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Since the first plasma realized in 2020, a series of key systems on HL-3 (known as HL-2M before) tokamak have been equipped/upgraded, including in-vessel components (the first wall, lower divertor, and toroidal cryogenic/water-cooling/baking/glow discharge systems, etc.), auxiliary heating system of 11 MW, and 28 diagnostic systems (to measure the plasma density electron temperature, radiation, magnetic field, etc.). Magnet field systems were commissioned firstly for divertor plasma discharges. During the 2nd experimental campaign of HL-3 tokamak, several great progresses have been achieved. Firstly, the successful operation with plasma current larger than 1 MA was achieved under a divertor configuration. Secondly, the advanced divertor concept with two distinct snowflake configurations was realized. It is found that the distribution of ion saturation current and heat flux on bottom plate becomes wide due to magnetic surface expansion, demonstrating the advantage of such configuration in the heat flux mitigation. In addition, using the combination of NBI, ECRH and LHCD, the standard sawtoothing high confinement mode of megampere plasma was firstly accessed on the HL-3. The successful commissioning of HL-3 is beneficial for the initial operation of ITER.

The mission of HL-2A is to explore the key physical topics relevant to ITER and to the advanced tokamak operation (e.g. the operation of future HL-2M), such as the access of H-mode, energetic particle physics, edge-localized mode (ELM) mitigation/suppression and disruption mitigation. Since the 2016 Fusion Energy Conference, the HL-2A team has focused on the investigations on the following areas: (i) pedestal dynamics and L-H transition, (ii) techniques of ELM control, (iii) turbulence and transport, (iv) energetic particle physics. The HL-2A results demonstrated that the increase of mean shear flow plays a key role in triggering L-I and I-H transitions, while the change of flow is mainly induced by the ion pressure gradient. Both mitigation and suppression of ELMs were realized by laser blow-off seeded impurity (Al, Fe, W). The 30% Ne mixture supersonic molecular beam injection seeding also robustly induced ELM mitigation. The ELMs were mitigated by low-hybrid current drive. The stabilization of m/n = 1/1 ion fishbone activities by electron cyclotron resonance heating was found on the HL-2A. A new m/n = 2/1 ion fishbone activity was observed recently, and the modelling indicated that passing fast ions dominantly contribute to the driving of 2/1 fishbone. The non-linear coupling between the toroidal Alfven eigenmode and tearing mode (TM) led to the generation of a high frequency mode with the toroidal mode number n = 0. The turbulence was modulated by TM when the island width exceeds a threshold and the modulation is localized merely in the inner area of the islands. Meanwhile, turbulence radial spread took place across the island region.

The synchronization of geodesic acoustic modes (GAMs) and magnetic fluctuations is identified in the edge plasmas of the HL-2A tokamak. Mesoscale electric fluctuations (MSEFs) having components of a dominant GAM, and m/n=6/2 potential fluctuations are found at the same frequency as that of the magnetic fluctuations of m/n=6/2 (m and n are poloidal and toroidal mode numbers, respectively). The temporal evolutions of the MSEFs and the magnetic fluctuations clearly show the frequency entrainment and the phase lock between the GAM and the m/n=6/2 magnetic fluctuations. The results indicate that GAMs and magnetic fluctuations can transfer energy through nonlinear synchronization. Such nonlinear synchronization may also contribute to low-frequency zonal flow formation, reduction of turbulence level, and thus confinement regime transitions.

This Letter presents the first observation on the interplay between nonlocal transport and neoclassical tearing modes (NTMs) during transient nonlocal heat transport events in the HL-2A tokamak. The nonlocality is triggered by edge cooling and large-scale, inward propagating avalanches. These lead to a locally enhanced pressure gradient at the q = 3/2 (or 2/1) rational surface and hence the onset of the NTM in relatively low β plasmas (βN

Transitions between low (L-mode) and intermediate (I-phase) confinement regimes triggered by sawteeth are investigated using multiple Langmuir probe arrays in the edge plasmas of the HL-2A tokamak. The I-phase is characterized by limit-cycle oscillations (LCOs). Repeated L-I-L transitions induced by sawtooth heat pulses are also observed. Statistical analyses show that the delay time of the L-I transition relative to sawtooth crashes is less than ∼1 ms. The intensity of turbulence bursts in the I-phase is stronger than those observed in L-mode plasmas. Measurements are consistent with zonal flow reducing turbulence intensity in the frequency band ∼20-100 kHz, while the LCO turbulence of frequency higher than 100 kHz has more power than that in the L-mode. The analyses of time-resolved power transfers between turbulence and zonal flows suggest that power transfers exist between turbulence and zonal flows. The direction of the power transfers is from turbulence into geodesic acoustic modes in ohmic plasmas. © 2013 IAEA, Vienna.

For the first time supersonic molecular beam injection (SMBI) and cluster jet injection (CJI) were applied to mitigate edge-localized modes (ELMs) in HL-2A successfully. The ELM frequency increased by a factor of 2-3 and the heat flux on the divertor target plates decreased by 50% on average after SMBI or CJI. Energetic particle induced modes were observed in different frequency ranges with high-power electron cyclotron resonance heating (ECRH). The high frequency (200-350 kHz) of the modes with a relatively small amplitude was close to the gap frequency of the toroidicity-induced Alfvén eigenmode. The coexistent multi-mode magnetic structures in the high-temperature and low-collision plasma could affect the plasma transport dramatically. Long-lived saturated ideal magnetohydrodynamic instabilities during strong neutral beam injection heating could be suppressed by high-power ECRH. The absolute rate of nonlinear energy transfer between turbulence and zonal flows was measured and the secondary mode competition between low-frequency (LF) zonal flows (ZFs) and geodesic acoustic modes (GAMs) was identified, which demonstrated that ZFs played an important role in the L-H transition. The spontaneously generated E × B shear flow was identified to be responsible for the generation of a large-scale coherent structure (LSCS), which provided unambiguous experimental evidence for the LSCS generation mechanism. New meso-scale electric potential fluctuations (MSEFs) at frequency f ∼ 10.5 kHz with two components of n = 0 and m/n = 6/2 were also identified in the edge plasmas for the first time. The MSEFs coexisted and interacted with magnetic islands of m/n = 6/2, turbulence and LF ZFs. © 2013 IAEA, Vienna.

The radial structures of multiple sheared flow populations and fluctuations are simultaneously measured using combinations of Langmuir probe arrays in the edge plasmas of the HL-2A tokamak with ohmic and electron cyclotron resonance heating (ECRH). The maximum of geodesic acoustic mode (GAM) amplitude locates at ∼2-3 cm inside the last close flux surface (LCFS). The low-frequency zonal flow (LFZF) and GAM tend to coexist in the inner region. The dependences of the amplitudes of the multiple sheared flows and turbulence on ECRH heating power are also investigated. The measured turbulent Reynolds stresses are shown to be strongly correlated with the sheared flows, as predicted by theory. The turbulence is modulated at the each frequency of the multiple sheared flows simultaneously, and the particle fluxes induced by the turbulence are significantly reduced near the LCFS and in the GAM peaking region. The analyses also show that the spatial structures of the turbulent envelopes at the LFZF and GAM frequencies are similar to those observed in LFZF and GAM. © 2013 IAEA, Vienna.

Abstract Density profiles in the pedestal region (H-mode) are measured in HL-2A and the characteristics of the density pedestal are described. Cold particle deposition by supersonic molecular beam injection (SMBI) within the pedestal is verified. Edge-localized mode (ELM) mitigation by SMBI into the H-mode pedestal is demonstrated and the relevant physics is elucidated. The sensitivity of the effect to SMBI pressure and duration is studied. Following SMBI, the ELM frequency increases and the ELM amplitude decreases for a finite duration. Increases in ELM frequency of are achieved. This experiment argues that the ELM mitigation results from an increase in higher frequency fluctuations and transport events in the pedestal, which are caused by SMBI. These inhibit the occurrence of large transport events which span the entire pedestal width. The observed change in the density pedestal profiles and edge particle flux spectrum with and without SMBI supports this interpretation. An analysis of the experiment and a model shows that ELMs can be mitigated by SMBI with shallow particle penetration into the pedestal.

