung cancer cells (A549) were further divided into four groups: group E (control group); group F (antisense group); group G (sense group); group H (false-sense group). The influence of antisense oligonucleotide HIF-1alpha on PPAR-alpha was detected by RT-PCR and Western-blot.Comparing with group A, the expressions of the mRNA and protein of PPAR-alpha and HIF-1alpha increased significantly in group B, and reached peak in group D. Conversely, the expressions of the mRNA and protein of PPAR-alpha were decreased after antisense oligonuclei of HIF-1alpha in group F, as compared with group E.The expressions of the mRNA and protein of PPAR-alpha and HIF-1alpha are increased by hypoxia, and PPAR-alpha may be regulated by HIF-1alpha.

This exploratory study examines the ethical justification that cancer care and dementia care nurses gave for active voluntary euthanasia. A convenient sample of 319 nurses working in seven countries was interviewed using a structured interview guide. The great majority of the nurses could not ethically justify active voluntary euthanasia. Even if the law changed, only 96 of the total sample viewed active voluntary euthanasia as ethical. For those nurses who could ethically justify active voluntary euthanasia, the majority did so because of the patients' suffering.

Superficial burns of the hand leave hardly any deformity after healing, but deep burns, especially those that have not been properly treated or just left to heal without skin grafting, will result in deformities with marked functional disturbances owing to scar contraction. Therefore, proper postburn reconstruction for these deformed hands is urgent and paramount. Since 1955, a total of 416 cases with postburn hand deformity has been admitted into our hospital for reconstruction; 317 patients were male and 99 female; 336 patients were adults and 80 children. Of the total patients, 40% (167 cases) were between 20 and 30 years old. In this chapter, we discuss the principles of treatment and methods adopted in our hospital.