Objective: To analyze the short-term clinical efficacy and safety of arsenic trioxide (ATO) combined with a modified N7 induction regimen in the treatment of children with high-risk neuroblastoma (NB). Methods: This study was a prospective, single-arm, multicenter phase Ⅱ clinical study. Sixty-seven high-risk NB children from eight units of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Wuhan Children's Hospital of Tongji Medical College of Huazhong University of Science and Technology, First Affiliated Hospital of Guangxi Medical University, Hainan General Hospital, Affiliated Hospital of Guangdong Medical University, Kunming Children's Hospital, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, and Guangdong Provincial Agricultural Reclamation Center Hospital were enrolled from January 2019 to August 2023 and were treated with ATO combined with a modified N7 induction regimen. The efficacy and adverse effects at the end of induction chemotherapy were assessed and analyzed, and the differences in the clinical characteristics were further compared between the treatment-responsive and treatment-unresponsive groups by using the Fisher's exact test. Results: Among 67 high-risk NB children, there were 40 males (60%) and 27 females (40%), with the age of disease onset of 3.5 (2.6, 4.8) years. Primary NB sites were mostly in retroperitoneum (including adrenal gland) (56/67, 84%) and the common metastases sites at initial diagnosis were distant lymph node in 25 cases (37%),bone in 48 cases (72%),bone marrow in 56 cases (84%) and intracalvarium in 3 cases (4%). MYCN gene amplification were detected in 28 cases (42%). At the end of induction, 33 cases (49%) achieved complete remission, 29 cases (43%) achieved partial remission, 1 case (1%) with stable disease, and 4 cases (6%) were assessed as progressive disease (PD). The objective remission rate was 93% (62/67) and the disease control rate was 94% (63/67). The percentage of central system metastases at the initial diagnosis was higher in the treatment-unresponsive group than in the treatment-responsive group (2/5 vs. 2% (1/62), P =0.013), whereas the difference in MYCN gene amplification was not statistically significant between two groups (3/5 vs. 40% (25/62), P =0.786). Grade Ⅲ or higher adverse reactions during the induction chemotherapy period were myelosuppression occurred in 60 cases (90%), gastrointestinal symptoms occurred in 33 cases (49%), infections occurred in 20 cases (30%), hepatotoxicity occurred in 4 cases (6%), and cardiovascular toxicity occurred in 1 case (2%). There were no chemotherapy-related deaths. Conclusion: ATO combined with N7-modified induction regimen had a superiority in efficacy and safety, which deserved further promotion in clinical practice.

Background: Mesenchymal stem cells (MSCs) have great potential for the treatment of various immune diseases due to their unique immunomodulatory properties. However, MSCs exposed to the harsh inflammatory environment of damaged tissue after intravenous transplantation cannot exert their biological effects, and therefore, their therapeutic efficacy is reduced. In this challenging context, an in vitro preconditioning method is necessary for the development of MSC-based therapies with increased immunomodulatory capacity and transplantation efficacy., Aim: To determine whether hypoxia and inflammatory factor preconditioning increases the immunosuppressive properties of MSCs without affecting their biological characteristics., Methods: Umbilical cord MSCs (UC-MSCs) were pretreated with hypoxia (2% O 2 ) exposure and inflammatory factors (interleukin-1β, tumor necrosis factor-α, interferon-γ) for 24 h. Flow cytometry, polymerase chain reaction, enzyme-linked immunosorbent assay and other experimental methods were used to evaluate the biological characteristics of pretreated UC-MSCs and to determine whether pretreatment affected the immunosuppressive ability of UC-MSCs in coculture with immune cells., Results: Pretreatment with hypoxia and inflammatory factors caused UC-MSCs to be elongated but did not affect their viability, proliferation or size. In addition, pretreatment significantly decreased the expression of coagulation-related tissue factors but did not affect the expression of other surface markers. Similarly, mitochondrial function and integrity were retained. Although pretreatment promoted UC-MSC apoptosis and senescence, it increased the expression of genes and proteins related to immune regulation. Pretreatment increased peripheral blood mononuclear cell and natural killer (NK) cell proliferation rates and inhibited NK cell-induced toxicity to varying degrees., Conclusion: In summary, hypoxia and inflammatory factor preconditioning led to higher immunosuppressive effects of MSCs without damaging their biological characteristics., Competing Interests: Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

The commercial cultivation of herbicide-resistant (HR) transgenic soybeans ( Glycine max L. Merr.) raises great concern that transgenes may introgress into wild soybeans ( Glycine soja Sieb. et Zucc.) via pollen-mediated gene flow, which could increase the ecological risks of transgenic weed populations and threaten the genetic diversity of wild soybean. To assess the fitness of hybrids derived from transgenic HR soybean and wild soybean, the F 2 and F 3 descendants of crosses of the HR soybean line T14R1251-70 and two wild soybeans (LNTL and JLBC, which were collected from LiaoNing TieLing and JiLin BaiCheng, respectively), were planted along with their parents in wasteland or farmland soil, with or without weed competition. The fitness of F 2 and F 3 was significantly increased compared to the wild soybeans under all test conditions, and they also showed a greater competitive ability against weeds. Seeds produced by F 2 and F 3 were superficially similar to wild soybeans in having a hard seed coat; however, closer morphological examination revealed that the hard-seededness was lower due to the seed coat structure, specifically the presence of thicker hourglass cells in seed coat layers and lower Ca content in palisade epidermis. Hybrid descendants containing the cp4-epsps HR allele were able to complete their life cycle and produce a large number of seeds in the test conditions, which suggests that they would be able to survive in the soil beyond a single growing season, germinate, and grow under suitable conditions. Our findings indicate that the hybrid descendants of HR soybean and wild soybean may pose potential ecological risks in regions of soybean cultivation where wild soybean occurs.

Objective: To investigate the effect of enhanced autophagy in megakaryocyte to proplatelet formation in children with immune thrombocytopenia(ITP)., Methods: Giemsa staining and immunofluorescence staining were used to observe megakaryocyte morphology and proplatelet formation, Western blot was used to determine the expression of cytoskeleton protein and autophagy related protein. Autophagr regulation drugs Rap or 3-MA was used to regulate autophagy of megakaryocytes., Results: Some vacuole-like structures was found in ITP megakaryocytes of the children, the expression of LC3II/I (ITP 1.32±0.18； Ctrl 0.49±0.16，P<0.05) and Atg5-Atg12 (ITP 0.69±0.17； Ctrl 0.12±0.08，P<0.05) was significantly higher in ITP children as compared with those in control group. The immu- nofluorescence staining showed that the cytoskeleton arrangement in megakaryocytes of ITP children was abnormal, and the phosphorylation of myosin light chain was also increased(ITP 0.74±0.09, Ctrl 0.05±0.02，P<0.05). In vitro, inducer or inhibitor of autophagy could regulate the production of proplatelet and the expression of cell cycle related protein, including CyclinD1（Veh 1.08±0.12; Rap 0.46±0.04; Rap+3-MA 0.70±0.03）, CyclinD2（Veh 0.47±0.04; Rap 0.27±0.04; Rap+3-MA 0.41±0.03）, P21（Veh 0.15±0.01; Rap 0.04±0.01; Rap+3-MA 0.05±0.01）., Conclusion: Enhanced autophagy is the key factor of poor proplatelet formation in megakaryocytes of ITP children.

A solid state terahertz interferometer has been developed on the recent commissioned HL-2M tokamak. It can work in a wide frequency region of 220-325 GHz, and the terahertz wave is generated from a low frequency phase locked voltage controlled oscillator with the frequency multiplying technique. A phase processor based on field programmable gate array (FPGA) technology is designed for the heterodyne interferometer, and it contributes to real-time display of electron density. To extract phase information, a novel numerical algorithm related to fast Fourier transform is written on the FPGA chip and enables one to obtain phase shift without being affected by amplitude variation induced by plasma absorption or frequency modulation from the outer electromagnetic environment. The interferometer achieves minimum measurable electron density in the order of 10 16  m -3 . With the plasma diagnosis, electron density and low frequency tearing mode have been measured during the first experimental campaign.

While assembling superparamagnetic units in a controlled manner is crucial for future applications of molecular nanomagnets, optimizing their magnetic properties while achieving directional assembly of these units still remains a formidable challenge. Herein, we demonstrate how the assembly of two dysprosium chain complexes, namely, [Dy 2 (L) 2 Cl 2 (CH 3 OH) 3 ] n ·nCH 3 OH (1) and [Dy(L)Cl(DMF)] n (2) (H 2 L = N'-(5-bromo-2-hydroxybenzylidene)pyrazine-N-oxide-carbohydrazide), can be successfully manipulated using an appropriate bridging ligand design. Both complexes contain similar dimeric units bridged by two alkoxido oxygens from an L 2- ligand, but extended by its pyrazine-N-oxide group exhibiting two distinct coordination modes, namely, single and double pyrazine-N-oxide bridges, respectively. Magnetic studies reveal that both complexes display typical slow magnetic relaxation under zero direct-current field; however, the anisotropy barrier and the coercive field at 2 K for complex 2 are twice as much as that of 1. A further theoretical study indicates that switching the coordination mode from a single pyrazine-N-oxide bridge to double bridges can enhance both the magnetic anisotropy of dysprosium ions and magnetic coupling within the dimeric cores. The synergistic effect between the magnetic anisotropy of dysprosium ions and magnetic interactions among them directly contributes to the overall better performance of complex 2.

Background: The role of thoracic consolidation radiotherapy in patients with extensive stage small cell lung cancer (ES-SCLC) remains controversial. This study aimed to evaluate the efficacy of thoracic radiotherapy (TRT) in these patients., Methods: A systematic literature search was performed in PubMed, Embase, and the Cochrane library to identify qualified clinical studies. The hazard ratios (HRs) and 95% confidence intervals (CIs) of overall survival (OS), progression-free survival (PFS) and local recurrence-free survival (LRFS) were extracted, and toxicity of the TRT group versus non-TRT group was analyzed., Results: A total of 12 studies were included in this meta-analysis, including 936 patients in the TRT group and 1,059 patients in the non-TRT group. The combined results showed that TRT significantly improved OS (HR =0.65; 95% CI: 0.55-0.77, P<0.00001), PFS (HR =0.64; 95% CI: 0.56-0.72, P<0.00001) and LRFS (HR =0.38, 95% CI: 0.26-0.53, P<0.00001). Subgroup analysis showed that OS benefits were observed in patients receiving sequential TRT (HR =0.67; 95% CI: 0.54-0.84, P=0.0006). The addition of TRT significantly improved OS in patients over 65 years of age (HR =0.55; 95% CI: 0.40-0.74, P=0.0001). For patients with only one organ metastasis, there was no significant difference in OS between the two groups (HR =0.61; 95% CI: 0.36-1.01, P=0.06). There was no statistical difference in hematologic toxicity (leukopenia, thrombocytopenia, anemia) and non-hematologic toxicity (nausea or vomiting) between the two groups. The incidence of grade ≥3 esophageal toxicity was 4.6% in the TRT group and 0% in the non-TRT group (P=0.0001). Grade ≥3 bronchopulmonary toxicity was 2.9% in the TRT group and 0.8% in the non-TRT group (P=0.02)., Conclusions: TRT improves OS, PFS and LRFS in patients with ES-SCLC, with a low increase in esophageal and bronchopulmonary toxicity. More randomized controlled trials (RCTs) are expected to confirm our conclusions., Prospero Registration Number: CRD42020190575., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-5765). The authors have no conflicts of interest to declare., (2021 Annals of Translational Medicine. All rights reserved.)

This study explored the association between oral microbes and head and neck cancer (HNC) as well as symptoms related to patients with HNC before surgical treatment. Fifty-six patients with HNC and 64 matched healthy controls were recruited from West China hospital in Southwest China. The demographic, clinical, and symptom data were collected. Salivary samples were collected to determine the microbial characteristics using 16S rRNA gene sequencing. Patients with HNC presented increased Capnocytophaga abundances. The oral microbial markers as Capnocytophaga (area under the curve=0.81) achieved a high classification power between the HNC patients and healthy controls. Moreover, using Capnocytophaga in conjunction with symptom of voice/speech difficulty achieved an overall predicting accuracy of 92.5% comparing with using Capnocytophaga alone (79.2% accuracy) in distinguishing the HNC patients from healthy controls. Salivary microbial profiles and HNC symptoms may be potential biomarkers for HNC screening., (Copyright © 2020 Zuo, Fu, Zhao, Du, Hu, Zhao, Ji, Feng, Zhumajiang, Zhou, Tian, Pei, Yu and Hu.)

Objective: To understand and explore the risk factors of the death of lymphoma patients from cardiovascular disease. Methods: The medical records and death information of 1 173 patients with lymphoma were collected, cases that died from cardiovascular disease were screened. A binary logistic regression model was used to analyze the independent risk factors of patients with lymphoma died from cardiovascular disease. Results: Among 1 173 patients with lymphoma, 75 (6.4%) died of cardiovascular disease, including 27 cases of coronary heart disease, 25 cases of stroke, 7 cases of hypertension, 5 cases of sudden cardiac death, 4 cases of pulmonary embolism, 3 cases of heart failure, 4 cases of others. Among the patients who survived for more than 5 years, 16.1% (35/217) died of cardiovascular disease. Among those who survived for more than 10 years, 11.7% (7/60) died of cardiovascular disease. Multivariate Logistic regression analysis showed that the primary site of lymphoma ( OR =0.521, P =0.039), stage (stage Ⅱ: OR =2.487, P =0.016; stage Ⅲ: OR =3.233, P =0.002) and cardiovascular toxicity in the course of diagnosis and treatment ( OR =3.019, P =0.001) are independent influencing factors for the death of cardiovascular disease in patients with lymphoma. Patients whose primary sites of lymphoma were lymph nodes had lower risk of dying from cardiovascular disease, while the patients with stage Ⅱ to Ⅲ stage and cardiovascular toxicity during diagnosis and treatment had higher risk of dying from cardiovascular disease. Conclusions: Cardiovascular disease is an important factor affecting the survival of patients with lymphoma. With the extension of survival time, the risk of dying from cardiovascular disease increases significantly. The primary site, tumor stage, and cardiovascular toxicity that occur during the diagnosis and treatment may be the independent influencing factors for patients with lymphoma that die from cardiovascular disease.

Background: Intraoperative hypotension is associated with increased morbidity and mortality after surgery. We hypothesized that intraoperative hypotension might also be associated with worse long-term survival after cancer surgery. Herein, we analyzed the correlation between intraoperative hyper-/hypotension and overall survival after lung cancer surgery., Methods: In this retrospective cohort study, 676 patients who received lung cancer surgery between January 1, 2006 and December 31, 2009 were reviewed. Intraoperative hyper- and hypotension were defined according to their correlation with long-term survival. The primary endpoint was overall survival. The association between episodes of intraoperative hyper-/hypotension and overall survival was analyzed with multivariable Cox proportional hazard models., Results: Long-term follow-ups were completed in 515 patients with a median duration of 5.2 years. The estimated 5-year survival rates were 66.5, 61.3, 56.5, and 41.2% in patients with only hypertension (systolic blood pressure > 140 mmHg for ≥5 min), with both hyper- and hypotension (systolic blood pressure < 100 mmHg for ≥5 min), with neither hyper- nor hypotension, and with only hypotension during surgery, respectively. After adjusting confounding factors, intraoperative hypotension was significantly associated with shortened overall survival (compared with patients with only intraoperative hypertension, those with both hyper- and hypotension: hazard ratio [HR]1.033, 95% confidence interval [CI] 0.709 to 1.507, p = 0.864; those with neither hyper- nor hypotension: HR 0.952, 95% CI 0.608 to 1.489, p = 0.829; those with only hypotension: HR 1.736, 95% CI 1.218 to 2.475, p = 0.002)., Conclusions: For patients undergoing lung cancer surgery, intraoperative hypotension, but not hypertension, was associated with shortened overall survival.

Objective: To analyze the characteristics of the second primary tumor affecting the survival of patients with lymphoma, and to explore the risk factors of death from the second primary tumor. Methods: The medical records and related death information of 1 173 lymphoma patients who had already died with known causes were collected. The basic causes of death and the characteristics of patients who died of the second primary tumor were analyzed. Cox regression model was used to analyze the risk factors of lymphoma patients who died of the second primary tumor. Results: Among the 1 173 patients who had died, 94 (8.0%) died of the second primary tumor, 935 (79.7%) died of the primary lymphoma and 144 (12.3%) died of other diseases. The second primary tumor accounted for 17.5% (38/217) of all causes of death in patients with the survival period of more than 5 years, and the second primary tumor accounted for 28.3% (17/60) of all causes of death in patients with the survival period of more than 10 years. Among 94 cases who died of second primary tumors, 31 died of lung cancer, 15 died of gastric cancer, 13 died of liver cancer, 9 died of pancreatic cancer, 6 died of colorectal cancer, 6 died of second primary lymphoma and 14 died of other types of tumors. Univariate Cox regression analysis showed that age, first-line treatment effect, and chest or mediastinal radiotherapy were associated with the death from second primary tumors for lymphoma patients (all P <0.05). Multivariate Cox regression analysis showed that the effect of first-line treatment ( P =0.030) and the chest or mediastinal radiotherapy ( P =0.039) were independent factors for the death of lymphoma patients from the second primary tumor. Conclusions: The second primary tumor is an important factor affecting the survival of lymphoma patients, and the risk of death from second primary tumors increases significantly over time. The effect of first-line treatment and radiotherapy in the chest or mediastinum are independent factors for the death of lymphoma patients from the second primary tumor.

Purpose: This study aimed to evaluate the clinical outcomes, toxicity, and prognostic factors of SBRT combined with gemcitabine plus capecitabine (GEM-CAP) in treating locally advanced pancreatic cancer (LAPC)., Methods: A total of 56 patients with LAPC treated with SBRT combined with GEM-CAP were reviewed from October 2010 to October 2016. The median total prescription dose at five fractions was 40 Gy (30-50 Gy). The patients were subjected to two cycles of GEM-CAP before SBRT. GEM-CAP chemotherapy was then offered for four cycles or until disease tolerance or progression. The primary endpoints included overall survival (OS) and progression-free survival (PFS)., Results: The median OS and PFS from the date of diagnosis was 19 (95% CI 14.6-23.4) and 12 months (95% CI 8.34-15.66), respectively. The 1-year and 2-year survival rates were 82.1% and 35.7%, whereas the 1-year and 2-year PFS rates were 48.2% and 14.3%, respectively. The median carbohydrate antigen 19-9-determined PFS time was 11 months (95% CI 5.77-16.24). Multivariate analysis demonstrated that tumor diameter, lymph node metastasis, pre-treatment CA19-9 level, and post-treatment CA19-9 decline were independent prognostic factors (p < 0.05). Acute toxicity was minimal, with two cases (3.6%) experiencing grade 3 duodenal obstruction. No adverse events greater than grade 3 occurred. In late toxicity, three patients (5.4%) developed grade 3 gastrointestinal toxicity and two (3.6%) suffered from perforation caused by grade 4 radiation enteritis and intestinal fistula., Conclusions: The combination of Cyberknife SBRT and GEM-CAP achieved excellent efficacy with acceptable toxicity for LAPC.

BACKGROUND This study explored relationship between Modic change and spinopelvic parameters in the sagittal plane. MATERIAL AND METHODS We divided 80 patients into 4 groups: 60 subjects diagnosed with Modic changes (MC) were enrolled in the MC groups (MC1, MC2, and MC3) with each MC type consisting of 20 subjects, and 60 healthy subjects were enrolled in the control group. Spinopelvic parameters in the sagittal plane were calculated to assess their associations with MC. Multivariate logistic regression was used to explore possible risk factors for MC. RESULTS PI and LL in the MC groups were significant smaller than in the control group (p<0.05). PI, SS, and PT were significantly correlated with LL with a correlation coefficient of 0.75PI, 0.71SS and 0.69PT (p<0.05). Multivariate logistic regression of the significant variables showed that PI (less than 43.2°) is an independent significant risk factor for MC. ROC analysis showed that moderate diagnostic value was obtained for the significant variable, with an area under the curve (AUC) of 0.80 (p>0.05). CONCLUSIONS We concluded that PI is risk factor for MC, and smaller PI is associated with higher incidence of MC.

In order to apply partial nitritation-ANAMMOX (PN/A) technology to treat wastewater with high concentrations of ammonia, autotrophic nitrogen-removing granular sludge was crushed and inoculated into a three-stage continuous flow reactor. The nitrogen loading rate (NLR), dissolved oxygen (DO) concentration, and free ammonia (FA) levels in each compartment of the reactor were controlled over a 106-day period. Results showed that the nitritation process occurred with the inoculated granules during the initial phase. A limited aeration strategy was employed in the reactor at relatively high NLRs. Given the effective suppression of nitrite-oxidizing bacteria and the prevention of ANAMMOX bacteria from high DO conditions, the compact structure and nitrogen-removal activity of the granules could be improved. When the ammonia-nitrogen concentration was increased in the influent to 350 mg·L -1 , the adverse impacts of high FA concentrations on the functional microbe activity in the first compartment should be eliminated. This occurs by reducing the influent pH and alkalinity dosage. This occurs by reducing the influent pH and degree of alkalinity. As a result, a total nitrogen removal rate of 7.2 kg·(m 3 ·d) -1 was achieved in the reactor, which is 50 to 100 times higher than that of conventional activated sludge systems. The consistent improvement in the nitrogen-removal activity of the granules was demonstrated by batch testing at different aeration intensities. This showed that activity was greatest in the first compartment, which showed the highest granular maturity. In addition, a clear linear correlation ( R 2 >0.97) was observed between the amount of extracellular polymeric substance and the specific nitrogen removal rate. This indicated that the dense granules played a positive role in enhancing the performance of the reactor.

Objective: To observe the clinical therapeutic effect of "Tiaoshen Zhitong" (mental regulating and pain relieving) needling and its influence on serological indicators in the treatment of post-stroke shoulder pain, so as to provide new therapeutic thoughts and approach for post-stroke shoulder pain., Methods: A total of 80 inpatients with post-stroke shoulder pain were randomly divided into a control group (routine needling, 39 cases) and an observation group ("Tiaoshen Zhitong" needling, 41 cases) according to the random number table. Patients of the two groups accepted basic medication treatment including anticoagulants, hypotensive drugs, hypoglycermic drugs, lipid-lowering drugs, etc. In addition, patients of the control group were also treated by routine acupuncture stimulation (uniform reinforcing-reducing stimulation) of Jianyu (LI15), Jianqian (EX-UE12), Jianhou (Extra), Jianliao (TE14), Waiguan (TE5) and Hegu (LI4) on the affected side, and those of the observation group also treated by "Tiaoshen Zhitong" needling of Ear-Shenmen (MA-TF1), bilateral Neiguan (PC6, lifting-thrusting-reducing method), Shuigou (GV26, lifting-thrusting-reducing method), and Jianyu (LI15), Jianliao(TE14), Jianzhen (SI9) and Yanglingquan (GB34, the latter 4 points were stimulated with uniform reinforcing-reducing method) on the affected side. The treatment was given once every day, 6 days a week for 4 weeks. The pain severity was assessed by using visual analogue scale (VAS), the upper limb function evaluated by using Fugl-Meyer assessment (FMA) scale, the shoulder-joint function evaluated by using Constant-Murley score (CMS) questionnaire, and the daily living ability assessed by using Barthel index (BI) scale. The enzyme linked immunosorbent assay (ELISA) was used to determine the contents of serum beta-endorphin (β-EP), enkephalin (ENK) and dynorphin (Dyn). The clinical therapeutic effect was evaluated by using Nimodipine scale method., Results: Of the 39 and 41 cases in the control and observation groups, 7(17.95%) and 12(29.27%) were basically cured, 12(30.77%) and 13(31.71%) experienced marked improvement, 8(20.51%) and 11(26.83%) were effective, 12(30.77%) and 5 (12.19%) failed, with the total effective rate being 69.23% and 87.80%, respectively. The effective rate of the observation group was significantly higher than that of the control group ( P <0.05). After the treatment, the VAS score was obviously reduced ( P <0.01), and the scores of FMA scale, CMS questionnaire and BI scale, and contents of serum β-EP, ENK and Dyn were all increased obviously in the two groups compared with their own pre-treatment ( P <0.01). The therapeutic effect of "Tiaoshen Zhitong" needling was significantly superior to that of the routine needling in lowering VAS, and in raising scores of FMA scale, CMS questionnaire and BI scale and in up-regulating serum β-EP, ENK and Dyn levels ( P <0.01)., Conclusion: "Tiaoshen Zhitong" needling is effective in reducing post-stroke shoulder pain and improving the motor function of the upper limb and shoulder-joint as well as the quality of daily life in stroke patients with shoulder pain. Its analgesic effect is probably related to the increase of the levels of serum β-EP, ENK and Dyn.

Objective: To investigate the effectiveness and adverse effects of Cyberknife stereotactic body radiotherapy (SBRT) on liver metastases from PCa., Methods: From June 2009 to September 2016, we treated 20 cases of PCa liver metastases by Cyberknife SBRT, at a total dose of 36 (30－50) Gy, on 1－3 liver metastatic lesions, for 3－5 times, with a prescription isodose line of 70－92%. We assessed the therapeutic effect according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST), calculated the survival and disease-control rates using the Kaplan-Meier method, and analyzed the adverse events based on the National Cancer Institute Common Terminology Criteria for Adverse Events－Version 4.0 (CTCAE 4.0)., Results: Of all the cases treated, complete response (CR) was found in 8 (40.0%), partial response (PR) in 9 (45.0%), stable disease (SD) in 2 (10.0%), and progressive disease (PD) in 1 (5.0%), with a local control rate (CR+PR) of 85.0% and a disease-control rate (CR+PR+SD) of 95.0%. Among the 14 patients with elevated PSA, 10 (71.4%) showed a significant decrease after treatment. The median follow-up time was 17 months, the 1- and 2-year survival rates were 85.0% and 15.0%, respectively, and the median survival time of the 20 patients was 16.5 months (95% CI: 12.12－22.88). Cyberknife SBRT was well tolerated in all the patients, with only a few mild adverse events (mainly grades 1 and 2 but no 4 and 5) during the whole course of treatment., Conclusions: Cyberknife SBRT is safe and effective in the treatment of PCa liver metastases, with a high local control rate, and capable of reducing the PSA level and raising the long-term survival rate of the patients.

MicroRNA-340 (miR-340) was considered as a tumor suppressor by affecting cancer cell proliferation, apoptosis, invasion, and migration, and was downregulated in diverse cancers. Moreover, dysregulation of miR-340 was also found to be associated with drug resistance and predicted patients' survival in various cancers. Herein, we investigated miR-340 expression and its clinical significance in acute myeloid leukemia (AML). Real-time quantitative polymerase chain reaction was performed to detect miR-340 expression in bone marrow (BM) from 99 newly diagnosed AML patients except for acute promyelocytic leukemia (APL), 19 AML patients achieved complete remission (CR), and 29 healthy donors. BM miR-340 expression was significantly underexpressed in newly diagnosed AML patients as compared with controls (p = 0.031) and AML patients achieved CR (p = 0.025). No significant differences were observed between miR-340 expression and most of the clinicopathologic features (p > 0.05). However, low miR-340 expression was found to be associated with lower CR rate in both non-APL-AML and cytogenetically normal AML (CN-AML; p = 0.001 and 0.031, respectively), and acted as an independent risk factor for CR by logistic regression analysis (p = 0.001 and 0.021, respectively). More important, among both non-APL-AML and CN-AML, low expression of miR-340 was also associated with shorter overall survival (OS; p = 0.013 and 0.005, respectively), and was further validated by Cox regression (p = 0.031 and 0.039, respectively). Collectively, our study showed that BM miR-340 expression was downregulated in AML, and low expression of miR-340 correlated with adverse prognosis., (© 2018 Wiley Periodicals, Inc.)

A new centrosymmetric tetranuclear aggregate [Dy4(L)2(OAc)8(CH3OH)2] (1) was assembled using a unique symmetrical Schiff base ligand 1,5-bis(salicylidene)-carbohydrazide (H2L). Magnetic studies reveal ferromagnetic interactions between dysprosium ions and two obvious relaxation processes under zero dc field with effective energy barriers Ueff of 38 K and 223 K, the highest among the reported tetranuclear dysprosium molecular nanomagnets. To obtain further evidence on the origination of the slow magnetic relaxation, a diamagnetic yttrium analogue [Y4(L)2(OAc)8(CH3OH)2] (2) and a diluted sample [(Dy0.06Y0.94)4(L)2(OAc)8(CH3OH)2] (3) were synthesized. Further magnetic studies on the diluted sample combined with theoretical calculations indicate that the two-step magnetic relaxation processes in complex 1 originate from the single-ion magnetic behaviors of dysprosium ions with different coordination environments.

Objective: To understand the healthy status of radiation workers on the staff in Nanjing, and to analysis the relationship between abnormal crystalline lens and its influencing factors. Methods: We described physical indicators including blood pressure (BP) 、blood sugar (BG) 、thyroid B ultrasound、crystalline lens、chromosome and so on among 3 349 radiation workers on the staff in the year 2016 from Jan 1 to Dec 31, and the abnormal results of crystalline lens were analyzed statistically. Results: The rate of abnormal BP、BG、WBC、Thyroid B ultrasound、crystalline lens was 19.0%、2.2%、5.8%、30.0%、3.6% respectively; The rate of chromosome aberration was 0.1%, and the chromosomal micronuclei are all within normal range. With the rate of abnormal crystalline lens increasing in age and working years, statistical significance both existed in the trend; Compared to the lowest group, the risk of abnormal crystalline lens increased 3.86 times in ≥60 year old group and 3.16 times in ≥30 years working group; The risk of abnormal crystalline lens in nosocomial radation group was higher than non-medical group; There's no found in smoking and drinking alcohol increasing the risk. Morphologically, dot abnormal focused on 30~39 years old and 0~9 working years group, while lamellar abnormal concentrated upon ≥60 year old、≥30 working years group; Age and working-year were both the risk factors of lamellar abnormal; The risk of lamellar abnormal in nosocomial radiation group was significantly higher than non-medical group. Conclusion: Existing nisk foctions in the radiation work has a serious impact on several healthy physiology indicators, the more prominent was crystalline lens. Attention should be paid to eye protection and comprehensive health management.

Objective: To analyze the relationship between the early treatment response and the pregnosis in children with acute lymphoblastic leukemia(ALL)., Methods: Two hundred and Seventy-eight ALL children diagnosed and treated in Hainan general hospital from March 2013 to March 2017 were collected. All ALL children received therapy with CCLg-ALL-2008 regimen. The 3 year event-free survival (EFS) rate of ALL children in different groups was analyzed in terms of 4 indexes including sensitivity response to prednison at day 8 (D8-SRP), bone marrow remission at day 15 (D15-BMR) and at day 33 (D33-BMR), and minimal residual disease at day 33 (D33-BMR), and minimal residual disease at day 33(D33-MRD). These 4 indexes and other indexes possibly affecting the prognosis of ALL children were enrolled in Cox regression model for analysis of independent factors affecting the prognosis of ALL children., Results: The D8-SRP test showed that among 269 ALL children, 240(89.22%) cases displayed prednisone poor response (PPR); the 3-year EFS rate in predrisone good response(PGR) group was significantly higher than that in PPR group(P<0.05). The D15-BMR detection showed that among 262 ALL children, the bone marrow remission(BMR) as M1 was observed in 230 cases (87.79%), M2 in 20 cases (7.63%) and M3 in 9 cases (4.58%); the 3-year EFS rate showed as follows:M1 group >M2 group >M3 group(P<0.05). The D33-BMR detection showed that among 257 ALL children, the BMR as M1 was observed in 227 cases (88.33%), M2 in 21 cses(8.17%) and M3 in 9 caes (3.51%); the 3-year EFS rate in 3 groups showed as follows: M1 group >M2 group >M3 group(P<0.05). The D33-MRD detection showed that among 185 ALL children, MRD<10 -10 was found in 128 cases (69.19%), MRD≥10 -4 -10 -2 in 43 cases (23.24%), MRD ≥10 -2 in 14 cases (7.57%); the 3-year EFS rate in 3 groups showed as follows: MRD <10 -4 group > MRD≥ 10 -4 -10 -2 group>MRD≥10 -2 group. The Cox regression analysis showed that PPR in D8-SRP test, M2 and M3 in D15 and D33 BMR detection, and MRD≥10 -2 in D33 MRD detection as well as T-ALL typing were independent risk factors affecting the prognosis of ALL children., Conclusion: The early treatment response can predict the prognosis of ALL children, which is an independent prognostic factor for ALL children.

Background: Surgical resection is the main treatment for patients with non-small-cell lung cancer (NSCLC), but patients' long-term outcome is still challenging. The purpose of this study was to identify predictors of long-term survival in patients after lung cancer surgery., Methods: Patients who underwent surgery for NSCLC from January 1, 2006, to December 31, 2009, were enrolled into this retrospective cohort study. The primary outcome was the survival length after surgery. Predictors of long-term survival were screened with the multivariable Cox proportional hazard model., Results: Postoperative follow-up was completed in 588 patients with a median follow-up duration of 5.2 years (interquartile range, 2.0-6.8). Two hundred ninety-one patients (49.5%) survived at the end of follow-up with median survival duration of 64.3 months (interquartile range, 28.5-81.6). The overall survival rates were 90.8%, 70.0%, and 57.1% at the end of the first, third, and fifth year after surgery, respectively. Limited resection (hazard ratio [HR], 1.46; 95% confidence interval [CI], 1.08-1.98; P = .013) and large tumor size (HR, 1.29; 95% CI, 1.17-1.42; P < .001) were associated with short survival; whereas high body mass index grade (HR, 0.82; 95% CI, 0.69-0.97; P = .021), highly differentiated tumor (HR, 0.59; 95% CI, 0.37-0.93; P = .024), dissection of mediastinal lymph node during surgery (HR, 0.45; 95% CI, 0.30-0.67; P < .001), and perioperative use of dexamethasone (HR, 0.70; 95% CI, 0.54-0.90; P = .006) were associated with long survival. No association was found between perioperative use of flurbiprofen axetil and long survival (HR, 0.80; 95% CI, 0.62-1.03; P = .086). However, combined administration of dexamethasone and flurbiprofen axetil was associated with longer survival (compared to no use of both: adjusted HR, 0.57; 95% CI, 0.38-0.84; P = .005)., Conclusions: Certain factors in particular perioperative dexamethasone and flurbiprofen axetil therapy may improve patients' long-term survival after surgery for NSCLC. Given the small sample size, these findings should be interpreted with caution, and randomized clinical trials are needed for further clarification.

Raffinose series oligosaccharides are the transport and storage sugars of many plants, Rehmannia glutinosa is one of the commonly used Chinese herbal medicines, medicinal parts ist he roots. Root and tuber of R. glutinosa contains stachyose, raffinose and other oligosaccharides, but the study about the process of growth and development of other organs in the non-structural changes in sugar content is rare.In this study, leaves, stems and roots of R. glutinosa were used as materials to analyze the diurnal variation and the changes of sugar content of sucrose, raffinose and stachyose in different organs of R. glutinosa. The results showed that the content of sucrose in R. glutinosa leaves gradually increased from seedling stage.However, the content of stachyose did not change much at the early stage of growth, and the stachyose rapidly increased at the later stage of growth. The raffinose content gradually decreased throughout the growing season, young leaves of R. glutinosa have higher ability to sucrose synthesis than mature leaves, while mature leaf has higher raffinose and stachyose synthesis ability than young leaves. Sucrose and stachyose content in stem gradually increased, while there was little change in raffinose content. The content of raffinose and stachyose in root increased rapidly from the beginning of fast growing period, while the content of sucrose did not change much. The content of sucrose in leaves of R. glutinosa did not change much at day and night, while the daily changes of raffinose and stachyose contents were very obvious. The contents of raffinose and stachyose in daytime were higher than those at night. The content of raffinose in root and stem was not changed much, but the change of stachyose in root, stem and leaf was very obvious, especially in stem and leaf. In summary, the leaf is the main synthetic organ of raffinose, leaves, stems and roots are stachyose synthesis organ. Sucrose, raffinose and stachyose are the major transport forms of carbohydrates in R. glutinosa., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Cloacal exstrophy variants are comprised of a wide range of characteristics, of which there are four primary features, including omphalocele, bladder exstrophy, an imperforate anus and spina bifida. The existing literature regarding the differential diagnosis from alternative urinary diseases prenatally are limited. If the bladder is present, defects in the ventral wall may not be visualized with prenatal ultrasound in certain conditions, including oligohydramnios, and differential diagnosis from urorectal septum malformation sequence is a challenge. In order to improve the diagnosis of cloacal exstrophy variants, the present study investigated the misdiagnosis of a cloacal exstrophy variant as a urorectal septum malformation in a fetus by ultrasound and analyzed the reasoning of diagnosis in detail.

Objective: To identify the relationship between nasal secretion eosinophilia and pulmonary function of patients with AR after treatment of intranasal budesonide. Method: Fifty patients with moderate to severe AR were selected, and compared to 50 normals, all had pulmonary function and nasal secretion of eosinophil number check, experimental group of AR received budesonide+loratadine treatment for 3 months, and then had lung function and nasal secretion eosinophil again, analysised the trends of change between two. Result: Eosinophils of AR patients was higher than its of control group ( P <0.05), lung function index MMEF and nasal secretion eosinophilia of 50 AR patients had a negative relationship( r =-0.945， P <0.05).Treated with eosinophils the number of nasal secretion eosinophilia of AR decreased 10 + 5.6, the difference compared to the before of the treatment was statistically significant( P <0.05), compared to the normal control group was significant( P <0.05). After the treatment of budesonide, the trends of change between nasal secretion eosinophils and pulmonary function was a positive correlation( r =0.803, P <0.01). Conclusion: The higher the number of eosinophils in nasal secretions of patients with AR, the more obvious the decline of lung function. After the treatment with budesonide, the more eosinophils decreased in patients with AR, the more obvious the improvement of pulmonary function., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Transforming growth factor beta 1(TGF-β1) polymorphism was associated with radiation pneumonitis (RP) susceptibility, but their results have been inconsistent. The PubMed and CNKI were searched for case-control studies published up to Januray 01, 2016 was Data were extracted and pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated. In this meta-analysis, we assessed eight publications involving 368 radiation pneumonitis cases and 855 controls of the association between TGF-β1 T869C (rs1982073) and G915C (rs1800471) polymorphism and RP susceptibility. Our analysis suggested that TGF-β1 T869C rs1982073 polymorphism was associated with lower RP risk for CT combined CC versus TT model (OR = 0.58, 95% CI = 0.43-0.77). However, for the G915C rs1800471 polymorphism, no association was found between the polymorphism and the susceptibility to RP in GC combined CC versus GG model (OR = 0.82, 95% CI = 0.50-1.35). These results from the meta-analysis suggest that T869C rs1982073 polymorphism of TGF-β1 may be associated with RP risk, and there may be no association between G915C polymorphism and RP risk., (© 2016 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.)

Aim: The aim of this study was to investigate the alterations of pulmonary function tests (PFTs) and their relationship with disease activity in inflammatory bowel diseases (IBDs)., Methods: Sixty-four IBD patients (31 Crohn's disease [CD] and 33 ulcerative colitis [UC]) and thirty healthy individuals (controls) were studied with regard to the following parameters of PFTs: Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), their ratio, mid-forced expiratory flow of 25-75% (FEF 25-75), residual volume, total lung capacity, and diffusing capacity of the lung for carbon monoxide (DLCO). The disease activity was calculated using the Crohn's Disease Activity Index for CD and Mayo Clinic Score for UC. Correlation analysis was performed between disease activity and sputum cytology and PFTs., Results: Nineteen of the 31 CD patients (61.29%) and 17 of the 33 UC patients (51.52%) but none of the controls showed at least one abnormal PFTs ( P < 0.05). Compared with controls, both CD and UC patients exhibited a significant reduction in FEV1 ( P < 0.05), FVC ( P < 0.05), FEF 25-75 ( P < 0.05), and DLCO ( P < 0.05). The majority with decreased measurements of PFTs were in the active phase of diseases ( P < 0.05). IBD activity scores correlated negatively with some parameters of PFTs and positively with lymphocytosis and eosinophilia of sputum ( P < 0.05)., Conclusions: Pulmonary function disorders are significantly common in IBD patients. The impairment in active disease is significantly greater than in remission.

Objective: The aim of this study was to observe the changes of pulmonary function in patients with allergic rhinitis and the effect of nasal glucocorticoid on pulmonary function. Method: Ninety patients with Moderate and severe AR and 50 healthy control subjects were recruited.All participates accepted a pulmonary function test and make a statistical analysis.90 patients of AR were divided into two groups:A group(50) and B group(40).A group treated with nasal budesonide and loratadine,while B group treated with nasal normal saline and loratadine.After 3 months,all patients reviewed the lung function. Result: Comparing with control,FEV1.0/FVC,MMEF,FEF50% and FEF75% reduced significantly in AR group( P <0.01),after 3 months,the treatment of A group compared before:FEV1.0/FVC( P <0.05),MMEF,FEF50% and FEF75%( P <0.01) had statistical significance.Compared B group after the treatment:FEF75% ( P <0.05) was significant.After the treatment of group A compared with normal group:there was no significance. Conclusion: The reduced pulmonary function of allergic rhinitis paitents is mainly due to the small airway dysfunction.Budesonide is superior to loratadine to improve the pulmonary function., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

The impact of impurity ions on a pedestal has been investigated in the HL-2A Tokamak, at the Southwestern Institute of Physics, Chengdu, China. Experimental results have clearly shown that during the H-mode phase, an electromagnetic turbulence was excited in the edge plasma region, where the impurity ions exhibited a peaked profile. It has been found that double impurity critical gradients are responsible for triggering the turbulence. Strong stiffness of the impurity profile has been observed during cyclic transitions between the I-phase and H-mode regime. The results suggest that the underlying physics of the self-regulated edge impurity profile offers the possibility for an active control of the pedestal dynamics via pedestal turbulence.

MicroRNAs play important roles in the pathogenesis of cancers by inhibiting gene expression at posttranscriptional level. Here, we identified that miR-590 and its predicted target gene RB1 are differentially expressed in T-cell acute lymphoblastic leukaemia (T-ALL). The correlation between miR-590 and RB1 was further confirmed in 395 T-ALL patients. In T-ALL cell lines, miR-590 promoted the cell proliferation by increasing G1/S transition. Moreover, migration and invasion assay showed that miR-590 promotes the migration and invasion of T-ALL cells by increasing E-cadherin and inhibiting MMP-9. Luciferase assays confirmed that miR-590 directly binds to the 3'untranslated region of RB1, and western blotting showed that miR-590 suppresses the expression of RB1 at the protein levels. This study indicated that miR-590 inhibits RB1 and promotes proliferation and invasion of T-ALL cells. Thus, miR-590 may represent a potential therapeutic target for T-ALL intervention., Competing Interests: Authors have declared that no competing interest exists.

A new radial neutron camera system has been developed and operated recently in the HL-2A tokamak to measure the spatial and time resolved 2.5 MeV D-D fusion neutron, enhancing the understanding of the energetic-ion physics. The camera mainly consists of a multichannel collimator, liquid-scintillation detectors, shielding systems, and a data acquisition system. Measurements of the D-D fusion neutrons using the camera have been successfully performed during the 2015 HL-2A experiment campaign. The measurements show that the distribution of the fusion neutrons in the HL-2A plasma has a peaked profile, suggesting that the neutral beam injection beam ions in the plasma have a peaked distribution. It also suggests that the neutrons are primarily produced from beam-target reactions in the plasma core region. The measurement results from the neutron camera are well consistent with the results of both a standard (235)U fission chamber and NUBEAM neutron calculations. In this paper, the new radial neutron camera system on HL-2A and the first experimental results are described.

Sarcoidosis is a multisystemic disorder of unknown cause that is characterized pathologically by noncaseating granulomas and predominantly affects the lungs and the lymphatic system, especially intrathoracically. Diagnosis is based on the association of a compatible clinical and radiological presentation, the presence of characteristic histopathological lesions and the exclusion of other potential causes of granuloma. Although the lungs and mediastinal lymph nodes are almost involved, endobronchial nodular lesions of sarcoidosis with lung involvements are rare. We report a case of sarcoidosis with lung involvements and endobronchial nodules as confirmed by bronchial biopsy., (© 2014 John Wiley & Sons Ltd.)

Objective: To observe the effect of "spleen-stomach needling" on changes of plasma malondialdehyde. (MDA), protein carbonyl (PCO, an oxidative stress damage biomaker), 8-hydroxyguanine (8-OHdG, an indicator of oxidative DNA damage) and the activity of superoxide dismutase (SOD) levels in patients with diabetic nephropathy, so as to explore its mechanisms underlying improving diabetic nephropathy., Methods: Diabetic nephropathy patients were randomized into routine acupuncture (control) group (n = 72) and spleen-stomach needling (observation) group (n = 70) according to a random digits table and by using multi-centers, randomized and blind methods in the present study. All the patients were received routine medication. In addition, patients of the control group were treated by acupuncture stimulation of Shenshu (BL 23), Taixi (KI 3), Sanyinjiao (SP 6), Yanglingquan (GB 34), Xuanzhong (GB 39), Guanyuan (CV 4), Shousanli (LI 10), Waiguan (TE 5), Yangxi (LI 5), Liangqiu (ST 34), Shangjuxu (ST 37), Neiting (ST.44), Huaroumen (ST 24), and Dachangshu (BL 25), and those of the observation group treated by acupuncture stimulation of Zhongwan (CV 12), Quchi (LI 11), HQgu (LI 4), Xuehai (SP 10), Zusanli (ST 36), Yinlingquan (SP 9), Fenglong (ST 40), Diji (SP 8), Sanyinjiao (SP 6),Taichong (LR 3), Gaohuang (BL 43), Shenshu (BL 23), Baihuanshu (BL 30) and Zhongji (CV 3) with spleen-stomach needling method. The treatment of both groups was conducted twice a day for six weeks except Sundays. Plasma MDA, PCO and 8-OHdG contents were detected by using ELISA, and SOD detected using xanthine oxidase method., Results: After 3 weeks' treatment, plasma MDA, PCO and 8-OHdG contents were significantly increased in both control and observation groups, and plasma SOD was obviously reduced in both groups (P < 0.05). No significant differences were found between the two groups in the plasma MDA, PCO and 8-OHdG contents (P > 0.05). While after 6 weeks' treatment, plasma MDA, PO and 8-OHdG contents were significantly decreased (turning to the normal levels) and plasma SOD level in the observation group was significantly up-regulated (P < 0.01). Following 3 weeks' treatment, of the 72 and 70 patients in the control and observation groups, 10 and 20 cases experienced marked improvement, 22 and 15 were improved, and 40 and 35 invalid, respectively. After 6 weeks' treatment, of the 72 and 70 patients in the control and observation groups, 12 and 39 experienced marked improvement, 28 and 20 cases were improved, 32 and 11 invalid, respectively. The therapeutic effect of the observation group was obviously superior to that of the control group (P < 0.01)., Conclusion: Acupuncture treatment with spleen-stomach regulation needling can down-regulate plasma MDA, PCO, 8-OHdG contents and up-regulate SOD activity in diabetic nephropathy patients, which may contribute to its effect in improving the patients' symptoms probably by resisting the oxidative stress damage.

Superhydrophobic surfaces on PET textiles were fabricated by combined bioinspiration from the strong adhesion of marine mussels and the two-scale structure of lotus leaves under mild conditions. Dopamine can spontaneously polymerize in alkaline aqueous solution to form a thin adhesive layer of polydopamine (PDA) wrapping on the micro-scale fibers. The as-formed thin PDA layer worked as a reactive template to generate PDA nanoparticles decorated on the fiber surfaces, imparting the textiles with excellent UV-shielding properties as well as a hierarchical structure similar to the morphology of the lotus leaf. After further modification with perfluorodecyl trichlorosilane, the textiles turned superhydrophobic with a water contact angle higher than 150°. Due to the strong adhesion of PDA to a wide range of materials, the present strategy may be extendable to fabrication of superhydrophobic surfaces on a variety of other substrates.

Aim: To assess laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through transanal resection without abdominal incisions., Methods: From March 2010 to June 2014, 30 patients (14 men and 16 women, aged 36-78 years, mean age 59.8 years) underwent laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through anus-preserving transanal resection. The tumors were 5-7 cm away from the anal margin in 24 cases, and 4 cm in six cases. In preoperative assessment, there were 21 cases of T1N0M0 and nine of T2N0M0. Through the middle approach, the sigmoid mesentery was freed at the root with an ultrasonic scalpel and the roots of the inferior mesenteric artery and vein were dissected, clamped and cut. Following the total mesorectal excision principle, the rectum was separated until the anorectal ring reached 3-5 cm from the distal end of the tumor. For perineal surgery, a ring incision was made 2 cm above the dentate line, and sharp dissection was performed submucosally towards the superior direction, until the plane of the levator ani muscle, to transect the rectum. The rectum and distal sigmoid colon were removed together from the anus, followed by a telescopic anastomosis between the full thickness of the proximal colon and the mucosa and submucosal tissue of the rectum., Results: For the present cohort of 30 cases, the mean operative time was 178 min, with an average of 13 positive lymph nodes detected. One case of postoperative anastomotic leak was observed, requiring temporary colostomy, which was closed and recovered 3 mo later. The postoperative pathology showed T1-T2N0M0 in 19 cases and T2N1M0 in 11 cases. Twelve months after surgery, 94.4% patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. The patients were followed up for 1-36 mo, with an average of 23 mo. There was no local recurrence, and 17 patients survived for > 3 years (with a survival rate of 100%)., Conclusion: Laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through transanal resection without abdominal incisions is safe and feasible.

MicroRNAs (miRNAs) play important roles in the pathogenesis of many types of cancers by negatively regulating gene expression at posttranscriptional level. However, the role of microRNAs in leukaemia, particularly T-cell acute lymphoblastic leukaemia (T-ALL), has remained elusive. Here, we identified miR-664 and its predicted target gene PLP2 were differentially expressed in T-ALL using bioinformatics methods. In T-ALL cell lines, CCK-8 proliferation assay indicated that the cell proliferation was promoted by miR-664, while miR-664 inhibitor could significantly inhibited the proliferation. Moreover, migration and invasion assay showed that overexpression of miR-664 could significantly promoted the migration and invasion of T-ALL cells, whereas miR-664 inhibitor could reduce cell migration and invasion. luciferase assays confirmed that miR-664 directly bound to the 3'untranslated region of PLP2, and western blotting showed that miR-664 suppressed the expression of PLP2 at the protein levels. This study indicated that miR-664 negatively regulates PLP2 and promotes proliferation and invasion of T-ALL cell lines. Thus, miR-664 may represent a potential therapeutic target for T-ALL intervention., (Copyright © 2015. Published by Elsevier Inc.)

Background: Down-expression of microRNA-497 (miR-497) was often found in malignancies. The purposes of this study were to determine the expression of miR-497 in human osteosarcoma and to establish the association between miR-497 expression with cell survival and the sensitivity to cisplatin in human osteosarcoma cells., Methods: The effects of ectopic miR-497 expression on the cell survival and cisplatin sensitivity in osteosarcoma cells were measured by the Cell Counting Kit-8 (CCK-8) assay. Quantitative real-time PCR (qRT-PCR) was utilized to determine the expression of miR-497. The effects of ectopic miR-497 expression on the expression of VEGFA, Akt and p-Akt were determined by western blot., Results: Real-time quantitative PCR analysis revealed that miR-497 was significantly down-regulated in osteosarcoma tissues and in the osteosarcoma cell line SAOS-2 compared with adjacent nontumorous osteosarcoma tissues and normal human osteoblasts. Up-regulation of miR-497 inhibited cell survival and enhanced the sensitivity to cisplatin in osteosarcoma cells. In addition, knockdown of miR-497 induced osteosarcoma cells growth and cisplatin resistance. Luciferase reporter assay and western blot confirmed that VEGFA was a direct target of miR-497. PI3K inhibitor LY294002 abrogated miR-497 inhibitors induced cisplatin resistance., Conclusion: Taken together, our results suggest that miR-497 modulates the sensitivity to cisplatin at least in part through PI3K/Akt pathway in osteosarcoma cells., (© 2015 S. Karger AG, Basel.© 2015 S. Karger AG, Basel.)

About 13 kinds of diagnostics for energetic particle physics studied on the HuanLiuqi-2A (commonly referred to as HL-2A) tokamak are described in this paper. Their measurement ranges, resolutions, and arrangement are presented. Three under-construction diagnostics including imaging fast ion D-alpha, scintillator matrix (for hard X-ray detection), and bundle fission chamber are described in detail.